DHCS Stakeholder Update - Lub Yim Hli 25, 2023
Xov xwm tshaj plaws
CalAIM Kev Pom Zoo Kev Pom Zoo Hloov Kho
On August 23, the Centers for Medicare & Medicaid Services (CMS) approved an amendment to the California Advancing and Innovating Medi-Cal (CalAIM) Section 1115 demonstration waiver, allowing the state to implement county-based model changes in its Medi-Cal managed care program. The amendment includes expenditure authority to limit the choice of managed care plans (MCPs) in non-rural areas. This authority would apply in the metro, large metro, and urban counties intending to participate in the County Organized Health System (COHS) or Single Plan models.
For rural counties, CMS approved an amendment to the CalAIM Section 1915(b) waiver on June 26 to limit plan choice in rural counties to participate either in the COHS or Single Plan models. These county-based model changes will go into effect on January 1, 2024. Twelve counties will become COHS and three will become Single Plan model counties. For more information about all counties, their current and 2024 model type, and the MCPs operating in the county, please see the MCP county table.
Kev hloov kho tshiab
Medi-Cal Rx
Thaum Lub Yim Hli 22, Chaw Pabcuam Neeg Siv Khoom Medi-Cal Rx tau siv qhov tshwj xeeb uas pab kom paub lub suab zoo dua rau cov tswv cuab, cov neeg sau tshuaj, cov kws muag tshuaj, thiab cov pej xeem. Cov kev txhim kho suav nrog kev soj ntsuam kev hu xov tooj, cov ntawv qhia zaub mov tseem ceeb los ua kom yooj yim rau kev hu xov tooj, cov lej los qhia cov neeg sawv cev txog cov laj thawj ntawm kev hu xov tooj, rov qab mus rau cov ntawv qhia zaub mov tseem ceeb kom cov neeg hu xov tooj tuaj yeem tshawb xyuas ntau yam khoom siv tus kheej, thiab txhim kho cov lus thiab qhov chaw sai.
On August 16, a New Start PA Reminder Alert was published about the prior authorization requirements that will be reinstated beginning on September 22 for new start enteral nutrition products for members 22 years of age and older.
Kev Xa Ntawv Qhia Txog Medi-Cal Rau Cov Menyuam Yaus Thiab Cov Hluas
On August 25, DHCS distributed an informational mailing to Medi-Cal fee-for-service (FFS) members and/or their parents or guardians about the federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, known in California as Medi-Cal for Kids & Teens. The FFS mailing includes: (1) Medi-Cal for Kids & Teens brochures to improve member understanding of how Medi-Cal works for children, teens, and young adults, what it covers, and its role in preventive care screening, diagnosis, and treatment. The child brochure is for children up to age 12, and the teen brochure is for ages 12-20; and (2) “Medi-Cal for Kids & Teens: Your Medi-Cal Rights” guide to help members under age 21 understand their Medi-Cal benefits and their recourse if medically necessary care is denied, delayed, reduced, or stopped. The materials, including translations, are posted on the Medi-Cal for Kids & Teens webpage.
Koom nrog peb pab neeg
DHCS tab tom ntiav rau peb cov nyiaj txiag, tib neeg cov peev txheej, kev cai lij choj, kev tshuaj xyuas, txoj cai tswjfwm kev noj qab haus huv, thiab pab pawg xov xwm thev naus laus zis. Yog xav paub ntxiv, thov mus saib hauv CalCareers lub vev xaib.
DHCS is dedicated to providing equitable access to quality health care, leading to a healthy California for all. DHCS’ goals and objectives express the tremendous work DHCS is leading to transform our health care system and reflect the organizational culture we are building together.
Cov Rooj Sib Tham Cov Neeg Koom Tes thiab Webinar yuav los tom ntej
Integrating Trauma-Informed Practices into Reproductive Health Services Webinar
Thaum Lub Yim Hli 30, txij 12 txog 1:30 teev tsaus ntuj, DHCS thiab California Prevention Training Center yuav tuav lub rooj sib tham hauv webinar txog Kev Koom Tes Ua Haujlwm Txog Kev Raug Mob rau hauv Kev Pabcuam Kev Noj Qab Haus Huv Txog Kev Yug Me Nyuam. Kev saib xyuas uas muaj kev paub txog kev raug mob lees paub qhov xav tau kev nkag siab txog tus neeg mob lub neej kev paub dhau los kom muab kev saib xyuas zoo thiab muaj peev xwm txhim kho kev koom tes ntawm tus neeg mob, kev ua raws li kev kho mob, thiab cov txiaj ntsig kev noj qab haus huv. Rau cov neeg uas tsis tuaj yeem koom nrog lub rooj sib tham hauv online, daim ntawv sau thiab cov ntaub ntawv kaw cia ntawm lub rooj sib tham hauv online, nrog rau cov peev txheej ntxiv, yuav muaj nyob rau ntawm lub vev xaib Family PACT.
Pawg Neeg Saib Xyuas Kev Noj Qab Haus Huv thiab Cov Neeg Tsim Nyog ntawm Indian Kev Pabcuam Kev Noj Qab Haus Huv Peb Hlis Webinar
On August 30, from 2 to 3 p.m., DHCS will host a webinar (advance registration required) for tribal and Indian health program representatives to provide feedback on DHCS initiatives with specific impact to tribes, Indian health programs, and American Indian Medi-Cal members. The webinar will provide information about State Plan Amendments, waivers, and demonstrations proposed for submission to CMS, including the Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) Medicaid section 1115 demonstration and transitional rent services amendment to the CalAIM section 1115 demonstration. Email questions or comments to TribalAffairs@dhcs.ca.gov.
Equity and Practice Transformation Payments Program Webinar
On August 30, from 3 to 4 p.m., DHCS will host an Equity and Practice Transformation Payments Program Webinar (advance registration required) to share an update on the Equity and Practice Transformation Payments Program, which is a one-time $700 million primary care practice transformation program initiative to advance health equity and population health and invest in upstream care models. Details about the Provider Directed Payment Program will be discussed during the webinar; the program application and other materials will be posted on the DHCS website in the future. Please email ept@dhcs.ca.gov with any questions.
DHCS Coverage Ambassadors: Qhia Tus Kws Qhia Webinar
On August 31, from 10 to 11:30 a.m., DHCS will host a webinar on Coverage Ambassadors: Train the Trainer. The webinar will serve as a training session for Coverage Ambassadors to better assist their communities as California resumes standard Medi-Cal operations and communicates the importance of members renewing their Medi-Cal coverage. The webinar will also describe the resources available and how to use them. For more information, visit the Coverage Ambassadors Coverage Ambassadors webpage. Join the Coverage Ambassadors mailing list to receive the latest information and updated toolkits as they become available.
Lub Chaw Saib Xyuas Kev Noj Qab Haus Huv Nyiaj Txiag Kev Hloov Kho Webinar
On September 7, from 2 to 3 p.m., DHCS will host a virtual stakeholder webinar to discuss the development of the Skilled Nursing Facility Workforce Standards Program and provide updates on other nursing facility financing reform programs authorized by Assembly Bill 186 (Chapter 46, Statutes of 2022). Stakeholder input will be accepted. Additional information is available on the Nursing Facility Financing Reform (AB 186) webpage.
Hearing Aid Coverage for Children Program (HACCP) Webinar for Families and Community Partners
On September 12, from 11 a.m. to 12 p.m., DHCS will host a HACCP webinar to share guidance with families and communities about applying for hearing aid coverage and helping children to maximizing their HACCP benefits once enrolled. DHCS welcomes newly interested families, those who are currently participating in HACCP, and community partners supporting families and children to join this webinar for program updates, tips, and a Q&A session. For more information, please visit www.dhcs.ca.gov/haccp.
Doula Implementation Workgroup Meeting
Thaum lub Cuaj Hlis 14, txij 12 txog 2 teev tav su, DHCS yuav tuav lub rooj sib tham thib peb ntawm Doula Implementation Workgroup. Ib qho txuas mus mloog lub rooj sib tham yuav raug tshaj tawm rau ntawm Doula Services ua nplooj ntawv web Medi-Cal Benefit thaum Lub Yim Hli 31. Lub rooj sib tham yuav suav nrog daim ntawv qhia txog DHCS txoj kev npaj Birthing Care Pathway thiab lub luag haujlwm ntawm doulas, thiab kev npaj rau cov rooj sib tham yav tom ntej. Pawg neeg ua haujlwm muaj lub luag haujlwm los tshuaj xyuas seb yuav ua li cas thiaj li muaj cov kev pabcuam doula ntau ntxiv los ntawm cov kev pabcuam kev kawm, txheeb xyuas thiab txo qis cov teeb meem rau cov kev pabcuam doula, thiab daws teeb meem kev ncua sijhawm them nyiaj thiab them rov qab rau cov doulas thiab cov tswv cuab.
Webinar rau cov kws kho mob thiab cov kws tshaj lij hnov lus
On September 14, from 12 to 1 p.m., DHCS will host a HACCP webinar to share information with providers to help pediatric patients and their families maximize HACCP benefits. The training session will address program requirements for families to apply for coverage and the claims submission process for audiologists, otolaryngologists, physicians, and their office staff. For more information, please visit www.dhcs.ca.gov/haccp.
Hauv Case Koj Tsis Tau Nws
California nthuav kev nkag mus rau Kev Kho Mob Opioid hauv Jails thiab Tsev Hais Plaub Tshuaj
On August 22, DHCS announced it will expand Medication Assisted Treatment (MAT) to jails and drug courts it will expand Medication Assisted Treatment (MAT) to jails and drug courts. The $2.9 million in funding will go to 29 counties to support the development or expansion of access to MAT. By bringing county teams together in a learning collaborative, county agencies and providers serving justice-involved residents can more effectively coordinate and further build system capacity to ensure access to effective treatment and recovery supports. This expansion will better serve residents in need, and MAT, specifically, has been shown to reduce criminal activity and reincarceration to better serve the entire community.
State Extends CalHOPE Schools Initiative Partnership
On August 24, DHCS announced the extension of the CalHOPE Schools Initiative through June 30, 2024 the extension of the CalHOPE Schools Initiative through June 30, 2024. The initiative provides free resources for school personnel, youth, and parents surrounding three powerful films that address student social-emotional and mental health needs: A Trusted Space: Redirecting Grief to Growth, Angst: Building Resilience, and Stories of Hope Shorts.
Capitol Lub Limtiam Kev Xav Txog Kev Txiav Txim Medi-Cal
Thaum Lub Yim Hli 20, Capitol Lub Limtiam tau khiav tawm tswv yim los ntawm LA Care CEO John Baackes. LA Care yog ib qho ntawm cov phiaj xwm kev kho mob Medi-Cal uas tswj hwm hauv Los Angeles County. Baackes hu rau "peb txhua tus - cov neeg zej zog, cov neeg koom tes hauv tsoomfwv, thiab cov neeg tawm tswv yim hauv zej zog - ua txhua yam peb ua tau kom peb cov phooj ywg thiab cov neeg zej zog muaj kev pov hwm" los ntawm Medi-Cal.
Thaum koj sib tham nrog cov tswv cuab Medi-Cal, thov qhia rau lawv cov lus qhia pab tau kom lawv khaws lawv txoj kev pov hwm. Yog tias lawv hnub txuas ntxiv tsim nyog yog thaum Lub Rau Hli lossis Lub Xya Hli, nws tseem tsis tau lig dhau. Lawv tuaj yeem xa lawv cov pob ntawv txuas ntxiv Medi-Cal mus rau lub chaw ua haujlwm hauv nroog hnub no kom rov qab tau lawv cov kev pov hwm rov qab mus rau hnub txuas ntxiv thawj zaug. Tsis tas li ntawd xwb, yog tias cov tswv cuab Medi-Cal tau tsiv teb tsaws chaw lossis lawv cov ntaub ntawv tiv tauj tau hloov pauv hauv ob peb xyoos dhau los, lawv yuav tsum xyuas kom meej tias lawv lub chaw ua haujlwm hauv nroog muaj lawv cov ntaub ntawv tam sim no kom lawv thiaj li tiv tauj tau nrog cov ntaub ntawv tseem ceeb txog kev rov ua dua tshiab. Thiab yog tias cov tswv cuab tau txais pob ntawv txuas ntxiv Medi-Cal hauv xa ntawv hauv lub hnab ntawv daj, lawv yuav tsum ua sai sai kom lawv thiab lawv tsev neeg tau txais kev pab los ntawm cov ntaub ntawv txuas ntxiv rov qab.