February 2, 2024 – Stakeholder News
Xov xwm tshaj plaws
Lub caij ntuj no cua daj cua dub kuaj xyuas
California has experienced a series of winter storms, with severe weather continuing over the next few days. During inclement weather, our priority is to ensure people’s safety and make it easier for them to access shelter, services, and other resources. We recommend that our community partners proactively check on older individuals with disabilities, are unhoused, and/or have chronic health conditions that may put them at risk. Reach out to them to check on how they’re doing and to connect them to resources as needed. We also encourage you to work with your local county and California Governor’s Office of Emergency Services (CalOES) to aid your communities, and we recommend that you become familiar with local resources you can offer to those in need, including shelters or warming centers.
To assist stakeholders with wellness checks, the California Health & Human Services Agency (CalHHS) developed an Emergency Resource Guide, and Appendix I: Universal Wellness Checks Questionnaire can be used when conducting wellness checks. Additional resources include the Listos California’s Severe Storm Safety Toolkit and the California Department of Public Health’s Winter Storm Preparedness Toolkit.
Txhim Kho Kev Tswj Xyuas Kev Kho Mob (ECM) thiab Kev Txhawb Zej Zog Txhawb Kev Ua Haujlwm Peb Hlis
DHCS tau tshaj tawm Daim Ntawv Qhia Txog Kev Siv ECM thiab Kev Txhawb Nqa Hauv Zej Zog rau Peb Hlis 2 2023. Daim ntawv tshaj tawm no sau luv luv txog cov qauv thiab cov ntaub ntawv ntawm kev siv ECM thiab Kev Txhawb Nqa Zej Zog rau 18 lub hlis thawj zaug ntawm cov kev pab cuam, txij lub Ib Hlis 2022 txog rau Lub Rau Hli 2023. Ib yam li Daim Ntawv Qhia Txog Kev Siv Xyoo Ib Xyoo 2022 uas tau tshaj tawm thaum Lub Yim Hli tas los, daim ntawv qhia no muab kev nkag siab txog cov ntaub ntawv theem xeev-, nroog-, thiab Medi-Cal managed care plan (MCP).
Hauv 18 lub hlis thawj zaug, muaj 140,886 tus tswv cuab ntawm MCP tau txais txiaj ntsig ECM, thiab 75,834 tus tswv cuab tau txais 167,960 cov kev pabcuam txhawb nqa hauv zej zog. Thaum California txuas ntxiv mus rau kev hloov pauv Medi-Cal, ECM thiab Kev Txhawb Nqa Hauv Zej Zog ua lub luag haujlwm tseem ceeb hauv kev txhawb nqa kev saib xyuas tus kheej rau cov tswv cuab Medi-Cal uas muaj kev xav tau kev kho mob thiab kev noj qab haus huv nyuaj. DHCS xav tias yuav pom ntau tus neeg sau npe kawm ntxiv thoob plaws ob qho kev pab cuam hauv ob lub hlis thiab xyoo tom ntej vim tias muaj ntau cov pej xeem uas xav tau kev pab cuam ECM thiab muaj kev pabcuam Txhawb Nqa Zej Zog ntxiv hauv ntau lub nroog. DHCS tseem cog lus tias yuav txhawb nqa thiab tswj hwm qhov kev loj hlob no los ntawm kev saib xyuas qhov kev pab cuam, kev txhim kho kev tsim qauv, thiab kev ua kom raws li tus qauv.
CalAIM Dashboard
DHCS today posted the first iteration of a public-facing California Advancing and Innovating Medi-Cal (CalAIM) dashboard to demonstrate the impact, progress, and key opportunity areas of CalAIM. The dashboard includes individual initiative pages for Behavioral Health, Community Supports, ECM, Incentive Payment Program, Integrated Care for Dual Eligible Members, Population Health Management, Providing Access and Transforming Health (PATH), Statewide Managed Long-Term Care, and Bold Goals: 50×2025 as outlined in DHCS’ Comprehensive Quality Strategy. This dashboard provides baseline data and highlights milestones in the Medi-Cal transformation. The data will be updated regularly and will expand to include additional quality measures, demographic data, and initiatives as the data become available.
Kev hloov kho tshiab
Lub Ib Hlis Ntuj xyoo 2024 Medi-Medi Plans Enrollment Update
Enrollment in Medicare Medi-Cal (Medi-Medi) Plans continues to increase as part of the CalAIM initiative to offer integrated care for members who are dually eligible for Medicare and Medi-Cal. As of January 2024, enrollment in Medi-Medi Plans is approximately 293,000 members, according to data published by the federal Centers for Medicare & Medicaid Services (CMS). This represents an increase of approximately 48,000 members over Medi-Medi Plan enrollment in October 2023. Integrated care is also available through the SCAN Connections Health Plan and the Program of All-Inclusive Care for the Elderly. Please visit the Medicare Advantage Options for Dual Eligible Beneficiaries webpage to view quarterly enrollment reports for dual eligible members by Medicare delivery system.
PATH Capacity and Infrastructure Transition, Expansion, and Development (CITED) Round 3 Daim Ntawv Thov
Hnub kawg rau kev thov rau PATH CITED Round 3 nyiaj yog Lub Ob Hlis 15. PATH CITED teg num muab nyiaj txiag los tsim kom muaj peev xwm thiab kev tsim kho ntawm cov neeg koom tes hauv av, suav nrog cov koom haum hauv zej zog, tsev kho mob pej xeem, cov koom haum hauv nroog, pab pawg neeg, thiab lwm tus, kom koom nrog Medi-Cal kom tiav. Cov sijhawm ua haujlwm txhua lub limtiam raug tuav mus txog Lub Ob Hlis 12 (sau npe rau ntawm PATH CITED lub vev xaib) los pab cov neeg thov yav tom ntej.
RFI: California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) Initiative Centers of Excellence (COE)
On January 31, DHCS released a Request for Information (RFI) to solicit input from interested parties to establish one or more COEs that will offer training and technical assistance to Medi-Cal specialty behavioral health providers and county behavioral health plans. This opportunity is to support fidelity implementation of a set of evidence-based practices (EBPs), including Assertive Community Treatment (ACT), Forensic Assertive Community Treatment (FACT), Coordinated Specialty Care for First Episode Psychosis (CSC for FEP), Individual Placement and Support (IPS) model of Supported Employment, Clubhouse Services, and additional EBPs for children and youth. Please review RFI #23-070 for more information about the specific functions of COEs and the included EBPs. The deadline for questions is February 14, and the deadline for responses to the RFI is March 1. Please submit your questions about this RFI to PCDRFI3@dhcs.ca.gov.
Smile, California Kev Sib Tw rau Medi-Cal Dental Services
Smile, California tab tom txhawb nqa Lub Hlis Kev Noj Qab Haus Huv Hniav Rau Menyuam Yaus Hauv Tebchaws (NCDHM) los ntawm kev sib tw ua haujlwm hnub no hauv cov vev xaib social media, suav nrog Facebook thiab Instagram, ua lus Askiv thiab lus Mev. Lub hom phiaj ntawm txoj kev sib tw no yog kom cov tswv cuab Medi-Cal paub ntau ntxiv txog ntau txoj kev kho mob qhov ncauj. Daim phiaj xwm no qhia cov tib neeg txog kev muab qhov tseem ceeb rau kev mus ntsib kws kho hniav rau tus menyuam ua ntej lawv cov hniav thawj zaug loj hlob, hais txog qhov tseem ceeb ntawm cov tshuaj nplaum hniav, mus kuaj hniav ob zaug hauv ib xyoos, tau txais cov tshuaj fluoride, txhawb kom tsis txhob noj zaub mov qab zib thiab dej haus, thiab xyuas kom meej tias cov menyuam yaus siv cov tshuaj txhuam hniav kom raug. Thaum kawg, qhov kev sib tw no muab cov ntsiab lus ntawm cov txiaj ntsig kho hniav uas Medi-Cal them.
Koom nrog peb pab neeg
Qhov kev xeem hauv qab no qhib:
- Tus Thawj Saib Xyuas Kev Noj Qab Haus Huv Indian, ntawm lwm lub luag haujlwm, yuav ua tus kws tshaj lij kws tshaj lij hauv Indian kev noj qab haus huv los pab DHCS hauv kev npaj, kev tsim kho, kev siv, kev sib koom tes, kev ua haujlwm, thiab kev ntsuam xyuas ntawm Indian Health Program. (Hnub kawg ua ntawv thov yog Lub Ob Hlis 16)
Also, DHCS is hiring for our communications, human resources, auditing, health policy, information technology, and other teams. For more information, please visit the CalCareers website.
Cov Rooj Sib Tham Cov Neeg Koom Tes thiab Webinar yuav los tom ntej
CalAIM Population Health Management (PHM) Lub Rooj Sib Tham Pab Pawg
Thaum Lub Ob Hlis 12, txij 10:30 sawv ntxov txog 12 teev tav su, DHCS yuav tuav lub rooj sib tham ntawm PHM Advisory Group. Lub rooj sib tham yuav tsom mus rau txoj cai Transitional Care Services (TCS), suav nrog kev qhia luv luv txog kev hloov kho txoj cai TCS uas tau pib siv rau lub Ib Hlis 1, 2024, rau txhua tus tswv cuab. Cov tswv cuab ntawm PHM Advisory Group yuav muaj lub sijhawm los tawm tswv yim txog DHCS qhov tseem ceeb rau kev siv TCS hauv xyoo 2024, suav nrog kev txuas cov tswv cuab mus rau kev saib xyuas thawj zaug, xyuas kom meej tias kev hloov pauv yooj yim rau cov neeg uas hloov mus rau lossis tawm ntawm cov chaw saib xyuas neeg mob thiab cov chaw saib xyuas mus sij hawm ntev, thiab cov kev pabcuam saib xyuas hloov pauv rau cov neeg yug menyuam. Tsis tas li ntawd xwb, cov tswv cuab yuav tham txog yuav siv TCS li cas los txhim kho kev xa cov neeg tsim nyog mus rau ECM, Kev Txhawb Nqa Hauv Zej Zog, thiab lwm yam kev pabcuam tom qab tawm hauv tsev kho mob. Tsis tas li ntawd xwb, DHCS txais tos cov lus qhia los ntawm cov tswv cuab txog kev txhim kho kev xa cov ntaub ntawv/cov ntaub ntawv raws sijhawm, ua kom tiav, thiab raug ntawm cov chaw tso tawm, MCPs, thiab cov chaw muab kev pab tom qab tso tawm.
DHCS tau tsim tsa Pawg Neeg Pab Tswv Yim PHM los muab cov tswv yim los txhawb kev tsim thiab kev siv ntawm PHM Program thiab Service. Cov tswv cuab ntawm pawg neeg pab tswv yim suav nrog cov neeg sawv cev los ntawm cov phiaj xwm kev noj qab haus huv, cov chaw muab kev pab, cov nroog, cov chaw haujlwm hauv xeev, cov koom haum rau cov neeg siv khoom, thiab lwm pab pawg. Cov rooj sib tham no qhib rau pej xeem, thiab cov ntaub ntawv thiab cov ntaub ntawv ntawm lub rooj sib tham yuav muaj nyob rau ntawm lub vev xaib DHCS. Cov neeg koom tes raug txhawb kom xa cov lus nug ua ntej lub rooj sib tham hauv webinar mus rau PHMSection@dhcs.ca.gov.
Hearing Aid Coverage for Children Program (HACCP) Webinar rau Cov Kws Kho Mob thiab Cov Kws Kho Hniav
On February 13, from 12 to 1 p.m., DHCS will host a HACCP webinar (advance registration required) to share information with providers to help pediatric patients and their families maximize HACCP benefits. The training session will outline program requirements for families to apply for coverage. It will also outline the claims submission process for audiologists, otolaryngologists, physicians, and their office staff. For more information, please visit www.dhcs.ca.gov/haccp.
CalAIM Subacute Care Facility Carve-In Virtual Office Teev
On February 14, from 2:30 to 3:30 p.m., DHCS will host an office hours session as part of an educational webinar series on the CalAIM subacute care facility long-term care (LTC) carve-in. The office hours provide a dedicated forum for DHCS to engage with subacute care facilities, Medi-Cal MCP representatives, and other stakeholders to address questions related to the subacute care facility carve-in policy requirements and implementation of the transition to managed care that took effect on January 1, 2024.
Participants are encouraged to submit questions in advance when registering for the office hours session or by emailing them to LTCtransition@dhcs.ca.gov. Additional details about past webinars are available on the CalAIM Subacute Care Facility LTC Carve-In transition webpage.
PATH Technical Assistance (TA) Marketplace Virtual Vendor Fair
On February 29, from 9 to 10:30 a.m., DHCS will host the first PATH TA Marketplace virtual Vendor Fair. TA Vendor Fairs are an opportunity for vendors to pitch their organization and services to potential TA recipients and encourage utilization of the TA Marketplace. TA recipients and organizations interested in learning more about the TA Marketplace, including how to apply to receive free services, are invited to attend. This is the first in a series of upcoming Vendor Fairs and will focus on presentations from vendors providing services in Domain 3 of the PATH TA Marketplace: “Engaging in CalAIM through Medi-Cal Managed Care”.
Hauv Case Koj Tsis Tau Nws
Medi-Cal Targeted Rate nce (TRI)
Pursuant to Assembly Bill (AB) 118 (Chapter 42, Statutes of 2023), DHCS published, as part of the proposed 2024–25 Governor’s Budget, a plan for targeted increases to Medi-Cal payments or other investments, effective in 2025, across primary care, maternal care, behavioral health care, specialty care, women’s health services, public hospital services, community and hospital outpatient services, emergency services, and other domains. The proposed investments will be supported with funding from the Managed Care Organization (MCO) Tax, authorized by AB 119 (Chapter 13 , Statutes of 2023), and are designed to advance access, quality, and equity for Medi-Cal members and promote provider participation in the Medi-Cal program. These proposed investments are subject to obtaining all necessary legislative and federal approvals, as applicable. For more information, please visit the Medi-Cal Targeted Provider Rate Increases and Investments webpage and view the Medi-Cal TRI policy paper and MCO Tax-funded investments.
CalAIM Kev Pabcuam Nruam rau Menyuam Yaus Cov Lus Qhia
Lub sijhawm 30 hnub rau pej xeem tawm tswv yim rau daim ntawv thov hloov kho CalAIM Tshooj 1115 Kev Pab Them Nqi Tsis Tu Ncua rau Cov Menyuam yog txij lub Ib Hlis 12 txog Lub Ob Hlis 12. Yuav kom paub tseeb tias yuav tau txais kev txiav txim siab ua ntej xa mus rau CMS, cov lus tawm tswv yim yuav tsum tau txais tsis pub dhau 11:59 PM PST rau lub Ob Hlis 12. DHCS txais tos txhua cov lus tawm tswv yim rau pej xeem.
DHCS thov kom hloov kho qhov kev qhia ntawm CalAIM Tshooj 1115 kom suav nrog kev siv nyiaj raws li Tshooj 1115(a)(2) kom tau txais cov nyiaj sib phim ntawm tsoomfwv los muab kev pab them nqi rau cov menyuam yaus mus txog thaum kawg ntawm lub hlis uas lawv hnub yug 5 xyoos, tsis hais thaum twg lawv thawj zaug rau npe hauv Medi-Cal lossis Txoj Haujlwm Pov Hwm Kev Noj Qab Haus Huv Rau Menyuam thiab txhua qhov kev hloov pauv ntawm cov xwm txheej uas yuav ua rau poob qhov tsim nyog. Kev siv txoj cai no yog nyob ntawm seb lub xeev txiav txim siab txog cov peev txheej ntawm General Fund uas muaj nyob rau xyoo 2024-2025 thiab cov xyoo nyiaj txiag tom ntej thiab CMS kev pom zoo. Cov ntaub ntawv ntxiv muaj nyob rau ntawm nplooj ntawv web DHCS CalAIM 1115 Demonstration thiab 1915(b) Waiver.
Medicare Kev Pabcuam Kev Noj Qab Haus Huv Tus Cwj Pwm
Thaum Lub Ib Hlis Ntuj hnub tim 30, DHCS thiab California Department of Aging tau tshaj tawm daim ntawv qhia txog cov neeg muab kev pab txog cov txiaj ntsig kev noj qab haus huv ntawm Medicare, suav nrog cov ntsiab lus tseem ceeb ntawm cov kev pabcuam nthuav dav thiab cov hom neeg muab kev pab uas muaj los ntawm Medicare hauv xyoo 2024. Txij li Lub Ib Hlis 1, 2024, Medicare kev them nqi thiab cov cai rau kev noj qab haus huv tus cwj pwm tau nthuav dav los npog cov kev pabcuam kev noj qab haus huv ntawm lub hlwb thiab kev mus ntsib nrog cov kws kho mob sib yuav thiab tsev neeg thiab cov kws pab tswv yim kev noj qab haus huv ntawm lub hlwb, npog cov kev pabcuam sab nraud ntau hauv qee qhov chaw, thiab txhawb kom muaj zog rau cov phiaj xwm Medicare Advantage los koom tes kev saib xyuas kev noj qab haus huv tus cwj pwm.
Daim ntawv qhia tseeb hais txog cov kev pabcuam kev noj qab haus huv uas tau them los ntawm Medicare, yuav ua li cas rau npe ua tus kws khomob Medicare thiab koom nrog Medicare, yuav ua li cas cov kws khomob tuaj yeem pab cov neeg tau txais txiaj ntsig Medicare tau txais kev saib xyuas, thiab xyoo 2024 hloov hauv Medicare rau kev noj qab haus huv. Cov kev pabcuam kev coj tus cwj pwm muaj xws li kev noj qab haus huv ntawm lub hlwb thiab kev siv tshuaj yeeb tshuaj. Ob leeg siv tsis tau hauv California ntawm Medicare cov neeg tau txais txiaj ntsig. Xyoo 2021, tsuas yog 8.8 feem pua ntawm California cov neeg muaj hnub nyoog 65 xyoo thiab laus dua tau pom tus kws kho mob rau kev mob hlwb lossis kev siv tshuaj yeeb. Cov kev cuam tshuam rau kev tau txais kev kho mob hauv Medicare suav nrog kev tsis paub tias Medicare suav nrog kev pabcuam kev noj qab haus huv ntawm tus cwj pwm, kev xav tau nce tus lej ntawm tus kws kho mob tus cwj pwm rau npe hauv Medicare, thiab kev qia dub uas yuav cuam tshuam nrog nrhiav kev kho mob.