June 3, 2024 – Stakeholder Update
June 3, 2024 – Stakeholder Update
Xov xwm tshaj plaws
Hloov tshiab: Kev Pabcuam Kev Kho Mob Tshwj Xeeb (SMHS) hauv Sacramento thiab Solano Counties
DHCS tau pom zoo nrog Kaiser Permanente, Partnership HealthPlan ntawm California, Sacramento County, thiab Solano County los hloov lub luag haujlwm ntawm SMHS los ntawm Kaiser thiab Partnership HealthPlan mus rau Sacramento County thiab Solano County cov phiaj xwm kev noj qab haus huv ntawm lub hlwb hauv ib txoj hauv kev, pib thaum Lub Xya Hli 1, 2024, thiab xaus rau Lub Kaum Ob Hlis 31, 2024. Yav tas los, nyob rau hauv California Advancing and Innovating Medi-Cal (CalAIM) cov txiaj ntsig kev pabcuam, DHCS tshaj tawm tias lub luag haujlwm rau kev muab SMHS rau cov tswv cuab tsim nyog hauv Sacramento thiab Solano counties yuav raug xa mus rau cov counties, ua kom cov txiaj ntsig uas cov phiaj xwm kev noj qab haus huv ntawm lub hlwb hauv lub xeev them tus qauv.
In May 2024, Kaiser began the phased approach to notify 4,836 Medi-Cal members in Sacramento County and 2,091 members in Solano County that coverage for their SMHS will be transferred to county mental health plans. Monthly transitions (and related member noticing) will occur from July 1 through December 31. Kaiser, Partnership HealthPlan, Sacramento County, Solano County, and DHCS have been working closely to prepare for a coordinated and successful transition.
DHCS cov cai tswjfwm kev saib xyuas txuas ntxiv mus yuav raug siv los zam kev cuam tshuam kev saib xyuas cov tswv cuab thiab pab txhawb kev sib pauv lus sov siab ntawm cov kws kho mob. Raws li cov cai no, cov tswv cuab yuav muaj peev xwm khaws lawv tus neeg muab kev pab SMHS tam sim no mus txog 12 lub hlis tom qab lawv hnub hloov pauv, yog tias tus neeg muab kev pab ntawd tsis yog ib feem ntawm lub network ntawm txoj kev npaj tshiab. Cov tswv cuab, tus neeg sawv cev uas tau tso cai ntawm tus tswv cuab uas muaj ntaub ntawv nrog Medi-Cal, lossis tus kws kho mob ntawm tus tswv cuab tuaj yeem thov kom muaj kev saib xyuas txuas ntxiv mus los ntawm txoj kev npaj kho mob hlwb tshiab ntawm lub nroog. Txoj cai no thiab cov cai ntawm cov tswv cuab tau piav qhia nyob rau hauv cov phau ntawv qhia rau cov tswv cuab uas muaj los ntawm txhua txoj kev npaj.
Members who are impacted by this transition and have questions about their SMHS may call Kaiser’s Member Services Contact Center (Medi-Cal) at 1-855-839-7613, TDD/TTY: 711, or call their county mental health plan: Sacramento County (1-888-881-4881) or Solano County (1-800-547-0495). Members may also contact the Medi-Cal Managed Care and Mental Health Office of the Ombudsman at (888) 452-8609 or MMCDOmbudsmanOffice@dhcs.ca.gov.
Kev hloov kho tshiab
Children’s Presumptive Eligibility (CPE) and Newborn Gateway Portals
Txij li thaum Lub Xya Hli 1, DHCS yuav tso tawm cov chaw muab kev pabcuam hauv online los txhim kho kev nkag mus rau kev pov hwm thiab kev saib xyuas rau cov tsev neeg tshiab. Los ntawm CPE, cov chaw muab kev pab cuam yuav muab kev pab cuam ib ntus, tag nrho rau cov neeg thov kev pab cuam los ntawm lub portal online. Lub portal no hloov chaw lub portal gateway Child Health and Disability Prevention (CHDP). Lub portal Newborn Gateway yog rau kev tshaj tawm txog kev yug menyuam uas muaj kev sib txuas rau Medi-Cal thiab Medi-Cal Access Infant Program hauv 72 teev tom qab yug los lossis 24 teev tom qab tawm hauv tsev kho mob, qhov twg ua ntej.
All providers seeking to participate in CPE must complete certification training to become familiar with the updated portals and reporting requirements. All qualified providers participating in presumptive eligibility must use the Newborn Gateway to enroll infants with linkage, who are born in their facilities, into coverage as of July 1. The Newborn Gateway certification training provides background as well as provider expectations and responsibilities. The Newborn Gateway certification is a required supplement to current presumptive eligibility certifications.
Thaum Lub Rau Hli 6 thaum 1 teev tsaus ntuj PDT, DHCS yuav tuav lub rooj sib tham hauv online txog CPE thiab Newborn Gateway portal. Yuav muaj lwm lub rooj sib tham hauv online txog kev txheeb xyuas dua thaum kawg Lub Rau Hli. Kev sau npe muaj los ntawm Medi-Cal Learning Portal. Tsis tas li ntawd xwb, thaum lub Tsib Hlis 30, DHCS tau tuav lub rooj sib tham txog CPE thiab Newborn Gateway portal. Cov ntaubntawv povthawj ntawm lub webinar yuav muaj nyob rau ntawm lub portal hauv 10 hnub.
Koom nrog peb pab neeg
DHCS tab tom nrhiav cov neeg txawj ntse, tshwj xeeb tshaj yog txhawb nqa cov tib neeg los ua:
- Tus Thawj Coj ntawm Medi-Cal Enterprise Systems Modernization los ua txhua yam kev siv thev naus laus zis (IT) kev tswj hwm thiab kev tswj hwm txoj cai rau lub Division, suav nrog kev siv cov txheej txheem agile / lub hauv paus los xyuas kom meej cov haujlwm thiab cov haujlwm ua tau raws li cov neeg siv khoom xav tau los ntawm kev xa khoom IT. (Hnub Kawg Ua Ntawv Thov: Lub Rau Hli 4)
- Tus Thawj Saib Xyuas Kev Lag Luam Technology Strategy Services los coj kev txhim kho, kev siv, thiab kev tswj hwm ntawm IT-hais txog lub tswv yim, cov cai, thiab kev npaj hauv kev lag luam system architecture, kev tswj hwm, qhov project portfolio thiab kev xa khoom, thiab kev tswj xyuas cov haujlwm. (Hnub Kawg Ua Ntawv Thov: Lub Rau Hli 4)
DHCS tseem ntiav rau kev sib txuas lus, tib neeg cov peev txheej, kev tshuaj xyuas, txoj cai tswjfwm kev noj qab haus huv, kev siv thev naus laus zis, thiab lwm pab pawg. Yog xav paub ntxiv, thov mus saib hauv CalCareers lub vev xaib.
Cov Rooj Sib Tham Cov Neeg Koom Tes thiab Webinar yuav los tom ntej
Behavioral Health Transformation Webinar
Thaum Lub Rau Hli 3, txij 2 txog 3:30 teev tsaus ntuj, California Health & Human Services Agency (CalHHS) yuav tuav lub rooj sib tham hauv online txog kev hloov pauv kev noj qab haus huv ntawm tus cwj pwm (yuav tsum tau sau npe ua ntej) rau pej xeem kom paub ntau ntxiv txog Proposition 1. Cov neeg sawv cev los ntawm CalHHS, DHCS, California Department of Veterans Affairs, thiab Department of Housing and Community Development yuav muab ib daim ntawv qhia txog nws cov kev cai, cov ntsiab lus tseem ceeb, thiab qhov twg yuav kawm ntxiv.
Mus saib nplooj ntawv web Behavioral Health Transformation kom paub ntxiv txog kev mloog pej xeem txhua hli thiab cov peev txheej ntxiv. Thov xa cov lus nug ntsig txog Proposition 1 thiab/lossis cov rooj sib tham rau pej xeem mus rau BHTinfo@dhcs.ca.gov. Tsis tas li ntawd xwb, thov sau npe rau hauv peb lub vev xaib kom tau txais cov xov xwm tshiab txhua hli.
Consumer-Focused Stakeholder Workgroup (CFSW)
On June 7, from 10 to 11:30 a.m., DHCS will convene the CFSW, which provides stakeholders an opportunity to review and provide feedback on a variety of consumer messaging materials. The forum focuses on eligibility- and enrollment-related activities and strives to offer an open discussion on Medi-Cal policies and functionality. Meeting materials, including the meeting agenda, will be posted to the CFSW webpage by noon on June 5. Please email your questions to DHCSCFSW@dhcs.ca.gov.
CalAIM Muab Kev Nkag Mus Nkag thiab Hloov Kho Kev Noj Qab Haus Huv (PATH) Txoj Cai Zoo Tshaj Plaws Webinar
Thaum Lub Rau Hli 27, txij 11 teev sawv ntxov txog 12 teev tav su PDT, DHCS yuav tuav lub rooj sib tham hauv online, Cov Cuab Yeej los Koom Tes Zoo Dua Cov Tswv Cuab Tsim Nyog hauv CalAIM (yuav tsum tau sau npe ua ntej). Lub rooj sib tham hauv online no yog ib feem ntawm cov rooj sib tham hauv online uas muaj ob xyoos ib zaug ntawm PATH Collaborative Planning and Implementation (CPI) uas tsim los qhia txog cov kev coj ua zoo tshaj plaws rau kev siv Enhanced Care Management thiab Community Supports, ua kom cov neeg muab kev pab koom tes zoo dua hauv CalAIM, thiab txhim kho kev koom tes nrog Medi-Cal managed care plans, lub xeev thiab cov koom haum tsoomfwv hauv zos, thiab lwm tus los tsim thiab xa cov kev pabcuam txhawb nqa zoo rau cov tswv cuab Medi-Cal. Yog xav paub ntxiv, suav nrog cov peev txheej webinar yav dhau los thiab cov ntaub ntawv kaw, thov mus saib PATH CPI webpage.