November 10, 2023 – Stakeholder News
Xov xwm tshaj plaws
Txhim Kho Kev Tswj Xyuas (ECM) rau Cov Menyuam Yaus thiab Cov Hluas Kev Pom Zoo (POF) tsom teeb
On November 3, DHCS published the ECM for Children and Youth POF Spotlight, which is designed to help contracted and prospective ECM providers serving children and youth develop and enhance their ECM models. It is also intended to support provider organizations that are considering if ECM for children and youth is right for them. The new resource outlines key ECM policies for the children and youth POFs, including areas where plans can leverage presumptive authorization; member scenarios that illustrate how to deliver ECM for the children and youth POFs, with examples of how Community Supports can be integrated to best serve children, youth, and caregivers; and guidance on how prospective providers can get started, with a collection of the key resources and funding opportunities.
DHCS is committed to providing technical assistance and support to California’s growing network of ECM providers. This is the first in a series of ECM spotlights that DHCS plans to release over the coming months to support stakeholders seeking more details on how providers tailor ECM to meet the needs of different POFs. For more information, visit the ECM and Community Supports webpage.
Kev hloov kho tshiab
Medi-Cal thiab Foster Care Updates
DHCS developed a resource to provide updates on foster care youth in Medi-Cal. The resource covers changes to managed care for the child welfare population in 2024, Enhanced Care Management and Community Supports transition policies, the 2024 Medi-Cal managed care plan (MCP) contract and memorandum of understanding requirements, and Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment child and youth components.
Doula Cov Kev Pabcuam Hloov Tshiab muaj nyob online
Thaum Lub Kaum Ib Hlis 3, DHCS tau hloov kho Doula Services raws li Medi-Cal Benefit lub vev xaib. Cov nplooj ntawv tshiab tshiab suav nrog cov peev txheej pab tau rau Medi-Cal cov tswv cuab thiab cov kws kho mob doula, suav nrog cov lus pom zoo uas tau tshaj tawm tshiab rau cov kev pabcuam doula los ntawm DHCS Tus Thawj Coj Kho Mob Dr. Karen Mark. Cov lus pom zoo sawv cev ua tiav raws li tsoomfwv txoj cai rau kev pom zoo rau cov kev pabcuam doula raws li kev pabcuam tiv thaiv.
Kev hloov kho tshiab rau nplooj ntawv web kuj suav nrog cov lus nug tshiab uas nquag nug rau cov tswv cuab doulas thiab Medi-Cal, tag nrho cov ntawv thov kev pom zoo doula tus kws kho mob thiab cov neeg muab kev pabcuam rau npe, thiab cov ntaub ntawv pov thawj uas txhawb nqa cov txiaj ntsig ntawm cov kev pabcuam doula rau kev yug menyuam thiab kev yug menyuam. Thov xa email rau cov lus nug txog kev pabcuam doula rau DoulaBenefit@dhcs.ca.gov.
Koom nrog peb pab neeg
DHCS tab tom ntiav! DHCS muaj cib fim rau:
- Chief of the Financial Management Division within Fiscal (final filing date (FFD) is November 15). This executive role develops policies and procedures to ensure fiscal integrity, transparency, and accountability of approximately $150 billion in annual state and federal funding for DHCS.
- Behavioral Health Policy Medical Consultant II within Behavioral Health (FFD is November 27). This position provides clinical expertise and strategic advice to DHCS Behavioral Health leadership on the development and implementation of policy and initiatives designed to strengthen behavioral health care access, quality, and service delivery.
- Senior Assistant Chief Counsel for Fiscal and Financing within the Office of Legal Services (FFD is November 28). This position is responsible for complex legal counsel and litigation strategy formulation regarding DHCS fiscal, financial management, and health care policy.
- Senior Assistant Chief Counsel for Health Care Delivery Systems nyob rau hauv lub Office of Legal Services (FFD yog lub Kaum Ib Hlis 30). Txoj hauj lwm no yog lub luag haujlwm rau cov kws pab tswv yim kev cai lij choj thiab kev tsim cov tswv yim hais txog ntau yam ntawm cov kab ke kev noj qab haus huv.
DHCS is also hiring for our human resources, auditing, health policy, and information technology teams. For more information, please visit the CalCareers website.
Cov Rooj Sib Tham Cov Neeg Koom Tes thiab Webinar yuav los tom ntej
Khaws Koj Lub Zej Zog Covered: Tsev Kawm Ntawv thiab Tsev Neeg Webinar
Thaum Lub Kaum Ib Hlis 16, thaum 2 txog 3 teev tsaus ntuj, DHCS yuav muaj kev sib tham hauv Webinar ntawm Khaws Koj Lub Zej Zog Covered: Tsev Kawm Ntawv thiab Tsev Neeg (yuav tsum tau sau npe ua ntej). Lub webinar yuav muab cov ntaub ntawv tseem ceeb rau tsev kawm ntawv cov neeg koom tes los pab cov tub ntxhais kawm thiab lawv tsev neeg nrog kev rov kho dua Medi-Cal. Lub webinar tseem yuav qhia txog cov peev txheej nthuav tawm thiab cov kev coj ua zoo tshaj plaws rau kev koom nrog tsev neeg nrog cov menyuam hnub nyoog kawm ntawv.
Medi-Cal Cov Cai Nkag Mus Kawm thiab Cov Txheej Txheem rau CBOs thiab LHJs Webinar
Thaum Lub Kaum Ib Hlis 17, thaum 10 txog 11:30 teev sawv ntxov, DHCS yuav tuav lub rooj sib hais rau pej xeem los ntawm webinar (yuav tsum tau sau npe ua ntej) los tham txog cov kev cai tswj xyuas cov ntawv xov xwm ntawm Medi-Cal cov kev cai rau npe kawm thiab cov txheej txheem rau cov koom haum hauv zej zog (CBO) thiab cov chaw saib xyuas kev noj qab haus huv hauv cheeb tsam (LHJ) cov chaw zov me nyuam / cov chaw pabcuam kev noj qab haus huv hauv zej zog. Pib txij lub Ib Hlis Ntuj hnub tim 9, 2024, CBO thiab LHJ cov chaw muab kev pab thov kev tso npe rau hauv Medi-Cal tus nqi-rau-kev pabcuam tuaj yeem xa lawv daim ntawv thov los ntawm Tus Muab Kev Pabcuam thiab Validation for Enrollment (PAVE) online enrollment portal.
Cov lus sau, cov lus nug, lossis cov lus qhia yuav raug xa tuaj thaum lub rooj sib hais hauv webinar tham. Rau cov neeg tsis tuaj yeem tuaj koom, cov lus sau yuav tsum xa los ntawm 5 teev tsaus ntuj rau lub Kaum Ib Hlis 17 kom txiav txim siab rau kev tshaj tawm. Thaum xa cov lus hauv kev sau ntawv, thov xyuas kom meej tias tus neeg tawm tswv yim thiab lub koom haum / koom haum uas sawv cev yog ob qho tib si raug txheeb xyuas hauv cov lus. Cov lus sau yuav tsum xa mus rau DHCSPEDStakeholder@dhcs.ca.gov. Raws li pej xeem cov lus tau txais, DHCS yuav tshaj tawm cov ntawv xov xwm kawg ntawm Medi-Cal thiab DHCS cov vev xaib.
CalAIM Intermediate Care Facility for the Developmentally Disabled (ICF/DD) Carve-In Billing and Payment Webinar
On November 17 at 1 p.m., DHCS will host the fourth in a series of educational webinars on the California Advancing and Innovating Medi-Cal (CalAIM) ICF/DD carve-in (advance registration required). These webinars outline changes to the ICF/DD carve-in policy requirements. Starting on January 1, 2024, all Medi-Cal MCPs will be required to cover and coordinate institutional long-term care for members residing in an ICF/DD. The webinar series will feature several topics, including ICF/DD carve-in 101, directed payment policy and payment requirements, the per diem rate, accommodation code changes, and best practices for billing and payment. ICF/DD home, Regional Center, and Medi-Cal managed care representatives are encouraged to attend. All webinars are open to the public.
If there are specific questions you would like addressed during the webinar, please submit them in advance using this registration form or by emailing them to LTCtransition@dhcs.ca.gov. Webinar materials, including recordings, and additional details about upcoming webinars are posted on the CalAIM ICF/DD Long-Term Care Carve-In webpage.
Lub Chaw Saib Xyuas Kev Noj Qab Haus Huv Nyiaj Txiag Kev Hloov Kho Webinar
On November 17, from 3 p.m. to 4 p.m., DHCS will hold a virtual stakeholder webinar (advance registration required) to discuss the development of the Skilled Nursing Facility Workforce Standards Program, Accountability Sanctions Program, and Workforce & Quality Incentive Program (WQIP) authorized by Assembly Bill 186 (Chapter 46, Statutes of 2022). This meeting will also provide an opportunity for stakeholder input. Additional information is posted on DHCS’ Nursing Facility Financing Reform (AB 186) webpage.
Hearing Aid Coverage for Children Program (HACCP) Webinar for Families and Community Partners
On November 28, from 11 a.m. to 12 p.m., DHCS will host a HACCP webinar (advance registration required) to share guidance with families and communities about applying for hearing aid coverage and helping children to maximize their HACCP benefits once enrolled. DHCS welcomes newly interested families, as well as families currently participating in HACCP, and community partners supporting families and children to join this webinar for program updates, tips, and a question-and-answer session. For more information, please visit www.dhcs.ca.gov/haccp.
HACCP Webinar rau Cov Kws Kho Mob thiab Cov Kws Kho Hniav
On December 19, 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 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.
Medi-Cal Asset Elimination Webinar
Thaum Lub Kaum Ib Hlis 29, thaum 1:30 txog 2:30 teev tsaus ntuj, DHCS yuav tuav ib lub rooj sib tham txog kev tshem tawm cov cuab tam rau cov kev pab cuam uas tsis tau hloov kho tag nrho cov nyiaj tau los (MAGI) Medi-Cal, pib lub Ib Hlis Ntuj 1, 2024. Thaum ua tiav, qhov kev pib no yuav tshem tawm qhov kev sim khoom vaj khoom tsev rau txhua qhov kev pabcuam uas tsis yog MAGI, suav nrog kev saib xyuas mus sij hawm ntev thiab Medicare Savings Programs. Lub webinar yuav muab cov ntaub ntawv keeb kwm yav dhau los ntawm kev tshem tawm cov cuab yeej cuab tam, kev npaj ua, kev hloov cov txheej txheem, thiab cov ntaub ntawv nthuav tawm. Cov ntaub ntawv ntau ntxiv muaj nyob rau ntawm Cov Khoom Muaj Cai Limit Hloov Pauv rau Non-MAGI Medi-Cal lub vev xaib.
CalAIM Tswj Kev Pabcuam Sijhawm Ntev thiab Kev Txhawb Nqa (MLTSS) thiab Duals Integration Workgroup Virtual Meeting
On November 30 at 10 a.m., DHCS will virtually host the CalAIM MLTSS and Duals Integration Workgroup meeting (advance registration required). The workgroup serves as a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible members, and allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare.
Agenda topics will include reminders about the 2024 Medi-Cal transitions and noticing timelines, updates on Medi-Medi Plan outreach and the 2024 Dual Eligible Special Needs Plan Policy Guide development, July 2023 duals enrollment data, a spotlight presentation on the CalAIM recuperative care Community Support, and a presentation on the continuous coverage unwinding.
Background materials, transcripts, and video recordings of previous workgroup meetings, along with additional information about the workgroup, are posted on the CalAIM MLTSS and Duals Integration Workgroup webpage. For questions or comments, please email DHCS at info@calduals.org.
Medi-Cal Adult Expansion Webinar
On December 4, from 11 a.m. to 12 p.m., DHCS will host a webinar on the adult expansion of Medi-Cal (advance registration required) for CBOs, MCPs, providers, and other interested stakeholders, including those representing consumers, immigration, health care, legal aid, and immigrant adults. DHCS is implementing this expansion pursuant to Senate Bill 184 (Chapter 47, Statutes of 2022) on January 1, 2024. When implemented, the expansion will provide individuals 26-49 years of age with full scope Medi-Cal benefits, regardless of citizenship or immigration status, if they meet all other Medi-Cal eligibility criteria.
The webinar, which will be live interpreted in Spanish, will provide background information about the expansion, implementation planning, noticing, outreach, and more. Individuals may also submit questions or request to register for the webinar by sending an email to AdultExpansion@dhcs.ca.gov.
Hauv Case Koj Tsis Tau Nws
Tshooj 1115 Kev Tawm Tsam: BH-CONNECT thiab CalAIM Kev Hloov Pauv Hloov Hloov Hloov
On October 20, DHCS submitted to Centers for Medicare & Medicaid Services (CMS) the new Section 1115 demonstration request, entitled the California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) demonstration, and the proposed amendment to the CalAIM Section 1115 demonstration related to transitional rent services. Additionally, the federal public comment period will be open for BH-CONNECT and CalAIM transitional rent services from October 27 through November 26, 2023.
Lub Ib Hlis 2024 Medi-Cal MCP Kev Hloov Pauv
As part of Medi-Cal transformation, some MCPs are changing on January 1, 2024, and approximately 1.2 million members will have new health plan options and/or will need to transition to new MCPs. Changing MCPs will not affect Medi-Cal member coverage or benefits. Members who transition to a new MCP are receiving notices about the transition. DHCS developed several resources to support members, providers, and other stakeholders with the transition, including the Managed Care Plan Transition Member webpage with a county “lookup” tool, links to member notices sent by Medi-Cal about MCP changes, frequently asked questions, and a Contact Us page for members to learn more about health plans and provider choices. There are also transition resources for providers and MCPs and stakeholders. More information about the transition is available in the 2024 Managed Care Plan Transition Policy Guide and Medi-Cal Eligibility Division Information Letter Number I 23-54.