Chaw Saib Xyuas Qib Nruab Nrab ntawm CalAIM rau Kev Saib Xyuas Mus Ntev uas Muaj Kev Tsis Taus Hauv Kev Loj Hlob
Rov qab mus rau CalAIM Long-Term Care Carve-in Transition
California tab tom hloov Medi-Cal los ntawm ntau txoj kev pib los txuas ntxiv tsav kev txhim kho qhov zoo ntawm kev saib xyuas, ua kom yooj yim thiab txo qhov nyuaj, thiab tsim kom muaj kev ncaj ncees, kev tsav tsheb ntawm cov ntaub ntawv, thiab kev saib xyuas tus neeg tag nrho. Lub Chaw Saib Xyuas Qib Nruab Nrab rau Cov Neeg Muaj Kev Tsis Taus Hauv Kev Loj Hlob (ICF/DD) uas tau muab tso rau hauv Medi-Cal kev saib xyuas kev tswj hwm ua tus qauv rau cov kev pabcuam ICF/DD uas tau them nyob rau hauv kev saib xyuas kev tswj hwm thoob plaws lub xeev kom txhawb nqa kev tswj hwm kev saib xyuas kev tswj hwm uas sib xws thiab sib koom ua ke thiab nce kev nkag mus rau kev sib koom tes saib xyuas kev saib xyuas, kev tswj hwm kev saib xyuas, thiab ntau yam kev pabcuam rau cov tswv cuab Medi-Cal hauv ICF/DD Homes (suav nrog kev kho mob thiab kev saib xyuas neeg mob).
Carve-In txhais li cas rau Californians
Thaum Lub Ib Hlis Ntuj hnub tim 1, 2024, txhua txoj kev npaj kho mob Medi-Cal (MCPs) tau muaj lub luag haujlwm los them rau cov kev pabcuam ICF/DD hauv qab no:
- ICF/DD
- ICF/DD-Habilitative (ICF/DD-H)
- ICF/DD-Nursing (ICF/DD-N)
Note: ICF/DD-Continuous Nursing Care (ICF/DD-CN) Homes are not subject to the Long-Term Care (LTC) Carve-In policy.
MCPs coordinate the care members require both within their ICF/DD Homes as well as from other providers. MCPs provide members with a network of health care providers and care coordination services to help manage member care. MCPs work closely with Regional Centers to preserve the Lanterman Act protections for individuals with developmental disabilities.
Xav paub ntau ntxiv rau cov tswv cuab tuaj yeem nrhiav tau ntawm LTC Carve-In Member Information webpage.
Key Carve-In Documents
Txoj Cai Qhia
- APL 24-011 ICF/DD – Kev Tswj Xyuas Cov Nyiaj Pab LTC thiab Kev Hloov Chaw ntawm Cov Tswv Cuab mus rau Kev Tswj Xyuas Kev Kho Mob (Hloov Kho Lub Cuaj Hli 16, 2024)
- Qauv Daim Ntawv Cog Lus (Hloov Kho Lub Kaum Ib Hlis 2023)
- ICF/DD Carve-In FAQs (Hloov Kho Lub Kaum Hli 25, 2024)
- MCP Tsab Ntawv Txog Kev Kho Mob Ntxiv rau cov tswv cuab nyob hauv ICD/DD Cov Tsev
Cov ntawv
Ntxiv Carve-In Resources
- Department of Developmental Services (DDS) Tso Cai rau Cov Chaw Hauv Cheeb Tsam kom txuas ntxiv muab nyiaj lag luam mus txog lub Kaum Ob Hlis 31, 2025 (Yog xav paub ntxiv, mus saib hauv DDS Regional Center Directive lub website )
- 2024 MCP los ntawm Lub Nroog thiab Lub Chaw Sib Txuas Hauv Cheeb Tsam
- ICF/DD Billing thiab Invoicing Guide
- ICF/DD Carve-In Resource Guide (Hloov Kho Lub Ib Hlis 2024)
- ICF/DD Carve-In Resource Round Up (Hloov Kho Lub Ib Hlis 2024)
Managed Care Resources rau LTC muab kev pab
- Medi-Cal Authorizations LTC Resources
- Medi-Cal Billing and Payment LTC Resource
- Medi-Cal Kev Tsim Nyog thiab MCP Kev Sau Npe LTC Kev Pabcuam
Cov ntaub ntawv Webinars
Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tau tuav lub vev xaib kev kawm los txhawb cov neeg muaj feem nrog LTC Carve-In kev coj ua. Cov ntsiab lus thiab cov ntaub ntawv rau webinars tuaj yeem pom ntawm qhov txuas hauv qab no:
ICF/DD Carve-In Workgroup Lub Rooj Sib Tham Archive
DHCS thiab DDS tau sib sau ua ke ib pawg neeg ua haujlwm txij lub Peb Hlis 2022 txog rau Lub Ob Hlis 2024 uas tsom mus rau kev hloov pauv ntawm cov kev pabcuam ICF/DD los ntawm Medi-Cal Fee-for-Service (FFS) mus rau Medi-Cal managed care delivery system. Pawg neeg ua haujlwm tau muab lub sijhawm rau cov neeg koom tes los koom tes thiab muab cov lus qhia txog DHCS txoj cai thiab kev siv zog ua haujlwm hauv kev txiav cov kev pabcuam ICF/DD.
Cov ntsiab lus thiab cov ntaub ntawv rau txhua lub rooj sib tham tuaj yeem pom ntawm qhov txuas hauv qab no:
Cov peev txheej ntxiv
- CalAIM Tswj Kev Pabcuam Sijhawm Ntev thiab Kev Txhawb Nqa & Duals Stakeholder Integration Workgroup
- California Kev Pabcuam Sijhawm Ntev thiab Txhawb Dashboard
- Transitional Care Services rau cov tswv cuab nrog cov kev pab mus sij hawm ntev thiab kev txhawb nqa
- Automated Eligibility Verification System (AEVS) ntawm DHCS Tus Muab Kev Pabcuam Portal - qhov chaw muab kev pabcuam tuaj yeem nrhiav MCP cov ntaub ntawv rau npe rau cov tswvcuab
Cov lus nug
Hu rau DHCS nrog rau cov lus nug txog ICF/DD LTC Carve-In ntawm LTCTransition@dhcs.ca.gov.