CalAIM行動健康イニシアチブのよくある質問
以下は、技術支援および情報ウェビナーから収集され、BHCalAIM@dhcs.ca.gov 電子メールに提出されたよくある質問のリストです。 DHCSは、このリストを四半期ごとに更新します。
覚書(MOU)
MCP、MHP、DMC-ODSのDHCSへの四半期報告書の提出プロセスはどのようなものですか?
Managed Care Plans (MCPs) must demonstrate a good faith effort to meet the Memorandum of Understanding (MOU) requirements of All Plan Letter (APL) 23-029. MCPs that are unable to execute the required MOUs by the required execution date must submit quarterly progress reports and documentation to DHCS demonstrating evidence of their good faith effort to execute the MOUs. The other Parties are not required to submit or sign the MCP’s quarterly reports, as the quarterly reports are specific to the MCPs compliance with the MOU requirements. DHCS has released an MOU Quarterly Reporting Template and instructions for submitting the required quarterly reports with the finalized template.
MHPs and DMC-ODS counties must demonstrate a good faith effort to meet the MOU requirements of Behavioral Health Information Notices (BHINs) and 23-057, respectively. MHPs and DMC-ODS counties that are unable to execute the required MOUs by January 1, 2024 must submit quarterly progress reports and documentation to DHCS demonstrating evidence of their good faith effort to execute the MOUs. The deadline for the first quarter submissions for MHPs and DMC-ODS counties is April 30, 2024. Please refer to BHIN 23-056 and 23-057 for the progress quarterly report submission deadline to DHCS. MHP and DMC-ODS counties shall submit the quarterly progress report to MCBHOMDMonitoring@dhcs.ca.gov. The quarterly updates will be required until the MOU is executed and all policies and procedures required by the MOU are established and submitted to DHCS.23-056 and 23-057, respectively. Mental Health Plans (MHPs) and Drug Medi-Cal-Organized Delivery System (DMC-ODS) counties that are unable to execute the required MOUs by January 1, 2024 must submit quarterly progress reports and documentation to DHCS demonstrating evidence of their good faith effort to execute the MOUs. The deadline for the first quarter submissions for MHPs and DMC-ODS counties is April 30, 2024. Please refer to BHIN 23-056 and 23-057 for the progress quarterly report submission deadline to DHCS. MHP and DMC-ODS counties shall submit the quarterly progress report to MCBHOMDMonitoring@dhcs.ca.gov. The quarterly updates will be required until the MOU is executed and all policies and procedures required by the MOU are established and submitted to DHCS.
Are MHPs and DMC-ODS county network/contracted providers required to be signatories to their delivery system’s respective MOU?
No. The required signatories (in addition to the Mental Health Plan (MHP) / Drug Medi-Cal-Organized Delivery System (DMC-ODS) County and the Managed Care Plans (MCPs)) are MCP Subcontractors or Downstream Subcontractors that are Knox-Keene licensed health care plans and have entered into agreements with MCPs to delegate all or part of their responsibilities relating to sending/receiving referrals and care coordination for members served by both parties of the Memorandum of Understanding (MOU). In addition, the MHP’s behavioral health director (or position above) or a designated member of the county’s Board of Supervisors must sign the MOU. This does not include network/contracted MHP and DMC-ODS providers.
MCP、MHP、DMC-ODSの各郡は、オプション規定の使用を含め、テンプレートのすべての更新のレッドラインバージョンを提出する必要がありますか?
マネージド・ケア・プラン(MCP)、メンタルヘルス・プラン(MHP)、およびDMC-ODS(Drug Medi-Cal-Organized Delivery System)の各郡では、実行前にレッドライン版とオプションの規定および追加に関する事前承認は必要ありません。 ただし、MCP、MHP、DMC-ODSの各郡については、追加またはオプションの規定が明確に示されているカバーシートが必要になります。 DHCSは、MCP、MHP、DMC-ODSの各郡で使用するためのカバーシートを開発しています。 このカバーシートには、選択したすべてのオプション規定と、MCP、MHP、DMC-ODS郡が追加の規定を記載する能力が含まれます。 DHCSは、技術支援を通じてこれらの要件を中継し、覚書(MOU)のよくある質問のFAQを更新します。
BHINs 23-056 および 23-057 に含まれる MHP および DMC-ODS MOU テンプレートは、APL 23-029 および MCP MOU Web サイトの MHP および DMC-ODS MOU テンプレートと同一ですか?
はい、メンタルヘルスプラン(MHP)と薬物医療組織化デリバリーシステム(DMC-ODS)の覚書(MOU)テンプレートは、行動健康情報通知(BHIN)、すべてのプランレター(APL)、およびWebサイトで参照されています。