カリフォルニア州は、南カリフォルニアの山火事の影響を受けたMedi-Calメンバーへの支援を拡大するために活動しています
2025年1月17日
SACRAMENTO — In response to the devastating Southern California wildfires and Governor Gavin Newsom’s proclaimed State of Emergency and Executive Order issued on January 7, 2025, the Department of Health Care Services (DHCS) swiftly implemented key administrative flexibilities to protect Medi-Cal members in affected regions of the state. These efforts include simplified Medi-Cal enrollment and renewal processes, waived requirements to access prescription medications and medical devices, and other flexibilities to ensure all Medi-Cal members have access to care during this emergency.
Help for Medi-Cal members in Los Angeles County and Ventura County includes:
- Simple renewal and enrollment: Simplified Medi-Cal enrollment and renewal processes to allow families to quickly secure or maintain Medi-Cal coverage. Allowed for self-attestation for residency and income if documentation is missing, and verification deadlines are extended. Local county offices are prioritizing Medi-Cal applications and any case restorations for affected Medi-Cal members, who are encouraged to contact their local clinic navigators or local county office if assistance is needed to resolve eligibility issues.
- Fast refills for pharmacy and medical equipment: Waived prescription signature requirements for Medi-Cal members. Released a provider alert to allow for early refill authorizations and emergency override of existing utilization management and prior authorization controls to facilitate expedited access to medications and pharmacy products to ensure timely care.
- Prioritized member transfers if moving out of Los Angeles or Ventura counties: Medi-Cal members who are displaced for an unknown amount of time may contact either their former county of residence or the new county to assist with transferring the case on a permanent or short-term basis. Members can visit the DHCS website to find their local county office.
- Emergency response protocols: Medi-Cal managed care plans that operate in the areas subject to the emergency, including L.A. Care Health Plan, Health Net, Molina Healthcare, Gold Coast Health Plan, Kaiser Permanente, Anthem, Blue Shield of California Promise Health Plan, Senior Care Action Network, and Positive Healthcare California (AIDS Healthcare Foundation), have activated their emergency response protocols. Protocols include deploying care management teams to conduct member outreach, especially for high needs populations; waiving prior authorization requirements; working to provide transportation to care; and ensuring members do not face any out-of-pocket costs for getting care from out-of-network providers, as needed.
DHCS understands recovering from these wildfires will be challenging and has developed an online resource to help answer Medi-Cal member questions about accessing services during this emergency.
Current flexibilities for Medi-Cal managed care plans and providers include:
- Behavioral health services: Ensured relocated clients from evacuated facilities receive continuous care, with licensing and certification flexibilities supporting affected treatment programs.
- Provider support: Extended reporting and administrative deadlines, enabling Medi-Cal providers to prioritize care delivery until the end of the emergency.
- Managed care flexibility: Waived prior authorizations and referral requirements for applicable services to help Medi-Cal managed care plans and their network providers deliver timely care to members affected by evacuations and service disruptions.
Additionally, DHCS submitted requests to the federal Centers for Medicare & Medicaid Services (CMS) to help Californians covered by Medi-Cal impacted by the Southern California wildfires. Section 1135 of the Social Security Act provides flexibility during national public health emergencies.
“At DHCS, our members are our top priority, and our hearts go out to the families affected by the Southern California wildfires,” said DHCS Director Michelle Baass. “We are working closely with CMS to obtain speedy federal approvals for flexibilities to help our state and Medi-Cal members meet the challenges posed by the wildfires. We will continue to issue guidance to providers so they can quickly take advantage of the new flexibilities to deliver quality, equitable health care to Southern Californian Medi-Cal members.”
Significant additional flexibilities requested by DHCS include:
- 診療所・施設への支援:
- 主要な施設が損傷したりアクセスできなくなったりした場合に、診療所が移動診療所や一時的な場所などの代替環境でケアを提供できるようにします。
- シェルターやホテルなどの一時的なケア環境で提供されるサービスに対する全額の払い戻しを承認します。
- Medi-Calメンバーのための追加の保護:
- 公正なヒアリング要求と給付金の復活のタイムラインを延長し、Medi-Calメンバーが適格性または給付の問題を解決するための追加の時間を与えます。
- 在宅医療サービスの要件を調整して、現在の制約による対面での出会いの遅延を許容します。
- Medi-Calプロバイダーの登録と払い戻し:
- プロバイダーの登録を迅速化および合理化して、プロバイダーが影響を受けるメンバーにケアを提供しやすくします。
- 長期的なサービスとサポート(LTSS)の柔軟性:
- 初期評価、再評価、ケアプランの見直しのタイムラインを延長し、年齢、障害、慢性疾患のために継続的なサポートが必要な個人が中断なくケアを受けられるようにします。
- LTSSの配送をシェルターやホテルなどの別の場所での配送を許可します。
- レポート作成と請求の要件の拡張機能:
- データ報告と請求提出の延長を付与し、影響を受ける地元の機関や教育機関が期限に間に合うようにします。
- 山火事が通常の運営を中断した場合でも、健康保険がメンバーにサービスを提供し続けることができるように、報告要件を満たすための柔軟性を高めます。 調整には、メンバーが治療のために移動する必要がある距離や、LTSSにどれだけ早くアクセスできるかについてのルールの調整が含まれます。
DHCS is dedicated to safeguarding the health and well-being of Medi-Cal members and communities suffering from the devastating effects of the Southern California wildfires. DHCS’ purpose extends beyond routine health care services, focusing on proactive planning, rapid response, and continuous support in the face of challenges like these wildfires.
DHCSは、州、地方、連邦、および部族のパートナーとの協調的な取り組みを通じて、影響を受けた個人にとって重要な医療サービスがアクセス可能でタイムリーに保たれるようにしています。 DHCSは、チームの専門知識と緊急規制の柔軟性を活用して、医療や行動医療サービスへのアクセスの促進から、医薬品や耐久性のある医療機器の利用可能性の確保まで、南カリフォルニアのコミュニティのユニークなニーズに対応しています。
BACKGROUND: On January 8, 2025, in response to the catastrophic wildfires in Southern California, President Joseph R. Biden, Jr. declared that a major disaster exists in the State of California in the areas affected by wildfires. On January 10, 2025, U.S. Department of Health & Human Services Secretary Xavier Becerra declared a public health emergency for California, granting CMS additional flexibility to address the health needs of impacted individuals. These measures were made possible through extensive preparedness planning and proactive emergency response protocols. These efforts underscore a strong state and federal partnership, ensuring uninterrupted care and services during this emergency.
DHCS administers Medi-Cal, California’s version of Medicaid, providing health coverage to nearly 15 million people, including nearly 4 million members in Los Angeles County and more than 250,000 members in Ventura County.
DHCS encourages all affected residents to follow local evacuation orders, monitor air quality, and wear masks outdoors, if needed. If Medi-Cal members need assistance, they should contact their health care provider or plan.
詳細情報: リソースと最新情報は、次のリンクから入手できます。
- DHCS南カリフォルニア火災対応
- DHCSの緊急時および災害支援に関する情報に関するFAQ
- カリフォルニア州保健福祉局緊急リソースガイド
- カリフォルニア州高齢化局の緊急時対応ガイド
- CalHOPEウォームラインとメンタルヘルスサポート
- Medi-Calメンバーアシスタンス
- カリフォルニア州移民のための災害支援サービスガイド(英語/スペイン語)
- 地方郡役所ディレクトリ
- クリニック健康登録ナビゲーター
- BenefitsCal: Medi-Calメンバーは、BenefitsCalにアクセスして連絡先情報を更新できます。
今すぐサポートを受ける:
- Californians can visit CA.gov/LAfires, a hub for information and resources from state, local, and federal governments.
- 山火事による損失を被った個人や事業主は、災害支援を申請できます。
- DisasterAssistance.gov でオンライン。
- 800-621-3362に電話して。
- 連邦緊急事態管理庁(FEMA)のスマートフォン アプリケーションを使用します。
- アシスタンスは 40以上の言語で利用できます。
- ビデオリレーサービス、字幕付き電話サービスなどのリレーサービスをご利用の場合は、FEMAにそのサービスの番号をお知らせください。
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接触：
Office of Communications
(916) 440-7660
www.dhcs.ca.gov