トップニュース​​ 

CalAIMデモンストレーション修正承認​​ 

On August 23, the Centers for Medicare & Medicaid Services (CMS) approved an amendment to the California Advancing and Innovating Medi-Cal (CalAIM) Section 1115 demonstration waiver, allowing the state to implement county-based model changes in its Medi-Cal managed care program. The amendment includes expenditure authority to limit the choice of managed care plans (MCPs) in non-rural areas. This authority would apply in the metro, large metro, and urban counties intending to participate in the County Organized Health System (COHS) or Single Plan models.​​ 

For rural counties, CMS approved an amendment to the CalAIM Section 1915(b) waiver on June 26 to limit plan choice in rural counties to participate either in the COHS or Single Plan models. These county-based model changes will go into effect on January 1, 2024. Twelve counties will become COHS and three will become Single Plan model counties. For more information about all counties, their current and 2024 model type, and the MCPs operating in the county, please see the MCP county table.​​ 

プログラムの最新情報​​ 

Medi-Cal Rxの​​ 

8月22日、メディカルRxカスタマーサービスセンターは、会員、処方医、薬剤師、および一般市民向けに、対話型音声認識機能の強化を導入しました。今回の機能強化には、通話調査、通話を効率化するメインメニュー、通話理由をオペレーターに伝えるコード、発信者が複数のセルフサービス項目を確認できるようにメインメニューに戻るループ機能、そしてプロンプトの文言と配置の改善などが含まれます。​​ 

On August 16, a New Start PA Reminder Alert was published about the prior authorization requirements that will be reinstated beginning on September 22 for new start enteral nutrition products for members 22 years of age and older.​​ 

子供とティーンエイジャーのためのメディカル（Medi-Cal）情報郵送物​​ 

On August 25, DHCS distributed an informational mailing to Medi-Cal fee-for-service (FFS) members and/or their parents or guardians about the federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, known in California as Medi-Cal for Kids & Teens. The FFS mailing includes: (1) Medi-Cal for Kids & Teens brochures to improve member understanding of how Medi-Cal works for children, teens, and young adults, what it covers, and its role in preventive care screening, diagnosis, and treatment. The child brochure is for children up to age 12, and the teen brochure is for ages 12-20; and (2) “Medi-Cal for Kids & Teens: Your Medi-Cal Rights” guide to help members under age 21 understand their Medi-Cal benefits and their recourse if medically necessary care is denied, delayed, reduced, or stopped. The materials, including translations, are posted on the Medi-Cal for Kids & Teens webpage.​​ 

私たちのチームに参加しませんか​​ 

DHCSは、財務、人事、法務、監査、医療政策、情報技術の各チームを募集しています。 詳細については、 CalCareersのWebサイトをご覧ください。​​ 

DHCS is dedicated to providing equitable access to quality health care, leading to a healthy California for all. DHCS’ goals and objectives express the tremendous work DHCS is leading to transform our health care system and reflect the organizational culture we are building together.​​ 

今後のステークホルダーミーティングとウェビナー​​ 

トラウマインフォームドプラクティスをリプロダクティブヘルスサービスウェビナーに統合する​​ 

8月30日午後12時から午後1時30分まで、DHCSとカリフォルニア予防研修センターは、「生殖医療サービスへのトラウマインフォームドケアの統合」に関するウェビナーを開催します。トラウマインフォームドケアは、効果的なケアを提供するためにはクライアントの人生経験を理解する必要があることを認識しており、患者の積極的な参加、治療への遵守、および健康状態の改善につながる可能性を秘めている。ライブウェビナーに参加できない方のために、ウェビナーの文字起こしと録画、およびその他の関連資料がFamily PACTのウェブサイトに掲載されます。​​ 

インディアン健康プログラムの部族と被指名人四半期ウェビナー​​ 

On August 30, from 2 to 3 p.m., DHCS will host a webinar (advance registration required) for tribal and Indian health program representatives to provide feedback on DHCS initiatives with specific impact to tribes, Indian health programs, and American Indian Medi-Cal members. The webinar will provide information about State Plan Amendments, waivers, and demonstrations proposed for submission to CMS, including the Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) Medicaid section 1115 demonstration and transitional rent services amendment to the CalAIM section 1115 demonstration. Email questions or comments to TribalAffairs@dhcs.ca.gov.​​ 

エクイティ&プラクティス・トランスフォーメーション・ペイメント・プログラム・ウェビナー​​ 

On August 30, from 3 to 4 p.m., DHCS will host an Equity and Practice Transformation Payments Program Webinar (advance registration required) to share an update on the Equity and Practice Transformation Payments Program, which is a one-time $700 million primary care practice transformation program initiative to advance health equity and population health and invest in upstream care models. Details about the Provider Directed Payment Program will be discussed during the webinar; the program application and other materials will be posted on the DHCS website in the future. Please email ept@dhcs.ca.gov with any questions.​​ 

DHCSカバレッジアンバサダー:トレーナー養成ウェビナー​​ 

On August 31, from 10 to 11:30 a.m., DHCS will host a webinar on Coverage Ambassadors: Train the Trainer. The webinar will serve as a training session for Coverage Ambassadors to better assist their communities as California resumes standard Medi-Cal operations and communicates the importance of members renewing their Medi-Cal coverage. The webinar will also describe the resources available and how to use them. For more information, visit the Coverage Ambassadors Coverage Ambassadors webpage. Join the Coverage Ambassadors mailing list to receive the latest information and updated toolkits as they become available.​​ 

介護施設の資金調達改革ウェビナー​​ 

On September 7, from 2 to 3 p.m., DHCS will host a virtual stakeholder webinar to discuss the development of the Skilled Nursing Facility Workforce Standards Program and provide updates on other nursing facility financing reform programs authorized by Assembly Bill 186 (Chapter 46, Statutes of 2022). Stakeholder input will be accepted. Additional information is available on the Nursing Facility Financing Reform (AB 186) webpage.​​ 

家族やコミュニティパートナー向けの子供向け補聴器カバレッジプログラム(HACCP)ウェビナー​​ 

On September 12, from 11 a.m. to 12 p.m., DHCS will host a HACCP webinar to share guidance with families and communities about applying for hearing aid coverage and helping children to maximizing their HACCP benefits once enrolled. DHCS welcomes newly interested families, those who are currently participating in HACCP, and community partners supporting families and children to join this webinar for program updates, tips, and a Q&A session. For more information, please visit www.dhcs.ca.gov/haccp.​​ 

ドゥーラ実装ワークグループ会議​​ 

9月14日午後12時から午後2時まで、DHCSは第3回ドゥーラ導入ワーキンググループ会議を開催します。会議の音声を聞くためのリンクは、8月31日までに、メディカル給付としてのドゥーラサービスに関するウェブページに掲載されます。今回の会議では、DHCS（保健医療サービス省）の出産ケア経路に関する提案とドゥーラの役割についての報告、および今後の会議の計画について話し合われます。この作業部会は、教育普及プログラムを通じてドゥーラサービスの利用可能性を高める方法を検討すること、ドゥーラサービスへの障壁を特定して最小限に抑えること、そしてドゥーラや会員への支払いや払い戻しの遅延に対処することを担当する。​​ 

医療従事者と聴覚専門家のためのウェビナー​​ 

On September 14, from 12 to 1 p.m., DHCS will host a HACCP webinar 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.​​ 

見逃した場合に備えて​​ 

カリフォルニア州、刑務所や麻薬裁判所でのオピオイド治療へのアクセスを拡大​​ 

On August 22, DHCS announced it will expand Medication Assisted Treatment (MAT) to jails and drug courts it will expand Medication Assisted Treatment (MAT) to jails and drug courts. The $2.9 million in funding will go to 29 counties to support the development or expansion of access to MAT. By bringing county teams together in a learning collaborative, county agencies and providers serving justice-involved residents can more effectively coordinate and further build system capacity to ensure access to effective treatment and recovery supports. This expansion will better serve residents in need, and MAT, specifically, has been shown to reduce criminal activity and reincarceration to better serve the entire community.​​ 

州がCalHOPEスクールイニシアチブパートナーシップを延長​​ 

On August 24, DHCS announced the extension of the CalHOPE Schools Initiative through June 30, 2024 the extension of the CalHOPE Schools Initiative through June 30, 2024. The initiative provides free resources for school personnel, youth, and parents surrounding three powerful films that address student social-emotional and mental health needs: A Trusted Space: Redirecting Grief to Growth, Angst: Building Resilience, and Stories of Hope Shorts.​​ 

Medi-Calの再決定に関するキャピトルウィークリーオピニオン​​ 

8月20日、キャピトル・ウィークリー紙はLAケアCEOのジョン・バックス氏の意見を掲載した。LA Careは、ロサンゼルス郡におけるメディカル（Medi-Cal）のマネージドケアプランの一つです。バックス氏は、「近隣住民、政府の協力者、地域社会の擁護者など、私たち全員が、友人や近隣住民がメディカル（Medi-Cal）による保険に加入し続けられるよう、できる限りのことをすべきだ」と呼びかけた。​​ 

メディカル加入者の方々と接する際には、保険適用を継続するための役立つヒントをぜひお伝えください。資格更新期限が6月か7月だった場合、まだ間に合います。彼らは本日中にメディカルの更新書類一式を地元の郡事務所に返送することで、元の更新日に遡って保険適用を再開することができます。また、メディカル加入者が過去数年以内に転居したり、連絡先情報が変更された場合は、重要な更新情報を連絡できるよう、居住地の郡事務所に最新の情報が登録されていることを確認してください。また、加入者が黄色の封筒に入ったメディカル（Medi-Cal）の更新書類一式を郵送で受け取った場合は、更新書類を返送することで、自身と家族の保障を継続するために迅速に行動する必要があります。​​