トップニュース​​ 

南カリフォルニアの山火事に対するDHCSの対応​​ 

On January 7 and 8, multiple fires erupted in the Los Angeles County area. DHCS is actively engaged in addressing the impacts of the fires. DHCS is working alongside local and federal partners to support health care facilities, ensure continuity of care, and prioritize the safety of affected residents. Specifically, DHCS is coordinating with facilities to manage evacuations and maintain care for residents and is supporting health care providers as they navigate road closures and other disruptions.​​ 

DHCS’ Emergency and Disaster Assistance Questions & Answers webpage provides guidance and contact information for Medi-Cal members and providers during emergencies. It includes information related to accessing medical care, filling prescriptions, securing transportation, and obtaining support for individuals with specific needs, including people in assisted living facilities and individuals receiving Home and Community-Based Alternatives services.​​ 

カリフォルニア州知事緊急事態対策室とリハビリテーション局は、障害のある人々のための緊急時対応ガイド／ツールキットを多言語で作成しました。このガイド／ツールキットには、特定の障害を持つ人々向けの情報や緊急時対応のヒントが含まれています。カリフォルニア州森林消防局（Cal Fire）および地元の緊急対応機関のウェブサイトで山火事に関するリアルタイムの最新情報を入手し、 calalerts.orgで地域の警報サービスに登録してください。詳細については、以下の追加資料をご覧ください。​​ 

• CA.gov/LAfires – ロサンゼルス山火事の影響を受けたカリフォルニア州民向けの情報を提供しています。​​ 
• Listos Californiaは、カリフォルニア州民が郵便番号または所在地に基づいて地域の警報システムに接続できるよう、緊急警報登録ページを提供しています。​​ 
• Ready.Gov – Provides guidance for individuals and families to prepare for, respond to, and recover from wildfire events. The resource includes tips for staying safe during wildfires and returning home once an area is declared safe.​​ 
• 薬物乱用・精神保健サービス局の山火事関連リソース– 山火事やその他の災害の影響を受けた生存者、家族、対応者、復旧作業員を支援します。掲載されている情報には、精神的苦痛の兆候、山火事後に精神的苦痛を受けやすい可能性のある人々、およびより詳しい情報や支援のためのリソースへのリンクが含まれています。​​ 
• 疾病対策センター（CDC ）は、山火事を含む危険に関する情報を提供し、山火事後の安全確保に関する情報や、山火事やその他の災害に関連する危険について学び、対処する方法に関する情報へのリンクを提供しています。​​ 
• American Red Cross – Suggests ways for people who have experienced a residential fire to take care of themselves and their loved ones and to help people who may need assistance. The site lists four steps to take right after a fire and includes links to more information about returning home safely after a fire and recovering emotionally and financially.
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DHCSは、この困難な時期にコミュニティを支援することに引き続き取り組んでおり、現場の緊急対応者と医療従事者に感謝しています。 安全を確保し、最新情報については公式の最新情報を確認し、地元当局が発令した避難指示に従ってください。​​ 

提案されたDHCS2025-26予算​​ 

The proposed 2025-26 Governor’s Budget for DHCS allocates $193.4 billion in total funds, including $42.8 billion from the General Fund, and supports 4,821.5 positions. This budget reflects the Administration’s continued investment in transforming Medi-Cal into a coordinated, person-centered, and equitable health system for Californians.​​ 

The budget prioritizes modernizing the health care delivery system, with a focus on improving accountability and transparency and strengthening community-based care. These strategic investments support DHCS’ purpose to provide equitable access to quality health care, leading to a healthy California for all.​​ 

プログラムの最新情報​​ 

州計画修正案(SPA)がダイアディックサービスで承認されました​​ 

On January 6, the federal Centers for Medicare & Medicaid Services (CMS) approved SPA #23-0010, which authorizes DHCS to utilize an Alternative Payment Methodology (APM) to pay Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHC), and Tribal Health Programs, which includes Tribal FQHCs and Indian Health Services-Memorandum of Understanding 638 Clinics, at the Medi-Cal fee-for-service (FFS) rate for dyadic services in certain circumstances. FQHCs and RHCs will receive a separate payment for dyadic services in addition to their standard Prospective Payment Services/All-Inclusive Rate billing payments in certain circumstances.​​ 

Dyadic care refers to serving both the parent/caregiver and child together as a dyad and is a form of treatment that targets family well-being to support healthy child development and mental health. Dyadic care fosters team-based approaches to meeting family needs, including addressing mental health and social support concerns, and it broadens and improves the delivery of pediatric preventive care. Offering parents and caregivers mental health services when they bring their babies and children to the doctor is an opportunity to expand access, which can improve outcomes. DHCS will release additional policy guidance in a future Medi-Cal Provider Manual update.​​ 

新しいファミリーPACTポータルへの移行​​ 

From January 13 through February 2, DHCS’ Family Planning, Access, Care and Treatment (PACT) program’s client eligibility and enrollment transaction services will transition from the Health Access Programs (HAP) Client Eligibility System to a new Family PACT portal. The HAP Client Eligibility System will be disabled on February 3, after which all Family PACT client enrollment, changes, and deactivations will be completed exclusively through the California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS) Family PACT portal. To support Family PACT providers during this transition, Family PACT providers will have access to comprehensive training materials and webinars through the Family PACT Online Training Center Learning Management System. These resources will ensure that providers are equipped to use the Family PACT portal effectively before its launch.​​ 

Medi-Cal Rx Pediatric Integration(PI)のポリシー調整​​ 

DHCS is making an important policy adjustment related to Medi-Cal Rx’s initiative for the reinstatement of prior authorization (PA) requirements and utilization management (UM) claim edits for Medi-Cal members 21 years of age and younger, including members of the California Children’s Services (CCS) program. This initiative, commonly referred to as PI, will be implemented on January 31. To directly address and help mitigate stakeholder concerns about the volume of PA requests and potential barriers to timely access that may occur because of PI implementation, as well as recognize the advanced credentialing of CCS Panel Provider Authority, DHCS is adjusting its PI policy approach for continuing therapies/prescriptions PI as follows:​​ 

• 60日以上の期間、請求が拒否コード75(PAが必要)で拒否されるが、Medi-Calメンバーが最近の請求履歴を持っている場合、請求は追加のPAを必要とせずに支払われます。 DHCSは、このアプローチにより、プロバイダーと処方者が内部プロセスを調整し、PI要件をより適切に計画し、プロアクティブなPAを提出するための追加の時間を提供することを意図しています。​​ 

DHCS will release additional, more detailed information through the Medi-Cal Rx website and will update various existing resource documents on a flow basis. DHCS remains committed to ensuring Medi-Cal members, providers, and other partners are supported so pharmacy benefits can be accessed in a safe, timely, and equitable manner. DHCS will continue to support and engage stakeholders on PI.​​ 

私たちのチームに参加しませんか​​ 

DHCSは、次のような役割を果たす才能と意欲のある個人を求めています。​​ 

• Chief of the Pharmacy Benefits Division. The Chief is responsible for overseeing the development and implementation of policy, services, and coverage criteria for outpatient pharmacy services for the state’s Medi-Cal program. This includes providing policy direction for Medi-Cal Rx as well as invoicing and collecting federal and state supplemental drug rebates. The Chief of PBD also leads the development of nutrition, vision care, and medical supply benefits and oversees the administration of the Medi-Cal Pharmacy and Vision Benefit programs. Applications must be submitted by February 7.​​ 

DHCS is also hiring for its accounting, program accountability, behavioral health, managed care quality and monitoring, eligibility, and other teams. For more information, please visit the CalCareers website.​​ 

今後のステークホルダーミーティングとウェビナー​​ 

行動健康変革、品質、公平性諮問委員会ウェビナー​​ 

On January 15, from 9 to 11 a.m. PST, DHCS will host the third Behavioral Health Transformation Quality and Equity Advisory Committee webinar. Once registered, you will receive a confirmation email with the webinar link and additional details. DHCS is pleased to continue its collaborative efforts to measure and evaluate the quality and efficacy of behavioral health services and programs. These public webinars provide an opportunity for participants to offer input for DHCS consideration. Visit the Behavioral Health Transformation Stakeholder Engagement webpage for more information about the webinars and additional resources. Please send questions related to Behavioral Health Transformation and/or the webinars to BHTinfo@dhcs.ca.gov.​​ 

スマイル・カリフォルニアのウェビナー：全米児童歯科健康月間におけるメディカル歯科給付の促進​​ 

On January 22, from 11 a.m. to 12 p.m. PST, Smile, California will host a webinar to kick off National Children’s Dental Health Month (NCDHM) in February. The webinar will feature a preview of the new Healthy Smile Land materials, strategies for promoting Medi-Cal dental services during NCDHM, and resources for accessing and distributing outreach materials. Attendees will also be able to connect with Smile, California representatives to ask about Medi-Cal dental benefits.​​ 

DHCSハームリダクションサミット​​ 

DHCS collaborates with communities across the state to promote harm reduction and low-barrier, patient-centered care within California’s substance use disorder treatment system. DHCS encourages substance use disorder treatment providers and staff (including social workers, peers, front desk staff, case managers, nurses, physicians, and all staff in substance use disorder treatment settings) to attend and learn about incorporating the tenets of harm reduction into substance use disorder treatment. Summits will be held in Fresno County (January 23), San Diego County (February 11), and Los Angeles County (February 27). Register on the event website.​​ 

カバレッジアンバサダーウェビナーシリーズ:正義に関与する再入国イニシアチブと子供と若者の行動健康イニシアチブの最新情報​​ 

1月30日午前11時から11時45分までPST、DHCSはDHCSカバレッジアンバサダー向けのウェビナーを開催します（事前登録が必要です）。このウェビナーでは、司法制度に関与した人々の社会復帰支援イニシアチブと、児童・青少年行動健康イニシアチブ（CYBHI）に関する最新情報を提供します。このシステムは、現在または過去に刑務所、少年矯正施設、または拘置所に収容されていた、司法制度に関与した個人に関する情報を提供するものであり、これらの個人は一般の人々よりも健康状態の悪化、負傷、死亡のリスクが高い。この報告書は、カリフォルニア州が、釈放後に地域社会への復帰を準備する人々の健康状態を改善するために講じている重要な措置に焦点を当て、釈放後も医療保障が継続されるようにするための取り組みを紹介する。さらに、カバレッジ・アンバサダーは、CYBHIを通じて幼児期の包括的な支援サービスがどのように拡大されるかを学びます。CYBHIは、子ども、若者、そして家族にメンタルヘルスサービスを提供します。DHCSカバレッジアンバサダーについて詳しく知りたい場合、またはカバレッジアンバサダーに登録したい場合は、こちらをご覧ください。​​ 

子宮内避妊器具(IUD)と避妊インプラント挿入トレーニング​​ 

On February 19, from 7:30 a.m. to 5:30 p.m. PST, DHCS’ Office of Family Planning will host an in-person Comprehensive IUD and Contraceptive Implant Insertion Training. The training, which is currently full, includes information about patient method selection, counseling and consent, techniques for using instruments during IUD placement, and instruction on the insertion of each type of IUD currently available in the United States. Additional topics to be covered include management of side effects, tips for managing difficult placements, pain management principles for office procedures, and prevention and management of complications. Please see IUD & Implant Resources for more information.​​ 

見逃した場合に備えて​​ 

CMSは、革新的な変革的な妊産婦の健康モデルのためにDHCSを選択しました​​ 

1月6日、CMSは、カリフォルニア州がメディケア・メディケイド革新センターの「母体健康変革（TMaH）モデル」に参加することを承認した。TMaHモデルは、エビデンスに基づいた介入を効果的に実施し、価値に基づく支払い（VBP）モデルによって維持することで、母体の健康状態を改善し、メディケイドとCHIPのプログラム支出を削減できるかどうかを検証するために設計された、10年間のメディケイドおよび児童健康保険プログラム（CHIP）の提供および支払いモデルである。​​ 

DHCSは、フレズノ、カーン、キングス、マデラ、トゥーレアの5つの郡でTMaHモデルを導入する予定です。TMaHモデルは、カリフォルニア州が母体保健における人種的・民族的な格差に対処し、すべての妊婦、特に低所得者層の人々が、妊娠と出産を安全に乗り切るために必要な支援を受けられるようにするという、より広範な取り組みの一環です。​​ 

オープン中:アクセスの提供と医療の変革(PATH)容量とインフラストラクチャの移行、拡張、開発(CITED)ラウンド4アプリケーション​​ 

On January 6, DHCS opened the PATH CITED Round 4 application window. The PATH CITED initiative provides funding to build the capacity and infrastructure of on-the-ground partners including community-based organizations, hospitals, county agencies, Tribes, and others, to successfully participate in Medi-Cal. Nearly $158 million is available for Round 4. The deadline to apply for PATH CITED Round 4 funding is 11:59 p.m. PST on March 7, 2025. The guidance document and application can be found by visiting the PATH CITED webpage. Please submit questions to cited@ca-path.com.​​ 

PATH Technical Assistance (TA) Marketplace Round 5 ベンダーアプリケーション​​ 

On January 1, DHCS opened the PATH TA Marketplace Round 5 vendor application. The deadline to apply is January 31. Round 5 will be a targeted procurement for new and existing hands-on service offerings that address TA Marketplace gaps. The Round 5 procurement will seek TA vendor applications for all seven TA domains, but it will focus on services for the following provider types: rural providers, Tribal and Indian health care providers, maternal and child-serving providers, and transitional rent providers.​​ 

DHCSは、ラウンド5の調達期間中、新しい既製プロジェクトの提出または既存の既製プロジェクトへの変更を受け付けません。 代わりに、ラウンド5アプリケーションは、既存のTAベンダーからオンデマンドのリソースを求めます。 TA Marketplace VendorのWebページにアクセスして、ガイダンスドキュメントにアクセスし、申請してください。ta-marketplace@ca-path.com に質問を送信してください。
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