November 10, 2023 – Stakeholder News
トップニュース
Focus (POF) Focused Populations of Children and Youth Populations of Focus(POF)のためのEnhanced Care Management(ECM)(ECM)(英語)
On November 3, DHCS published the ECM for Children and Youth POF Spotlight, which is designed to help contracted and prospective ECM providers serving children and youth develop and enhance their ECM models. It is also intended to support provider organizations that are considering if ECM for children and youth is right for them. The new resource outlines key ECM policies for the children and youth POFs, including areas where plans can leverage presumptive authorization; member scenarios that illustrate how to deliver ECM for the children and youth POFs, with examples of how Community Supports can be integrated to best serve children, youth, and caregivers; and guidance on how prospective providers can get started, with a collection of the key resources and funding opportunities.
DHCS is committed to providing technical assistance and support to California’s growing network of ECM providers. This is the first in a series of ECM spotlights that DHCS plans to release over the coming months to support stakeholders seeking more details on how providers tailor ECM to meet the needs of different POFs. For more information, visit the ECM and Community Supports webpage.
プログラムの最新情報
Medi-Calとフォスターケアの最新情報
DHCS developed a resource to provide updates on foster care youth in Medi-Cal. The resource covers changes to managed care for the child welfare population in 2024, Enhanced Care Management and Community Supports transition policies, the 2024 Medi-Cal managed care plan (MCP) contract and memorandum of understanding requirements, and Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment child and youth components.
Doula Services のアップデートをオンラインで公開
11月3日、DHCS はDoula ServicesをMedi-Cal Benefitのウェブページとして更新しました。 更新されたウェブページには、DHCSメディカルディレクターのカレン・マーク博士が新たに発行したドゥーラサービスに関する継続的な推奨事項など、Medi-Calメンバーとドゥーラプロバイダーに役立つリソースが含まれています。 この現行の推奨事項は、予防サービスとしてのドゥーラサービスの推奨に関する連邦政府の要件を満たしています。
ウェブページの更新には、ドゥーラとMedi-Calのメンバー向けの新しいよくある質問、承認されたドゥーラプロバイダーの申請と登録された個々のプロバイダーの総数、および出産と母体の結果に対するドゥーラサービスの利点を裏付ける証拠に関する情報も含まれています。 ドゥーラサービスに関するご質問は 、DoulaBenefit@dhcs.ca.gov までメールでお問い合わせください。
私たちのチームに参加しませんか
DHCSでは募集中です! DHCSには、次のような機会があります。
- Chief of the Financial Management Division within Fiscal (final filing date (FFD) is November 15). This executive role develops policies and procedures to ensure fiscal integrity, transparency, and accountability of approximately $150 billion in annual state and federal funding for DHCS.
- Behavioral Health Policy Medical Consultant II within Behavioral Health (FFD is November 27). This position provides clinical expertise and strategic advice to DHCS Behavioral Health leadership on the development and implementation of policy and initiatives designed to strengthen behavioral health care access, quality, and service delivery.
- Senior Assistant Chief Counsel for Fiscal and Financing within the Office of Legal Services (FFD is November 28). This position is responsible for complex legal counsel and litigation strategy formulation regarding DHCS fiscal, financial management, and health care policy.
- 法務サービス局内のヘルスケアデリバリーシステム担当シニアアシスタントチーフカウンセル(FFDは11月30日)。このポジションは、医療提供システムのさまざまな側面に関する複雑な法律顧問および訴訟戦略の策定を担当しています。
DHCS is also hiring for our human resources, auditing, health policy, and information technology 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
コミュニティをカバー:学校と家族のウェビナー
11月16日午後2時から3時まで、DHCSはウェビナーを開催します あなたのコミュニティをカバーする:学校と家族 (事前登録が必要です)。 このウェビナーは、学校のパートナーに、学生とその家族がMedi-Calのカバレッジを更新するのを支援するための重要な情報を提供します。 ウェビナーでは、学齢期の子供を持つ家族を引き込むための利用可能なアウトリーチリソースとベストプラクティスも取り上げます。
CBOおよびLHJウェビナーのMedi-Cal登録要件と手順
11月17日午前10時から11時30分まで、DHCSはウェビナー(事前登録が必要) を通じて公開ステークホルダーヒアリング を開催し、コミュニティベースの組織(CBO)および地域保健管轄区域(LHJ)プロバイダーのMedi-Cal登録要件と手順に関する規制当局の速報について話し合いますコミュニティ医療従事者および/または喘息予防サービスを提供します。 1月 9日より、 2024年、CBO、およびLHJプロバイダーは、Medi-Calのフィー・フォー・サービス・プログラムへの登録を希望し、PAVE(Provider Application and Validation for Enrollment)オンライン登録ポータルを通じて申請書を提出することができます。
書面によるコメント、質問、または提案は、ウェビナーチャットのヒアリング中に提出される場合があります。 出席できない方は、11月17日午後5時までにコメントを提出し、公開を検討する必要があります。 コメントを書面で提出する場合は、コメント投稿者と代表される組織/協会の両方がコメントで特定されていることを確認してください。 書面によるコメントは DHCSPEDStakeholder@dhcs.ca.gov に提出する必要があります。 DHCSは、寄せられたパブリックコメントに基づいて、 Medi-Cal および DHCS のWebサイトで最終速報を公開します。
CalAIM発達障害者のための中級介護施設(ICF / DD)カーブイン請求および支払いウェビナー
On November 17 at 1 p.m., DHCS will host the fourth in a series of educational webinars on the California Advancing and Innovating Medi-Cal (CalAIM) ICF/DD carve-in (advance registration required). These webinars outline changes to the ICF/DD carve-in policy requirements. Starting on January 1, 2024, all Medi-Cal MCPs will be required to cover and coordinate institutional long-term care for members residing in an ICF/DD. The webinar series will feature several topics, including ICF/DD carve-in 101, directed payment policy and payment requirements, the per diem rate, accommodation code changes, and best practices for billing and payment. ICF/DD home, Regional Center, and Medi-Cal managed care representatives are encouraged to attend. All webinars are open to the public.
If there are specific questions you would like addressed during the webinar, please submit them in advance using this registration form or by emailing them to LTCtransition@dhcs.ca.gov. Webinar materials, including recordings, and additional details about upcoming webinars are posted on the CalAIM ICF/DD Long-Term Care Carve-In webpage.
介護施設の資金調達改革ウェビナー
On November 17, from 3 p.m. to 4 p.m., DHCS will hold a virtual stakeholder webinar (advance registration required) to discuss the development of the Skilled Nursing Facility Workforce Standards Program, Accountability Sanctions Program, and Workforce & Quality Incentive Program (WQIP) authorized by Assembly Bill 186 (Chapter 46, Statutes of 2022). This meeting will also provide an opportunity for stakeholder input. Additional information is posted on DHCS’ 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 November 28, from 11 a.m. to 12 p.m., DHCS will host a HACCP webinar (advance registration required) to share guidance with families and communities about applying for hearing aid coverage and helping children to maximize their HACCP benefits once enrolled. DHCS welcomes newly interested families, as well as families currently participating in HACCP, and community partners supporting families and children to join this webinar for program updates, tips, and a question-and-answer session. For more information, please visit www.dhcs.ca.gov/haccp.
医療提供者と聴覚専門家のためのHACCPウェビナー
On December 19, from 12 to 1 p.m., DHCS will host a HACCP webinar (advance registration required) 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.
Medi-Cal資産排除ウェビナー
11月29日午後1時30分から午後2時30分まで、DHCSは、1月1日、2024日より、非修正調整総所得(MAGI)Medi-Calプログラムの資産排除に関するウェビナーを開催します。このイニシアチブが実施されると、長期介護やメディケア貯蓄プログラムなど、MAGI以外のすべてのプログラムの資産テストがなくなります。 このウェビナーでは、資産排除、実装計画、手続きの変更、およびアウトリーチ資料に関する背景情報を提供します。 詳細については、 非MAGI Medi-Calの資産制限の変更 に関するWebページをご覧ください。
CalAIM管理長期サービスおよびサポート(MLTSS)およびDuals統合ワークグループ仮想会議
On November 30 at 10 a.m., DHCS will virtually host the CalAIM MLTSS and Duals Integration Workgroup meeting (advance registration required). The workgroup serves as a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible members, and allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare.
Agenda topics will include reminders about the 2024 Medi-Cal transitions and noticing timelines, updates on Medi-Medi Plan outreach and the 2024 Dual Eligible Special Needs Plan Policy Guide development, July 2023 duals enrollment data, a spotlight presentation on the CalAIM recuperative care Community Support, and a presentation on the continuous coverage unwinding.
Background materials, transcripts, and video recordings of previous workgroup meetings, along with additional information about the workgroup, are posted on the CalAIM MLTSS and Duals Integration Workgroup webpage. For questions or comments, please email DHCS at info@calduals.org.
Medi-Calアダルトエクスパンションウェビナー
On December 4, from 11 a.m. to 12 p.m., DHCS will host a webinar on the adult expansion of Medi-Cal (advance registration required) for CBOs, MCPs, providers, and other interested stakeholders, including those representing consumers, immigration, health care, legal aid, and immigrant adults. DHCS is implementing this expansion pursuant to Senate Bill 184 (Chapter 47, Statutes of 2022) on January 1, 2024. When implemented, the expansion will provide individuals 26-49 years of age with full scope Medi-Cal benefits, regardless of citizenship or immigration status, if they meet all other Medi-Cal eligibility criteria.
The webinar, which will be live interpreted in Spanish, will provide background information about the expansion, implementation planning, noticing, outreach, and more. Individuals may also submit questions or request to register for the webinar by sending an email to AdultExpansion@dhcs.ca.gov.
見逃した場合に備えて
セクション1115デモンストレーション:BH-CONNECTおよびCalAIM移行賃料修正
On October 20, DHCS submitted to Centers for Medicare & Medicaid Services (CMS) the new Section 1115 demonstration request, entitled the California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) demonstration, and the proposed amendment to the CalAIM Section 1115 demonstration related to transitional rent services. Additionally, the federal public comment period will be open for BH-CONNECT and CalAIM transitional rent services from October 27 through November 26, 2023.
2024年1月Medi-CalMCP移行
As part of Medi-Cal transformation, some MCPs are changing on January 1, 2024, and approximately 1.2 million members will have new health plan options and/or will need to transition to new MCPs. Changing MCPs will not affect Medi-Cal member coverage or benefits. Members who transition to a new MCP are receiving notices about the transition. DHCS developed several resources to support members, providers, and other stakeholders with the transition, including the Managed Care Plan Transition Member webpage with a county “lookup” tool, links to member notices sent by Medi-Cal about MCP changes, frequently asked questions, and a Contact Us page for members to learn more about health plans and provider choices. There are also transition resources for providers and MCPs and stakeholders. More information about the transition is available in the 2024 Managed Care Plan Transition Policy Guide and Medi-Cal Eligibility Division Information Letter Number I 23-54.