4월 1, 2025
인기 뉴스
DHCS, 최신 강화된 케어 관리 및 커뮤니티 지원 분기별 보고서 발표
On March 27, DHCS released the latest Enhanced Care Management (ECM) and Community Supports quarterly report summarizing utilization data from July 2024 through September 2024. Key highlights from the report include:
- 지속적인 성장: 2022년 1월 ECM이 출시된 이후, 279,824명의 고유 Medi-Cal 회원이 ECM 혜택에 성공적으로 등록했습니다. 2024년 3분기에만 143,188명의 고유 회원이 ECM 혜택에 액세스했으며, 이는 2024년 2분기보다 13% 증가한 수치입니다.
- 청소년 참여: 2024년 3분기에는 21세 미만의 어린이와 청소년이 28,342명이 ECM 혜택을 이용했으며, 이는 2024년 2분기 대비 13% 증가한 수치입니다.
- 커뮤니티 지원 이용 현황: 약 296,500명의 메디칼 회원이 커뮤니티 지원을 이용했으며, 총 754,000건 이상의 서비스가 제공되었습니다. 2024년 3분기에만 136,031명의 고유 회원이 커뮤니티 지원을 받았으며, 이는 2024년 2분기보다 7.5% 증가한 수치입니다.
- 서비스 접근성 향상: 2024년 3분기까지 Medi-Cal 가입자의 거의 90%가 14개 커뮤니티 지원 서비스 중 10개 이상을 이용할 수 있게 되었습니다. 회원의 41% 이상이 전체 서비스 제품군을 이용하고 있습니다.
- 주요 서비스 이용 현황: 커뮤니티 지원을 이용하는 회원 중 61% 이상이 의료 맞춤형 식사/의료 지원 식품을 이용했으며, 약 32%는 주거 트리오(주거 전환 탐색 서비스, 주택 임차 및 유지 서비스, 주택 보증금)의 서비스를 한 가지 이상 이용했습니다.
이 최신 ECM 및 커뮤니티 지원 이행 보고서는 주 전역의 카운티에서 추가 대상 인구가 ECM을 받을 수 있게 되고 커뮤니티 지원 서비스가 추가로 제공됨에 따라 분기별 이용률이 지속적으로 증가한 것으로 나타났습니다. DHCS는 향후 몇 개월 및 몇 년 동안 ECM 및 커뮤니티 지원 전반에서 더 많은 등록이 증가할 것으로 예상하고 있습니다. 2025년에도 DHCS는 ECM 및 커뮤니티 지원 프로그램 모니터링 노력의 확대, 강력한 이해관계자 참여, 정책 설계 개선을 통해 이러한 성장을 지속적으로 지원하고 유지할 것입니다.
프로그램 업데이트
지역 사회 보건 종사자
Effective April 1, DHCS updated Medi-Cal’s existing Community Health Worker (CHW) policy to allow supervising Medi-Cal providers to bill for covered CHW services provided by CHWs using two new Healthcare Common Procedure Coding System (HCPCS) codes recently added by the Centers for Medicare & Medicaid Services (CMS). DHCS is updating this policy to allow CHWs to better address the economic and social conditions that influence Medi-Cal members and community health, such as food, housing, and transportation insecurities and access to essential utilities. DHCS’ updated CHW policy aims to more effectively support and promote improved health outcomes for Medi-Cal members by addressing needs affected by social drivers of health. DHCS also issued a State Plan Amendment Public Notice to set the rates for these two codes to 100 percent of the Medicare rate, pursuant to Welfare & Institutions Code Section 14105.25.
Additionally, on April 1, DHCS issued a statewide standing recommendation that all Medi-Cal members who meet defined eligibility criteria for receiving CHW services would benefit from CHW services. This standing recommendation, issued to improve access and reduce barriers to Medi-Cal members receiving and Medi-Cal providers rendering CHW services, is signed by Dr. Karen Mark, DHCS’ Medical Director for Policy and Evaluation. Consistent with existing policy, this standing recommendation authorizes CHWs to provide covered Medi-Cal CHW services, including health education, health navigation, screening and assessment, and individual support and advocacy.
팀에 합류하세요
DHCS는 재능 있고 의욕적인 인재를 찾고 있습니다:
- Chief of the Benefits Division (BD). The Chief of BD leads the development, implementation, and administration of medical coverage policies for health care services provided by the state’s Medi-Cal program. The Chief also oversees several specialty programs within Health Care Benefits and Eligibility, including Every Woman Counts, Prostate Cancer Treatment, and Hearing Aid Coverage for Children. Applications must be submitted by April 18.
DHCS는 계약, 감사, 매니지드 케어, 인구 건강 관리 및 기타 팀에서도 채용을 진행하고 있습니다. 자세한 내용은 CalCareers 웹사이트를 참조하세요.
예정된 이해관계자 회의 및 웨비나
DHCS posts upcoming public meetings on the Calendar of Events.
강력한 시작 & 비욘드 파트너 웨비나
On April 2, from 12 to 12:45 p.m. PDT, California Surgeon General Dr. Diana E. Ramos will host the next Strong Start & Beyond partner webinar on prevention to improve lifelong health. Strong Start & Beyond is a bold movement to reduce California’s maternal mortality rate by 50 percent by December 2026. By leveraging the state’s investments and partnerships, we can foster awareness, encourage active participation in health, and build access to resources for mothers, pregnant people, and their families. Joining Dr. Ramos are Dr. Erica Pan, California Department of Public Health Director and State Public Health Officer; Dr. Bernadette Lim, Founder and Executive Director of the Freedom Community Clinic; and Dr. Atul Nakhasi, Transformational Physician Executive. Please contact the Office of the California Surgeon General if you have any questions.
소비자 중심 이해관계자 워킹그룹(CFSW)
On April 4, from 10 to 11:30 a.m. PDT, DHCS will convene the CFSW, which provides stakeholders an opportunity to review and provide feedback on a variety of consumer messaging materials. The forum focuses on eligibility and enrollment-related activities and strives to offer an open discussion on Medi-Cal policies and functionality. Meeting materials, including the meeting agenda, will be posted by April 2 on the DHCS Consumer-Focused Stakeholder Workgroup webpage.
California Children’s Services (CCS) Advisory Group Meeting
On April 9, from 1 to 4 p.m. PDT, DHCS will host the CCS Advisory Group quarterly meeting (advance registration required). DHCS and the CCS Advisory Group partner to ensure children in the CCS/Whole Child Model (WCM) program receive appropriate and timely access to quality care. Agenda topics include updates on 2025 priorities, including the 2025 WCM expansion; county compliance, monitoring and oversight; and Medi-Cal Rx pediatric integration. Additional information and meeting details are available on the CCS Advisory Group webpage.
둘라 구현 이해관계자 워크그룹
On April 11, from 10 a.m. to 12 p.m. PDT, DHCS will host the next Doula Implementation Stakeholder Workgroup meeting, as required by Senate Bill 65 (Statutes of 2021, Chapter 449), to examine the implementation of the Medi-Cal doula benefit, in accordance with section 14132.24 of the Welfare and Institutions Code. The meeting will be held at 1501 Capitol Avenue, Sacramento, CA, and is open to the public. The link for this meeting will be available on the DHCS Doula Implementation Stakeholder Workgroup webpage. The workgroup will discuss ways to minimize barriers to doula services and continue discussions regarding the workgroup’s report to the Legislature, which must be posted on DHCS’ website by July 1, 2025.
의료 접근성 보호법(PAHCA)-이해관계자 자문 위원회(SAC)
On April 14, from 11:30 a.m. to 3:30 p.m. PDT, DHCS will host the PAHCA-SAC meeting (advance registration for online participation required) at 1700 K Street (first-floor conference room 17.1014), Sacramento. The committee is responsible for advising DHCS on developing and implementing components of the Protect Access to Health Care Act of 2024 (Proposition 35). For general inquiries or to receive more information about meetings, please email DHCSPAHCA@dhcs.ca.gov.
전통적 건강 관리 관행의 혜택 구현
On April 22, DHCS will present an overview of Behavioral Health Information Notice (BHIN) 25-007 – Traditional Health Care Practices Benefit Implementation at the Tribes and Indian Health Program Representatives meeting (advance registration required). The presentation is open to the public and will review policy guidance to support Indian Health Care Providers and Drug Med-Cal Organized Delivery System counties in implementing this new benefit. Attendees are encouraged to submit questions in advance to traditionalhealing@dhcs.ca.gov with the subject line “Traditional Health Care Practices Implementation.” For questions about traditional health care practices or this BHIN, please email traditionalhealing@dhcs.ca.gov.
놓친 경우를 대비하여
DHCS, 오피오이드 사용 장애 치료 어워드 발표
On March 25, DHCS awarded $800,000 to two Local Emergency Medical Service Agencies to foster low-barrier access to clinically proven opioid use disorder (OUD) treatment for patients in an emergency medical services (EMS) setting who are at risk of overdose and often do not have access to services in other settings. The grants—awarded through the Emergency Medical Services Buprenorphine Use Pilot Program (EMSBUP) to the Stanislaus County EMS Agency and Ventura County EMS Agency—will enable these two agencies to address substance use disorder as a treatable emergency condition, utilizing paramedics to identify and treat patients who would benefit from medications for addiction treatment (MAT). MAT is the use of medications in combination with counseling and behavioral therapies, which is effective in treating OUDs and helping some people sustain recovery.
지금 신청하세요: 접근성 제공 및 보건 혁신(PATH) 역량 및 인프라 전환, 확장 및 개발(CITED) 4라운드 지원서 접수
On January 6, DHCS opened the PATH CITED Round 4 application window, which includes funding opportunities to support the implementation of the new transitional rent Community Support. 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. All organizations providing the transitional rent Community Support must do so in partnership with their county behavioral health department. To demonstrate this partnership, all CITED applicants planning to request funding to support the transitional rent Community Support must also submit a Letter of Support in collaboration with the county behavioral health department.
The deadline to apply for PATH CITED Round 4 funding is 11:59 p.m. PDT on May 2, 2025. The guidance document and application are available on the PATH CITED webpage. Please send any questions to cited@ca-path.com.