1월 13, 2025
인기 뉴스
남부 캘리포니아 산불에 대한 DHCS 대응
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.
캘리포니아주 비상사태관리국과 재활국은 특정 장애를 가진 개인을 위한 정보와 비상 대비 요령을 담은 ‘장애인 비상 대비 가이드/툴킷’을 여러 언어로 제작하여 제공하고 있습니다. 산불에 대한 실시간 소식을 확인하려면 Cal Fire 와 지역 비상 당국의 소식을 팔로우하고,calalerts.org에서 지역 경보 서비스를 신청하세요. 자세한 내용은 아래의 추가 자료를 참고해 주십시오:
- CA.gov/LAfires – 로스앤젤레스 산불로 피해를 입은 캘리포니아 주민들을 위한 지원 정보를 제공합니다.
- Listos California – 우편번호나 위치를 입력하면 캘리포니아 주민들이 해당 지역의 경보 시스템에 연결될 수 있도록 돕는 긴급 경보 등록 페이지를 제공합니다.
- 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.
- 미국 약물남용 및 정신건강 서비스국(SAMHSA) 산불 지원 자료 – 산불 및 기타 재난으로 피해를 입은 생존자, 가족, 현장 대응 요원, 복구 인력을 지원합니다. 이 정보에는 정서적 고통의 징후, 산불 발생 후 고통에 더 취약할 수 있는 집단, 그리고 추가 정보 및 지원을 받을 수 있는 관련 자료 링크가 포함되어 있습니다.
- 미국 질병통제예방센터(CDC) – 산불을 비롯한 각종 위험 요소에 대한 정보를 제공하며, 산불 발생 후 안전을 지키는 방법과 산불 및 기타 재난과 관련된 위험 요소를 이해하고 대처하는 방법에 대한 정보로 연결되는 링크를 제공합니다.
- 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.
DHCS는 이 어려운 시기에 지역사회를 지원하기 위해 최선을 다하고 있으며 현장의 응급 구조대원 및 의료진에게 감사를 표합니다. 안전을 유지하고, 공식 업데이트를 통해 최신 정보를 확인하고, 현지 공무원이 내린 대피 명령을 따르세요.
DHCS 2025-26 예산안
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.
프로그램 업데이트
다이애딕 서비스에 대한 주 계획 수정안(SPA) 승인
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.
새로운 패밀리 PACT 포털로 전환
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 소아과 통합(PI)을 위한 정책 조정
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:
- 60일 이상의 기간 동안, 청구가 거부 코드 75(PA 필요)로 거부될 수 있지만 Medi-Cal 가입자에게 최근 청구 내역이 있는 경우, 추가 PA 없이 청구가 지급됩니다. DHCS는 이러한 접근 방식을 통해 제공자와 처방자가 내부 프로세스를 조정하고 PI 요건을 더 잘 계획하고 사전 예방적 PA를 제출할 수 있는 추가 시간을 확보하고자 합니다.
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.
팀에 합류하세요
DHCS는 재능 있고 의욕적인 인재를 찾고 있습니다:
- 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.
예정된 이해관계자 회의 및 웨비나
행동 건강 혁신 품질 및 형평성 자문 위원회 웨비나
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.
스마일, 캘리포니아 웨비나: ‘전국 어린이 치아 건강의 달’을 맞아 메디칼 치과 혜택 홍보
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 피해 감소 서밋
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.
커버리지 앰배서더 웨비나 시리즈: 법무부 관련 재입소 이니셔티브 및 아동 및 청소년 행동 건강 이니셔티브 업데이트
1월 30일 오전 11시부터 11시 45분까지 PST와 DHCS는 DHCS 보험 가입 홍보대사들을 대상으로 웨비나를 개최할 예정입니다(사전 등록 필수). 이번 웨비나에서는 사법 관련 재사회화 이니셔티브(Justice-Involved Reentry Initiative)와 아동·청소년 행동 건강 이니셔티브(CYBHI)에 대한 최신 정보를 제공할 예정입니다. 이 자료는 현재 구치소, 청소년 교정 시설 또는 교도소에 수감 중이거나 과거에 수감된 적이 있으며, 일반인보다 건강 악화, 부상 및 사망 위험이 더 높은 사법 시스템 관련 대상자에 대한 정보를 제공할 것입니다. 이 보고서는 캘리포니아주가 출소자들이 지역사회로 복귀할 준비를 하는 과정에서 건강 상태가 좋지 않은 이들의 상황을 개선하기 위해 취하고 있는 주요 조치들에 초점을 맞출 것이며, 특히 이들이 출소 후에도 의료보험 혜택을 지속적으로 받을 수 있도록 보장하는 데 주력할 것입니다. 또한, 커버리지 앰배서더들은 아동·청소년·가족 건강 보험(CYBHI)을 통해 아동기 종합 지원 서비스가 어떻게 확대될지, 그리고 이를 통해 아동, 청소년 및 가족에게 정신 건강 서비스가 어떻게 제공될지 배우게 될 것입니다. DHCS 보장 홍보대사에 대해 자세히 알아보거나, 보장 홍보대사로 등록하세요.
자궁 내 장치(IUD) 및 피임 임플란트 삽입 교육
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.
놓친 경우를 대비하여
CMS, 혁신적 모성 건강 모델에 DHCS 선정
1월 6일, CMS는 캘리포니아주의 ‘메디케어·메디케이드 혁신 센터(CMMI) ’ 산하 ‘산모 건강 혁신(TMaH) (TMaH) 모델에 대한 캘리포니아주의 참여를 승인했습니다. 이 모델은 가치 기반 지불(VBP) 모델을 통해 뒷받침되는 근거 기반 중재의 효과적인 실행이 산모의 건강 결과를 개선하고 메디케이드 및 CHIP의 프로그램 지출을 줄일 수 있는지 검증하기 위해 고안된 10년 간의 메디케이드 및 아동 건강 보험 프로그램(CHIP) 제공 및 지불 모델입니다.
DHCS는 5개 카운티에서 TMaH 모델을 구현할 예정입니다: 프레즈노, 컨, 킹스, 마데라, 툴라레입니다. TMaH 모델은 산모 건강 분야에서 나타나는 인종 및 민족 간 격차를 해소하고, 모든 임산부, 특히 저소득 지역 주민들이 임신과 출산 과정을 안전하게 보낼 수 있도록 필요한 지원을 받을 수 있도록 보장하려는 캘리포니아주의 포괄적인 노력의 일환입니다.
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. 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 기술 지원(TA) 마켓플레이스 5라운드 벤더 신청서
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.
DHCS는 5라운드 조달 기간 동안 새로운 규격품 프로젝트 또는 기존 규격품 프로젝트의 변경에 대한 제출을 받지 않습니다. 대신, 5라운드 신청은 기존 TA 공급업체로부터 온디맨드 리소스를 요청할 것입니다. TA 마켓플레이스 벤더 웹페이지를 방문하여 안내 문서에 액세스하고 신청하세요. 질문은 ta-marketplace@ca-path.com 으로 제출해 주세요.