2022년 6월 이해관계자 커뮤니케이션 업데이트로 돌아가기​​ 

자산 한도 - 수정되지 않은 조정 총소득(MAGI) Medi-Cal 메디칼​​ 

Assembly Bill (AB) 133 (Chapter 143, Statutes of 2021) authorizes a two-phased approach to eliminating the asset test for all non-MAGI Medi-Cal programs, including long-term care and the Medicare Savings Programs. Phase I will be implemented on July 1, and will increase asset limits to $130,000 per person and $65,000 per additional person being evaluated. Phase II will be implemented on January 1, 2024, and will eliminate the asset test. In November 2021, CMS approved State Plan Amendment 21-0053, and DHCS issued policy guidance to the counties regarding the Phase I implementation in an All County Welfare Directors Letter (ACWDL 21-31). DHCS has also submitted to CMS an application to amend the CalAIM Section 1115 demonstration waiver to permit California to increase, and eventually eliminate, the asset test for the Supplementary Security Income deemed coverage groups. DHCS published Medi-Cal Eligibility Division Information Letter (MEDIL I 22-02), which provides counties, advocacy groups, and other partners with global outreach messaging to use in their outreach activities regarding the increased asset limits as of July 1.​​ 

행동 건강 연속성 인프라 프로그램(BHCIP) 업데이트​​ 

BHCIP 3라운드: 출시 준비​​ 
1월 31일, DHCS는 캘리포니아 사회복지부(CDSS)와 협력하여 BHCIP 3라운드: 시작 준비 및 CDSS 커뮤니티 케어 확장(CCE) 프로그램 공동 신청 요청서(RFA)를 발표했습니다. 지원자는 펀딩 기회 중 하나 또는 둘 다에 지원할 수 있었습니다. BHCIP 3라운드: 출시 준비 신청 마감일은 4월 8일이었으며, 신청자들이 약 20억 달러를 신청한 가운데 신청서 검토가 진행 중입니다. DHCS는 6월에 BHCIP 3라운드: Launch Ready 어워드를 발표할 예정입니다.​​ 

BHCIP 신청자는 Medi-Cal 수혜자에게 서비스를 제공하는 환경에서 행동 건강 치료 및 서비스의 연속성을 통해 프로젝트 확장을 입증해야 하며, 프로젝트가 시행될 준비가 되었는지 확인하기 위한 유효한 계획 프로세스를 갖추고 있어야 합니다. DHCS는 BHCIP 3라운드: 출시 준비에 최대 5억 1850만 달러의 보조금을 지급할 예정이며, 2024년 6월까지 자금을 집행하고 2026년 12월까지 청산해야 합니다.​​   

BHCIP 4라운드: 어린이 및 청소년​​ 
BHCIP 4라운드: 아동 및 청소년은 임산부 및 산후조리원과 그 자녀, 어린이, 전환기 청소년(TAY) 및 그 가족을 포함한 25세 이하의 아동 및 청소년에 초점을 맞춥니다. 모든 신청자는 자신의 인프라 프로젝트가 이 인구만을 위한 행동 건강 서비스를 어떻게 확장할 수 있는지 입증해야 합니다. 이번 4차 경쟁 보조금 공모를 통해 DHCS는 아동 및 청소년 중심의 행동 건강 인프라 프로젝트에 4억 8,050만 달러를 지원할 예정입니다.  
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The RFA for Round 4: Children and Youth was released on June 1. DHCS has released a program update as a supplement to the upcoming RFA for BHCIP Round 4: Children and Youth funding. As was the case with Round 3: Launch Ready, applicants are required to undergo a pre-application consultation. They will be expected to demonstrate “project readiness”, as detailed in the forthcoming RFA, and will be funded according to which of three pre-construction phases their project is in. Full project funding will be contingent upon completion of all three phases of development planning. 
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DHCS was authorized through 2021 legislation to establish BHCIP and award $2.1 billion to construct, acquire, and expand properties and invest in mobile crisis infrastructure related to behavioral health. CDSS oversees the CCE program, which was established through AB 172 (Chapter 20, Statutes of 2021) as a companion effort, totaling $805 million. The CCE program focuses on the acquisition, construction, and rehabilitation of adult and senior care facilities that serve Supplemental Security Income/State Supplementary Payment and Cash Assistance Program for Immigrants applicants and recipients and other adults who are experiencing or at risk of homelessness. For more information, please visit the BHCIP project website or email BHCIP@dhcs.ca.gov.​​ 

행동 건강 연방 보조금 업데이트​​ 

DHCS는 최근 연방 자금 지원 기관인 약물 남용 및 정신 건강 서비스국에 2년차 중반 주 오피오이드 대응(SOR) II 진행 보고서를 제출했습니다. 2021년 9월부터 2022년 3월까지 SOR 보조금은 오피오이드 사용 장애가 있는 21,672명의 개인에게 치료 서비스를 지원했습니다. 이 중 16,000명 이상이 부프레노르핀을, 5,000명이 메타돈을, 400명이 주사제 날트렉손을 투여받았습니다. 또한 SOR은 3만 명 이상의 개인에게 회복 또는 동료 코칭을, 1,600명 이상의 개인에게 회복 주택 서비스를, 약 1,500명의 개인에게 고용 서비스를 지원했습니다. 이 기간 동안 SOR은 날록손 배포 프로젝트를 지원하여 9,000건 이상의 오피오이드 과다 복용을 역전시켰습니다. 또한, SOR은 5,600명 이상의 개인에게 각성제 사용 장애 치료 서비스를 지원했습니다.​​ 

For more information about the SOR grant, please visit the Medication Assisted Treatment Expansion Project webpage or email DHCSMATExpansion@dhcs.ca.gov.​​  

행동 건강 품질 개선 프로그램(BHQIP)​​ 

The Department of Health Care Services (DHCS) created a three-year Behavioral Health Quality Improvement Program (BHQIP) to support implementation of the CalAIM initiative. The CalAIM BHQIP is structured as an incentive program, whereby counties may earn incentive payments by achieving certain CalAIM implementation milestones. Senate Bill (SB) 129 (Chapter 69; Statutes of 2021), authorized $21,750,000 in General Fund dollars for the CalAIM BHQIP for Fiscal Year 2021-22, which included a startup allocation amount of $250,000 to each County Behavioral Health Plan participating in BHQIP, and the rest was allocated to counties based on each county’s share of statewide claims value reported to DHCS. For inquiries about BHQIP, please contact BHQIP@dhcs.ca.gov.​​ 

CalAIM 업데이트​​ 

커뮤니티 지원​​ 
On April 15, DHCS received final updated Models of Care (MOCs) from Medi-Cal MCPs implementing Community Supports in all 58 California counties, including proposed networks and estimated capacities for services. On July 1, MCPs will proceed with the next phase of implementation of Community Supports and bring on additional Community Supports services elected through the MOC process. Revised Community Supports elections will be posted on the  CalAIM webpage in mid-June, once DHCS has approved all outstanding MCP MOCs. DHCS will continue to update Community Supports elections at least semi-annually.
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향상된 케어 관리(ECM)​​ 
ECM was implemented in counties with Health Homes Programs (HHP) and Whole Person Care (WPC) pilots on January 1, 2022. On July 1, 2022, counties that did not have HHP and WPC programs will begin implementation of ECM for the following Populations of Focus (POF): individuals and families experiencing homelessness, adult high utilizers, and adults with serious mental illness (SMI) or substance use disorder (SUD). DHCS is reviewing each MCP’s policies and procedures and confirming provider networks are ready for implementation.
Also, to ensure operational readiness, MCPs will submit updated MOCs by July 1 for two long-term care (LTC) POFs (members eligible for LTC and those at risk of institutionalization; and nursing home residents transitioning to the community), scheduled to go-live on January 1, 2023.
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인구 건강 관리(PHM)​​ 
On May 3, DHCS released the Draft PHM Strategy and Roadmap for public comment, and written comments were due on May 16. This document describes DHCS’ vision for PHM, outlining key policy initiatives and accountability mechanisms, defining and describing PHM concepts and terminology, and detailing requirements for Medi-Cal MCPs for 2023 and 2024. On May 9, DHCS issued an Invitation for Proposal (IFP) for the PHM Service, and anticipates awarding a contract to the selected vendor by this summer.
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접근성 제공 및 건강 변화(PATH)​​ 
In June, the first round of application submissions for the PATH Collaborative Planning participants and facilitators, Justice-Involved Capacity Building, and the Capacity and Infrastructure Transition Expansion and Development (CITED) initiative will begin. DHCS completed the IFP procurement for the PATH Third Party Administrator (TPA) in May. DHCS is evaluating the proposals and aims to award the TPA vendor contract by the end of June. DHCS continues to develop and finalize the guidance documents for the Technical Assistance Marketplace, Collaborative Planning, CITED, and Justice-Involved Capacity Building initiatives. Visit the CalAIM PATH Initiative webpage for current information and resources on PATH initiatives.​​ 

CalHOPE​​ 

CalHOPE has continued providing Crisis Counseling Assistance and Training Program (CCP) services to Californians in need of support. CalHOPE was approved for a 30-day and a 60-day cost extension that allowed CCP services through May 10, 2022. The federal partners recently approved DHCS’ 90-day no-cost extension, extending CalHOPE CCP services through July 9, 2022 and administrative close out activities through August 10, 2022.​​ 

CalHOPE continues to provide CCP educational services to schools, raising awareness of the negative effects of anxiety. CalHOPE has been partnering with IndieFlix since October 2021, including releasing the film ANGST: Building Resilience, which is based on a mental health support program. The outreach has been successful, as more than 150 school districts registered, multiple in-person Angst screenings were conducted in schools, and outreach/communication to other venues have been scheduled. Additionally, All It Takes, in partnership with CalHOPE and the California Department of Education, has received positive feedback after the release of the film, A Trusted Space, which is aimed at training educators on how to help mitigate the effects of emotional stressors on students and their families.​​ 

DHCS’ service provider, California Consortium of Urban Indian Health (CCUIH), has remained engaged in outreach of CCP services to their Tribal community. CCUIH has tabled various indigenous events, such as the Stanford Pow Wow, Mariposa Pow Wow, Indigenous Red Markets, and Healing and Coping events, sharing resources of the CalHOPE RedLine.​​ 

지역사회 정신 건강 형평성 프로젝트(CMHEP)​​ 

DHCS, in partnership with the California Department of Public Health, is providing support to CBOs and county behavioral health departments through CMHEP to implement population-specific and community-driven approaches. AB 74 (Chapter 23, Statutes of 2019) authorized funding to provide training and technical assistance to county behavioral health departments. CMHEP efforts will cover two years. DHCS hired the Center for Applied Research Solutions to develop statewide community-driven policy guidance, along with strategies and interventions aimed at reducing disparities in access to health and behavioral health care. A robust data collection framework to evaluate improvements in access to culturally responsive care will accompany the newly developed policy guidance. For more information, visit the CMHEP website.​​ 

DHCS 가정 및 지역사회 기반 서비스(HCBS) 지출 계획 이니셔티브​​ 

CalBridge 행동 건강 프로그램​​ 
2022년 2월 현재, 공중보건연구소/CA 브리지(PHI)는 약물 사용 내비게이터가 진료한 환자 112,474명, 오피오이드 사용 장애로 확인된 환자 90,593명, 약물 보조 치료를 받은 환자 40,044명을 보고했습니다. 가정 및 지역사회 기반 서비스를 통해 DHCS는 CalBridge 행동 건강 네비게이터 프로그램을 통해 정신 건강 상태와 약물 사용 장애를 더 잘 해결하기 위해 프로그램의 범위와 네비게이터의 역할을 확대하기 위해 PHI와 4천만 달러에 계약을 체결했습니다. 기금 배분을 위해 PHI는 2022년 4월에 응급실, 의료 시스템, 병원 재단 또는 의사 그룹이 있는 병원의 참여를 요청하는 신청 요청 RFA를 발표했습니다.​​  

For more information about the CalBridge Behavioral Health Navigator Program, please visit the Bridge Navigator Program website.​​  

고령자 메디칼 전체 범위 확대​​ 

On May 1, individuals 50 years of age or older who met all Medi-Cal eligibility criteria, and who do not have satisfactory immigration status for federally-funded full-scope Medi-Cal, became newly eligible for state-funded full-scope Medi-Cal under the Older Adult Expansion. DHCS successfully transitioned 247,522 existing Older Adult Expansion individuals in restricted scope Medi-Cal to full-scope Medi-Cal, effective May 1. Individuals who apply now will automatically be determined eligible for full-scope Medi-Cal if they are 50 years of age or older and meet all other Medi-Cal eligibility criteria, regardless of immigration status. This expansion of Medi-Cal supports the Newsom Administration’s vision of a Healthy California for All by addressing health coverage disparities that disproportionately impact disadvantaged communities.​​ 

동료 지원 서비스​​ 

On May 2, DHCS received CMS approval of SPA 22-0024, with an effective date of July 1, to broaden the definition of a Peer Support Specialist as someone who must be in recovery themselves or have lived experience with the process of recovery as a parent, caregiver, or family member. Prior to this update, Peer Support Specialists were defined solely as individuals in recovery, which excluded parents, caregivers, or family members from becoming certified as Peer Support Specialists. This update aligns the definition of Peer Support Specialist with the Medi-Cal Peer Support Specialist Certification Program requirements.​​ 

On May 6, DHCS issued Behavioral Health Information Notice (BHIN) 22-026, which provides guidance regarding the submission of an opt-in letter and claiming requirements for Peer Support Services in the Drug Medi-Cal (DMC), Drug Medi-Cal Organized Delivery System (DMC-ODS), and Specialty Mental Health Services (SMHS) programs. In order to implement Peer Support Services effective July 1, counties must have provided a letter to DHCS stating their request to opt in to provide peer support services, and indicating the program(s) (SMHS, DMC-ODS, and/or DMC) for which they are opting in. The letter must be signed by the Behavioral Health Director and emailed to CountySupport@dhcs.ca.gov by May 20 to implement peer support services, effective July 1. To date, 48 counties have submitted a signed letter stating their request to opt in to provide Peer Support Services effective July 1, 2022, with most counties opting to cover Peer Support Services in both their SMHS and their DMC or DMC-ODS programs.​​ 

5월 20일 마감일까지 동료 지원 서비스 제공을 선택하지 못한 카운티에서도 6개월마다 선택할 수 있는 기회가 주어집니다. DHCS는 향후 동료 지원 서비스 제공에 동의할 수 있는 후속 기회에 대한 추가 정보를 제공할 예정입니다.​​ 

치과 의료 서비스 제공자를 위한 PAVE(의료 서비스 제공자 신청 및 등록 확인) 포털​​ 

DHCS는 2022년 가을에 치과 의료 서비스 제공자를 위한 PAVE 포털을 구현할 예정입니다. PAVE 포털은 등록 절차를 간소화하고 가속화하도록 설계된 웹 기반 애플리케이션입니다. PAVE는 치과 제공자 등록 신청서 및 필수 서류를 DHCS에 제출할 수 있는 새로운 모드를 제공하여 신청자가 Medi-Cal 제공자 전자 양식 신청서라는 전자 양식을 사용할 수 있도록 합니다. DHCS는 PAVE가 시행되면 더 이상 종이 신청서를 받지 않습니다.​​  

메디칼 치과 서비스를 위한 캘리포니아 스마일 캠페인​​ 

SmileCalifornia.org, SonrieCalifornia.org, and all materials pertaining to pregnant members were updated to reflect the American Rescue Plan Act of 2021 Postpartum Care Extension policy that was enacted on April 1, 2022.​​ 

Smile, California launched a promotion in April to support the required Kindergarten Oral Health Assessment (KOHA). The promotion brought awareness to the California law that requires all children to complete a dental assessment by their first year in public school, either Kindergarten or first grade, before May 31. Local oral health programs, school-based health centers, and CBOs received digital toolkits with educational KOHA materials, and the KOHA landing page was updated on SmileCalifornia.org and SonrieCalifornia.org.​​  

In May, Smile, California launched an effort to promote the new Medi-Cal Older Adult Expansion to inform adults 50 years of age or older enrolled in restricted scope Medi-Cal that they are now eligible to receive full-scope Medi-Cal benefits, regardless of immigration status. A new landing page was created on SmileCalifornia.org and SonrieCalifornia.org with information about the expansion, frequently asked questions, and covered dental services. Social media ads and boosted posts ran on the Smile, California Facebook and Instagram accounts throughout May.

At the end of April, SmileCalifornia.org and SonrieCalifornia.org had received 66,794 new visitors, of which 51,361 clicked the “Find a Dentist” button.​​