DHCS Stakeholder News Update – May 6, 2022
ເຖິງບັນດາພາກສ່ວນກ່ຽວຂ້ອງ,
ພະແນກບໍລິການການດູແລສຸຂະພາບ (DHCS) ກໍາລັງສະຫນອງການປັບປຸງນີ້ກ່ຽວກັບການພັດທະນາທີ່ສໍາຄັນກ່ຽວກັບໂຄງການ DHCS, ເຊັ່ນດຽວກັນກັບຄໍາແນະນໍາທີ່ກ່ຽວຂ້ອງກັບການສຸກເສີນດ້ານສຸຂະພາບສາທາລະນະ COVID-19.
ການປ່ຽນແປງພະນັກງານບໍລິຫານ DHCS
ໃນວັນທີ 31 ພຶດສະພາ, ທ່ານ Kelly Pfeifer, ຮອງຜູ້ອໍານວຍການດ້ານສຸຂະພາບພຶດຕິກໍາ, ຈະອອກຈາກການຮັບໃຊ້ລັດເພື່ອດໍາເນີນຄວາມພະຍາຍາມອື່ນໆ. ເປັນເວລາເກືອບສາມປີ, Kelly ໄດ້ນໍາພາການພັດທະນາແລະການປະຕິບັດໂຄງການການບໍລິການສຸຂະພາບຈິດທີ່ປ່ຽນແປງ, ປະຫວັດສາດແລະຄວາມບໍ່ເປັນລະບຽບຂອງການນໍາໃຊ້ສານເສບຕິດ, ລວມທັງການລິເລີ່ມຂອງ California Advancing and Innovating Medi-Cal (CalAIM), Behavioral Health Continuum Infrastructure Program (BHCIP), ແລະ Behavioral Health Modernization project.
ທ່ານ Tyler Sadwith, ຮອງຜູ້ອຳນວຍການຝ່າຍສຸຂະພາບທາງດ້ານພຶດຕິກຳ, ຈະດຳລົງຕຳແໜ່ງຮອງຜູ້ອຳນວຍການແທນທ່ານ Kelly ຫຼັງຈາກທ່ານ Kelly ອອກຈາກຕຳແໜ່ງ.
BHCIP ແລະການປັບປຸງໂຄງການຂະຫຍາຍການດູແລຊຸມຊົນ
The 2021-22 California State Budget provided once-in-a-generation investments in infrastructure funding alongside significant new state and federal resources to address homelessness, support health care delivery reform, and strengthen the social safety net. Together these commitments will address historic gaps in the behavioral health continuum to meet growing demand for services and supports. Infrastructure resources, led by DHCS and the California Department of Social Services, will ensure care can be provided in the least-restrictive settings by creating a wide range of options, including outpatient alternatives, urgent care, peer respite, wellness centers, social rehabilitation models, and licensed community care facilities. A variety of care placements can provide a vital off-ramp from intensive behavioral health service settings and transition the most vulnerable Californians to community living, as well as provide housing options for older adults and people with disabilities. For more information about these programs, please visit the BHCIP webpage.
ນະໂຍບາຍການຫັນປ່ຽນ 180 ວັນ Medi-Cal Rx
When Medi-Cal Rx launched, a 180-day transition policy was implemented to reduce the impact of the transition on Medi-Cal beneficiaries by extending their previously approved prescriptions, with or without previously approved prior authorizations (PA), through July 1, 2022. Medi-Cal Rx will continue to use historical PA and claims data for the transition policy beyond July 1, 2022. DHCS and Magellan Medicaid Administration are evaluating the appropriate time to terminate this transition policy. Detailed information will be provided in the coming weeks. Stakeholders will be given 90 days’ notice prior to the end of the 180-day transition policy.
ສັນຍາຜູ້ຂາຍການຄຸ້ມຄອງສຸຂະພາບປະຊາກອນ (PHM).
On May 9, DHCS will release an Invitation for Proposal (IFP) for a PHM Service vendor, as part of the CalAIM initiative. DHCS intends to award the resulting contract by July 2022. This procurement solicits applications for the development, operation, and eventual turnover to DHCS of the PHM Service.
ການບໍລິການ PHM ຊອກຫາການຫັນປ່ຽນການໃຫ້ການດູແລບຸກຄົນທັງໝົດໃຫ້ກັບຜູ້ໄດ້ຮັບຜົນປະໂຫຍດ Medi-Cal, ໃນຂະນະທີ່ຄຸ້ມຄອງຄວາມສ່ຽງ ແລະແກ້ໄຂຊ່ອງຫວ່າງໃນການດູແລ ແລະຜູ້ຂັບຂີ່ທາງດ້ານສຸຂະພາບຂອງສັງຄົມ. ການບໍລິການ PHM ຈະສະຫນັບສະຫນູນທັດສະນະຂອງຜູ້ໄດ້ຮັບຜົນປະໂຫຍດສໍາລັບຄູ່ຮ່ວມງານທຸລະກິດ (ພະແນກຂອງລັດແລະອົງການ, ຄູ່ຮ່ວມງານຂອງເຂດທ້ອງຖິ່ນ, ແລະອື່ນໆ); ຄູ່ຮ່ວມງານການຈັດສົ່ງການດູແລສຸຂະພາບ (ໂຮງຫມໍ, ສະຖານທີ່ພະຍາບານທີ່ມີຄວາມຊໍານິຊໍານານ, ແລະອື່ນໆ); ແລະອົງການຈັດຕັ້ງການດູແລທີ່ມີການຄຸ້ມຄອງ (county Drug Medi-Cal, Medicare Advantage, ແລະອື່ນໆ) ທີ່ມີການເຂົ້າເຖິງຂໍ້ມູນທາງດ້ານຄລີນິກແລະໂຄງການທີ່ສາມາດນໍາໃຊ້ເພື່ອຊ່ວຍປັບປຸງຄຸນນະພາບຂອງການດູແລ.
DHCS anticipates that implementation of the PHM Service will contribute to the overall CalAIM goal of improving beneficiaries’ quality of life and health outcomes, aligned with Medi-Cal initiatives outlined in Assembly Bill 133 (Chapter 143, Statutes of 2021). More information about the PHM Service is available in the draft PHM Program and Service Roadmap. For questions or comments, please email CalAIM@dhcs.ca.gov.