ຂ່າວເດັ່ນ​​ 

ກົດໝາຍວ່າດ້ວຍການບໍລິການສຸຂະພາບພຶດຕິກຳໃໝ່ (BHSA) ສະໜັບສະໜູນຄວາມໝັ້ນຄົງຂອງລາຍຮັບ ແລະ ການວາງແຜນ​​ 

DHCS released the BHSA Revenue Stability Workgroup Report with recommendations to reduce the variance of county Behavioral Health Services Funds (BHSF). The recommendations are intended to help counties manage revenue more consistently, maintain services through economic ups and downs, and bring greater predictability and accountability to local behavioral health care funding.​​ 

The BHSA Revenue Stability Workgroup, comprising state leaders and counties, was required to develop and recommend solutions to reduce BHSA revenue volatility and propose appropriate prudent reserve levels to support the sustainability of county programs and services. It reviewed and analyzed current and historical revenues generated by the MHSA and the BHSA and prudent reserve levels to develop the recommendations.​​ 

The State Controller’s Office will continue to follow the current process to distribute BHSA local assistance funds to counties monthly. The goal is to balance local assistance revenue allocation and program stability, helping counties effectively plan and provide critical behavioral health services during revenue downturns. Highlights include:​​ 

• ພື້ນ​ທີ່​ການ​ໃຊ້​ຈ່າຍ​ປະ​ຈໍາ​ປີ​ໂດຍ​ອີງ​ໃສ່​ສະ​ເລ່ຍ​ສາມ​ປີ​, ການ​ປັບ​ຕົວ​ສໍາ​ລັບ​ໄພ​ເງິນ​ເຟີ້​.​​ 
• ຂອບເຂດສະຫງວນໃຫມ່ (10-15 ເປີເຊັນ, ຂຶ້ນກັບຂະຫນາດຂອງຄາວຕີ້).​​ 
• ຄວາມຕ້ອງການຄັ້ງດຽວເພື່ອໃຊ້ຈ່າຍສະຫງວນເກີນລະຫວ່າງ 2026-2029.​​ 
• ຄວາມຍືດຫຍຸ່ນໃນການປັບງົບປະມານຖ້າລາຍຮັບຫຼຸດລົງ.​​ 
• ຄວາມໂປ່ງໃສຫຼາຍຂຶ້ນ, ດ້ວຍການລາຍງານສາທາລະນະທີ່ຈຳເປັນ ແລະ ການປ້ອນຂໍ້ມູນຊຸມຊົນ.​​ 

This approach supports California’s Mental Health for All vision by promoting stability, transparency, and community-centered behavioral health care. State legislation is required to enact recommendations from the BHSA Revenue Stability Workgroup Report.​​ 

ຊຸມຊົນສະຫນັບສະຫນູນສະແດງໃຫ້ເຫັນປະສິດທິພາບຄ່າໃຊ້ຈ່າຍໃນຕອນຕົ້ນໃນຂະນະທີ່ຕອບສະຫນອງຄວາມຕ້ອງການຂອງສະມາຊິກ Medi-Cal​​ 

DHCS recently submitted to the Centers for Medicare & Medicaid Services (CMS) its Community Supports, or In Lieu of Services (ILOS), Annual Report[TO1] , which reviews the progress and impact of Medi-Cal Community Supports in 2024. For the first time, the report also includes a cost-effectiveness analysis for 2023. The report highlights key achievements, such as reduced emergency room visits, hospitalizations, and long-term care use, pointing to early evidence of both improved health outcomes and reduced costs when compared to the services they are replacing, such as inpatient, emergency department, and long-term care services. Of the 12 Community Supports studied, nine are already proving cost-effective, and the remaining three are expected to prove to be cost-effective over time.​​ 

The report also outlines operational improvements made by DHCS and managed care plans (MCP) to expand services, grow provider networks, and support implementation. While progress has been significant, the report also identifies ongoing challenges and opportunities for further improvement, ensuring these services continue to evolve to meet the needs of Medi-Cal members.​​ 

ອັບເດດໂຄງການ​​ 

ການປັບປຸງການຈັດຊື້ MCP ການຄ້າ Medi-Cal​​ 

DHCS ຈະເລື່ອນການຈັດຊື້ Medi-Cal MCP ທາງການຄ້າຄັ້ງຕໍ່ໄປຢ່າງໜ້ອຍສອງປີ. ການຈັດຊື້ທີ່ມີການແຂ່ງຂັນຄັ້ງຕໍ່ໄປສຳລັບ MCPs ຈະເລີ່ມຕົ້ນບໍ່ໄວກວ່າປີ 2029, ໂດຍສັນຍາຄາດວ່າຈະມີຜົນບັງຄັບໃຊ້ບໍ່ໄວກວ່າປີ 2031. ກ່ອນໜ້ານີ້ DHCS ໄດ້ຊີ້ບອກວ່າການຈັດຊື້ຄືນໃໝ່ສຳລັບ MCP ທາງການຄ້າຈະຖືກດຳເນີນທຸກໆຫ້າປີ. ພາຍໃຕ້ໄລຍະເວລາທີ່ສົມມຸດໄວ້ນີ້, DHCS ຈະຕ້ອງປ່ອຍຄຳຮ້ອງຂໍຂໍ້ສະເໜີ (RFP) ໃນປີ 2027 ສຳລັບວັນທີ່ມີຜົນບັງຄັບໃຊ້ຂອງສັນຍາໃນວັນທີ 1 ມັງກອນ 2029.​​ 

The additional time will allow DHCS to focus on critical California Advancing and Innovating Medi-Cal (CalAIM) initiatives. It will also help maintain stability for members and support ongoing improvements to care quality and access, while also supporting the long-term success of the Medi-Cal managed care program.​​ 

In accordance with current policy, MCP contracts will be renewed annually following the contractual requirements identified in Exhibit E, 1.1.15 of the 2024 Managed Care Boilerplate Contract. Current MCP contracts will be extended from January 1, 2026, to December 31, 2026, by the established annual process. DHCS remains committed to fostering an inclusive, flexible, and responsive process that supports the Medi-Cal program and ensures continued equitable access to high-quality care for Californians. Please visit the Medi-Cal Managed Care webpage for more information.​​ 

ການຫັນປ່ຽນການດູແລຄຸ້ມຄອງແຂ້ວ​​ 

During the week of May 26, DHCS will mail a 30-day notice to about 350,000 Medi-Cal members in Sacramento and Los Angeles counties to notify them of upcoming changes to their dental service delivery, effective July 1, 2025. The member notice explains what is changing, if the member needs to make a plan choice, the member’s continuity of care protections, and other important information, and will include a Medi-Cal managed care enrollment packet.​​ 

Members in Sacramento County who are currently enrolled in Access Dental Plan or dental fee-for-service (FFS) must select a new Dental Managed Care plan, while members in Los Angeles County who do not choose a Dental Managed Care plan will remain in FFS. Members currently enrolled with Health Net or Liberty will not be affected by these changes. Additionally, changing Dental Managed Care plans will not affect Medi-Cal coverage or benefits.​​ 

ຕົວເລືອກການດູແລສຸຂະພາບຂອງ Medi-Cal ກຳລັງດຳເນີນການໂຄສະນາການໂທອອກໄປຫາສະມາຊິກຜູ້ທີ່ໄດ້ຮັບຊຸດການລົງທະບຽນການດູແລທີ່ມີການຄຸ້ມຄອງ. ໃນລະຫວ່າງການໂທເຫຼົ່ານີ້, ຕົວແທນຂອງ HCO ຈະທົບທວນຄືນທາງເລືອກແຜນການດູແລສຸຂະພາບແຂ້ວທີ່ມີໃຫ້, ຕອບຄຳຖາມ ແລະ ອຳນວຍຄວາມສະດວກໃນການລົງທະບຽນໃນແຜນການທີ່ສະມາຊິກເລືອກຜ່ານທາງໂທລະສັບ. DHCS ໄດ້ພັດທະນາ ໜ້າເວັບແຈ້ງການສະມາຊິກການຫັນປ່ຽນທາງດ້ານທັນຕະກຳ ເພື່ອໃຫ້ສະມາຊິກສາມາດເບິ່ງແຈ້ງການ ແລະ ຂໍ້ມູນອື່ນໆກ່ຽວກັບການຫັນປ່ຽນການດູແລທີ່ຄຸ້ມຄອງທາງດ້ານທັນຕະກຳ.​​ 

ຄວາມຕ້ອງການ ແລະຂັ້ນຕອນການລົງທະບຽນ Medi-Cal ສໍາລັບຜູ້ໃຫ້ບໍລິການຮ້ານຂາຍຢາ​​ 

ມີຜົນບັງຄັບໃຊ້ໃນເດືອນສິງຫາ 1, 2025, ຜູ້ໃຫ້ບໍລິການຮ້ານຂາຍຢາທີ່ມີໃບຢັ້ງຢືນການຍົກເວັ້ນການປັບປຸງຫ້ອງທົດລອງທາງດ້ານຄລີນິກ (CLIA) ທີ່ຖືກຕ້ອງ ແລະ ໃບຢັ້ງຢືນການລົງທະບຽນຫ້ອງທົດລອງທາງດ້ານຄລີນິກຂອງລັດຄາລິຟໍເນຍໃນປະຈຸບັນອາດຈະຮຽກເກັບຄ່າກວດທີ່ໄດ້ຮັບການຍົກເວັ້ນ CLIA ທີ່ສະໜອງໃຫ້ພາຍໃນຂອບເຂດການປະຕິບັດຂອງຮ້ານຂາຍຢາຕາມທີ່ໄດ້ກຳນົດໂດຍຄະນະກຳມະການຮ້ານຂາຍຢາຂອງລັດຄາລິຟໍເນຍ ແລະ ໄດ້ຮັບອະນຸຍາດໃນປະມວນກົດໝາຍທຸລະກິດ ແລະ ອາຊີບ ມາດຕາ 4052.4. ຜູ້ໃຫ້ບໍລິການຮ້ານຂາຍຢາຕ້ອງສະໝັກລົງທະບຽນໃນໂຄງການ Medi-Cal ໂດຍການສົ່ງໃບສະໝັກລົງທະບຽນຜູ້ໃຫ້ບໍລິການ Medi-Cal ທາງອອນລາຍ, ພ້ອມກັບເອກະສານສະໜັບສະໜູນທັງໝົດ.​​ 

On June 10, from 10 to 11 a.m. PDT, DHCS will hold a public stakeholder hearing via webinar (advance registration required) to discuss the draft regulatory provider bulletin entitled, “Medi-Cal Enrollment Requirements and Procedures for Pharmacy Providers that Hold a Clinical Laboratory Improvement Amendments (CLIA) Certificate of Waiver.”​​ 

ຄຳເຫັນ, ຄຳຖາມ ຫຼື ຄຳແນະນຳເປັນລາຍລັກອັກສອນສາມາດສົ່ງໄດ້ໃນລະຫວ່າງການໄຕ່ສວນໃນການສົນທະນາທາງເວັບ. ສຳລັບຜູ້ທີ່ບໍ່ສາມາດເຂົ້າຮ່ວມໄດ້, ຄຳເຫັນເປັນລາຍລັກອັກສອນຕ້ອງຖືກສົ່ງພາຍໃນເວລາ 17:00 ໂມງ ຕາມເວລາ PDT ຂອງວັນທີ 10 ມິຖຸນາ ເພື່ອພິຈາລະນາເຜີຍແຜ່. ເມື່ອສົ່ງຄຳເຫັນເປັນລາຍລັກອັກສອນ, ກະລຸນາຮັບປະກັນວ່າທັງຜູ້ໃຫ້ຄຳເຫັນ ແລະ ອົງການ/ສະມາຄົມທີ່ເປັນຕົວແທນໄດ້ຖືກລະບຸຢູ່ໃນຄຳເຫັນ. ກະລຸນາສົ່ງຄຳເຫັນເປັນລາຍລັກອັກສອນໄປທີ່ DHCSPEDStakeholder@dhcs.ca.gov. ອີງຕາມຄຳເຫັນຂອງສາທາລະນະຊົນທີ່ໄດ້ຮັບ, DHCS ຈະເຜີຍແຜ່ແຈ້ງການສຸດທ້າຍໃນເວັບໄຊທ໌ຂອງຜູ້ໃຫ້ບໍລິການ Medi-Cal ແລະ ພະແນກລົງທະບຽນຜູ້ໃຫ້ບໍລິການ DHCS .​​ 

ເຂົ້າຮ່ວມທີມງານຂອງພວກເຮົາ​​ 

DHCS ກຳລັງຊອກຫາບຸກຄົນທີ່ມີພອນສະຫວັນ ແລະ ມີແຮງຈູງໃຈເພື່ອຮັບໃຊ້ເປັນ:​​ 

• ຫົວໜ້າ​ພະ​ແນ​ກພັດທະນາ​ອັດຕາ​ສ່ວນ​ຕົວ​ເລກ. ຫົວຫນ້ານໍາພາກິດຈະກໍາການກໍານົດອັດຕາສໍາລັບແຜນການດູແລທີ່ຄຸ້ມຄອງໂດຍ Medi-Cal ແລະໂຄງການການດູແລລວມທັງຫມົດສໍາລັບອົງການຈັດຕັ້ງຜູ້ສູງອາຍຸ. ກິດ​ຈະ​ກໍາ​ປະ​ກອບ​ມີ​ການ​ປະ​ຕິ​ບັດ​ວິ​ທີ​ການ​ຄາດ​ຄະ​ເນ​ສໍາ​ລັບ​ການ​ສ້າງ​ອັດ​ຕາ​ການ capitation ແລະ​ດູ​ແລ​ການ​ພັດ​ທະ​ນາ​ແລະ​ການ​ປະ​ຕິ​ບັດ​ນະ​ໂຍ​ບາຍ​ແລະ​ອະ​ນຸ​ສັນ​ຍາ​ສໍາ​ລັບ​ການ​ຈ່າຍ​ຄືນ​. ນອກຈາກນັ້ນ, ຫົວຫນ້າຮັບປະກັນວິທີການທາງດ້ານການເງິນແມ່ນສອດຄ່ອງກັບການສະຫນອງການດູແລສຸຂະພາບທີ່ມີຄຸນນະພາບທີ່ມີປະສິດທິພາບແລະປະຕິບັດຕາມກົດຫມາຍ, ກົດລະບຽບແລະກົດລະບຽບຂອງລັດແລະລັດຖະບານກາງ. ໃບສະໝັກຕ້ອງສົ່ງພາຍໃນວັນທີ 30 ພຶດສະພາ.
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• ຮອງຜູ້ອຳນວຍການ (ADD), ບໍລິການເຕັກໂນໂລຊີວິສາຫະກິດ (ETS). ບົດບາດ ADD ໃໝ່ນີ້ຈະສ້າງສາຍພົວພັນການເຮັດວຽກຮ່ວມມືກັບພະນັກງານບໍລິຫານຂອງ DHCS, ຄູ່ຮ່ວມງານໂຄງການ, ແລະ ຜູ້ມີສ່ວນຮ່ວມພາຍນອກ, ແລະ ຊ່ວຍເຫຼືອໃນການນຳພາໂຄງການ ແລະ ການບໍລິການດ້ານໄອທີຂອງ DHCS. ນອກຈາກນັ້ນ, ADD ຈະມີບົດບາດສຳຄັນໃນການນຳພາການພັດທະນາ ແລະ ການຈັດຕັ້ງປະຕິບັດນະໂຍບາຍໄອທີ, ສະຖາປັດຕະຍະກຳລະບົບ, ຄວາມປອດໄພ, ການປັບປຸງ ແລະ ວິທີແກ້ໄຂສຳລັບໂຄງການ DHCS, ລວມທັງ Medi-Cal ແລະ ສຸຂະພາບທາງດ້ານພຶດຕິກຳ. ໃບສະໝັກຕ້ອງຍື່ນພາຍໃນວັນທີ 2 ມິຖຸນາ.​​ 

DHCS ກຳລັງຮັບສະໝັກພະນັກງານດ້ານການດູແລທີ່ມີການຄຸ້ມຄອງຂອງ Medi-Cal, ການວິເຄາະຂໍ້ມູນ, ເງື່ອນໄຂການມີສິດໄດ້ຮັບ Medi-Cal, ແລະທີມງານອື່ນໆ. ສຳລັບຂໍ້ມູນເພີ່ມເຕີມ, ກະລຸນາເຂົ້າເບິ່ງ ເວັບໄຊທ໌ CalCareers.​​ 

ກອງປະຊຸມຜູ້ມີສ່ວນກ່ຽວຂ້ອງ ແລະກອງປະຊຸມທາງເວັບທີ່ຈະມາເຖິງ​​ 

DHCS posts upcoming public meetings on the Calendar of Events. DHCS provides free assistive services, including language interpretation, real-time captioning, and alternate formatting of meeting materials. To request services, please email DHCS at the appropriate contact email address at least ten working days before the meeting.​​ 

Coverage Ambassador Series: Birthing Care Pathway​​  

On May 29, from 11 a.m. to 12 p.m. PDT, DHCS will hold a Coverage Ambassador webinar that will focus on DHCS’ Birthing Care Pathway initiative (advance registration required). The webinar will provide information about maternity services for pregnant and postpartum Medi-Cal members from conception through 12 months postpartum and review highlights from the Birthing Care Pathway Report released on February 4. This initiative helps to ensure Medi-Cal members have access to high-quality, equitable care to improve maternal health outcomes and reduce disparities. Coverage Ambassadors will also learn about DHCS’ social media platforms, which offer up-to-date information on relevant topics that can benefit both Coverage Ambassadors and Medi-Cal members. Simultaneous interpretation in Spanish will be offered during the webinar.​​ 

ໃນກໍລະນີທີ່ທ່ານພາດມັນ​​ 

ຄໍາຮ້ອງຂໍຄໍາຮ້ອງສະຫມັກ (RFA): ສະນຸກເກີທີ່ພັກອາໄສແບບຍືດຫຍຸ່ນ​​  

On May 7, DHCS announced the Flexible Housing Subsidy Pools (“Flex Pools”) RFA. DHCS will select up to 10 local teams to participate in the Flex Pools TA Academy and receive Flex Pools planning grants of approximately $150,000. The launch of Medi-Cal Transitional Rent and Behavioral Health Services Act (BHSA) Housing Interventions creates an unprecedented opportunity to help people achieve better health outcomes through housing stability.​​ 

Flex Pools are intended to help counties and Tribal entities improve housing stability for individuals experiencing or at risk of homelessness. They are a locally designed model to coordinate rental assistance and make the best use of available housing supports, aligning the work of managed care plans, county behavioral health agencies, and other key partners in the homeless services and rehousing systems. Applications are due to DHCS by 5 p.m. PDT on June 13, 2025. Organizations selected will be notified in July 2025. To learn more and apply, please visit the DHCS Housing for Health website.​​ 

ຄໍາຮ້ອງສະຫມັກການແກ້ໄຂການຍົກເວັ້ນ HCBA - ໄລຍະເວລາຄໍາເຫັນສາທາລະນະ 30 ມື້​​ 

ໃນວັນທີ 12 ພຶດສະພາ, DHCS ໄດ້ເຜີຍແຜ່ຮ່າງ ກົດໝາຍວ່າດ້ວຍທາງເລືອກທີ່ອີງໃສ່ເຮືອນ ແລະ ຊຸມຊົນ (HCBA) ປີ 2025 ສຳລັບໄລຍະເວລາໃຫ້ຄຳເຫັນສາທາລະນະ 30 ວັນ, ກ່ອນທີ່ຈະສົ່ງສະບັບສຸດທ້າຍໄປໃຫ້ CMS ເພື່ອຂໍອະນຸຍາດຄືນໃໝ່. ການຍົກເວັ້ນ HCBA ອະນຸຍາດໃຫ້ຜູ້ລົງທະບຽນທີ່ມີສິດໄດ້ຮັບການບໍລິການທີ່ໄດ້ຮັບການອະນຸມັດຜ່ານລະບົບການໃຫ້ບໍລິການສຸຂະພາບທາງໄກ. ການປ່ຽນແປງທີ່ສະເໜີໃນການແກ້ໄຂການຍົກເວັ້ນລວມມີ:​​ 

• ຊີ້ແຈງຄໍາແນະນໍາແລະຄວາມຄາດຫວັງສໍາລັບການບໍລິການດ້ານສຸຂະພາບທາງໂທລະສັບ.​​ 
• ການຖອນສິ່ງອໍານວຍຄວາມສະດວກໃນການດູແລລະດັບປານກາງສໍາລັບການພັດທະນາການພະຍາບານຕໍ່ຄົນພິການ - ການພະຍາບານຢ່າງຕໍ່ເນື່ອງ (ICF/DD-CN) ທີ່ບໍ່ແມ່ນຊ່ອງຫວ່າງແລະ vent-dependent ຜົນປະໂຫຍດແລະການຕັ້ງຄ່າ, ຍ້ອນວ່າພວກເຂົາກໍາລັງຖືກປ່ຽນໄປສູ່ແຜນ Medicaid State ເປັນຜົນປະໂຫຍດການດູແລໄລຍະຍາວ.​​ 

This transition advances California’s efforts to comply with the federal Medicaid Home and Community-Based Settings (HCBS) Final Rule by reinforcing the delivery of services in integrated, community-based settings that support individual choice and autonomy.​​ 

DHCS ຂໍເຊີນຊວນທຸກພາກສ່ວນທີ່ສົນໃຈມາທົບທວນການດັດແກ້ ແລະ ຄຳແນະນຳໃນການໃຫ້ຄຳເຫັນໃນໜ້າເວັບ DHCS ກ່ຽວກັບການຍົກເວັ້ນ HCBA ພາຍໃຕ້ຫົວຂໍ້ໃບສະໝັກການດັດແກ້ການຍົກເວັ້ນ HCBA – ຄຳເຫັນສາທາລະນະ 30 ວັນ ແຕ່ເດືອນພຶດສະພາ 12, 2025 – ເດືອນມິຖຸນາ 12, 2025 . ຄຳເຫັນທັງໝົດຕ້ອງໄດ້ຮັບພາຍໃນວັນທີ 5 12 ມິຖຸນາ,. 2025 ຖ້າທ່ານມີຄໍາຖາມໃດໆ, ກະລຸນາສົ່ງອີເມວຫາ hcbspolicy@dhcs.ca.gov.​​ 

ການປັບປຸງແຜນລັດ Medicaid (SPA) – ໄລຍະເວລາການໃຫ້ຄຳເຫັນສາທາລະນະ 30 ວັນ​​  

On May 12, DHCS posted the ICF/DD-CN: Transition of Benefit/Setting SPA (SPA #25-0026) for a 30-day public comment period, prior to submitting the final version to CMS for approval. ICF/DD-CNs provide 24-hour personal care, developmental services, and nursing supervision for individuals with developmental disabilities who have continuous needs for skilled nursing care and have been certified by a physician and surgeon as warranting continuous skilled nursing care. This service is currently provided through the HCBA waiver. This SPA will transition the ICF/DD-CN benefit/setting from the HCBA waiver to the Medicaid State Plan as a long-term care setting. This transition advances California’s efforts to comply with the federal HCBS Final Rule by reinforcing the delivery of services in integrated, community-based settings that support individual choice and autonomy. All comments must be received by June 12, 2025. If you have any questions, please email PublicInput@dhcs.ca.gov.​​