ຂ່າວເດັ່ນ​​ 

ການ​ຄຸ້ມ​ຄອງ​ການ​ດູ​ແລ​ທີ່​ປັບ​ປຸງ (ECM) ແລະ​ຊຸມ​ຊົນ​ສະ​ຫນັບ​ສະ​ຫນູນ​ຂໍ້​ມູນ​ການ​ປະ​ຕິ​ບັດ​​ 

ໃນອາທິດນີ້ໄດ້ເຜີຍແຜ່ ECM ແລະ ການອັບເດດການຈັດຕັ້ງປະຕິບັດການສະໜັບສະໜູນຊຸມຊົນ: ຂໍ້ມູນຜ່ານໄຕຣມາດທີ 2 ປີ 2023. ການອັບເດດນີ້ສະຫຼຸບຂໍ້ມູນລະດັບລັດຈາກ ECM ແລະ ການສະໜັບສະໜູນຊຸມຊົນ, ເຊິ່ງເປີດຕົວໃນປີ 2022 ເພື່ອຮັບໃຊ້ສະມາຊິກແຜນການດູແລທີ່ມີການຄຸ້ມຄອງ (MCP) ທີ່ມີຄວາມຕ້ອງການທາງສັງຄົມທີ່ກ່ຽວຂ້ອງກັບທາງດ້ານການແພດ, ບໍ່ແມ່ນທາງດ້ານການແພດ, ແລະ ສຸຂະພາບທີ່ສຳຄັນ. ໂດຍອີງໃສ່ບົດລາຍງານປີທຳອິດຂອງ ECM ແລະ ການສະໜັບສະໜູນຊຸມຊົນ, ການອັບເດດການຈັດຕັ້ງປະຕິບັດປະກອບມີຂໍ້ມູນໃໝ່ກ່ຽວກັບສະມາຊິກ Medi-Cal ແລະ ເຄືອຂ່າຍຜູ້ໃຫ້ບໍລິການ ແລະ ສະເໜີໃຫ້ເບິ່ງການລົງທະບຽນ ECM ເປັນຄັ້ງທຳອິດສຳລັບກຸ່ມປະຊາກອນດູແລໄລຍະຍາວສອງກຸ່ມທີ່ມີສິດໄດ້ຮັບ ECM ໃນເດືອນມັງກອນ 2023. ຂໍ້ມູນສຳລັບກຸ່ມປະຊາກອນ ECM ເພີ່ມເຕີມທີ່ສຸມໃສ່ເຊິ່ງໄດ້ເປີດຕົວຫຼັງຈາກໄຕຣມາດທີ 2 ປີ 2023, ລວມທັງເດັກນ້ອຍ ແລະ ຊາວໜຸ່ມ, ຈະຖືກເນັ້ນໃຫ້ເຫັນໃນການລາຍງານໃນອະນາຄົດ.​​ 

Both ECM and Community Supports continued to grow and serve more Californians during the first half of 2023, including a 29 percent growth in cumulative ECM enrollment and 108 percent growth in cumulative Community Supports recipients since the end of 2022. To provide further data transparency and visibility around ECM and Community Supports, DHCS will soon release a comprehensive report with MCP- and county-level data through Q2 2023.​​ 

ຄູ່ມືນະໂຍບາຍການຫັນປ່ຽນ Medi-Cal MCP 2024​​ 

On November 15, DHCS released frequently asked questions (FAQs) as a companion resource to version five of the 2024 Medi-Cal MCP Transition Policy Guide that includes DHCS policy and MCP requirements related to member transitions of Medi-Cal MCPs that take effect on January 1, 2024. The latest version includes a summary of communications resources, a transition policy for assessment and screening tools, and updates to the data sharing section and Appendix. Please email questions about the policy guide to MCPTransitionPolicyGuide@dhcs.ca.gov. The policy guide and FAQs will be updated throughout the remainder of this calendar year to keep MCPs informed of new and developing guidance.​​ 

ອັບເດດໂຄງການ​​ 

ແນະນຳຕົວແບບ ແລະ ປະສົບການການເສື່ອມເສີຍທີ່ໄດ້ຮັບການປັບປຸງ (GUIDE) ແລະ Webinar​​ 

To help address the needs of Medicare beneficiaries, including those dually eligible for Medicare and Medi-Cal, with Alzheimer’s disease and related dementias, the Centers for Medicare & Medicaid Services (CMS) released a Request for Applications (RFA) for the GUIDE model. This model aims to support people living with dementia and their unpaid caregivers by helping them with care coordination and management, infrastructure building, and higher quality of care. Interested applicants should submit their application via web portal by January 30, 2024.​​ 

The GUIDE model begins on July 1, 2024, and will continue for eight years. The goal of the model is to improve the quality of life, reduce the burden and strain on unpaid caregivers of people living with dementia, and prevent or delay long-term nursing home care. The care delivery approach is a person-centered plan that standardizes a set of services, has an interdisciplinary care team, and includes training requirements for the care team to improve care coordination to address the behavioral and functional needs of people living with dementia. Original Medicare providers may apply to participate. Since many Medicare beneficiaries with dementia are also dually eligible for Medi-Cal, DHCS strongly encourages California Medicare providers to participate in the GUIDE model. For more information, please visit the CMS GUIDE webpage.​​ 

Also, on December 8, from 11 a.m. to 12 p.m., DHCS, in partnership with the University of California, San Francisco and DHCS’ Dementia Care Aware initiative, will host a webinar on the GUIDE model in California (advance registration required). This webinar will offer Medicare providers and community-based organizations information about what is required to participate in GUIDE, examples of a successful partnership in California that follows the GUIDE model, and resources to help California applicants apply for the GUIDE model. For more information, please visit the Dementia Care Aware webpage.​​ 

ໝາຍເຫດ: DHCS ຈະບໍ່ອອກອັບເດດປະຈຳອາທິດກ່ຽວກັບຜູ້ມີສ່ວນຮ່ວມໃນອາທິດໜ້າ. ການອັບເດດຄັ້ງຕໍ່ໄປຈະອອກໃນວັນສຸກ, ວັນທີ 1 ທັນວາ.​​ 

ເຂົ້າຮ່ວມທີມງານຂອງພວກເຮົາ​​ 

DHCS ກໍາລັງຈ້າງ! DHCS ມີໂອກາດສໍາລັບ:​​ 

• ຮອງຜູ້ອຳນວຍການຝ່າຍບໍລິການເຕັກໂນໂລຊີວິສາຫະກິດ ແລະ ຫົວໜ້າເຈົ້າໜ້າທີ່ຂໍ້ມູນຂ່າວສານ ເພື່ອນຳພາ ແລະ ຄຸ້ມຄອງການບໍລິການໄອທີທົ່ວພະແນກ (FFD ແມ່ນວັນທີ 8 ທັນວາ). ຮັບຜິດຊອບໃນການຄຸ້ມຄອງການບໍລິການໄອທີທັງໝົດ, ຄວາມປອດໄພຂອງຂໍ້ມູນຂ່າວສານ, ໂຄງການວິສາຫະກິດ ແລະ ຄວາມພະຍາຍາມດ້ານນະວັດຕະກໍາຍຸດທະສາດ.​​ 

• Behavioral Health Policy Medical Consultant II within Behavioral Health (FFD is November 27). This position provides clinical expertise and strategic advice to DHCS Behavioral Health leadership on the development and implementation of policy and initiatives designed to strengthen behavioral health care access, quality, and service delivery.​​ 

• ຜູ້ອຳນວຍການດ້ານການແພດຮ່ວມ ສຳລັບລະບົບການດູແລແບບປະສົມປະສານ (FFD ແມ່ນວັນທີ 29 ພະຈິກ). ຕຳແໜ່ງນີ້ຮັບຜິດຊອບຕໍ່ການປຶກສາຫາລືທາງການແພດດ້ານວິຊາການສຳລັບໂຄງການສາທາລະນະສຸກທີ່ສຳຄັນຂອງລັດຄາລິຟໍເນຍ, ແລະ ຈະໃຫ້ຄຳແນະນຳ ແລະ ຄຳແນະນຳກ່ຽວກັບການບໍລິການທີ່ຈຳເປັນທາງການແພດສຳລັບບຸກຄົນທີ່ອ່ອນແອທາງການແພດ.​​ 

• Senior Assistant Chief Counsel for Fiscal and Financing within the Office of Legal Services (FFD is November 28). This position is responsible for complex legal counsel and litigation strategy formulation regarding DHCS fiscal, financial management, and health care policy.​​ 

• ຜູ້ຊ່ວຍຫົວໜ້າທີ່ປຶກສາອາວຸໂສ ສຳລັບລະບົບການຈັດສົ່ງການດູແລສຸຂະພາບພາຍໃນຫ້ອງການບໍລິການທາງດ້ານກົດໝາຍ (FFD ແມ່ນວັນທີ 30 ພະຈິກ). ຕໍາແໜ່ງນີ້ແມ່ນຮັບຜິດຊອບສໍາລັບທີ່ປຶກສາທາງດ້ານກົດໝາຍທີ່ສັບສົນ ແລະການສ້າງຍຸດທະສາດການດໍາເນີນຄະດີກ່ຽວກັບລັກສະນະຕ່າງໆຂອງລະບົບການໃຫ້ການດູແລສຸຂະພາບ.​​  

DHCS is also hiring for our human resources, auditing, health policy, and information technology teams. For more information, please visit the CalCareers website.​​ 

ກອງປະຊຸມຜູ້ມີສ່ວນກ່ຽວຂ້ອງ ແລະກອງປະຊຸມທາງເວັບທີ່ຈະມາເຖິງ​​ 

ໂຄງການຄຸ້ມຄອງເຄື່ອງຊ່ວຍຟັງສຳລັບເດັກນ້ອຍ (HACCP) Webinar ສໍາລັບຄອບຄົວ ແລະຄູ່ຮ່ວມງານຊຸມຊົນ​​ 

ໃນວັນທີ 28 ເດືອນພະຈິກ, ເວລາ 11 ໂມງເຊົ້າຫາ 12 ໂມງແລງ, DHCS ຈະເປັນເຈົ້າພາບຈັດກອງປະຊຸມ HACCP webinar (ຕ້ອງລົງທະບຽນລ່ວງໜ້າ) ເພື່ອແບ່ງປັນຄຳແນະນຳກັບຄອບຄົວ ແລະ ຊຸມຊົນກ່ຽວກັບການຍື່ນຂໍການຄຸ້ມຄອງເຄື່ອງຊ່ວຍຟັງ ແລະ ຊ່ວຍເຫຼືອເດັກນ້ອຍໃຫ້ໄດ້ຜົນປະໂຫຍດສູງສຸດຂອງ HACCP. DHCS ຍິນດີຕ້ອນຮັບຄອບຄົວທີ່ສົນໃຈໃໝ່, ຄອບຄົວທີ່ເຂົ້າຮ່ວມ HACCP ໃນປັດຈຸບັນ, ແລະຄູ່ຮ່ວມງານຊຸມຊົນທີ່ສະຫນັບສະຫນູນຄອບຄົວແລະເດັກນ້ອຍເຂົ້າຮ່ວມ webinar ນີ້ສໍາລັບການອັບເດດໂຄງການ, ຄໍາແນະນໍາ, ແລະກອງປະຊຸມຄໍາຖາມແລະຄໍາຕອບ. ສໍາລັບຂໍ້ມູນເພີ່ມເຕີມ, ກະລຸນາເຂົ້າໄປທີ່ www.dhcs.ca.gov/haccp.​​ 

Webinar ການລົບລ້າງຊັບສິນ Medi-Cal​​ 

ໃນວັນທີ 29 ພະຈິກ, ເວລາ 1:30 ຫາ 2:30 ໂມງ, DHCS ຈະຈັດກອງປະຊຸມ webinar ສໍາລັບຄູ່ຮ່ວມງານຂອງຊຸມຊົນ, ລວມທັງຜູ້ສະຫນັບສະຫນູນ, ຜູ້ໃຫ້ບໍລິການ, MCPs, ແລະອື່ນໆ, ກ່ຽວກັບ ການລົບລ້າງຊັບສິນສໍາລັບໂຄງການ Medi-Cal ທີ່ບໍ່ມີການດັດແກ້ (ທີ່ບໍ່ແມ່ນ MAGI), ມີຜົນສັກສິດໃນເດືອນມັງກອນ 1, 2024 ເມື່ອປະຕິບັດ, ການລິເລີ່ມນີ້ຈະລົບລ້າງການທົດສອບຊັບສິນສໍາລັບທຸກໂຄງການທີ່ບໍ່ແມ່ນ MAGI, ລວມທັງການດູແລໄລຍະຍາວແລະໂຄງການເງິນຝາກປະຢັດ Medicare. webinar ຈະໃຫ້ຂໍ້ມູນພື້ນຖານກ່ຽວກັບການກໍາຈັດຊັບສິນ, ການວາງແຜນການປະຕິບັດ, ການປ່ຽນແປງຂັ້ນຕອນ, ແລະອຸປະກອນການເຜີຍແຜ່. ຂໍ້​ມູນ​ເພີ່ມ​ເຕີມ​ແມ່ນ​ມີ​ຢູ່​ໃນ ການ​ປ່ຽນ​ແປງ​ຂອບ​ເຂດ​ຈໍາ​ກັດ​ຊັບ​ສິນ​ສໍາ​ລັບ​ຫນ້າ​ເວັບ​ທີ່​ບໍ່​ແມ່ນ MAGI Medi-Cal .​​ 

CalAIM: Subacute Care Facility Carve-In Billing and Payment Webinar​​ 

On November 29, from 3 to 4 p.m., DHCS will virtually host the third in a series of educational webinars on the California Advancing and Innovating Medi-Cal (CalAIM) long-term care (LTC) carve-in of subacute care facilities in Medi-Cal managed care. The goal of these webinars is to provide subacute care facilities and Medi-Cal MCPs with an understanding of the carve-in to operationalize the new benefit, including scope of services and relevant policies, in preparation for the January 1, 2024, carve-in.​​ 

ການສຳມະນາທາງເວັບ ເຊິ່ງເປີດໃຫ້ສາທາລະນະຊົນເຂົ້າຮ່ວມ ຈະສຸມໃສ່ການໃຫ້ຄວາມເຂົ້າໃຈກ່ຽວກັບຂໍ້ກຳນົດນະໂຍບາຍການຈ່າຍເງິນ ແລະ ການປະຕິບັດທີ່ມີຄວາມຫວັງກ່ຽວກັບການຮຽກເກັບເງິນສຳລັບ MCPs ແລະ ສະຖານທີ່ດູແລສຸຂະພາບແບບບໍ່ສ້ວຍແຫຼມ. ລາຍລະອຽດເພີ່ມເຕີມກ່ຽວກັບການຫັນປ່ຽນສະຖານທີ່ດູແລສຸຂະພາບແບບ subacute Care Facility LTC Carve-In ແມ່ນມີຢູ່ໃນ ໜ້າເວັບການຫັນປ່ຽນ CalAIM Subacute Care Facility LTC Carve-In.​​ 

CalAIM: ການ​ບໍ​ລິ​ການ​ໄລ​ຍະ​ຍາວ​ການ​ຄຸ້ມ​ຄອງ​ແລະ​ການ​ສະ​ຫນັບ​ສະ​ຫນູນ (MLTSS) ແລະ​ກອງ​ປະ​ຊຸມ Virtual Workgroup Duals​​ 

On November 30 at 10 a.m., DHCS will virtually host the CalAIM MLTSS and Duals Integration Workgroup meeting (advance registration required). The workgroup serves as a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible members, and allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare.​​ 

Agenda topics will include reminders about the 2024 Medi-Cal transitions and noticing timelines, updates on Medi-Medi Plan outreach and the 2024 Dual Eligible Special Needs Plan Policy Guide development, July 2023 duals enrollment data, a spotlight presentation on the CalAIM recuperative care Community Support, and a presentation on the continuous coverage unwinding.​​ 

Background materials, transcripts, and video recordings of previous workgroup meetings, along with additional information about the workgroup, are posted on the CalAIM MLTSS and Duals Integration Workgroup webpage. For questions or comments, please email DHCS at info@calduals.org.​​ 

CalAIM: ກອງ​ປະ​ຊຸມ​ຄະ​ນະ​ກໍາ​ມະ​ການ​ສຸ​ຂະ​ພາບ​ພຶດ​ຕິ​ກໍາ​​ 

On December 1, DHCS will virtually convene the CalAIM Behavioral Health Workgroup meeting to provide updates on and discussion of the California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) and CalAIM behavioral health documentation redesign initiatives. Workgroup members may provide feedback on implementation and operational considerations. The meeting is open to the public. Please email questions to BHCalAIM@dhcs.ca.gov.​​ 

Medi-Cal Webinar ການຂະຫຍາຍຕົວສໍາລັບຜູ້ໃຫຍ່​​ 

ໃນວັນທີ 4 ທັນວາ, ຕັ້ງແຕ່ເວລາ 11 ໂມງເຊົ້າ ຫາ 12 ໂມງທ່ຽງ, DHCS ຈະເປັນເຈົ້າພາບຈັດກອງປະຊຸມທາງເວັບກ່ຽວກັບ ການຂະຫຍາຍ Medi-Cal ສຳລັບຜູ້ໃຫຍ່ (ຕ້ອງລົງທະບຽນລ່ວງໜ້າ) ສຳລັບອົງການຈັດຕັ້ງໃນຊຸມຊົນ, MCPs, ຜູ້ໃຫ້ບໍລິການ ແລະ ຜູ້ມີສ່ວນຮ່ວມອື່ນໆທີ່ສົນໃຈ, ລວມທັງຜູ້ທີ່ເປັນຕົວແທນຂອງຜູ້ບໍລິໂພກ, ການເຂົ້າເມືອງ, ການດູແລສຸຂະພາບ, ການຊ່ວຍເຫຼືອທາງດ້ານກົດໝາຍ ແລະ ຜູ້ໃຫຍ່ທີ່ເຂົ້າເມືອງ. DHCS ກຳລັງຈັດຕັ້ງປະຕິບັດການຂະຫຍາຍນີ້ຕາມຮ່າງກົດໝາຍວ່າດ້ວຍສະພາສູງ 184 (ບົດທີ 47, ກົດໝາຍປີ 2022) ໃນວັນ 1 ມັງກອນ, 2024. ເມື່ອຈັດຕັ້ງປະຕິບັດ, ການຂະຫຍາຍດັ່ງກ່າວຈະໃຫ້ຜົນປະໂຫຍດ Medi-Cal ຢ່າງເຕັມທີ່ແກ່ບຸກຄົນທີ່ມີອາຍຸ 26-49 ປີ, ໂດຍບໍ່ຄໍານຶງເຖິງສັນຊາດ ຫຼື ສະຖານະພາບການເຂົ້າເມືອງ, ຖ້າພວກເຂົາມີຄຸນສົມບັດຄົບຖ້ວນຕາມເງື່ອນໄຂການມີສິດໄດ້ຮັບ Medi-Cal ອື່ນໆທັງໝົດ.​​ 

The webinar, which will be live interpreted in Spanish, will provide background information about the expansion, implementation planning, noticing, outreach, and more. Individuals may also submit questions or request to register for the webinar by sending an email to AdultExpansion@dhcs.ca.gov.​​ 

ການສະຫນອງການເຂົ້າເຖິງແລະການຫັນປ່ຽນສຸຂະພາບ (PATH) ການວາງແຜນການຮ່ວມມືແລະການຈັດຕັ້ງປະຕິບັດ (CPI) Webinar Best Practices​​ 

On December 7, from 12:30 to 1:30 p.m., DHCS will host a statewide webinar, Relationship Building with Organizations in the CalAIM Environment (advance registration required) for community-based organizations, county, city, and local government agencies, federally qualified health centers, MCPs, Medi-Cal tribal and designees of Indian Health Programs, and providers. The webinar is part of a biannual series of PATH CPI webinars designed to highlight best practices for implementing ECM and Community Supports, increasing providers’ successful participation in CalAIM, and improving collaboration with MCPs, state and local government agencies, and others to build and deliver quality support services to Medi-Cal members. For more information, please visit the PATH CPI webpage.​​ 

HACCP Webinar ສໍາລັບຜູ້ໃຫ້ບໍລິການທາງການແພດແລະຜູ້ຊ່ຽວຊານດ້ານການໄດ້ຍິນ​​ 

On December 19, from 12 to 1 p.m., DHCS will host a HACCP webinar (advance registration required) to share information with providers to help pediatric patients and their families maximize HACCP benefits. The training session will address program requirements for families to apply for coverage and the claims submission process for audiologists, otolaryngologists, physicians, and their office staff. For more information, please visit www.dhcs.ca.gov/haccp.​​ 

ໃນກໍລະນີທີ່ທ່ານພາດມັນ​​ 

ລັດຄາລິຟໍເນຍສືບຕໍ່ການຫັນປ່ຽນ Medi-Cal ໄປສູ່ການດູແລທີ່ເນັ້ນໃສ່ບຸກຄົນ, ຄວາມສະເໝີພາບ​​ 

On November 15, DHCS issued a news release about how the Department is transforming Medi-Cal to ensure Californians can get the care they need to live healthier lives. As a result of the new Medi-Cal managed care contract, Medi-Cal members will have access to new and improved services to get person-centered, whole-person care that goes beyond the doctor’s office or hospital and addresses their physical and behavioral health and health care-related social needs.​​ 

ພາກທີ 1115 ການສາທິດ: BH-CONNECT ແລະ CalAIM ການດັດແກ້ຄ່າເຊົ່າໄລຍະຂ້າມຜ່ານ​​ 

ໃນວັນທີ 20 ຕຸລາ, DHCS ໄດ້ຍື່ນຄຳຮ້ອງຂໍການສາທິດມາດຕາ 1115 ໃໝ່ໃຫ້ແກ່ CMS - ການສາທິດ BH-CONNECT - ແລະ ການດັດແກ້ທີ່ສະເໜີ ຕໍ່ການສາທິດມາດຕາ 1115 ຂອງ CalAIM ທີ່ກ່ຽວຂ້ອງກັບການບໍລິການເຊົ່າໃນໄລຍະຂ້າມຜ່ານ. ນອກຈາກນັ້ນ, ໄລຍະເວລາໃຫ້ຄຳເຫັນຂອງສາທາລະນະຊົນລະດັບລັດຖະບານກາງຈະເປີດໃຫ້ ບໍລິການເຊົ່າຊົ່ວຄາວ BH-CONNECT ແລະ CalAIM ແຕ່ວັນທີ 27 ຕຸລາ ຫາ ວັນທີ 26 ພະຈິກ.​​ 

ການປ່ຽນ Medi-Cal MCP ເດືອນມັງກອນ 2024​​ 

As part of Medi-Cal transformation, some MCPs are changing on January 1, 2024, and approximately 1.2 million members will have new health plan options and/or will need to transition to new MCPs. Changing MCPs will not affect Medi-Cal member coverage or benefits. Members who transition to a new MCP are receiving notices about the transition. DHCS developed several resources to support members, providers, and other stakeholders with the transition, including the Managed Care Plan Transition Member webpage with a county “lookup” tool, links to member notices sent by Medi-Cal about MCP changes, frequently asked questions, and a Contact Us page for members to learn more about health plans and provider choices. There are also transition resources for providers and MCPs and stakeholders. More information about the transition is available in the 2024 Managed Care Plan Transition Policy Guide and Medi-Cal Eligibility Division Information Letter Number I 23-54.​​