Январь 13, 2025
Главные новости
Реакция DHCS на лесные пожары в Южной Калифорнии
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.
The California Governor’s Office of Emergency Services and the Department of Rehabilitation developed an Emergency Preparedness Guide/Toolkit for Individuals with Disabilities available in multiple languages that includes information and emergency preparedness tips for individuals with specific disabilities. Follow Cal Fire and your local emergency officials for real-time updates about the wildfires, and sign up for local alerts at calalerts.org. Please see the below additional resources for more information:
- CA.gov/LAfires – Provides resources for Californians impacted by the Los Angeles wildfires.
- Listos California – Offers an Emergency Alerts sign-up page to help connect Californians with their local alerts systems based on a provided zip code or location.
- 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.
- Substance Abuse and Mental Health Services Administration Wildfire Resources – Supports survivors, family members, responders, and recovery workers affected by wildfires and other disasters. Information includes signs of emotional distress, populations who may be at greater risk for distress after a wildfire, and links to resources for more information and support.
- The Centers for Disease Control and Prevention – Provides information on hazards, including wildfires, and offers links to information about staying safe after a wildfire and learning about and coping with hazards linked to wildfires and other disasters.
- 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.
Департамент здравоохранения и социальных служб США по-прежнему привержен оказанию поддержки сообществам в это непростое время и выражает благодарность спасателям и работникам здравоохранения на местах. Берегите себя, следите за официальными обновлениями для получения последней информации и следуйте распоряжениям местных властей об эвакуации.
Предлагаемый бюджет DHCS на 2025-26 гг.
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.
Обновления программы
Поправка к государственному плану (SPA) одобрена для диадических услуг
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.
Переход на новый портал Family PACT
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.
Корректировка политики для интеграции педиатрических услуг Medi-Cal Rx (PI)
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:
- В течение периода не менее 60 дней, если в противном случае заявка была бы отклонена с кодом отклонения 75 (требуется PA), но у участника Medi-Cal есть недавняя история претензий, заявка будет оплачена без необходимости в дополнительном PA. DHCS предполагает, что такой подход предоставит поставщикам и врачам дополнительное время для корректировки внутренних процессов, лучшего планирования требований PI и подачи упреждающих PA.
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.
Присоединяйтесь к нашей команде
DHCS ищет талантливого и мотивированного человека на должность:
- 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.
Предстоящие встречи заинтересованных сторон и вебинары
Вебинар Консультативного комитета по вопросам качества и справедливости в области трансформации поведенческого здоровья
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.
Smile, California Webinar: Promoting the Medi-Cal Dental Benefit for National Children’s Dental Health Month
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.
Саммиты по снижению вреда DHCS
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.
Серия вебинаров посла освещения: Инициатива по возвращению в общество с участием правосудия и Инициатива поведенческого здоровья детей и молодежи. Обновление
On January 30, from 11 to 11:45 a.m. PST, DHCS will host a webinar for DHCS Coverage Ambassadors (advance registration required). The webinar will provide updates on the Justice-Involved Reentry Initiative and Children Youth Behavioral Health Initiative (CYBHI). It will convey information on justice-involved individuals who are now, or have spent time, in jails, youth correctional facilities, or prisons and who are at higher risk for poor health outcomes, injury, and death than the public. It will focus on significant steps California is taking to improve poor health outcomes for individuals as they prepare to reenter their communities by working to ensure they have continuity of coverage upon their release. Additionally, Coverage Ambassadors will learn how early childhood wraparound services will be expanded through the CYBHI, which will provide mental health services to children, youth, and families. Find out more about DHCS Coverage Ambassadors, or sign up to become a Coverage Ambassador.
Обучение установке внутриматочных контрацептивов (ВМС) и противозачаточных имплантатов
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.
На случай, если вы это пропустили
CMS выбирает DHCS для инновационной модели трансформации материнского здоровья
On January 6, CMS approved California’s participation in its Center for Medicare and Medicaid Innovation’s Transforming Maternal Health (TMaH) Model, a ten-year Medicaid and Children’s Health Insurance Program (CHIP) delivery and payment model designed to test whether effective implementation of evidence-informed interventions, sustained by a value-based payment (VBP) model, can improve maternal outcomes and reduce program expenditures for Medicaid and CHIP.
DHCS will implement the TMaH Model in five counties: Fresno, Kern, Kings, Madera, and Tulare. The TMaH Model is part of California’s broader commitment to addressing racial and ethnic disparities in maternal health and ensuring that all pregnant people, especially people in low-income communities, receive the support they need to safely navigate pregnancy and childbirth.
Открыто: Предоставление доступа и трансформация здравоохранения (PATH) Переход, расширение и развитие инфраструктуры (CITED) Раунд 4 Заявка
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.
Заявка поставщика на участие в 5-м раунде технической помощи (TA) PATH Marketplace
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.
DHCS не будет принимать заявки на новые готовые проекты или изменения в существующих готовых проектах в течение периода закупок 5-го раунда. Вместо этого заявка на 5-й раунд будет запрашивать ресурсы по запросу у существующих поставщиков ТА. Посетите веб-страницу поставщика TA Marketplace, чтобы получить доступ к руководящим документам и подать заявку. Пожалуйста, отправляйте вопросы на ta-marketplace@ca-path.com.