October 14, 2024 – Stakeholder Update​​ 

Главные новости​​ 

Инициатива по возвращению в общество с участием правосудия DHCS запущена​​ 

On October 1, DHCS launched the Justice-Involved Reentry Initiative, which is designed to provide a targeted suite of medical and mental health services for youth and adults in state prisons, county jails, and youth correctional facilities in the 90 days prior to their release, aiming to ensure a smoother transition and improving overall well-being and public health outcomes. Three counties – Inyo, Santa Clara, and Yuba – were approved as of October 1 to begin delivering Medi-Cal services to people returning to communities after incarceration. Additional counties will begin offering services in early 2025.​​ 

California is the first state in the nation to receive federal approval and implement this historic initiative. For those eligible, a care manager will be assigned—either in-person or via telehealth—to establish a relationship with the individual, understand their health needs, coordinate vital services, and make a plan for community transition. The Justice-Involved Reentry Initiative is designed to help stabilize chronic and significant clinical health conditions, including mental illness and substance use disorders, and to facilitate a coordinated reentry to support smoother transitions and improve public health. Further, the Justice-Involved Reentry Initiative aims to close equity gaps and improve health outcomes for people who are or have been incarcerated.​​ 

DHCS worked closely with its implementation partners, including the California Department of Corrections and Rehabilitation, county jails and probation, county behavioral health and social services, Medi-Cal managed care plans, community-based providers, and Tribal partners, to launch the Justice-Involved Reentry Initiative. Correctional facilities have the flexibility to determine their go-live dates between October 1, 2024, and September 30, 2026, and will be subject to a DHCS readiness review process before they can launch.​​ 

Обновления программы​​ 

Medi-Cal’s Superior Systems Waiver​​ 

The federal Centers for Medicare & Medicaid Services approved the Superior Systems Waiver (SSW) renewal application, effective from October 1, 2024, through September 30, 2029. The SSW describes the utilization review process for acute inpatient hospitals that serve fee-for-service Medi-Cal patients. Under SSW authority, DHCS employs the following utilization review approaches, depending on the type of acute inpatient service, hospital type, and characteristics of the member’s health care coverage:​​ 

• Процесс запроса на разрешение лечения (TAR): Процесс TAR требует, чтобы DHCS одобрило стационарные услуги больницы до утверждения возмещения. Больницы направляют запросы на прием в DHCS для рассмотрения и одобрения госпитализации, чтобы убедиться в медицинской необходимости до подачи заявки на услуги.​​  
• Процесс TAR-Free: Процесс TAR-Free требует, чтобы больницы использовали основанные на фактических данных стандартизированные критерии медицинской экспертизы для определения медицинской необходимости и требований по стационарным больничным услугам, в то время как DHCS проводит постплатежные клинические и административные проверки соответствия, используя статистически обоснованные выборки требований по оплаченным стационарным больничным услугам.​​  

Please see the SSW webpage for more information, and please email your questions to SSWRenewal@dhcs.ca.gov. The Cal Health Find database includes listings of different facilities, including acute care hospitals.​​ 

Присоединяйтесь к нашей команде​​ 

DHCS ищет высококвалифицированных, исключительно мотивированных людей на должности:​​ 

• Начальник отдела регистрации поставщиков услуг (PED) будет руководить разработкой и внедрением политик, процессов и услуг, связанных с регистрацией поставщиков услуг, включая проверку, регистрацию и повторную сертификацию поставщиков услуг Medi-Cal. Кроме того, начальник PED несет полную ответственность за разработку и внедрение нормативных и процессуальных изменений в бизнес-требования и усовершенствования системы подачи заявок и проверки поставщиков для регистрации. (Окончательная дата подачи: 14 октября)
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• Начальник отдела финансирования местных органов власти, который будет осуществлять организационное руководство и разрабатывать политику в поддержку программ Medi-Cal Behavioral Health и услуг местного образовательного агентства, а также других мероприятий по федеральному возмещению и финансированию на местном и окружном уровне. (Окончательная дата подачи: 18 октября)​​ 

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

Предстоящие встречи заинтересованных сторон и вебинары​​ 

Вебинар рабочей группы по поведенческому здоровью (BHTF)​​ 

On October 15, from 12 to 1:30 p.m. PDT, the BHTF will hold a webinar on population-based prevention (advanced registration is required). Participants include Dr. Tomás Aragón, MD, DrPH, Director of the California Department of Public Health (CDPH) and State Public Health Officer, and Julie Nagasako, Deputy Director of the Office of Policy and Planning at CDPH. This webinar will help prepare attendees for an in-depth discussion at the November 13 BHTF quarterly meeting. The webinar will be recorded and posted on the BHTF website. For questions, comments, or to join the BHTF listserv, please email BehavioralHealthTaskForce@chhs.ca.gov.​​ 

Консультативный комитет заинтересованных сторон (SAC)/Совещание поведенческого здоровья (BH)-SAC​​ 

On October 16, from 9:30 a.m. to 3 p.m. PDT, DHCS will host the hybrid SAC/BH-SAC meeting (advance registration required for online and in-person participation) at 1700 K Street (first-floor conference room 17.1014), Sacramento. SAC provides DHCS with valuable input on ongoing California Advancing and Innovating Medi-Cal (CalAIM) implementation efforts and helps DHCS further its efforts to provide high-quality, equitable care. BH-SAC provides DHCS with input regarding behavioral health activities and was created as part of the ongoing effort to integrate behavioral health with the greater health care system. It incorporates existing groups that have advised DHCS on behavioral health topics. The agenda is available in the meeting materials. For more information, please email SACinquiries@dhcs.ca.gov or BehavioralHealthSAC@dhcs.ca.gov.​​ 

Саммиты по снижению вреда DHCS​​ 

Registration is currently open for the first two DHCS Harm Reduction Summits in Shasta County (October 24) and San Mateo County (November 19). Through these convenings, DHCS aims to collaborate with communities across the state to promote harm reduction within California’s substance use disorder (SUD) treatment system and create low-barrier, patient-centered care. DHCS encourages SUD treatment providers and staff (including social workers, peers, front desk staff, case managers, nurses, physicians, and all staff in SUD treatment settings) to attend and learn about best practices for incorporating the tenets of harm reduction into SUD treatment. Additional summits will be held in Fresno County, Los Angeles County, and San Diego County in winter 2025. Register on the event website.​​ 

Вебинар Chosen Family: Контрацепция для трансгендеров и людей с разной гендерной принадлежностью​​ 

On October 29, from 10 a.m. to 11:30 a.m. PDT, DHCS and the California Prevention Training Center will host the Chosen Family: Contraception for Transgender and Gender Diverse People webinar (advanced registration required). Transgender and gender diverse (TGD) people represent a growing subset of patient populations, yet many continue to report a lack of provider knowledge when it comes to TGD health. This webinar will build upon TGD health terminology and competency essentials by reviewing evidence-based recommendations for contraceptive counseling. For those unable to attend the live webinar, a transcript and recording of the webinar, along with additional resources, will be available on the Family PACT website at a later date.​​ 

Программа стандартов для квалифицированных работников учреждений сестринского ухода​​ 

On November 6, from 10 to 11 a.m. PST, DHCS will host a provider webinar (advance registration required) to provide an overview of the Skilled Nursing Facility (SNF) Workforce Standards Program (WSP) opt-in process launched by DHCS on October 1. Providers can send questions they would like answered during the webinar to SNFWSP@dhcs.ca.gov by October 30.​​ 

This program will provide an increased Workforce Rate Adjustment to SNFs that maintain a collective bargaining agreement, participate in a statewide multi-employer labor management committee, or meet basic wages and benefit standards established by DHCS. The SNF WSP makes available more than $500 million annually to enable SNFs to recruit and retain a workforce that provides high-quality long-term care to Medi-Cal members. SNFs wishing to participate in the WSP for calendar years 2024 and 2025 must submit the required opt-in materials no later than December 1, 2024. Please visit the SNF WSP webpage for more information.​​ 

Вебинар по программе обеспечения детей слуховыми аппаратами (HACCP) для медицинских работников и специалистов по слуху​​ 

On November 12, from 12 to 1 p.m. PST, DHCS will host the quarterly HACCP webinar for medical providers and hearing professionals. For more information and to register, please visit DHCS’ HACCP webpage.​​ 

Вебинар HACCP для семей и общественных партнеров​​ 

On December 3, from 11 a.m. to 12 p.m. PST, DHCS will host a webinar to share guidance with families and community partners about applying for hearing aid coverage and maximizing HACCP benefits once enrolled. For more information and to pre-register, please visit the HACCP webpage.​​  

На случай, если вы это пропустили​​ 

Доступна критически важная возможность финансирования для расширения услуг поведенческого здоровья​​ 

On July 17, DHCS released the Bond Behavioral Health Continuum Infrastructure Program (BHCIP) Round 1: Launch Ready Request for Applications. Eligible organizations can apply for funding to construct, acquire, and rehabilitate properties for behavioral health services for Medi-Cal members. Interested parties can find application instructions on the BHCIP website and must sign up for a pre-application consultation by October 15 in order to be eligible. Applications must be submitted by December 13. This initiative, part of Proposition 1, seeks to transform California’s mental health and substance use disorder systems, providing more comprehensive care for the state’s most vulnerable populations. For more information, contact DHCS at BHTinfo@dhcs.ca.gov​​ 

Поддержка психического здоровья​​ 

DHCS, in concert with The Children’s Partnership, announced the awarding of $8 million to eight California high schools to serve as pilot sites to conduct the Peer-to-Peer Youth Mental Health Program. The awards are part of Governor Gavin Newsom’s Children and Youth Behavioral Health Initiative, a cornerstone of his Master Plan for Kids’ Mental Health. The program was designed in collaboration with youth to identify promising, evidence-based peer-to-peer interventions to improve youth mental health.
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