Tahanan Balita sa mga Stakeholder ng DHCS – Mayo 12, 2023​​ 

DHCS Stakeholder News – May 12, 2023​​ 

Nangungunang Balita​​  

Governor’s May Revision​​  

Governor Gavin Newsom proposed a $156 billion May Revision for DHCS programs and services for fiscal year 2023-24. It proposes to support vital services that reinforce the state’s commitment to preserve and improve the overall health and well-being of all Californians while operating within a responsible budgetary structure. Highlights include:​​  

Managed Care Organization (MCO) Tax and Medi-Cal Provider Rate increases. The May Revision includes the renewal of the MCO tax, effective April 1, 2023, nine months earlier than planned at Governor’s Budget. This earlier start results in approximately $3.7 billion in additional General Fund for calendar year 2023. Additionally, the May Revision increases MCO revenue (as compared to Governor’s Budget) to achieve an approximately $5 billion annual state benefit.
A portion of this revenue will support an increase in provider rates to at least 87.5 percent of Medicare for specified providers, including Primary Care (inclusive of nurse practitioners and physician assistants), Maternity Care (inclusive of OB/GYN and doulas), and non-specialty mental health services beginning January 1, 2024.
Additionally, in collaboration with key stakeholders in the Medi-Cal delivery system and with a focus on enhancing equitable access to care, DHCS will assess which ongoing, long-term rate augmentations will deliver the greatest benefit to improving Medi-Cal systems across California. The focus will be to look at additional augmentations to primary care, maternal care, and behavioral health as well as specialty care, outpatient, and acute care systems with attention on how to increase the commitment of providers to serve Medi-Cal members, support providers in disproportionately impacted areas, and build robust teams and programs with a strong workforce, to ensure care is provided in the right settings, at the right time, and at the highest quality. Following this process, DHCS will return with a proposed set of investments and augmentations that will be put forward to the Legislature in the 2024-25 Governor’s Budget, with an intended effective date of January 1, 2025. 
Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT). Formerly known as California Behavioral Health Community-Based Continuum (CalBH-CBC), the proposal continues to include the 1115 demonstration waiver to address the gaps in the behavioral health continuum of care for Medi-Cal members living with serious mental illness (SMI) and serious emotional disturbance (SED). The May Revision adds a new Workforce Initiative to the waiver, $480 million a year for the five years ($2.4 billion total funding), to strengthen the pipeline of behavioral health professionals, including improving short-term recruitment and retention efforts. 
Behavioral Health Modernization. The May Revision includes initial funding to support the behavioral health modernization proposal.​​  

Mga Dokumento ng Badyet sa Pagbabago ng Mayo:​​ 

Nag-anunsyo ang DHCS ng Bagong Pangalan para sa Pagwawaksi sa Kalusugan ng Pag-uugali​​  

DHCS is renaming the proposed California Behavioral Health Community-Based Continuum (CalBH-CBC) demonstration waiver to better align with the Department’s mission, vision, and goals. It will now be known as the Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) waiver. The name change emphasizes DHCS’ commitment to providing a robust continuum of community-based behavioral health care services and improving equity, quality, and access for all Medi-Cal members living with SMI and SED, particularly populations experiencing disparities in behavioral health access and outcomes. The waiver name is new, but its objectives and approach remain the same.  

The waiver is informed by findings from DHCS’ 2022 report, Assessing the Continuum of Care for Behavioral Health Services in California, and is a historic opportunity to make significant investments in the full continuum of care for behavioral health, with a particular focus on the most vulnerable populations. For more information about this waiver, please visit the DHCS website.​​  

Mga Update sa Programa​​  

Concept Paper sa Updated Population Needs Assessment (PNA)​​  

DHCS released a concept paper that outlines DHCS’ vision of a reimagined PNA that Medi-Cal managed care plans (MCPs) are required to complete. DHCS envisions a modified PNA that promotes greater alignment with local health departments and other community stakeholders, more robust community engagement, and a deeper understanding of member health and social needs and preferences and the communities in which they live. This approach will help target resources and interventions to support improved health outcomes for Medi-Cal members. DHCS encourages feedback on the concept paper through written comments and by participating in upcoming public forums and advisory groups. DHCS will accept public comment through 5 p.m. on June 2, 2023, to PHMSection@dhcs.ca.gov, with the subject line “Comments on PNA Concept Paper”.​​   

Along with the concept paper, DHCS will soon issue a new All Plan Letter (APL) to replace APL 19-011 and provide near-term MCP guidance on the modified PNA and the new population health management strategy. For more information and regular updates, please visit the CalAIM Population Health Management Initiative webpage.​​  

Proyekto ng Health Enrollment Navigators​​   

Noong Mayo 12, ipinaalam ng DHCS sa mga kasosyo na nag-aplay para sa natitirang hindi nakalaan na pagpopondo ng Health Enrollment Navigator na $ 3.6 milyon na naaangkop sa pamamagitan ng Assembly Bill 74 (Kabanata 23, Mga Batas ng 2019) at Senate Bill 154 (Kabanata 43, Mga Batas ng 2022). Ang mga karagdagang pondo na ito ay agad na magbibigay-daan sa mga kasosyo na magtatag ng mga bago, at dagdagan ang umiiral na, mga aktibidad at kaganapan na may kaugnayan sa pagpapalawak ng Medi-Cal at pag-renew ng Medi-Cal sa panahon ng patuloy na pag-unwind ng saklaw. Ang mga lokal na organisasyong nakabase sa komunidad na interesadong tumulong sa mga pagsisikap na ito ay maaaring sumangguni sa Impormasyon sa Pakikipag-ugnay sa Kasosyo ng Proyekto sa seksyon ng Mga Kasosyo sa Proyekto ng website ng DHCS.​​  

Medi-Cal Rx Update​​  

Sa Mayo 19, ipapatupad ang Phase III, Lift 3 , na inaalis ang Transition Policy para sa 22 Standard Therapeutic Classes. Ito ang pangatlo sa isang serye ng mga pag-angat upang i-phase out ang pag-grandfather sa mga makasaysayang naunang awtorisasyon at pag-angkin sa pamamagitan ng pagbabalik sa Reject Code 75 – Kinakailangan ang Paunang Awtorisasyon.​​  

Smile, California Campaign para sa Medi-Cal Dental Services​​ 

Sa linggo ng Mayo 22, isang buwanang Smile Alert e-newsletter ang ipapadala sa lahat ng subscriber na nagsisilbing paalala para sa mga miyembro ng Medi-Cal na kumuha ng 2023 Member Customer Service survey. Tatawagin din ng newsletter ang pansin sa pahina ng mga karaniwang tanong sa SmileCalifornia.org, kung saan maaaring ma-access ng mga miyembro ng Medi-Cal ang mga karaniwang tanong tungkol sa saklaw ng dental ng Medi-Cal.​​    

Taunang Ulat ng Programa ng Family PACT​​   

Noong Mayo 12, nai-post ng DHCS ang Family Planning, Access, Care and Treatment (Family PACT) Program Fiscal Year 2019-20 Report sa Family PACT website. Ang batas ay nangangailangan ng taunang pagsusuri ng mga pangunahing sukatan ng programa. Ang taunang ulat na ito ay batay sa enrollment at mga claim data na naglalarawan sa Family PACT provider at populasyon ng kliyente, mga uri ng mga serbisyong ginamit, at pagbabayad ng programa. Ang mga petsa ng serbisyo sa ulat na ito ay para sa taon ng pananalapi 2019-20, na nagsimula noong Hulyo 1, 2019, at natapos noong Hunyo 30, 2020.​​  

Sumali sa Aming Koponan​​    

DHCS is hiring! DHCS has an immediate opening for Deputy Director and Chief Counsel, Office of Legal Services. This executive role offers the right attorney an opportunity to lead DHCS’ legal team in providing comprehensive legal and regulatory services and advice regarding Medi-Cal and behavioral health.​​  

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

Ang DHCS ay nakatuon sa pangangalaga at pagpapabuti ng pangkalahatang kalusugan at kagalingan ng lahat ng mga taga-California. Ang misyon ng DHCS ay magbigay sa mga pinakamahihirap na residente ng patas na pag-access sa abot-kaya, pinagsama, mataas na kalidad na pangangalagang pangkalusugan, at kasalukuyang binabago ang programa ng Medi-Cal upang matiyak na ibinibigay nito ang pangangalagang kailangan ng mga taga-California upang mamuhay ng mas malusog, mas maligayang buhay. ​​  

Mga Paparating na Mga Pagpupulong ng Stakeholder at Webinar​​  

Dementia Care Aware – Cognitive Health Assessment (CHA) Virtual Training​​  

Simula Mayo 19, 2023, ang Dementia Care Aware ay nag-aalok ng buwanang mga pagsasanay sa Zoom (kinakailangan ang advance na pagpaparehistro) sa CHA, na pinangunahan ng mga eksperto sa geriatric medicine sa University of California, Irvine. Ang CHA ay isang diskarte sa screening ng dementia na nilalayon na isagawa sa mga pasyenteng may edad nang nasa hustong gulang kapag may ipinahiwatig na cognitive screen. Ang mga tagapagbigay ng pangunahing pangangalaga at mga koponan ay dapat sumali sa pagsasanay sa Mayo 19, at sa una at ikatlong Biyernes ng bawat buwan pagkatapos noon, upang matuto nang higit pa tungkol sa kung paano mabibigyang kapangyarihan ng pagtatasa na ito ang mga tagapagbigay ng pangunahing pangangalaga at kanilang mga koponan upang mas mahusay na matukoy ang dementia sa kanilang mga pasyente. Available ang libreng patuloy na edukasyong medikal at patuloy na edukasyon.​​   

Na-update na Mga Kinakailangan at Pamamaraan para sa Pagpapatala ng Medi-Cal Dental Provider​​  

On May 22, from 1:30 to 3 p.m., DHCS will hold a public hearing via webinar (advance registration required) to discuss the regulatory provider bulletin entitled, “Updated Requirements and Procedures for the Enrollment of Medi-Cal Dental Providers.” Stakeholders can submit questions and suggestions during the hearing, and written comments will be accepted on the day of the hearing. Based on the public comments received, DHCS will publish the final bulletins on the Medi-Cal and DHCS websites. The changes will become effective 30 days after publication.​​   

For those who are unable to attend, written comments to be considered prior to publication may be submitted by 5 p.m. on May 22 to DHCSPEDStakeholder@dhcs.ca.gov. Please ensure the commenter and organization/association represented are identified in the comment.​​  

Stakeholder Advisory Committee (SAC) at Behavioral Health Stakeholder Advisory Committee (BH-SAC) Meeting​​   

Sa Mayo 24, mula 9:30 am hanggang 3:30 pm, iho-host ng DHCS ang pangalawang SAC at BH-SAC hybrid meeting ng 2023 (kinakailangan ang advance na pagpaparehistro). Ito ay magbubukas bilang magkasanib na pagpupulong, na may mga paksang ibinahagi ng SAC at BH-SAC. Magkakaroon ng BH-SAC-only meeting na gaganapin pagkatapos ng joint meeting; walang SAC-only meeting. Ang mga dadalo ay maaaring dumalo nang personal sa The California Endowment, na matatagpuan sa 1414 K Street sa downtown Sacramento, o halos. Para sa karagdagang impormasyon, mangyaring bisitahin ang SAC at BH-SAC webpage.​​  

Workgroup ng Iskedyul ng Bayad​​  

Sa Mayo 25, mula 1 hanggang 3 pm, ang DHCS, sa pakikipagtulungan ng Department of Managed Health Care (DMHC), ay halos magho-host ng ika-apat na pampublikong workgroup meeting (kinakailangan ang advance na pagpaparehistro) upang talakayin ang pagbuo ng iskedyul ng bayad sa buong estadong nagbabayad para sa mga serbisyo sa kalusugan ng pag-uugali na nakabatay sa paaralan sa ilalim ng Inisyatibong Pangkalusugan ng Pag-uugali ng Mga Bata at Kabataan. Makikipag-ugnayan ang DHCS at DMHC sa mga kasosyong kumakatawan sa K-12 na edukasyon, mga institusyon ng mas mataas na edukasyon, mga Medi-Cal MCP, mga komersyal na planong pangkalusugan, mga departamento ng kalusugan ng pag-uugali ng county, mga tagapagbigay ng kalusugan sa pag-uugali, mga asosasyon, mga tagapagtaguyod, kabataan, at mga magulang/tagapag-alaga sa iba't ibang mga paksa ng patakaran at pagpapatakbo upang ipaalam ang pagbuo at pagpipino ng disenyo ng programa.​​     

Kung sakaling Nalampasan Mo Ito​​  

DHCS Director Michelle Baass’ Message on the End of the COVID-19 Public Health Emergency (PHE)  ​​  

DHCS expresses gratitude to our plans, providers, stakeholders, and other partners for their commitment and partnership during the COVID-19 PHE. We worked together and adapted quickly to the pandemic’s challenges and difficulties to care for millions of Californians. Our joint efforts enabled us to navigate the PHE with resilience and perseverance, and we are grateful for your ongoing engagement.  Read the full statement.​​   

Mga Bagong Lifesaving Tool at Resources para sa Pag-iwas, Paggamot, at Pagbawi ng Substance Use Disorder​​  

On May 11, DHCS launched a partnership with national nonprofit Shatterproof to help combat the substance use crisis, keep Californians safe, and provide recovery resources to those in need. The new resources include Treatment Atlas, a confidential addiction treatment locator, assessment, and standards website platform that connects individuals and their families to appropriate evidence-based, high-quality addiction treatment. Additionally, to empower individuals and change attitudes about substance use disorders, DHCS launched Unshame California, a science-driven and content-based campaign that promotes anti-stigma messaging through stories of Californians impacted by substance use disorders. Both of these resources are available in English and Spanish.​​   

Nai-publish na Impormasyon sa COVID-19​​