Tahanan Balita Nagsusumikap ang California na Palawakin ang Suporta para sa mga Miyembro ng Medi-Cal na Naapektuhan ng mga Sunog sa Kagubatan sa Timog California​​ 

Gumagana ang California na Palawakin ang Suporta para sa mga Miyembro ng Medi-Cal na Naapektuhan ng Southern California Wildfires​​ 

Enero 17, 2025​​ 

SACRAMENTO — In response to the devastating Southern California wildfires and Governor Gavin Newsom’s proclaimed State of Emergency and Executive Order issued on January 7, 2025, the Department of Health Care Services (DHCS) swiftly implemented key administrative flexibilities to protect Medi-Cal members in affected regions of the state. These efforts include simplified Medi-Cal enrollment and renewal processes, waived requirements to access prescription medications and medical devices, and other flexibilities to ensure all Medi-Cal members have access to care during this emergency.​​ 

Help for Medi-Cal members in Los Angeles County and Ventura County includes:​​ 

  • Simple renewal and enrollment: Simplified Medi-Cal enrollment and renewal processes to allow families to quickly secure or maintain Medi-Cal coverage. Allowed for self-attestation for residency and income if documentation is missing, and verification deadlines are extended. Local county offices are prioritizing Medi-Cal applications and any case restorations for affected Medi-Cal members, who are encouraged to contact their local clinic navigators or local county office if assistance is needed to resolve eligibility issues.​​ 
  • Fast refills for pharmacy and medical equipment: Waived prescription signature requirements for Medi-Cal members. Released a provider alert to allow for early refill authorizations and emergency override of existing utilization management and prior authorization controls to facilitate expedited access to medications and pharmacy products to ensure timely care.​​ 
  • Prioritized member transfers if moving out of Los Angeles or Ventura counties: Medi-Cal members who are displaced for an unknown amount of time may contact either their former county of residence or the new county to assist with transferring the case on a permanent or short-term basis. Members can visit the DHCS website to find their local county office.​​ 
  • Emergency response protocols: Medi-Cal managed care plans that operate in the areas subject to the emergency, including L.A. Care Health Plan, Health Net, Molina Healthcare, Gold Coast Health Plan, Kaiser Permanente, Anthem, Blue Shield of California Promise Health Plan, Senior Care Action Network, and Positive Healthcare California (AIDS Healthcare Foundation), have activated their emergency response protocols. Protocols include deploying care management teams to conduct member outreach, especially for high needs populations; waiving prior authorization requirements; working to provide transportation to care; and ensuring members do not face any out-of-pocket costs for getting care from out-of-network providers, as needed.​​ 

DHCS understands recovering from these wildfires will be challenging and has developed an online resource to help answer Medi-Cal member questions about accessing services during this emergency.​​ 

Current flexibilities for Medi-Cal managed care plans and providers include:​​ 

  • Behavioral health services: Ensured relocated clients from evacuated facilities receive continuous care, with licensing and certification flexibilities supporting affected treatment programs.​​ 
  • Provider support: Extended reporting and administrative deadlines, enabling Medi-Cal providers to prioritize care delivery until the end of the emergency.​​ 
  • Managed care flexibility: Waived prior authorizations and referral requirements for applicable services to help Medi-Cal managed care plans and their network providers deliver timely care to members affected by evacuations and service disruptions.​​ 

Additionally, DHCS submitted requests to the federal Centers for Medicare & Medicaid Services (CMS) to help Californians covered by Medi-Cal impacted by the Southern California wildfires. Section 1135 of the Social Security Act provides flexibility during national public health emergencies.​​ 

“At DHCS, our members are our top priority, and our hearts go out to the families affected by the Southern California wildfires,” said DHCS Director Michelle Baass. “We are working closely with CMS to obtain speedy federal approvals for flexibilities to help our state and Medi-Cal members meet the challenges posed by the wildfires. We will continue to issue guidance to providers so they can quickly take advantage of the new flexibilities to deliver quality, equitable health care to Southern Californian Medi-Cal members.”​​ 

Significant additional flexibilities requested by DHCS include:​​ 

  • Suporta para sa mga klinika at pasilidad:​​ 
    • Pahintulutan ang mga klinika na maghatid ng pangangalaga sa mga alternatibong setting, tulad ng mga mobile clinic o pansamantalang lokasyon, kapag ang mga pangunahing pasilidad ay nasira o hindi naa-access.​​ 
    • Pahintulutan ang buong reimbursement para sa mga serbisyong ibinigay sa mga setting ng pansamantalang pangangalaga, kabilang ang mga shelter at hotel.​​ 
  • Mga karagdagang proteksyon para sa mga miyembro ng Medi-Cal:​​ 
    • Palawigin ang mga timeline para sa mga kahilingan sa patas na pagdinig at muling pagbabalik ng benepisyo, na nagbibigay sa mga miyembro ng Medi-Cal ng karagdagang oras upang lutasin ang mga isyu sa pagiging kwalipikado o mga benepisyo.​​ 
    • Isaayos ang mga kinakailangan sa serbisyong pangkalusugan sa tahanan upang payagan ang mga pagkaantala sa mga harapang pagkikita dahil sa kasalukuyang mga hadlang.​​  
  • Pagpapatala at reimbursement ng provider ng Medi-Cal:​​ 
    • Pabilisin at i-streamline ang pagpapatala ng provider upang gawing mas madali para sa mga provider na mag-alok ng pangangalaga sa mga apektadong miyembro.​​ 
  • Kakayahang umangkop para sa mga pangmatagalang serbisyo at suporta (LTSS):​​ 
    • Palawigin ang mga timeline para sa mga paunang pagsusuri, muling pagtatasa, at pagrepaso sa plano ng pangangalaga upang matiyak ang walang patid na pangangalaga para sa mga indibidwal na nangangailangan ng patuloy na suporta dahil sa edad, kapansanan, o malalang sakit.​​ 
    • Payagan ang paghahatid ng LTSS sa mga alternatibong lokasyon, gaya ng mga shelter o hotel.​​ 
  • Mga extension para sa pag-uulat at pag-claim ng mga kinakailangan:​​ 
    • Magbigay ng mga extension para sa pag-uulat ng data at pagsusumite ng mga claim, na nagpapahintulot sa mga apektadong lokal na ahensya at institusyong pang-edukasyon na matugunan ang mga deadline.​​ 
    • Payagan ang mga planong pangkalusugan ng higit na kakayahang umangkop sa pagtugon sa mga kinakailangan sa pag-uulat upang matiyak na maaari silang magpatuloy sa paglilingkod sa mga miyembro kung ang mga wildfire ay makagambala sa mga normal na operasyon. Kasama sa mga pagsasaayos ang pagsasaayos ng mga panuntunan tungkol sa kung gaano kalayo ang maaaring kailanganin ng mga miyembro para sa pangangalaga at kung gaano kabilis nila maa-access ang LTSS.​​ 

DHCS is dedicated to safeguarding the health and well-being of Medi-Cal members and communities suffering from the devastating effects of the Southern California wildfires. DHCS’ purpose extends beyond routine health care services, focusing on proactive planning, rapid response, and continuous support in the face of challenges like these wildfires.​​ 

Sa pamamagitan ng pinagsama-samang pagsisikap sa mga kasosyo ng estado, lokal, pederal, at Tribal, tinitiyak ng DHCS na ang mahahalagang serbisyo sa pangangalagang pangkalusugan ay mananatiling naa-access at napapanahon para sa mga apektadong indibidwal. Ginagamit ng DHCS ang kadalubhasaan ng mga koponan nito at ang flexibility ng mga regulasyong pang-emergency upang tugunan ang mga natatanging pangangailangan ng mga komunidad sa Southern California, mula sa pagpapadali ng pag-access sa pangangalagang medikal at mga serbisyo sa kalusugan ng pag-uugali hanggang sa pagtiyak ng pagkakaroon ng mga gamot at matibay na kagamitang medikal.​​ 

BACKGROUND: On January 8, 2025, in response to the catastrophic wildfires in Southern California, President Joseph R. Biden, Jr. declared that a major disaster exists in the State of California in the areas affected by wildfires. On January 10, 2025, U.S. Department of Health & Human Services Secretary Xavier Becerra declared a public health emergency for California, granting CMS additional flexibility to address the health needs of impacted individuals. These measures were made possible through extensive preparedness planning and proactive emergency response protocols. These efforts underscore a strong state and federal partnership, ensuring uninterrupted care and services during this emergency.​​ 

DHCS administers Medi-Cal, California’s version of Medicaid, providing health coverage to nearly 15 million people, including nearly 4 million members in Los Angeles County and more than 250,000 members in Ventura County.​​ 

DHCS encourages all affected residents to follow local evacuation orders, monitor air quality, and wear masks outdoors, if needed. If Medi-Cal members need assistance, they should contact their health care provider or plan.​​  

KARAGDAGANG IMPORMASYON: Available ang mga mapagkukunan at update sa mga sumusunod na link:​​ 

Kumuha ng tulong ngayon:​​ 

  • Californians can visit CA.gov/LAfires, a hub for information and resources from state, local, and federal governments.​​ 
  • Ang mga indibidwal at may-ari ng negosyo na nawalan ng mga wildfire ay maaaring mag-aplay para sa tulong sa sakuna:​​ 
  • Online sa DisasterAssistance.gov.​​ 
  • Sa pamamagitan ng pagtawag sa 800-621-3362.​​ 
  • Sa pamamagitan ng paggamit ng Federal Emergency Management Agency (FEMA) smartphone application.​​ 
  • Ang tulong ay makukuha sa higit sa 40 mga wika.​​ 
  • Kung gumagamit ka ng serbisyo ng relay, gaya ng serbisyo ng video relay, serbisyo ng teleponong may caption, o iba pa, ibigay sa FEMA ang numero para sa serbisyong iyon.​​ 

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CONTACT:​​ 
Office of Communications
(916) 440-7660
www.dhcs.ca.gov​​