Abril 1, 2025
Nangungunang Balita
Inilabas ng DHCS ang Pinakabagong Pamamahala sa Pinahusay na Pangangalaga at Suporta ng Komunidad sa Quarterly Report
On March 27, DHCS released the latest Enhanced Care Management (ECM) and Community Supports quarterly report summarizing utilization data from July 2024 through September 2024. Key highlights from the report include:
- Patuloy na paglago: Mula noong inilunsad ang ECM noong Enero 2022, 279,824 natatanging miyembro ng Medi-Cal ang matagumpay na nakapag-enroll sa mga benepisyo ng ECM. Sa ikatlong quarter lamang ng 2024, 143,188 natatanging miyembro ang naka-access sa mga benepisyo ng ECM, isang pagtaas ng 13 porsiyento mula sa ikalawang quarter ng 2024.
- Paglahok ng kabataan: Noong Q3 2024, 28,342 na bata at kabataang wala pang 21 taong gulang ang naka-access sa mga benepisyo ng ECM, na nagmarka ng 13 porsiyentong pagtaas mula sa Q2 2024.
- Paggamit ng Community Supports: Humigit-kumulang 296,500 natatanging miyembro ng Medi-Cal ang gumamit ng Community Supports, na may higit sa 754,000 kabuuang mga serbisyong naihatid. Sa ikatlong quarter lamang ng 2024, 136,031 natatanging miyembro ang nakatanggap ng Mga Suporta sa Komunidad, isang pagtaas ng 7.5 porsiyento mula sa ikalawang quarter ng 2024.
- Mas mataas na access sa serbisyo: Pagsapit ng Q3 2024, halos 90 porsiyento ng mga miyembro ng Medi-Cal ay nagkaroon ng access sa hindi bababa sa 10 sa 14 na mga serbisyong Suporta sa Komunidad. Mahigit sa 41 porsiyento ng mga miyembro ang may access sa buong hanay ng mga serbisyo.
- Nagamit ang mga pangunahing serbisyo: Mahigit sa 61 porsiyento ng mga miyembrong gumagamit ng Mga Suporta ng Komunidad ang na-access ang Mga Pagkain na Pinasadyang Medikal/Mga Pagkain na Nakasuporta sa Medikal, at humigit-kumulang 32 porsiyento ang gumamit ng isa o higit pang mga serbisyo mula sa Housing Trio (Mga Serbisyo sa Pag-navigate sa Transisyon ng Pabahay, Mga Serbisyo sa Pangungupahan at Pagpapanatili ng Pabahay, at Mga Deposito sa Pabahay).
Ang pinakabagong ulat sa pagpapatupad ng ECM at Community Supports ay nagpapakita ng patuloy na pagtaas sa paggamit ng quarter-over-quarter habang ang mga karagdagang populasyon na nakatutok ay naging karapat-dapat para sa ECM at ang mga karagdagang serbisyo ng Mga Suporta sa Komunidad ay iniaalok sa mga county sa buong estado. Inaasahan ng DHCS na makakita ng higit pang paglago ng enrollment sa ECM at Community Supports sa mga darating na buwan at taon. Sa 2025, patuloy na susuportahan at pananatilihin ng DHCS ang paglago na ito sa pamamagitan ng pinalawak na pagsusumikap sa pagsubaybay sa programa ng ECM at Community Supports, matatag na pakikipag-ugnayan ng stakeholder, at mga pagpipino sa disenyo ng patakaran.
Mga Update sa Programa
Mga Manggagawa sa Kalusugan ng Komunidad
Effective April 1, DHCS updated Medi-Cal’s existing Community Health Worker (CHW) policy to allow supervising Medi-Cal providers to bill for covered CHW services provided by CHWs using two new Healthcare Common Procedure Coding System (HCPCS) codes recently added by the Centers for Medicare & Medicaid Services (CMS). DHCS is updating this policy to allow CHWs to better address the economic and social conditions that influence Medi-Cal members and community health, such as food, housing, and transportation insecurities and access to essential utilities. DHCS’ updated CHW policy aims to more effectively support and promote improved health outcomes for Medi-Cal members by addressing needs affected by social drivers of health. DHCS also issued a State Plan Amendment Public Notice to set the rates for these two codes to 100 percent of the Medicare rate, pursuant to Welfare & Institutions Code Section 14105.25.
Additionally, on April 1, DHCS issued a statewide standing recommendation that all Medi-Cal members who meet defined eligibility criteria for receiving CHW services would benefit from CHW services. This standing recommendation, issued to improve access and reduce barriers to Medi-Cal members receiving and Medi-Cal providers rendering CHW services, is signed by Dr. Karen Mark, DHCS’ Medical Director for Policy and Evaluation. Consistent with existing policy, this standing recommendation authorizes CHWs to provide covered Medi-Cal CHW services, including health education, health navigation, screening and assessment, and individual support and advocacy.
Sumali sa Aming Koponan
Ang DHCS ay naghahanap ng isang may talento at motibasyon na indibidwal na maglingkod bilang:
- Chief of the Benefits Division (BD). The Chief of BD leads the development, implementation, and administration of medical coverage policies for health care services provided by the state’s Medi-Cal program. The Chief also oversees several specialty programs within Health Care Benefits and Eligibility, including Every Woman Counts, Prostate Cancer Treatment, and Hearing Aid Coverage for Children. Applications must be submitted by April 18.
Ang DHCS ay kumukuha din para sa mga kontrata, pag-audit, pinamamahalaang pangangalaga, pamamahala ng kalusugan ng populasyon, at iba pang mga koponan. Para sa karagdagang impormasyon, mangyaring bisitahin ang website ng CalCareers.
Mga Paparating na Mga Pagpupulong ng Stakeholder at Webinar
DHCS posts upcoming public meetings on the Calendar of Events.
Malakas na Start & Beyond Partner Webinar
On April 2, from 12 to 12:45 p.m. PDT, California Surgeon General Dr. Diana E. Ramos will host the next Strong Start & Beyond partner webinar on prevention to improve lifelong health. Strong Start & Beyond is a bold movement to reduce California’s maternal mortality rate by 50 percent by December 2026. By leveraging the state’s investments and partnerships, we can foster awareness, encourage active participation in health, and build access to resources for mothers, pregnant people, and their families. Joining Dr. Ramos are Dr. Erica Pan, California Department of Public Health Director and State Public Health Officer; Dr. Bernadette Lim, Founder and Executive Director of the Freedom Community Clinic; and Dr. Atul Nakhasi, Transformational Physician Executive. Please contact the Office of the California Surgeon General if you have any questions.
Consumer Focused Stakeholder Workgroup (CFSW)
On April 4, from 10 to 11:30 a.m. PDT, DHCS will convene the CFSW, which provides stakeholders an opportunity to review and provide feedback on a variety of consumer messaging materials. The forum focuses on eligibility and enrollment-related activities and strives to offer an open discussion on Medi-Cal policies and functionality. Meeting materials, including the meeting agenda, will be posted by April 2 on the DHCS Consumer-Focused Stakeholder Workgroup webpage.
California Children’s Services (CCS) Advisory Group Meeting
On April 9, from 1 to 4 p.m. PDT, DHCS will host the CCS Advisory Group quarterly meeting (advance registration required). DHCS and the CCS Advisory Group partner to ensure children in the CCS/Whole Child Model (WCM) program receive appropriate and timely access to quality care. Agenda topics include updates on 2025 priorities, including the 2025 WCM expansion; county compliance, monitoring and oversight; and Medi-Cal Rx pediatric integration. Additional information and meeting details are available on the CCS Advisory Group webpage.
Workgroup ng Stakeholder ng Pagpapatupad ng Doula
On April 11, from 10 a.m. to 12 p.m. PDT, DHCS will host the next Doula Implementation Stakeholder Workgroup meeting, as required by Senate Bill 65 (Statutes of 2021, Chapter 449), to examine the implementation of the Medi-Cal doula benefit, in accordance with section 14132.24 of the Welfare and Institutions Code. The meeting will be held at 1501 Capitol Avenue, Sacramento, CA, and is open to the public. The link for this meeting will be available on the DHCS Doula Implementation Stakeholder Workgroup webpage. The workgroup will discuss ways to minimize barriers to doula services and continue discussions regarding the workgroup’s report to the Legislature, which must be posted on DHCS’ website by July 1, 2025.
Protektahan ang Access sa Health Care Act (PAHCA)-Stakeholder Advisory Committee (SAC)
On April 14, from 11:30 a.m. to 3:30 p.m. PDT, DHCS will host the PAHCA-SAC meeting (advance registration for online participation required) at 1700 K Street (first-floor conference room 17.1014), Sacramento. The committee is responsible for advising DHCS on developing and implementing components of the Protect Access to Health Care Act of 2024 (Proposition 35). For general inquiries or to receive more information about meetings, please email DHCSPAHCA@dhcs.ca.gov.
Pagpapatupad ng Benepisyo sa Mga Tradisyunal na Kasanayan sa Pangangalagang Pangkalusugan
On April 22, DHCS will present an overview of Behavioral Health Information Notice (BHIN) 25-007 – Traditional Health Care Practices Benefit Implementation at the Tribes and Indian Health Program Representatives meeting (advance registration required). The presentation is open to the public and will review policy guidance to support Indian Health Care Providers and Drug Med-Cal Organized Delivery System counties in implementing this new benefit. Attendees are encouraged to submit questions in advance to traditionalhealing@dhcs.ca.gov with the subject line “Traditional Health Care Practices Implementation.” For questions about traditional health care practices or this BHIN, please email traditionalhealing@dhcs.ca.gov.
Kung sakaling Nalampasan Mo Ito
Ang DHCS ay nag-anunsyo ng Opioid Use Disorder Treatment Awards
On March 25, DHCS awarded $800,000 to two Local Emergency Medical Service Agencies to foster low-barrier access to clinically proven opioid use disorder (OUD) treatment for patients in an emergency medical services (EMS) setting who are at risk of overdose and often do not have access to services in other settings. The grants—awarded through the Emergency Medical Services Buprenorphine Use Pilot Program (EMSBUP) to the Stanislaus County EMS Agency and Ventura County EMS Agency—will enable these two agencies to address substance use disorder as a treatable emergency condition, utilizing paramedics to identify and treat patients who would benefit from medications for addiction treatment (MAT). MAT is the use of medications in combination with counseling and behavioral therapies, which is effective in treating OUDs and helping some people sustain recovery.
Bukas Na Ngayon: Pagbibigay ng Access and Transforming Health (PATH) Capacity at Infrastructure Transition, Expansion, and Development (CITED) Round 4 Application
On January 6, DHCS opened the PATH CITED Round 4 application window, which includes funding opportunities to support the implementation of the new transitional rent Community Support. 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. All organizations providing the transitional rent Community Support must do so in partnership with their county behavioral health department. To demonstrate this partnership, all CITED applicants planning to request funding to support the transitional rent Community Support must also submit a Letter of Support in collaboration with the county behavioral health department.
The deadline to apply for PATH CITED Round 4 funding is 11:59 p.m. PDT on May 2, 2025. The guidance document and application are available on the PATH CITED webpage. Please send any questions to cited@ca-path.com.