Nangungunang Balita​​ 

Mga Lokal na Ahensyang Pang-edukasyon (LEA) na Inaprubahan Upang Makilahok sa Iskedyul ng Bayad sa Maramihang Nagbabayad ng CYBHI​​ 

On December 1, DHCS announced the first cohort of 47 LEAs (across 25 counties) approved to participate in the Children and Youth Behavioral Health Initiative (CYBHI) statewide multi-payer school-linked fee schedule, which will launch in January 2024, and statewide provider network. As part of the CYBHI, DHCS is expanding access to school-based (or school-linked) behavioral health services provided to students at a school site. Specifically, DHCS, in collaboration with the Department of Managed Health Care and California Department of Insurance, is establishing a statewide multi-payer school-linked fee schedule to reimburse school-linked providers for the provision of specified outpatient mental health and substance use disorder services furnished to students 25 years of age or younger at a school site. A fee schedule establishes a scope of services (e.g., psychoeducation, screening/assessment, treatment, and care coordination services), identifies billing codes and rates, and specifies provider types eligible to bill for services. Under state law, Medi-Cal managed care plans (MCP), commercial health plans, and disability insurers are obligated to reimburse eligible school-linked providers, including LEAs (e.g., services performed by pupil personnel services credentialed practitioners) and school-linked affiliated community-based organizations.​​ 

Welfare and Institutions Code section 5961.4(b) authorizes DHCS to “develop and maintain a school-linked statewide provider network of school-site behavioral health counselors.” To develop the CYBHI fee schedule provider network, DHCS implemented an operational readiness review process for all interested county offices of education and LEAs. In determining LEA readiness for this cohort, DHCS considered a variety of factors, including, but not limited to, Medi-Cal enrollment, service delivery infrastructure and capacity building, data collection and documentation, and billing infrastructure. The 47 LEAs met readiness review requirements and will participate in a learning collaborative to inform state level policy and operational guidance for the CYBHI fee schedule program. Cohort 2 will launch in July 2024 and Cohort 3 in January 2025.​​ 

More information about the CYBHI fee schedule program is available on the Statewide Multi-Payer School-Linked Fee Schedule webpage.​​ 

 

Sumali sa Aming Koponan​​ 

Ang DHCS ay kumukuha. Ang DHCS ay may mga pagkakataon para sa:​​ 

• Chief of Fee-for-Service Rates Development within Health Care Financing to develop, interpret, and issue policy on Medi-Cal reimbursement methodologies for Medi-Cal fee-for-service non-institutional and long-term care services and provider fee programs, ensuring uniform application of federal and state laws and regulations. (Final filing date (FFD) is December 20)​​ 
• Chief of Capitated Rates Development within Health Care Financing to serve as the principal policymaker for all rate-setting activities to ensure high-quality and cost-efficient health care through DHCS’ contracted Medi-Cal managed care plans. (FFD is December 19)​​ 
• Deputy Director of Enterprise Technology Services and Chief Information Officer to lead and manage Department-wide IT services. Responsible for managing all IT services, information security, enterprise projects, and strategic innovation efforts. (FFD is December 8)​​ 
• Deputy Chief Counsel in the Office of Legal Services to provide advice and counsel to the directorate, deputy director and chief counsel, and other deputy directors on legal policy litigation, federal policy, financial operations, and legislation. (FFD is December 4)​​  

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

Mga Paparating na Mga Pagpupulong ng Stakeholder at Webinar​​ 

Medi-Cal Adult Expansion Webinar​​ 

Sa Disyembre 4, mula 11 a.m. hanggang 12 p.m., ang DHCS ay magho-host ng isang webinar sa pagpapalawak ng pang-adulto ng Medi-Cal (kinakailangan ang paunang pagpaparehistro) para sa mga organisasyong nakabatay sa komunidad, MCP, provider, at iba pang mga interesadong stakeholder, kabilang ang mga kumakatawan sa mga mamimili, pangangalagang pangkalusugan, legal na tulong, at mga may sapat na gulang na imigrante. Ipapatupad ng DHCS ang pagpapalawak na ito alinsunod sa Senate Bill 184 (Kabanata 47, Mga Batas ng 2022) sa Enero 1, 2024. Kapag ipinatupad, ang pagpapalawak ay magbibigay sa mga may sapat na gulang na 26-49 taong gulang na may buong saklaw na mga benepisyo ng Medi-Cal, anuman ang pagkamamamayan o katayuan sa imigrasyon, kung natutugunan nila ang lahat ng iba pang mga pamantayan sa pagiging karapat-dapat sa Medi-Cal.​​ 

The webinar, which will be live and interpreted in Spanish, will provide background information about the expansion, implementation planning, noticing, outreach, and more. Individuals may also submit questions or request to register for the webinar by sending an email to AdultExpansion@dhcs.ca.gov.​​ 

Pagbibigay ng Access and Transforming Health (PATH) Mga Oras ng Opisina ng Programang Kasangkot sa Katarungan​​ 

Sa Disyembre 4 sa 12 p.m., ang DHCS ay magho-host ng susunod na sesyon ng virtual na oras ng opisina ng PATH Justice-Involved Program para sa mga awardee ng Round 3 (kinakailangan ang paunang pagpaparehistro). Ang mga oras ng opisina ay gaganapin tuwing ikalawang Lunes sa 12 p.m. hanggang Disyembre 18, 2023, upang matulungan ang mga ahensya ng Round 3, kabilang ang pagsuporta sa pagsusumite ng plano sa pagpapatupad. Para sa karagdagang impormasyon, bisitahin ang website ng Justice-Involved Program.​​   

Trauma Inquiry at Tugon sa Family Planning Webinar​​ 

Sa Disyembre 7, mula 12 hanggang 1:30 p.m., ang DHCS at ang California Prevention Center ay magho-host ng isang webinar ng Trauma Inquiry and Response in Family Planning (kinakailangan ang advanced na pagpaparehistro). Ang trauma, kabilang ang masamang karanasan sa pagkabata, karahasan sa interpersonal, at sekswal na pag-atake, ay may malaking epekto sa mga kinalabasan sa kalusugan at karaniwan sa mga taong naghahanap ng mga serbisyo sa pagpaplano ng pamilya. Ang trauma ay nakakaapekto sa sekswal at reproductive health, pagbubuntis, at kalusugang pangkaisipan, kaya mahalaga para sa mga clinician na matugunan ang trauma kapag nagbibigay ng mga serbisyo sa pagpaplano ng pamilya.​​ 

Tatalakayin ng webinar na ito ang balangkas ng Trauma and Resilience-informed Inquiry for Adversity, Distress, and Strengths (TRIADS) at mga paraan na maaaring maging kapaki-pakinabang sa mga clinician sa pagpaplano ng pamilya. Gamit ang mga pag-aaral ng kaso, ilalarawan ng mga nagtatanghal kung paano nagtatatag ang balangkas ng TRIADS ng isang pundasyon ng empatiya, paggalang, at pakikiramay, sa gayon ay nadaragdagan ang pakikipag-ugnayan sa pangangalaga at pagpapabuti ng mga resulta ng kalusugan sa mga pasyenteng naghahanap ng mga serbisyo sa pagpaplano ng pamilya.​​ 

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.​​ 

PATH Collaborative Planning and Implementation (CPI) Best Practices Webinar​​ 

On December 7, from 12:30 to 1:30 p.m., DHCS will host a statewide webinar, Relationship Building with Organizations in the California Advancing and Innovating Medi-Cal (CalAIM) Environment (advance registration required) for community-based organizations, county, city, and local government agencies, federally qualified health centers, MCPs, Medi-Cal tribal and designees of Indian Health Programs, and providers. The webinar is part of a biannual series of PATH CPI webinars designed to highlight best practices for implementing Enhanced Care Management (ECM) and Community Supports, increasing providers’ successful participation in CalAIM, and improving collaboration with MCPs, state and local government agencies, and others to build and deliver quality support services to Medi-Cal members. For more information, please visit the PATH CPI webpage.​​ 

Paggabay sa isang Pinahusay na Karanasan sa Dementia (GUIDE) na Modelong Webinar​​ 

On December 8, from 11 a.m. to 12 p.m., DHCS, in partnership with the University of California, San Francisco and DHCS’ Dementia Care Aware initiative, will host a webinar on the GUIDE model in California (advance registration required). This webinar will offer Medicare providers and community-based organizations information about what is required to participate in GUIDE, examples of a successful partnership in California that follows the GUIDE model, and resources to help California applicants apply for the GUIDE model. For more information, please visit the Dementia Care Aware webpage.​​ 

CalAIM Population Health Management (PHM) Advisory Group Meeting​​ 

On December 11, from 10:30 a.m. to 12 p.m., DHCS will host a PHM Advisory Group meeting (advance registration required). This meeting will include a briefing on policy guidance for changes to the modified Population Needs Assessment (PNA). To support the success of the PHM Program and broader transformation efforts, DHCS is redesigning MCP requirements for developing a PNA, which has historically been MCPs’ primary mechanism for identifying the priority health and social needs of their members, including health disparities. A central component of DHCS’ approach is for MCPs to meaningfully participate on local health departments’ Community Health Assessments (LHD CHA)/Community Health Improvement Plans (CHIP) rather than complete a separate PNA focused solely on their own members’ data. This meeting will provide an overview of forthcoming PHM policy guidance for MCPs to participate in LHD CHA/CHIP processes.​​ 

DHCS established the PHM Advisory Group to provide input to support the design and implementation of the PHM Program and PHM Service. Members, which include representatives from health plans, providers, counties, state departments, consumer organizations, and other groups, will participate in advisory group meetings and provide real-time feedback and recommendations. The meetings are open to the public, and meeting information and materials will be available on the DHCS website. Stakeholders are encouraged to submit questions in advance of the webinar to PHMSection@dhcs.ca.gov.​​ 

CalAIM LTC Carve-In: Paano Sinusuportahan ng Medi-Cal Managed Care ang Subacute Care Facility at ICF/DD Home Residents Webinar​​ 

Sa Disyembre 15, ang DHCS ay halos magho-host ng isang pang-edukasyon na webinar sa CalAIM long-term care (LTC) carve-in (kinakailangan ang paunang pagpaparehistro). Ang layunin ng webinar na ito ay upang magbigay ng mga pasilidad sa pangangalaga sa subacute , intermediate care facility para sa mga tahanan na may kapansanan sa pag-unlad (ICF / DD), Regional Center, at Medi-Cal MCP na may pag-unawa sa mga kinakailangan sa patakaran, saklaw ng mga serbisyo, at mga benepisyo na magagamit sa mga pasilidad ng subacute care at mga residente ng ICF / DD home sa ilalim ng pinamamahalaang pangangalaga bilang paghahanda para sa Enero 1, 2024, carve-in. Ang karagdagang mga detalye tungkol sa mga webinar at ang carve-in ay magagamit sa webpage ng CalAIM LTC Carve-In Transition.​​  

ECM at Community Supports Healthcare Common Procedure Coding System (HPCCS) Coding Guidance Webinar​​ 

Sa Disyembre 18, mula 11 a.m. hanggang 12 p.m., ang DHCS ay nagho-host ng isang webinar upang magbigay ng isang pangkalahatang-ideya ng mga kamakailang pag-update sa ECM at Community Supports HCPCS Coding Guidance (kinakailangan ang paunang pagpaparehistro). Una nang inilabas ng DHCS ang patnubay noong 2021 na kinabibilangan ng mga code at modifier ng HCPCS na dapat gamitin upang mag-ulat at singilin para sa mga nakatagpo ng serbisyo ng ECM at Mga Suporta sa Komunidad. Kabilang dito ang data ng pakikipagtagpo na isinumite ng mga tagapagbigay ng serbisyo ng ECM at Mga Suporta sa Komunidad sa mga MCP para sa pag-angkin o pag-invoice, at na isinumite ng mga MCP sa DHCS upang subaybayan ang pagganap at integridad ng programa. Batay sa feedback na isinumite mula sa mga stakeholder sa mga unang taon ng pagpapatupad ng ECM at Community Supports, na-update ng DHCS ang patnubay na ito upang madagdagan ang antas ng standardisasyon ng data sa buong estado at mapagaan ang pasanin sa pangangasiwa.​​ 

Sa partikular, ang DHCS ay nagdagdag ng bagong ECM at Community Supports HCPCS code/modifier na kumbinasyon at na-codify ang pangangailangan na maaaring hindi hilingin o payagan ng mga MCP ang kanilang mga provider na mag-ulat ng mga code o modifier para sa mga serbisyo ng ECM at Community Supports na lampas sa tinukoy ng DHCS sa gabay. Ang webinar na ito ay mag-aalok sa mga provider ng MCP, ECM at Community Supports, at iba pang interesadong stakeholder ng pagkakataong matuto pa at magtanong tungkol sa mga update na ginawa sa ECM at Community Supports HCPCS coding guidance.​​ 

Hearing Aid Coverage for Children Programa (HACCP) Webinar para sa mga Medical Provider at Hearing Professionals​​ 

Sa Disyembre 19, mula 12 hanggang 1 p.m., ang DHCS ay magho-host ng isang webinar ng HACCP (kinakailangan ang paunang pagpaparehistro) upang magbahagi ng impormasyon sa mga provider upang matulungan ang mga pasyente ng pediatric at kanilang mga pamilya na i-maximize ang mga benepisyo ng HACCP. Ang sesyon ng pagsasanay ay tatalakayin ang mga kinakailangan sa programa para sa mga pamilya na mag-aplay para sa saklaw at ang proseso ng pagsusumite ng mga claim para sa mga audiologist, otolaryngologist, manggagamot, at kanilang mga kawani sa opisina. Para sa karagdagang impormasyon, mangyaring bisitahin ang www.dhcs.ca.gov/haccp.​​ 

Kung sakaling Nalampasan Mo Ito​​ 

Enero 2024 Medi-Cal MCP Transition​​ 

As part of Medi-Cal transformation, some MCPs are changing on January 1, 2024, and approximately 1.2 million members will have new health plan options and/or will need to transition to new MCPs. Changing MCPs will not affect Medi-Cal member coverage or benefits. Members who transition to a new MCP are receiving notices about the transition. DHCS developed several resources to support members, providers, and other stakeholders with the transition, including the Managed Care Plan Transition Member webpage with a county “lookup” tool, links to member notices sent by Medi-Cal about MCP changes, frequently asked questions, and a Contact Us page for members to learn more about health plans and provider choices. There are also transition resources for providers and MCPs and stakeholders. More information about the transition is available in the 2024 Managed Care Plan Transition Policy Guide and Medi-Cal Eligibility Division Information Letter Number I 23-54.
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