DHCS Stakeholder News Update – May 6, 2022
Minamahal naming mga Stakeholder,
Ibinibigay ng Department of Health Care Services (DHCS) ang update na ito ng mga makabuluhang development patungkol sa mga programa ng DHCS, pati na rin ang gabay na nauugnay sa COVID-19 public health emergency.
Pagbabago ng Executive Staff ng DHCS
Sa Mayo 31, si Kelly Pfeifer, Deputy Director para sa Behavioral Health, ay magreretiro mula sa serbisyo ng estado upang ituloy ang iba pang mga pagsisikap. Sa loob ng halos tatlong taon, pinamunuan ni Kelly ang pagbuo at pagpapatupad ng mga programa at inisyatiba sa pagbabago, makasaysayang kalusugan ng isip at mga serbisyo sa sakit sa paggamit ng sangkap, kabilang ang inisyatiba ng California Advancing and Innovating Medi-Cal (CalAIM), Behavioral Health Continuum Infrastructure Program (BHCIP), at Behavioral Health Modernization project.
Si Tyler Sadwith, Assistant Deputy Director para sa Behavioral Health, ay magsisilbing Acting Deputy Director sa pag-alis ni Kelly.
Update ng BHCIP at Community Care Expansion Program
The 2021-22 California State Budget provided once-in-a-generation investments in infrastructure funding alongside significant new state and federal resources to address homelessness, support health care delivery reform, and strengthen the social safety net. Together these commitments will address historic gaps in the behavioral health continuum to meet growing demand for services and supports. Infrastructure resources, led by DHCS and the California Department of Social Services, will ensure care can be provided in the least-restrictive settings by creating a wide range of options, including outpatient alternatives, urgent care, peer respite, wellness centers, social rehabilitation models, and licensed community care facilities. A variety of care placements can provide a vital off-ramp from intensive behavioral health service settings and transition the most vulnerable Californians to community living, as well as provide housing options for older adults and people with disabilities. For more information about these programs, please visit the BHCIP webpage.
Medi-Cal Rx 180-Day Transition Policy
When Medi-Cal Rx launched, a 180-day transition policy was implemented to reduce the impact of the transition on Medi-Cal beneficiaries by extending their previously approved prescriptions, with or without previously approved prior authorizations (PA), through July 1, 2022. Medi-Cal Rx will continue to use historical PA and claims data for the transition policy beyond July 1, 2022. DHCS and Magellan Medicaid Administration are evaluating the appropriate time to terminate this transition policy. Detailed information will be provided in the coming weeks. Stakeholders will be given 90 days’ notice prior to the end of the 180-day transition policy.
Kontrata ng Vendor sa Pamamahala ng Kalusugan ng Populasyon (PHM).
On May 9, DHCS will release an Invitation for Proposal (IFP) for a PHM Service vendor, as part of the CalAIM initiative. DHCS intends to award the resulting contract by July 2022. This procurement solicits applications for the development, operation, and eventual turnover to DHCS of the PHM Service.
Ang Serbisyo ng PHM ay naglalayong baguhin ang buong-tao na paghahatid ng pangangalaga sa mga benepisyaryo ng Medi-Cal, habang pinamamahalaan ang panganib at tinutugunan ang mga puwang sa pangangalaga at mga social driver ng kalusugan. Susuportahan ng Serbisyo ng PHM ang pananaw na nakasentro sa benepisyaryo para sa mga kasosyo sa negosyo (mga departamento at ahensya ng estado, mga kasosyo sa lokal na county, atbp.); mga kasosyo sa paghahatid ng pangangalagang pangkalusugan (mga ospital, mga pasilidad ng skilled nursing, atbp.); at mga organisasyon ng pinamamahalaang pangangalaga (county Drug Medi-Cal, Medicare Advantage, atbp.) na may access sa klinikal at programmatic na data na maaaring magamit upang makatulong na mapabuti ang kalidad ng pangangalaga.
DHCS anticipates that implementation of the PHM Service will contribute to the overall CalAIM goal of improving beneficiaries’ quality of life and health outcomes, aligned with Medi-Cal initiatives outlined in Assembly Bill 133 (Chapter 143, Statutes of 2021). More information about the PHM Service is available in the draft PHM Program and Service Roadmap. For questions or comments, please email CalAIM@dhcs.ca.gov.