Update ng Stakeholder ng DHCS -Agosto 25, 2023
Nangungunang Balita
Pag-apruba sa Pagbabago sa Pagpapakita ng CalAIM
On August 23, the Centers for Medicare & Medicaid Services (CMS) approved an amendment to the California Advancing and Innovating Medi-Cal (CalAIM) Section 1115 demonstration waiver, allowing the state to implement county-based model changes in its Medi-Cal managed care program. The amendment includes expenditure authority to limit the choice of managed care plans (MCPs) in non-rural areas. This authority would apply in the metro, large metro, and urban counties intending to participate in the County Organized Health System (COHS) or Single Plan models.
For rural counties, CMS approved an amendment to the CalAIM Section 1915(b) waiver on June 26 to limit plan choice in rural counties to participate either in the COHS or Single Plan models. These county-based model changes will go into effect on January 1, 2024. Twelve counties will become COHS and three will become Single Plan model counties. For more information about all counties, their current and 2024 model type, and the MCPs operating in the county, please see the MCP county table.
Mga Update sa Programa
Medi-Cal Rx
Noong Agosto 22, ipinatupad ng Medi-Cal Rx Customer Service Center ang isang interactive na tampok sa pagpapahusay ng pagkilala sa boses para sa mga miyembro, tagapagreseta, parmasyutiko, at publiko. Kabilang sa mga pagpapahusay ang mga survey sa tawag, mga pangunahing menu upang gawing mas madali ang mga tawag, mga code upang ipaalam sa mga ahente ang tungkol sa mga dahilan ng mga tawag, pagbabalik-tanaw sa pangunahing menu upang masuri ng mga tumatawag ang maraming self-service na item, at pinahusay na wika at pagkakalagay ng prompt.
On August 16, a New Start PA Reminder Alert was published about the prior authorization requirements that will be reinstated beginning on September 22 for new start enteral nutrition products for members 22 years of age and older.
Medi-Cal para sa mga Bata at Kabataan sa Pagpapadala ng Impormasyon
On August 25, DHCS distributed an informational mailing to Medi-Cal fee-for-service (FFS) members and/or their parents or guardians about the federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, known in California as Medi-Cal for Kids & Teens. The FFS mailing includes: (1) Medi-Cal for Kids & Teens brochures to improve member understanding of how Medi-Cal works for children, teens, and young adults, what it covers, and its role in preventive care screening, diagnosis, and treatment. The child brochure is for children up to age 12, and the teen brochure is for ages 12-20; and (2) “Medi-Cal for Kids & Teens: Your Medi-Cal Rights” guide to help members under age 21 understand their Medi-Cal benefits and their recourse if medically necessary care is denied, delayed, reduced, or stopped. The materials, including translations, are posted on the Medi-Cal for Kids & Teens webpage.
Sumali sa Aming Koponan
Ang DHCS ay kumukuha para sa aming mga pangkat ng piskal, human resources, legal, pag-audit, patakaran sa kalusugan, at teknolohiya ng impormasyon. Para sa karagdagang impormasyon, mangyaring bisitahin ang website ng CalCareers.
DHCS is dedicated to providing equitable access to quality health care, leading to a healthy California for all. DHCS’ goals and objectives express the tremendous work DHCS is leading to transform our health care system and reflect the organizational culture we are building together.
Mga Paparating na Mga Pagpupulong ng Stakeholder at Webinar
Pagsasama ng Trauma-Informed Practice sa Reproductive Health Services Webinar
Sa Agosto 30, mula 12 hanggang 1:30 ng hapon, ang DHCS at ang California Prevention Training Center ay magho-host ng isang webinar na "Integrating Trauma-Informed Practices into Reproductive Health Services". Kinikilala ng trauma-informed care ang pangangailangang maunawaan ang mga karanasan sa buhay ng isang kliyente upang makapagbigay ng epektibong pangangalaga at may potensyal na mapabuti ang pakikipag-ugnayan ng pasyente, pagsunod sa paggamot, at mga resulta sa kalusugan. Para sa mga hindi makakadalo sa live webinar, ang transcript at recording ng webinar, kasama ang mga karagdagang resources, ay makukuha sa website ng Family PACT.
Tribal at Designees ng Indian Health Programs Quarterly Webinar
On August 30, from 2 to 3 p.m., DHCS will host a webinar (advance registration required) for tribal and Indian health program representatives to provide feedback on DHCS initiatives with specific impact to tribes, Indian health programs, and American Indian Medi-Cal members. The webinar will provide information about State Plan Amendments, waivers, and demonstrations proposed for submission to CMS, including the Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) Medicaid section 1115 demonstration and transitional rent services amendment to the CalAIM section 1115 demonstration. Email questions or comments to TribalAffairs@dhcs.ca.gov.
Webinar ng Equity and Practice Transformation Payments Program
On August 30, from 3 to 4 p.m., DHCS will host an Equity and Practice Transformation Payments Program Webinar (advance registration required) to share an update on the Equity and Practice Transformation Payments Program, which is a one-time $700 million primary care practice transformation program initiative to advance health equity and population health and invest in upstream care models. Details about the Provider Directed Payment Program will be discussed during the webinar; the program application and other materials will be posted on the DHCS website in the future. Please email ept@dhcs.ca.gov with any questions.
DHCS Coverage Ambassadors: Sanayin ang Trainer Webinar
On August 31, from 10 to 11:30 a.m., DHCS will host a webinar on Coverage Ambassadors: Train the Trainer. The webinar will serve as a training session for Coverage Ambassadors to better assist their communities as California resumes standard Medi-Cal operations and communicates the importance of members renewing their Medi-Cal coverage. The webinar will also describe the resources available and how to use them. For more information, visit the Coverage Ambassadors Coverage Ambassadors webpage. Join the Coverage Ambassadors mailing list to receive the latest information and updated toolkits as they become available.
Webinar ng Reporma sa Pagpopondo sa Pasilidad ng Narsing
On September 7, from 2 to 3 p.m., DHCS will host a virtual stakeholder webinar to discuss the development of the Skilled Nursing Facility Workforce Standards Program and provide updates on other nursing facility financing reform programs authorized by Assembly Bill 186 (Chapter 46, Statutes of 2022). Stakeholder input will be accepted. Additional information is available on the Nursing Facility Financing Reform (AB 186) webpage.
Webinar ng Hearing Aid Coverage for Children Program (HACCP) para sa Mga Pamilya at Kasosyo sa Komunidad
On September 12, from 11 a.m. to 12 p.m., DHCS will host a HACCP webinar to share guidance with families and communities about applying for hearing aid coverage and helping children to maximizing their HACCP benefits once enrolled. DHCS welcomes newly interested families, those who are currently participating in HACCP, and community partners supporting families and children to join this webinar for program updates, tips, and a Q&A session. For more information, please visit www.dhcs.ca.gov/haccp.
Doula Implementation Workgroup Meeting
Sa Setyembre 14, mula 12 hanggang 2 ng hapon, ang DHCS ang magho-host ng ikatlong pulong ng Doula Implementation Workgroup. Maglalagay ng link para makinig sa pulong sa webpage ng Doula Services bilang isang Medi-Cal Benefit pagsapit ng Agosto 31. Kasama sa pulong ang isang ulat tungkol sa panukala ng DHCS para sa Birthing Care Pathway at ang papel ng mga doula, at ang pagpaplano para sa mga susunod na pulong. Ang workgroup ay responsable sa pagrepaso kung paano madaragdagan ang pagkakaroon ng mga serbisyo ng doula sa pamamagitan ng mga programang pang-edukasyon, pagtukoy at pagbabawas ng mga hadlang sa mga serbisyo ng doula, at pagtugon sa mga pagkaantala sa mga pagbabayad at reimbursement sa mga doula at mga miyembro.
Webinar para sa mga Medical Provider at Hearing Professionals
On September 14, from 12 to 1 p.m., DHCS will host a HACCP webinar to share information with providers to help pediatric patients and their families maximize HACCP benefits. The training session will address program requirements for families to apply for coverage and the claims submission process for audiologists, otolaryngologists, physicians, and their office staff. For more information, please visit www.dhcs.ca.gov/haccp.
Kung sakaling Nalampasan Mo Ito
Pinalawak ng California ang Access sa Opioid Treatment sa Mga Kulungan at Drug Court
On August 22, DHCS announced it will expand Medication Assisted Treatment (MAT) to jails and drug courts it will expand Medication Assisted Treatment (MAT) to jails and drug courts. The $2.9 million in funding will go to 29 counties to support the development or expansion of access to MAT. By bringing county teams together in a learning collaborative, county agencies and providers serving justice-involved residents can more effectively coordinate and further build system capacity to ensure access to effective treatment and recovery supports. This expansion will better serve residents in need, and MAT, specifically, has been shown to reduce criminal activity and reincarceration to better serve the entire community.
Pinalawak ng Estado ang CalHOPE Schools Initiative Partnership
On August 24, DHCS announced the extension of the CalHOPE Schools Initiative through June 30, 2024 the extension of the CalHOPE Schools Initiative through June 30, 2024. The initiative provides free resources for school personnel, youth, and parents surrounding three powerful films that address student social-emotional and mental health needs: A Trusted Space: Redirecting Grief to Growth, Angst: Building Resilience, and Stories of Hope Shorts.
Lingguhang Opinyon ng Kapitolyo sa Mga Redeterminasyon ng Medi-Cal
Noong Agosto 20, nagpatakbo ng opinyon ang Capitol Weekly ng CEO ng LA Care na si John Baackes. Ang LA Care ay isa sa mga planong pinamamahalaang pangangalaga ng Medi-Cal sa Los Angeles County. Nanawagan si Baackes sa “tayong lahat – mga kapitbahay, mga katuwang sa gobyerno, at mga tagapagtaguyod ng komunidad – na gawin ang lahat ng ating makakaya upang mapanatiling nakaseguro ang ating mga kaibigan at kapitbahay” ng Medi-Cal.
Habang nakikipag-ugnayan ka sa mga miyembro ng Medi-Cal, mangyaring ibahagi sa kanila ang mga kapaki-pakinabang na tip upang mapanatili ang kanilang saklaw. Kung ang petsa ng kanilang pag-renew ng eligibility ay sa Hunyo o Hulyo, hindi pa huli ang lahat. Maaari nilang ibalik ang kanilang Medi-Cal renewal packet sa lokal na tanggapan ng county ngayon upang maibalik ang kanilang saklaw sa kanilang orihinal na petsa ng pag-renew. Gayundin, kung lumipat ang mga miyembro ng Medi-Cal o nagbago ang kanilang impormasyon sa pakikipag-ugnayan sa mga nakaraang taon, dapat nilang tiyakin na ang kanilang lokal na tanggapan ng county ay mayroong kanilang kasalukuyang impormasyon upang makontak sila na may mahahalagang impormasyon sa pag-renew. At kung makatanggap ang mga miyembro ng pakete ng renewal ng Medi-Cal sa koreo na nakalagay sa isang dilaw na sobre, dapat silang kumilos nang mabilis upang mapanatili ang kanilang sarili at ang kanilang mga pamilya na sakop ng mga dokumentong nagbabalik ng renewal.