Nangungunang Balita

Tugon ng DHCS sa Southern California Wildfires

On January 7 and 8, multiple fires erupted in the Los Angeles County area. DHCS is actively engaged in addressing the impacts of the fires. DHCS is working alongside local and federal partners to support health care facilities, ensure continuity of care, and prioritize the safety of affected residents. Specifically, DHCS is coordinating with facilities to manage evacuations and maintain care for residents and is supporting health care providers as they navigate road closures and other disruptions.

DHCS’ Emergency and Disaster Assistance Questions & Answers webpage provides guidance and contact information for Medi-Cal members and providers during emergencies. It includes information related to accessing medical care, filling prescriptions, securing transportation, and obtaining support for individuals with specific needs, including people in assisted living facilities and individuals receiving Home and Community-Based Alternatives services.

Ang Tanggapan ng mga Serbisyong Pang-emerhensya ng Gobernador ng California at ang Kagawaran ng Rehabilitasyon ay bumuo ng isang Gabay/Toolkit sa Paghahanda para sa Emerhensya para sa mga Indibidwal na may mga Kapansanan na makukuha sa maraming wika na kinabibilangan ng impormasyon at mga tip sa paghahanda para sa emerhensya para sa mga indibidwal na may mga partikular na kapansanan. Sundan ang Cal Fire at ang iyong mga lokal na opisyal sa emerhensiya para sa mga real-time na update tungkol sa mga sunog sa kagubatan, at mag-sign up para sa mga lokal na alerto sa calalerts.org. Pakitingnan ang mga karagdagang mapagkukunan sa ibaba para sa karagdagang impormasyon:

• CA.gov/LAfires – Nagbibigay ng mga mapagkukunan para sa mga taga-California na naapektuhan ng mga sunog sa Los Angeles.
• Listos California – Nag-aalok ng pahina ng pag-sign-up para sa mga Emergency Alert upang makatulong na ikonekta ang mga taga-California sa kanilang mga lokal na sistema ng alerto batay sa ibinigay na zip code o lokasyon.
• Ready.Gov – Provides guidance for individuals and families to prepare for, respond to, and recover from wildfire events. The resource includes tips for staying safe during wildfires and returning home once an area is declared safe.
• Pangasiwaan ng Mga Serbisyo sa Pang-aabuso ng Substansiya at Kalusugang Pangkaisipan Mga Mapagkukunan sa Sunog sa Kagubatan – Sinusuportahan ang mga nakaligtas, miyembro ng pamilya, tagatugon, at mga manggagawa sa pagbangon na naapektuhan ng mga sunog sa kagubatan at iba pang mga sakuna. Kabilang sa impormasyon ang mga palatandaan ng emosyonal na pagkabalisa, mga populasyon na maaaring nasa mas malaking panganib na makaranas ng pagkabalisa pagkatapos ng sunog sa kagubatan, at mga link sa mga mapagkukunan para sa karagdagang impormasyon at suporta.
• Ang Centers for Disease Control and Prevention – Nagbibigay ng impormasyon tungkol sa mga panganib, kabilang ang mga sunog sa kagubatan, at nag-aalok ng mga link sa impormasyon tungkol sa pananatiling ligtas pagkatapos ng sunog sa kagubatan at pag-aaral tungkol sa at pagharap sa mga panganib na nauugnay sa mga sunog sa kagubatan at iba pang mga sakuna.
• American Red Cross – Suggests ways for people who have experienced a residential fire to take care of themselves and their loved ones and to help people who may need assistance. The site lists four steps to take right after a fire and includes links to more information about returning home safely after a fire and recovering emotionally and financially.
  

Ang DHCS ay nananatiling nakatuon sa pagsuporta sa mga komunidad sa mapanghamong panahong ito at nagpapasalamat sa mga emergency responder at mga manggagawa sa pangangalagang pangkalusugan sa lupa. Manatiling ligtas, tingnan ang mga opisyal na update para sa pinakabagong impormasyon, at sundin ang mga utos sa paglikas na ibinigay ng mga lokal na opisyal.

Iminungkahing Badyet ng DHCS 2025-26

The proposed 2025-26 Governor’s Budget for DHCS allocates $193.4 billion in total funds, including $42.8 billion from the General Fund, and supports 4,821.5 positions. This budget reflects the Administration’s continued investment in transforming Medi-Cal into a coordinated, person-centered, and equitable health system for Californians.

The budget prioritizes modernizing the health care delivery system, with a focus on improving accountability and transparency and strengthening community-based care. These strategic investments support DHCS’ purpose to provide equitable access to quality health care, leading to a healthy California for all.

Mga Update sa Programa

Inaprubahan ang State Plan Amendment (SPA) para sa Dyadic Services

On January 6, the federal Centers for Medicare & Medicaid Services (CMS) approved SPA #23-0010, which authorizes DHCS to utilize an Alternative Payment Methodology (APM) to pay Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHC), and Tribal Health Programs, which includes Tribal FQHCs and Indian Health Services-Memorandum of Understanding 638 Clinics, at the Medi-Cal fee-for-service (FFS) rate for dyadic services in certain circumstances. FQHCs and RHCs will receive a separate payment for dyadic services in addition to their standard Prospective Payment Services/All-Inclusive Rate billing payments in certain circumstances.

Dyadic care refers to serving both the parent/caregiver and child together as a dyad and is a form of treatment that targets family well-being to support healthy child development and mental health. Dyadic care fosters team-based approaches to meeting family needs, including addressing mental health and social support concerns, and it broadens and improves the delivery of pediatric preventive care. Offering parents and caregivers mental health services when they bring their babies and children to the doctor is an opportunity to expand access, which can improve outcomes. DHCS will release additional policy guidance in a future Medi-Cal Provider Manual update.

Paglipat sa Bagong Pamilya PACT Portal

From January 13 through February 2, DHCS’ Family Planning, Access, Care and Treatment (PACT) program’s client eligibility and enrollment transaction services will transition from the Health Access Programs (HAP) Client Eligibility System to a new Family PACT portal. The HAP Client Eligibility System will be disabled on February 3, after which all Family PACT client enrollment, changes, and deactivations will be completed exclusively through the California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS) Family PACT portal. To support Family PACT providers during this transition, Family PACT providers will have access to comprehensive training materials and webinars through the Family PACT Online Training Center Learning Management System. These resources will ensure that providers are equipped to use the Family PACT portal effectively before its launch.

Pagsasaayos ng Patakaran para sa Medi-Cal Rx Pediatric Integration (PI)

DHCS is making an important policy adjustment related to Medi-Cal Rx’s initiative for the reinstatement of prior authorization (PA) requirements and utilization management (UM) claim edits for Medi-Cal members 21 years of age and younger, including members of the California Children’s Services (CCS) program. This initiative, commonly referred to as PI, will be implemented on January 31. To directly address and help mitigate stakeholder concerns about the volume of PA requests and potential barriers to timely access that may occur because of PI implementation, as well as recognize the advanced credentialing of CCS Panel Provider Authority, DHCS is adjusting its PI policy approach for continuing therapies/prescriptions PI as follows:

• Para sa isang panahon na hindi bababa sa 60 araw, kung ang isang claim ay tatanggihan kung hindi man ay may Reject Code 75 (PA kinakailangan), ngunit ang miyembro ng Medi-Cal ay may kamakailang kasaysayan ng mga claim, ang claim ay magbabayad nang hindi nangangailangan ng karagdagang PA. Nilalayon ng DHCS ang pamamaraang ito na bigyan ang mga tagapagkaloob at tagapagreseta ng karagdagang oras upang ayusin ang kanilang mga panloob na proseso at mas mahusay na plano para sa mga kinakailangan ng PI at magsumite ng mga aktibong PA.

DHCS will release additional, more detailed information through the Medi-Cal Rx website and will update various existing resource documents on a flow basis. DHCS remains committed to ensuring Medi-Cal members, providers, and other partners are supported so pharmacy benefits can be accessed in a safe, timely, and equitable manner. DHCS will continue to support and engage stakeholders on PI.

Sumali sa Aming Koponan

Ang DHCS ay naghahanap ng isang may talento at motibasyon na indibidwal na maglingkod bilang:

• Chief of the Pharmacy Benefits Division. The Chief is responsible for overseeing the development and implementation of policy, services, and coverage criteria for outpatient pharmacy services for the state’s Medi-Cal program. This includes providing policy direction for Medi-Cal Rx as well as invoicing and collecting federal and state supplemental drug rebates. The Chief of PBD also leads the development of nutrition, vision care, and medical supply benefits and oversees the administration of the Medi-Cal Pharmacy and Vision Benefit programs. Applications must be submitted by February 7.

DHCS is also hiring for its accounting, program accountability, behavioral health, managed care quality and monitoring, eligibility, and other teams. For more information, please visit the CalCareers website.

Mga Paparating na Mga Pagpupulong ng Stakeholder at Webinar

Webinar ng Quality and Equity Advisory Committee sa Pagbabago ng Kalusugan ng Pag-uugali

On January 15, from 9 to 11 a.m. PST, DHCS will host the third Behavioral Health Transformation Quality and Equity Advisory Committee webinar. Once registered, you will receive a confirmation email with the webinar link and additional details. DHCS is pleased to continue its collaborative efforts to measure and evaluate the quality and efficacy of behavioral health services and programs. These public webinars provide an opportunity for participants to offer input for DHCS consideration. Visit the Behavioral Health Transformation Stakeholder Engagement webpage for more information about the webinars and additional resources. Please send questions related to Behavioral Health Transformation and/or the webinars to BHTinfo@dhcs.ca.gov.

Webinar ng Smile, California : Pagtataguyod ng Benepisyo sa Ngipin ng Medi-Cal para sa Pambansang Buwan ng Kalusugan ng Ngipin ng mga Bata

On January 22, from 11 a.m. to 12 p.m. PST, Smile, California will host a webinar to kick off National Children’s Dental Health Month (NCDHM) in February. The webinar will feature a preview of the new Healthy Smile Land materials, strategies for promoting Medi-Cal dental services during NCDHM, and resources for accessing and distributing outreach materials. Attendees will also be able to connect with Smile, California representatives to ask about Medi-Cal dental benefits.

DHCS Harm Reduction Summits

DHCS collaborates with communities across the state to promote harm reduction and low-barrier, patient-centered care within California’s substance use disorder treatment system. DHCS encourages substance use disorder treatment providers and staff (including social workers, peers, front desk staff, case managers, nurses, physicians, and all staff in substance use disorder treatment settings) to attend and learn about incorporating the tenets of harm reduction into substance use disorder treatment. Summits will be held in Fresno County (January 23), San Diego County (February 11), and Los Angeles County (February 27). Register on the event website.

Coverage Ambassador Webinar Series: Justice-Involved Reentry Initiative at Bata at Kabataan Behavioral Health Initiative Update

Sa Enero 30, mula 11:00 hanggang 11:45 ng umaga PST, magho-host ang DHCS ng webinar para sa mga DHCS Coverage Ambassador (kinakailangan ang maagang pagpaparehistro). Magbibigay ang webinar ng mga update tungkol sa Justice-Involved Reentry Initiative at Children Youth Behavioral Health Initiative (CYBHI). Maghahatid ito ng impormasyon tungkol sa mga indibidwal na sangkot sa hustisya na ngayon, o gumugol ng panahon, sa mga kulungan, mga pasilidad ng pagwawasto ng kabataan, o mga bilangguan at mas mataas ang panganib na magkaroon ng mahinang kalusugan, pinsala, at kamatayan kaysa sa publiko. Ito ay tututok sa mga mahahalagang hakbang na ginagawa ng California upang mapabuti ang mahihirap na resulta sa kalusugan para sa mga indibidwal habang naghahanda silang bumalik sa kanilang mga komunidad sa pamamagitan ng pagsisikap na matiyak na mayroon silang patuloy na saklaw sa oras na sila ay malaya. Bukod pa rito, matututunan ng mga Coverage Ambassador kung paano palalawakin ang mga serbisyong pangkaisipan para sa mga bata sa pamamagitan ng CYBHI, na magbibigay ng mga serbisyo sa kalusugang pangkaisipan sa mga bata, kabataan, at pamilya. Alamin ang higit pa tungkol sa mga DHCS Coverage Ambassador, o mag-sign up upang maging isang Coverage Ambassador.

Intrauterine Device (IUD) at Contraceptive Implant Insertion Training

On February 19, from 7:30 a.m. to 5:30 p.m. PST, DHCS’ Office of Family Planning will host an in-person Comprehensive IUD and Contraceptive Implant Insertion Training. The training, which is currently full, includes information about patient method selection, counseling and consent, techniques for using instruments during IUD placement, and instruction on the insertion of each type of IUD currently available in the United States. Additional topics to be covered include management of side effects, tips for managing difficult placements, pain management principles for office procedures, and prevention and management of complications. Please see IUD & Implant Resources for more information.

Kung sakaling Nalampasan Mo Ito

Pinipili ng CMS ang DHCS para sa Innovative Transforming Maternal Health Model

Noong Enero 6, inaprubahan ng CMS ang pakikilahok ng California sa Transforming Maternal Health (TMaH) Model ng Center for Medicare and Medicaid Innovation, isang sampung-taong modelo ng paghahatid at pagbabayad ng Medicaid and Children's Health Insurance Program (CHIP) na idinisenyo upang subukan kung ang epektibong pagpapatupad ng mga interbensyon na batay sa ebidensya, na sinusuportahan ng isang modelo ng pagbabayad batay sa halaga (VBP), ay maaaring mapabuti ang mga resulta ng ina at mabawasan ang mga gastos sa programa para sa Medicaid at CHIP.

Ipapatupad ng DHCS ang TMaH Model sa limang county: Fresno, Kern, Kings, Madera, at Tulare. Ang TMaH Model ay bahagi ng mas malawak na pangako ng California sa pagtugon sa mga pagkakaiba sa kalusugan ng ina dahil sa lahi at etniko at pagtiyak na ang lahat ng mga buntis, lalo na ang mga tao sa mga komunidad na may mababang kita, ay makakatanggap ng suportang kailangan nila upang ligtas na malampasan ang pagbubuntis at panganganak.

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. 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. Nearly $158 million is available for Round 4. The deadline to apply for PATH CITED Round 4 funding is 11:59 p.m. PST on March 7, 2025. The guidance document and application can be found by visiting the PATH CITED webpage. Please submit questions to cited@ca-path.com.

PATH Technical Assistance (TA) Marketplace Round 5 Vendor Application

On January 1, DHCS opened the PATH TA Marketplace Round 5 vendor application. The deadline to apply is January 31. Round 5 will be a targeted procurement for new and existing hands-on service offerings that address TA Marketplace gaps. The Round 5 procurement will seek TA vendor applications for all seven TA domains, but it will focus on services for the following provider types: rural providers, Tribal and Indian health care providers, maternal and child-serving providers, and transitional rent providers.

Ang DHCS ay hindi tatanggap ng mga pagsusumite para sa mga bagong off-the-shelf na proyekto o mga pagbabago sa mga umiiral na off-the-shelf na proyekto sa panahon ng Round 5 procurement period. Sa halip, ang Round 5 na application ay hihingi ng on-demand na mapagkukunan mula sa mga umiiral nang TA vendor. Mangyaring bisitahin ang TA Marketplace Vendor webpage upang ma-access ang mga dokumento ng gabay at mag-apply. Mangyaring magsumite ng mga tanong sa ta-marketplace@ca-path.com.