November 10, 2023 – Stakeholder News
Nangungunang Balita
Enhanced Care Management (ECM) for Children and Youth Populations of Focus (POF) Spotlight
On November 3, DHCS published the ECM for Children and Youth POF Spotlight, which is designed to help contracted and prospective ECM providers serving children and youth develop and enhance their ECM models. It is also intended to support provider organizations that are considering if ECM for children and youth is right for them. The new resource outlines key ECM policies for the children and youth POFs, including areas where plans can leverage presumptive authorization; member scenarios that illustrate how to deliver ECM for the children and youth POFs, with examples of how Community Supports can be integrated to best serve children, youth, and caregivers; and guidance on how prospective providers can get started, with a collection of the key resources and funding opportunities.
DHCS is committed to providing technical assistance and support to California’s growing network of ECM providers. This is the first in a series of ECM spotlights that DHCS plans to release over the coming months to support stakeholders seeking more details on how providers tailor ECM to meet the needs of different POFs. For more information, visit the ECM and Community Supports webpage.
Mga Update sa Programa
Mga Update sa Medi-Cal at Foster Care
DHCS developed a resource to provide updates on foster care youth in Medi-Cal. The resource covers changes to managed care for the child welfare population in 2024, Enhanced Care Management and Community Supports transition policies, the 2024 Medi-Cal managed care plan (MCP) contract and memorandum of understanding requirements, and Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment child and youth components.
Available Online ang Mga Update sa Serbisyo ng Doula
Noong Nobyembre 3, in-update ng DHCS ang Doula Services bilang isang Medi-Cal Benefit webpage. Kasama sa na-update na webpage ang mga kapaki-pakinabang na mapagkukunan para sa mga miyembro ng Medi-Cal at doula provider, kabilang ang bagong ibinigay na standing recommendation para sa mga serbisyo ng doula mula sa DHCS Medical Director na si Dr. Karen Mark. Tinutupad ng nakatayong rekomendasyon ang pederal na kinakailangan para sa isang rekomendasyon para sa mga serbisyo ng doula bilang isang serbisyong pang-iwas.
Kasama rin sa mga update sa webpage ang mga bagong madalas itanong para sa mga miyembro ng doula at Medi-Cal, ang kabuuang bilang ng mga aprubadong aplikasyon ng doula provider at mga naka-enroll na indibidwal na provider, at impormasyon sa ebidensya na sumusuporta sa mga benepisyo ng mga serbisyo ng doula para sa mga resulta ng panganganak at ina. Mangyaring mag-email ng anumang mga katanungan tungkol sa mga serbisyo ng doula sa DoulaBenefit@dhcs.ca.gov.
Sumali sa Aming Koponan
Ang DHCS ay kumukuha! Ang DHCS ay may mga pagkakataon para sa:
- Chief of the Financial Management Division within Fiscal (final filing date (FFD) is November 15). This executive role develops policies and procedures to ensure fiscal integrity, transparency, and accountability of approximately $150 billion in annual state and federal funding for DHCS.
- Behavioral Health Policy Medical Consultant II within Behavioral Health (FFD is November 27). This position provides clinical expertise and strategic advice to DHCS Behavioral Health leadership on the development and implementation of policy and initiatives designed to strengthen behavioral health care access, quality, and service delivery.
- Senior Assistant Chief Counsel for Fiscal and Financing within the Office of Legal Services (FFD is November 28). This position is responsible for complex legal counsel and litigation strategy formulation regarding DHCS fiscal, financial management, and health care policy.
- Ang Senior Assistant Chief Counsel para sa Health Care Delivery System sa loob ng Office of Legal Services (FFD ay Nobyembre 30). Ang posisyon na ito ay responsable para sa kumplikadong legal na tagapayo at pagbubuo ng diskarte sa paglilitis tungkol sa iba't ibang aspeto ng sistema ng paghahatid ng pangangalagang pangkalusugan.
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
Panatilihing Saklaw ang Iyong Komunidad: Webinar ng Mga Paaralan at Pamilya
Sa Nobyembre 16, mula 2 hanggang 3 pm, ang DHCS ay magdaraos ng webinar sa Panatilihing Saklaw ang Iyong Komunidad: Mga Paaralan at Pamilya (kinakailangan ang maagang pagpaparehistro). Ang webinar ay magbibigay sa mga kasosyo sa paaralan ng mahalagang impormasyon upang tulungan ang mga mag-aaral at kanilang mga pamilya sa pag-renew ng saklaw ng Medi-Cal. Itinatampok din ng webinar ang mga magagamit na mapagkukunan ng outreach at pinakamahuhusay na kagawian para sa pakikipag-ugnayan sa mga pamilyang may mga batang nasa edad na ng paaralan.
Mga Kinakailangan at Pamamaraan sa Pagpapatala ng Medi-Cal para sa Webinar ng mga CBO at LHJ
Sa Nobyembre 17, mula 10 hanggang 11:30 am, magsasagawa ang DHCS ng pampublikong pagdinig ng stakeholder sa pamamagitan ng webinar (kinakailangan ang advance na pagpaparehistro) para talakayin ang regulatory provider bulletin sa mga kinakailangan at pamamaraan sa pagpapatala ng Medi-Cal para sa mga community-based organization (CBO) at local health jurisdiction (LHJ) provider na nag-aalok ng community health worker at/o asthma preventive services. Epektibo sa Enero 9, 2024, CBO at LHJ provider na humihiling ng pagpapatala sa Medi-Cal fee-for-service program ay maaaring magsumite ng kanilang aplikasyon sa pamamagitan ng Provider Application and Validation for Enrollment (PAVE) online enrollment portal.
Ang mga nakasulat na komento, tanong, o mungkahi ay maaaring isumite sa panahon ng pagdinig sa webinar chat. Para sa mga hindi makadalo, ang mga nakasulat na komento ay kailangang isumite bago ang ika-5 ng hapon sa Nobyembre 17 upang maisaalang-alang para sa publikasyon. Kapag nagsusumite ng mga komento nang nakasulat, pakitiyak na ang nagkokomento at organisasyon/asosasyong kinakatawan ay parehong tinutukoy sa mga komento. Ang mga nakasulat na komento ay dapat isumite sa DHCSPEDStakeholder@dhcs.ca.gov. Batay sa mga pampublikong komento na natanggap, ilalathala ng DHCS ang huling bulletin sa mga website ng Medi-Cal at DHCS .
CalAIM Intermediate Care Facility for the Developmentally Disabled (ICF/DD) Carve-In Billing and Payment Webinar
On November 17 at 1 p.m., DHCS will host the fourth in a series of educational webinars on the California Advancing and Innovating Medi-Cal (CalAIM) ICF/DD carve-in (advance registration required). These webinars outline changes to the ICF/DD carve-in policy requirements. Starting on January 1, 2024, all Medi-Cal MCPs will be required to cover and coordinate institutional long-term care for members residing in an ICF/DD. The webinar series will feature several topics, including ICF/DD carve-in 101, directed payment policy and payment requirements, the per diem rate, accommodation code changes, and best practices for billing and payment. ICF/DD home, Regional Center, and Medi-Cal managed care representatives are encouraged to attend. All webinars are open to the public.
If there are specific questions you would like addressed during the webinar, please submit them in advance using this registration form or by emailing them to LTCtransition@dhcs.ca.gov. Webinar materials, including recordings, and additional details about upcoming webinars are posted on the CalAIM ICF/DD Long-Term Care Carve-In webpage.
Webinar ng Reporma sa Pagpopondo sa Pasilidad ng Narsing
On November 17, from 3 p.m. to 4 p.m., DHCS will hold a virtual stakeholder webinar (advance registration required) to discuss the development of the Skilled Nursing Facility Workforce Standards Program, Accountability Sanctions Program, and Workforce & Quality Incentive Program (WQIP) authorized by Assembly Bill 186 (Chapter 46, Statutes of 2022). This meeting will also provide an opportunity for stakeholder input. Additional information is posted on DHCS’ 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 November 28, from 11 a.m. to 12 p.m., DHCS will host a HACCP webinar (advance registration required) to share guidance with families and communities about applying for hearing aid coverage and helping children to maximize their HACCP benefits once enrolled. DHCS welcomes newly interested families, as well as families currently participating in HACCP, and community partners supporting families and children to join this webinar for program updates, tips, and a question-and-answer session. For more information, please visit www.dhcs.ca.gov/haccp.
HACCP Webinar para sa mga Medical Provider at Hearing Professionals
On December 19, from 12 to 1 p.m., DHCS will host a HACCP webinar (advance registration required) 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.
Medi-Cal Asset Elimination Webinar
Sa Nobyembre 29, mula 1:30 hanggang 2:30 pm, ang DHCS ay magdaraos ng webinar sa pag-aalis ng mga asset para sa mga non-Modified Adjusted Gross Income (MAGI) Medi-Cal programs, epektibo sa Enero 1, 2024. Kapag ipinatupad, aalisin ng inisyatibong ito ang pagsusuri sa asset para sa lahat ng programang hindi MAGI, kabilang ang pangmatagalang pangangalaga at Mga Programang Pagtitipid ng Medicare. Ang webinar ay magbibigay ng background na impormasyon sa pag-aalis ng asset, pagpaplano ng pagpapatupad, mga pagbabago sa pamamaraan, at mga materyales sa outreach. Higit pang impormasyon ay makukuha sa Asset Limit Changes para sa Non-MAGI Medi-Cal webpage.
CalAIM Managed Long-Term Services and Supports (MLTSS) at Duals Integration Workgroup Virtual Meeting
On November 30 at 10 a.m., DHCS will virtually host the CalAIM MLTSS and Duals Integration Workgroup meeting (advance registration required). The workgroup serves as a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible members, and allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare.
Agenda topics will include reminders about the 2024 Medi-Cal transitions and noticing timelines, updates on Medi-Medi Plan outreach and the 2024 Dual Eligible Special Needs Plan Policy Guide development, July 2023 duals enrollment data, a spotlight presentation on the CalAIM recuperative care Community Support, and a presentation on the continuous coverage unwinding.
Background materials, transcripts, and video recordings of previous workgroup meetings, along with additional information about the workgroup, are posted on the CalAIM MLTSS and Duals Integration Workgroup webpage. For questions or comments, please email DHCS at info@calduals.org.
Medi-Cal Adult Expansion Webinar
On December 4, from 11 a.m. to 12 p.m., DHCS will host a webinar on the adult expansion of Medi-Cal (advance registration required) for CBOs, MCPs, providers, and other interested stakeholders, including those representing consumers, immigration, health care, legal aid, and immigrant adults. DHCS is implementing this expansion pursuant to Senate Bill 184 (Chapter 47, Statutes of 2022) on January 1, 2024. When implemented, the expansion will provide individuals 26-49 years of age with full scope Medi-Cal benefits, regardless of citizenship or immigration status, if they meet all other Medi-Cal eligibility criteria.
The webinar, which will be live 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.
Kung sakaling Nalampasan Mo Ito
Mga Demonstrasyon ng Seksyon 1115: BH-CONNECT at CalAIM Transitional Rent Amendment
On October 20, DHCS submitted to Centers for Medicare & Medicaid Services (CMS) the new Section 1115 demonstration request, entitled the California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) demonstration, and the proposed amendment to the CalAIM Section 1115 demonstration related to transitional rent services. Additionally, the federal public comment period will be open for BH-CONNECT and CalAIM transitional rent services from October 27 through November 26, 2023.
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.