Nangungunang Balita​​ 

Data ng Pagpapatupad ng Enhanced Care Management (ECM) at Community Supports Implementation​​ 

Inilathala ng DHCS ngayong linggo ang ECM and Community Supports Implementation Update: Data Through Q2 2023. Binubuod ng update na ito ang datos sa antas ng estado mula sa ECM at Community Supports, na inilunsad noong 2022 upang paglingkuran ang mga miyembro ng managed care plan (MCP) na may mahahalagang klinikal, di-klinikal, at mga pangangailangang panlipunan na may kaugnayan sa kalusugan. Batay sa ECM at Community Supports Year One Report, ang update sa implementasyon ay kinabibilangan ng mga bagong datos sa mga miyembro ng Medi-Cal at mga network ng provider at nag-aalok ng unang sulyap sa pagpapatala sa ECM para sa dalawang populasyon ng pangmatagalang pangangalaga na naging karapat-dapat para sa ECM noong Enero 2023. Ang datos para sa mga karagdagang populasyon ng ECM na pinagtutuunan ng pansin na inilunsad pagkatapos ng ikalawang kwarter ng 2023, kabilang ang mga bata at kabataan, ay itatampok sa mga pag-uulat sa hinaharap.​​ 

Both ECM and Community Supports continued to grow and serve more Californians during the first half of 2023, including a 29 percent growth in cumulative ECM enrollment and 108 percent growth in cumulative Community Supports recipients since the end of 2022. To provide further data transparency and visibility around ECM and Community Supports, DHCS will soon release a comprehensive report with MCP- and county-level data through Q2 2023.​​ 

2024 Medi-Cal MCP Transition Policy Guide​​ 

On November 15, DHCS released frequently asked questions (FAQs) as a companion resource to version five of the 2024 Medi-Cal MCP Transition Policy Guide that includes DHCS policy and MCP requirements related to member transitions of Medi-Cal MCPs that take effect on January 1, 2024. The latest version includes a summary of communications resources, a transition policy for assessment and screening tools, and updates to the data sharing section and Appendix. Please email questions about the policy guide to MCPTransitionPolicyGuide@dhcs.ca.gov. The policy guide and FAQs will be updated throughout the remainder of this calendar year to keep MCPs informed of new and developing guidance.​​ 

Mga Update sa Programa​​ 

Paggabay sa Isang Pinahusay na Karanasan sa Dementia (GUIDE) na Modelo at Webinar​​ 

To help address the needs of Medicare beneficiaries, including those dually eligible for Medicare and Medi-Cal, with Alzheimer’s disease and related dementias, the Centers for Medicare & Medicaid Services (CMS) released a Request for Applications (RFA) for the GUIDE model. This model aims to support people living with dementia and their unpaid caregivers by helping them with care coordination and management, infrastructure building, and higher quality of care. Interested applicants should submit their application via web portal by January 30, 2024.​​ 

The GUIDE model begins on July 1, 2024, and will continue for eight years. The goal of the model is to improve the quality of life, reduce the burden and strain on unpaid caregivers of people living with dementia, and prevent or delay long-term nursing home care. The care delivery approach is a person-centered plan that standardizes a set of services, has an interdisciplinary care team, and includes training requirements for the care team to improve care coordination to address the behavioral and functional needs of people living with dementia. Original Medicare providers may apply to participate. Since many Medicare beneficiaries with dementia are also dually eligible for Medi-Cal, DHCS strongly encourages California Medicare providers to participate in the GUIDE model. For more information, please visit the CMS GUIDE webpage.​​ 

Also, 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.​​ 

PAALALA: Hindi maglalabas ang DHCS ng lingguhang update para sa mga stakeholder sa susunod na linggo. Ang susunod na update ay ilalabas sa Biyernes, Disyembre 1.​​ 

Sumali sa Aming Koponan​​ 

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

• Deputy Director para sa Enterprise Technology Services at Chief Information Officer upang pamunuan at pamahalaan ang mga serbisyong IT sa buong Departamento (FFD ay Disyembre 8). Responsable sa pamamahala ng lahat ng serbisyo ng IT, seguridad ng impormasyon, mga proyekto ng negosyo, at mga pagsisikap sa estratehikong inobasyon.​​ 

• 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.​​ 

• Ang Associate Medical Director para sa Integrated Systems of Care (FFD ay Nobyembre 29). Ang posisyong ito ay responsable para sa mga teknikal na konsultasyong medikal para sa mga kritikal na programa sa kalusugan ng publiko ng California, at magbibigay ng payo at gabay sa mga serbisyong kinakailangang medikal para sa mga indibidwal na mahina sa kalusugan.​​ 

• 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​​ 

Webinar ng Hearing Aid Coverage for Children Program (HACCP) para sa Mga Pamilya at Kasosyo sa Komunidad​​ 

Sa Nobyembre 28, mula 11 am hanggang 12 pm, magho-host ang DHCS ng HACCP webinar (kinakailangan ang advance na pagpaparehistro) para magbahagi ng patnubay sa mga pamilya at komunidad tungkol sa pag-aplay para sa coverage ng hearing aid at pagtulong sa mga bata na mapakinabangan ang kanilang mga benepisyo sa HACCP. Tinatanggap ng DHCS ang mga bagong interesadong pamilya, mga pamilyang kasalukuyang kalahok sa HACCP, at mga kasosyo sa komunidad na sumusuporta sa mga pamilya at mga bata na sumali sa webinar na ito para sa mga update sa programa, mga tip, at isang sesyon ng tanong-sagot. Para sa karagdagang impormasyon, pakibisita ang 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 para sa mga kasosyo sa komunidad, kabilang ang mga tagapagtaguyod, tagapagkaloob, MCP, at iba pa, sa pag-aalis ng mga asset para sa mga programang Medi-Cal na hindi Modified Adjusted Gross Income (non-MAGI), 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: Subacute Care Facility Carve-In Billing and Payment Webinar​​ 

On November 29, from 3 to 4 p.m., DHCS will virtually host the third in a series of educational webinars on the California Advancing and Innovating Medi-Cal (CalAIM) long-term care (LTC) carve-in of subacute care facilities in Medi-Cal managed care. The goal of these webinars is to provide subacute care facilities and Medi-Cal MCPs with an understanding of the carve-in to operationalize the new benefit, including scope of services and relevant policies, in preparation for the January 1, 2024, carve-in.​​ 

Ang webinar, na bukas sa publiko, ay tututok sa pagbibigay ng pag-unawa sa mga kinakailangan sa patakaran sa pagbabayad at mga magagandang kasanayan sa pagsingil para sa mga MCP at mga pasilidad ng pangangalagang subacute. Makakakuha ng karagdagang detalye tungkol sa subacute care facility carve-in sa webpage ng transition ng CalAIM Subacute Care Facility LTC Carve-In.​​ 

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.​​ 

CalAIM: Behavioral Health Workgroup Meeting​​ 

On December 1, DHCS will virtually convene the CalAIM Behavioral Health Workgroup meeting to provide updates on and discussion of the California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) and CalAIM behavioral health documentation redesign initiatives. Workgroup members may provide feedback on implementation and operational considerations. The meeting is open to the public. Please email questions to BHCalAIM@dhcs.ca.gov.​​ 

Medi-Cal Adult Expansion Webinar​​ 

Sa Disyembre 4, mula 11:00 ng umaga hanggang 12:00 ng tanghali, magho-host ang DHCS ng isang webinar tungkol sa pagpapalawak ng Medi-Cal para sa mga nasa hustong gulang (kinakailangan ang maagang pagpaparehistro) para sa mga organisasyong nakabase sa komunidad, mga MCP, mga tagapagbigay ng serbisyo, at iba pang interesadong stakeholder, kabilang ang mga kumakatawan sa mga mamimili, imigrasyon, pangangalagang pangkalusugan, legal aid, at mga imigranteng nasa hustong gulang. Ipatutupad ng DHCS ang pagpapalawak na ito alinsunod sa Senate Bill 184 (Kabanata 47, Mga Batas ng 2022) sa Enero 1, 2024. Kapag naipatupad na, ang pagpapalawak ay magbibigay sa mga indibidwal na may edad 26-49 ng buong saklaw ng mga benepisyo ng Medi-Cal, anuman ang kanilang pagkamamamayan o katayuan sa imigrasyon, kung natutugunan nila ang lahat ng iba pang pamantayan sa pagiging karapat-dapat sa Medi-Cal.​​ 

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.​​ 

Pagbibigay ng Access and Transforming Health (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 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 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.​​ 

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.​​ 

Kung sakaling Nalampasan Mo Ito​​ 

Ipinagpapatuloy ng California ang Medi-Cal Transformation Tungo sa Person-Centered, Equity-Focused Care​​ 

On November 15, DHCS issued a news release about how the Department is transforming Medi-Cal to ensure Californians can get the care they need to live healthier lives. As a result of the new Medi-Cal managed care contract, Medi-Cal members will have access to new and improved services to get person-centered, whole-person care that goes beyond the doctor’s office or hospital and addresses their physical and behavioral health and health care-related social needs.​​ 

Mga Demonstrasyon ng Seksyon 1115: BH-CONNECT at CalAIM Transitional Rent Amendment​​ 

Noong Oktubre 20, isinumite ng DHCS sa CMS ang bagong kahilingan para sa demonstrasyon ng Seksyon 1115 – ang demonstrasyon ng BH-CONNECT – at ang iminungkahing susog sa demonstrasyon ng CalAIM Seksyon 1115 kaugnay ng mga serbisyo sa transisyonal na renta. Bukod pa rito, ang panahon ng pederal na pampublikong pagkomento ay magbubukas para sa mga serbisyo ng transisyonal na renta ng BH-CONNECT at CalAIM mula Oktubre 27 hanggang Nobyembre 26.​​ 

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.​​