Mga Update sa Programa
Bumalik sa June 2022 Stakeholder Communications Update
Mga Limitasyon sa Asset – Non-Modified Adjusted Gross Income (MAGI) Medi-Cal
Assembly Bill (AB) 133 (Chapter 143, Statutes of 2021) authorizes a two-phased approach to eliminating the asset test for all non-MAGI Medi-Cal programs, including long-term care and the Medicare Savings Programs. Phase I will be implemented on July 1, and will increase asset limits to $130,000 per person and $65,000 per additional person being evaluated. Phase II will be implemented on January 1, 2024, and will eliminate the asset test. In November 2021, CMS approved State Plan Amendment 21-0053, and DHCS issued policy guidance to the counties regarding the Phase I implementation in an All County Welfare Directors Letter (ACWDL 21-31). DHCS has also submitted to CMS an application to amend the CalAIM Section 1115 demonstration waiver to permit California to increase, and eventually eliminate, the asset test for the Supplementary Security Income deemed coverage groups. DHCS published Medi-Cal Eligibility Division Information Letter (MEDIL I 22-02), which provides counties, advocacy groups, and other partners with global outreach messaging to use in their outreach activities regarding the increased asset limits as of July 1.
Pag-update ng Behavioral Health Continuum Infrastructure Program (BHCIP).
BHCIP Round 3: Ilunsad ang Handa
Noong Enero 31, ang DHCS, sa pakikipagtulungan ng California Department of Social Services (CDSS), ay naglabas ng BHCIP Round 3: Ready Ready at CDSS Community Care Expansion (CCE) Program joint Request for Application (RFA). Ang mga aplikante ay inanyayahan na mag-aplay para sa alinman sa pagkakataon sa pagpopondo o pareho. Ang deadline para sa BHCIP Round 3: Launch Ready na mga aplikasyon ay noong Abril 8, at ang mga pagsusuri sa aplikasyon ay isinasagawa, na ang mga aplikante ay humihiling ng humigit-kumulang $2 bilyon. Inaasahan ng DHCS na ianunsyo ang BHCIP Round 3: Launch Ready na mga parangal sa Hunyo.
Ang mga aplikante ng BHCIP ay kinakailangang magpakita ng pagpapalawak ng proyekto sa pamamagitan ng pagpapatuloy ng kalusugan ng pag-uugali ng paggamot at mga serbisyo sa mga setting na nagsisilbi sa mga benepisyaryo ng Medi-Cal, at magkaroon ng wastong proseso ng pagpaplano upang matiyak na ang mga proyekto ay handa na para sa pagpapatupad. Maggagawad ang DHCS ng hanggang $518.5 milyon na grant funds para sa BHCIP Round 3: Launch Ready, at ang pagpopondo ay dapat na obligado bago ang Hunyo 2024 at likidahin sa Disyembre 2026.
BHCIP Round 4: Mga Bata at Kabataan
BHCIP Round 4: Ang Mga Bata at Kabataan ay nakatuon sa mga bata at kabataang edad 25 pababa, kabilang ang mga buntis at postpartum na mga tao at kanilang mga anak, mga bata, at mga kabataan sa edad ng paglipat (TAY), gayundin ang kanilang mga pamilya. Ang lahat ng mga aplikante ay kailangang ipakita kung paano ang kanilang proyekto sa imprastraktura ay magpapalawak ng mga serbisyo sa kalusugan ng pag-uugali para sa populasyon na ito ng eksklusibo. Sa pamamagitan ng ika-apat na round na ito ng mapagkumpitensyang mga gawad, ang DHCS ay magbibigay ng $480.5 milyon para sa mga proyekto sa imprastraktura ng kalusugan ng pag-uugali na nakatuon sa mga bata at kabataan.
The RFA for Round 4: Children and Youth was released on June 1. DHCS has released a program update as a supplement to the upcoming RFA for BHCIP Round 4: Children and Youth funding. As was the case with Round 3: Launch Ready, applicants are required to undergo a pre-application consultation. They will be expected to demonstrate “project readiness”, as detailed in the forthcoming RFA, and will be funded according to which of three pre-construction phases their project is in. Full project funding will be contingent upon completion of all three phases of development planning.
DHCS was authorized through 2021 legislation to establish BHCIP and award $2.1 billion to construct, acquire, and expand properties and invest in mobile crisis infrastructure related to behavioral health. CDSS oversees the CCE program, which was established through AB 172 (Chapter 20, Statutes of 2021) as a companion effort, totaling $805 million. The CCE program focuses on the acquisition, construction, and rehabilitation of adult and senior care facilities that serve Supplemental Security Income/State Supplementary Payment and Cash Assistance Program for Immigrants applicants and recipients and other adults who are experiencing or at risk of homelessness. For more information, please visit the BHCIP project website or email BHCIP@dhcs.ca.gov.
Update sa Mga Pederal na Grant para sa Kalusugan ng Pag-uugali
Kamakailan ay isinumite ng DHCS ang ulat ng pag-unlad ng Year 2, Mid-Year State Opioid Response (SOR) II nito sa pederal na tagapondo nito, ang Substance Abuse and Mental Health Services Administration. Sa pagitan ng Setyembre 2021 at Marso 2022, sinusuportahan ng grant ng SOR ang mga serbisyo sa paggamot para sa 21,672 indibidwal na may opioid use disorder. Sa mga iyon, higit sa 16,000 ang nakatanggap ng buprenorphine, 5,000 ang nakatanggap ng methadone, at 400 ang nakatanggap ng injectable naltrexone. Sinuportahan din ng SOR ang recovery o peer coaching para sa higit sa 30,000 indibidwal, recovery housing services para sa higit sa 1,600 indibidwal, at mga serbisyo sa pagtatrabaho para sa halos 1,500 indibidwal. Sa panahong ito, sinuportahan ng SOR ang Naloxone Distribution Project, na humahantong sa higit sa 9,000 opioid overdose reversals. Bukod pa rito, pinondohan ng SOR ang stimulant use disorder treatment services para sa higit sa 5,600 indibidwal.
For more information about the SOR grant, please visit the Medication Assisted Treatment Expansion Project webpage or email DHCSMATExpansion@dhcs.ca.gov.
Programa sa Pagpapahusay ng Kalidad ng Kalusugan ng Pag-uugali (BHQIP)
The Department of Health Care Services (DHCS) created a three-year Behavioral Health Quality Improvement Program (BHQIP) to support implementation of the CalAIM initiative. The CalAIM BHQIP is structured as an incentive program, whereby counties may earn incentive payments by achieving certain CalAIM implementation milestones. Senate Bill (SB) 129 (Chapter 69; Statutes of 2021), authorized $21,750,000 in General Fund dollars for the CalAIM BHQIP for Fiscal Year 2021-22, which included a startup allocation amount of $250,000 to each County Behavioral Health Plan participating in BHQIP, and the rest was allocated to counties based on each county’s share of statewide claims value reported to DHCS. For inquiries about BHQIP, please contact BHQIP@dhcs.ca.gov.
Mga Update ng CalAIM
Mga Suporta sa Komunidad
On April 15, DHCS received final updated Models of Care (MOCs) from Medi-Cal MCPs implementing Community Supports in all 58 California counties, including proposed networks and estimated capacities for services. On July 1, MCPs will proceed with the next phase of implementation of Community Supports and bring on additional Community Supports services elected through the MOC process. Revised Community Supports elections will be posted on the CalAIM webpage in mid-June, once DHCS has approved all outstanding MCP MOCs. DHCS will continue to update Community Supports elections at least semi-annually.
Enhanced Care Management (ECM)
ECM was implemented in counties with Health Homes Programs (HHP) and Whole Person Care (WPC) pilots on January 1, 2022. On July 1, 2022, counties that did not have HHP and WPC programs will begin implementation of ECM for the following Populations of Focus (POF): individuals and families experiencing homelessness, adult high utilizers, and adults with serious mental illness (SMI) or substance use disorder (SUD). DHCS is reviewing each MCP’s policies and procedures and confirming provider networks are ready for implementation.
Also, to ensure operational readiness, MCPs will submit updated MOCs by July 1 for two long-term care (LTC) POFs (members eligible for LTC and those at risk of institutionalization; and nursing home residents transitioning to the community), scheduled to go-live on January 1, 2023.
Pamamahala sa Kalusugan ng Populasyon (PHM)
On May 3, DHCS released the Draft PHM Strategy and Roadmap for public comment, and written comments were due on May 16. This document describes DHCS’ vision for PHM, outlining key policy initiatives and accountability mechanisms, defining and describing PHM concepts and terminology, and detailing requirements for Medi-Cal MCPs for 2023 and 2024. On May 9, DHCS issued an Invitation for Proposal (IFP) for the PHM Service, and anticipates awarding a contract to the selected vendor by this summer.
Pagbibigay ng Access and Transforming Health (PATH)
In June, the first round of application submissions for the PATH Collaborative Planning participants and facilitators, Justice-Involved Capacity Building, and the Capacity and Infrastructure Transition Expansion and Development (CITED) initiative will begin. DHCS completed the IFP procurement for the PATH Third Party Administrator (TPA) in May. DHCS is evaluating the proposals and aims to award the TPA vendor contract by the end of June. DHCS continues to develop and finalize the guidance documents for the Technical Assistance Marketplace, Collaborative Planning, CITED, and Justice-Involved Capacity Building initiatives. Visit the CalAIM PATH Initiative webpage for current information and resources on PATH initiatives.
CalHOPE
CalHOPE has continued providing Crisis Counseling Assistance and Training Program (CCP) services to Californians in need of support. CalHOPE was approved for a 30-day and a 60-day cost extension that allowed CCP services through May 10, 2022. The federal partners recently approved DHCS’ 90-day no-cost extension, extending CalHOPE CCP services through July 9, 2022 and administrative close out activities through August 10, 2022.
CalHOPE continues to provide CCP educational services to schools, raising awareness of the negative effects of anxiety. CalHOPE has been partnering with IndieFlix since October 2021, including releasing the film ANGST: Building Resilience, which is based on a mental health support program. The outreach has been successful, as more than 150 school districts registered, multiple in-person Angst screenings were conducted in schools, and outreach/communication to other venues have been scheduled. Additionally, All It Takes, in partnership with CalHOPE and the California Department of Education, has received positive feedback after the release of the film, A Trusted Space, which is aimed at training educators on how to help mitigate the effects of emotional stressors on students and their families.
DHCS’ service provider, California Consortium of Urban Indian Health (CCUIH), has remained engaged in outreach of CCP services to their Tribal community. CCUIH has tabled various indigenous events, such as the Stanford Pow Wow, Mariposa Pow Wow, Indigenous Red Markets, and Healing and Coping events, sharing resources of the CalHOPE RedLine.
Community Mental Health Equity Project (CMHEP)
DHCS, in partnership with the California Department of Public Health, is providing support to CBOs and county behavioral health departments through CMHEP to implement population-specific and community-driven approaches. AB 74 (Chapter 23, Statutes of 2019) authorized funding to provide training and technical assistance to county behavioral health departments. CMHEP efforts will cover two years. DHCS hired the Center for Applied Research Solutions to develop statewide community-driven policy guidance, along with strategies and interventions aimed at reducing disparities in access to health and behavioral health care. A robust data collection framework to evaluate improvements in access to culturally responsive care will accompany the newly developed policy guidance. For more information, visit the CMHEP website.
Inisyatiba ng Plano sa Paggastos ng DHCS Home and Community-Based Services (HCBS).
CalBridge Behavioral Health Program
Noong Pebrero 2022, ang Public Health Institute/CA Bridge (PHI) ay nag-ulat ng 112,474 na pasyente na nakita ng isang substance use navigator, 90,593 na pasyente na natukoy na may opioid use disorder at 40,044 na pasyente na binigyan ng paggamot na tinulungan ng gamot. Sa pamamagitan ng Home and Community-Based Services, ang DHCS ay nakikipagkontrata sa PHI para sa $40 milyon upang palawakin ang abot ng programa at ang papel ng navigator upang mas mahusay na matugunan ang mga kondisyon sa kalusugan ng isip gayundin ang mga karamdaman sa paggamit ng substance sa pamamagitan ng CalBridge Behavioral Health Navigator Program. Para ilaan ang mga pondo, naglabas ang PHI ng Request for Application RFA noong Abril 2022 para manghingi ng partisipasyon ng mga ospital na may mga emergency department, health system, hospital foundation, o mga grupo ng doktor.
For more information about the CalBridge Behavioral Health Navigator Program, please visit the Bridge Navigator Program website.
Pagpapalawak ng Medi-Cal na Buong Saklaw ng Mas Matatanda
On May 1, individuals 50 years of age or older who met all Medi-Cal eligibility criteria, and who do not have satisfactory immigration status for federally-funded full-scope Medi-Cal, became newly eligible for state-funded full-scope Medi-Cal under the Older Adult Expansion. DHCS successfully transitioned 247,522 existing Older Adult Expansion individuals in restricted scope Medi-Cal to full-scope Medi-Cal, effective May 1. Individuals who apply now will automatically be determined eligible for full-scope Medi-Cal if they are 50 years of age or older and meet all other Medi-Cal eligibility criteria, regardless of immigration status. This expansion of Medi-Cal supports the Newsom Administration’s vision of a Healthy California for All by addressing health coverage disparities that disproportionately impact disadvantaged communities.
Mga Serbisyo sa Suporta ng Peer
On May 2, DHCS received CMS approval of SPA 22-0024, with an effective date of July 1, to broaden the definition of a Peer Support Specialist as someone who must be in recovery themselves or have lived experience with the process of recovery as a parent, caregiver, or family member. Prior to this update, Peer Support Specialists were defined solely as individuals in recovery, which excluded parents, caregivers, or family members from becoming certified as Peer Support Specialists. This update aligns the definition of Peer Support Specialist with the Medi-Cal Peer Support Specialist Certification Program requirements.
On May 6, DHCS issued Behavioral Health Information Notice (BHIN) 22-026, which provides guidance regarding the submission of an opt-in letter and claiming requirements for Peer Support Services in the Drug Medi-Cal (DMC), Drug Medi-Cal Organized Delivery System (DMC-ODS), and Specialty Mental Health Services (SMHS) programs. In order to implement Peer Support Services effective July 1, counties must have provided a letter to DHCS stating their request to opt in to provide peer support services, and indicating the program(s) (SMHS, DMC-ODS, and/or DMC) for which they are opting in. The letter must be signed by the Behavioral Health Director and emailed to CountySupport@dhcs.ca.gov by May 20 to implement peer support services, effective July 1. To date, 48 counties have submitted a signed letter stating their request to opt in to provide Peer Support Services effective July 1, 2022, with most counties opting to cover Peer Support Services in both their SMHS and their DMC or DMC-ODS programs.
Ang mga county na hindi makakapiling mag-opt in na magbigay ng Peer Support Services bago ang deadline ng Mayo 20 ay magkakaroon pa rin ng mga pagkakataong mag-opt in bawat anim na buwan. Magbibigay ang DHCS ng karagdagang impormasyon tungkol sa mga kasunod na pagkakataon para sa pag-opt in upang magbigay ng Mga Serbisyo sa Suporta ng Peer sa hinaharap.
Portal ng Application ng Provider at Validation for Enrollment (PAVE) para sa mga Dental Provider
Ipapatupad ng DHCS ang portal ng PAVE para sa mga tagapagbigay ng ngipin sa taglagas ng 2022. Ang PAVE portal ay isang web-based na application na idinisenyo upang pasimplehin at pabilisin ang mga proseso ng pagpapatala. Magbibigay ang PAVE ng bagong mode para sa pagsusumite ng mga aplikasyon sa pagpapatala ng dental provider at kinakailangang dokumentasyon sa DHCS, na nagpapahintulot sa mga aplikante na gumamit ng electronic form na tinatawag na Medi-Cal Provider e-Form Application. Ang DHCS ay hindi na tatanggap ng mga aplikasyon sa papel kapag ipinatupad ang PAVE.
Smile, California Campaign para sa Medi-Cal Dental Services
SmileCalifornia.org, SonrieCalifornia.org, and all materials pertaining to pregnant members were updated to reflect the American Rescue Plan Act of 2021 Postpartum Care Extension policy that was enacted on April 1, 2022.
Smile, California launched a promotion in April to support the required Kindergarten Oral Health Assessment (KOHA). The promotion brought awareness to the California law that requires all children to complete a dental assessment by their first year in public school, either Kindergarten or first grade, before May 31. Local oral health programs, school-based health centers, and CBOs received digital toolkits with educational KOHA materials, and the KOHA landing page was updated on SmileCalifornia.org and SonrieCalifornia.org.
In May, Smile, California launched an effort to promote the new Medi-Cal Older Adult Expansion to inform adults 50 years of age or older enrolled in restricted scope Medi-Cal that they are now eligible to receive full-scope Medi-Cal benefits, regardless of immigration status. A new landing page was created on SmileCalifornia.org and SonrieCalifornia.org with information about the expansion, frequently asked questions, and covered dental services. Social media ads and boosted posts ran on the Smile, California Facebook and Instagram accounts throughout May.
At the end of April, SmileCalifornia.org and SonrieCalifornia.org had received 66,794 new visitors, of which 51,361 clicked the “Find a Dentist” button.