Bumalik sa Update sa Komunikasyon ng Stakeholder sa Oktubre​​ 

Update sa Mga Pederal na Grant para sa Kalusugan ng Pag-uugali​​ 

Noong Setyembre 27, 2021, muling inilabas ng DHCS ang pagkakataon sa pagpopondo ng Crisis Care Mobile Units (CCMU), na magiging available hanggang Nobyembre 29, 2021. Ang orihinal na $205 milyon na pagkakataon sa pagpopondo ay inilabas mula Hulyo 23, 2021, hanggang Agosto 23, 2021, sa mga county ng California, mga ahensya sa kalusugan ng pag-uugali ng lungsod, pinagsamang mga grupo ng mga county at/o mga ahensya sa kalusugan ng pag-uugali ng lungsod, at mga entidad ng tribo. Kasalukuyang sinusuri ng DHCS ang mga aplikasyon mula sa paunang round ng pagpopondo na naghahanap ng $159 milyon. Ang mga kinakailangan sa pagiging karapat-dapat ay nananatiling pareho, at habang ang mga nakaraang aplikante ay maaaring mag-aplay para sa karagdagang pagpopondo, uunahin ng DHCS ang mga bagong aplikante. Ang minimum na $46 milyon ay makukuha sa dalawang track: 1) pagpaplano ng mga gawad ng hanggang $200,000 para masuri ang mga pangangailangan ng mobile crisis at non-crisis programs at para bumuo ng action plan para matugunan ang pangangailangan; at 2) implementasyon ay nagbibigay ng hanggang $1 milyon bawat CCMU team para magpatupad ng bago, o palawakin ang isang umiiral na, CCMU program. Ang lahat ng CCMU grantees ay kinakailangang unahin ang mga serbisyo sa mobile behavioral health crisis para sa mga indibidwal na edad 25 at mas bata, habang naglilingkod din sa mas malawak na populasyon, at hinihikayat na suportahan ang mga serbisyo ng interbensyon ng hustisya. Available ang pagpopondo para sa round na ito ng mga grantees mula Enero 3, 2022, hanggang Hunyo 30, 2025.​​ 

Ang parehong CCMU funding rounds ay sinusuportahan ng: $55 milyon sa pamamagitan ng Substance Abuse Prevention and Treatment Block Grant at Community Mental Health Services Block Grant na iginawad ng Substance Abuse and Mental Health Services Administration sa pamamagitan ng mga pondong inilaan mula sa Coronavirus Response and Relief Supplemental Appropriations Act; at $150 milyon na kasama sa taon ng pananalapi ng estado 2021-22 General Funds sa pamamagitan ng Behavioral Health Continuum Infrastructure Program. Para sa karagdagang impormasyon tungkol sa pagkakataon sa pagpopondo ng CCMU, mangyaring mag-email sa BHRRP@dhcs.ca.gov.​​ 

Pag-update ng Behavioral Health Continuum Infrastructure Program (BHCIP).​​ 

Noong Oktubre 1, nag-host ang DHCS ng sesyon ng pakikinig ng BHCIP para sa mga organisasyon ng county, Tribal, non-profit, at for-profit. Ang sesyon ng pakikinig ay tinalakay ang mga pagkakataon sa pagpopondo ng BHCIP, mga timeline ng programa, at magagamit na teknikal na tulong, at nagbigay ng pagkakataon para sa mga kwalipikadong aplikante na magbigay ng mga insight, kabilang ang nakasulat at pasalitang feedback, nang direkta sa DHCS sa mga iminungkahing aktibidad ng BHCIP.​​ 

BHCIP provides DHCS with funding to award competitive grants to qualified entities to construct, acquire, and rehabilitate real estate assets, or to invest in mobile crisis infrastructure to expand the community continuum of behavioral health treatment resources. A portion of the funding is available for increased infrastructure targeted to children and youth age 25 and younger. For more information, please email BHCIP@dhcs.ca.gov or visit the DHCS website.​​ 

CalHOPE​​ 

The CalHOPE Crisis Counseling Assistance and Training Program (CCP) received federal approval to extend services, allowing the program to continue through February 9, 2022, to provide emotional support for all Californians. Each week, the CalHOPE Connect chat feature continues to assist individuals with an average of 4,000 chats per week. CalHOPE also continues to partner with Together for Wellness and Juntos por Nuestro Bienestar, which feature evidence-based and community resources to help manage stress and anxiety, and offer the CalHOPE Warm Line, (800) 317-HOPE (4673). The Warm Line connects callers to other people who have persevered through struggles with stress, anxiety, and depression.​​ 

CalHOPE provided individual crisis counseling, group counseling, public education, brief education, and supportive contact services to 40,075 Californians in July and 46,961 in August. Additionally, from July 1 through September 10, CalHOPE provided CCP services to 459,146 Californians, which involved helpline contact, email responses, resource materials handed out/mailed, and mass media outreach. The most recent statistics and accomplishments are located on the CalHOPE Impact page. Additionally, American gymnast Mary Lou Retton delivered a message identifying CalHOPE as a local sponsor of NBC Universal’s coverage of the Tokyo Olympics.​​ 

Benepisyo sa Serbisyo ng Community Health Worker (CHW).​​ 

DHCS is adding CHW services as a preventive service in the State Plan. In order to allow for the successful launch of the CHW benefit, DHCS is adjusting the implementation date for these benefits from January 1, 2022, to July 1, 2022. Additional time is needed to work with stakeholders and health plans, review their input, incorporate their feedback into the State Plan Amendment, ensure successful system updates, seek federal approval from CMS, and allow time for plans to prepare to offer these services. CHWs are skilled and trained health educators, assist individuals with accessing health care services, and provide key linkages with other similar and related community-based resources. CHWs would render Medi-Cal covered benefits and services under the supervision of an enrolled Medi-Cal provider. These services would be available under both the fee-for-service (FFS) and managed care delivery systems. DHCS met with stakeholders on August 18 and September 17 to discuss developing the State Plan Amendment (SPA) to add CHW services as a covered benefit. More information is available on the DHCS website, including future opportunities for stakeholders to provide input on developing the benefit.​​ 

Dental Transformation Initiative (DTI)​​ 

The July 2021 payment of $2 million for Domain 1 was released on August 2, 2021. The goal of DTI’s Domain 1 is to increase by 10 percentage points the statewide proportion of children through age 20 enrolled in Medi-Cal who receive a preventive dental service during a five-year period. As of August 31, the amount of Domain 2 payments issued was approximately $194.4 million, and 3,375 providers have opted in to participate. The goal of Domain 2 is to diagnose early childhood caries by utilizing caries risk assessments to treat it as a chronic disease and to introduce a model that proactively prevents and mitigates oral disease. For more information, please visit the DHCS website.​​ 

Drug Medi-Cal Organized Delivery System (DMC-ODS)​​ 

California’s first regional DMC-ODS model began operating in seven counties on July 1, 2020, bringing the number of counties participating in the DMC-ODS to 37 and covering more than 96 percent of the Medi-Cal population. The regional model is a collaboration among seven Northern California counties and Partnership HealthPlan of California that allows access to screening, assessment, early intervention, and continuum of substance use disorder (SUD) treatment. The DMC-ODS provides a continuum of care modeled after the American Society of Addiction Medicine (ASAM) criteria for SUD treatment services.​​ 

Sa 2021, ang DHCS ay patuloy na nagpupulong ng mga webinar para sa mga interesadong county ng DMC State Plan. Kasama sa mga paksa sa webinar ang mga opsyon sa indibidwal at panrehiyong modelo, pag-access sa Medication Assisted Treatment (MAT), mga pamantayan sa kasapatan ng network, at mga implikasyon at pagtataya sa pananalapi, lahat upang suportahan ang pagpapatupad ng DMC-ODS.​​ 

As of February 1, DHCS implemented Senate Bill (SB) 823 (Chapter 781, Statutes of 2018) through Behavioral Health Notice No.: 21-001, which requires DHCS’ licensed alcohol and other drug (AOD) recovery treatment facilities to obtain at least one DHCS Level of Care (LOC) Designation and/or at least one residential ASAM LOC Certification consistent with all of its program services. DHCS has processed 1,425 total designations for AOD providers in California. Of those designations, 1,126 are active for 420 providers. More information about the DMC-ODS is available on the DHCS website.​​ 

DHCS also contracts with an External Quality Review Organization (EQRO) that reviews DMC-ODS counties annually regarding access, timely access, and quality of care. The information from these reviews is summarized in annual county reports. For FY 2020-21, the EQRO completed and posted 29 DMC‑ODS county reviews, including the first review of the DMC-ODS regional model. In April 2021, DHCS submitted the annual statewide technical report as well as performance improvement project reports to CMS. All EQRO. The EQRO commenced FY 2021-22 county reviews in September. Additionally, under contract with the University of California Los Angeles, Integrated Substance Abuse Programs (UCLA ISAP), DHCS is conducting annual DMC‑ODS waiver evaluation activities to measure and monitor outcomes. The evaluation focuses on access to care, quality of care, cost, and the integration and coordination of SUD care, both within the SUD system and with medical and mental health services. The latest DMC‑ODS waiver evaluation report is posted on the UCLA ISAP website.​​ 

Benepisyo ng Doula Services​​ 

DHCS is adding doula services to the list of Medi-Cal preventive services to improve health equity and address health disparities. In order to allow for the successful launch of this benefit, DHCS is adjusting the implementation date for this benefit from January 1, 2022, to July 1, 2022. Additional time is needed to work with stakeholders and health plans, review their input, incorporate their feedback into the State Plan Amendment, ensure successful system updates, seek federal approval from CMS, and allow time for plans to prepare to offer these services. Doula services include emotional and physical support to individuals throughout pregnancy, labor, childbirth, and the postpartum period. Pursuant to federal regulations, doula services will need to be recommended by a physician or other licensed practitioner. DHCS met with stakeholders on September 16 to discuss developing the SPA, including defining qualifications of doulas, covered services, and supervision. These services will be available in both the FFS and managed care delivery systems. More information is available on the DHCS website, including future opportunities for stakeholders to provide input on doula services and the SPA.​​ 

HIV/AIDS Medi-Cal Waiver Program (MCWP) Renewal​​ 

On September 29, 2021, DHCS submitted the HIV/AIDS MCWP renewal application to CMS. The renewal application is posted on both the DHCS and California Department of Public Health (CDPH) websites. DHCS, in collaboration with CDPH, must renew its HIV/AIDS MCWP every five years. The current HIV/AIDS MCWP term ends on December 31, 2021. The new waiver term will be January 1, 2022, through December 31, 2026. From August 13 through September 13, DHCS posted the HIV/AIDS MCWP renewal to the AIDS Medi-Cal Waiver Program webpage for a 30-day public comment period. CDPH received and responded to 10 comments from stakeholders, and updated the MCWP renewal application to reflect stakeholder comments.​​ 

Ang HIV/AIDS MCWP, na pinahintulutan sa ilalim ng seksyon 1915(c) ng Social Security Act, ay nagbibigay ng komprehensibong pamamahala ng kaso at direktang pangangalaga ng mga serbisyo sa mga taong nabubuhay na may HIV/AIDS bilang alternatibo sa pangangalaga sa nursing facility o ospital. Ang mga layunin ng MCWP ay: (1) magbigay ng mga serbisyo sa tahanan at komunidad para sa mga taong may HIV na maaaring mangailangan ng mga serbisyong institusyonal; (2) tulungan ang mga kalahok sa pamamahala sa kalusugan ng HIV; (3) pagbutihin ang pag-access sa suporta sa kalusugang panlipunan at asal; at (4) i-coordinate ang mga service provider at alisin ang pagdoble ng mga serbisyo.​​ 

Home and Community-Based Alternatives (HCBA) Waiver Renewal​​ 

On September 29, 2021, DHCS submitted the HCBA waiver renewal application to CMS. The renewal application, and additional information, is posted on the DHCS website. DHCS must renew its HCBA waiver every five years. The current waiver term ends on December 31, 2021; the new one will be effective from January 1, 2022, through December 31, 2026. From August 16 through September 16, DHCS posted the HCBA waiver renewal application to the DHCS website for a 30-day public comment period. DHCS received and responded to 128 comments from 36 stakeholders, and updated the HCBA waiver renewal application to reflect stakeholder comments.​​ 

Ang waiver ng HCBA, na pinahintulutan sa ilalim ng seksyon 1915(c) ng Social Security Act, ay nagbibigay ng pangmatagalan, mga serbisyo at suportang nakabatay sa komunidad sa mga benepisyaryo na kwalipikado sa Medi-Cal sa setting ng komunidad na kanilang pinili. Kasama sa mga serbisyong ito ang pribadong tungkuling pag-aalaga, pamamahala ng kaso, at mga serbisyo sa personal na pangangalaga na kinakailangan upang mapanatili ang kalusugan at kaligtasan ng isang indibidwal na may antas ng pangangalaga sa pangangalaga, sa isang komunidad sa halip na isang institusyon.​​ 

Plano sa Paggastos ng Home and Community-Based Services (HCBS).​​ 

On September 3, 2021, CMS notified DHCS that California’s HCBS Spending Plan was granted partial approval of the initiatives proposed, with one initiative denied and additional information requested for other initiatives. On September 17, DHCS, in collaboration with sister departments, provided CMS with the additional information requested for specific initiatives. DHCS and its partners are currently developing implementation strategies and timelines. More information will be made available to stakeholders and posted on the DHCS website in the coming weeks.​​ 

On July 12, DHCS submitted California’s $4.6 billion Medicaid HCBS Spending Plan to CMS for review and approval. The American Rescue Plan Act of 2021 (ARPA) provides states with a temporary increase in federal funds for certain HCBS Medicaid expenditures from April 1, 2021, through March 31, 2022. The HCBS plan reflects many of the investments included in the initial version released by DHCS in early June, as well as program funding included in the 2021 Budget Act. The plan will expand services for California’s most vulnerable and at-risk residents through new and existing programs that will strengthen HCBS in the state’s Medicaid delivery systems. These investments will also build capacity and transform critical safety net programs, as well as promote economic mobility and social stability.​​ 

Proyekto ng Medical Interpreters Pilot (MIP).​​ 

Pursuant to SB 165 (Chapter 365, Statutes of 2019), DHCS is required to collaborate with stakeholders to establish a pilot at up to four sites to evaluate the provision of medical interpretation services for beneficiaries with Limited English Proficiency (LEP) enrolled in Medi-Cal managed care and FFS Medi-Cal. A primary goal of the pilot will be to determine whether providing medical interpretation services results in a reduction of disparities in access to and use of services, and quality of care, with respect to beneficiaries with LEP and beneficiaries who are proficient in English. DHCS will make available up to $5 million for the pilot project and the associated ongoing, independent evaluation to be conducted throughout the term of the pilot by California State University at San Diego’s Institute for Public Health.​​ 

On August 31, DHCS announced the following selected pilot site contractors: Contra Costa County—Monterey Language Services; Los Angeles County—Language World Services, Inc.; San Diego County—Hanna Interpreting Services, L.L.C.; and San Joaquin County—J. Rivera Associates. DHCS anticipates that the pilot project will run from November 1, 2021, through September 30, 2023. For more information, visit the DHCS website.​​ 

Pamamahala ng Medication Therapy (MTM)​​ 

As part of the Governor’s 2021 Budget Act, DHCS submitted SPA 21-0028 to CMS seeking to add MTM as a payable FFS pharmacy service provided in conjunction with certain complex chronic medical conditions. On September 15, DHCS received CMS approval of this SPA, and is now working to finalize provider contracts and meet with stakeholders to obtain feedback and insights regarding the specific requirements and allowances of the MTM benefit. To participate in this program, Medi-Cal-enrolled pharmacies will be required to enter into a contract with DHCS. The contract will outline the requirements and guidelines necessary to receive reimbursement under this methodology.​​ 

Update sa Pagpapatupad ng Medi-Cal Rx​​ 

Medi-Cal Rx is scheduled to launch on January 1, 2022. Outreach and education activities have begun and will run through December, in advance of the January 1 go-live date. DHCS will send a 60-day notice to all Medi-Cal beneficiaries and a 30-day notice to all FFS beneficiaries. MCPs will also send a 30-day notice to their members as part of a broader outreach campaign. Additionally, DHCS has resumed Medi-Cal Rx stakeholder engagements and meeting schedules. For more information, please visit the DHCS website or email RxCarveOut@dhcs.ca.gov.​​ 

Money Follow the Person (MFP) Supplemental Funding Application​​ 

Ang programa ng pagpapakita ng MFP ay sumusuporta sa mga pagsisikap ng estado para sa muling pagbabalanse ng mga pangmatagalang serbisyo at sistema ng suporta ng estado upang ang mga indibidwal ay may pagpipilian kung saan sila nakatira at makatanggap ng mga serbisyo. Ang mga layunin ng programa ng MFP ay pataasin ang paggamit ng HCBS at bawasan ang paggamit ng mga serbisyong nakabatay sa institusyon, kapag naaangkop, habang pinapalakas ang kakayahan ng mga programang Medicaid na magbigay ng HCBS sa mga taong pipiliing lumipat sa labas ng mga institusyon.​​ 

Noong Setyembre 23, 2020, inihayag ng CMS ang karagdagang pagpopondo na hanggang $165 milyon para sa mga estado na kasalukuyang nagpapatakbo ng isang programa sa pagpapakita ng MFP. Ang bawat estado ay karapat-dapat na tumanggap ng hanggang $5 milyon sa karagdagang pagpopondo para sa pagpaplano at mga aktibidad sa pagbuo ng kapasidad upang mapabilis ang disenyo at pagpapatupad ng pagbabago ng sistema ng pangmatagalang pangangalaga, at palawakin ang kapasidad ng HCBS. Upang makatanggap ng parangal sa pagpopondo, ang mga grantees ng estado ay kinakailangang magsumite ng panukala na may kasamang salaysay ng proyekto bago ang Hunyo 30.​​ 

On July 27, CMS approved DHCS’ $5 million MFP supplemental funding application to conduct a statewide gap analysis and multiyear roadmap of its HCBS and Managed Medi-Cal Long-Term Supports and Services (MLTSS) programs and networks. The CMS-approved application is available on the DHCS website​​ 

Peer Specialist Certification Program​​ 

On July 22, 2021, DHCS released Behavioral Health Information Notice 21-041 identifying the state standards for Medi-Cal peer support specialist certification programs that may be implemented by counties, or an entity representing counties, that opt in to provide these programs, according to SB 803 (Chapter 150, Statutes of 2020) requirements. This certification is required for Medi-Cal reimbursement, but does not impact peer programs with other funding sources. For questions about Medi-Cal peer support specialist certification, email Peers@dhcs.ca.gov.​​ 

On August 27, DHCS released for stakeholder feedback a draft of SPA 21-0051, which seeks to establish peer support services as a distinct specialty mental health service, and peer support specialists as a distinct provider type.​​ 

Ang DHCS ay nasa proseso ng pagsusumite sa CMS ng lahat ng pederal na pagwawaksi ng Medi-Cal at Mga Pagbabago sa Plano ng Estado na kinakailangan upang ipatupad ang bagong benepisyo ng peer support specialist. Sa pag-apruba ng CMS, maaaring magsimula ang mga serbisyo ng peer support specialist sa Hulyo 1, 2022.​​ 

Saklaw ng Pangangalaga sa Postpartum​​ 

Under the provisions of ARPA, DHCS is opting to broaden the scope of Medi-Cal coverage for currently eligible and newly eligible pregnant individuals. Medi-Cal will cover the full breadth of medically necessary services, during both the pregnancy and postpartum periods, by adding ten months of coverage following the current 60-day postpartum period, for a total of 12 months. In the interest of aligning the Medi-Cal Access Program (MCAP) with the Medi-Cal postpartum care extension policies described above, DHCS submitted a Children’s Health Insurance Program (CHIP) SPA, CA-21-0032, proposing to create a Health Services Initiative (HSI) to extend the provisions allowed in ARPA to MCAP. On September 14, DHCS received federal approval for the HSI. Under the provisions of ARPA and the HSI, individuals will maintain coverage through their pregnancy and 12-month extended postpartum coverage period regardless of income changes, citizenship, or immigration status. This policy is targeted for implementation on April 1, 2022.​​ 

Smile, California Campaign para sa Medi-Cal Dental Services​​ 

The statewide “Back-Tooth-School” campaign, which aimed to encourage parents and caregivers to send their children back to school with healthy smiles by scheduling a dental check-up before the start of the 2021-22 school year, concluded in September. Smile, California developed 15 new resources and assets (translated in Spanish and some in Chinese) as part of this campaign. Fifty-six local oral health programs participated in the campaign by co-branding Smile, California resources, sharing messaging through social media, and conducting kindergarten oral health assessment events.​​ 

Also, two new videos were posted to SmileCalifornia.org and SonrieCalifornia.org. The first video, entitled “How to Use the Find A Dentist Tool,” is available in both English and Spanish. The second video, “Healthy Children are Ready to Learn!“, underscores the important role good oral health and regular dental check-ups play in school readiness. This video is also available in both English and Spanish.​​ 

Additionally, in October, Smile, California will partner with 185 school-based health centers, which do not offer dental treatment as a service, by providing them with a new 11×17 inch poster in English, Spanish, Mandarin, and Vietnamese. The poster will feature a 2-2-2 tip message (visit the dentist 2x a year, and brush for 2 minutes 2x a day each day) and will feature a list of the free and low-cost services provided by the Medi-Cal Dental Program. Further, in celebration of the campaign’s third anniversary, five Medi-Cal dental provider testimonial videos will premiere on Smile, California’s website and social media accounts. Watch the series on SmileCalifornia.org, Facebook, or Instagram.​​ 

By the end of August, SmileCalifornia.org had 19,854 new visitors, of which 14,505 clicked the “Find a Dentist” button.
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