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DHCS 发布最新的增强护理管理和社区支持季度报告

On March 27, DHCS released the latest Enhanced Care Management (ECM) and Community Supports quarterly report summarizing utilization data from July 2024 through September 2024. Key highlights from the report include:

• 持续增长：自 2022 年 1 月推出 ECM 以来，已有 279,824 名独特的 Medi-Cal 会员成功注册 ECM 福利。仅在 2024 年第三季度，就有 143,188 名独立会员享受了 ECM 福利，比 2024 年第二季度增长了 13%。
• 青年参与：2024 年第三季度，28,342 名 21 岁以下儿童和青年获得了 ECM 福利，比 2024 年第二季度增加了 13%。
• 社区支持使用情况：约有 296,500 名独特的 Medi-Cal 会员利用了社区支持，总共提供了超过 754,000 项服务。仅在 2024 年第三季度，就有 136,031 名独立会员获得了社区支持，比 2024 年第二季度增长了 7.5%。
• 增加服务访问：到 2024 年第三季度，近 90% 的 Medi-Cal 会员可以访问 14 项社区支持服务中的至少 10 项。超过 41% 的会员可以享受全套服务。
• 使用的关键服务：超过 61% 的社区支持成员获得了医疗定制膳食/医疗支持食品，约 32% 的成员使用了住房三重奏（住房过渡导航服务、住房租赁和维持服务以及住房押金）中的一项或多项服务。

最新的 ECM 和社区支持实施报告显示，随着更多重点人群获得 ECM 资格以及全州各县提供更多社区支持服务，利用率逐季持续增长。DHCS 预计在未来几个月和几年内 ECM 和社区支持方面的入学人数将进一步增长。2025 年，DHCS 将通过扩大 ECM 和社区支持计划监测工作、积极的利益相关者参与以及政策设计改进来继续支持和维持这一增长。

项目更新

社区卫生工作者

Effective April 1, DHCS updated Medi-Cal’s existing Community Health Worker (CHW) policy to allow supervising Medi-Cal providers to bill for covered CHW services provided by CHWs using two new Healthcare Common Procedure Coding System (HCPCS) codes recently added by the Centers for Medicare & Medicaid Services (CMS). DHCS is updating this policy to allow CHWs to better address the economic and social conditions that influence Medi-Cal members and community health, such as food, housing, and transportation insecurities and access to essential utilities. DHCS’ updated CHW policy aims to more effectively support and promote improved health outcomes for Medi-Cal members by addressing needs affected by social drivers of health. DHCS also issued a State Plan Amendment Public Notice to set the rates for these two codes to 100 percent of the Medicare rate, pursuant to Welfare & Institutions Code Section 14105.25.

此外，4 月 1 日，DHCS 发布了一项全州范围内的常设建议，即所有符合获得 CHW 服务资格标准的 Medi-Cal 成员都将受益于 CHW 服务。这项旨在改善 Medi-Cal 会员获得社区卫生工作者服务以及 Medi-Cal 提供者提供社区卫生工作者服务的途径并减少障碍的长期建议，由加州医疗保健服务部 (DHCS) 政策与评估医疗主任 Karen Mark 博士签署。根据现行政策，这项长期建议授权社区卫生工作者提供 Medi-Cal 涵盖的社区卫生工作者服务，包括健康教育、健康导航、筛查和评估以及个人支持和倡导。

加入我们的团队

DHCS 正在寻找一位有才华、有上进心的个人担任以下职务：

• Chief of the Benefits Division (BD). The Chief of BD leads the development, implementation, and administration of medical coverage policies for health care services provided by the state’s Medi-Cal program. The Chief also oversees several specialty programs within Health Care Benefits and Eligibility, including Every Woman Counts, Prostate Cancer Treatment, and Hearing Aid Coverage for Children. Applications must be submitted by April 18.

DHCS 还在为其合同、审计、管理式医疗、人口健康管理和其他团队招聘人员。如需了解更多信息，请访问 CalCareers 网站。

即将举行的利益相关方会议和网络研讨会

DHCS posts upcoming public meetings on the Calendar of Events. 

强势起步及超越合作伙伴网络研讨会

On April 2, from 12 to 12:45 p.m. PDT, California Surgeon General Dr. Diana E. Ramos will host the next Strong Start & Beyond partner webinar on prevention to improve lifelong health. Strong Start & Beyond is a bold movement to reduce California’s maternal mortality rate by 50 percent by December 2026. By leveraging the state’s investments and partnerships, we can foster awareness, encourage active participation in health, and build access to resources for mothers, pregnant people, and their families. Joining Dr. Ramos are Dr. Erica Pan, California Department of Public Health Director and State Public Health Officer; Dr. Bernadette Lim, Founder and Executive Director of the Freedom Community Clinic; and Dr. Atul Nakhasi, Transformational Physician Executive. Please contact the Office of the California Surgeon General if you have any questions.

消费者焦点利益相关者工作组 (CFSW)

On April 4, from 10 to 11:30 a.m. PDT, DHCS will convene the CFSW, which provides stakeholders an opportunity to review and provide feedback on a variety of consumer messaging materials. The forum focuses on eligibility and enrollment-related activities and strives to offer an open discussion on Medi-Cal policies and functionality. Meeting materials, including the meeting agenda, will be posted by April 2 on the DHCS Consumer-Focused Stakeholder Workgroup webpage. 

California Children’s Services (CCS) Advisory Group Meeting 

4 月 9 日下午 1 点至 4 点（太平洋夏令时），DHCS 将举办 CCS 咨询小组季度会议（需提前注册）。DHCS 和 CCS 咨询小组合作，确保参加 CCS/全人教育模式 (WCM) 项目的儿童能够及时获得适当的优质护理。议程主题包括 2025 年优先事项的最新进展，包括 2025 年 WCM 扩展；县级合规性、监测和监督；以及 Medi-Cal Rx 儿科整合。更多信息和会议详情请访问CCS咨询小组网页。  

导乐实施利益相关者工作组

On April 11, from 10 a.m. to 12 p.m. PDT, DHCS will host the next Doula Implementation Stakeholder Workgroup meeting, as required by Senate Bill 65 (Statutes of 2021, Chapter 449), to examine the implementation of the Medi-Cal doula benefit, in accordance with section 14132.24 of the Welfare and Institutions Code. The meeting will be held at 1501 Capitol Avenue, Sacramento, CA, and is open to the public. The link for this meeting will be available on the DHCS Doula Implementation Stakeholder Workgroup webpage. The workgroup will discuss ways to minimize barriers to doula services and continue discussions regarding the workgroup’s report to the Legislature, which must be posted on DHCS’ website by July 1, 2025.

保护医疗保健法案 (PAHCA) - 利益相关者咨询委员会 (SAC) 

On April 14, from 11:30 a.m. to 3:30 p.m. PDT, DHCS will host the PAHCA-SAC meeting (advance registration for online participation required) at 1700 K Street (first-floor conference room 17.1014), Sacramento. The committee is responsible for advising DHCS on developing and implementing components of the Protect Access to Health Care Act of 2024 (Proposition 35). For general inquiries or to receive more information about meetings, please email DHCSPAHCA@dhcs.ca.gov.

传统医疗保健实践有利于实施

On April 22, DHCS will present an overview of Behavioral Health Information Notice (BHIN) 25-007 – Traditional Health Care Practices Benefit Implementation at the Tribes and Indian Health Program Representatives meeting (advance registration required). The presentation is open to the public and will review policy guidance to support Indian Health Care Providers and Drug Med-Cal Organized Delivery System counties in implementing this new benefit. Attendees are encouraged to submit questions in advance to traditionalhealing@dhcs.ca.gov with the subject line “Traditional Health Care Practices Implementation.” For questions about traditional health care practices or this BHIN, please email traditionalhealing@dhcs.ca.gov.

如果你错过了

DHCS 宣布阿片类药物使用障碍治疗奖

3 月 25 日，DHCS向两家地方紧急医疗服务机构拨款 80 万美元，旨在为在紧急医疗服务 (EMS) 环境中面临过量用药风险且往往无法在其他环境中获得服务的患者，提供低门槛的、经临床验证的阿片类药物使用障碍 (OUD) 治疗。这些拨款——通过紧急医疗服务丁丙诺啡使用试点计划 (EMSBUP) 授予斯坦尼斯劳斯县 EMS 机构和文图拉县 EMS 机构——将使这两个机构能够将物质使用障碍作为一种可治疗的紧急情况来处理，利用护理人员来识别和治疗那些可以从药物成瘾治疗 (MAT) 中受益的患者。药物辅助治疗 (MAT) 是将药物与咨询和行为疗法相结合，可有效治疗阿片类药物使用障碍 (OUD) 并帮助一些人维持康复。

现已开放：提供访问和转变健康 (PATH) 能力以及基础设施转型、扩展和发展 (CITED) 第 4 轮申请

On January 6, DHCS opened the PATH CITED Round 4 application window, which includes funding opportunities to support the implementation of the new transitional rent Community Support. 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. All organizations providing the transitional rent Community Support must do so in partnership with their county behavioral health department. To demonstrate this partnership, all CITED applicants planning to request funding to support the transitional rent Community Support must also submit a Letter of Support in collaboration with the county behavioral health department.

The deadline to apply for PATH CITED Round 4 funding is 11:59 p.m. PDT on May 2, 2025. The guidance document and application are available on the PATH CITED webpage. Please send any questions to cited@ca-path.com.