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CMS Approves California’s BH-CONNECT Initiative to Transform Behavioral Health Services​​ 

The Centers for Medicare & Medicaid Services (CMS) approved the California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) demonstration. This transformative initiative will expand access to essential behavioral health services for Medi-Cal members with significant mental health and substance use needs. Key features of BH-CONNECT include:​​ 

• 劳动力投资：支持 19 亿美元的强劲而多样化的行为健康劳动力计划，其中包括奖学金、贷款偿还计划、招聘激励、居住权和奖学金扩展以及专业发展。 该劳动力计划将由医疗保健获取和信息部（HCAI）管理。​​ 
• Transitional Rent Assistance: Provides up to six months of rental support, through a member’s managed care plan, for eligible Medi-Cal members transitioning from institutions, congregate settings, or homelessness. This support is crucial in stabilizing individuals during vulnerable periods, significantly reducing the risk of returning to institutional care or experiencing homelessness. Transitional rent will serve as a bridge to permanent housing for members who need it. For members with significant behavioral health needs, the Behavioral Health Transformation funding dedicated to Housing Interventions will provide permanent rental subsidies and housing following Transitional Rent, providing seamless continuity, and supporting members in achieving long-term housing stability.​​ 
• 对儿童和青少年的支持：包括活动资金，用于改善参与儿童福利的青少年获得专业心理健康服务的机会和结果。​​ 
• 对县的激励措施：支持 19 亿美元的获取、改革和成果激励计划：奖励县行为健康计划，以改善获取、减少差异并加强行为健康质量改进。​​ 
• 社区过渡内联服务：支持成员从长期机构住宿过渡，以确保护理的连续性和成功融入社区。​​ 
• 短期住院精神病治疗：为符合联邦精神疾病机构标准的住院和住宅治疗环境中提供的短期精神卫生护理的联邦 Medi-Cal 资金提供新的灵活性。​​ 

在获得第 1115 条示范批准所授予的支出和豁免权力的同时，DHCS 正在实施 BH-CONNECT 示范的其他不需要第 1115 条示范权力的功能，其中包括：​​  

• Medi-Cal 为循证实践 (EBP) 提供保险，包括（可根据县选择提供）：​​   
  • 积极社区治疗（ACT）是一种全面的、以社区为基础的、跨学科的团队服务模式，旨在帮助患有严重精神疾病的个人应对其心理健康状况的症状并发展或恢复在社区中活动的技能。​​ 
  • 法医 ACT 是专为参与司法系统的个人量身定制的 ACT 计划。​​ 
    • 首次发病精神病的协调专科护理是一种全面的、以社区为基础的、跨学科的团队服务模式，旨在帮助个人应对早期精神病的症状并继续融入社区。​​ 
    • 支持性就业的个人安置和支持模式、以社区和团队为基础的服务，帮助有行为健康问题的个人在社区中过上正常而富有成效的生活，包括获得和/或维持有竞争力的就业。​​ 
    • 社区卫生工作者服务，由值得信赖的社区成员通过专业行为健康服务系统提供的预防服务，提供健康教育、宣传和导航服务，以支持成员获取所需的医疗保健和社区资源，以解决健康的社会驱动因素。​​  
    • 俱乐部会所服务，在康复计划中提供的服务，为有重大行为健康需求的人们提供一个实体场所，以建立关系、参与工作和教育活动以及获得支持服务。​​ 
• 澄清针对儿童和青少年的循证实践 (EBP) 的 Medi-Cal 覆盖要求，包括多系统治疗、功能性家庭治疗、亲子互动治疗和高保真环绕治疗（全州实施）。BH-CONNECT 通过为这些 EBP 提供更清晰的指导方针和覆盖要求，旨在确保加州更多的儿童和青少年能够获得这些有效的治疗。​​ 
• 管理式护理计划中的管理级县儿童福利联络员负责监督和提供增强型护理管理，参加儿童和家庭团队会议，确保管理式护理服务与其他服务相协调，并在护理管理人员遇到运营障碍时充当升级点（全州实施）。​​ 
• 卓越中心为行为健康服务系统和提供者提供培训和技术援助，以支持 EBP 治疗和交付的完整性（全州实施）。​​  
• 当儿童进入福利机构时进行儿童福利/专业心理健康联合访问（全州实施）。​​  

This multi-billion-dollar initiative combines federal, state, and local investments to create a more robust, equitable behavioral health system that prioritizes community-based solutions. By reducing emergency department visits and institutional stays, BH-CONNECT will help Californians achieve stability and recovery while building a stronger workforce and infrastructure to support long-term improvements.​​ 

Stay tuned for further updates, including stakeholder engagement opportunities and additional program details. Visit the DHCS BH-CONNECT webpage for more information.​​ 

Additionally, CMS approved an amendment to the California Advancing and Innovating Medi-Cal (CalAIM) section 1115 demonstration, effective through December 31, 2026. The CalAIM amendment expands the service duration and frequency criteria for several Community Supports, including Recuperative Care (Medical Respite) and Short-Term Post-Hospitalization Housing services, in alignment with CMS’ national policy, and makes other technical changes.​​ 

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 Managed Care Quality and Monitoring Division to lead compliance-related activities for the state’s Medi-Cal managed care plans. These activities include, but are not limited to, developing and implementing policies, establishing standard operating procedures, engaging in continual improvement efforts, providing technical assistance, and conducting risk analysis for managed care plan audit programs in partnership with DHCS’ Contract and Enrollment Review Division. Applications must be submitted by December 26.​​ 

DHCS 还在为其健康政策、信息技术和其他团队招聘人员。 欲了解更多信息，请访问CalCareers 网站。​​ 

即将举行的利益相关方会议和网络研讨会​​ 

长期护理 (LTC) 学习系列：面向 LTC 提供者的管理式护理资源​​ 

On December 17, from 9 to 10:30 a.m. PST, DHCS will host the Managed Care Resources for LTC Providers session (advanced registration required) as part of its educational LTC Learning Series. This session is designed for providers working in skilled nursing facilities, subacute care facilities, and intermediate care facilities for the developmentally disabled. Topics include Medi-Cal eligibility and managed care plan enrollment, LTC authorizations, and managed care billing and payment. Additionally, the agenda includes an overview of newly developed resources that provide information and helpful tips on various managed care topics. The session will feature managed care plan guest speakers.​​ 

LTC Learning Series participants are encouraged to submit questions in advance when registering for the session or by emailing them to LTCtransition@dhcs.ca.gov. Additional details about the LTC Learning Series are available on the CalAIM LTC Carve-In transition webpage.​​ 

DHCS 减害峰会​​ 

DHCS aims to collaborate with communities across the state to promote harm reduction and low-barrier, patient-centered care within California’s substance use disorder treatment system. DHCS encourages substance use disorder treatment providers and staff (including social workers, peers, front desk staff, case managers, nurses, physicians, and all staff in substance use disorder treatment settings) to attend and learn about best practices for incorporating the tenets of harm reduction into substance use disorder treatment. Summits will be held in Fresno, Los Angeles, and San Diego counties in winter 2025. Register on the event website.​​ 

如果你错过了​​ 

过渡至 Medicare A 部分购买协议​​ 

On January 1, 2025, California will become a Medicare Part A buy-in state, meaning eligible Medi-Cal members will receive Medicare Part A services for free if they are enrolled in Medicare Part B and they qualify for the Qualified Medicare Beneficiary (QMB) program. For these members, Medicare, instead of Medi-Cal, will provide primary coverage for hospitalizations and other inpatient benefits covered through Medicare Part A. California’s new Medicare Part A buy-in agreement with the federal Centers for Medicare & Medicaid Services will eliminate the conditional enrollment requirements for Medicare Part A at the Social Security Administration. As a Part A buy-in state, California can enroll eligible QMB members in Medicare Part A year-round through a streamlined enrollment process without any late enrollment penalties.​​ 

提供访问和转变健康 (PATH) 能力和基础设施、过渡、扩展和发展 (CITED) 第 4 轮申请​​ 

年6月2025日，DHCS 将开放PATH CITED第 4 轮申请窗口。 PATH CITED 计划提供资金来建设实地合作伙伴（包括社区组织、医院、县级机构、部落等）的能力和基础设施，以成功参与 Medi-Cal。 申请 CITED 第四轮资助的截止日期为太平洋标准时间 3 月7日2025晚上 11:59。 鼓励有兴趣的组织查阅申请大纲和指导文件，以帮助准备申请。 请将问题提交至cite@ca-path.com 。​​