DHCS Stakeholder News – December 9, 2022
DHCS 正在提供有关 DHCS 计划重大进展的更新。
热门新闻
更正 Cal MediConnect (CMC) 错误发送的通知
11 月下旬，DHCS 向洛杉矶、河滨、圣贝纳迪诺、圣迭戈和圣克拉拉县的 CMC 会员错误地邮寄了一封取消注册信 (DL) 。 DHCS 可以确认，会员没有提前退出其 CMC 计划，他们不需要对此通知采取任何行动。31,2022, 会员将在 12 月之前继续参加他们的计划，并将在 1 月1,2023 自动加入其所属的医疗保险-Medi-Cal 计划，而不会出现保险空白期。
DHCS 正在通过 Health Care Options 向所有收到信件的会员进行电话外呼，通知他们不要理会错误发送的通知，他们目前的 CMC 计划不会中断。
DHCS 已在Cal MediConnect 的未来网页上发布了所有成员通知和更多信息。 如有任何问题，请发送电子邮件至info@calduals.org。
行为健康连续基础设施计划 (BHCIP) 第 4 轮：儿童和青少年补助金
On December 7, DHCS awarded $480.5 million in funding to 54 behavioral health projects in California serving children, youth, transition-age youth, and pregnant and postpartum women. These awards are being made through the BHCIP Round 4: Children and Youth grants. BHCIP represents the largest provision of resources for mental health and/or substance use disorder infrastructure in the state’s history, and an unprecedented opportunity to address historic gaps and effect meaningful, sustainable change in California’s behavioral health continuum. Additional information about BHCIP Round 4: Children and Youth awardees is available at BHCIP Grant Award Information.
提供机会和转型健康 (PATH) 司法相关项目第二轮申请截止日期延长
DHCS 已将加州推进和创新 Medi-Cal (CalAIM) PATH 司法参与第二轮资助的申请截止日期延长至 3 月31 ，2023 。2022PATH 计划的第三方管理机构 (TPA) 正在将 11 月10 发布的ACWDL 22-27 的申请更新纳入第 2 轮申请中。涉及司法的第二轮申请将下线至 1 月25 ，2023 ，以完成申请更新。任何正在准备申请的人都应等到 1 月 25 日重新开放申请时再提交。我们将尽快提供更多信息。
如对第二轮申请延期有任何疑问，请发送电子邮件至justice-involved@ca-path.com。
Medi-Cal Rx 事先授权 (PA) 要求
DHCS 已开始与 Medi-Cal Rx 利益相关者（管理式医疗计划、药房提供者、处方人员、医院、成员倡导者及其各自的协会）会面，以介绍恢复 PA 要求和终止过渡政策的最后三个阶段的信息。
- 到24年2023月，对于年龄 22 岁及以上且接受新开始药物的成年会员，所有 PA 要求都将恢复。
- 到23年2023月，针对 22 岁及以上成年人的祖父级 PA 的过渡政策将逐步取消。
- 最后阶段将恢复 PA 要求，同时取消针对 21 岁及以下儿童以及肠内营养产品的过渡政策。
DHCS has presented the timelines and scope of each phase, including the impact of the policy changes to members of Medi-Cal, California Children’s Services (CCS), Genetically Handicapped Persons Program, and Early and Periodic Screening, Diagnostic, and Treatment. DHCS will continue to engage stakeholders throughout the process.
远程医疗：会员信息通知
DHCS 起草了一份会员信息通知草案，供公众评论，截止日期为 12 月 16 日。 会员通知将于 2023 年发布，告知会员可用的远程医疗服务，并告知他们以下权利：
- 通过访问远程医疗以外的医疗服务提供者来获取承保的医疗服务。
- 选择远程医疗作为一种医疗方式。
- 获得前往医疗保健预约的交通服务。
- 了解使用远程医疗的局限性/风险。
- 提出与远程医疗相关的投诉。
意见可以通过电子邮件发送至Medi-Cal_Telehealth@dhcs.ca.gov 。
项目更新
长期服务和支持 (LTSS) 仪表板
On December 12, DHCS will launch the LTSS Data Dashboard, an initiative of the Home and Community-Based Services (HCBS) Spending Plan . The dashboard will track demographic, utilization, quality, and cost data related to LTSS. It will include statewide nursing home and HCBS data, with the goal of increased transparency to make it possible for regulators, policymakers, and the public to be informed while the state continues to expand, enhance, and improve the quality of LTSS in all home, community, and congregate settings.
长期医疗服务仪表板将采用分阶段的方式推出，最初的数据将包括 38 项重点关注利用情况的措施。在未来几个月内，还将按流量增加其他措施。仪表板的未来迭代将增强数据可视化能力，并增加有关质量和成本的数据。
This initial release of the dashboard shows that California continues to have a strong rate of LTSS “rebalancing”, otherwise known as HCBS utilization, compared to overall LTSS use. This is due to the state’s robust array of HCBS programs. In 2021, 85 percent of Medi-Cal members that used LTSS services used HCBS; only about 15 percent of LTSS members stayed in a long-term care (LTC) facility, but did not use HCBS.
This release also shows an increase in HCBS utilization each year, as well as a decline in average monthly census and overall use of LTC facilities in 2020 and 2021 due to the impact of the COVID-19 pandemic.
即将推出：接受诊所员工稳定保留补助金 (CWSRP) 申请
On December 29, DHCS will begin accepting applications for CWSRP. All successfully registered qualified clinics will receive a link to the application for submitting employee information. All requests for payment must be submitted no later than 5 p.m. on January 27, 2023. DHCS encourages early submissions so that all applications can be validated before the final due date. Additional application guidance and templates for submission will be posted on the CWSRP webpage on or before the opening of the application period.
此外，DHCS 还提醒所有符合条件的合格诊所注册 CWSRP，注册截止日期为 12 月20 ，2022 。已发布最新的常见问题 (FAQ)。有关注册指南和链接，请访问CWSRP 网页。
医院和专业护理机构 (SNF) COVID-19 员工保留补助 (WRP) 申请截止日期
DHCS 提醒所有 成功注册的承保实体 (CE) 、承保服务雇主 ( CSE)、医生团体实体 (PGE) 和独立医生提交医院和 SNF WRP 申请。所有付款申请必须在 12 月30 日下午 5 点之前提交，2022 。DHCS 鼓励尽早递交申请，以便在申请递交截止日期后不久验证所有申请。如果您是 CE、CSE、PGE 或独立医师，且尚未注册，请在 12 月21 前访问WRP 网页进行注册，2022 。
有关注册和申请指南、申请视频教程以及所有其他支持信息，请访问WRP 网页。
CMS 批准加州 HCBS 支出计划季度报告
On November 29, CMS approved DHCS’ quarterly reports for California’s HCBS Spending Plan for Quarters 1 and 2 of federal fiscal year 2022-23. California remains in compliance with program requirements, set forth in CMS’ State Medicaid Director Letters #21-003 and #22-002. Under the American Rescue Plan Act of 2021, the HCBS Spending Plan permits California to receive a temporary 10 percentage point increase to the Federal Medical Assistance Percentage for certain Medicaid expenditures for HCBS. The approved quarterly reports and more information are available on the HCBS Spending Plan webpage.
住院前筛查和住院医师评估 (PASRR) 在线系统试点测试
On December 1, DHCS began a pilot project to allow general acute care hospitals (GACHs) to test PASRR’s online system. The initial pilot group consists of six GACHs, and testing will be facilitated from December 1, 2022, through January 31, 2023. The remaining GACHs will be enrolled by region from February through April 2023.
PASRR is a federal and state-mandated program designed to identify evidence of a serious mental illness, intellectual and/or developmental disability, or related condition in all individuals (regardless of insurance type), who are seeking admission to a skilled nursing facility (SNF). To comply with federal regulations, the PASRR process must be completed prior to a beneficiary being admitted to a SNF.
DHCS is required to be fully compliant with California’s PASRR process by July 1, 2023. To achieve this, all GACHs will be enrolled in PASRR’s online system and must incorporate the PASRR screening protocol in their discharge process. The online system will streamline their efforts to complete the PASRR process before discharging a member to a Medicaid-certified SNF. For more information, visit the PASRR webpage.
儿童助听器覆盖计划 (HACCP) 资格扩展
自 1 月 1 日起，DHCS 欢迎符合其他计划标准且需要助听器及相关服务保险的 18 至 20 岁新符合条件的年轻成人申请加入 HACCP。此外，自 1 月 1 日起，符合计划资格要求的 21 岁以下申请人，即使拥有部分其他医疗保险，也可申请加入 HACCP，以获得每年 1,500 美元或以下的助听器保险。更多计划信息，请访问HACCP 网页。家庭可通过 HACCP 的在线申请门户申请加入保险。
加入我们的团队
DHCS 正在招聘！我们正在寻找三位有使命感、积极进取的人才，担任质量与人口健康管理计划 的价值付费处处长 、 质量 与健康公平评估和监测处处长 以及 质量& 健康公平转型处处长 。这些一级公共卫生医疗管理员职位将帮助 DHCS 为最弱势的加州人提供服务。
DHCS is also hiring Californians to join our fiscal, human resources, legal, auditing, health policy, and information technology teams. For more information, please visit the CalCareers website.
DHCS 致力于维护和改善所有加州人的整体健康和福祉。DHCS 的使命是为最弱势的居民提供负担得起的、综合的、高质量的和公平的医疗保健服务，目前正在对 Medi-Cal 计划进行改革，以确保提供加州人所需的医疗保健服务，使他们生活得更健康、更快乐。
即将举行的利益相关方会议和网络研讨会
痴呆症护理意识网络研讨会
On December 13, from 12 to 1 p.m., DHCS’ Dementia Care Aware will virtually host the “Next Steps in Assessment and Management After a Positive Cognitive Health Assessment (advance registration required)” webinar. The webinar will include an update on next steps in assessment and management after a positive cognitive health assessment.
Participants of the live webinar are eligible to receive 1 Continuing Medical Education (CME) and California Marriage and Family Therapists (CAMFT) credit. Providers are also encouraged to take the cognitive health assessment training (1.5 CME/CAMFT credit) Additional information about the Dementia Care Aware Initiative is available at www.dementiacareaware.org.
CalAIM 管理长期服务和支持 (MLTSS) 及双重集成工作组 12 月会议
12 月 15 日上午 10 时至中午 12 时，DHCS 将以虚拟方式主办 CalAIM MLTSS 和双重保险整合工作组会议（需提前注册）。议程项目包括 2023 年 1 月注册变更概述、2024 年双合格特殊需求计划 (D-SNP) 姑息关怀护理协调指南概述、长期服务和支持仪表板更新、最近发布的 2023 年 CalAIM D-SNPs 政策指南章节更新，以及 2023 年 1 月熟练护理机构长期关怀例外条款过渡审查。
Background materials, transcripts, and video recordings of the previous workgroup meetings, along with additional information about the workgroup, are posted on the CalAIM MLTSS and Duals Integration Workgroup webpage. Please email your questions to DHCS at info@calduals.org.
CalAIM 筛查和 Medi-Cal 心理健康服务护理工具过渡
12 月 15 日下午 3 点至 4 点，DHCS 将举办一场网络研讨会（需要提前注册），让利益相关者了解 Medi-Cal 精神健康服务计划的筛查和护理工具过渡，该计划将于 1 月1日2023上线，作为 CalAIM 的一部分。 该计划的重点是开发全州范围内针对成年人和 21 岁以下个人的筛查和护理过渡工具，供县心理健康计划 (MHP) 和 Medi-Cal MCP 使用。 网络研讨会将回顾实施的时间表和预期，重点介绍 MCP 和 MHP 可以采取的支持成功启动的步骤，并解答常见问题。 如有任何疑问，请发送电子邮件至 BHCalAIM@dhcs.ca.gov 。
护理机构融资改革网络研讨会
在 12 月 21 日下午 3 点至 4 点，DHCS 将举办一次虚拟利益相关者会议，讨论由议会第 186 号法案（2022 年法规第 46 章）授权的劳动力和质量激励计划 (WQIP)。 本次会议将介绍 WQIP 的最终方案设计，并为利益相关者提供进一步的反馈机会。 有关如何参加 12 月 21 日网络研讨会的信息将在会议日期临近时发布在护理机构融资改革 AB 186 网页上。