DHCS Stakeholder News – January 13, 2023
热门新闻
Medi-Cal COVID-19 公共卫生紧急事件 (PHE) 和持续保险取消运营计划更新
1 月 13 日,DHCS 更新了 Medi-Cal COVID-19 PHE 和持续承保解除行动计划 ,以纳入 12 月颁布的 2023 年联邦综合拨款法案(Consolidated Appropriations Act of 2023)带来的政策变化 ,29 2022,以及医疗保险中心(Centers for Medicare& Medicaid Services)(CMS) 于 1 月以 CMCS 信息公告的 形式发布的相应指南5 2023, 。更新后的计划反映了自1 年 4 月起连续参保要求与公共健康保险脱钩的情况,2023 ,为恢复加州医 疗保险的重新确定奠定了基础。
The plan is intended to inform the public about DHCS’ approach to return Medi-Cal to a normal state of operations. The plan also includes additional resources, including information about the DHCS Coverage Ambassadors campaign and links to CMS guidance documents.
冬季风暴健康检查
California has experienced a series of devastating storms, with predicted severe weather continuing, potentially resulting in damaging winds, heavy rain, and flooding. We must double down on our communication efforts over the coming days as additional rain is expected statewide through the next several days.
在接下来的三天里,我们希望您能集中精力为您的人群进行健康检查。请鼓励其他人使用这些资源来检查邻居、家人和朋友的情况。
健康检查 101
During inclement weather, the priority should be on ensuring people’s safety in emergencies and making it easier for them to access shelter and other resources by removing all possible barriers.
我们建议我们的社区合作伙伴积极主动地检查那些年龄较大、有残疾、无住房和/或有慢性疾病的人,因为这些人可能会面临风险。与他们联系,了解他们的情况,并在必要时为他们联系资源。
我们鼓励您与当地县和应急服务办公室合作,为您的社区提供援助。我们还建议您和您的员工熟悉当地的资源,包括当地的避难所或取暖中心,以便为有需要的人提供帮助。
To assist stakeholders with wellness checks, the California Health & Human Services Agency (CalHHS) developed an Emergency Resource Guide, Appendix I: Universal Wellness Checks Questionnaire that can be used when conducting wellness checks.
残疾人应急准备指南/工具包
The California Office of Emergency Services (CalOES) and Department of Rehabilitation have developed an Emergency Preparedness Guide/Toolkit for Individuals with Disabilities available in multiple languages that includes information and emergency preparedness tips for individuals with specific types of disabilities.
Evacuation: Please make sure that if local officials issue evacuation orders, please evacuate.
Stay Updated: Follow CalOES and your local emergency officials for real-time updates about the storm and its threats. Sign up for local alerts at calalerts.org.
We appreciate your efforts as we work together to improve preparedness and response to disasters and emergencies.
州长 2023-24 财政年度(FY)拟议预算
Governor Gavin Newsom proposed a $144.4 billion budget for DHCS programs and services in the next FY. The budget for DHCS supports vital services that reinforce the state’s commitment to preserve and improve the overall health and well-being of all Californians while operating within a responsible budgetary structure. Highlights include the expansion of full scope Medi-Cal coverage to all adults regardless of immigration status beginning January 1, 2024, CalAIM justice-involved initiatives, and provider rate changes. DHCS is also proposing the Behavioral Health Community-Based Continuum (CalBH-CBC) demonstration to expand access and strengthen mental health services for Medi-Cal members living with serious mental health illness and serious emotional disturbance. Additionally, DHCS will develop an 1115 demonstration waiver to support the state’s reproductive health safety net.
- DHCS FY 2023-24 Governor’s Budget Highlights (January 10)
- 州长的拟议预算(1 月 10 日)
- Medi-Cal 当地援助预估
- 家庭健康本地援助估算
- SMHS Budget Supplement – M22 (January 10)
- 药物 Medi-Cal 补充图表(1 月 10 日)
美国卫生与公众服务部 (HHS) 续签 PHE
On January 11, HHS renewed the federal COVID-19 PHE for a full 90-day extension through April 11. The formal PHE declaration was posted on the HHS website. The Biden Administration has committed to providing a minimum 60-day advance notice before it ends the PHE. Please contact the DHCS Medi-Cal Eligibility Division COVID inbox at MCED.COVID@dhcs.ca.gov with any questions.
项目更新
Medi-Cal 远程医疗更新
DHCS has released several updates to the Medi-Cal Telehealth webpage that reflect DHCS’ current telehealth policy:
正如远程保健政策文件所反映的那样,在联邦宣布的 COVID-19 PHE 到期后,大多数远程保健覆盖政策将得到保留。
如有任何问题或意见,请发送电子邮件至 Medi-Cal Telehealth@dhcs.ca.gov。
Medi-Cal Rx 更新
从 1 月 20 日开始,下一波恢复预先授权(PA)的工作将包括对另外 39 种治疗类别的预先授权,随后在 2 月 24 日恢复其余治疗类别(不包括肠内营养产品)的预先授权。届时,将全面恢复 22 岁及以上会员的 PA 要求。对于因报销历史而根据过渡政策支付的报销申请,医疗服务提供者可在 2 月 24 日开始的过渡期结束前提交 PA。 有关其他详细信息,请访问Medi-Cal Rx 网站的恢复页面。此外,Medi-Cal Rx 开始出版每周通讯("复职聚焦"),以支持利益相关者的参与和教育,并为利益相关者提供最近发布的资源和信息更新链接。
加州青年提升计划 (EYC) 申请请求 (RFA)
1 月 16 日,DHCS 将针对社区和部落组织发布另一份 EYC RFA,以建设组织能力,在受毒品战争影响严重的社区实施青年社会正义、指导和同伴支持预防计划。 由第 64 号提案青少年教育、预防、早期干预和治疗账户资助,可用资金近 1700 万美元,每个组织最多可申请 40 万美元的资金。欲了解更多信息,请访问EYC 网站。
行为健康桥梁住房 (BHBH)
DHCS 目前正在与利益相关者合作,最终确定 BHBH 计划的资金策略和允许用途,以解决无家可归和患有严重行为健康疾病的人的紧急住房和治疗需求。 2023 年 1 月下旬,将向县行为健康机构发布一份 RFA,以参与第一轮拨款计划资助。 对于第二轮融资,将于 2023 年春季发布 RFA 供部落实体申请资金。欲了解更多信息,请访问BHBH 网站。
诊所员工稳定保留补助金 (CWSRP) 申请截止日期
DHCS reminds all successfully registered qualified clinics to submit their CWSRP applications before the deadline. All requests for payment must be submitted no later than 5 p.m. on January 27. DHCS encourages early submissions so all applications can be validated shortly after the application submission deadline.
For application guidance, an application video tutorial, and all other supporting information, please visit the CWSRP webpage.
CalAIM 行为健康行政整合计划概念文件
1 月,DHCS 将发布一份关于加州推进和创新 Medi-Cal (CalAIM) 行为健康行政整合倡议的概念文件,该倡议旨在到 2027-28 财年将 Medi-Cal 特殊精神健康服务和药物 Medi-Cal 或药物 Medi-Cal 组织化交付系统服务计划整合为一个以县为基础的单一行为健康计划。概念文件将包括倡议框架和目标概述、从现在到 2027-28 财年的分阶段实施方法,以及 DHCS 关于利益相关者持续参与和技术援助的建议。
DHCS will accept stakeholder feedback on the concept paper through February 13. The concept paper will be available on the CalAIM Behavioral Health webpage.
微笑,加州Medi-Cal 牙科服务运动
In the coming weeks, Smile, California will debut a new tri-fold brochure for new and expecting parents, entitled “Healthy Smiles from Pregnancy Through the Toddler Years”. The brochure will be available in English, Spanish, Vietnamese, Chinese, and Korean, and will be available to view and download on SmileCalifornia.org.
加入我们的团队
DHCS is hiring! We are currently searching for a mission-driven, motivated individual to serve as the Chief of the Medi-Cal Eligibility Division. This position provides leadership, direction, and coordination of Medi-Cal and Children’s Health Insurance Program eligibility policy and operations. We are also hiring a Chief of the Human Resources Division.
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 is dedicated to preserving and improving the overall health and well-being of all Californians. DHCS’ mission is to provide the most vulnerable residents with equitable access to affordable, integrated, and high-quality health care, and is currently transforming the Medi-Cal program to make sure it provides the care Californians need to live healthier, happier lives.
即将举行的利益相关方会议和网络研讨会
CalAIM 人口健康管理 (PHM) 过渡护理服务网络研讨会
1 月 19 日下午 2:30 至 4:00,DHCS 将举办网络研讨会,讨论作为 CalAIM 基石的PHM 计划下的过渡性护理服务(需提前注册)。过渡性护理服务为从一种护理环境或护理级别过渡到另一种护理环境或护理级别(如从医院出院到家庭)的个人提供支持,以促进护理的连续性并限制服务中断。网络研讨会将就 2023 年为高风险会员实施过渡性护理服务的新做法进行小组讨论,并概述最新要求,包括分阶段实施时间表。
CalAIM 成人和青少年筛查以及 Medi-Cal 心理健康服务护理工具过渡网络研讨会
1 月 19 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 1 月 1 日上线的 Medi-Cal 心理健康服务成人和青少年筛查及护理工具过渡计划。 作为 CalAIM 的一部分,该计划致力于在全州范围内为成年人和 21 岁以下的个人实施筛查和护理过渡工具,供 Medi-Cal 管理式医疗计划 (MCP) 和县心理健康计划使用。 网络研讨会将概述该计划的目的、回顾最终的指导和工具、以及对常见问题的解答。
全州家庭和社区服务 (HCBS) 差距分析网络研讨会
On January 20, from 1 to 3 p.m., DHCS, in partnership with the California Department of Aging (CDA), will host a stakeholder engagement webinar (join at scheduled time) to present the preliminary approach for the Statewide HCBS Gap Analysis. This analysis will inform the development of a multiyear roadmap to address identified gaps in the service delivery system. DHCS’ gap analysis will focus on the Medi-Cal population and services and CDA’s will target aging and disability populations and services outside of Medi-Cal. This will be the first of multiple stakeholder engagement efforts. To be included on the invitation list for upcoming webinars, please email HCBSGapAnalysis@dhcs.ca.gov.
儿童助听器覆盖计划 (HACCP) 提供商网络研讨会
1 月 24 日中午 12 点至下午 12 点 50 分,DHCS 将举办HACCP 网络研讨会(需要提前注册) ,与供应商分享信息,以便他们能够更好地帮助儿科患者及其家人最大限度地发挥 HACCP 的益处。 培训课程将讨论家庭申请保险的计划要求以及听力学家、耳鼻喉科医生、医生及其办公室工作人员的索赔提交流程。
CalAIM 行为健康管理整合概念文件概述网络研讨会
1 月 26 日下午 3 点至 4 点,健康与社会服务部将举办网络研讨会,概述 CalAIM 行为健康管理整合概念文件(需提前注册)。网络研讨会将概述该倡议的框架和目标、从现在到 2027-28 财年的分阶段实施方法,以及 DHCS 关于利益相关者持续参与和技术援助的建议。如需了解更多信息,请访问CalAIM 行为健康倡议网页。
导乐政策制定最终利益相关者工作组会议
1 月 26 日下午 1 点至 3 点,DHCS 将在线上举办最后一次公共利益相关者工作组会议(按预定时间加入网络研讨会),讨论将助产士服务添加为 Medi-Cal 承保的福利。 在最后一次会议上,DHCS 将介绍助产师如何与 MCP 签约,并将讨论将于 3 月份开始的下一个助产师工作组的计划。 根据参议院第 65 号法案(2021 年法规第 449 章)的要求,Doula 实施工作组将审查该福利的实施情况。
如果你错过了
加州宣布投资 5200 万美元用于阿片类药物预防和治疗服务
On January 11, Governor Newsom issued a news release announcing that DHCS awarded $52 million to providers of Medication-Assisted Treatment (MAT) services to support the prevention, assessment, diagnosis, and treatment of opioid and substance use disorders, as well as recovery. To learn more about the California MAT Expansion project, visit the California MAT website.
加州青少年阿片类药物应对计划 3 (YOR 3) 申请
DHCS 发布了一份 RFA,以加强青少年(12-24 岁)及其家庭获得预防、治疗和康复服务的能力和途径,以及获得 MAT 的途径。这一机会旨在促进协调和加强现有的多系统网络,并鼓励为青少年提供服务的机构之间建立新的合作伙伴关系。实施项目的受赠方最多可获得 750,000 美元,能力建设项目的受赠方最多可获得 50,000 美元。欲了解更多信息并在 1 月 19 日截止日期前提出申请,请访问YOR CA 网站或发送电子邮件至YORCalifornia@ahpnet.com。
部落危机和非危机行为健康护理 RFA
1 月 11 日,DHCS发布了一份 RFA 征求加州部落实体的申请,以通过基础设施资金扩大部落危机和非危机行为健康护理的可及性。这笔资金必须专门用于车辆和允许的车辆相关费用,以改善行为健康流动危机和非危机服务的获取。项目期为 2 月1,2023, 至 6 月30,2025 。提供行为健康服务的合格加州部落实体可申请 5 万至 100 万美元不等的资金。 申请截止日期为 2 月 13 日。
双重合格患者的医疗保险提供商账单信息
健康与社会服务部为医疗保险提供方发布了最新的情况说明书和工具包,以解释参加 Medi-Cal 管理性护理的双重资格成员的提供方计费流程。本资料介绍了现有的交叉计费流程,在 CalAIM 下该流程不会改变。为具有双重资格的病人提供服务的联邦医疗保险医疗服务提供者无需加入 Medi-Cal MCP 以继续获得报销。全州超过 70% 的双重资格成员已加入 Medi-Cal MCP。加入 Medi-Cal MCP 后,医疗保险福利和医疗服务提供者不会改变。
对于原始(收费服务)医疗保险的患者,医疗保险管理承包商处理主要的医疗保险付款申请,然后将申请转发给 Medi-Cal MCP(或 DHCS),由 Medi-Cal 支付次要费用。对于参加联邦医疗保险优势计划 (MA) 的患者,联邦医疗保险医疗服务提供者向 MA 计划收取主要费用。二次付款程序可能取决于患者的 Medi-Cal MCP 与 MA 计划是相同还是不同。如需更多信息,请访问全州 Medi-Cal 双重合格会员管理式护理注册网页。
儿童助听器覆盖计划 (HACCP) 资格扩展
Effective January 1, DHCS welcomes newly eligible young adults ages 18 to 20 who meet other program criteria and need coverage for their hearing aid(s) and related services to apply for HACCP enrollment. Also, effective January 1, applicants under age 21 who meet program eligibility requirements may apply to enroll in HACCP even if they have partial other health coverage for hearing aids subject to a coverage limit of $1,500 or less per year. Additional program information is available on the HACCP webpage. Families can apply to enroll for coverage through HACCP’s Online Application Portal.