DHCS Stakeholder News – January 27, 2023
热门新闻
联邦合作伙伴批准涉及司法的豁免
1月26日，联邦医疗保险和医疗补助服务中心（CMS）通知加利福尼亚州，该州成为全国第一个获得批准，向州监狱、县监狱和青少年惩教所内的青少年和成年人提供为期90天的释放前有针对性的医疗补助服务的州。 作为我们改造 Medi-Cal 工作的一部分，通过联邦医疗补助 1115 示范豁免，DHCS 将建立一个协调的社区重返流程，帮助出狱人员在获释后获得所需的身体和行为健康服务。
此次示威的目的是为涉及司法系统的 Medi-Cal 成员搭建一座通往社区护理的桥梁，为他们提供稳定病情的服务，并在他们获释前制定重返社区护理的计划。 这将有助于减少护理差距、改善健康结果、防止不必要地进入住院医院、精神病院、疗养院和急诊室，并减少药物过量、自杀、无家可归和累犯。
此外，特例还授权 4.1 亿美元用于 "提供就医机会 "和 "改变健康状况"、支持合作规划的 "司法参与能力建设 "赠款，以及旨在支持实施释放前和重返社会规划的信息技术投资。
DHCS 为我们的合作伙伴开发了社交媒体工具包。请将工具包广泛分享给那些可能会发现这些信息很有帮助的人。如需了解更多信息，请访问 "参与司法 "网页。
开设 CalAIM 提供准入和转型健康 (PATH) 技术援助 (TA) 市场
On January 31, DHCS will open the virtual PATH TA Marketplace to the public. The TA Marketplace is a virtual marketplace for partners and potential partners to receive technical assistance services to support the implementation of California Advancing and Innovating Medi-Cal (CalAIM), including Enhanced Care Management (ECM) and Community Supports. The TA Marketplace is a one-stop-shop website where entities can find and be connected to TA resources from curated and approved providers. TA offerings include the option to request custom, hands-on technical support or to request off-the-shelf TA products, which are packaged and ready for implementation.
To receive no-cost services, providers, community-based organizations, Medi-Cal Tribal and Designees of Indian Health Programs, counties, and other eligible TA recipients will be able to submit a Recipient Registration form that, once approved, will allow registrants to shop and apply for TA services beginning in February 2023.
Please visit ca-path.com/ta-marketplace to learn more.
项目更新
DHCS 获得 Doula 州计划修正案 (SPA) 的批准
On January 26, CMS informed DHCS that it had approved State Plan Amendment (SPA) 22-0002 for doula services, and that DHCS would receive the approval letter on January 27. The approved SPA will be posted on the DHCS webpage by February 3. DHCS submitted the SPA to CMS on November 7, 2022, after working with stakeholders for more than a year to develop the benefit. The coverage description reflects the input from the Doula Stakeholder Workgroup and other stakeholders on the description of covered services and the qualifications of doulas. The final meeting of the current doula workgroup was held on January 26. The Doula Implementation Workgroup, required by section 14132.24 of Welfare and Institutions Code pursuant to Senate Bill 65 (Chapter 449, Statutes of 2021), will hold its first meeting on March 30. The new workgroup will examine issues of service availability, payment, and outreach, as identified in the statute. More information is available on the doula webpage.
DHCS 重启 PATH 司法项目第二轮融资
1 月 30 日，DHCS 将重新开放PATH 司法相关计划第二轮申请。 第二轮资金将支持惩教机构、机构和其他与司法相关的利益相关者实施释放前的 Medi-Cal 登记和暂停流程。 欲了解更多信息，请访问司法相关能力建设计划网站。
Medicare/Medi-Cal 双重合格者的 Medi-Cal 管理式医疗计划 (MCP) 注册
Effective January 1, 2023, members dually eligible for Medicare and Medi-Cal across the state became eligible to be mandatorily enrolled in Medi-Cal MCPs for their Medi-Cal benefits only. As a reminder to our stakeholders, this change in Medi-Cal does not change access to Medicare providers or benefits. Additionally, Medicare providers serving dual eligible patients do not need to enroll in a Medi-Cal MCP to continue receiving reimbursement. More than 70 percent of dual eligible members statewide are already enrolled in Medi-Cal MCPs; this step transfers the remaining 30 percent into Medi-Cal MCPs.
DHCS published an updated fact sheet and toolkit for Medicare providers to explain the provider billing process for dual eligible members enrolled in Medi-Cal managed care. This fact sheet describes the existing crossover billing process, which does not change under CalAIM.
For patients in Original (fee-for-service) Medicare, the Medicare Administrative Contractor processes the primary claim for Medicare payment, and then forwards the claim to the Medi-Cal MCP (or DHCS) for secondary Medi-Cal payment. For patients in Medicare Advantage (MA), the Medicare provider bills the MA plan for primary payment. The secondary payment process may depend upon whether the patient’s Medi-Cal MCP is the same as or different than the MA plan. For more information, please visit the Statewide Medi-Cal Managed Care Enrollment for Dual Eligible Members webpage.
微笑，加州 Medi-Cal 牙科服务运动
On February 1, the National Children’s Dental Health Month promotion will launch, focusing on the importance of preventive dental care. The theme, Love Your Teeth, will be weaved into existing and new resources and messaging for promotion on SmileCalifornia.org and SonrieCalifornia.org.
加入我们的团队
DHCS 正在招聘！健康与社会服务部（DHCS）立即招聘一名新的计划首席运营官。这一高级行政职位负责领导和监督该部三个关键业务领域的所有方面：企业数据和信息管理、企业技术服务以及计划运营。
DHCS 还在为我们的财政、人力资源、法律、审计、卫生政策和信息技术团队招聘人员。如需了解更多信息，请访问CalCareers 网站。
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公平获得负担得起的、综合的、高质量的医疗保健服务的机会，目前正在对 Medi-Cal 计划进行改革，以确保它能为加州人提供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
康复部 (DOR) 州任命研讨会
On January 30, from 12 to 1 p.m., DOR Director Joe Xavier and Governor Newsom’s Appointments Secretary Cathryn Rivera will host a virtual informational workshop (advance registration required) to provide an overview of the state appointments process and why it is important to have disability representation on state boards and commissions. For more information about state appointments, including a current list of state board and commission vacancies, please visit the Office of the Governor’s Appointments webpage.
California Children’s Services (CCS) Monitoring and Oversight Workgroup Webinar
On January 30, from 12 to 4 p.m., DHCS will virtually host the CCS Monitoring and Oversight Workgroup meeting (advance registration required) to develop and implement the CCS Compliance, Monitoring, and Oversight Program, a component of the CalAIM initiative. Agenda topics for discussion at this meeting include the Grievance Numbered Letter (NL), Training NL, Surveying NL, Memorandum of Understanding development, compliance activities, and enforcement proposal. Additional information is available on the CCS Compliance, Monitoring, and Oversight Program webpage.
CalAIM 专业护理机构 (SNF) 加入网络研讨会：Medi-Cal 管理式医疗如何支持 SNF 居民
On January 30, from 2 to 3 p.m., DHCS will virtually host the fourth in a series of public educational webinars for the SNF Carve-In (advance registration required) to support Medi-Cal MCPs and SNF providers as they implement Medi-Cal managed care coverage of SNFs statewide that began on January 1, 2023. The webinar will provide an overview of key Medi-Cal managed care benefits, services, and programs that supports current SNF residents and SNF residents transitioning back to their home or community. Additional details on upcoming webinars are available on the CalAIM LTC Carve-In transition webpage.
药物 Medi-Cal 有序交付系统 (DMC-ODS) 行为健康信息通知 (BHIN) 网络研讨会更新概述
On January 31, from 11 a.m. to 12 p.m., DHCS will host a webinar (advance registration required) to provide an opportunity for stakeholders to learn about updates related to the DMC-ODS. Specifically, DHCS will discuss updates to BHIN 21-075. Time will be reserved at the end of the webinar for a questions and answers session. A recording of the webinar will be available following the webinar. For more information, visit the CalAIM Behavioral Health Initiative webpage. For questions, email BHCalAIM@dhcs.ca.gov. You will find a copy of the agenda here.
PATH 司法相关倡议第二轮融资信息网络研讨会
1 月 31 日上午 10:30 至下午 2:00，DHCS 将举行一次信息网络研讨会（需提前注册），在 3 月 31 日新的 PATH 涉案人员倡议第二轮资助申请截止日期之前为感兴趣的实体提供申请支持。会议邀请函和其他详细信息将在参与司法能力建设计划网站上公布。如有任何疑问，请联系CalAIMJusticePreReleaseApps@dhcs.ca.gov。
护理机构融资改革网络研讨会
2月1日下午1:30至2:30，DHCS将举办护理机构融资改革网络研讨会（需提前注册），讨论186号议会法案（2022年法规第46章）授权的劳动力标准计划的发展。更多信息请访问护理机构融资改革网页。
健康登记导航员网络研讨会
On February 6, from 1 to 2:30 p.m., the Health Enrollment Navigators Project is virtually hosting a joint stakeholder meeting with county and community-based organization partners, advocates, and other interested individuals to provide updates and answer questions on the DHCS Navigators Project team. Information regarding this meeting, other general information, and updates will be available on the Health Enrollment Navigators Project webpage. Interested parties may also request to be added to the meeting notice by emailing HealthNavigators@dhcs.ca.gov.
供应商注册 供应商公告 利益相关方会议
2 月 9 日，DHCS 将通过网络召开两次利益相关者公开会议，讨论监管提供商公告。上午 10:00 至 11:30 将举行 "远程或间接从其营业地址提供服务的医疗服务提供者注册加州医保的要求和程序"讲座。利益相关者将有机会在听证会上提出问题和建议；听证会当天接受书面意见，截止时间为下午 5 点。根据收到的公众意见，DHCS 将在 Medi-Cal 和 DHCS 网站上发布最终公告。更改将在公布 30 天后生效。
如果你错过了
CalAIM 行为健康行政整合概念文件发布，供公众评论和网络研讨会
DHCS 发布了 CalAIM 行为健康行政整合倡议的概念文件，该倡议旨在到 2027 年将 Medi-Cal 特殊精神健康服务计划和 Medi-Cal 药物或 DMC-ODS 服务合并为一个以县为单位的行为健康计划。健康与安全部正在接受利益相关者对概念文件中所述方法的反馈意见，截止日期为 2 月 21 日。请将所有意见以书面形式提交至bhcalaim@dhcs.ca.gov。尽管 DHCS 不打算发布修订后的概念文件，但在征求意见期间收到的反馈意见将为 DHCS 的政策决策、实施战略以及对潜在指导和其他技术援助材料的考虑提供参考。如需了解更多信息，请访问行为健康 CalAIM网页。
危机恢复资源
如果您或您认识的人感到压力、焦虑、沮丧或需要情感支持，我们可以提供帮助。 以下是资源列表，包括心理健康服务以及对遭遇自然或人为灾难的人的支持。
紧急或危机应对（所有州）
- 911：如果您遇到紧急情况并需要立即援助，请拨打 911。
- 988：如果您正经历自杀危机或情绪困扰，并希望获得保密的情感支持，请拨打或发短信至 988 寻求英语或西班牙语的帮助。 988 生命热线为处于困境中的人们提供全天候、免费和保密的支持，为您或您的亲人提供预防和危机资源，并为美国专业人士提供最佳实践。 988lifeline.org提供聊天服务。
灾难支持（所有州）
- SAMHSA Disaster Distress Helpline: If you’ve experienced a natural or human-caused disaster, you can call or text the SAMHSA Disaster Distress Helpline’s toll-free number (1–800–985–5990) and receive immediate counseling. This free, confidential, multilingual crisis support service is available to anyone experiencing distress as a result of a natural or human-caused disaster. People who call and text are connected to trained, caring professionals from crisis counseling centers in the network. Helpline staff provide confidential counseling, referrals, and other needed support services.
- SAMHSA 为服务提供商和其他专业人员提供的灾难资源：美国药物滥用和精神健康服务管理局 (SAMHSA) 还为行为健康服务提供商、急救人员和其他专业人员提供灾难支持资源和技术援助。 请访问：
SAMHSA 灾害技术援助中心
- 创伤应激研究中心 (CSTS)： CSTS 是一个联邦学术组织，致力于推进创伤知识、领导力和方法。 CSTS为受害者、家庭成员、急救人员和社区领袖提供免费的事实说明书和资源。
心理健康资源（加利福尼亚州）
- CalHOPE： CalHOPE 为感到压力、焦虑、沮丧或担忧的个人提供免费支持。 CalHOPE.org网站是访问多种 CalHOPE 资源的中心。 Together for Wellness/Juntos por Nuestro Bienestar提供 10 种语言的在线工具，以满足不同文化群体的需求。 如果您想与某人聊天，可以去CalHOPE Connect ，如果您想与某人交谈，可以拨打 CalHOPE 热线 833 317-HOPE (4673) 为您服务。
- 加利福尼亚州全国精神疾病联盟 (NAMI)： 加利福尼亚州全国精神疾病联盟是一个由生活受到严重精神疾病影响的家庭和个人组成的基层组织。加利福尼亚州当地的 NAMI 附属机构为心理健康患者及其家人提供免费的支持小组和课程。查找您当地的分支机构，了解如何获得帮助和希望。
- 当前和以前寄养青年家庭紧急反应系统 (FURS)： FURS 是一条免费的、全州范围的 24 小时热线，当前或以前寄养青年及其照顾者可以拨打该热线并获得大大小小的问题的即时帮助。 除了热线援助外，移动响应小组还可以为当前和以前的寄养青年及其照顾者提供即时的创伤知情支持。 如果您是现任或前任寄养青年或看护者，请致电 833-939-3877 或访问cal-furs.org寻求帮助。
面向 Medi-Cal 受益人的心理健康和药物使用资源（加利福尼亚州）
如果您是 Medi-Cal 受益人，则精神健康和药物滥用状况服务均属于承保福利。 您可以通过 Medi-Cal 管理式医疗计划或您所在县的行为健康计划获得心理健康或药物使用支持：
- Medi-Cal 管理式医疗：如果您参加了 Medi-Cal 管理式医疗，您的Medi-Cal 管理式医疗计划将为您提供 Medi-Cal 承保的儿童和成人心理健康服务。
- County Mental Health Services: Your county mental health plan can also connect you to appropriate services, including treatment for adults with more severe mental health conditions. Specialty mental health services for children are also covered. Contact information for each county’s Medi-Cal specialty mental health plan is available here: County Mental Health Access Lines.
- 县药物使用服务： 如果您在酗酒或吸毒方面需要帮助，您所在的县可为您联系 Medi-Cal 药物使用服务。您可以使用此处提供的电话号码联系您所在的县，以获取药物使用信息和服务：县药物使用障碍求助热线。
通过 Medi-Cal 提供专业和非专业心理健康服务 包括但不限于：
- 评估和治疗，包括个人、团体和家庭治疗
- 精神健康状况药物及相关支持服务
- 护理协调
- 危机干预与稳定
- 住院或精神病院治疗
Medi-Cal 涵盖的药物使用服务包括但不限于：
- 评估和治疗，包括个人和团体咨询
- 成瘾治疗药物 (MAT)
- 强化门诊治疗
- 护理协调
- 住院治疗（针对所有 21 岁以下的青少年、怀孕期间和怀孕后立即接受治疗，以及某些县的成年人）
早期和定期筛查、诊断和治疗 (EPSDT) Medi-Cal 福利： EPSDT 涵盖的福利为参加 Medi-Cal 的 21 岁以下个人提供全面的预防性医疗保健服务。 这些服务对于确保儿童和青少年获得适当的预防医疗、牙科、视力、听力、心理健康、物质使用障碍、发展和专业服务以及解决发现的任何缺陷、疾病或状况的所有必要服务至关重要。 心理健康和药物滥用服务属于 EPSDT 福利的一部分，此外还包括医生、执业护士和医院服务；物理、言语/语言和职业治疗；家庭保健服务；以及视力、听力和牙科疾病和障碍的治疗。