DHCS Stakeholder News Update – May 6, 2022
尊敬的各位利益相关方：
卫生保健服务部 (DHCS) 正在提供有关 DHCS 计划重大进展的最新消息，以及与 COVID-19 公共卫生紧急情况相关的指导。
DHCS 执行人员变动
5 月 31 日，行为健康副主任凯利·普法伊弗 (Kelly Pfeifer) 将辞去公职，从事其他工作。 近三年来，凯利一直领导制定和实施具有变革性、历史性的心理健康和物质使用障碍服务计划和举措，包括加州推进和创新医疗补助（CalAIM）计划、行为健康连续基础设施计划（BHCIP）和行为健康现代化项目。
行为健康部门助理副主任 Tyler Sadwith 将在 Kelly 离职后担任代理副主任。
BHCIP 和社区护理扩展计划更新
The 2021-22 California State Budget provided once-in-a-generation investments in infrastructure funding alongside significant new state and federal resources to address homelessness, support health care delivery reform, and strengthen the social safety net. Together these commitments will address historic gaps in the behavioral health continuum to meet growing demand for services and supports. Infrastructure resources, led by DHCS and the California Department of Social Services, will ensure care can be provided in the least-restrictive settings by creating a wide range of options, including outpatient alternatives, urgent care, peer respite, wellness centers, social rehabilitation models, and licensed community care facilities. A variety of care placements can provide a vital off-ramp from intensive behavioral health service settings and transition the most vulnerable Californians to community living, as well as provide housing options for older adults and people with disabilities. For more information about these programs, please visit the BHCIP webpage.
Medi-Cal Rx 180 天过渡政策
When Medi-Cal Rx launched, a 180-day transition policy was implemented to reduce the impact of the transition on Medi-Cal beneficiaries by extending their previously approved prescriptions, with or without previously approved prior authorizations (PA), through July 1, 2022. Medi-Cal Rx will continue to use historical PA and claims data for the transition policy beyond July 1, 2022. DHCS and Magellan Medicaid Administration are evaluating the appropriate time to terminate this transition policy. Detailed information will be provided in the coming weeks. Stakeholders will be given 90 days’ notice prior to the end of the 180-day transition policy.
人口健康管理 (PHM) 供应商合同
On May 9, DHCS will release an Invitation for Proposal (IFP) for a PHM Service vendor, as part of the CalAIM initiative. DHCS intends to award the resulting contract by July 2022. This procurement solicits applications for the development, operation, and eventual turnover to DHCS of the PHM Service.
PHM 服务致力于改变对 Medi-Cal 受益人的全人护理服务，同时管理风险并解决护理和社会健康驱动因素方面的差距。 PHM 服务将支持以受益人为中心的视角，为业务合作伙伴（州政府部门和机构、当地县级合作伙伴等）、医疗保健服务合作伙伴（医院、专业护理机构等）和管理式医疗组织（县级药品 Medi-Cal、Medicare Advantage 等）提供临床和项目数据，用于帮助改善护理质量。
DHCS anticipates that implementation of the PHM Service will contribute to the overall CalAIM goal of improving beneficiaries’ quality of life and health outcomes, aligned with Medi-Cal initiatives outlined in Assembly Bill 133 (Chapter 143, Statutes of 2021). More information about the PHM Service is available in the draft PHM Program and Service Roadmap. For questions or comments, please email CalAIM@dhcs.ca.gov.