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。​​ 

七月是残障人士骄傲月​​ 

DHCS celebrates the culture, diversity, and contributions of people with disabilities during Disability Pride Month. The Americans with Disabilities Act (ADA) was passed on July 26, 1990, prohibiting discrimination against people with disabilities, and giving rise to this important celebration. DHCS is committed to work toward a healthier California where all individuals can live with purpose and dignity and are supported and valued.  

DHCS provides Californians with disabilities access to affordable, integrated, high-quality health care to preserve and support their overall health and well-being, and strives toward health equity to ensure equal opportunities for all Californians. DHCS, in collaboration with sister departments, oversees a variety of programs serving persons with disabilities, including: California Children’s Services, the Genetically Handicapped Persons Program for adults, the Home and Community-Based Alternatives Waiver, and Home and Community-Based Services for individuals with intellectual and developmental disabilities. DHCS also makes available many other resources to support persons with disabilities. DHCS will continue to support Californians with disabilities through high-quality and person-centered care.​​ 

最终人口健康管理 (PHM) 战略和路线图​​ 

5,2022, DHCS 发布了最终的 PHM 战略和路线图，其中纳入了利益相关者对 PHM 框架所有组成部分的反馈意见。健康与社会服务部感谢利益相关者提出的深思熟虑的意见，这些意见有助于改善健康与社会服务部对公共健康管理的愿景。需要提醒的是，DHCS 将于 2023 年 1 月启动PHM 计划，该计划是加州推进和创新 Medi-Cal (CalAIM) 的基石。PHM 计划将建立一个具有凝聚力的全州性方法，确保所有 Medi-Cal 会员都能获得一个全面的计划，从而延长健康寿命，改善健康状况，实现健康公平。该路线图概述了关键政策措施和问责机制，定义并描述了 PHM 概念和术语，并详细说明了 2023 年和 2024 年对 Medi-Cal 管理性护理计划 (MCP) 的要求。最终 PHM 战略和路线图可在 DHCSCalAIM 人口健康管理网页上查阅。如有任何问题，请发送电子邮件至CalAIM@dhcs.ca.gov。​​ 

双重资格政策更新​​ 

As a component of CalAIM, DHCS is implementing policies to promote integrated care for beneficiaries dually eligible for Medicare and Medi-Cal. Under this effort, for contract year 2023, DHCS will limit new Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs) and expanded county service areas to only those D-SNPs with an ongoing affiliation with Medi-Cal MCPs. This policy, which is in line with the federal approach and in other states, is being implemented because when a county has separate health plans for Medicare and Medi-Cal benefits, there can be beneficiary and provider confusion, duplication of care managers, and more complexity for hospital and nursing home discharge planners.

This approach in 2023 will not result in any members needing to disenroll from their existing Medicare plans. To avoid Medicare provider network disruption, DHCS will continue any existing D-SNP contracts and service areas so members in existing D-SNPs will not be required to disenroll.​​    

Having Medicare and Medi-Cal benefits managed by the same organization is an important component of CalAIM, and aligns with DHCS’ Managed Long-Term Services and Supports (MLTSS) strategy. In 2023, CalAIM policies will provide a more robust Medi-Cal managed care delivery system for dual eligible beneficiaries statewide, including: mandatory Medi-Cal managed care enrollment; Medi-Cal managed care carve-in of skilled nursing facility care; and Enhanced Care Management for populations who are at risk for long-term skilled nursing facility care, or who reside in a nursing facility and want to transition to the community. In addition, Community Supports services designed to address social drivers of health will continue to be implemented by Medi-Cal MCPs.​​  

儿童和青少年行为健康倡议 (CYBHI) 信息请求 (RFI)​​ 

7 月 6 日，DHCS 发布了一份关于 CYBHI 的RFI，邀请供应商向 DHCS 提供信息，为行为健康虚拟服务平台的规划、设计、开发和 2024 年 1 月前的启动提供帮助。DHCS 将于 7 月 13 日为潜在供应商举办一次供应商会议。

作为《2021 年预算法案》的一部分，CYBHI 是一项多年期、跨部门的一揽子投资计划，旨在重新构想为加州所有儿童、青少年及其家庭提供行为健康支持的系统，无论支付方是谁。工作重点是促进社会和情感福祉，预防行为健康挑战，为 0-25 岁儿童和青少年新出现和现有的行为健康（心理健康和药物使用）需求提供公平、适当、及时和方便的服务。CYBHI 立足于关注公平；以儿童和青年的声音、优势、需求、优先事项和经历为中心开展工作；推动变革性的系统变革；以及将持续学习作为变革和改善儿童和青年成果的基础。​​ 

CYBHI 的一个工作流是构建和推动行为健康虚拟服务平台的采用，以支持提供公平、适当和及时的行为健康服务（从预防到治疗再到康复），并为儿科和初级保健提供者提供电子咨询平台，以便与行为健康提供者进行电子咨询。​​