热门新闻​​ 

冬季风暴健康检查​​ 

California has experienced a series of winter storms, with severe weather continuing over the next few days. During inclement weather, our priority is to ensure people’s safety and make it easier for them to access shelter, services, and other resources. We recommend that our community partners proactively check on older individuals with disabilities, are unhoused, and/or have chronic health conditions that may put them at risk. Reach out to them to check on how they’re doing and to connect them to resources as needed. We also encourage you to work with your local county and California Governor’s Office of Emergency Services (CalOES) to aid your communities, and we recommend that you become familiar with local resources you can offer to those in need, including shelters or warming centers.

To assist stakeholders with wellness checks, the California Health & Human Services Agency (CalHHS) developed an Emergency Resource Guide, and Appendix I: Universal Wellness Checks Questionnaire can be used when conducting wellness checks. Additional resources include the Listos California’s Severe Storm Safety Toolkit and the California Department of Public Health’s Winter Storm Preparedness Toolkit.​​ 

增强护理管理 (ECM) 和社区支持季度实施报告​​ 

DHCS 发布了《2023 年第 2 季度 ECM 和社区支持季度实施报告》。本报告总结了 ECM 和社区支持计划前 18 个月的实施趋势和数据，时间跨度为 2022 年 1 月至 2023 年 6 月。与去年 8 月发布的《2022 年第一年实施报告》类似，本报告深入分析了州、县和 Medi-Cal 管理性护理计划 (MCP) 级别的数据。

在最初的 18 个月中，140 886 名 MCP 会员获得了 ECM 福利，75 834 名会员获得了 167 960 项社区支持服务。随着加州继续推进 Medi-Cal 改革，ECM 和社区支持在支持具有复杂医疗和健康相关社会需求的 Medi-Cal 会员的全人护理方面发挥着至关重要的作用。DHCS 预计，随着更多的重点人群符合 ECM 条件，以及更多的县提供更多的社区支持服务，这两项计划的注册人数将在未来数月和数年内出现更多增长。DHCS 始终致力于通过计划监督、设计改进和标准化来支持和维持这一增长。​​ 

CalAIM 仪表板​​ 

DHCS today posted the first iteration of a public-facing California Advancing and Innovating Medi-Cal (CalAIM) dashboard to demonstrate the impact, progress, and key opportunity areas of CalAIM. The dashboard includes individual initiative pages for Behavioral Health, Community Supports, ECM, Incentive Payment Program, Integrated Care for Dual Eligible Members, Population Health Management, Providing Access and Transforming Health (PATH), Statewide Managed Long-Term Care, and Bold Goals: 50×2025 as outlined in DHCS’ Comprehensive Quality Strategy. This dashboard provides baseline data and highlights milestones in the Medi-Cal transformation. The data will be updated regularly and will expand to include additional quality measures, demographic data, and initiatives as the data become available.​​ 

项目更新​​ 

2024 年 1 月 Medi-Medi 计划注册更新​​ 

Enrollment in Medicare Medi-Cal (Medi-Medi) Plans continues to increase as part of the CalAIM initiative to offer integrated care for members who are dually eligible for Medicare and Medi-Cal. As of January 2024, enrollment in Medi-Medi Plans is approximately 293,000 members, according to data published by the federal Centers for Medicare & Medicaid Services (CMS). This represents an increase of approximately 48,000 members over Medi-Medi Plan enrollment in October 2023. Integrated care is also available through the SCAN Connections Health Plan and the Program of All-Inclusive Care for the Elderly. Please visit the Medicare Advantage Options for Dual Eligible Beneficiaries webpage to view quarterly enrollment reports for dual eligible members by Medicare delivery system.​​ 

PATH 容量和基础设施转型、扩展和发展 (CITED) 第三轮申请​​ 

PATH CITED 第三轮资助的申请截止日期为 2 月 15 日。PATH CITED 计划提供资金，用于建设实地合作伙伴的能力和基础设施，包括社区组织、公立医院、县级机构、部落等，以成功参与 Medi-Cal。每周办公时间将持续到 2 月 12 日（请在 PATH CITED 网站上注册），以便为潜在申请人提供帮助。​​ 

RFI：加州行为健康社区公平护理和治疗组织网络 (BH-CONNECT) 倡议卓越中心 (COE)​​ 

On January 31, DHCS released a Request for Information (RFI) to solicit input from interested parties to establish one or more COEs that will offer training and technical assistance to Medi-Cal specialty behavioral health providers and county behavioral health plans. This opportunity is to support fidelity implementation of a set of evidence-based practices (EBPs), including Assertive Community Treatment (ACT), Forensic Assertive Community Treatment (FACT), Coordinated Specialty Care for First Episode Psychosis (CSC for FEP), Individual Placement and Support (IPS) model of Supported Employment, Clubhouse Services, and additional EBPs for children and youth. Please review RFI #23-070 for more information about the specific functions of COEs and the included EBPs. The deadline for questions is February 14, and the deadline for responses to the RFI is March 1. Please submit your questions about this RFI to PCDRFI3@dhcs.ca.gov.​​ 

微笑，加州 Medi-Cal 牙科服务运动​​ 

微笑吧，加利福尼亚》（Smile, California）今天在 Facebook 和 Instagram 等社交媒体网站上发起了一项活动，用英语和西班牙语宣传 "全国儿童牙齿健康月"（NCDHM）。该活动的目标是增加 Medi-Cal 会员对几种口腔护理方法的了解。该活动教育个人在婴儿长出第一颗牙齿之前优先为其进行牙科检查，强调牙齿密封剂的重要性，保持每年两次的牙科检查，进行氟化物治疗，鼓励避免食用含糖食物和饮料，并确保儿童正确使用牙膏。最后，该活动提供了 Medi-Cal 所涵盖的牙科福利的详细信息。​​ 

加入我们的团队​​ 

以下考试已开放：​​ 

• 除其他职责外，印度健康协调员将担任印度健康领域的主要专业顾问，为 DHCS 提供印度健康计划的规划、开发、实施、协调、运营和评估服务。 （最终提交日期为 2 月 16 日）​​ 

Also, DHCS is hiring for our communications, human resources, auditing, health policy, information technology, and other teams. For more information, please visit the CalCareers website.​​ 

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) 咨询小组会议​​ 

2 月 12 日上午 10:30 至中午 12:00，DHCS 将举办 PHM 咨询小组会议。会议将重点讨论过渡性关怀服务 (TCS) 政策，包括概述 1 月1 ，2024 ，对所有会员生效的过渡性关怀服务政策更新。 PHM 咨询小组成员将有机会就 DHCS 在 2024 年实施过渡性护理服务的优先事项发表意见，包括将会员与初级护理联系起来，确保那些过渡到或离开专业护理和长期护理设施的人员顺利过渡，以及为分娩人员提供过渡性护理服务。此外，成员们还将讨论如何利用 TCS 来更好地将符合条件的个人转介到 ECM、社区支持和其他出院后服务。此外，健康与社会服务部欢迎各成员就改善出院设施、医疗保健中心（MCP）和出院后医疗服务提供者之间数据/信息的及时、全面和准确传输提出建议。

健康与安全部成立了健康与安全管理咨询小组，为设计和实施健康与安全管理计划和服务提供支持。 咨询小组成员包括来自医疗计划、医疗服务提供者、县、州部门、消费者组织和其他团体的代表。 会议向公众开放，会议信息和材料将在DHCS 网站上公布。鼓励利益相关者在网络研讨会之前将问题提交至PHMSection@dhcs.ca.gov。​​ 

面向医疗服务提供者和听力专业人士的儿童助听器覆盖计划 (HACCP) 网络研讨会​​ 

On February 13, from 12 to 1 p.m., DHCS will host a HACCP webinar (advance registration required) to share information with providers to help pediatric patients and their families maximize HACCP benefits. The training session will outline program requirements for families to apply for coverage. It will also outline the claims submission process for audiologists, otolaryngologists, physicians, and their office staff. For more information, please visit www.dhcs.ca.gov/haccp.​​ 

CalAIM 亚急性护理机构加入虚拟办公时间​​ 

On February 14, from 2:30 to 3:30 p.m., DHCS will host an office hours session as part of an educational webinar series on the CalAIM subacute care facility long-term care (LTC) carve-in. The office hours provide a dedicated forum for DHCS to engage with subacute care facilities, Medi-Cal MCP representatives, and other stakeholders to address questions related to the subacute care facility carve-in policy requirements and implementation of the transition to managed care that took effect on January 1, 2024. 

Participants are encouraged to submit questions in advance when registering for the office hours session or by emailing them to LTCtransition@dhcs.ca.gov. Additional details about past webinars are available on the CalAIM Subacute Care Facility LTC Carve-In transition webpage.​​   

PATH 技术援助 (TA) 市场虚拟供应商博览会​​ 

On February 29, from 9 to 10:30 a.m., DHCS will host the first PATH TA Marketplace virtual Vendor Fair. TA Vendor Fairs are an opportunity for vendors to pitch their organization and services to potential TA recipients and encourage utilization of the TA Marketplace. TA recipients and organizations interested in learning more about the TA Marketplace, including how to apply to receive free services, are invited to attend. This is the first in a series of upcoming Vendor Fairs and will focus on presentations from vendors providing services in Domain 3 of the PATH TA Marketplace: “Engaging in CalAIM through Medi-Cal Managed Care”.​​ 

如果你错过了​​ 

Medi-Cal 目标费率增长 (TRI)​​ 

Pursuant to Assembly Bill (AB) 118 (Chapter 42, Statutes of 2023), DHCS published, as part of the proposed 2024–25 Governor’s Budget, a plan for targeted increases to Medi-Cal payments or other investments, effective in 2025, across primary care, maternal care, behavioral health care, specialty care, women’s health services, public hospital services, community and hospital outpatient services, emergency services, and other domains. The proposed investments will be supported with funding from the Managed Care Organization (MCO) Tax, authorized by AB 119 (Chapter 13 , Statutes of 2023), and are designed to advance access, quality, and equity for Medi-Cal members and promote provider participation in the Medi-Cal program. These proposed investments are subject to obtaining all necessary legislative and federal approvals, as applicable. For more information, please visit the Medi-Cal Targeted Provider Rate Increases and Investments webpage and view the Medi-Cal TRI policy paper and MCO Tax-funded investments.​​ 

CalAIM 儿童持续保险公众意见​​ 

CalAIM 第 1115 款 "儿童持续保险 "修正案申请的30 天公众评议期为 1 月 12 日至 2 月 12 日。为确保在提交 CMS 之前得到考虑，意见必须在太平洋标准时间 2 月 12 日晚上 11:59 之前收到。健康与社会服务部欢迎公众提出意见。

DHCS 申请修订 CalAIM 第 1115 款示范计划，以纳入第 1115(a)(2)款规定的支出授权，接受联邦配套资金，为儿童提供持续的保险，直至其 5 岁生日所在月份的月底，无论他们何时首次加入 Medi-Cal 或儿童健康保险计划，也无论情况发生任何变化，否则将导致丧失资格。该政策的实施取决于州政府对 2024-2025 年及其后财政年度普通基金可用资源的确定以及 CMS 的批准。更多信息请访问DHCS CalAIM 1115 Demonstration 和 1915(b) Waiver 网页。​​ 

行为健康服务的医疗保险覆盖范围​​ 

1 月 30 日，DHCS 和加利福尼亚州老龄化部为医疗服务提供者发布了一份关于医疗保险行为健康福利的概况介绍，包括 2024 年通过医疗保险提供的扩展服务和医疗服务提供者类型的要点。 自1 年 1 月起，2024 ，医疗保险对行为健康的承保范围和政策已扩大到包括心理健康服务以及婚姻和家庭治疗师及心理健康顾问的就诊，涵盖特定环境下的强化门诊服务，并加强了对医疗保险优势计划协调行为健康护理的要求。​​  

该情况说明书涵盖了 Medicare 涵盖的行为健康服务、如何注册成为 Medicare 提供者并参与 Medicare、提供者如何帮助 Medicare 受益人获得医疗服务，以及 2024 年 Medicare 在行为健康方面的变化。 行为健康服务包括心理健康和物质使用障碍治疗。 在加州，医疗保险受益人中，这两种保险都没有得到充分利用。 2021 年，只有 8.8% 的 65 岁及以上加州人因精神健康或物质使用障碍而寻求医疗保健专业人士的帮助。 接受医疗保险覆盖治疗的障碍包括缺乏对医疗保险覆盖行为健康服务的认识、需要增加参加医疗保险的行为健康服务提供者的数量、以及寻求治疗可能带来的耻辱感。​​