热门新闻

DHCS 对南加州野火的响应

On January 7 and 8, multiple fires erupted in the Los Angeles County area. DHCS is actively engaged in addressing the impacts of the fires. DHCS is working alongside local and federal partners to support health care facilities, ensure continuity of care, and prioritize the safety of affected residents. Specifically, DHCS is coordinating with facilities to manage evacuations and maintain care for residents and is supporting health care providers as they navigate road closures and other disruptions.

DHCS’ Emergency and Disaster Assistance Questions & Answers webpage provides guidance and contact information for Medi-Cal members and providers during emergencies. It includes information related to accessing medical care, filling prescriptions, securing transportation, and obtaining support for individuals with specific needs, including people in assisted living facilities and individuals receiving Home and Community-Based Alternatives services.

加利福尼亚州州长应急服务办公室与康复部共同编制了《残疾人应急准备指南/工具包》，该指南提供多种语言版本，其中包含针对不同残疾人群体的相关信息及应急准备建议。请关注加州消防局（Cal Fire）和当地应急管理部门，获取有关山火的实时更新，并登录calalerts.org 订阅当地警报。如需了解更多信息，请参阅以下补充资料：

• CA.gov/LAfires– 为受洛杉矶山火影响的加州居民提供相关资源。
• Listos California– 提供了一个紧急警报注册页面，帮助加州居民根据提供的邮政编码或位置，连接到当地的警报系统。
• Ready.Gov – Provides guidance for individuals and families to prepare for, respond to, and recover from wildfire events. The resource includes tips for staying safe during wildfires and returning home once an area is declared safe.
• 美国药物滥用与心理健康服务管理局野火资源——为受野火及其他灾害影响的幸存者、家属、应急响应人员及灾后重建人员提供支持。信息内容包括情绪困扰的迹象、在野火过后可能面临更高情绪困扰风险的人群，以及获取更多信息和支持的资源链接。
• 美国疾病控制与预防中心——提供有关各类风险（包括野火）的信息，并提供相关链接，帮助公众了解野火发生后的安全防护措施，以及如何识别和应对野火及其他灾害带来的风险。
• American Red Cross – Suggests ways for people who have experienced a residential fire to take care of themselves and their loved ones and to help people who may need assistance. The site lists four steps to take right after a fire and includes links to more information about returning home safely after a fire and recovering emotionally and financially.
  

DHCS 在这一困难时期始终致力于为社区提供支持，并向当地的紧急救援人员和医护工作者表示感谢。 注意安全，查看官方更新以获取最新信息，并遵守当地官员发布的疏散命令。

DHCS 2025-26 年度预算提案

The proposed 2025-26 Governor’s Budget for DHCS allocates $193.4 billion in total funds, including $42.8 billion from the General Fund, and supports 4,821.5 positions. This budget reflects the Administration’s continued investment in transforming Medi-Cal into a coordinated, person-centered, and equitable health system for Californians.

The budget prioritizes modernizing the health care delivery system, with a focus on improving accountability and transparency and strengthening community-based care. These strategic investments support DHCS’ purpose to provide equitable access to quality health care, leading to a healthy California for all.

项目更新

州计划修正案 (SPA) 获批准用于二元服务

On January 6, the federal Centers for Medicare & Medicaid Services (CMS) approved SPA #23-0010, which authorizes DHCS to utilize an Alternative Payment Methodology (APM) to pay Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHC), and Tribal Health Programs, which includes Tribal FQHCs and Indian Health Services-Memorandum of Understanding 638 Clinics, at the Medi-Cal fee-for-service (FFS) rate for dyadic services in certain circumstances. FQHCs and RHCs will receive a separate payment for dyadic services in addition to their standard Prospective Payment Services/All-Inclusive Rate billing payments in certain circumstances.

Dyadic care refers to serving both the parent/caregiver and child together as a dyad and is a form of treatment that targets family well-being to support healthy child development and mental health. Dyadic care fosters team-based approaches to meeting family needs, including addressing mental health and social support concerns, and it broadens and improves the delivery of pediatric preventive care. Offering parents and caregivers mental health services when they bring their babies and children to the doctor is an opportunity to expand access, which can improve outcomes. DHCS will release additional policy guidance in a future Medi-Cal Provider Manual update.

过渡到新的家庭 PACT 门户

From January 13 through February 2, DHCS’ Family Planning, Access, Care and Treatment (PACT) program’s client eligibility and enrollment transaction services will transition from the Health Access Programs (HAP) Client Eligibility System to a new Family PACT portal. The HAP Client Eligibility System will be disabled on February 3, after which all Family PACT client enrollment, changes, and deactivations will be completed exclusively through the California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS) Family PACT portal. To support Family PACT providers during this transition, Family PACT providers will have access to comprehensive training materials and webinars through the Family PACT Online Training Center Learning Management System. These resources will ensure that providers are equipped to use the Family PACT portal effectively before its launch.

Medi-Cal Rx 儿科整合 (PI) 政策调整

DHCS is making an important policy adjustment related to Medi-Cal Rx’s initiative for the reinstatement of prior authorization (PA) requirements and utilization management (UM) claim edits for Medi-Cal members 21 years of age and younger, including members of the California Children’s Services (CCS) program. This initiative, commonly referred to as PI, will be implemented on January 31. To directly address and help mitigate stakeholder concerns about the volume of PA requests and potential barriers to timely access that may occur because of PI implementation, as well as recognize the advanced credentialing of CCS Panel Provider Authority, DHCS is adjusting its PI policy approach for continuing therapies/prescriptions PI as follows:

• 在不少于 60 天的时间内，如果索赔因拒绝代码 75（需要 PA）而被拒绝，但 Medi-Cal 会员有近期索赔历史，则该索赔将支付，而无需额外的 PA。 DHCS 希望通过这种方法为供应商和开处方者提供更多时间来调整他们的内部流程、更好地规划 PI 要求并提交主动 PA。

DHCS 将通过 Medi-Cal Rx网站发布更多详细信息，并将按进度更新各种现有资源文件。DHCS 将继续致力于确保 Medi-Cal 会员、医疗服务提供者和其他合作伙伴获得支持，以便他们能够以安全、及时和公平的方式获得药房福利。DHCS将继续支持利益相关者参与绩效改进工作。

加入我们的团队

DHCS 正在寻找一位有才华、有上进心的个人担任以下职务：

• Chief of the Pharmacy Benefits Division. The Chief is responsible for overseeing the development and implementation of policy, services, and coverage criteria for outpatient pharmacy services for the state’s Medi-Cal program. This includes providing policy direction for Medi-Cal Rx as well as invoicing and collecting federal and state supplemental drug rebates. The Chief of PBD also leads the development of nutrition, vision care, and medical supply benefits and oversees the administration of the Medi-Cal Pharmacy and Vision Benefit programs. Applications must be submitted by February 7.

DHCS is also hiring for its accounting, program accountability, behavioral health, managed care quality and monitoring, eligibility, 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

行为健康转型质量和公平咨询委员会网络研讨会

On January 15, from 9 to 11 a.m. PST, DHCS will host the third Behavioral Health Transformation Quality and Equity Advisory Committee webinar. Once registered, you will receive a confirmation email with the webinar link and additional details. DHCS is pleased to continue its collaborative efforts to measure and evaluate the quality and efficacy of behavioral health services and programs. These public webinars provide an opportunity for participants to offer input for DHCS consideration. Visit the Behavioral Health Transformation Stakeholder Engagement webpage for more information about the webinars and additional resources. Please send questions related to Behavioral Health Transformation and/or the webinars to BHTinfo@dhcs.ca.gov.

加利福尼亚州斯迈尔市网络研讨会：在“全国儿童口腔健康月”期间推广Medi-Cal牙科福利

On January 22, from 11 a.m. to 12 p.m. PST, Smile, California will host a webinar to kick off National Children’s Dental Health Month (NCDHM) in February. The webinar will feature a preview of the new Healthy Smile Land materials, strategies for promoting Medi-Cal dental services during NCDHM, and resources for accessing and distributing outreach materials. Attendees will also be able to connect with Smile, California representatives to ask about Medi-Cal dental benefits.

DHCS 减害峰会

DHCS 与全州各地的社区合作，在加州的药物滥用障碍治疗系统中推广减少伤害和低门槛、以患者为中心的护理。DHCS 鼓励药物滥用障碍治疗提供者和工作人员（包括社会工作者、同伴、前台工作人员、个案经理、护士、医生以及药物滥用障碍治疗机构的所有工作人员）参加并学习如何将减少伤害的原则融入药物滥用障碍治疗中。峰会将在弗雷斯诺县（1月23日）、圣地亚哥县（2月11日）和洛杉矶县（2月27日）举行。请在活动网站上注册。

报道大使网络研讨会系列：涉及司法的重返社会计划以及儿童和青少年行为健康计划更新

1月30日上午11点至11点45分PST 和 DHCS 将为 DHCS 保险推广大使举办一场网络研讨会（需提前注册）。本次网络研讨会将介绍“涉司法人员重返社会计划”和“儿童青少年行为健康计划”（CYBHI）的最新进展。该报告将提供有关目前正在或曾被关押在监狱、青少年矫正机构或监狱中的涉案人员的信息，这些人面临的健康问题、受伤及死亡风险高于普通公众。该计划将重点关注加利福尼亚州正在采取的重要措施，旨在改善个人健康状况——这些人在准备重返社区之际，通过努力确保他们在获释后能够延续医疗保险覆盖。此外，保险覆盖大使还将了解如何通过CYBHI扩大早期儿童综合服务，该计划将为儿童、青少年及其家庭提供心理健康服务。了解 有关 DHCS 保险推广大使 的更多信息 ，或 注册 成为保险推广大使。

宫内节育器 (IUD) 和避孕植入物植入培训

2 月 19 日上午 7:30 至下午 5:30（太平洋标准时间），DHCS 家庭计划办公室将举办现场综合性宫内节育器和避孕植入剂植入培训。目前的培训课程已满，内容包括患者避孕方法选择、咨询和知情同意、宫内节育器放置过程中使用器械的技巧，以及美国目前可用的每种宫内节育器的插入方法。其他将要涵盖的主题包括副作用管理、处理困难植入的技巧、门诊手术疼痛管理原则以及并发症的预防和处理。请参阅宫内节育器和植入式避孕器资源了解更多信息。

如果你错过了

CMS 选择 DHCS 实现创新转型孕产妇健康模式

1月6日，美国医疗保险和医疗补助服务中心（CMS）批准了加利福尼亚州参与其医疗保险和医疗补助创新中心（CMMI）的“孕产妇健康转型” （TMaH）模式。该模式是一项为期十年的医疗补助计划（Medicaid）和儿童健康保险计划（CHIP）服务提供与支付模式，旨在验证：在基于价值的支付（VBP）模式支持下，有效实施循证干预措施能否改善孕产妇健康结局，并降低医疗补助计划和CHIP的项目支出。

DHCS 将在五个县实施 TMaH 模式：弗雷斯诺、克恩、金斯、马德拉和图莱尔。TMaH 模式是加利福尼亚州为解决孕产妇健康领域种族和族裔差异所做更广泛承诺的一部分，旨在确保所有孕妇，特别是低收入社区的孕妇，都能获得所需的支持，从而安全度过孕期和分娩过程。

现已开放：提供访问和转变健康 (PATH) 能力以及基础设施转型、扩展和发展 (CITED) 第 4 轮申请

On January 6, DHCS opened the PATH CITED Round 4 application window. The PATH CITED initiative provides funding to build the capacity and infrastructure of on-the-ground partners including community-based organizations, hospitals, county agencies, Tribes, and others, to successfully participate in Medi-Cal. Nearly $158 million is available for Round 4. The deadline to apply for PATH CITED Round 4 funding is 11:59 p.m. PST on March 7, 2025. The guidance document and application can be found by visiting the PATH CITED webpage. Please submit questions to cited@ca-path.com.

PATH 技术援助 (TA) 市场第 5 轮供应商申请

On January 1, DHCS opened the PATH TA Marketplace Round 5 vendor application. The deadline to apply is January 31. Round 5 will be a targeted procurement for new and existing hands-on service offerings that address TA Marketplace gaps. The Round 5 procurement will seek TA vendor applications for all seven TA domains, but it will focus on services for the following provider types: rural providers, Tribal and Indian health care providers, maternal and child-serving providers, and transitional rent providers.

在第 5 轮采购期间，DHCS 不会接受新的现成项目的提交或对现有现成项目的更改。 相反，第五轮申请将向现有的 TA 供应商征求按需资源。 请访问TA 市场供应商网页以访问指导文件并进行申请。 请将问题提交至ta-marketplace@ca-path.com 。