November 10, 2023 – Stakeholder News
热门新闻
重点关注儿童和青少年人群 (POF) 的增强护理管理 (ECM)
On November 3, DHCS published the ECM for Children and Youth POF Spotlight, which is designed to help contracted and prospective ECM providers serving children and youth develop and enhance their ECM models. It is also intended to support provider organizations that are considering if ECM for children and youth is right for them. The new resource outlines key ECM policies for the children and youth POFs, including areas where plans can leverage presumptive authorization; member scenarios that illustrate how to deliver ECM for the children and youth POFs, with examples of how Community Supports can be integrated to best serve children, youth, and caregivers; and guidance on how prospective providers can get started, with a collection of the key resources and funding opportunities.
DHCS is committed to providing technical assistance and support to California’s growing network of ECM providers. This is the first in a series of ECM spotlights that DHCS plans to release over the coming months to support stakeholders seeking more details on how providers tailor ECM to meet the needs of different POFs. For more information, visit the ECM and Community Supports webpage.
项目更新
Medi-Cal 和寄养护理更新
DHCS developed a resource to provide updates on foster care youth in Medi-Cal. The resource covers changes to managed care for the child welfare population in 2024, Enhanced Care Management and Community Supports transition policies, the 2024 Medi-Cal managed care plan (MCP) contract and memorandum of understanding requirements, and Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment child and youth components.
导乐服务更新可在线获取
11 月 3 日，DHCS 将Doula 服务更新为 Medi-Cal 福利网页。 更新后的网页包括对 Medi-Cal 会员和助产士提供者有用的资源，包括 DHCS 医疗主任 Karen Mark 博士新发布的助产士服务常设建议。 长期推荐满足了联邦政府对助产服务作为预防性服务的建议要求。
网页更新还包括针对助产师和 Medi-Cal 会员的新常见问题、已获批准的助产师服务提供者申请总数和已登记的个人服务提供者总数，以及有关支持助产师服务对分娩和产妇结果有益的证据信息。 如果对助产士服务有任何疑问，请发送电子邮件至DoulaBenefit@dhcs.ca.gov 。
加入我们的团队
DHCS 正在招聘！ DHCS 提供以下机会：
- Chief of the Financial Management Division within Fiscal (final filing date (FFD) is November 15). This executive role develops policies and procedures to ensure fiscal integrity, transparency, and accountability of approximately $150 billion in annual state and federal funding for DHCS.
- Behavioral Health Policy Medical Consultant II within Behavioral Health (FFD is November 27). This position provides clinical expertise and strategic advice to DHCS Behavioral Health leadership on the development and implementation of policy and initiatives designed to strengthen behavioral health care access, quality, and service delivery.
- Senior Assistant Chief Counsel for Fiscal and Financing within the Office of Legal Services (FFD is November 28). This position is responsible for complex legal counsel and litigation strategy formulation regarding DHCS fiscal, financial management, and health care policy.
- 法律服务办公室内医疗保健系统高级助理总法律顾问（FFD 为 11 月 30 日）。 该职位负责有关医疗保健系统各个方面的复杂法律咨询和诉讼策略制定。
DHCS is also hiring for our human resources, auditing, health policy, and information technology 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
保障社区安全：学校和家庭网络研讨会
11 月 16 日下午 2 点至 3 点，DHCS 将举办一场主题为“保护您的社区：学校和家庭”的网络研讨会（需要提前注册）。 该网络研讨会将向学校合作伙伴提供重要信息，以帮助学生及其家人更新 Medi-Cal 保险。 网络研讨会还将重点介绍可用的外展资源以及让有学龄儿童的家庭参与的最佳做法。
社区组织 (CBO) 和地方卫生专员 (LHJ) 的 Medi-Cal 登记要求和程序网络研讨会
11 月 17 日上午 10 点至 11 点 30 分，DHCS 将通过网络研讨会 (需要提前注册) 举行公众利益相关者听证会，讨论有关社区组织 (CBO) 和提供社区卫生工作者和/或哮喘预防服务的当地卫生管辖区 (LHJ) 提供者的 Medi-Cal 注册要求和程序的监管提供者公告。 自9年2024月起，申请加入 Medi-Cal 收费服务计划的 CBO 和 LHJ 提供商可以通过提供商申请和注册验证 (PAVE) 在线注册门户提交申请。
听证会期间，可以通过网络研讨会聊天提交书面评论、问题或建议。 对于无法出席的人，必须在 11 月 17 日下午 5 点之前提交书面意见，以供考虑发表。 以书面形式提交评论时，请确保评论中同时标明评论者和所代表的组织/协会。 书面意见应提交至DHCSPEDStakeholder@dhcs.ca.gov 。 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。
CalAIM 中级残障人士护理机构 (ICF/DD) 附加账单和付款网络研讨会
On November 17 at 1 p.m., DHCS will host the fourth in a series of educational webinars on the California Advancing and Innovating Medi-Cal (CalAIM) ICF/DD carve-in (advance registration required). These webinars outline changes to the ICF/DD carve-in policy requirements. Starting on January 1, 2024, all Medi-Cal MCPs will be required to cover and coordinate institutional long-term care for members residing in an ICF/DD. The webinar series will feature several topics, including ICF/DD carve-in 101, directed payment policy and payment requirements, the per diem rate, accommodation code changes, and best practices for billing and payment. ICF/DD home, Regional Center, and Medi-Cal managed care representatives are encouraged to attend. All webinars are open to the public.
If there are specific questions you would like addressed during the webinar, please submit them in advance using this registration form or by emailing them to LTCtransition@dhcs.ca.gov. Webinar materials, including recordings, and additional details about upcoming webinars are posted on the CalAIM ICF/DD Long-Term Care Carve-In webpage.
护理机构融资改革网络研讨会
On November 17, from 3 p.m. to 4 p.m., DHCS will hold a virtual stakeholder webinar (advance registration required) to discuss the development of the Skilled Nursing Facility Workforce Standards Program, Accountability Sanctions Program, and Workforce & Quality Incentive Program (WQIP) authorized by Assembly Bill 186 (Chapter 46, Statutes of 2022). This meeting will also provide an opportunity for stakeholder input. Additional information is posted on DHCS’ Nursing Facility Financing Reform (AB 186) webpage.
面向家庭和社区伙伴的儿童助听器覆盖计划 (HACCP) 网络研讨会
On November 28, from 11 a.m. to 12 p.m., DHCS will host a HACCP webinar (advance registration required) to share guidance with families and communities about applying for hearing aid coverage and helping children to maximize their HACCP benefits once enrolled. DHCS welcomes newly interested families, as well as families currently participating in HACCP, and community partners supporting families and children to join this webinar for program updates, tips, and a question-and-answer session. For more information, please visit www.dhcs.ca.gov/haccp.
面向医疗服务提供者和听力专业人士的 HACCP 网络研讨会
On December 19, 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 address program requirements for families to apply for coverage and the claims submission process for audiologists, otolaryngologists, physicians, and their office staff. For more information, please visit www.dhcs.ca.gov/haccp.
Medi-Cal 资产消除网络研讨会
11 月 29 日下午 1:30 至 2:30，DHCS 将举办一场网络研讨会，讨论非调整后总收入 (MAGI) Medi-Cal 计划的资产消除问题，该问题将于 1 月1日、 2024日生效。 该计划实施后，将取消所有非 MAGI 计划（包括长期护理和医疗保险储蓄计划）的资产测试。 网络研讨会将提供有关资产消除、实施计划、程序变更和外展材料的背景信息。 更多信息请参阅非 MAGI Medi-Cal 资产限制变化网页。
CalAIM 管理的长期服务和支持 (MLTSS) 及双重集成工作组虚拟会议
On November 30 at 10 a.m., DHCS will virtually host the CalAIM MLTSS and Duals Integration Workgroup meeting (advance registration required). The workgroup serves as a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible members, and allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare.
Agenda topics will include reminders about the 2024 Medi-Cal transitions and noticing timelines, updates on Medi-Medi Plan outreach and the 2024 Dual Eligible Special Needs Plan Policy Guide development, July 2023 duals enrollment data, a spotlight presentation on the CalAIM recuperative care Community Support, and a presentation on the continuous coverage unwinding.
Background materials, transcripts, and video recordings of previous workgroup meetings, along with additional information about the workgroup, are posted on the CalAIM MLTSS and Duals Integration Workgroup webpage. For questions or comments, please email DHCS at info@calduals.org.
Medi-Cal 成人扩展网络研讨会
On December 4, from 11 a.m. to 12 p.m., DHCS will host a webinar on the adult expansion of Medi-Cal (advance registration required) for CBOs, MCPs, providers, and other interested stakeholders, including those representing consumers, immigration, health care, legal aid, and immigrant adults. DHCS is implementing this expansion pursuant to Senate Bill 184 (Chapter 47, Statutes of 2022) on January 1, 2024. When implemented, the expansion will provide individuals 26-49 years of age with full scope Medi-Cal benefits, regardless of citizenship or immigration status, if they meet all other Medi-Cal eligibility criteria.
The webinar, which will be live interpreted in Spanish, will provide background information about the expansion, implementation planning, noticing, outreach, and more. Individuals may also submit questions or request to register for the webinar by sending an email to AdultExpansion@dhcs.ca.gov.
如果你错过了
第 1115 条示威活动：BH-CONNECT 和 CalAIM 过渡性租金修正案
On October 20, DHCS submitted to Centers for Medicare & Medicaid Services (CMS) the new Section 1115 demonstration request, entitled the California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) demonstration, and the proposed amendment to the CalAIM Section 1115 demonstration related to transitional rent services. Additionally, the federal public comment period will be open for BH-CONNECT and CalAIM transitional rent services from October 27 through November 26, 2023.
2024 年 1 月 Medi-Cal MCP 过渡期
As part of Medi-Cal transformation, some MCPs are changing on January 1, 2024, and approximately 1.2 million members will have new health plan options and/or will need to transition to new MCPs. Changing MCPs will not affect Medi-Cal member coverage or benefits. Members who transition to a new MCP are receiving notices about the transition. DHCS developed several resources to support members, providers, and other stakeholders with the transition, including the Managed Care Plan Transition Member webpage with a county “lookup” tool, links to member notices sent by Medi-Cal about MCP changes, frequently asked questions, and a Contact Us page for members to learn more about health plans and provider choices. There are also transition resources for providers and MCPs and stakeholders. More information about the transition is available in the 2024 Managed Care Plan Transition Policy Guide and Medi-Cal Eligibility Division Information Letter Number I 23-54.