十月27 ， 2025
热门新闻
DHCS 领导人入选 2026 年医疗补助路径计划
Bambi Cisneros, Assistant Deputy Director for Managed Care, Health Care Delivery Systems, was selected to participate in the national Medicaid Pathways Program’s 2026 class. Cisneros provides leadership on policy development, compliance, and oversight for the Medi-Cal managed care delivery system. The Medicaid Pathways Program, led by the Center for Health Care Strategies, is designed to strengthen the leadership capacity of senior Medicaid leaders. Now in its fifth year, 100 senior Medicaid agency leaders have participated in this leadership training program. “I’m proud to advocate for our state’s most vulnerable and to support the teams I lead. Together, we work to expand access to care for all Medi-Cal members,” said Cisneros. Program participants are competitively selected to join the nine-month leadership training program designed for individuals who are new to Medicaid leadership roles or aspire to advance into more senior positions.
CalHHS Connect 网络研讨会：联邦政策变化如何影响人人享有健康的加州
今年早些时候，国会中的共和党多数派和特朗普总统颁布了 H.R. 1 号法案（《美丽大法案法案》）。10 月 27 日上午 10 时PDT, California Health& Human Services Agency (CalHHS) 领导层将分享应对 H.R. 1 对加州安全网计划影响的最新努力。会议还将介绍该州申请 "农村卫生转型计划 "的最新情况，以及通过创新系统转型来加强农村社区医疗服务的可及性、质量和效果的机会。发言人包括加州卫生与健康服务部部长 Kim Johnson、DHCS 主任 Michelle Baass、加州社会服务部 (CDSS) 主任 Jennifer Troia 和加州医疗保健访问& 信息部主任 Elizabeth Landsberg。
项目更新
2024 年度网络认证 (ANC)
On October 30, DHCS will publish the 2024 Network Adequacy and Access Assurances Report (NAAAR) on its Network Adequacy webpage. The report includes ANC results for Managed Care Plans (MCP) and Dental MCPs for calendar year 2024, and Behavioral Health Plans (BHP) – Mental Health Plans (MHP) and Drug Medi-Cal Organized Delivery System (DMC-ODS) Plans – for Fiscal Year (FY) 2024–25. The NAAAR fulfills federal Centers for Medicare & Medicaid Services (CMS) requirements by reporting each plan’s compliance with California’s network adequacy standards.
DHCS assessed 24 MCPs for compliance with provider-to-member ratios and mandatory provider types. All MCPs met these standards. However, under a more rigorous methodology for non-specialty mental health services, Anthem, Health Net, and Santa Clara Family Health Plan did not comply. This noncompliance does not reflect a decline in access, but the elevated standard. All MCPs, except Kaiser Permanente, met geographic access standards. Kaiser must now submit individual Alternative Access Standard (AAS) requests due to changes in its contract model. MCPs with deficiencies are under Corrective Action Plans (CAP), requiring out-of-network access and transportation when standards aren’t met. Also, all six Dental MCPs operating in Los Angeles and Sacramento counties were found compliant with network adequacy standards. Where time or distance standards weren’t met, plans submitted and received approval for AAS requests. DHCS currently oversees eight active Dental MCP AAS requests.
此外，在 2024-25 财年，DHCS 根据 41 项标准对 MHP 进行了评估，根据 40 项标准对 DMC-ODS 计划进行了评估。初步结果显示，根据行为健康信息通知 (BHIN) 24-020 中概述的方法，56 个 MHP 中的 56 个（包括有两个联合 MHP 的 58 个县）和 32 个 DMC-ODS 计划中的 28 个（38 个县）被发现不符合一项或多项标准。由于数据报告的延迟和 DHCS 监测程序的改进，CAP 阶段未能在公布前完成。因此，NAAAR 反映的是实施《行动计划》前的数据，可能无法准确代表最终的合规结果。从历史上看，许多问题都是在联合呼吁程序阶段解决的。然而，DHCS 预计，许多 BHP 可能仍然不符合至少一项标准，由于评估行为健康网络适当性的方法严格且不断变化，这种情况并不少见。DHCS 正在评估是否根据BHIN 25-023实施经济制裁，以加强合规性。NAAAR 的结果以及要求 BHPs 完成纠正措施或面临经济制裁的规定，强调了 DHCS 对加强公共资助、县级管理的行为健康服务的问责制和透明度的承诺。
微笑，加利福尼亚：流动牙科车活动（莫多克县）
11 月 6 日至 8 日，北京时间上午 8 时至下午 5 时，将在莫多克县举行流动牙科车活动，提供免费牙科服务。面包车将停放在阿尔图拉斯市北大街 701 号 6 室。加州微笑 将通过定制传单、社交媒体帖子和微笑快讯来支持此次活动，通知会员和合作伙伴即将举行的活动。我们鼓励参观者在活动开始前拨打 1-888-585-3368 进行预先登记并填写同意书。
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：
- 管理式医疗质量与监督处处长 .主任负责领导和监督 Medi-Cal MCP 的合规相关活动。活动包括但不限于与医疗保健专业人员合作，制定和实施全州范围内的 MCP 政策、流程和变革管理工作，以及为与 MCP 相关的审计和合规计划提供技术援助和进行风险分析。执业医师的薪资范围更高。申请必须在 11 月 7 日之前提交。
DHCS is also hiring for its Accounting, Communications, Medi-Cal Eligibility Division, 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
DHCS 在 DHCS活动日历上公布即将举行的公开会议。DHCS 提供免费的辅助服务，包括语言翻译、实时字幕和会议材料的替代格式。如需申请服务，请在会议召开前至少十个工作日向 DHCS 发送电子邮件至相应的联系邮箱。
利益相关者咨询委员会 (SAC)/行为健康 (BH)-SAC 会议
10 月 29 日，太平洋时间上午 9:30 至下午 3:00，DHCS 将在萨克拉门托 K 街 1700 号（一楼 17.1014 会议室）举行 SAC/BH-SAC 混合 会议 （在线和现场参会均需提前注册）。在会议期间，与会者将了解更多有关即将到来的 H.R. 1 变更、2026 年 Medi-Medi 计划扩展、行为健康社区公平护理和治疗组织网络 (BH-CONNECT) 政策和实施更新以及过渡性租房的信息。SAC 为 DHCS 提供了宝贵的意见和反馈，帮助 DHCS 公平地提供优质医疗服务。BH-SAC 为 DHCS 提供有关行为健康倡议的意见，是将行为健康与更广泛的医疗保健系统相结合的持续努力的一部分。会议议程和其他会议材料将在会议日期临近时公布。如需了解更多信息，请发送电子邮件至SACinquiries@dhcs.ca.gov或BehavioralHealthSAC@dhcs.ca.gov。
社区合作伙伴关系的紧迫性：网络研讨会
On October 30, from 12 to 1:30 p.m. PDT, DHCS will host a webinar, “The Fierce Urgency for Community Partnerships” (advance registration required). DHCS Director Michelle Baass will provide opening remarks, setting the stage for a conversation about how California is advancing health equity and improving outcomes by partnering across sectors and centering community voices. Leadership from DHCS and the California Department of Public Health (CDPH) will provide an overview of California’s health care delivery transformation, share updates on initiatives that improve accountability, community engagement, and transparency, and discuss recent efforts to strengthen and align community planning and community investments across public health, managed care, and behavioral health. All are welcome to attend.
计划生育网络研讨会
太平洋时间 10 月 30 日中午 12:00 至下午 1:30，DHCS 将举办 "从同意到信任"：在计划生育就诊期间与青少年合作的最佳实践网络研讨会（需提前注册）。本网络研讨会将探讨与青少年和年轻成年人合作的最佳实践，考虑未成年人同意和保密、性健康和生殖健康以及青少年在医疗保健系统中的自主权等问题。它将重点关注如何为青少年开始管理其医疗保健需求的终身旅程做好最佳准备。 对于无法参加现场网络研讨会的人员，日后将在Family PACT 网站上提供网络研讨会的文字记录和录音，以及其他资源。
过渡性租金支付方法
DHCS 发布了最终的过渡性租金支付方法。正如《社区支持政策指南》第 2 卷所概述的，加州医疗保险 MCP 必须涵盖行为健康人群的过渡性租房服务，作为第一项强制性社区支持服务，从 1 月开始1 ，2026 。为了提供有关过渡性租金支付方法的更多信息，DHCS 将于 10 月 31 日上午 10 点至 11 点举办网络研讨会。DHCS 还鼓励合作伙伴和利益相关者访问ECM 和社区支持网页，了解更多信息，并访问新的DHCS 住房促进健康网页，了解 DHCS 领导的各种以住房为重点的倡议的最新情况。
Medi-Cal Children’s Health Advisory Panel (MCHAP) Meeting
11 月 6 日，太平洋标准时间上午 10 点至下午 2 点，DHCS 将在萨克拉门托 K 街 1700 号一楼会议室 (17.1014) 或通过公开网络研讨会召开 MCHAP 季度会议。MCHAP 就影响 Medi-Cal 儿童的政策和运作问题向 DHCS 提供建议。会议将提供有关几个关键主题的信息，包括通过 Medi-Cal for Kids& Teens 改善预防性护理服务；Drug Medi-Cal 和 DMC-ODS：渗透率数据和讨论；以及加州儿童和青少年心理健康访问门户网站 (Cal-MAP)。如需了解更多信息，请发送电子邮件至 MCHAP@dhcs.ca.gov。
64 号提案咨询小组会议
太平洋标准时间 11 月 13 日上午 10 点至下午 2 点，DHCS 将召开64 号提案顾问小组会议。会议将以混合形式在萨克拉门托市 River Plaza Drive 2150 号 400 室的 Sierra Health Foundation Center for Health Program Management 举行。会上，与会者将听取加州自然资源局、加州社会服务部、加州公共卫生署和 Sierra Health 基金会中心介绍其 64 号提案资助的青少年教育、预防、早期干预和治疗 (YEPEITA) 计划在过去一年中取得的进展。DHCS 还将概述2025 年 YEPEITA 立法报告。会议信息，包括议程和其他材料，将发布在64 号提案咨询小组的网页上。请将您的问题通过电子邮件发送至DHCSProp64@dhcs.ca.gov。
如果你错过了
加州医保家庭和社区服务（HCBS）1915(c) 加州发育障碍者豁免的拟议修正案
DHCS is seeking input from members, providers, and other interested stakeholders on the proposed amendment to the Medi-Cal HCBS 1915(c) Waiver for Californians with Developmental Disabilities (HCBS-DD waiver). DHCS plans to submit the proposed waiver amendment to CMS by November 28, for a proposed effective date of March 1, 2026. Copies of the proposed amendment can be obtained, and comments may be submitted, by emailing Federal.Programs@dds.ca.gov. Please include “HCBS Waiver” in the subject line or message. To ensure consideration, comments must be received by November 12. While comments submitted after this date will still be accepted, DHCS may not be able to review them before submitting the HCBS-DD waiver amendment to CMS.
DHCS 与 CalABLE 的合作
On October 1, DHCS participated in a webinar hosted by California Achieving a Better Life Experience (CalABLE). This session, Understanding CalABLE and Medi-Cal: Save Without Sacrifice, helped individuals with disabilities and their families learn more about CalABLE and Medi-Cal. The webinar covered how CalABLE and Medi-Cal work together to help families save and invest money without losing access to health care and other essential public benefits. Attendees included CalABLE account holders, people with disabilities and their families, state employees, and service providers. Please watch the webinar recording for more information.