项目更新
资产限制 - 非调整后总收入 (MAGI) Medi-Cal
Assembly Bill (AB) 133 (Chapter 143, Statutes of 2021) authorizes a two-phased approach to eliminating the asset test for all non-MAGI Medi-Cal programs, including long-term care and the Medicare Savings Programs. Phase I will be implemented on July 1, and will increase asset limits to $130,000 per person and $65,000 per additional person being evaluated. Phase II will be implemented on January 1, 2024, and will eliminate the asset test. In November 2021, CMS approved State Plan Amendment 21-0053, and DHCS issued policy guidance to the counties regarding the Phase I implementation in an All County Welfare Directors Letter (ACWDL 21-31). DHCS has also submitted to CMS an application to amend the CalAIM Section 1115 demonstration waiver to permit California to increase, and eventually eliminate, the asset test for the Supplementary Security Income deemed coverage groups. DHCS published Medi-Cal Eligibility Division Information Letter (MEDIL I 22-02), which provides counties, advocacy groups, and other partners with global outreach messaging to use in their outreach activities regarding the increased asset limits as of July 1.
行为健康连续基础设施计划 (BHCIP) 更新
BHCIP 第三轮：准备启动
1 月 31 日，DHCS 与加州社会服务部 (CDSS) 合作发布了 BHCIP 第三轮：启动准备和 CDSS 社区护理扩展 (CCE) 计划联合申请请求 (RFA)。 申请人可申请其中一项资助机会或两项都申请。 BHCIP 第三轮：启动准备申请的截止日期为 4 月 8 日，申请审核正在进行中，申请人请求的资金约为 20 亿美元。 DHCS 预计将于 6 月公布 BHCIP 第三轮：启动准备奖项。
BHCIP 申请人必须证明项目扩展了为 Medi-Cal 受益人提供服务的环境中的行为健康治疗和服务连续性，并且拥有有效的规划流程以确保项目已准备好实施。 DHCS 将为 BHCIP 第三轮：启动准备项目提供高达 5.185 亿美元的赠款资金，并且必须在 2024 年 6 月前拨付资金，并在 2026 年 12 月前清算。
BHCIP 第四轮：儿童和青年
BHCIP第四轮：儿童和青少年重点关注 25 岁及以下的儿童和青少年，包括孕妇和产后妇女及其子女、儿童和过渡期青少年 (TAY) 以及他们的家人。 所有申请者都需要证明他们的基础设施项目将如何专门为这一人群扩大行为健康服务。 通过第四轮竞争性拨款，DHCS 将为以儿童和青少年为重点的行为健康基础设施项目拨款 4.805 亿美元。
The RFA for Round 4: Children and Youth was released on June 1. DHCS has released a program update as a supplement to the upcoming RFA for BHCIP Round 4: Children and Youth funding. As was the case with Round 3: Launch Ready, applicants are required to undergo a pre-application consultation. They will be expected to demonstrate “project readiness”, as detailed in the forthcoming RFA, and will be funded according to which of three pre-construction phases their project is in. Full project funding will be contingent upon completion of all three phases of development planning.
DHCS was authorized through 2021 legislation to establish BHCIP and award $2.1 billion to construct, acquire, and expand properties and invest in mobile crisis infrastructure related to behavioral health. CDSS oversees the CCE program, which was established through AB 172 (Chapter 20, Statutes of 2021) as a companion effort, totaling $805 million. The CCE program focuses on the acquisition, construction, and rehabilitation of adult and senior care facilities that serve Supplemental Security Income/State Supplementary Payment and Cash Assistance Program for Immigrants applicants and recipients and other adults who are experiencing or at risk of homelessness. For more information, please visit the BHCIP project website or email BHCIP@dhcs.ca.gov.
行为健康联邦补助金更新
DHCS 最近向其联邦资助机构药物滥用和精神健康服务管理局提交了其第二年、年中州阿片类药物反应 (SOR) II 进展报告。 2021 年 9 月至 2022 年 3 月期间，SOR 拨款为 21,672 名阿片类药物使用障碍患者提供治疗服务。 其中，超过 16,000 人接受了丁丙诺啡治疗，5,000 人接受了美沙酮治疗，400 人接受了注射纳曲酮治疗。 SOR 还为超过 30,000 名个人提供康复或同伴辅导，为超过 1,600 名个人提供康复住房服务，并为近 1,500 名个人提供就业服务。 在此期间，SOR 支持了纳洛酮分发项目，成功逆转了 9,000 多起阿片类药物过量用药事件。 此外，SOR 还为 5,600 多名个人提供兴奋剂使用障碍治疗服务。
For more information about the SOR grant, please visit the Medication Assisted Treatment Expansion Project webpage or email DHCSMATExpansion@dhcs.ca.gov.
行为健康质量改进计划（BHQIP）
The Department of Health Care Services (DHCS) created a three-year Behavioral Health Quality Improvement Program (BHQIP) to support implementation of the CalAIM initiative. The CalAIM BHQIP is structured as an incentive program, whereby counties may earn incentive payments by achieving certain CalAIM implementation milestones. Senate Bill (SB) 129 (Chapter 69; Statutes of 2021), authorized $21,750,000 in General Fund dollars for the CalAIM BHQIP for Fiscal Year 2021-22, which included a startup allocation amount of $250,000 to each County Behavioral Health Plan participating in BHQIP, and the rest was allocated to counties based on each county’s share of statewide claims value reported to DHCS. For inquiries about BHQIP, please contact BHQIP@dhcs.ca.gov.
CalAIM 更新
社区支持
On April 15, DHCS received final updated Models of Care (MOCs) from Medi-Cal MCPs implementing Community Supports in all 58 California counties, including proposed networks and estimated capacities for services. On July 1, MCPs will proceed with the next phase of implementation of Community Supports and bring on additional Community Supports services elected through the MOC process. Revised Community Supports elections will be posted on the CalAIM webpage in mid-June, once DHCS has approved all outstanding MCP MOCs. DHCS will continue to update Community Supports elections at least semi-annually.
增强护理管理 (ECM)
ECM was implemented in counties with Health Homes Programs (HHP) and Whole Person Care (WPC) pilots on January 1, 2022. On July 1, 2022, counties that did not have HHP and WPC programs will begin implementation of ECM for the following Populations of Focus (POF): individuals and families experiencing homelessness, adult high utilizers, and adults with serious mental illness (SMI) or substance use disorder (SUD). DHCS is reviewing each MCP’s policies and procedures and confirming provider networks are ready for implementation.
Also, to ensure operational readiness, MCPs will submit updated MOCs by July 1 for two long-term care (LTC) POFs (members eligible for LTC and those at risk of institutionalization; and nursing home residents transitioning to the community), scheduled to go-live on January 1, 2023.
人口健康管理（PHM）
On May 3, DHCS released the Draft PHM Strategy and Roadmap for public comment, and written comments were due on May 16. This document describes DHCS’ vision for PHM, outlining key policy initiatives and accountability mechanisms, defining and describing PHM concepts and terminology, and detailing requirements for Medi-Cal MCPs for 2023 and 2024. On May 9, DHCS issued an Invitation for Proposal (IFP) for the PHM Service, and anticipates awarding a contract to the selected vendor by this summer.
提供途径和转变健康（PATH）
In June, the first round of application submissions for the PATH Collaborative Planning participants and facilitators, Justice-Involved Capacity Building, and the Capacity and Infrastructure Transition Expansion and Development (CITED) initiative will begin. DHCS completed the IFP procurement for the PATH Third Party Administrator (TPA) in May. DHCS is evaluating the proposals and aims to award the TPA vendor contract by the end of June. DHCS continues to develop and finalize the guidance documents for the Technical Assistance Marketplace, Collaborative Planning, CITED, and Justice-Involved Capacity Building initiatives. Visit the CalAIM PATH Initiative webpage for current information and resources on PATH initiatives.
CalHOPE
CalHOPE has continued providing Crisis Counseling Assistance and Training Program (CCP) services to Californians in need of support. CalHOPE was approved for a 30-day and a 60-day cost extension that allowed CCP services through May 10, 2022. The federal partners recently approved DHCS’ 90-day no-cost extension, extending CalHOPE CCP services through July 9, 2022 and administrative close out activities through August 10, 2022.
CalHOPE continues to provide CCP educational services to schools, raising awareness of the negative effects of anxiety. CalHOPE has been partnering with IndieFlix since October 2021, including releasing the film ANGST: Building Resilience, which is based on a mental health support program. The outreach has been successful, as more than 150 school districts registered, multiple in-person Angst screenings were conducted in schools, and outreach/communication to other venues have been scheduled. Additionally, All It Takes, in partnership with CalHOPE and the California Department of Education, has received positive feedback after the release of the film, A Trusted Space, which is aimed at training educators on how to help mitigate the effects of emotional stressors on students and their families.
DHCS’ service provider, California Consortium of Urban Indian Health (CCUIH), has remained engaged in outreach of CCP services to their Tribal community. CCUIH has tabled various indigenous events, such as the Stanford Pow Wow, Mariposa Pow Wow, Indigenous Red Markets, and Healing and Coping events, sharing resources of the CalHOPE RedLine.
社区心理健康公平项目（CMHEP）
DHCS, in partnership with the California Department of Public Health, is providing support to CBOs and county behavioral health departments through CMHEP to implement population-specific and community-driven approaches. AB 74 (Chapter 23, Statutes of 2019) authorized funding to provide training and technical assistance to county behavioral health departments. CMHEP efforts will cover two years. DHCS hired the Center for Applied Research Solutions to develop statewide community-driven policy guidance, along with strategies and interventions aimed at reducing disparities in access to health and behavioral health care. A robust data collection framework to evaluate improvements in access to culturally responsive care will accompany the newly developed policy guidance. For more information, visit the CMHEP website.
DHCS 家庭和社区服务 (HCBS) 支出计划倡议
CalBridge 行为健康计划
截至 2022 年 2 月，公共卫生研究所/CA Bridge (PHI) 报告称，有 112,474 名患者接受了药物使用导航员的诊治，有 90,593 名患者被确诊为阿片类药物使用障碍，有 40,044 名患者接受了药物辅助治疗。 通过家庭和社区服务，DHCS 与 PHI 签订了 4000 万美元的合同，以扩大该计划的覆盖范围和导航员的作用，通过 CalBridge 行为健康导航员计划更好地解决心理健康状况以及物质使用障碍。 为了分配资金，PHI 于 2022 年 4 月发布了一份申请请求 (RFA)，以征求设有急诊科的医院、卫生系统、医院基金会或医生团体的参与。
For more information about the CalBridge Behavioral Health Navigator Program, please visit the Bridge Navigator Program website.
老年人全范围 Medi-Cal 扩展计划
On May 1, individuals 50 years of age or older who met all Medi-Cal eligibility criteria, and who do not have satisfactory immigration status for federally-funded full-scope Medi-Cal, became newly eligible for state-funded full-scope Medi-Cal under the Older Adult Expansion. DHCS successfully transitioned 247,522 existing Older Adult Expansion individuals in restricted scope Medi-Cal to full-scope Medi-Cal, effective May 1. Individuals who apply now will automatically be determined eligible for full-scope Medi-Cal if they are 50 years of age or older and meet all other Medi-Cal eligibility criteria, regardless of immigration status. This expansion of Medi-Cal supports the Newsom Administration’s vision of a Healthy California for All by addressing health coverage disparities that disproportionately impact disadvantaged communities.
同伴支持服务
On May 2, DHCS received CMS approval of SPA 22-0024, with an effective date of July 1, to broaden the definition of a Peer Support Specialist as someone who must be in recovery themselves or have lived experience with the process of recovery as a parent, caregiver, or family member. Prior to this update, Peer Support Specialists were defined solely as individuals in recovery, which excluded parents, caregivers, or family members from becoming certified as Peer Support Specialists. This update aligns the definition of Peer Support Specialist with the Medi-Cal Peer Support Specialist Certification Program requirements.
On May 6, DHCS issued Behavioral Health Information Notice (BHIN) 22-026, which provides guidance regarding the submission of an opt-in letter and claiming requirements for Peer Support Services in the Drug Medi-Cal (DMC), Drug Medi-Cal Organized Delivery System (DMC-ODS), and Specialty Mental Health Services (SMHS) programs. In order to implement Peer Support Services effective July 1, counties must have provided a letter to DHCS stating their request to opt in to provide peer support services, and indicating the program(s) (SMHS, DMC-ODS, and/or DMC) for which they are opting in. The letter must be signed by the Behavioral Health Director and emailed to CountySupport@dhcs.ca.gov by May 20 to implement peer support services, effective July 1. To date, 48 counties have submitted a signed letter stating their request to opt in to provide Peer Support Services effective July 1, 2022, with most counties opting to cover Peer Support Services in both their SMHS and their DMC or DMC-ODS programs.
无法在 5 月 20 日截止日期之前选择加入同伴支持服务的县仍有机会每六个月选择加入一次。 DHCS 将提供有关未来选择加入同伴支持服务的后续机会的更多信息。
牙科服务提供商申请和注册验证 (PAVE) 门户
DHCS 将于 2022 年秋季为牙科服务提供商实施 PAVE 门户。 PAVE 门户是一个基于网络的应用程序，旨在简化和加速注册流程。 PAVE 将提供一种向 DHCS 提交牙科服务提供商注册申请和所需文件的新模式，允许申请人使用一种名为 Medi-Cal 服务提供商电子表格申请的电子表格。 一旦 PAVE 实施，DHCS 将不再接受纸质申请。
微笑，加州 Medi-Cal 牙科服务运动
SmileCalifornia.org, SonrieCalifornia.org, and all materials pertaining to pregnant members were updated to reflect the American Rescue Plan Act of 2021 Postpartum Care Extension policy that was enacted on April 1, 2022.
Smile, California launched a promotion in April to support the required Kindergarten Oral Health Assessment (KOHA). The promotion brought awareness to the California law that requires all children to complete a dental assessment by their first year in public school, either Kindergarten or first grade, before May 31. Local oral health programs, school-based health centers, and CBOs received digital toolkits with educational KOHA materials, and the KOHA landing page was updated on SmileCalifornia.org and SonrieCalifornia.org.
In May, Smile, California launched an effort to promote the new Medi-Cal Older Adult Expansion to inform adults 50 years of age or older enrolled in restricted scope Medi-Cal that they are now eligible to receive full-scope Medi-Cal benefits, regardless of immigration status. A new landing page was created on SmileCalifornia.org and SonrieCalifornia.org with information about the expansion, frequently asked questions, and covered dental services. Social media ads and boosted posts ran on the Smile, California Facebook and Instagram accounts throughout May.
At the end of April, SmileCalifornia.org and SonrieCalifornia.org had received 66,794 new visitors, of which 51,361 clicked the “Find a Dentist” button.