项目更新
行为健康联邦补助金更新
年 9 月27日， 2021 DHCS 重新发布了危机护理移动单位 (CCMU) 资助机会，有效期至 年 11 月29日， 2021 。 最初的 2.05 亿美元融资机会于 年23月2021日至 年23月2021向加州各县、市行为健康机构、县和/或市行为健康机构联合团体以及部落实体发放。 DHCS 目前正在审查首轮融资申请，融资金额为 1.59 亿美元。 资格要求保持不变，虽然以前的申请人可以申请额外资金，但 DHCS 将优先考虑新申请人。 至少 4600 万美元将通过两种方式提供：1）高达 20 万美元的规划补助金，用于评估移动危机和非危机计划的需求并制定行动计划来满足需求；2）每个 CCMU 团队高达 100 万美元的实施补助金，用于实施新的 CCMU 计划或扩展现有的 CCMU 计划。 所有 CCMU 受助者都必须优先为 25 岁及以下的个人提供移动行为健康危机服务，同时也为更广泛的人群提供服务，并将鼓励他们支持司法干预服务。 本轮受助者的资助期限为2022年 1 月3日至2025 30
CCMU 的两轮融资均由以下机构支持：通过药物滥用预防和治疗专项拨款和社区精神卫生服务专项拨款，获得 5500 万美元，这些资金来自药物滥用和精神卫生服务管理局通过冠状病毒应对和救济补充拨款法案拨出的资金；以及通过行为健康连续基础设施计划，纳入州 2021-22 财政年度普通基金的 1.5 亿美元。 有关 CCMU 资助机会的更多信息，请发送电子邮件至 BHRRP@dhcs.ca.gov。
行为健康连续基础设施计划 (BHCIP) 更新
10 月 1 日，DHCS 为县、部落、非营利组织和营利组织举办了 BHCIP 听证会。 听证会讨论了 BHCIP 的资助机会、计划时间表和可用的技术援助，并为符合条件的申请人提供了机会，让他们直接向 DHCS 提供有关拟议的 BHCIP 活动的见解，包括书面和口头反馈。
BHCIP provides DHCS with funding to award competitive grants to qualified entities to construct, acquire, and rehabilitate real estate assets, or to invest in mobile crisis infrastructure to expand the community continuum of behavioral health treatment resources. A portion of the funding is available for increased infrastructure targeted to children and youth age 25 and younger. For more information, please email BHCIP@dhcs.ca.gov or visit the DHCS website.
CalHOPE
The CalHOPE Crisis Counseling Assistance and Training Program (CCP) received federal approval to extend services, allowing the program to continue through February 9, 2022, to provide emotional support for all Californians. Each week, the CalHOPE Connect chat feature continues to assist individuals with an average of 4,000 chats per week. CalHOPE also continues to partner with Together for Wellness and Juntos por Nuestro Bienestar, which feature evidence-based and community resources to help manage stress and anxiety, and offer the CalHOPE Warm Line, (800) 317-HOPE (4673). The Warm Line connects callers to other people who have persevered through struggles with stress, anxiety, and depression.
CalHOPE provided individual crisis counseling, group counseling, public education, brief education, and supportive contact services to 40,075 Californians in July and 46,961 in August. Additionally, from July 1 through September 10, CalHOPE provided CCP services to 459,146 Californians, which involved helpline contact, email responses, resource materials handed out/mailed, and mass media outreach. The most recent statistics and accomplishments are located on the CalHOPE Impact page. Additionally, American gymnast Mary Lou Retton delivered a message identifying CalHOPE as a local sponsor of NBC Universal’s coverage of the Tokyo Olympics.
社区卫生工作者 (CHW) 服务福利
DHCS is adding CHW services as a preventive service in the State Plan. In order to allow for the successful launch of the CHW benefit, DHCS is adjusting the implementation date for these benefits from January 1, 2022, to July 1, 2022. Additional time is needed to work with stakeholders and health plans, review their input, incorporate their feedback into the State Plan Amendment, ensure successful system updates, seek federal approval from CMS, and allow time for plans to prepare to offer these services. CHWs are skilled and trained health educators, assist individuals with accessing health care services, and provide key linkages with other similar and related community-based resources. CHWs would render Medi-Cal covered benefits and services under the supervision of an enrolled Medi-Cal provider. These services would be available under both the fee-for-service (FFS) and managed care delivery systems. DHCS met with stakeholders on August 18 and September 17 to discuss developing the State Plan Amendment (SPA) to add CHW services as a covered benefit. More information is available on the DHCS website, including future opportunities for stakeholders to provide input on developing the benefit.
牙科转型计划 (DTI)
The July 2021 payment of $2 million for Domain 1 was released on August 2, 2021. The goal of DTI’s Domain 1 is to increase by 10 percentage points the statewide proportion of children through age 20 enrolled in Medi-Cal who receive a preventive dental service during a five-year period. As of August 31, the amount of Domain 2 payments issued was approximately $194.4 million, and 3,375 providers have opted in to participate. The goal of Domain 2 is to diagnose early childhood caries by utilizing caries risk assessments to treat it as a chronic disease and to introduce a model that proactively prevents and mitigates oral disease. For more information, please visit the DHCS website.
药物 Medi-Cal 有序配送系统 (DMC-ODS)
California’s first regional DMC-ODS model began operating in seven counties on July 1, 2020, bringing the number of counties participating in the DMC-ODS to 37 and covering more than 96 percent of the Medi-Cal population. The regional model is a collaboration among seven Northern California counties and Partnership HealthPlan of California that allows access to screening, assessment, early intervention, and continuum of substance use disorder (SUD) treatment. The DMC-ODS provides a continuum of care modeled after the American Society of Addiction Medicine (ASAM) criteria for SUD treatment services.
2021 年，DHCS 将继续为感兴趣的 DMC 州计划县召开网络研讨会。 网络研讨会主题包括个人和区域模型选项、药物辅助治疗 (MAT) 访问、网络充分性标准以及财政影响和预测，所有这些都是为了支持 DMC-ODS 的实施。
As of February 1, DHCS implemented Senate Bill (SB) 823 (Chapter 781, Statutes of 2018) through Behavioral Health Notice No.: 21-001, which requires DHCS’ licensed alcohol and other drug (AOD) recovery treatment facilities to obtain at least one DHCS Level of Care (LOC) Designation and/or at least one residential ASAM LOC Certification consistent with all of its program services. DHCS has processed 1,425 total designations for AOD providers in California. Of those designations, 1,126 are active for 420 providers. More information about the DMC-ODS is available on the DHCS website.
DHCS also contracts with an External Quality Review Organization (EQRO) that reviews DMC-ODS counties annually regarding access, timely access, and quality of care. The information from these reviews is summarized in annual county reports. For FY 2020-21, the EQRO completed and posted 29 DMC‑ODS county reviews, including the first review of the DMC-ODS regional model. In April 2021, DHCS submitted the annual statewide technical report as well as performance improvement project reports to CMS. All EQRO. The EQRO commenced FY 2021-22 county reviews in September. Additionally, under contract with the University of California Los Angeles, Integrated Substance Abuse Programs (UCLA ISAP), DHCS is conducting annual DMC‑ODS waiver evaluation activities to measure and monitor outcomes. The evaluation focuses on access to care, quality of care, cost, and the integration and coordination of SUD care, both within the SUD system and with medical and mental health services. The latest DMC‑ODS waiver evaluation report is posted on the UCLA ISAP website.
助产服务福利
DHCS is adding doula services to the list of Medi-Cal preventive services to improve health equity and address health disparities. In order to allow for the successful launch of this benefit, DHCS is adjusting the implementation date for this benefit from January 1, 2022, to July 1, 2022. Additional time is needed to work with stakeholders and health plans, review their input, incorporate their feedback into the State Plan Amendment, ensure successful system updates, seek federal approval from CMS, and allow time for plans to prepare to offer these services. Doula services include emotional and physical support to individuals throughout pregnancy, labor, childbirth, and the postpartum period. Pursuant to federal regulations, doula services will need to be recommended by a physician or other licensed practitioner. DHCS met with stakeholders on September 16 to discuss developing the SPA, including defining qualifications of doulas, covered services, and supervision. These services will be available in both the FFS and managed care delivery systems. More information is available on the DHCS website, including future opportunities for stakeholders to provide input on doula services and the SPA.
HIV/AIDS Medi-Cal 豁免计划 (MCWP) 续签
On September 29, 2021, DHCS submitted the HIV/AIDS MCWP renewal application to CMS. The renewal application is posted on both the DHCS and California Department of Public Health (CDPH) websites. DHCS, in collaboration with CDPH, must renew its HIV/AIDS MCWP every five years. The current HIV/AIDS MCWP term ends on December 31, 2021. The new waiver term will be January 1, 2022, through December 31, 2026. From August 13 through September 13, DHCS posted the HIV/AIDS MCWP renewal to the AIDS Medi-Cal Waiver Program webpage for a 30-day public comment period. CDPH received and responded to 10 comments from stakeholders, and updated the MCWP renewal application to reflect stakeholder comments.
HIV/AIDS MCWP 根据《社会保障法》第 1915(c) 条授权，为 HIV/AIDS 感染者提供全面的病例管理和直接护理服务，作为护理机构护理或住院治疗的替代方案。 MCWP 的目标是：（1）为可能需要机构服务的艾滋病毒感染者提供家庭和社区服务；（2）帮助参与者进行艾滋病毒健康管理；（3）改善获得社会和行为健康支持的渠道；（4）协调服务提供商并消除服务重复。
家庭和社区替代医疗 (HCBA) 豁免续签
On September 29, 2021, DHCS submitted the HCBA waiver renewal application to CMS. The renewal application, and additional information, is posted on the DHCS website. DHCS must renew its HCBA waiver every five years. The current waiver term ends on December 31, 2021; the new one will be effective from January 1, 2022, through December 31, 2026. From August 16 through September 16, DHCS posted the HCBA waiver renewal application to the DHCS website for a 30-day public comment period. DHCS received and responded to 128 comments from 36 stakeholders, and updated the HCBA waiver renewal application to reflect stakeholder comments.
根据《社会保障法》第 1915(c) 条授权的 HCBA 豁免，为符合 Medi-Cal 资格的受益人在他们选择的社区环境中提供长期的、以社区为基础的服务和支持。 这些服务包括私人护理、病例管理和个人护理服务，这些服务对于在社区环境而非机构中维护有护理需求的个人的健康和安全是必要的。
家庭和社区服务 (HCBS) 支出计划
On September 3, 2021, CMS notified DHCS that California’s HCBS Spending Plan was granted partial approval of the initiatives proposed, with one initiative denied and additional information requested for other initiatives. On September 17, DHCS, in collaboration with sister departments, provided CMS with the additional information requested for specific initiatives. DHCS and its partners are currently developing implementation strategies and timelines. More information will be made available to stakeholders and posted on the DHCS website in the coming weeks.
On July 12, DHCS submitted California’s $4.6 billion Medicaid HCBS Spending Plan to CMS for review and approval. The American Rescue Plan Act of 2021 (ARPA) provides states with a temporary increase in federal funds for certain HCBS Medicaid expenditures from April 1, 2021, through March 31, 2022. The HCBS plan reflects many of the investments included in the initial version released by DHCS in early June, as well as program funding included in the 2021 Budget Act. The plan will expand services for California’s most vulnerable and at-risk residents through new and existing programs that will strengthen HCBS in the state’s Medicaid delivery systems. These investments will also build capacity and transform critical safety net programs, as well as promote economic mobility and social stability.
医疗口译员试点（MIP）项目
Pursuant to SB 165 (Chapter 365, Statutes of 2019), DHCS is required to collaborate with stakeholders to establish a pilot at up to four sites to evaluate the provision of medical interpretation services for beneficiaries with Limited English Proficiency (LEP) enrolled in Medi-Cal managed care and FFS Medi-Cal. A primary goal of the pilot will be to determine whether providing medical interpretation services results in a reduction of disparities in access to and use of services, and quality of care, with respect to beneficiaries with LEP and beneficiaries who are proficient in English. DHCS will make available up to $5 million for the pilot project and the associated ongoing, independent evaluation to be conducted throughout the term of the pilot by California State University at San Diego’s Institute for Public Health.
On August 31, DHCS announced the following selected pilot site contractors: Contra Costa County—Monterey Language Services; Los Angeles County—Language World Services, Inc.; San Diego County—Hanna Interpreting Services, L.L.C.; and San Joaquin County—J. Rivera Associates. DHCS anticipates that the pilot project will run from November 1, 2021, through September 30, 2023. For more information, visit the DHCS website.
药物治疗管理 (MTM)
As part of the Governor’s 2021 Budget Act, DHCS submitted SPA 21-0028 to CMS seeking to add MTM as a payable FFS pharmacy service provided in conjunction with certain complex chronic medical conditions. On September 15, DHCS received CMS approval of this SPA, and is now working to finalize provider contracts and meet with stakeholders to obtain feedback and insights regarding the specific requirements and allowances of the MTM benefit. To participate in this program, Medi-Cal-enrolled pharmacies will be required to enter into a contract with DHCS. The contract will outline the requirements and guidelines necessary to receive reimbursement under this methodology.
Medi-Cal Rx 实施更新
Medi-Cal Rx is scheduled to launch on January 1, 2022. Outreach and education activities have begun and will run through December, in advance of the January 1 go-live date. DHCS will send a 60-day notice to all Medi-Cal beneficiaries and a 30-day notice to all FFS beneficiaries. MCPs will also send a 30-day notice to their members as part of a broader outreach campaign. Additionally, DHCS has resumed Medi-Cal Rx stakeholder engagements and meeting schedules. For more information, please visit the DHCS website or email RxCarveOut@dhcs.ca.gov.
资金跟进 (MFP) 补充资金申请
MFP 示范项目支持州政府努力重新平衡州政府长期服务和支持系统，以便个人可以选择居住地和接受服务的地点。 MFP 计划的目标是在适当的情况下增加 HCBS 的使用并减少机构服务的使用，同时加强医疗补助计划向选择退出机构的人们提供 HCBS 的能力。
年 9 月23日， 2020 CMS 宣布为当前正在运行 MFP 示范项目的各州提供高达 1.65 亿美元的补充资金。 每个州都有资格获得高达 500 万美元的补充资金，用于规划和能力建设活动，以加速长期护理系统转型的设计和实施，并扩大 HCBS 的能力。 为了获得资助，州政府资助者必须在 6 月 30 日之前提交一份包含项目叙述的提案。
On July 27, CMS approved DHCS’ $5 million MFP supplemental funding application to conduct a statewide gap analysis and multiyear roadmap of its HCBS and Managed Medi-Cal Long-Term Supports and Services (MLTSS) programs and networks. The CMS-approved application is available on the DHCS website
同行专家认证计划
On July 22, 2021, DHCS released Behavioral Health Information Notice 21-041 identifying the state standards for Medi-Cal peer support specialist certification programs that may be implemented by counties, or an entity representing counties, that opt in to provide these programs, according to SB 803 (Chapter 150, Statutes of 2020) requirements. This certification is required for Medi-Cal reimbursement, but does not impact peer programs with other funding sources. For questions about Medi-Cal peer support specialist certification, email Peers@dhcs.ca.gov.
On August 27, DHCS released for stakeholder feedback a draft of SPA 21-0051, which seeks to establish peer support services as a distinct specialty mental health service, and peer support specialists as a distinct provider type.
DHCS 正在向 CMS 提交实施新的同伴支持专家福利所需的所有联邦 Medi-Cal 豁免和州计划修正案。 经 CMS 批准后，同行支持专家服务将于1年 7 月2022日开始。
产后护理保障
Under the provisions of ARPA, DHCS is opting to broaden the scope of Medi-Cal coverage for currently eligible and newly eligible pregnant individuals. Medi-Cal will cover the full breadth of medically necessary services, during both the pregnancy and postpartum periods, by adding ten months of coverage following the current 60-day postpartum period, for a total of 12 months. In the interest of aligning the Medi-Cal Access Program (MCAP) with the Medi-Cal postpartum care extension policies described above, DHCS submitted a Children’s Health Insurance Program (CHIP) SPA, CA-21-0032, proposing to create a Health Services Initiative (HSI) to extend the provisions allowed in ARPA to MCAP. On September 14, DHCS received federal approval for the HSI. Under the provisions of ARPA and the HSI, individuals will maintain coverage through their pregnancy and 12-month extended postpartum coverage period regardless of income changes, citizenship, or immigration status. This policy is targeted for implementation on April 1, 2022.
微笑，加州 Medi-Cal 牙科服务运动
The statewide “Back-Tooth-School” campaign, which aimed to encourage parents and caregivers to send their children back to school with healthy smiles by scheduling a dental check-up before the start of the 2021-22 school year, concluded in September. Smile, California developed 15 new resources and assets (translated in Spanish and some in Chinese) as part of this campaign. Fifty-six local oral health programs participated in the campaign by co-branding Smile, California resources, sharing messaging through social media, and conducting kindergarten oral health assessment events.
Also, two new videos were posted to SmileCalifornia.org and SonrieCalifornia.org. The first video, entitled “How to Use the Find A Dentist Tool,” is available in both English and Spanish. The second video, “Healthy Children are Ready to Learn!“, underscores the important role good oral health and regular dental check-ups play in school readiness. This video is also available in both English and Spanish.
Additionally, in October, Smile, California will partner with 185 school-based health centers, which do not offer dental treatment as a service, by providing them with a new 11×17 inch poster in English, Spanish, Mandarin, and Vietnamese. The poster will feature a 2-2-2 tip message (visit the dentist 2x a year, and brush for 2 minutes 2x a day each day) and will feature a list of the free and low-cost services provided by the Medi-Cal Dental Program. Further, in celebration of the campaign’s third anniversary, five Medi-Cal dental provider testimonial videos will premiere on Smile, California’s website and social media accounts. Watch the series on SmileCalifornia.org, Facebook, or Instagram.
By the end of August, SmileCalifornia.org had 19,854 new visitors, of which 14,505 clicked the “Find a Dentist” button.