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本地教育機構（LEA）獲批准參加 CYBHI 多付款人費表​​ 

On December 1, DHCS announced the first cohort of 47 LEAs (across 25 counties) approved to participate in the Children and Youth Behavioral Health Initiative (CYBHI) statewide multi-payer school-linked fee schedule, which will launch in January 2024, and statewide provider network. As part of the CYBHI, DHCS is expanding access to school-based (or school-linked) behavioral health services provided to students at a school site. Specifically, DHCS, in collaboration with the Department of Managed Health Care and California Department of Insurance, is establishing a statewide multi-payer school-linked fee schedule to reimburse school-linked providers for the provision of specified outpatient mental health and substance use disorder services furnished to students 25 years of age or younger at a school site. A fee schedule establishes a scope of services (e.g., psychoeducation, screening/assessment, treatment, and care coordination services), identifies billing codes and rates, and specifies provider types eligible to bill for services. Under state law, Medi-Cal managed care plans (MCP), commercial health plans, and disability insurers are obligated to reimburse eligible school-linked providers, including LEAs (e.g., services performed by pupil personnel services credentialed practitioners) and school-linked affiliated community-based organizations.​​ 

Welfare and Institutions Code section 5961.4(b) authorizes DHCS to “develop and maintain a school-linked statewide provider network of school-site behavioral health counselors.” To develop the CYBHI fee schedule provider network, DHCS implemented an operational readiness review process for all interested county offices of education and LEAs. In determining LEA readiness for this cohort, DHCS considered a variety of factors, including, but not limited to, Medi-Cal enrollment, service delivery infrastructure and capacity building, data collection and documentation, and billing infrastructure. The 47 LEAs met readiness review requirements and will participate in a learning collaborative to inform state level policy and operational guidance for the CYBHI fee schedule program. Cohort 2 will launch in July 2024 and Cohort 3 in January 2025.​​ 

More information about the CYBHI fee schedule program is available on the Statewide Multi-Payer School-Linked Fee Schedule webpage.​​ 

 

加入我們的團隊​​ 

DHCS 正在招聘。 DHCS 具有以下機會：​​ 

• Chief of Fee-for-Service Rates Development within Health Care Financing to develop, interpret, and issue policy on Medi-Cal reimbursement methodologies for Medi-Cal fee-for-service non-institutional and long-term care services and provider fee programs, ensuring uniform application of federal and state laws and regulations. (Final filing date (FFD) is December 20)​​ 
• Chief of Capitated Rates Development within Health Care Financing to serve as the principal policymaker for all rate-setting activities to ensure high-quality and cost-efficient health care through DHCS’ contracted Medi-Cal managed care plans. (FFD is December 19)​​ 
• Deputy Director of Enterprise Technology Services and Chief Information Officer to lead and manage Department-wide IT services. Responsible for managing all IT services, information security, enterprise projects, and strategic innovation efforts. (FFD is December 8)​​ 
• Deputy Chief Counsel in the Office of Legal Services to provide advice and counsel to the directorate, deputy director and chief counsel, and other deputy directors on legal policy litigation, federal policy, financial operations, and legislation. (FFD is December 4)​​  

DHCS is also hiring for our human resources, auditing, health policy, and information technology teams. For more information, please visit the CalCareers website.​​ 

即將舉行的利害關係人會議和網絡​​ 

Medi-Cal 成人擴展網路研討會​​ 

12 月 4 日上午 11 點至中午 12 點，DHCS 將為社區組織、MCP、醫療服務提供者及其他有興趣的利害關係人，包括代表消費者、醫療保健、法律援助及成人移民的利害關係人，舉辦有關 Medi-Cal 成人擴展的網路研討會（需事先報名）。DHCS 將依據參議院第 184 號法案（2022 年成文法第 47 章）於1,2024 實施此擴展計劃。擴展計劃實施後，只要符合 Medi-Cal 的所有其他資格標準，26-49 歲的成人不論其公民身份或移民身份，均可享有 Medi-Cal 的全面福利。​​ 

The webinar, which will be live and 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.​​ 

提供訪問和轉型健康（PATH）與正義相關計劃辦公時間​​ 

12 月 4 日中午 12 點，DHCS 將為第 3 輪獲獎人舉辦下一場 PATH 正義介入計劃虛擬辦公時間會議（需提前報名）。至 12 月18 ，2023 ，每隔一週一下午 12 點為第 3 輪機構提供協助，包括支援實施計劃的提交。如需詳細資訊，請造訪 Justic-Involved Program 網站。​​   

計劃家庭網路研討會中的創傷調查與回應​​ 

12 月 7 日中午 12 點至下午 1 點 30 分，DHCS 和加州預防中心將舉辦家庭計劃中的創傷探究與回應網路研討會（需提前註冊）。創傷 (包括不良童年經驗、人際暴力和性侵害) 對健康結果有重大影響，在尋求家庭計劃服務的人中很常見。創傷會影響性健康和生殖健康、懷孕和心理健康，因此臨床醫生在提供家庭計劃服務時，必須處理創傷問題。​​ 

本次網絡研討會將討論創傷和復原因應逆境、困難和強大的調查（TRIADS）框架，以及它對計劃家庭臨床醫生可能有用的方式。 使用案例研究，講者將描述 TRIADS 框架如何建立同理心、尊重和同情的基礎，從而增加對照護的參與並改善尋求計劃生育服務的患者的健康成果。​​ 

For those unable to attend the live webinar, a transcript and recording of the webinar, along with additional resources, will be available on the Family PACT website at a later date.​​ 

PATH 協作規劃與實施 (CPI) 最佳實踐網路研討會​​ 

On December 7, from 12:30 to 1:30 p.m., DHCS will host a statewide webinar, Relationship Building with Organizations in the California Advancing and Innovating Medi-Cal (CalAIM) Environment (advance registration required) for community-based organizations, county, city, and local government agencies, federally qualified health centers, MCPs, Medi-Cal tribal and designees of Indian Health Programs, and providers. The webinar is part of a biannual series of PATH CPI webinars designed to highlight best practices for implementing Enhanced Care Management (ECM) and Community Supports, increasing providers’ successful participation in CalAIM, and improving collaboration with MCPs, state and local government agencies, and others to build and deliver quality support services to Medi-Cal members. For more information, please visit the PATH CPI webpage.​​ 

指導改善認知障礙症體驗（GUIDE）模型網絡研討會​​ 

On December 8, from 11 a.m. to 12 p.m., DHCS, in partnership with the University of California, San Francisco and DHCS’ Dementia Care Aware initiative, will host a webinar on the GUIDE model in California (advance registration required). This webinar will offer Medicare providers and community-based organizations information about what is required to participate in GUIDE, examples of a successful partnership in California that follows the GUIDE model, and resources to help California applicants apply for the GUIDE model. For more information, please visit the Dementia Care Aware webpage.​​ 

卡拉伊姆人口健康管理 (PHM) 諮詢小組會議​​ 

On December 11, from 10:30 a.m. to 12 p.m., DHCS will host a PHM Advisory Group meeting (advance registration required). This meeting will include a briefing on policy guidance for changes to the modified Population Needs Assessment (PNA). To support the success of the PHM Program and broader transformation efforts, DHCS is redesigning MCP requirements for developing a PNA, which has historically been MCPs’ primary mechanism for identifying the priority health and social needs of their members, including health disparities. A central component of DHCS’ approach is for MCPs to meaningfully participate on local health departments’ Community Health Assessments (LHD CHA)/Community Health Improvement Plans (CHIP) rather than complete a separate PNA focused solely on their own members’ data. This meeting will provide an overview of forthcoming PHM policy guidance for MCPs to participate in LHD CHA/CHIP processes.​​ 

DHCS established the PHM Advisory Group to provide input to support the design and implementation of the PHM Program and PHM Service. Members, which include representatives from health plans, providers, counties, state departments, consumer organizations, and other groups, will participate in advisory group meetings and provide real-time feedback and recommendations. The meetings are open to the public, and meeting information and materials will be available on the DHCS website. Stakeholders are encouraged to submit questions in advance of the webinar to PHMSection@dhcs.ca.gov.​​ 

CalAim LTC 加入：Medi-Cal 管理護理如何支持下急性護理設施和 ICF/DD 家居住戶網絡研討會​​ 

12 月 15 日，DHCS 將以虛擬方式舉辦 CalAIM 長期護理 (LTC) 分案教育網路研討會（需提前註冊）。本網路研討會的目的是讓亞急 性護理設施、發展障礙者中級護理設施 (ICF/DD) 院舍、區域中心和 Medi-Cal MCP 瞭解管理性護理下亞急性護理設施和 ICF/DD 院舍居民的政策要求、服務範圍和福利，為 1 月1 、2024 的分割做準備。有關網路研討會和 Carve-in 的其他詳細資訊，請參閱 CalAIM LTC Carve-In 過渡網頁。​​  

ECM 和社區支持醫療保健共同程序編碼系統（HCPCS）編碼指導網絡研討會​​ 

12 月 18 日上午 11 點至中午 12 點，DHCS 將舉辦網路研討會，概述 ECM 和社區支援 HCPCS 編碼指南的最新更新（需提前註冊）。DHCS 最初於 2021 年發佈指南，其中包括必須用於報告 ECM 和「社區支援」服務的 HCPCS 代碼和修改項。這包括 ECM 和社區支援服務提供者提交給 MCP 用於索賠或開票的遭遇資料，以及 MCP 提交給 DHCS 用於監控計劃績效和完整性的遭遇資料。根據 ECM 和社區支援實施初期利益相關者提交的反饋意見，DHCS 已更新本指南，以提高全州資料標準化水平並減輕行政負擔。​​ 

具體而言，DHCS 添加了新的 ECM 和社區支持 HCPCS 代碼/修改器組合，並編碼了 MCP 可能不要求或允許其提供者報告 ECM 和社區支持服務的代碼或修改因子，超過指南中 DHCS 所定義的條件。 本次網絡研討會將為 MCP、ECM 和社區支持提供者以及其他有興趣的利害關係人提供了有關 ECM 和社區支持 HCPCS 編碼指南的更新進一步了解並提出問題的機會。​​ 

兒童助聽器覆蓋專案 (HACCP) 醫療服務提供者和聽力專業人員的網路研討會​​ 

12 月 19 日中午 12 點至下午 1 點，DHCS 將舉辦 HACCP 網路研討會（需提前註冊），與醫療服務提供者分享資訊，以幫助兒科病人及其家屬最大化 HACCP 福利。訓練課程將說明家庭申請承保的計劃要求，以及聽力學家、耳鼻喉科醫師、醫師及其辦公室人員的索賠申請程序。如需詳細資訊，請造訪 www.dhcs.ca.gov/haccp。​​ 

如果你錯過了​​ 

二零二四年一月醫療通訊系統轉型​​ 

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.
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