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CMS Approves California’s BH-CONNECT Initiative to Transform Behavioral Health Services​​ 

The Centers for Medicare & Medicaid Services (CMS) approved the California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) demonstration. This transformative initiative will expand access to essential behavioral health services for Medi-Cal members with significant mental health and substance use needs. Key features of BH-CONNECT include:​​ 

• 勞動力投資：支持 1.9 億美元的強大且多樣化的行為健康勞動力計劃，其中包括獎學金，貸款還款計劃，招聘激勵措施，居留和獎學金擴展以及專業發展。 勞動力計劃將由衞生護理取得及資訊部（HCAI）管理。​​ 
• Transitional Rent Assistance: Provides up to six months of rental support, through a member’s managed care plan, for eligible Medi-Cal members transitioning from institutions, congregate settings, or homelessness. This support is crucial in stabilizing individuals during vulnerable periods, significantly reducing the risk of returning to institutional care or experiencing homelessness. Transitional rent will serve as a bridge to permanent housing for members who need it. For members with significant behavioral health needs, the Behavioral Health Transformation funding dedicated to Housing Interventions will provide permanent rental subsidies and housing following Transitional Rent, providing seamless continuity, and supporting members in achieving long-term housing stability.​​ 
• 對兒童和青少年的支持：包括活動基金，以改善參與兒童福利服務接受特殊精神健康服務的青少年的機會和成果。​​ 
• 為縣提供的激勵措施：支持 1.9 億美元的訪問，改革和成果激勵計劃：獎勵縣行為健康計劃，以改善接入，減少差距和加強行為健康質量改善。​​ 
• 社區轉型接觸式服務：支持成員從長期機構住宿過渡，以確保護的持續性和成功重新融入社區。​​ 
• 短期住院精神病護理：為符合聯邦精神疾病機構標準的住院和住宿治療機構提供的短期精神健康護理提供的聯邦 Medi-Cal 資金提供了新的靈活性。​​ 

與作為第 1115 條示範批准的一部分授予的開支和豁免機關，DHCS 正在實施不需要第 1115 條示範權限的 BH-CONNECT 示範的其他功能，包括：​​  

• 以證據為基礎的實踐（EBP）的 Medi-Cal 涵蓋範圍，包括（根據縣選項提供）：​​   
  • 決心社區治療（ACT）是一種全面、以社區為基礎的跨領域團隊為基礎的服務模式，旨在幫助患有嚴重精神疾病的人應對自己的心理健康狀況的症狀，並發展或恢復社區功能的技能。​​ 
  • 法醫 ACT，為與司法系統相關的個人量身定制的 ACT 計劃。​​ 
    • 第一次精神病的協調專科護理，是一種全面、以社區為基礎的跨學科團隊為基礎的服務模式，可幫助個人應對早期精神病症狀並保持融入社區。​​ 
    • 支持就業、社區和團隊為基礎的服務的個人安置和支持模型，可幫助有行為健康狀況的個人在社區中生活功能和生產力，包括獲得和/或維持競爭力的就業。​​ 
    • 社區健康工作者服務，由值得信賴的社區成員通過特殊行為健康傳遞系統提供的預防服務，提供健康教育、倡導和導航服務，以支持成員獲取需要的醫療護理和社區資源，以解決健康的社會驅動因素。​​  
    • 會所服務是康復計劃中提供的服務，為有重大行為健康需求的人提供實體位置，以建立關係，參與工作和教育活動，並接受支持服務。​​ 
• 澄清兒童和青少年實證實踐（EBP）的 Medi-Cal 覆蓋要求，包括多系統治療，功能性家庭療法，親子互動治療和高忠誠度整合（全州實施）。通過為這些 EBP 提供更清晰的指南和保障要求，BH-CONNECT 旨在確保加利福尼亞州的更多兒童和青少年可以接受這些有效的治療。​​ 
• 管理照護計劃內的管理層級縣兒童福利聯絡人，可監督和提供增強照護管理，參加兒童和家庭團隊會議，確保管理照護服務與其他服務協調，並在護理經理遇到營運障礙時成為升級點（全州實施）。​​ 
• 卓越中心為行為健康交付系統和提供者提供培訓和技術幫助，以支持 EBP 的治療和交付的完整性（全州實施）。​​  
• 兒童進入福利時，兒童福利/專科心理健康聯合訪問（全州實施）。​​  

This multi-billion-dollar initiative combines federal, state, and local investments to create a more robust, equitable behavioral health system that prioritizes community-based solutions. By reducing emergency department visits and institutional stays, BH-CONNECT will help Californians achieve stability and recovery while building a stronger workforce and infrastructure to support long-term improvements.​​ 

Stay tuned for further updates, including stakeholder engagement opportunities and additional program details. Visit the DHCS BH-CONNECT webpage for more information.​​ 

Additionally, CMS approved an amendment to the California Advancing and Innovating Medi-Cal (CalAIM) section 1115 demonstration, effective through December 31, 2026. The CalAIM amendment expands the service duration and frequency criteria for several Community Supports, including Recuperative Care (Medical Respite) and Short-Term Post-Hospitalization Housing services, in alignment with CMS’ national policy, and makes other technical changes.​​ 

加入我們的團隊​​ 

DHCS 正在尋找一個有才華和有動力的個人，以作為：​​ 

• Chief of the Managed Care Quality and Monitoring Division to lead compliance-related activities for the state’s Medi-Cal managed care plans. These activities include, but are not limited to, developing and implementing policies, establishing standard operating procedures, engaging in continual improvement efforts, providing technical assistance, and conducting risk analysis for managed care plan audit programs in partnership with DHCS’ Contract and Enrollment Review Division. Applications must be submitted by December 26.​​ 

DHCS 還正在招聘其健康政策，信息技術和其他團隊。 有關更多信息，請訪問 CalCareers 網站。​​ 

即將舉行的利害關係人會議和網絡​​ 

長期護理（LTC）學習系列：LTC 提供者的管理護理資源​​ 

On December 17, from 9 to 10:30 a.m. PST, DHCS will host the Managed Care Resources for LTC Providers session (advanced registration required) as part of its educational LTC Learning Series. This session is designed for providers working in skilled nursing facilities, subacute care facilities, and intermediate care facilities for the developmentally disabled. Topics include Medi-Cal eligibility and managed care plan enrollment, LTC authorizations, and managed care billing and payment. Additionally, the agenda includes an overview of newly developed resources that provide information and helpful tips on various managed care topics. The session will feature managed care plan guest speakers.​​ 

LTC Learning Series participants are encouraged to submit questions in advance when registering for the session or by emailing them to LTCtransition@dhcs.ca.gov. Additional details about the LTC Learning Series are available on the CalAIM LTC Carve-In transition webpage.​​ 

DHCS 減少危害高峰會​​ 

DHCS aims to collaborate with communities across the state to promote harm reduction and low-barrier, patient-centered care within California’s substance use disorder treatment system. DHCS encourages substance use disorder treatment providers and staff (including social workers, peers, front desk staff, case managers, nurses, physicians, and all staff in substance use disorder treatment settings) to attend and learn about best practices for incorporating the tenets of harm reduction into substance use disorder treatment. Summits will be held in Fresno, Los Angeles, and San Diego counties in winter 2025. Register on the event website.​​ 

如果你錯過了​​ 

過渡至聯邦醫療保險 A 部分購買協議​​ 

On January 1, 2025, California will become a Medicare Part A buy-in state, meaning eligible Medi-Cal members will receive Medicare Part A services for free if they are enrolled in Medicare Part B and they qualify for the Qualified Medicare Beneficiary (QMB) program. For these members, Medicare, instead of Medi-Cal, will provide primary coverage for hospitalizations and other inpatient benefits covered through Medicare Part A. California’s new Medicare Part A buy-in agreement with the federal Centers for Medicare & Medicaid Services will eliminate the conditional enrollment requirements for Medicare Part A at the Social Security Administration. As a Part A buy-in state, California can enroll eligible QMB members in Medicare Part A year-round through a streamlined enrollment process without any late enrollment penalties.​​ 

提供存取和轉型健康 (PATH) 容量和基礎設施、過渡、擴展和開發（CITED）第四輪申請​​ 

在 2025 年 1 月 6，DHCS 將打開「路徑被引用第四輪」申請窗口。 PATH CITED 計劃提供資金，以建立現場合作夥伴的能力和基礎設施，包括社區組織，醫院，縣機構，部落和其他人，以成功參與 Medi-Cal。 申請 CITED 第四輪資助的截止日期為太平洋標準時間 2025 三月 7 日下午 11 時 59 分。 鼓勵有興趣的組織查閱申請大綱和指導文件，以協助準備申請。 請向 cited@ca-path.com 提交問題。​​