DHCS Stakeholder News – January 27, 2023
熱門新聞
聯邦合作夥伴批准與司法相關的豁免
1 月 26 日,聯邦醫療保險中心 & 醫療補助服務(CMS)通知加利福尼亞州,它是美國第一個獲得批准,為州監獄、縣監獄和青少年懲教設施的青年和成年人提供一套針對性醫療補助服務的州,最多在釋放前 90 天。 作為我們改變 Medi-Cal 的工作的一部分,通過聯邦 Medicaid 1115 示範豁免,DHCS 將建立一個協調的社區重新進入過程,該過程將幫助離開監獄的人在釋放時與他們所需的身體和行為健康服務連接。
這次示範的目的是為與正義相關的 Medi-Cal 成員建立一個社區基礎的照顧之橋樑,為他們提供穩定病情的服務,並在釋放前為他們的社區基礎護理建立重新入境計劃。 這應該會減少照護中的差距,改善健康成果,並預防不必要進入住院醫院,精神科醫院,護理院和急診部,並減少過量、自殺、無家可歸和再次性。
此外,豁免授權 4.1 億美元用於提供醫療服務和醫療改革、司法介入能力建設補助金以支援合作規劃,以及旨在支援釋放前和重返社會規劃實施的 IT 投資。
DHCS 為我們的合作夥伴開發了社交媒體工具包。請廣泛分享此工具包,讓那些可能會發現此資訊有幫助的人知道。如需詳細資訊,請造訪Justic-Involved 網頁。
開設 CalAIM 提供訪問和轉型健康(PATH)技術支持(TA)市場
On January 31, DHCS will open the virtual PATH TA Marketplace to the public. The TA Marketplace is a virtual marketplace for partners and potential partners to receive technical assistance services to support the implementation of California Advancing and Innovating Medi-Cal (CalAIM), including Enhanced Care Management (ECM) and Community Supports. The TA Marketplace is a one-stop-shop website where entities can find and be connected to TA resources from curated and approved providers. TA offerings include the option to request custom, hands-on technical support or to request off-the-shelf TA products, which are packaged and ready for implementation.
To receive no-cost services, providers, community-based organizations, Medi-Cal Tribal and Designees of Indian Health Programs, counties, and other eligible TA recipients will be able to submit a Recipient Registration form that, once approved, will allow registrants to shop and apply for TA services beginning in February 2023.
Please visit ca-path.com/ta-marketplace to learn more.
專案更新
DHCS 獲得杜拉州計劃修訂(SPA)的批准
On January 26, CMS informed DHCS that it had approved State Plan Amendment (SPA) 22-0002 for doula services, and that DHCS would receive the approval letter on January 27. The approved SPA will be posted on the DHCS webpage by February 3. DHCS submitted the SPA to CMS on November 7, 2022, after working with stakeholders for more than a year to develop the benefit. The coverage description reflects the input from the Doula Stakeholder Workgroup and other stakeholders on the description of covered services and the qualifications of doulas. The final meeting of the current doula workgroup was held on January 26. The Doula Implementation Workgroup, required by section 14132.24 of Welfare and Institutions Code pursuant to Senate Bill 65 (Chapter 449, Statutes of 2021), will hold its first meeting on March 30. The new workgroup will examine issues of service availability, payment, and outreach, as identified in the statute. More information is available on the doula webpage.
DHCS 重新開放 PATH 與正義相關的第二輪融資
1 月 30 日,DHCS 將重新開放 PATH 涉及正義倡議第二輪申請。 第二輪資助將支持懲教機構、機構和其他與司法相關的利益相關者,他們實施發放前 Medi-Cal 註冊和暫停流程。 有關更多信息,請訪問與正義相關的能力建設計劃網站。
Medi-Cal 管理護理計劃(MCP)註冊醫療保健/醫療卡雙重資格
Effective January 1, 2023, members dually eligible for Medicare and Medi-Cal across the state became eligible to be mandatorily enrolled in Medi-Cal MCPs for their Medi-Cal benefits only. As a reminder to our stakeholders, this change in Medi-Cal does not change access to Medicare providers or benefits. Additionally, Medicare providers serving dual eligible patients do not need to enroll in a Medi-Cal MCP to continue receiving reimbursement. More than 70 percent of dual eligible members statewide are already enrolled in Medi-Cal MCPs; this step transfers the remaining 30 percent into Medi-Cal MCPs.
DHCS published an updated fact sheet and toolkit for Medicare providers to explain the provider billing process for dual eligible members enrolled in Medi-Cal managed care. This fact sheet describes the existing crossover billing process, which does not change under CalAIM.
For patients in Original (fee-for-service) Medicare, the Medicare Administrative Contractor processes the primary claim for Medicare payment, and then forwards the claim to the Medi-Cal MCP (or DHCS) for secondary Medi-Cal payment. For patients in Medicare Advantage (MA), the Medicare provider bills the MA plan for primary payment. The secondary payment process may depend upon whether the patient’s Medi-Cal MCP is the same as or different than the MA plan. For more information, please visit the Statewide Medi-Cal Managed Care Enrollment for Dual Eligible Members webpage.
加利福尼亞州微笑醫療牙科服務活動
On February 1, the National Children’s Dental Health Month promotion will launch, focusing on the importance of preventive dental care. The theme, Love Your Teeth, will be weaved into existing and new resources and messaging for promotion on SmileCalifornia.org and SonrieCalifornia.org.
加入我們的團隊
DHCS 正在招聘!DHCS 現正招募新的計畫營運長。此高級主管職位負責領導和監督該部門三個主要營運領域的所有方面:企業資料與資訊管理、企業技術服務及計畫營運。
DHCS 也正在為我們的財務、人力資源、法律、審計、健康政策和資訊技術團隊進行招聘。如需詳細資訊,請造訪CalCareers 網站。
DHCS 致力於維護和改善所有加州人的整體健康和福祉。DHCS 的使命是為最脆弱的居民提供公平獲得可負擔、綜合、高品質醫療照護的機會,目前正在改革 Medi-Cal 計畫,以確保它能提供加州人所需的照護,讓他們活得更健康、更快樂。
即將舉行的利害關係人會議和網絡
康復部(DOR)國家任命工作坊
On January 30, from 12 to 1 p.m., DOR Director Joe Xavier and Governor Newsom’s Appointments Secretary Cathryn Rivera will host a virtual informational workshop (advance registration required) to provide an overview of the state appointments process and why it is important to have disability representation on state boards and commissions. For more information about state appointments, including a current list of state board and commission vacancies, please visit the Office of the Governor’s Appointments webpage.
California Children’s Services (CCS) Monitoring and Oversight Workgroup Webinar
On January 30, from 12 to 4 p.m., DHCS will virtually host the CCS Monitoring and Oversight Workgroup meeting (advance registration required) to develop and implement the CCS Compliance, Monitoring, and Oversight Program, a component of the CalAIM initiative. Agenda topics for discussion at this meeting include the Grievance Numbered Letter (NL), Training NL, Surveying NL, Memorandum of Understanding development, compliance activities, and enforcement proposal. Additional information is available on the CCS Compliance, Monitoring, and Oversight Program webpage.
CalAim 技術護理設施(SNF)培養網絡研討會:Medi-Cal 管理護理如何支持新西蘭基金會居民
On January 30, from 2 to 3 p.m., DHCS will virtually host the fourth in a series of public educational webinars for the SNF Carve-In (advance registration required) to support Medi-Cal MCPs and SNF providers as they implement Medi-Cal managed care coverage of SNFs statewide that began on January 1, 2023. The webinar will provide an overview of key Medi-Cal managed care benefits, services, and programs that supports current SNF residents and SNF residents transitioning back to their home or community. Additional details on upcoming webinars are available on the CalAIM LTC Carve-In transition webpage.
藥物醫藥組織分配系統 (DMC-ODS) 行為健康資訊通知 (BHIN) 網路研討會的更新概述
On January 31, from 11 a.m. to 12 p.m., DHCS will host a webinar (advance registration required) to provide an opportunity for stakeholders to learn about updates related to the DMC-ODS. Specifically, DHCS will discuss updates to BHIN 21-075. Time will be reserved at the end of the webinar for a questions and answers session. A recording of the webinar will be available following the webinar. For more information, visit the CalAIM Behavioral Health Initiative webpage. For questions, email BHCalAIM@dhcs.ca.gov. You will find a copy of the agenda here.
PATH 與正義參與倡議第二輪資助資訊網絡研討會
1 月 31 日上午 10:30 至下午 2:00,DHCS 將舉辦資訊網路研討會(需提前報名),在 3 月 31 日新的 PATH 正義介入計畫第 2 輪資金申請截止日期之前,為有興趣的實體提供申請支援。會議邀請函和其他詳細資訊將可在司法介入能力建構計畫網站上取得。如有任何疑問,請聯絡CalAIMJusticePreReleaseApps@dhcs.ca.gov。
護理設施融資改革網絡研討會
2 月 1 日下午 1:30 至 2:30,DHCS 將舉辦護理設施融資改革網路研討會(需提前報名),討論由眾議院第 186 號法案(2022 年成文法第 46 章)授權的勞動力標準計劃的發展。如需其他資訊,請參閱Nursing Facility Financing Reform 網頁。
健康註冊導覽器網路研討會
On February 6, from 1 to 2:30 p.m., the Health Enrollment Navigators Project is virtually hosting a joint stakeholder meeting with county and community-based organization partners, advocates, and other interested individuals to provide updates and answer questions on the DHCS Navigators Project team. Information regarding this meeting, other general information, and updates will be available on the Health Enrollment Navigators Project webpage. Interested parties may also request to be added to the meeting notice by emailing HealthNavigators@dhcs.ca.gov.
提供者註冊提供者公告利益相關者會議
2 月 9 日,DHCS 將透過網路研討會舉行兩場公眾利害關係人會議,討論監管提供者公告。從商業地址遠端或間接提供服務的醫療服務提供者註冊 Medi-Cal 的要求和程序」將於上午 10 點至 11 點 30 分舉行。停止 COVID-19 緊急付費服務 Medi-Cal 註冊」,將於下午 1:30 至 3:00 舉行。利害關係人有機會在聽證會中提出問題和建議;聽證會當天接受書面意見,截止時間為下午 5 點。根據收到的公眾意見,DHCS 將在Medi-Cal和DHCS網站上公佈最終公告。變更將於公佈後 30 天生效。
如果你錯過了
CalAIM 行為健康行政整合概念文件發表,供公眾評論和網絡研討會
DHCS 已發佈 CalAIM 行為健康行政整合計畫的概念文件,其目的是在 2027 年前將 Medi-Cal 特殊心理健康服務計畫和 Medi-Cal 藥物或 DMC-ODS 服務合併為單一以縣為基礎的行為健康計畫。DHCS 接受利益相關者對概念文件中所述方法的反饋意見,截止日期為 2 月 21 日。請將所有意見以書面形式提交至bhcalaim@dhcs.ca.gov。雖然 DHCS 不打算發佈經修訂的概念文件,但在評論期間收到的反饋意見將為 DHCS 的政策決策、執行策略以及考慮可能的指南和其他技術援助材料提供資訊。如需詳細資訊,請造訪行為健康 CalAIM網頁。
危機復原資源
如果您或您認識的人感到壓力,焦慮,抑鬱,或需要情緒支持,請提供幫助。 以下是資源列表,包括心理健康服務,以及對經歷自然或人為造成災害的人提供支持。
緊急或危機應變(所有州)
- 911:如果您遇到緊急情況並需要立即幫助,請致電 911。
- 988:如果您正在遇到自殺危機或情緒困擾,並需要機密的情緒支持,請致電或發短信 988 以英語或西班牙語尋求幫助。 988 Lifeline 為遇難的人提供全天候的免費和機密支持,為您或您的親人提供預防和危機資源,並為美國專業人士提供最佳做法。 聊天服務可於 988 lifeine.org 提供。
災難支援 (所有州)
- SAMHSA Disaster Distress Helpline: If you’ve experienced a natural or human-caused disaster, you can call or text the SAMHSA Disaster Distress Helpline’s toll-free number (1–800–985–5990) and receive immediate counseling. This free, confidential, multilingual crisis support service is available to anyone experiencing distress as a result of a natural or human-caused disaster. People who call and text are connected to trained, caring professionals from crisis counseling centers in the network. Helpline staff provide confidential counseling, referrals, and other needed support services.
- 服務提供商和其他專業人士的 SAMHSA 災難資源:美國藥物濫用和心理健康服務管理局(SAMHSA)還為行為健康提供者,急救人員和其他專業人士提供災難支持資源和技術幫助。 請瀏覽:
SAMHSA 災難技術援助中心
- 創傷壓力研究中心(CSTS):CSTS 是一個基於聯邦學術的組織,致力於提高創傷知識,領導力和方法。 CSTS 為受害者、家庭成員、急救人員和社區領袖提供免費的資料表和資源。
心理健康資源(加利福尼亞州)
- CalHope:CalHope 為感到壓力,焦慮,抑鬱或擔憂的人提供免費支持。 Calhope.org 網站是訪問多個 CalHope 資源的中心。 在「一起為健康」/「我們的健康團隊」中提供 10 種語言的在線工具,這些工具已經選擇以滿足不同文化團體的需求。 如果您想與某人聊天,卡爾霍普通是您好去的地方,如果您想與某人交談,卡爾霍普熱線電話號碼 833 317-HOPE(4673)就會為您服務。
- 全國精神疾病聯盟 (NAMI) 加利福尼亞州: NAMI California 是一個由生活受到嚴重精神疾病影響的家庭和個人所組成的草根組織。加州當地的 NAMI 分支機構為心理健康狀況患者及其家人提供免費的支援小組和課程。尋找您當地的分會,瞭解更多有關如何尋找幫助和希望的資訊。
- 現任和前寄養青少年(FURS)的家庭緊急應變系統(FURS):FURS 是一個免費的全州範圍內的 24 小時熱線,供當前或前寄養青少年和您的照顧者致電並獲得即時幫助,解決大小問題。 除了熱線支援外,流動應變小組亦可為現任及前寄養青少年及其照顧者提供即時受創傷資訊的支援。 如果您是現任或前寄養青少年或照顧者,請致電 833-939-3877 或訪問 cal-furs.org 尋求幫助。
醫療服務受益人的心理健康和藥物使用資源(加利福尼亞州)
如果您是 Medi-Cal 受益人,則為精神健康和物質使用條件提供的服務受保。 您可以通過 Medi-Cal 託管護理計劃或您的縣行為健康計劃獲得心理健康或物質使用支持:
- Medi-Cal 託管護理:如果您註冊了 Medi-Cal 託管護理,您的 Medi-Cal 託管護理計劃將您與 Medi-Cal 涵蓋的兒童和成人的心理健康服務聯繫起來。
- County Mental Health Services: Your county mental health plan can also connect you to appropriate services, including treatment for adults with more severe mental health conditions. Specialty mental health services for children are also covered. Contact information for each county’s Medi-Cal specialty mental health plan is available here: County Mental Health Access Lines.
- 縣物質使用服務: 如果您需要酒精或藥物使用方面的協助,您所在的縣可為您連線 Medi-Cal 物質使用服務。您可以使用此處提供的電話號碼聯絡您所在的縣,以獲得藥物使用資訊和服務:縣藥物使用障礙求助專線。
通過 Medi-Cal 提供的專科和非專業精神健康服務 包括但不限於:
- 評估和治療,包括個人、團體和家庭治療
- 精神健康狀況的藥物及相關支援服務
- 護理協調
- 危機干預及穩定
- 住院或住院精神科醫院治療
Medi-Cal 涵蓋的物質使用服務包括但不限於:
- 評估和治療,包括個人和小組諮詢
- 成癮治療藥物(MAT)
- 密集門診治
- 護理協調
- 住宿治療(適用於所有 21 歲以下的青少年,懷孕期間和懷孕後即時,以及某些縣的成年人)
早期和定期篩查、診斷和治療(EPSDT)醫療保障:EPSDT 涵蓋的福利為 21 歲以下註冊 Medi-Cal 的個人提供全面和預防性的健康護理服務。 這些服務是確保兒童和青少年獲得適當的預防性醫療、牙科、視力、聽力、精神健康、藥物使用障礙、發展和專科服務,以及所有必要的服務,以解決任何發現的缺陷、疾病或條件的所有必要服務。 精神健康和物質使用服務包括 EPSDT 福利的一部分,以及醫生、護士和醫院服務;身體、言語/語言和職業治療;家庭健康服務;以及視力、聽力和牙科疾病和疾病的治療。