DHCS Stakeholder News – July 29, 2022
衞生護理服務部(DHCS)正在提供有關 DHCS 計劃的重要發展的更新,以及與 COVID-19 公共衛生緊急情況(PHE)有關的指導。
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關於持份者每兩個月更新的公告
DHCS 正在整合其利益相關者更新,未來將發布每週利益相關者新聞電子郵件,而不是每兩個月更新。 這項變更將使利害關係人更頻繁地接收更及時的新聞。
ACE 認知
The ACEs Aware initiative released a new quarterly data report detailing the number of Adverse Childhood Experience (ACE) screenings conducted for children and adults in California between January 1, 2020, and September 30, 2021. The data show that Medi-Cal clinicians – primarily pediatric, family medicine, and behavioral health professionals – conducted approximately 987,500 ACE screenings of more than 793,000 unique Medi-Cal beneficiaries.
The report also tracks the number of clinical team members that completed the “Becoming ACEs Aware in California” online training between December 4, 2019, and May 31, 2022. The data show that more than 23,400 individuals have taken the ACEs Aware training, 11,900 of whom are Medi-Cal clinicians who are ACEs Aware-certified and eligible to receive Medi-Cal payment for conducting ACE screenings.
行為健康持續基礎設施計劃(BHCIP)更新
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. Funding is being released through several rounds for the expansion of behavioral health facilities, here is an update on upcoming rounds:
- BHCIP 第四輪:兒童及青少年
Round 4 focuses on children and youth ages 25 and younger, including pregnant and postpartum people and their children, children, and transition-age youth, as well as their families. All applicants must demonstrate how their infrastructure project will expand behavioral health services for this population exclusively. DHCS will award $480.5 million for children- and youth-focused behavioral health infrastructure projects in this fourth round of competitive grants. The deadline to submit applications for the Request for Application (RFA) for Round 4: Children and Youth is August 31, 2022. Applicants will be expected to demonstrate “project readiness”, as detailed in the posted 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.
- BHCIP 第 5 輪和第 6 輪:第 5 輪和第 6 輪目前處於規劃階段。第 5 輪:危機連續性的聽取會議預定於 8 月 4 日下午 1 點至 2 點舉行,為符合資格的申請人提供直接向 DHCS 提供意見的機會,以便為 BHCIP 第 5 輪的規劃和實施提供資訊。第 5 輪聆聽會必須註冊。如需 BHCIP 的詳細資訊,請造訪 BHCIP 專案網站或寄電子郵件至 BHCIP@dhcs.ca.gov。
牙科轉型倡議
On August 1, DHCS will begin issuing final Dental Transformation Initiative (DTI) payments for specific domains. The Budget Act of 2022 included $30.2 million to make DTI payments in fiscal year (FY) 2022-23 and $1.5 million in FY 2023-24. The DTI consisted of four domains to improve dental health for Medi-Cal children by focusing on high-value care, improved access, and utilization of performance measures to drive delivery system reform.
Domain 1 compensated service office locations with incentive payments for select preventive services if the provider increased enrolled Medi-Cal beneficiary utilization. Domain 2 allowed participating Medi-Cal Dental providers to receive payments for providing services to enrolled Medi-Cal beneficiaries, ages 6 and under, for a bundled service that included a caries risk assessment, treatment plan, nutritional counseling, and motivational interviewing. Domain 3 provided annual incentive payments to service office locations that maintained continuity of care for enrolled Medi-Cal beneficiaries. Dental managed care plans are not offered these incentive payments given the inherent requirement that managed care delivery systems provide continuity of care for their covered populations.
領域 1 和領域 2 的付款將支付給全州 Medi-Cal 牙科付費服務 (FFS) 提供系統中所有符合資格的 Medi-Cal 牙科服務提供者,包括符合資格的安全網診所(如聯邦合格醫療中心、鄉村醫療診所和印第安人醫療服務/協議備忘錄診所(社區醫療中心)),以及 Sacramento 和洛杉磯縣的牙科管理性護理提供系統。領域 1 的付款將於 8 月 1 日當週發出,領域 2 的付款將於 8 月 8 日當週發出。領域 3 的付款也將於 8 月 1 日當週支付給 FFS 醫療服務提供者。
DHCS 預計這個付款週期是領域 1 和領域 2 的最後一次付款,另外一次領域 3 的付款將於 7 月3,2023 。將於 7 月 29 日在 Medi-Cal 牙醫保健提供者公告網站發佈和出版一份特別提供者公告,以通知提供者。
Domain 4, Local Dental Pilot Projects (LDPP), addressed Domains 1-3 through local pilot programs aimed at specific demographics. The goals were to address one or more of the three domains through alternative programs and potentially use strategies focused on rural areas, including local case management initiatives and education partnerships. As of December 31, 2020, all 13 LDPPs concluded their operations and began their administrative closeout phase.
加強審查設定公開評論期間
7 月 29 日,DHCS 公佈了居家和社區服務 (HCBS) 設定最終規則文件,以徵求 30 天的公眾意見。這包括 115 家被 DHCS 確定為需要加強審查的生活輔助和集中居住保健設施的摘要表,這些設施後來被 DHCS 確定為符合 HCB 設定最終規則的標準。
根據 HCB 設定最終規則的要求,州政府必須確定哪些設定被假定為具有機構特質。這些環境包括1) 在提供住院機構治療的公有或私有設施內;2) 在公共機構內,或緊鄰公共機構;或 3) 將接受 Medi-Cal 資助 HCBS 服務的個人與更廣泛的社區隔離。只有在州政府確定該環境克服了機構推定時,才會啟動加強審查程序;因此,州政府向聯邦醫療保險& 聯邦醫療補助服務中心 (CMS) 提交的任何加強審查環境,都是那些已證明其本質上不是機構的環境。
對於每一種設施環境,都有一份摘要表,說明該設施環境、需要加強審查的原因,以及支持 DHCS 認定該設施環境符合 HCB 設定最終規則標準的可用證據,供公眾在 7 月 29 日至 8 月 28 日期間提出意見。
DHCS HCBS 全州過渡計劃網頁上有提交公眾意見的說明。DHCS 將收集此資訊,並更新全州過渡計劃的最終版本,以便在提交 CMS 之前再給公眾一個評論期。DHCS 鼓勵利益相關者繼續訪問網站以獲取更多資訊,如有任何問題,請發送電子郵件至STP@dhcs.ca.gov。
猴子花更新:實驗室計費
7 月26 ,2022 ,美國醫學協會現行程序術語 (CPT) 編輯小組建立並發佈了 CPT代碼,以簡化目前在美國可用的矯正痘病毒和猴痘檢測報告,其中包括實驗室檢測的代碼:
- 87593:通過核酸(DNA 或 RNA)檢測傳染病因;正直腸病毒(例如猴子花病毒,牛花病毒,疫苗病毒),擴大探測技術,各種。
目前,該新代碼尚未被編程用於 FFS Medi-Cal 的計費。Medi-Cal 將在索賠裁決系統準備就緒時發佈公告,並發布供應商在對猴痘檢測代碼進行計費時應使用的其他說明。在此之前,建議醫療服務提供者在有醫療指徵時進行測試,並暫緩提交 Medi-Cal 索賠申請,直至另行通知。
Testing is becoming more available, with several large commercial laboratories, including Labcorp, Quest, Aegis, Mayo Clinic Labs, and Sonic Healthcare, offering testing. Testing is also available by some local public health laboratories. There is no fee for public health testing, and commercial testing should be billed as indicated above. At this time, the federal government has allocated a limited number of monkeypox vaccine doses to California, and the California Department of Public Health (CDPH) is working with local health departments to make available these doses.
隨著相關指引的發布,DHCS將繼續向所有Medi-Cal醫療服務提供者更新和通報與猴痘相關的檢測和疫苗接種資訊。
CDPH和疾病管制與預防中心的網站均提供了有關猴痘症狀、檢測、治療和疫苗接種的進一步指導。
牙科提供者申請和註冊驗證(PAVE)門戶網站
10 月 31 日,DHCS 將為牙科服務提供者實施 PAVE 入口網站。PAVE 入口網站是以網路為基礎的應用程式,旨在簡化並加速註冊程序。PAVE 將提供一個新的模式,讓申請人使用 Medi-Cal 提供者電子表格申請表,向 DHCS 提交牙科提供者註冊申請和所需文件。一旦實施 PAVE,DHCS 將不再接受紙質申請表。
歡迎牙科從業人員參加線上演示。該系列講座分為兩部分,將於 8 月 24 日開始介紹 PAVE,並於 10 月概述主要功能。PAVE系統實施後,將於11月安排一次更深入的培訓課程。每節課時長一小時。示範過程將會錄製下來,並發佈在 DHCS PAVE 網頁上,以供日後參考。DHCS 將於 8 月 8 日發布特別供應商公告,通知供應商即將進行的培訓。
全州 HCBS 差距分析和多年路線圖 — 承包商選擇
2022 年 3 月,DHCS 發佈了一份資訊徵求 (RFI),向有興趣的各方徵求資訊,以協助 DHCS 開展一項重大計畫,對加州的 HCBS 和 Medi-Cal 長期支援與服務 (MLTSS) 計畫和網路進行全州範圍的差距分析和多年期路線圖。DHCS 收到了多份競標書,並通過其嚴謹的選擇過程,確定 Mathematica 最適合實現 Money Follows the Person (MFP) Supplemental Funding - Gap Analysis and Multiyear Roadmap 的目標。DHCS 計劃在 8 月與 Mathematica 敲定合約/工作範圍,承包商將在合約執行後立即開始工作。差距分析將於 9 月前提交30,2023, 多年期路線圖將於 3 月前提交31,2024 。DHCS 將於 6 月30,2024 前向利益相關者和立法者提交最終成果。
已發佈的 COVID-19 信息
- 更新:中醫新冠肺炎疫苗接種率
- SPA 22-0037:選擇性服務範圍修改
即將舉行的利害關係人會議和網絡
CalAIM 網絡研討會和辦公時間:增強護理管理(ECM)和社區支持計劃數據交換概述
8 月 4 日上午 10:30 至中午 12 點,DHCS 將舉辦一場關於 ECM 和社區支持所需資料交換的網路研討會,主要針對 2022 年 7 月啟動 ECM 的縣的管理式醫療計劃 (MCP) 和醫療服務提供者,但也向所有人開放,作為複習資料。DHCS 將概述去年發布的指導文件和相應的資料流,重點關注 MCP 與 ECM 和社區支援提供者之間發生的資訊交換。本次網路研討會針對 ECM 和社區支援提供者、MCP 以及其他參與 ECM 和社區支援實施的人員。
There will be time reserved during the webinar for participant questions and answers, as well as a follow-up office hours session for further questions on August 11, from 2 p.m. to 3 p.m. Advance registration is required for the ECM webinar and the office hours session. Please email CalAIMECMILOS@dhcs.ca.gov with any questions.
Medi-Cal 以消費者為中心的利益相關者工作小組(CFSW)會議
8 月 5 日,DHCS 將透過網路研討會主持下一次 CFSW 會議。有關該工作組的其他資訊,請參閱CFSW 網頁。如有任何疑問,請發送電子郵件至DHCSCFSW@dhcs.ca.gov。