尊敬的利益相關者，​​ 

衛生護理服務部（DHCS）正在提供有關 DHCS 計劃的重要發展的更新。​​ 

七月是殘疾驕傲月​​ 

DHCS celebrates the culture, diversity, and contributions of people with disabilities during Disability Pride Month. The Americans with Disabilities Act (ADA) was passed on July 26, 1990, prohibiting discrimination against people with disabilities, and giving rise to this important celebration. DHCS is committed to work toward a healthier California where all individuals can live with purpose and dignity and are supported and valued.  

DHCS provides Californians with disabilities access to affordable, integrated, high-quality health care to preserve and support their overall health and well-being, and strives toward health equity to ensure equal opportunities for all Californians. DHCS, in collaboration with sister departments, oversees a variety of programs serving persons with disabilities, including: California Children’s Services, the Genetically Handicapped Persons Program for adults, the Home and Community-Based Alternatives Waiver, and Home and Community-Based Services for individuals with intellectual and developmental disabilities. DHCS also makes available many other resources to support persons with disabilities. DHCS will continue to support Californians with disabilities through high-quality and person-centered care.​​ 

最終人口健康管理（PHM）策略和路線圖​​ 

5,2022 ，DHCS 發佈了PHM 最終戰略和路線圖，其中納入了利益相關者對 PHM 架構所有組成部分的反饋意見。DHCS 感謝利益相關者所提供的深思熟慮的意見，這些意見有助於改善該部對 PHM 的願景。需要提醒的是，DHCS 將於 2023 年 1 月推出PHM 計畫，這是加州進步與創新 Medi-Cal (CalAIM) 的基石。PHM 計畫將建立一個具凝聚力的全州性方法，以確保所有 Medi-Cal 會員都能獲得一個全面性的計畫，從而獲得更長壽和更健康的生活、改善健康成果以及促進健康公平。該路線圖概述了主要政策措施和責任機制，定義並描述了 PHM 概念和術語，並詳述了 2023 年和 2024 年 Medi-Cal 管理性護理計劃 (MCP) 的要求。最終 PHM 策略和路線圖可在 DHCSCalAIM 人口健康管理網頁上獲得。如果您有任何問題，請發送電子郵件至 CalAIM@dhcs.ca.gov。​​ 

雙重資格政策更新​​ 

As a component of CalAIM, DHCS is implementing policies to promote integrated care for beneficiaries dually eligible for Medicare and Medi-Cal. Under this effort, for contract year 2023, DHCS will limit new Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs) and expanded county service areas to only those D-SNPs with an ongoing affiliation with Medi-Cal MCPs. This policy, which is in line with the federal approach and in other states, is being implemented because when a county has separate health plans for Medicare and Medi-Cal benefits, there can be beneficiary and provider confusion, duplication of care managers, and more complexity for hospital and nursing home discharge planners.

This approach in 2023 will not result in any members needing to disenroll from their existing Medicare plans. To avoid Medicare provider network disruption, DHCS will continue any existing D-SNP contracts and service areas so members in existing D-SNPs will not be required to disenroll.​​    

Having Medicare and Medi-Cal benefits managed by the same organization is an important component of CalAIM, and aligns with DHCS’ Managed Long-Term Services and Supports (MLTSS) strategy. In 2023, CalAIM policies will provide a more robust Medi-Cal managed care delivery system for dual eligible beneficiaries statewide, including: mandatory Medi-Cal managed care enrollment; Medi-Cal managed care carve-in of skilled nursing facility care; and Enhanced Care Management for populations who are at risk for long-term skilled nursing facility care, or who reside in a nursing facility and want to transition to the community. In addition, Community Supports services designed to address social drivers of health will continue to be implemented by Medi-Cal MCPs.​​  

兒童和青少年行為健康倡議（CYBHI）索取信息（RFI）​​ 

7 月 6 日，DHCS 發佈了 CYBHI 的RFI，邀請供應商提供資訊給 DHCS，以協助規劃、設計、開發，並在 2024 年 1 月前推出行為健康虛擬服務平台。DHCS 將於 7 月 13 日為潛在 供應商舉 辦 供應商會議 。

作為 2021 年預算法案的一部分，CYBHI 是一項多年期、跨部門的一籃子投資，旨在重新構想支援加州所有兒童、青少年及其家庭行為健康的系統，不論支付方為何。工作重點為促進社會和情緒健康、預防行為健康挑戰，以及針對 0-25 歲兒童和青少年新興和現有的行為健康 (心理健康和藥物使用) 需求，提供公平、適當、及時且容易獲得的服務。CYBHI 立足於注重公平；以兒童和青少年的聲音、優勢、需求、優先事項和經驗為中心；推動轉型系統變革；以及將持續學習作為改變和改善兒童和青少年成果的基礎。​​ 

CYBHI 的一個工作流程是建立和推動採用行為健康虛擬服務平台，以支持從預防到治療到康復的公平，適當和及時的行為健康服務提供，並為兒科和基層醫療提供者提供電子諮詢平台，以便與行為健康提供者進行電子諮詢。​​