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DHCS 對南加州森林火災的回應

On January 7 and 8, multiple fires erupted in the Los Angeles County area. DHCS is actively engaged in addressing the impacts of the fires. DHCS is working alongside local and federal partners to support health care facilities, ensure continuity of care, and prioritize the safety of affected residents. Specifically, DHCS is coordinating with facilities to manage evacuations and maintain care for residents and is supporting health care providers as they navigate road closures and other disruptions.

DHCS’ Emergency and Disaster Assistance Questions & Answers webpage provides guidance and contact information for Medi-Cal members and providers during emergencies. It includes information related to accessing medical care, filling prescriptions, securing transportation, and obtaining support for individuals with specific needs, including people in assisted living facilities and individuals receiving Home and Community-Based Alternatives services.

加州州長緊急事務辦公室與復健局共同編製了《身心障礙者緊急應變指南／工具包》，該指南提供多種語言版本，內容包含針對特定身心障礙族群的相關資訊及緊急應變建議。請追蹤加州消防局（Cal Fire）及當地緊急應變單位，以獲取野火的即時更新資訊，並至calalerts.org 訂閱當地警報。如需更多資訊，請參閱以下補充資源：

• CA.gov/LAfires– 為受洛杉磯野火影響的加州居民提供相關資源。
• Listos California– 提供緊急警報註冊頁面，協助加州居民根據提供的郵遞區號或位置，連結至當地的警報系統。
• Ready.Gov – Provides guidance for individuals and families to prepare for, respond to, and recover from wildfire events. The resource includes tips for staying safe during wildfires and returning home once an area is declared safe.
• 美國藥物濫用與心理健康服務署野火資源——為受野火及其他災害影響的倖存者、家屬、應急人員及災後重建工作者提供支援。相關資訊包含情緒困擾的徵兆、在野火過後可能面臨較高情緒困擾風險的族群，以及可獲取更多資訊與支援的資源連結。
• 美國疾病控制與預防中心（CDC）—— 提供有關各類災害（包括野火）的資訊，並提供相關連結，協助民眾了解野火過後如何確保安全，以及如何認識並應對野火及其他災害所帶來的風險。
• American Red Cross – Suggests ways for people who have experienced a residential fire to take care of themselves and their loved ones and to help people who may need assistance. The site lists four steps to take right after a fire and includes links to more information about returning home safely after a fire and recovering emotionally and financially.
  

DHCS 繼續致力於在這個充滿挑戰的時期為社區提供支持，並感謝現場的緊急救援人員和醫療保健工作人員。 保持安全，查看官方更新以獲取最新信息，並遵循當地官員發出的疏散命令。

建議的 DHCS 2025-26 年度財政預算案

The proposed 2025-26 Governor’s Budget for DHCS allocates $193.4 billion in total funds, including $42.8 billion from the General Fund, and supports 4,821.5 positions. This budget reflects the Administration’s continued investment in transforming Medi-Cal into a coordinated, person-centered, and equitable health system for Californians.

The budget prioritizes modernizing the health care delivery system, with a focus on improving accountability and transparency and strengthening community-based care. These strategic investments support DHCS’ purpose to provide equitable access to quality health care, leading to a healthy California for all.

專案更新

國家計劃修正案（SPA）批准用於二代化服務

On January 6, the federal Centers for Medicare & Medicaid Services (CMS) approved SPA #23-0010, which authorizes DHCS to utilize an Alternative Payment Methodology (APM) to pay Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHC), and Tribal Health Programs, which includes Tribal FQHCs and Indian Health Services-Memorandum of Understanding 638 Clinics, at the Medi-Cal fee-for-service (FFS) rate for dyadic services in certain circumstances. FQHCs and RHCs will receive a separate payment for dyadic services in addition to their standard Prospective Payment Services/All-Inclusive Rate billing payments in certain circumstances.

Dyadic care refers to serving both the parent/caregiver and child together as a dyad and is a form of treatment that targets family well-being to support healthy child development and mental health. Dyadic care fosters team-based approaches to meeting family needs, including addressing mental health and social support concerns, and it broadens and improves the delivery of pediatric preventive care. Offering parents and caregivers mental health services when they bring their babies and children to the doctor is an opportunity to expand access, which can improve outcomes. DHCS will release additional policy guidance in a future Medi-Cal Provider Manual update.

轉換至新家庭協定入口網站

From January 13 through February 2, DHCS’ Family Planning, Access, Care and Treatment (PACT) program’s client eligibility and enrollment transaction services will transition from the Health Access Programs (HAP) Client Eligibility System to a new Family PACT portal. The HAP Client Eligibility System will be disabled on February 3, after which all Family PACT client enrollment, changes, and deactivations will be completed exclusively through the California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS) Family PACT portal. To support Family PACT providers during this transition, Family PACT providers will have access to comprehensive training materials and webinars through the Family PACT Online Training Center Learning Management System. These resources will ensure that providers are equipped to use the Family PACT portal effectively before its launch.

醫療 Cal Rx 兒科整合（PI）的政策調整

DHCS is making an important policy adjustment related to Medi-Cal Rx’s initiative for the reinstatement of prior authorization (PA) requirements and utilization management (UM) claim edits for Medi-Cal members 21 years of age and younger, including members of the California Children’s Services (CCS) program. This initiative, commonly referred to as PI, will be implemented on January 31. To directly address and help mitigate stakeholder concerns about the volume of PA requests and potential barriers to timely access that may occur because of PI implementation, as well as recognize the advanced credentialing of CCS Panel Provider Authority, DHCS is adjusting its PI policy approach for continuing therapies/prescriptions PI as follows:

• 在不少於 60 天內，如果索賠會以拒絕代碼 75（需要 PA）拒絕，但 Medi-Cal 成員有最近的索賠歷史，則索償將無需額外的 PA 支付。 DHCS 打算這種方法為供應商和處方人員提供額外的時間來調整其內部流程，並更好地計劃 PI 要求並提交主動性 PA。

DHCS will release additional, more detailed information through the Medi-Cal Rx website and will update various existing resource documents on a flow basis. DHCS remains committed to ensuring Medi-Cal members, providers, and other partners are supported so pharmacy benefits can be accessed in a safe, timely, and equitable manner. DHCS will continue to support and engage stakeholders on PI.

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 Pharmacy Benefits Division. The Chief is responsible for overseeing the development and implementation of policy, services, and coverage criteria for outpatient pharmacy services for the state’s Medi-Cal program. This includes providing policy direction for Medi-Cal Rx as well as invoicing and collecting federal and state supplemental drug rebates. The Chief of PBD also leads the development of nutrition, vision care, and medical supply benefits and oversees the administration of the Medi-Cal Pharmacy and Vision Benefit programs. Applications must be submitted by February 7.

DHCS is also hiring for its accounting, program accountability, behavioral health, managed care quality and monitoring, eligibility, and other teams. For more information, please visit the CalCareers website.

即將舉行的利害關係人會議和網絡

行為健康轉型品質和公平諮詢委員會網絡研討會

On January 15, from 9 to 11 a.m. PST, DHCS will host the third Behavioral Health Transformation Quality and Equity Advisory Committee webinar. Once registered, you will receive a confirmation email with the webinar link and additional details. DHCS is pleased to continue its collaborative efforts to measure and evaluate the quality and efficacy of behavioral health services and programs. These public webinars provide an opportunity for participants to offer input for DHCS consideration. Visit the Behavioral Health Transformation Stakeholder Engagement webpage for more information about the webinars and additional resources. Please send questions related to Behavioral Health Transformation and/or the webinars to BHTinfo@dhcs.ca.gov.

加州斯邁爾市線上研討會：為「全國兒童牙齒健康月」推廣Medi-Cal牙科福利

On January 22, from 11 a.m. to 12 p.m. PST, Smile, California will host a webinar to kick off National Children’s Dental Health Month (NCDHM) in February. The webinar will feature a preview of the new Healthy Smile Land materials, strategies for promoting Medi-Cal dental services during NCDHM, and resources for accessing and distributing outreach materials. Attendees will also be able to connect with Smile, California representatives to ask about Medi-Cal dental benefits.

DHCS 減少危害高峰會

DHCS collaborates 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 incorporating the tenets of harm reduction into substance use disorder treatment. Summits will be held in Fresno County (January 23), San Diego County (February 11), and Los Angeles County (February 27). Register on the event website.

報導大使網絡研討會系列：與正義相關的重新入境計劃和兒童和青少年行為健康倡議更新

1月30日上午11時至11時45分PST 與 DHCS 將為 DHCS 保險推廣大使舉辦一場線上研討會（需事先註冊）。本次網路研討會將提供關於「司法系統涉案者重返社會計畫」及「兒童與青少年行為健康計畫」（CYBHI）的最新資訊。該報告將提供有關曾被司法系統處理、目前或曾經在監獄、少年矯正機構或監獄服刑，且其健康狀況惡化、受傷及死亡風險較一般大眾更高的個體之相關資訊。該計畫將著重於加州為改善個人健康狀況所採取的重大措施，這些措施旨在協助準備重返社區的人士，透過確保他們在獲釋後能維持醫療保險的連續性，從而改善其健康狀況。此外，保險覆蓋大使將了解如何透過「兒童與青少年健康保險計劃」（CYBHI）擴大早期兒童全方位服務，該計劃將為兒童、青少年及其家庭提供心理健康服務。進一步了解DHCS 保險推廣大使，或註冊成為保險推廣大使。

子宮內設備（IUD）和避孕植入體插入訓練

On February 19, from 7:30 a.m. to 5:30 p.m. PST, DHCS’ Office of Family Planning will host an in-person Comprehensive IUD and Contraceptive Implant Insertion Training. The training, which is currently full, includes information about patient method selection, counseling and consent, techniques for using instruments during IUD placement, and instruction on the insertion of each type of IUD currently available in the United States. Additional topics to be covered include management of side effects, tips for managing difficult placements, pain management principles for office procedures, and prevention and management of complications. Please see IUD & Implant Resources for more information.

如果你錯過了

CMS 選擇 DHCS 進行創新轉型孕婦健康模式

1月6日，聯邦醫療保險與醫療補助服務中心（CMS）批准加州參與其「聯邦醫療保險與醫療補助創新中心」的「孕產婦健康轉型 （TMaH）模式。該模式為期十年，是針對醫療補助（Medicaid）及兒童健康保險計畫（CHIP）所設計的服務提供與支付模式，旨在驗證：若能有效實施以實證為基礎的介入措施，並輔以價值導向支付（VBP）模式作為支撐，是否能改善孕產婦健康結果，並降低醫療補助及兒童健康保險計畫的支出。

DHCS 將在五個縣實施 TMaH 模式：Fresno、Kern、Kings、Madera 和 Tulare。TMaH 模式是加州為解決孕產婦健康方面的種族與族裔差異所做出的更廣泛承諾的一部分，旨在確保所有孕婦——尤其是來自低收入社區的孕婦——都能獲得所需的支持，以安全地度過懷孕與分娩的過程。

現正開放：提供存取和轉型健康（PATH）容量和基礎設施轉型、擴展和開發（CITED）第四輪申請

On January 6, DHCS opened the PATH CITED Round 4 application window. The PATH CITED initiative provides funding to build the capacity and infrastructure of on-the-ground partners including community-based organizations, hospitals, county agencies, Tribes, and others, to successfully participate in Medi-Cal. Nearly $158 million is available for Round 4. The deadline to apply for PATH CITED Round 4 funding is 11:59 p.m. PST on March 7, 2025. The guidance document and application can be found by visiting the PATH CITED webpage. Please submit questions to cited@ca-path.com.

PATH 技術支援 (TA) 市場第五輪供應商申請

On January 1, DHCS opened the PATH TA Marketplace Round 5 vendor application. The deadline to apply is January 31. Round 5 will be a targeted procurement for new and existing hands-on service offerings that address TA Marketplace gaps. The Round 5 procurement will seek TA vendor applications for all seven TA domains, but it will focus on services for the following provider types: rural providers, Tribal and Indian health care providers, maternal and child-serving providers, and transitional rent providers.

在第五輪採購期間，DHCS 將不接受新的現貨項目或對現有現有現貨項目的更改提交的意見書。 相反，第 5 輪應用程序將從現有 TA 供應商那裡尋求隨需資源。 請訪問 TA 市場供應商網頁以訪問指導文件並申請。 請向 ta-marketplace@ca-path.com 提交問題。