熱門新聞​​ 

新的行為健康服務法案（BHSA）報告支持收入穩定性和規劃​​ 

DHCS released the BHSA Revenue Stability Workgroup Report with recommendations to reduce the variance of county Behavioral Health Services Funds (BHSF). The recommendations are intended to help counties manage revenue more consistently, maintain services through economic ups and downs, and bring greater predictability and accountability to local behavioral health care funding.​​ 

The BHSA Revenue Stability Workgroup, comprising state leaders and counties, was required to develop and recommend solutions to reduce BHSA revenue volatility and propose appropriate prudent reserve levels to support the sustainability of county programs and services. It reviewed and analyzed current and historical revenues generated by the MHSA and the BHSA and prudent reserve levels to develop the recommendations.​​ 

The State Controller’s Office will continue to follow the current process to distribute BHSA local assistance funds to counties monthly. The goal is to balance local assistance revenue allocation and program stability, helping counties effectively plan and provide critical behavioral health services during revenue downturns. Highlights include:​​ 

• 年度支出上限以三年平均為基準，並根據通脹調整。​​ 
• 新的儲備限制（10-15％，取決於縣規模）。​​ 
• 一次性要求在 2026-2029 年間消耗多餘儲備。​​ 
• 如果收入下降，可靈活調整預算。​​ 
• 更具透明度，需要的公開報告和社區意見。​​ 

This approach supports California’s Mental Health for All vision by promoting stability, transparency, and community-centered behavioral health care. State legislation is required to enact recommendations from the BHSA Revenue Stability Workgroup Report.​​ 

社區支持在滿足 Medi-Cal 會員需求的同時展現早期成本效益​​ 

DHCS recently submitted to the Centers for Medicare & Medicaid Services (CMS) its Community Supports, or In Lieu of Services (ILOS), Annual Report[TO1] , which reviews the progress and impact of Medi-Cal Community Supports in 2024. For the first time, the report also includes a cost-effectiveness analysis for 2023. The report highlights key achievements, such as reduced emergency room visits, hospitalizations, and long-term care use, pointing to early evidence of both improved health outcomes and reduced costs when compared to the services they are replacing, such as inpatient, emergency department, and long-term care services. Of the 12 Community Supports studied, nine are already proving cost-effective, and the remaining three are expected to prove to be cost-effective over time.​​ 

The report also outlines operational improvements made by DHCS and managed care plans (MCP) to expand services, grow provider networks, and support implementation. While progress has been significant, the report also identifies ongoing challenges and opportunities for further improvement, ensuring these services continue to evolve to meet the needs of Medi-Cal members.​​ 

專案更新​​ 

Medi-Cal 商業 MCP 採購更新​​ 

DHCS 將把下一次商業 Medi-Cal MCP 採購至少推遲兩年。下一次 MCP 的競爭性採購最快也要到 2029 年才會開始，合約預計最早也要到 2031 年才會生效。DHCS 先前曾表示，商業 MCP 的重新採購將每五年進行一次。根據此假設的時間表，DHCS 必須在 2027 年發布招標書 (RFP)，合約生效日期為 1 月 1、2029 日。​​ 

The additional time will allow DHCS to focus on critical California Advancing and Innovating Medi-Cal (CalAIM) initiatives. It will also help maintain stability for members and support ongoing improvements to care quality and access, while also supporting the long-term success of the Medi-Cal managed care program.​​ 

In accordance with current policy, MCP contracts will be renewed annually following the contractual requirements identified in Exhibit E, 1.1.15 of the 2024 Managed Care Boilerplate Contract. Current MCP contracts will be extended from January 1, 2026, to December 31, 2026, by the established annual process. DHCS remains committed to fostering an inclusive, flexible, and responsive process that supports the Medi-Cal program and ensures continued equitable access to high-quality care for Californians. Please visit the Medi-Cal Managed Care webpage for more information.​​ 

牙科管理護理過渡​​ 

During the week of May 26, DHCS will mail a 30-day notice to about 350,000 Medi-Cal members in Sacramento and Los Angeles counties to notify them of upcoming changes to their dental service delivery, effective July 1, 2025. The member notice explains what is changing, if the member needs to make a plan choice, the member’s continuity of care protections, and other important information, and will include a Medi-Cal managed care enrollment packet.​​ 

Members in Sacramento County who are currently enrolled in Access Dental Plan or dental fee-for-service (FFS) must select a new Dental Managed Care plan, while members in Los Angeles County who do not choose a Dental Managed Care plan will remain in FFS. Members currently enrolled with Health Net or Liberty will not be affected by these changes. Additionally, changing Dental Managed Care plans will not affect Medi-Cal coverage or benefits.​​ 

Medi-Cal Health Care Options 正在進行一項外呼活動，向收到醫療管理註冊資料包的會員進行宣傳。在這些通話中，HCO 代表將審查可用的牙科管理式醫療計劃選擇，回答問題，並透過電話協助會員註冊其選擇的計劃。DHCS 開發了牙科過渡會員通知網頁，供會員查看有關牙科管理式醫療過渡的通知和其他資訊。​​ 

藥房提供者的 Medi-Cal 註冊要求和程序​​ 

自 8 月1 、 2025起，持有有效的臨床實驗室改進修正案 (CLIA) 豁免證書和當前California臨床實驗室註冊證書的藥房提供者，可以對在California藥房委員會定義的執業範圍內提供的 CLIA 豁免測試進行收費，該執業範圍已獲得商業和職業法典第 4052.4 條的授權。 藥局供應商必須透過線上提交Medi-Cal供應商註冊申請以及所有證明文件來申請加入Medi-Cal Program 。​​ 

On June 10, from 10 to 11 a.m. PDT, DHCS will hold a public stakeholder hearing via webinar (advance registration required) to discuss the draft regulatory provider bulletin entitled, “Medi-Cal Enrollment Requirements and Procedures for Pharmacy Providers that Hold a Clinical Laboratory Improvement Amendments (CLIA) Certificate of Waiver.”​​ 

聽證會期間，可透過網路研討會聊天提交書面意見、問題或建議。無法到場的人士，請於太平洋時間 6 月 10 日下午 5 點前提交書面意見，以便考慮發表。提交書面評論時，請確保評論者及其所代表的組織/協會均在評論中註明。請將書面意見提交至DHCSPEDStakeholder@dhcs.ca.gov 。根據收到的公眾意見，DHCS 將在Medi-Cal提供者和DHCS 提供者註冊部門網站上發布最終公告。​​ 

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：​​ 

• 資本利率發展部長主管為 Medi-Cal 管理護理計劃和長者全包護理組織計劃領導費率設定活動。活動包括實施精算方法，以確定資本率，以及監督發放補償政策和協議的制定和實施。此外，總監確保財務方法與高效提供優質醫療保健一致，並遵守州和聯邦法律、法規和規則。申請必須在 5 月 30 日前提交。
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• 企業技術服務（ETS）助理副主任（ADD） 。這項新的 ADD 職位將與DHCS執行人員、 Program合作夥伴和外部利害關係人建立協作工作關係，並協助領導DHCS的 IT Program和服務。 此外，ADD 將在領導DHCS Program （包括Medi-Cal和行為健康）的 IT 政策、系統架構、安全、改進和解決方案的製定和實施方面發揮至關重要的作用。 申請截止日期為6月2日。​​ 

DHCS正在為其Medi-Cal Managed Care 、數據分析、 Medi-Cal資格和其他團隊招募人員。 欲了解更多信息，請訪問CalCareers 網站。​​ 

即將舉行的利害關係人會議和網絡​​ 

DHCS posts upcoming public meetings on the Calendar of Events. DHCS provides free assistive services, including language interpretation, real-time captioning, and alternate formatting of meeting materials. To request services, please email DHCS at the appropriate contact email address at least ten working days before the meeting.​​ 

報導大使網絡研討會系列：產科護理途徑​​  

On May 29, from 11 a.m. to 12 p.m. PDT, DHCS will hold a Coverage Ambassador webinar that will focus on DHCS’ Birthing Care Pathway initiative (advance registration required). The webinar will provide information about maternity services for pregnant and postpartum Medi-Cal members from conception through 12 months postpartum and review highlights from the Birthing Care Pathway Report released on February 4. This initiative helps to ensure Medi-Cal members have access to high-quality, equitable care to improve maternal health outcomes and reduce disparities. Coverage Ambassadors will also learn about DHCS’ social media platforms, which offer up-to-date information on relevant topics that can benefit both Coverage Ambassadors and Medi-Cal members. Simultaneous interpretation in Spanish will be offered during the webinar.​​ 

如果你錯過了​​ 

申請申請（RFA）：靈活房屋資助池​​  

On May 7, DHCS announced the Flexible Housing Subsidy Pools (“Flex Pools”) RFA. DHCS will select up to 10 local teams to participate in the Flex Pools TA Academy and receive Flex Pools planning grants of approximately $150,000. The launch of Medi-Cal Transitional Rent and Behavioral Health Services Act (BHSA) Housing Interventions creates an unprecedented opportunity to help people achieve better health outcomes through housing stability.​​ 

Flex Pools are intended to help counties and Tribal entities improve housing stability for individuals experiencing or at risk of homelessness. They are a locally designed model to coordinate rental assistance and make the best use of available housing supports, aligning the work of managed care plans, county behavioral health agencies, and other key partners in the homeless services and rehousing systems. Applications are due to DHCS by 5 p.m. PDT on June 13, 2025. Organizations selected will be notified in July 2025. To learn more and apply, please visit the DHCS Housing for Health website.​​ 

HCBA 豁免修訂申請 — 30 天公眾意見期​​ 

5 月 12 日，DHCS 發布了 2025 年居家和社區替代方案 (HCBA) 豁免修正案草案，進行為期 30 天的公眾評議，之後將最終版本提交給 CMS 進行重新授權。HCBA豁免允許符合資格的參保人透過Telehealth醫療服務系統獲得批准的服務。 擬議的豁免修正案變更內容包括：​​ 

• 澄清遠程醫療服務的指導和期望。​​ 
• 移除發展殘疾人士的中間護理設施 — 持續護理（ICF/DD-CN）非通風和通風相依的福利和設置，因為它們正在轉換為 Medicaid 州立計劃作為長期護理福利。​​ 

This transition advances California’s efforts to comply with the federal Medicaid Home and Community-Based Settings (HCBS) Final Rule by reinforcing the delivery of services in integrated, community-based settings that support individual choice and autonomy.​​ 

DHCS邀請所有有興趣的當事人在DHCS HCBA豁免網頁的「HCBA豁免修正申請 - 5月12 、 2025至6月12 、 2025期間30天公眾評議」標題下查看修正案和評論說明。所有意見必須在六月12、2025之前收到。如有任何疑問，請發送電子郵件至 hcbspolicy@dhcs.ca.gov 。​​ 

醫療補助州計劃修訂（SPA）— 30 天公眾評論期​​  

On May 12, DHCS posted the ICF/DD-CN: Transition of Benefit/Setting SPA (SPA #25-0026) for a 30-day public comment period, prior to submitting the final version to CMS for approval. ICF/DD-CNs provide 24-hour personal care, developmental services, and nursing supervision for individuals with developmental disabilities who have continuous needs for skilled nursing care and have been certified by a physician and surgeon as warranting continuous skilled nursing care. This service is currently provided through the HCBA waiver. This SPA will transition the ICF/DD-CN benefit/setting from the HCBA waiver to the Medicaid State Plan as a long-term care setting. This transition advances California’s efforts to comply with the federal HCBS Final Rule by reinforcing the delivery of services in integrated, community-based settings that support individual choice and autonomy. All comments must be received by June 12, 2025. If you have any questions, please email PublicInput@dhcs.ca.gov.​​