November 10, 2023 – Stakeholder News
熱門新聞
針對焦點兒童和青少年人群的加強照顧管理（ECM）
On November 3, DHCS published the ECM for Children and Youth POF Spotlight, which is designed to help contracted and prospective ECM providers serving children and youth develop and enhance their ECM models. It is also intended to support provider organizations that are considering if ECM for children and youth is right for them. The new resource outlines key ECM policies for the children and youth POFs, including areas where plans can leverage presumptive authorization; member scenarios that illustrate how to deliver ECM for the children and youth POFs, with examples of how Community Supports can be integrated to best serve children, youth, and caregivers; and guidance on how prospective providers can get started, with a collection of the key resources and funding opportunities.
DHCS is committed to providing technical assistance and support to California’s growing network of ECM providers. This is the first in a series of ECM spotlights that DHCS plans to release over the coming months to support stakeholders seeking more details on how providers tailor ECM to meet the needs of different POFs. For more information, visit the ECM and Community Supports webpage.
專案更新
醫療及寄養服務更新
DHCS developed a resource to provide updates on foster care youth in Medi-Cal. The resource covers changes to managed care for the child welfare population in 2024, Enhanced Care Management and Community Supports transition policies, the 2024 Medi-Cal managed care plan (MCP) contract and memorandum of understanding requirements, and Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment child and youth components.
在線提供杜拉服務更新
11 月 3 日，DHCS 更新了杜拉服務為醫療福利網頁。 更新的網頁包括為 Medi-Cal 會員和杜拉提供商提供的有用資源，包括 DHCS 醫學總監 Karen Mark 博士的新發布的杜拉服務常設建議。 該常設建議符合了聯邦要求對杜拉服務作為預防服務推薦的要求。
該網頁更新還包括對杜拉和 Medi-Cal 會員的新常見問題，獲批准的杜拉提供者申請和註冊的個人提供者的總數，以及支持杜拉服務對出生和母親結果的好處的證據信息。 有關杜拉服務的任何疑問，請電子郵件發送至 DoulaBenefit@dhcs.ca.gov。
加入我們的團隊
DHCS 正在招聘！ DHCS 具有以下機會：
- Chief of the Financial Management Division within Fiscal (final filing date (FFD) is November 15). This executive role develops policies and procedures to ensure fiscal integrity, transparency, and accountability of approximately $150 billion in annual state and federal funding for DHCS.
- Behavioral Health Policy Medical Consultant II within Behavioral Health (FFD is November 27). This position provides clinical expertise and strategic advice to DHCS Behavioral Health leadership on the development and implementation of policy and initiatives designed to strengthen behavioral health care access, quality, and service delivery.
- Senior Assistant Chief Counsel for Fiscal and Financing within the Office of Legal Services (FFD is November 28). This position is responsible for complex legal counsel and litigation strategy formulation regarding DHCS fiscal, financial management, and health care policy.
- 法律服務辦公室醫療保健提供系統高級助理首席顧問（FFD 為 11 月 30 日）。 該職位負責對醫療保健提供系統各方面的複雜法律顧問和訴訟策略制定。
DHCS is also hiring for our human resources, auditing, health policy, and information technology teams. For more information, please visit the CalCareers website.
即將舉行的利害關係人會議和網絡
保護您的社區：學校和家庭網絡研討會
11 月 16 日，下午 2 時至 3 點，DHCS 將舉行網絡研討會，題為保持社區保護：學校和家庭（需要提前註冊）。 網絡研討會將為學校合作夥伴提供重要信息，以幫助學生和他們的家人更新 Medi-Cal 報導。 網絡研討會還將重點介紹可用的外展資源和最佳做法，以吸引有學齡兒童的家庭參與。
CBO 和 LHJs 網絡研討會的 Medi-Cal 註冊要求和程序
11 月 17 日，上午 10 時至 11 時 30 分，DHCS 將通過網絡研討會舉行公開利益相關者聽證會（需要提前註冊），討論提供社區健康工作者和/或哮喘預防服務的社區組織（CBO）和當地衛生管轄區提供者（LHJ）提供者的 Medi-Cal 註冊要求和程序的監管提供商公告。 由 9 年 1 月 2024 生效，申請註冊 Medi-Cal 服務費計劃的 CBO 和 LHJ 提供者可以通過提供者申請和註冊驗證 (PAVE) 在線入學門戶提交申請。
在聽證會期間可以在網絡研討會聊天中提交書面意見，問題或建議。 對於無法出席的人士，必須於十一月十七日下午五時前提交書面意見，以便作出版。 以書面提交意見時，請確保在意見中標明評論者和代表的組織/協會。 書面意見應提交至 DHCSPEDStakeholder@dhcs.ca.gov。 根據收到的公眾意見，DHCS 將在 Medi-Cal 和 DHCS 網站發布最終 公告。
CalAIM 發展殘疾人士中間護理設施（ICF/DD）內部計費和付款網絡研討會
On November 17 at 1 p.m., DHCS will host the fourth in a series of educational webinars on the California Advancing and Innovating Medi-Cal (CalAIM) ICF/DD carve-in (advance registration required). These webinars outline changes to the ICF/DD carve-in policy requirements. Starting on January 1, 2024, all Medi-Cal MCPs will be required to cover and coordinate institutional long-term care for members residing in an ICF/DD. The webinar series will feature several topics, including ICF/DD carve-in 101, directed payment policy and payment requirements, the per diem rate, accommodation code changes, and best practices for billing and payment. ICF/DD home, Regional Center, and Medi-Cal managed care representatives are encouraged to attend. All webinars are open to the public.
If there are specific questions you would like addressed during the webinar, please submit them in advance using this registration form or by emailing them to LTCtransition@dhcs.ca.gov. Webinar materials, including recordings, and additional details about upcoming webinars are posted on the CalAIM ICF/DD Long-Term Care Carve-In webpage.
護理設施融資改革網絡研討會
On November 17, from 3 p.m. to 4 p.m., DHCS will hold a virtual stakeholder webinar (advance registration required) to discuss the development of the Skilled Nursing Facility Workforce Standards Program, Accountability Sanctions Program, and Workforce & Quality Incentive Program (WQIP) authorized by Assembly Bill 186 (Chapter 46, Statutes of 2022). This meeting will also provide an opportunity for stakeholder input. Additional information is posted on DHCS’ Nursing Facility Financing Reform (AB 186) webpage.
兒童助聽器保障計劃（HACCP）家庭和社區合作夥伴網絡研討會
On November 28, from 11 a.m. to 12 p.m., DHCS will host a HACCP webinar (advance registration required) to share guidance with families and communities about applying for hearing aid coverage and helping children to maximize their HACCP benefits once enrolled. DHCS welcomes newly interested families, as well as families currently participating in HACCP, and community partners supporting families and children to join this webinar for program updates, tips, and a question-and-answer session. For more information, please visit www.dhcs.ca.gov/haccp.
適用於醫療提供者和聽力專業人員的 HACCP 網絡研討會
On December 19, from 12 to 1 p.m., DHCS will host a HACCP webinar (advance registration required) to share information with providers to help pediatric patients and their families maximize HACCP benefits. The training session will address program requirements for families to apply for coverage and the claims submission process for audiologists, otolaryngologists, physicians, and their office staff. For more information, please visit www.dhcs.ca.gov/haccp.
Medi-Cal 資產消除網路研討會
11 月 29 日，下午 1 時 30 分至下午 2 時 30 分，DHCS 將舉行關於消除非修改調整後的總收入（MAGI）Medi-Cal 計劃資產的網絡研討會，從 1 月 2024 生效。 當實施後，此計劃將消除所有非 Magi 計劃的資產測試，包括長期護理和聯邦醫療保險儲蓄計劃。 網絡研討會將提供有關資產消除，實施計劃，程序變更和外展材料的背景信息。 更多資訊請參閱非 Magi Medi-Cal 資產限額變更網頁。
CalAIM 託管長期服務和支持（MLTSS）和雙重整合工作組虛擬會議
On November 30 at 10 a.m., DHCS will virtually host the CalAIM MLTSS and Duals Integration Workgroup meeting (advance registration required). The workgroup serves as a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible members, and allows stakeholders to provide feedback and share information about policy, operations, and strategy for upcoming changes to Medi-Cal and Medicare.
Agenda topics will include reminders about the 2024 Medi-Cal transitions and noticing timelines, updates on Medi-Medi Plan outreach and the 2024 Dual Eligible Special Needs Plan Policy Guide development, July 2023 duals enrollment data, a spotlight presentation on the CalAIM recuperative care Community Support, and a presentation on the continuous coverage unwinding.
Background materials, transcripts, and video recordings of previous workgroup meetings, along with additional information about the workgroup, are posted on the CalAIM MLTSS and Duals Integration Workgroup webpage. For questions or comments, please email DHCS at info@calduals.org.
Medi-Cal 成人擴展網路研討會
On December 4, from 11 a.m. to 12 p.m., DHCS will host a webinar on the adult expansion of Medi-Cal (advance registration required) for CBOs, MCPs, providers, and other interested stakeholders, including those representing consumers, immigration, health care, legal aid, and immigrant adults. DHCS is implementing this expansion pursuant to Senate Bill 184 (Chapter 47, Statutes of 2022) on January 1, 2024. When implemented, the expansion will provide individuals 26-49 years of age with full scope Medi-Cal benefits, regardless of citizenship or immigration status, if they meet all other Medi-Cal eligibility criteria.
The webinar, which will be live interpreted in Spanish, will provide background information about the expansion, implementation planning, noticing, outreach, and more. Individuals may also submit questions or request to register for the webinar by sending an email to AdultExpansion@dhcs.ca.gov.
如果你錯過了
第 1115 條示範：BH-CONNECT 和卡拉伊姆過渡性租金修訂
On October 20, DHCS submitted to Centers for Medicare & Medicaid Services (CMS) the new Section 1115 demonstration request, entitled the California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) demonstration, and the proposed amendment to the CalAIM Section 1115 demonstration related to transitional rent services. Additionally, the federal public comment period will be open for BH-CONNECT and CalAIM transitional rent services from October 27 through November 26, 2023.
二零二四年一月醫療通訊系統轉型
As part of Medi-Cal transformation, some MCPs are changing on January 1, 2024, and approximately 1.2 million members will have new health plan options and/or will need to transition to new MCPs. Changing MCPs will not affect Medi-Cal member coverage or benefits. Members who transition to a new MCP are receiving notices about the transition. DHCS developed several resources to support members, providers, and other stakeholders with the transition, including the Managed Care Plan Transition Member webpage with a county “lookup” tool, links to member notices sent by Medi-Cal about MCP changes, frequently asked questions, and a Contact Us page for members to learn more about health plans and provider choices. There are also transition resources for providers and MCPs and stakeholders. More information about the transition is available in the 2024 Managed Care Plan Transition Policy Guide and Medi-Cal Eligibility Division Information Letter Number I 23-54.