11 月17,2023 - 利益相關者新聞
熱門新聞
增強護理管理（ECM）和社區支持實施數據
DHCS 本週發佈了ECM 和社區支援實施更新：截至 2023 年第 2 季的資料。本更新彙總了 ECM 和社區支援的州層級資料，ECM 和社區支援於 2022 年推出，為有重大臨床、非臨床和健康相關社會需求的管理性照護計劃 (MCP) 成員提供服務。在 ECM 和社區支援第一年度報告的基礎上，實施更新包括 Medi-Cal 會員和醫療服務提供者網路的新資料，並首次提供在 2023 年 1 月符合 ECM 資格的兩個長期照護重點族群的 ECM 入會情況。2023 年第二季之後推出的其他 ECM 重點族群 (包括兒童和青少年) 的資料，將在未來的報告中強調。
Both ECM and Community Supports continued to grow and serve more Californians during the first half of 2023, including a 29 percent growth in cumulative ECM enrollment and 108 percent growth in cumulative Community Supports recipients since the end of 2022. To provide further data transparency and visibility around ECM and Community Supports, DHCS will soon release a comprehensive report with MCP- and county-level data through Q2 2023.
2024 年中醫藥 MCP 過渡政策指南
On November 15, DHCS released frequently asked questions (FAQs) as a companion resource to version five of the 2024 Medi-Cal MCP Transition Policy Guide that includes DHCS policy and MCP requirements related to member transitions of Medi-Cal MCPs that take effect on January 1, 2024. The latest version includes a summary of communications resources, a transition policy for assessment and screening tools, and updates to the data sharing section and Appendix. Please email questions about the policy guide to MCPTransitionPolicyGuide@dhcs.ca.gov. The policy guide and FAQs will be updated throughout the remainder of this calendar year to keep MCPs informed of new and developing guidance.
專案更新
指導改善認知障礙症體驗（GUIDE）模型和網絡研討會
To help address the needs of Medicare beneficiaries, including those dually eligible for Medicare and Medi-Cal, with Alzheimer’s disease and related dementias, the Centers for Medicare & Medicaid Services (CMS) released a Request for Applications (RFA) for the GUIDE model. This model aims to support people living with dementia and their unpaid caregivers by helping them with care coordination and management, infrastructure building, and higher quality of care. Interested applicants should submit their application via web portal by January 30, 2024.
The GUIDE model begins on July 1, 2024, and will continue for eight years. The goal of the model is to improve the quality of life, reduce the burden and strain on unpaid caregivers of people living with dementia, and prevent or delay long-term nursing home care. The care delivery approach is a person-centered plan that standardizes a set of services, has an interdisciplinary care team, and includes training requirements for the care team to improve care coordination to address the behavioral and functional needs of people living with dementia. Original Medicare providers may apply to participate. Since many Medicare beneficiaries with dementia are also dually eligible for Medi-Cal, DHCS strongly encourages California Medicare providers to participate in the GUIDE model. For more information, please visit the CMS GUIDE webpage.
Also, on December 8, from 11 a.m. to 12 p.m., DHCS, in partnership with the University of California, San Francisco and DHCS’ Dementia Care Aware initiative, will host a webinar on the GUIDE model in California (advance registration required). This webinar will offer Medicare providers and community-based organizations information about what is required to participate in GUIDE, examples of a successful partnership in California that follows the GUIDE model, and resources to help California applicants apply for the GUIDE model. For more information, please visit the Dementia Care Aware webpage.
注意：DHCS 下週不會發佈利益相關者的每週更新。下次更新將於 12 月 1 日（星期五）發佈。
加入我們的團隊
DHCS 正在招聘！ DHCS 具有以下機會：
- 企業技術服務副總監兼資訊長，負責領導和管理整個部門的 IT 服務（FFD 為 12 月 8 日）。負責管理所有 IT 服務、資訊安全、企業專案和策略性創新工作。
- 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.
- 綜合照護系統副醫療總監（FFD 為 11 月 29 日）。此職位負責為加州重要的公共衛生計劃提供技術性醫療諮詢，並將為醫療上脆弱的個人提供醫療上必要的服務建議和指導。
- 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
兒童助聽器保障計劃（HACCP）家庭和社區合作夥伴網絡研討會
11 月 28 日，從上午 11 點到下午 12 點，DHCS 將舉辦 HACCP 網絡研討會（需要提前註冊），以與家庭和社區分享有關申請助聽器保障並幫助兒童最大限度地發揮 HACCP 福利的指導。 DHCS 歡迎新感興趣的家庭、目前參與 HACCP 的家庭以及支持家庭和兒童的社區合作夥伴加入此網絡研討會，以獲取計劃更新、提示和問答會。 有關更多信息，請訪問 www.dh cs.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 將為社區合作夥伴（包括倡導者、提供商、MCP 等）舉行網絡研討會，關於消除非修改調整後的總收入（非 Magi）Medi-Cal 計劃資產的資產，將於 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：急性護理設施嵌入帳單和付款網絡研討會
On November 29, from 3 to 4 p.m., DHCS will virtually host the third in a series of educational webinars on the California Advancing and Innovating Medi-Cal (CalAIM) long-term care (LTC) carve-in of subacute care facilities in Medi-Cal managed care. The goal of these webinars is to provide subacute care facilities and Medi-Cal MCPs with an understanding of the carve-in to operationalize the new benefit, including scope of services and relevant policies, in preparation for the January 1, 2024, carve-in.
該網路研討會對大眾開放，將著重於提供對付款政策要求的瞭解，以及有關 MCP 和亞急性照護設施計費的可行做法。CalAIM Subacute Care Facility LTC Carve-In 過渡網頁 提供有關 Subacute Care Facility Carve-In 的 其他詳細資訊。
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.
CalAIM：行為健康工作小組會議
On December 1, DHCS will virtually convene the CalAIM Behavioral Health Workgroup meeting to provide updates on and discussion of the California Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) and CalAIM behavioral health documentation redesign initiatives. Workgroup members may provide feedback on implementation and operational considerations. The meeting is open to the public. Please email questions to BHCalAIM@dhcs.ca.gov.
Medi-Cal 成人擴展網路研討會
12 月 4 日上午 11 點至中午 12 點，DHCS 將為社區組織、MCP、醫療服務提供者及其他有興趣的利害關係人，包括代表消費者、移民、健康照護、法律援助及成人移民的人士，舉辦有關Medi-Cal 成人擴展的網路研討會（需事先報名）。DHCS 依據參議院第 184 號法案 (2022 年法令第 47 章) 於 1 月1,2024 實施此擴展計劃。擴展計劃實施後，只要符合 Medi-Cal 的所有其他資格標準，26-49 歲的個人，不論其公民身份或移民身份，均可享有 Medi-Cal 的全面福利。
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.
提供存取與轉型健康狀況 (PATH) 協作規劃與實作 (CPI) 最佳實踐網路研討會
On December 7, from 12:30 to 1:30 p.m., DHCS will host a statewide webinar, Relationship Building with Organizations in the CalAIM Environment (advance registration required) for community-based organizations, county, city, and local government agencies, federally qualified health centers, MCPs, Medi-Cal tribal and designees of Indian Health Programs, and providers. The webinar is part of a biannual series of PATH CPI webinars designed to highlight best practices for implementing ECM and Community Supports, increasing providers’ successful participation in CalAIM, and improving collaboration with MCPs, state and local government agencies, and others to build and deliver quality support services to Medi-Cal members. For more information, please visit the PATH CPI webpage.
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.
如果你錯過了
加州繼續邁向以人為中心，以公平為中心的醫療轉型
On November 15, DHCS issued a news release about how the Department is transforming Medi-Cal to ensure Californians can get the care they need to live healthier lives. As a result of the new Medi-Cal managed care contract, Medi-Cal members will have access to new and improved services to get person-centered, whole-person care that goes beyond the doctor’s office or hospital and addresses their physical and behavioral health and health care-related social needs.
第 1115 條示範：BH-CONNECT 和卡拉伊姆過渡性租金修訂
10 月 20 日，DHCS 向 CMS 提交了新的 1115 條示範要求 - BH-CONNECT 示範 - 以及與過渡性租金服務相關的 CalAIM 1115 條示範修正提案。此外，BH-CONNECT 和CalAIM 過渡性租金服務的聯邦公眾評論期將於 10 月 27 日至 11 月 26 日開放。
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.