專案更新
輔助生活豁免（ALW）插槽擴展
On January 7, CMS approved DHCS’ amendment to the ALW to add 7,000 slots to eliminate the current waitlist and expand waiver capacity. This amendment is retroactive to July 1, 2021. The purpose of the ALW is to keep eligible seniors and persons with disabilities in their communities and out of institutional care settings.
On July 12, 2021, DHCS submitted Medi-Cal’s Home and Community-Based Services (HCBS) Spending Plan, authorized by Section 9817 of the American Rescue Plan Act (ARPA). ARPA includes an additional 10 percent Federal Medical Assistance Percentage (FMAP) on certain HCBS services, which can then be reinvested to expand and improve HCBS. CMS conditionally approved California’s HCBS Spending Plan on January 4, 2022. DHCS intends to fund the ALW slot expansion through the enhanced FMAP available through ARPA.
行為健康持續基礎設施計劃（BHCIP）更新
On January 10, DHCS released the “BHCIP Round 2B: Planning Grant – Request for Application (RFA)” to solicit applications from county behavioral health agencies and tribal entities for DHCS’ BHCIP and the California Department of Social Services’ (CDSS) Community Care Expansion (CCE) program. DHCS and CDSS re-released this non-competitive joint RFA for eligible organizations to receive up to $150,000 each to initiate and support planning efforts, from April 2022 through December 2022, for the acquisition and expansion of behavioral health infrastructure throughout the state. DHCS and CDSS released the initial RFA from November 1-30, 2021, and on January 3 awarded a total of $5,351,756 to 36 entities (nine are tribes). The BHCIP Round 2B: Planning Grant RFA deadline is February 28, 2022.
1 月 31 日，DHCS 與 CDSS 合作發布 BHCIP：第三輪啟動準備和 CDSS 社區關懷擴展計劃聯合 RFA。 BHCIP 第 3 輪：Launch Ready 的合資格組織可以申請並獲得資助，以在服務 Medi-Cal 受益人的環境中建造，獲得和恢復房地產資產。 對於 BHCIP，僅接受來自確定已經經過規劃過程，已準備好實施，並將擴展行為健康持續性的項目的申請。 DHCS 將為 BHCIP 第三輪：啟動準備提供高達 518,5 萬美元的撥款資金，並且必須在 2024 年 6 月前完成資金，並在 2026 年 12 月前清算。
BHCIP 第三輪：Launch Ready 將由兩個應用程序部分組成，以平衡能夠立即擴展的項目和需要更多時間來開發應用程序的申請人的需求。 這將為申請人提供兩個潛在提交的截止日期。 第一部分未獲得的剩餘資金將適用於第二部分申請人。 所有第一部分申請的截止日期為 31、2022、第二部分申請的截止日期為 5 月 31、2022。
DHCS was authorized through 2021 legislation to establish BHCIP and award $2.1 billion to construct, acquire, and expand properties and invest in mobile crisis infrastructure related to behavioral health. CDSS oversees CCE, which was established through Assembly Bill (AB) 172 (Chapter 20, Statutes of 2021) as a companion effort, totaling $805 million, and focused on the acquisition, construction, and rehabilitation of adult and senior care facilities that serve Supplemental Security Income/State Supplementary Payment and Cash Assistance Program for Immigrants applicants and recipients and other adults who are experiencing or at risk of homelessness.
For more information, please email BHCIP@dhcs.ca.gov or visit the BHCIP project website.
行為健康聯邦補助更新
在 27，2021 年 12 月，DHCS 發布了一份 RFA，於 1 月 28，2022 關閉，向公營和私營非營利組織提供 11 億美元的 RFA，從 3 月 1、2022 至 2 月 28，在 LGBTQ2S+ 社區計劃中實施阿片類藥物使用和刺激劑使用預防和恢復服務2023. 符合條件的實體每個單位最多可申請 250,000 美元，以支持針對整個加利福尼亞州 LGBTQ2S+ 社區特別針對阿片類藥物和刺激劑使用的預防和恢復服務。 合資格活動包括：培訓和資助藥物使用導航員、行為健康顧問、推廣公司、文化經紀人、社區倡導者、同行員等人員，以將阿片類藥物使用和刺激劑使用外展、預防和治療轉介進行工作流程；推行減少歧視活動；開發和傳播教育預防材料；融入創傷知識教育和外展；以及康復服務。
This initiative is funded by the State Opioid Response 2 grant and the Coronavirus Response and Relief Supplemental Appropriations Act, awarded by the federal Substance Abuse and Mental Health Services Administration, and is administered by Sierra Health Foundation: Center for Health Program Management as the administrative entity on behalf of DHCS. For more information about this funding opportunity, please email DHCSMATExpansion@dhcs.ca.gov or visit the DHCS website.
CalHealthCares 貸款償還專案
2018 年財政預算法案向 DHCS 撥出二億二千二百萬元的提案第 56 億元。 參議院條例草案（SB）849（2018 年章程第 47 章）制定了《56 號醫療醫生和牙醫貸款償還法案》（LRP）（通常稱為 CalHealthcare）。 《2019 年財政預算法案》向 DHCS 撥款額外一億一億二千二百萬元，分別為五個組織管理的總額為 340 億元。 合資格醫生可申請貸款還款額高達 300,000 元，以換取五年服務義務。 符合條件的牙醫可申請貸款還款額高達 300,000 元，以換取五年服務義務，或申請高達 300,000 元的實踐支持補助，以換取十年服務義務。
The Fiscal Year (FY) 2021-22 Cohort 4 application cycle for CalHealthCares opened on January 24 and will close on February 25. Approximately $54 million is available for physicians and $9 million for dentists who are committed to seeing Medi-Cal patients in California over five years. Please visit CalHealthCares.org for specific eligibility requirements, application information, and informational webinar dates.
CalHOPE
CalHope 繼續為整個加利福尼亞州難以接觸的人口提供情緒支持服務。 2021 年 12 月，卡爾霍普和媒體解決方案在便利商店和美國軍團和外戰退伍軍人地點推出了 CalHope 海報的新航班。 此外，媒體解決方案推出了針對數字顯示、社交、廣播和印刷品的特殊節日主題 CalHope 創意，共提供 59,000 個媒體廣告。
In January 2022, All It Takes, in partnership with CalHOPE and the California Department of Education, launched A Trusted Space, a film-based program aimed at training educators to help mitigate the effects of emotional stressors on students and their families. This program will be provided to all California public middle and high schools during the 2021-2022 academic year. Lastly, CalHOPE collaborated with the NBA’s Sacramento Kings to provide messaging outside and inside of Golden 1 Center during their game against the Cleveland Cavaliers on January 10.
隨著 COVID-19 的不確定性持續，在 1 月，CalHope 向聯邦政府提交了 30 天的延長，並獲得批准將該計劃延長到 3 月 11 日。 CalHope 還提交了額外的 60 天延長請求，以在 2022 年春季提供危機諮詢服務和情緒支持。
連續葡萄糖監測器
DHCS added Therapeutic Continuous Glucose Monitoring Systems as a pharmacy-billed medical supply benefit through Medi-Cal Rx, effective January 1. The coverage criteria and provider bulletins are available on the Medi-Cal Rx website.
認知障礙症倡議和 SB 48
As part of the HCBS Spending Plan, DHCS is developing the Dementia Aware initiative that will leverage $25 million in one-time enhanced federal funding to establish a statewide provider training program in culturally competent dementia care as well as a referral protocol on cognitive health and dementia for Medi-Cal beneficiaries. This is consistent with the standards for detecting cognitive impairment under Medicare and the recommendations by the American Academy of Neurology, the California Department of Public Health’s (CDPH’s) Alzheimer’s Disease Program, and CDPH’s ten California Alzheimer’s Disease Centers (CADC).
根據此計劃，SB 48（第 484 章，2021 年規例）制定了年度認知健康評估，作為 MEDI-Cal 保障的保障，適用於 65 歲或以上且不符合聯邦醫療保險的類似評估的受益人。 SB 48 只有在提供者完成 DHCS 指定的認知健康評估培訓時，才符合 Medi-Cal 提供者的資格獲得此福利的付款。 此福利的目標實施日期為 1 月 2022。
DHCS met with CDPH’s Alzheimer’s Disease Program, the CADCs, the Alzheimer’s Association, the California Academy of Family Physicians, the California Health & Human Services Agency Alzheimer’s Disease and Related Disorders Advisory Committee, and other stakeholders during the last quarter of 2021 to further establish the needs of the provider training program and to collect clinical and training resources to review and potentially incorporate into the initiative. In collaboration with a University of California (UC) contractor, DHCS will review resources and develop an online provider training. DHCS issued a Request for Information to potential UC collaborators, with the goal of executing a contract in March. DHCS will continue to solicit feedback from stakeholders as the initiative unfolds.
牙科轉型計劃（DTI）
As of December 31, 2021, Domain 2 payments issued total approximately $228 million, and 3,512 providers have opted in to participate. The goal of Domain 2 is to diagnose early childhood caries by using caries risk assessments to treat it as a chronic disease and to introduce a model that prevents and mitigates oral disease. In accordance with the Medi-Cal 2020 waiver extension, DTI concluded on December 31, 2021. For more information, please visit the DHCS website.
全方位懷孕
On December 16, 2021, CMS approved SPA 21-0066 to provide full-scope Medicaid coverage to all beneficiaries in the Medicaid pregnancy eligibility group with incomes up to and including 213 percent of the federal poverty level, effective January 1. The targeted population for this policy is citizens and lawfully residing individuals. DHCS will issue an All County Welfare Directors Letter to notify partners, publish provider bulletins and newsflashes, and update the DHCS pregnancy webpage.
Medi-Cal 健康註冊導覽器項目
由於 COVID-19 對社區健康的影響，健康註冊導航員服務現在比以往任何時候都更加重要。根據 AB 74（2019 年成文法第 23 章），撥出 5,970 萬加元給 DHCS，用於與縣和社區組織 (CBO) 合作，為難以接觸到的 Medi-Cal 和可能符合 Medi-Cal 資格的人口進行 Medi-Cal 外展、入會、保留和導航服務。專案合作夥伴已實施創新且具創意的方法，以聯絡當地社區中符合資格的人口並為其登記，在地方層級提供疫苗資訊和外展服務，並吸引各級大學生參與。本階段的專案可讓 CBO 和各縣為所有參與者加入新的活動或擴大現有活動，並繼續調整外展和入會方式，以克服 COVID-19 所帶來的挑戰。截至 2022 年 1 月，有五個專案合作夥伴已釋出未動用的資金，這些資金將盡早重新分配給現有的合作夥伴。
藥物治療管理（MTM）
MTM services are now a Medi-Cal benefit for pharmacists. MTM pharmacy services may be billed by a Medi-Cal enrolled pharmacy with an approved Medi-Cal Specialty Pharmacy Provider Application (MC 3155), as well as a signed supplemental services agreement with DHCS for MTM services. Providers may refer to part 2 of the Provider Manual for a detailed explanation of MTM benefits. Providers wishing to receive a copy of the contract must send their requests to MTMquestions@dhcs.ca.gov.
MTM 藥房服務是符合某些合資格條件的合資格 Medi-Cal 受益人的福利（請參閱提供者手冊的第 2 部分以獲取完整清單）。 此外，Medi-Cal 受益人必須使用藥物（或藥物）來治療診斷疾病（如需完整清單，請參閱提供者手冊的第 2 部分）。 最初，DHCS 將簽訂與以下相關的 MTM 服務合約：
- HIV/AIDS
- 嚴重的心理健康狀況（精神病障礙，例如精神分裂症/分裂情緒障礙，雙相情感障礙等）
- 癌症
- 血友病
- 糖尿病
未來幾個月將根據流量基礎添加其他條件。 MTM 藥房服務是從 Medi-Cal 管理的護理中形成的。 有關補充協議、合約程序或 MTM 服務的問題可以提交至 MTMquestions@dhcs.ca.gov。
多用途高級服務計劃（MSSP）豁免修訂
在 19 月 2021，DHCS 向 CMS 提交了一項修正案，從 1115 橋改革示範中劃出 MSSP 計劃，並修改 1915（c）豁免。 10 月 1 日，DHCS 與加州老齡部合作發布了豁免修正案，為 30 天的公眾評論期間。 對 1915（c）豁免的修訂將使所有協調照護倡議行動縣（聖馬特奧縣除外）恢復為 MSSP 豁免服務提供費制度。 豁免的其他更改包括對已經服務的縣地理服務區域的更新，預計實施電子訪問驗證，以及增加參與者名額。 DHCS 正在等待 CMS 對豁免修訂的最終批准。
MSSP 豁免提供社會和健康護理管理，為有資格安置在護理設施，但希望留在社區內的弱弱老客戶提供了社會和醫療保健管理。 MSSP 的目標是避免人士早安置在護理設施，同時促進社區內獨立生活。
關於指定藥物醫療服務供應商的分類風險水平的公開聽證會
On February 24, DHCS is holding a virtual public hearing to discuss changes to the designation of categorical risk levels for Drug Medi-Cal applicants. In accordance with CMS’ newly designated categorical risk levels for newly enrolling and revalidating opioid treatment programs, DHCS is issuing a provider bulletin to update the designation of categorical risk levels for Drug Medi-Cal applicants with Narcotic Treatment Program or Heroin Detoxification Program services modalities. Stakeholders will have the opportunity to submit questions and suggestions during the hearing; written comments will be accepted on the day of the hearing until 5 p.m. After reviewing the public comments received, DHCS will publish the final bulletin on the Medi-Cal and DHCS websites. The changes will become effective 30 days after publication.
加利福尼亞州微笑醫療牙科服務活動
2021 年 11 月，加利福尼亞州 Smile 在 Facebook Live 上舉辦了兩個英語和西班牙語的虛擬會員演講。 這些簡報概述了 Medi-Cal 涵蓋的所有年齡組別的牙科服務，並強調了有關福利和保障的常見問題。這些簡報總共獲得 228 次觀看次數。
Also in November, a Smile, California outreach representative participated in a live radio segment. The segment was translated into Mixteco, an indigenous language spoken by tens of thousands of California migrants. The interview was broadcast throughout Ventura County. The interview received more than 10,000 radio impressions. The outreach representative discussed the Medi-Cal Dental Program, the program’s covered services, the importance of regular dental visits, and how to find a Medi-Cal dentist.
In December, the social media gallery on SmileCalifornia.org was updated with five new social media images and suggested captions for partners and providers to post to their social media accounts featuring the following topics:
- 疼痛意識
- 摩爾密封劑
- Caring for loved ones’ oral health
- 中卡牙科保障
- 牙科檢查對兒童的重要性
Smile, California is supporting National Children’s Dental Health Month (NCDHM) in February. Two virtual informational webinars were held on January 19 and 20 to empower local health champions statewide to motivate Medi-Cal enrolled and eligible members in their communities to learn about the Medi-Cal Dental Program and schedule dental appointments for themselves and their children. The webinars were recorded and posted on SmileCalifornia.org under “Partners and Providers.”
Also, a new webpage dedicated to NCDHM is published on SmileCalifornia.org and SonrieCalifornia.org, which feature educational resources about children’s oral health, activity sheets, and a new dental health superhero coloring sheet available for download