專案更新
資產限額 — 未修改調整後的總收入 (MAGI) 中資
2021 年第 143 號法令（AB 133）授權分兩個階段取消所有非 MAGI Medi-Cal Program （包括長期照護和Medicare Savings Program的資產測試。 第一階段將於7月1日實施，並將資產限額提高至每人13萬美元，每增加一名接受評估的人員，資產限額將提高至6.5萬美元。第二階段將於 1 月 1、2024 日實施，並將取消資產測試。2021 年 11 月，CMS 批准了州計畫修正案21-0053 ，DHCS 向各縣發布了關於第一階段實施的政策指導，該指導以《全縣福利主任信函》（ ACWDL 21-31 ）的形式發布。DHCS也向 CMS 提交了一份申請，要求修改CalAIM第 1115 節示範豁免，以允許California提高並最終取消補充保障收入認定覆蓋群體的資產測試。 DHCS 發布了 Medi-Cal 資格部門資訊函（ MEDIL I 22-02 ），為各縣、倡導團體和其他合作夥伴提供了全球宣傳信息，以便在有關 7 月 1 日起提高資產限額的宣傳活動中使用。
行為健康持續基礎設施計劃（BHCIP）更新
BHCIP 第三輪：啟動準備
1 月 31 日，DHCS 與加州社會服務部（CDSS）合作發布 BHCIP 第三輪：啟動準備和 CDSS 社區關懷擴展（CCE）計劃聯合申請申請（RFA）。 申請人獲邀申請任何一項資助機會或兩者申請。 BHCIP 第三輪：啟動準備申請的截止日期為 4 月 8 日，申請審查正在進行中，申請人要求約 20 億美元。 DHCS 預計將於 6 月宣布 BHCIP 第三輪：啟動準備獎項。
BHCIP 申請人必須在服務 Medi-Cal 受益人的環境中以行為健康持續的治療和服務展示項目擴展，並具有有效的計劃過程，以確保項目準備好實施。 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 第四輪：兒童及青少年
BHCIP 第四輪：兒童和青少年專注於 25 歲及以下的兒童和青少年，包括懷孕和產後的人和他們的孩子，兒童和過渡年齡青年（TAY）以及他們的家庭。 所有申請人都需要證明他們的基礎設施項目將如何專門為該人群擴展行為健康服務。 通過第四輪競爭性補助金，DHCS 將為兒童和青少年重視行為健康基礎設施項目提供 480.5 萬美元。
The RFA for Round 4: Children and Youth was released on June 1. DHCS has released a program update as a supplement to the upcoming RFA for BHCIP Round 4: Children and Youth funding. As was the case with Round 3: Launch Ready, applicants are required to undergo a pre-application consultation. They will be expected to demonstrate “project readiness”, as detailed in the forthcoming RFA, and will be funded according to which of three pre-construction phases their project is in. Full project funding will be contingent upon completion of all three phases of development planning.
DHCS 透過 2021 年的立法獲得授權，設立 BHCIP，並撥款 21 億美元用於建設、收購和擴建房產，以及投資與行為健康相關的行動危機基礎設施。CDSS 負責監督 CCE Program ，該項目是根據AB 172 （2021 年法令第 20 章）設立的配套項目，總額達 8.05 億美元。 CCE Program重點關注成人和老年人護理設施的購買、建設和改造，這些設施服務於補充保障收入/州補充支付和移民現金援助Program的申請人和受益人以及其他正在經歷或面臨無家可歸風險的成年人。 如需了解更多信息，請訪問 BHCIP 計畫網站或發送電子郵件至 BHCIP@dhcs.ca.gov 。
行為健康聯邦補助更新
DHCS 最近向其聯邦資助機構藥物濫用和心理健康服務管理局提交了其第二年度的州阿片類藥物反應（SOR）II 進度報告。 2021 年 9 月至 2022 年 3 月期間，SOR 撥款為 21,672 名阿片類藥物使用障礙患者提供治療服務。 其中，超過 16,000 人接受了布普諾芬，5,000 人接受甲沙酮，400 人接受了注射的納爾曲松。 SOR 還為超過三萬個人提供康復或同行輔導，為 1,600 多個人提供恢復住房服務，並為近 1,500 個人提供就業服務。 在此期間，SOR 支持納洛克松分配項目，導致超過 9,000 次阿片類藥物過量逆轉。 此外，SOR 為 5,600 多個人提供刺激劑使用障礙治療服務。
有關 SOR 撥款的更多信息，請訪問藥物輔助治療擴展項目網頁或發送電子郵件至DHCSMATExpansion@dhcs.ca.gov 。
行為健康質量改善計劃（BHQIP）
The Department of Health Care Services (DHCS) created a three-year Behavioral Health Quality Improvement Program (BHQIP) to support implementation of the CalAIM initiative. The CalAIM BHQIP is structured as an incentive program, whereby counties may earn incentive payments by achieving certain CalAIM implementation milestones. Senate Bill (SB) 129 (Chapter 69; Statutes of 2021), authorized $21,750,000 in General Fund dollars for the CalAIM BHQIP for Fiscal Year 2021-22, which included a startup allocation amount of $250,000 to each County Behavioral Health Plan participating in BHQIP, and the rest was allocated to counties based on each county’s share of statewide claims value reported to DHCS. For inquiries about BHQIP, please contact BHQIP@dhcs.ca.gov.
卡拉艾姆更新
社區支持
4 月 15 日，DHCS 收到了 Medi-Cal MCP 提供的最終更新的護理模式 (MOC)，這些模式在加州所有 58 個縣實施社區支持，包括擬議的網路和服務的估計容量。7 月 1 日起，MCP 將進入社區支持實施的下一階段，並引入透過 MOC 流程選定的其他社區支援服務。修訂後的社區支持選舉將於 6 月中旬在CalAIM 網頁上公佈，前提是 DHCS 已批准所有未決的 MCP MOC。DHCS將繼續至少每半年更新一次社區支持選舉。
加強護理管理 (ECM)
ECM was implemented in counties with Health Homes Programs (HHP) and Whole Person Care (WPC) pilots on January 1, 2022. On July 1, 2022, counties that did not have HHP and WPC programs will begin implementation of ECM for the following Populations of Focus (POF): individuals and families experiencing homelessness, adult high utilizers, and adults with serious mental illness (SMI) or substance use disorder (SUD). DHCS is reviewing each MCP’s policies and procedures and confirming provider networks are ready for implementation.
Also, to ensure operational readiness, MCPs will submit updated MOCs by July 1 for two long-term care (LTC) POFs (members eligible for LTC and those at risk of institutionalization; and nursing home residents transitioning to the community), scheduled to go-live on January 1, 2023.
人口健康管理 (PHM)
5月3日，DHCS發布了PHM策略和路線圖草案，供公眾評議，書面評議截止日期為5月16日。本文件描述了DHCS對PHM的願景，概述了關鍵的政策舉措和問責機制，定義和描述了PHM的概念和術語，並詳細說明了2023年和2024年Medi-Cal MCP的要求。5月9日，DHCS發布了PHM服務招標邀請書（IFP） ，預計將於今年夏季
選定的供應商授予合約。
提供存取和轉換健康狀況 (PATH)
6 月，PATH 合作規劃參與者和促進者、司法涉案能力建設以及能力和基礎設施轉型擴展和發展 (CITED) 計劃的第一輪申請提交將開始。DHCS 於 5 月完成了 PATH 第三方管理機構 (TPA) 的 IFP 採購。DHCS正在評估這些提案，目標是在6月底前授予第三方管理機構（TPA）供應商合約。DHCS 繼續制定和改善技術援助市場、合作規劃、CITED 和司法相關能力建構倡議的指導文件。請造訪CalAIM PATH 計畫網頁，以了解有關 PATH 計畫的最新資訊和資源。
CalHOPE
CalHOPE has continued providing Crisis Counseling Assistance and Training Program (CCP) services to Californians in need of support. CalHOPE was approved for a 30-day and a 60-day cost extension that allowed CCP services through May 10, 2022. The federal partners recently approved DHCS’ 90-day no-cost extension, extending CalHOPE CCP services through July 9, 2022 and administrative close out activities through August 10, 2022.
CalHOPE 繼續為學校提供 CCP 教育服務，提高人們對焦慮負面影響的認識。自 2021 年 10 月以來，CalHOPE 一直與IndieFlix合作，包括發行電影《ANGST：建立韌性》 ，該片以心理健康支持計劃為基礎。此次推廣活動取得了成功，已有超過 150 個學區註冊，在學校進行了多次 Angst 現場放映，並已安排了與其他場所的推廣/溝通。此外， All It Takes與 CalHOPE 和加州教育部合作推出的影片《值得信賴的空間》上映後獲得了正面的回饋。該影片旨在培訓教育工作者如何幫助減輕情緒壓力對學生及其家庭的影響。
DHCS’ service provider, California Consortium of Urban Indian Health (CCUIH), has remained engaged in outreach of CCP services to their Tribal community. CCUIH has tabled various indigenous events, such as the Stanford Pow Wow, Mariposa Pow Wow, Indigenous Red Markets, and Healing and Coping events, sharing resources of the CalHOPE RedLine.
社區心理健康平等項目（CMHEP）
DHCS 與加州公共衛生部合作，透過 CMHEP 為 CBO 和縣行為健康部門提供支持，以實施針對特定人群和社區驅動的方法。AB 74（2019 年第 23 號法令）授權撥款，為縣行為健康部門提供培訓和技術援助。CMHEP計畫將持續兩年。DHCS 聘請應用研究解決方案中心製定全州社區驅動的政策指導，以及旨在減少獲得健康和行為健康護理方面差距的策略和乾預措施。新制定的政策指導方針將附帶一個健全的數據收集框架，用於評估在獲得文化響應式護理方面的改進。欲了解更多信息，請訪問CMHEP 網站。
DHCS 家居和社區服務（HCBS）支出計劃倡議
卡爾布里奇行為健康計劃
截至 2022 年 2 月，公共衛生研究所/CA 橋（PHI）報告了一名物質使用導航員看到 112,474 名患者、90,593 名患者患有阿片類藥物使用障礙和 40,044 名患者接受藥物輔助治療。 通過以家庭和社區為基礎的服務，DHCS 與 PHI 簽訂了 40 億美元的合約，以擴大該計劃的範圍和導航員的角色，以通過 CalBridge 行為健康導航計劃更好地解決心理健康狀況以及藥物使用障礙。 為了分配資金，PHI 於 2022 年 4 月發布了申請申請 RFA，以邀請具有急診部門，醫療系統，醫院基金會或醫生團體的醫院參與。
For more information about the CalBridge Behavioral Health Navigator Program, please visit the Bridge Navigator Program website.
長者全範圍醫療擴充功能
On May 1, individuals 50 years of age or older who met all Medi-Cal eligibility criteria, and who do not have satisfactory immigration status for federally-funded full-scope Medi-Cal, became newly eligible for state-funded full-scope Medi-Cal under the Older Adult Expansion. DHCS successfully transitioned 247,522 existing Older Adult Expansion individuals in restricted scope Medi-Cal to full-scope Medi-Cal, effective May 1. Individuals who apply now will automatically be determined eligible for full-scope Medi-Cal if they are 50 years of age or older and meet all other Medi-Cal eligibility criteria, regardless of immigration status. This expansion of Medi-Cal supports the Newsom Administration’s vision of a Healthy California for All by addressing health coverage disparities that disproportionately impact disadvantaged communities.
同儕支援服務
On May 2, DHCS received CMS approval of SPA 22-0024, with an effective date of July 1, to broaden the definition of a Peer Support Specialist as someone who must be in recovery themselves or have lived experience with the process of recovery as a parent, caregiver, or family member. Prior to this update, Peer Support Specialists were defined solely as individuals in recovery, which excluded parents, caregivers, or family members from becoming certified as Peer Support Specialists. This update aligns the definition of Peer Support Specialist with the Medi-Cal Peer Support Specialist Certification Program requirements.
On May 6, DHCS issued Behavioral Health Information Notice (BHIN) 22-026, which provides guidance regarding the submission of an opt-in letter and claiming requirements for Peer Support Services in the Drug Medi-Cal (DMC), Drug Medi-Cal Organized Delivery System (DMC-ODS), and Specialty Mental Health Services (SMHS) programs. In order to implement Peer Support Services effective July 1, counties must have provided a letter to DHCS stating their request to opt in to provide peer support services, and indicating the program(s) (SMHS, DMC-ODS, and/or DMC) for which they are opting in. The letter must be signed by the Behavioral Health Director and emailed to CountySupport@dhcs.ca.gov by May 20 to implement peer support services, effective July 1. To date, 48 counties have submitted a signed letter stating their request to opt in to provide Peer Support Services effective July 1, 2022, with most counties opting to cover Peer Support Services in both their SMHS and their DMC or DMC-ODS programs.
無法在 5 月 20 日截止日期前選擇選擇提供同行支持服務的縣，仍然有機會每六個月選擇一次。 DHCS 將提供有關後續選擇在未來提供同行支持服務的機會的其他信息。
牙科提供者申請和註冊驗證（PAVE）門戶網站
DHCS 將在 2022 年秋季為牙科提供者實施 PAVE 門戶。 PAVE 入口網站是一個基於 Web 的應用程式，旨在簡化和加速註冊程序。 PAVE 將為 DHCS 提交牙科提供者註冊申請和所需文件的新模式，允許申請人使用稱為 Medi-Cal 提供者電子表格申請的電子表格。 一旦實施 PAVE，DHCS 將不再接受紙質申請。
加利福尼亞州微笑醫療牙科服務活動
SmileCalifornia.org, SonrieCalifornia.org, and all materials pertaining to pregnant members were updated to reflect the American Rescue Plan Act of 2021 Postpartum Care Extension policy that was enacted on April 1, 2022.
Smile, California launched a promotion in April to support the required Kindergarten Oral Health Assessment (KOHA). The promotion brought awareness to the California law that requires all children to complete a dental assessment by their first year in public school, either Kindergarten or first grade, before May 31. Local oral health programs, school-based health centers, and CBOs received digital toolkits with educational KOHA materials, and the KOHA landing page was updated on SmileCalifornia.org and SonrieCalifornia.org.
In May, Smile, California launched an effort to promote the new Medi-Cal Older Adult Expansion to inform adults 50 years of age or older enrolled in restricted scope Medi-Cal that they are now eligible to receive full-scope Medi-Cal benefits, regardless of immigration status. A new landing page was created on SmileCalifornia.org and SonrieCalifornia.org with information about the expansion, frequently asked questions, and covered dental services. Social media ads and boosted posts ran on the Smile, California Facebook and Instagram accounts throughout May.
At the end of April, SmileCalifornia.org and SonrieCalifornia.org had received 66,794 new visitors, of which 51,361 clicked the “Find a Dentist” button.