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DHCS 覆蓋大使
DHCS 已在全州發起了一項全州的努力，以幫助 Medi-Cal 受益人保持他們的 Medi-Cal 保障或註冊其他保障。
In the largest effort of its kind, across the country, Medicaid (e.g., Medi-Cal) and the Children’s Health Insurance Program will soon begin the process of redetermining eligibility for about 85 million people who use these programs to access the health care they need. This large, complex effort will be triggered by the official end of the COVID-19 public health emergency (PHE) and the end of the federal Medicaid continuous coverage requirement that was implemented as part of the Families First Coronavirus Response Act.
由於加利福尼亞計劃恢復正常的 Medi-Cal 資格運作，大約 14500 萬受益人將需要重新確定其保障資格。 在綜合資助計劃結束時，各縣將根據其下一年續期的日期重新確定所有受益人的 Medi-Cal 資格（按循環進行，而不是一次全部進行）。 由於該程序，兩至三百萬受益人將無法再獲得 Medi-Cal 的資格。
DHCS has been actively preparing for this unprecedented event for many months, and has implemented a two-phased communication campaign to reach beneficiaries with messages across multiple channels using trusted partners called DHCS Coverage Ambassadors. DHCS encourages its partners, including local county social services agencies, managed care plans (MCPs), health enrollment navigators, clinics, providers, and community stakeholders, to sign up to serve as DHCS Coverage Ambassadors.
For Phase 1 of the campaign, DHCS recently launched a customizable Medi-Cal Continuous Coverage toolkit and webpage to help trusted entities and individuals act as DHCS Coverage Ambassadors to provide critical information to beneficiaries and to help preserve health coverage for millions. The toolkit includes social media, call scripts, noticing, and website banners. During Phase 1, trusted entities and individuals encourage beneficiaries to update their contact information with their local county offices, if they have not done so already. Beneficiaries need to know what to expect and what they can do to keep their Medi-Cal health coverage. Those no longer eligible for Medi-Cal may qualify for tax subsidies that allow them to buy affordable Covered California coverage.
第二階段計劃於 COVID-19 PHE 結束前大約 60 天推出，旨在鼓勵受益人更新聯繫信息並向當地縣政府報告任何情況的變化，並檢查其郵件是否即將到來的續訂包。 隨著額外的工具包或資源可用，DHCS 將通過電子郵件發送重要更新，以通知 DHCS 覆蓋大使，以便他們可以傳播信息。
DHCS 知道分享信息並聽到您的反饋非常重要，因為我們共同採取措施以超越 COVID-19 PHE。 我們所有人都需要合作，才能幫助受益人知道他們必須做什麼以及何時才能維持或轉換他們的健康保障。 感謝您持續的合作夥伴關係。
中醫新冠肺炎疫苗接種激勵計劃
DHCS allocated up to $350 million to incentivize COVID-19 vaccination efforts in the Medi-Cal managed care delivery system from September 1, 2021, through February 28, 2022. Medi-Cal MCPs are eligible to earn incentive payments for activities designed to close vaccination gaps with their enrolled members, and to address vaccine uptake disparities for specific age and race/ethnicity groups. The second outcome ascertainment period for the program ended on January 2. Between November 1 and January 2, the total vaccination rates showed improvement in all reported measures. Statewide, the target (59.2 percent) was exceeded (61.4 percent) for improving the percentage of primary care providers in MCP networks giving the COVID-19 vaccine in their office. On January 2, target goals for all vaccine outcome measures increased to closing two-thirds of the gap between Medi-Cal and county rates, which was a challenge for plans to meet. Three beneficiary sub-groups (ages 12-25 years, African-Americans, and American Indians/Alaska Natives) were successful in closing more than one-third of the gap at this time point, while an additional three groups (overall age 12+ years, 50-64 years, and 65+ years) were within 2 percent of closing one-third of the gap. Specifications for the High Performance Pool program were released to MCPs. For more information, please refer to All Plan Letter (APL) 21-010, Attachment A.
老年人擴展
On May 1, California will expand state-funded full-scope Medi-Cal benefits to individuals who are 50 years of age or older, regardless of citizenship or immigration status. This coverage expansion includes approximately 185,000 individuals 50 years of age or older who are currently enrolled in restricted scope Medi-Cal. Under this coverage expansion, eligible individuals will be able to access the full range of benefits available to Medi-Cal beneficiaries who have full-scope coverage, including no-cost/low-cost quality health, behavioral health, substance use disorder services, and dental services through organized delivery systems under the Medi-Cal program. Enrolled individuals in restricted-scope Medi-Cal who are eligible under this expansion will receive a My Medi-Cal Choice packet in the mail so they can enroll in a Medi-Cal managed care plan for coordinated, integrated medically necessary services. Once enrolled in a plan, they can select a primary care doctor in their plan network. For more information, please visit the DHCS website.
55 歲及以上加利福尼亞人的醫療保健調查
In April, DHCS will release the results from a survey of California adults ages 55 and older on health care needs, services, and coverage, including Medicare, Medi-Cal, and other health coverage. The survey included questions about respondents’ medical needs, coordination of and access to health care services, caregiver experiences, and the need for and access to in-home care and services. Interviews for this survey were conducted between January 25 and February 10, 2022. A total of 1,540 individuals completed the survey. It was administered by NORC at the University of Chicago, with funding from The SCAN Foundation and oversight from DHCS’ Office of Medicare Innovation and Integration. The survey results will be posted on the DHCS website.