專案更新
行為健康聯邦補助更新
九月 27, 2021, 衞生署重新發布危機關懷流動單位 (CCMU) 資助機會，該機會將於 11 月 29、2021 開始使用。 原有 2.500 萬美元的資助機會由 23、2021 年 7 月至 8 月 23、2021，發放給加利福尼亞州縣、城市行為健康機構、縣和/或城市行為健康機構的聯合組織和/或部落實體。 DHCS 目前正在審查初始融資輪的申請，尋求 159 億美元。 資格要求保持不變，儘管以前的申請人可以申請額外資金，但 DHCS 將優先考慮新申請人。 最少將在兩個方向上提供 4,600 萬美元：1) 計劃撥款高達 200,000 美元，以評估移動危機和非危機計劃的需求，並制定一個行動計劃以解決需求；2) 每個 CCMU 團隊實施最多 100 萬美元的實施資助，以實施新的或擴展現有 CCMU 計劃。 所有 CCMU 資助受款人都必須優先為 25 歲或以下個人提供移動行為健康危機服務的優先順序，同時為更廣泛的人口服務提供服務，並鼓勵支持司法干預服務。 本輪獲資助人的資助將於 3、2022 年 1 月至 6 月 30、2025 期間提供。
CCMU 兩輪資助均獲得：通過藥物濫用預防和治療組別補助金以及由藥物濫用和心理健康服務管理局通過從冠狀病毒應變和救濟補助法撥款撥款授予的 55 億美元；以及通過行為健康持續基礎設施計劃中的 2021-22 財政年度一般資金納入 150 萬美元。 有關 CCMU 資助機會的更多信息，請發送電子郵件 BHRRP@dhcs.ca.gov。
行為健康持續基礎設施計劃（BHCIP）更新
10 月 1 日，DHCS 為縣、部落、非營利組織和非營利組織舉辦 BHCIP 聆聽會議。 聆聽會議討論了 BHCIP 資助機會，計劃時間表和可用的技術幫助，並為符合條件的申請人提供了一個機會直接向 DHCS 提供有關建議的 BHCIP 活動的見解，包括書面和口頭反饋。
BHCIP provides DHCS with funding to award competitive grants to qualified entities to construct, acquire, and rehabilitate real estate assets, or to invest in mobile crisis infrastructure to expand the community continuum of behavioral health treatment resources. A portion of the funding is available for increased infrastructure targeted to children and youth age 25 and younger. For more information, please email BHCIP@dhcs.ca.gov or visit the DHCS website.
CalHOPE
The CalHOPE Crisis Counseling Assistance and Training Program (CCP) received federal approval to extend services, allowing the program to continue through February 9, 2022, to provide emotional support for all Californians. Each week, the CalHOPE Connect chat feature continues to assist individuals with an average of 4,000 chats per week. CalHOPE also continues to partner with Together for Wellness and Juntos por Nuestro Bienestar, which feature evidence-based and community resources to help manage stress and anxiety, and offer the CalHOPE Warm Line, (800) 317-HOPE (4673). The Warm Line connects callers to other people who have persevered through struggles with stress, anxiety, and depression.
CalHOPE provided individual crisis counseling, group counseling, public education, brief education, and supportive contact services to 40,075 Californians in July and 46,961 in August. Additionally, from July 1 through September 10, CalHOPE provided CCP services to 459,146 Californians, which involved helpline contact, email responses, resource materials handed out/mailed, and mass media outreach. The most recent statistics and accomplishments are located on the CalHOPE Impact page. Additionally, American gymnast Mary Lou Retton delivered a message identifying CalHOPE as a local sponsor of NBC Universal’s coverage of the Tokyo Olympics.
社區衛生工作者服務福利
DHCS is adding CHW services as a preventive service in the State Plan. In order to allow for the successful launch of the CHW benefit, DHCS is adjusting the implementation date for these benefits from January 1, 2022, to July 1, 2022. Additional time is needed to work with stakeholders and health plans, review their input, incorporate their feedback into the State Plan Amendment, ensure successful system updates, seek federal approval from CMS, and allow time for plans to prepare to offer these services. CHWs are skilled and trained health educators, assist individuals with accessing health care services, and provide key linkages with other similar and related community-based resources. CHWs would render Medi-Cal covered benefits and services under the supervision of an enrolled Medi-Cal provider. These services would be available under both the fee-for-service (FFS) and managed care delivery systems. DHCS met with stakeholders on August 18 and September 17 to discuss developing the State Plan Amendment (SPA) to add CHW services as a covered benefit. More information is available on the DHCS website, including future opportunities for stakeholders to provide input on developing the benefit.
牙科轉型計劃（DTI）
The July 2021 payment of $2 million for Domain 1 was released on August 2, 2021. The goal of DTI’s Domain 1 is to increase by 10 percentage points the statewide proportion of children through age 20 enrolled in Medi-Cal who receive a preventive dental service during a five-year period. As of August 31, the amount of Domain 2 payments issued was approximately $194.4 million, and 3,375 providers have opted in to participate. The goal of Domain 2 is to diagnose early childhood caries by utilizing caries risk assessments to treat it as a chronic disease and to introduce a model that proactively prevents and mitigates oral disease. For more information, please visit the DHCS website.
藥物加州醫療補助健康保健計劃有組織的交付系統（DMC-ODS）
California’s first regional DMC-ODS model began operating in seven counties on July 1, 2020, bringing the number of counties participating in the DMC-ODS to 37 and covering more than 96 percent of the Medi-Cal population. The regional model is a collaboration among seven Northern California counties and Partnership HealthPlan of California that allows access to screening, assessment, early intervention, and continuum of substance use disorder (SUD) treatment. The DMC-ODS provides a continuum of care modeled after the American Society of Addiction Medicine (ASAM) criteria for SUD treatment services.
2021 年，DHCS 繼續為有興趣的 DMC 州計劃縣舉行網絡研討會。 網路研討會主題包括個別和區域模型選項、藥物輔助治療（MAT）訪問、網絡充足標準以及財政影響和預測，所有這些都是為了支持 DMC-ODS 的實施。
As of February 1, DHCS implemented Senate Bill (SB) 823 (Chapter 781, Statutes of 2018) through Behavioral Health Notice No.: 21-001, which requires DHCS’ licensed alcohol and other drug (AOD) recovery treatment facilities to obtain at least one DHCS Level of Care (LOC) Designation and/or at least one residential ASAM LOC Certification consistent with all of its program services. DHCS has processed 1,425 total designations for AOD providers in California. Of those designations, 1,126 are active for 420 providers. More information about the DMC-ODS is available on the DHCS website.
DHCS also contracts with an External Quality Review Organization (EQRO) that reviews DMC-ODS counties annually regarding access, timely access, and quality of care. The information from these reviews is summarized in annual county reports. For FY 2020-21, the EQRO completed and posted 29 DMC‑ODS county reviews, including the first review of the DMC-ODS regional model. In April 2021, DHCS submitted the annual statewide technical report as well as performance improvement project reports to CMS. All EQRO. The EQRO commenced FY 2021-22 county reviews in September. Additionally, under contract with the University of California Los Angeles, Integrated Substance Abuse Programs (UCLA ISAP), DHCS is conducting annual DMC‑ODS waiver evaluation activities to measure and monitor outcomes. The evaluation focuses on access to care, quality of care, cost, and the integration and coordination of SUD care, both within the SUD system and with medical and mental health services. The latest DMC‑ODS waiver evaluation report is posted on the UCLA ISAP website.
杜拉服務優惠
DHCS is adding doula services to the list of Medi-Cal preventive services to improve health equity and address health disparities. In order to allow for the successful launch of this benefit, DHCS is adjusting the implementation date for this benefit from January 1, 2022, to July 1, 2022. Additional time is needed to work with stakeholders and health plans, review their input, incorporate their feedback into the State Plan Amendment, ensure successful system updates, seek federal approval from CMS, and allow time for plans to prepare to offer these services. Doula services include emotional and physical support to individuals throughout pregnancy, labor, childbirth, and the postpartum period. Pursuant to federal regulations, doula services will need to be recommended by a physician or other licensed practitioner. DHCS met with stakeholders on September 16 to discuss developing the SPA, including defining qualifications of doulas, covered services, and supervision. These services will be available in both the FFS and managed care delivery systems. More information is available on the DHCS website, including future opportunities for stakeholders to provide input on doula services and the SPA.
艾滋病毒/艾滋病醫療豁免計劃（MCWP）續期
On September 29, 2021, DHCS submitted the HIV/AIDS MCWP renewal application to CMS. The renewal application is posted on both the DHCS and California Department of Public Health (CDPH) websites. DHCS, in collaboration with CDPH, must renew its HIV/AIDS MCWP every five years. The current HIV/AIDS MCWP term ends on December 31, 2021. The new waiver term will be January 1, 2022, through December 31, 2026. From August 13 through September 13, DHCS posted the HIV/AIDS MCWP renewal to the AIDS Medi-Cal Waiver Program webpage for a 30-day public comment period. CDPH received and responded to 10 comments from stakeholders, and updated the MCWP renewal application to reflect stakeholder comments.
根據《社會保障法》第 1915 (c) 條授權的艾滋病毒/艾滋病 MCWP，為患有艾滋病毒/艾滋病患者提供全面的個案管理和直接照顧服務，作為護理設施護理或住院的替代方案。 MCWP 的目標是：(1) 為其他可能需要機構服務的愛滋病病毒患者提供家庭和社區服務；(2) 協助參與者進行愛滋病病毒健康管理；(3) 改善獲得社會和行為健康支援；及 (4) 協調服務提供者並消除重複服務。
家庭和社區替代方案（HCBA）豁免續期
On September 29, 2021, DHCS submitted the HCBA waiver renewal application to CMS. The renewal application, and additional information, is posted on the DHCS website. DHCS must renew its HCBA waiver every five years. The current waiver term ends on December 31, 2021; the new one will be effective from January 1, 2022, through December 31, 2026. From August 16 through September 16, DHCS posted the HCBA waiver renewal application to the DHCS website for a 30-day public comment period. DHCS received and responded to 128 comments from 36 stakeholders, and updated the HCBA waiver renewal application to reflect stakeholder comments.
根據《社會保障法》第 1915 (c) 條授權的 HCBA 豁免，為他們選擇的社區環境中提供長期、以社區為本的服務和支持。 這些服務包括私人職務護理、個案管理和個人護理服務，以維護具有護理水平需要的個人健康和安全，而不是在社區環境中，而不是機構。
家居及社區服務支出計劃
On September 3, 2021, CMS notified DHCS that California’s HCBS Spending Plan was granted partial approval of the initiatives proposed, with one initiative denied and additional information requested for other initiatives. On September 17, DHCS, in collaboration with sister departments, provided CMS with the additional information requested for specific initiatives. DHCS and its partners are currently developing implementation strategies and timelines. More information will be made available to stakeholders and posted on the DHCS website in the coming weeks.
On July 12, DHCS submitted California’s $4.6 billion Medicaid HCBS Spending Plan to CMS for review and approval. The American Rescue Plan Act of 2021 (ARPA) provides states with a temporary increase in federal funds for certain HCBS Medicaid expenditures from April 1, 2021, through March 31, 2022. The HCBS plan reflects many of the investments included in the initial version released by DHCS in early June, as well as program funding included in the 2021 Budget Act. The plan will expand services for California’s most vulnerable and at-risk residents through new and existing programs that will strengthen HCBS in the state’s Medicaid delivery systems. These investments will also build capacity and transform critical safety net programs, as well as promote economic mobility and social stability.
醫學口譯員試驗計劃
Pursuant to SB 165 (Chapter 365, Statutes of 2019), DHCS is required to collaborate with stakeholders to establish a pilot at up to four sites to evaluate the provision of medical interpretation services for beneficiaries with Limited English Proficiency (LEP) enrolled in Medi-Cal managed care and FFS Medi-Cal. A primary goal of the pilot will be to determine whether providing medical interpretation services results in a reduction of disparities in access to and use of services, and quality of care, with respect to beneficiaries with LEP and beneficiaries who are proficient in English. DHCS will make available up to $5 million for the pilot project and the associated ongoing, independent evaluation to be conducted throughout the term of the pilot by California State University at San Diego’s Institute for Public Health.
On August 31, DHCS announced the following selected pilot site contractors: Contra Costa County—Monterey Language Services; Los Angeles County—Language World Services, Inc.; San Diego County—Hanna Interpreting Services, L.L.C.; and San Joaquin County—J. Rivera Associates. DHCS anticipates that the pilot project will run from November 1, 2021, through September 30, 2023. For more information, visit the DHCS website.
藥物治療管理（MTM）
As part of the Governor’s 2021 Budget Act, DHCS submitted SPA 21-0028 to CMS seeking to add MTM as a payable FFS pharmacy service provided in conjunction with certain complex chronic medical conditions. On September 15, DHCS received CMS approval of this SPA, and is now working to finalize provider contracts and meet with stakeholders to obtain feedback and insights regarding the specific requirements and allowances of the MTM benefit. To participate in this program, Medi-Cal-enrolled pharmacies will be required to enter into a contract with DHCS. The contract will outline the requirements and guidelines necessary to receive reimbursement under this methodology.
醫用卡 Rx 實作更新
Medi-Cal Rx is scheduled to launch on January 1, 2022. Outreach and education activities have begun and will run through December, in advance of the January 1 go-live date. DHCS will send a 60-day notice to all Medi-Cal beneficiaries and a 30-day notice to all FFS beneficiaries. MCPs will also send a 30-day notice to their members as part of a broader outreach campaign. Additionally, DHCS has resumed Medi-Cal Rx stakeholder engagements and meeting schedules. For more information, please visit the DHCS website or email RxCarveOut@dhcs.ca.gov.
錢跟隨人（MFP）補充資金申請
MFP 示範計劃支持國家努力重新平衡國家長期服務和支持系統，以便個人可以選擇他們居住的地方和接收服務。 MFP 計劃的目標是增加 HBS 的使用並在適當時減少機構為基礎的服務的使用，同時增強 Medicaid 計劃為選擇退出機構的人提供 HCBS 的能力。
23 月 2020，CMS 宣布為目前運營 MFP 示範計劃的州提供高達 1.65 億美元的補充資金。 每個州都有資格獲得高達 5 萬美元的補充資金，用於規劃和能力建設活動，以加速長期護理系統轉型設計和實施，以及擴大 HBS 能力。 要獲得資助獎勵，州的受助人必須在 6 月 30 日前提交包括項目敘述的提案。
On July 27, CMS approved DHCS’ $5 million MFP supplemental funding application to conduct a statewide gap analysis and multiyear roadmap of its HCBS and Managed Medi-Cal Long-Term Supports and Services (MLTSS) programs and networks. The CMS-approved application is available on the DHCS website
同行專家認證計劃
On July 22, 2021, DHCS released Behavioral Health Information Notice 21-041 identifying the state standards for Medi-Cal peer support specialist certification programs that may be implemented by counties, or an entity representing counties, that opt in to provide these programs, according to SB 803 (Chapter 150, Statutes of 2020) requirements. This certification is required for Medi-Cal reimbursement, but does not impact peer programs with other funding sources. For questions about Medi-Cal peer support specialist certification, email Peers@dhcs.ca.gov.
On August 27, DHCS released for stakeholder feedback a draft of SPA 21-0051, which seeks to establish peer support services as a distinct specialty mental health service, and peer support specialists as a distinct provider type.
DHCS 正在向 CMS 提交所有執行新的同行支持專家福利所需的聯邦 Medi-Cal 豁免和州計劃修訂。 在 CMS 批准後，同行支持專家服務可以在 2022 7 月 1 開始。
產後護理保障
Under the provisions of ARPA, DHCS is opting to broaden the scope of Medi-Cal coverage for currently eligible and newly eligible pregnant individuals. Medi-Cal will cover the full breadth of medically necessary services, during both the pregnancy and postpartum periods, by adding ten months of coverage following the current 60-day postpartum period, for a total of 12 months. In the interest of aligning the Medi-Cal Access Program (MCAP) with the Medi-Cal postpartum care extension policies described above, DHCS submitted a Children’s Health Insurance Program (CHIP) SPA, CA-21-0032, proposing to create a Health Services Initiative (HSI) to extend the provisions allowed in ARPA to MCAP. On September 14, DHCS received federal approval for the HSI. Under the provisions of ARPA and the HSI, individuals will maintain coverage through their pregnancy and 12-month extended postpartum coverage period regardless of income changes, citizenship, or immigration status. This policy is targeted for implementation on April 1, 2022.
加利福尼亞州微笑醫療牙科服務活動
The statewide “Back-Tooth-School” campaign, which aimed to encourage parents and caregivers to send their children back to school with healthy smiles by scheduling a dental check-up before the start of the 2021-22 school year, concluded in September. Smile, California developed 15 new resources and assets (translated in Spanish and some in Chinese) as part of this campaign. Fifty-six local oral health programs participated in the campaign by co-branding Smile, California resources, sharing messaging through social media, and conducting kindergarten oral health assessment events.
Also, two new videos were posted to SmileCalifornia.org and SonrieCalifornia.org. The first video, entitled “How to Use the Find A Dentist Tool,” is available in both English and Spanish. The second video, “Healthy Children are Ready to Learn!“, underscores the important role good oral health and regular dental check-ups play in school readiness. This video is also available in both English and Spanish.
Additionally, in October, Smile, California will partner with 185 school-based health centers, which do not offer dental treatment as a service, by providing them with a new 11×17 inch poster in English, Spanish, Mandarin, and Vietnamese. The poster will feature a 2-2-2 tip message (visit the dentist 2x a year, and brush for 2 minutes 2x a day each day) and will feature a list of the free and low-cost services provided by the Medi-Cal Dental Program. Further, in celebration of the campaign’s third anniversary, five Medi-Cal dental provider testimonial videos will premiere on Smile, California’s website and social media accounts. Watch the series on SmileCalifornia.org, Facebook, or Instagram.
By the end of August, SmileCalifornia.org had 19,854 new visitors, of which 14,505 clicked the “Find a Dentist” button.