DHCS Stakeholder News - November 18, 2022
Dear Stakeholders,
The Department of Health Care Services (DHCS) is providing this update of significant developments regarding DHCS programs.
Top News
California Behavioral Health Community-Based Continuum (CalBH-CBC) Demonstration Concept Paper Released
On November 15, DHCS released the CalBH-CBC Demonstration concept paper. The concept paper announces DHCS' intent to apply for a new Medicaid Section 1115 demonstration. DHCS will accept public comments on the concept paper through January 13, 2023. Please submit feedback to CalBHCBC@dhcs.ca.gov and include “CalBH-CBC Demonstration" in the subject line.
The demonstration, known as the CalBH-CBC Demonstration, will expand a robust continuum of community-based behavioral health care services for Medi-Cal beneficiaries living with serious mental illness (SMI) and serious emotional disturbance (SED). It takes advantage of the Centers for Medicare & Medicaid Services' (CMS) guidance and associated federal funding aimed at improving care for people living with SMI or SED. It will also amplify California's ongoing behavioral health initiatives, and be informed by findings from DHCS' 2022 Assessing the Continuum of Care for Behavioral Health Services in California.
This demonstration opportunity is similar to California's historic commitment to creating a full continuum of care for substance use disorder treatment and recovery services—in 2015, California launched the Drug Medi-Cal Organized Delivery System (DMC-ODS), a first-in-the-nation model that has been emulated in many other states. Like DMC-ODS, this opportunity allows California to make historic investments in building out the full continuum of care for behavioral health, with a special focus on the populations most at risk.
In the months ahead, DHCS will work with stakeholders to refine and revise the approach to the CalBH-CBC Demonstration with the intent of submitting a formal demonstration application to the federal government in 2023. For more information, please visit the CalBH-CBC webpage.
Coming Soon: Accepting Applications for Hospital and Skilled Nursing Facility COVID-19 Worker Retention Payments (WRP)
On November 29, DHCS will begin accepting applications for Hospital and Skilled Nursing Facility COVID-19 WRP. All registered Covered Entities (CEs), Covered Services Employers (CSEs), Physician Group Entities (PGEs), and Independent Physicians will receive a link to the application for submitting employee information. All requests for payment must be submitted no later than 5 p.m. on December 30, 2022. DHCS encourages early submissions, so that all applications can be validated before the final due date. Additional application guidance and templates for submission will be posted on the WRP webpage on or before the opening of the application period.
In addition, DHCS is reminding all eligible CEs, CSEs, PGEs, and Independent Physicians to register for WRP, as registration closes on December 21, 2022. Additionally, updated Frequently Asked Questions have been posted. For guidance and a link to register, please visit the WRP webpage.
Program Updates
Cal MediConnect (CMC) Member Transition to Medi-Cal Rx
Beginning on January 1, 2023, CMC members will transition to Medicare Medi-Cal Plans, and DHCS will also transition the Medi-Cal pharmacy benefit for these members to Medi-Cal Rx.
These members have already received 90- and 60-day notifications. On November 16, a 45-day alert was published on the Medi-Cal Rx website for prescribers and pharmacies reminding them of the CMC transition.
Smile, California Testimonial Video Series
To increase Medi-Cal dental provider engagement with the Smile, California campaign and encourage Medi-Cal members to familiarize themselves with Medi-Cal dentists, the “Get to know a Medi-Cal Dentist" testimonial video series for providers will be expanded with four new videos. The first video was published on November 7. In the coming weeks, the remaining three videos will be published to SmileCalifornia.org and one of which will be in Spanish and published on SonrieCalifornia.org.
Join Our Team
DHCS is hiring! For opportunities to join our fiscal, human resources, legal, auditing, health policy, and information technology teams, visit the CalCareers website.
DHCS is dedicated to preserving and improving the overall health and well-being of all Californians. DHCS' mission is to provide the most vulnerable residents with access to affordable, integrated, high-quality, and equitable health care, and is currently transforming the Medi-Cal program to make sure it provides the care Californians need to live healthier, happier lives.
Upcoming Stakeholder Meetings and Webinars
CalAIM Behavioral Health Workgroup Webinar
On November 21, from 12 to 1 p.m., DHCS will virtually host the CalAIM Behavioral Health Workgroup (advance registration required) meeting. The purpose of this meeting is to solicit stakeholder feedback on a concept paper on DHCS' intent to apply for a new Medicaid Section 1115 demonstration. California's 1115 demonstration will expand access to and strengthen the continuum of community-based mental health services for Medi-Cal beneficiaries living with serious emotional disturbance or mental illness. It will also leverage California's ongoing behavioral health initiatives, and be informed by findings from DHCS' 2022 Assessing the Continuum of Care for Behavioral Health Services in California. This meeting will be open to the public, in listen-only mode, with time for public comment at the end of the meeting. For more information, please visit the CalAIM Behavioral Health Workgroup webpage.
Doula Stakeholder Meeting
On November 21, from 1 to 3 p.m., DHCS will host a virtual public stakeholder workgroup meeting about the addition of doula services as a covered Medi-Cal benefit, effective January 1. DHCS engaged with workgroup members on policy development details that will be reflected in the Medi-Cal provider manual and other policy guidance documents. All interested stakeholders may listen to the workgroup discussion regarding stakeholder feedback and provide input via email. DHCS will discuss next steps in implementing doula services as a Medi-Cal benefit, including enrollment and providing services in fee-for-service Medi-Cal and managed care. Information related to the meeting will be posted on the Doula Services as a Medi-Cal Benefit webpage.
Smile, California Campaign for Medi-Cal Dental Services Facebook Live Event
On November 21, from 5:30 to 6:30 p.m., Smile, California will host a Facebook Live Event in Spanish to inform and educate members about their dental benefits available through Medi-Cal. A Smile, California Member Outreach Representative will talk about the dental services covered for members of all ages, and a Provider Relations Trainer will answer questions about members' dental benefits.
CalAIM Office Hours: How Organizations Are Sharing Data for Enhanced Care Management (ECM) and Community Supports
On December 1, from 2 to 3 p.m., DHCS will virtually host an “Office Hours" discussion (advance registration required) on how CalAIM organizations are sharing data for ECM and Community Supports. Participants are invited to submit questions by November 28 to CalAIMECMILOS@dhcs.ca.gov. Attendees will also have an opportunity to ask questions during the session.
CalAIM Skilled Nursing Facility (SNF) Carve-In Billing and Payment Webinar
On December 2, from 1 to 2 p.m., DHCS will virtually host the third in a series of public educational webinars for the SNF carve-in to prepare for managed care plans (MCP) coverage of SNFs statewide beginning on January 1, 2023. The December 2 webinar (advance registration required) will focus on providing stakeholders with an understanding of the directed payment policy for implementing the SNF long-term care (LTC) benefit standardization and the transition of members to managed care; review of what is included in the SNF per diem rate and what ancillary services may be covered outside of that rate; and promising practices in billing and payment. Additional details on upcoming webinars are available on the CalAIM LTC Carve-In transition webpage.
CalAIM Population Health Management (PHM) and Children & Youth Advisory Group – December Meeting
On December 5, from 10 to 11:30 a.m., DHCS will host a joint public PHM and Children and Youth Advisory Group meeting (advance registration required). The PHM Advisory Group will be joined by members of the Children and Youth Advisory Group. The meeting will feature a panel discussion, facilitated by DHCS, on implementing ECM for children, youth, and maternal populations of focus. DHCS will also share key takeaways from the MCP PHM Readiness Deliverable submissions and the new phased implementation policy for Transitional Care Services under the PHM Program.
DHCS established the PHM Advisory Group to support the design and implementation of the PHM Program and Service, and the CalAIM Children and Youth Advisory Group to inform policy design and implementation work for CalAIM initiatives that impact children and youth. For more information, please visit the CalAIM PHM initiative webpage.
Children and Youth Behavioral Health Initiative (CYBHI) Fee Schedule Workgroup Session 2
On December 5, from 3 to 5 p.m., DHCS, in collaboration with the Department of Managed Health Care (DMHC), will virtually host the second public workgroup meeting (advance registration required) to inform the development of the statewide all-payer fee schedule for school-based behavioral health services under the CYBHI. DHCS and DMHC will engage workgroup members on a variety of policy and operational topics to inform the development and refinement of the program design.
CYBHI Monthly Public Webinar
On December 7, from 2 to 3:30 p.m., DHCS will virtually host a webinar (advance registration required) to keep stakeholders apprised of DHCS' progress in implementing various work streams for the CYBHI.
