DHCS Stakeholder News - January 27, 2023

In addition, the waiver authorizes $410 million for Providing Access and Transforming Health, Justice-Involved Capacity Building grants to support collaborative planning, and IT investments intended to support implementation of pre-release and reentry planning. 

DHCS developed a social media toolkit for our partners. Please share the toolkit widely with those who may find this information helpful. For more information, please visit the Justice-Involved webpage.   

Opening of CalAIM Providing Access and Transforming Health (PATH) Technical Assistance (TA) Marketplace

On January 31, DHCS will open the virtual PATH TA Marketplace to the public. The TA Marketplace is a virtual marketplace for partners and potential partners to receive technical assistance services to support the implementation of California Advancing and Innovating Medi-Cal (CalAIM), including Enhanced Care Management (ECM) and Community Supports. The TA Marketplace is a one-stop-shop website where entities can find and be connected to TA resources from curated and approved providers. TA offerings include the option to request custom, hands-on technical support or to request off-the-shelf TA products, which are packaged and ready for implementation.

To receive no-cost services, providers, community-based organizations, Medi-Cal Tribal and Designees of Indian Health Programs, counties, and other eligible TA recipients will be able to submit a Recipient Registration form that, once approved, will allow registrants to shop and apply for TA services beginning in February 2023.

Please visit ca-path.com/ta-marketplace to learn more.

Program Updates 

DHCS Receives Approval for the Doula State Plan Amendment (SPA)

On January 26, CMS informed DHCS that it had approved State Plan Amendment (SPA) 22-0002 for doula services, and that DHCS would receive the approval letter on January 27. The approved SPA will be posted on the DHCS webpage by February 3. DHCS submitted the SPA to CMS on November 7, 2022, after working with stakeholders for more than a year to develop the benefit. The coverage description reflects the input from the Doula Stakeholder Workgroup and other stakeholders on the description of covered services and the qualifications of doulas. The final meeting of the current doula workgroup was held on January 26. The Doula Implementation Workgroup, required by section 14132.24 of Welfare and Institutions Code pursuant to Senate Bill 65 (Chapter 449, Statutes of 2021), will hold its first meeting on March 30. The new workgroup will examine issues of service availability, payment, and outreach, as identified in the statute. More information is available on the doula webpage.

DHCS Reopens PATH Justice-Involved Round 2 Funding

On January 30, DHCS will reopen the PATH Justice-Involved Initiative Round 2 application. Round 2 funding will support correctional agencies, institutions, and other justice-involved stakeholders as they implement pre-release Medi-Cal enrollment and suspension processes. For more information, visit the Justice-Involved Capacity Building Program website.

Medi-Cal Managed Care Plan (MCP) Enrollment for Medicare/Medi-Cal Dual Eligibles

Effective January 1, 2023, members dually eligible for Medicare and Medi-Cal across the state became eligible to be mandatorily enrolled in Medi-Cal MCPs for their Medi-Cal benefits only. As a reminder to our stakeholders, this change in Medi-Cal does not change access to Medicare providers or benefits. Additionally, Medicare providers serving dual eligible patients do not need to enroll in a Medi-Cal MCP to continue receiving reimbursement. More than 70 percent of dual eligible members statewide are already enrolled in Medi-Cal MCPs; this step transfers the remaining 30 percent into Medi-Cal MCPs.

DHCS published an updated fact sheet and toolkit for Medicare providers to explain the provider billing process for dual eligible members enrolled in Medi-Cal managed care. This fact sheet describes the existing crossover billing process, which does not change under CalAIM.

For patients in Original (fee-for-service) Medicare, the Medicare Administrative Contractor processes the primary claim for Medicare payment, and then forwards the claim to the Medi-Cal MCP (or DHCS) for secondary Medi-Cal payment. For patients in Medicare Advantage (MA), the Medicare provider bills the MA plan for primary payment. The secondary payment process may depend upon whether the patient's Medi-Cal MCP is the same as or different than the MA plan. For more information, please visit the Statewide Medi-Cal Managed Care Enrollment for Dual Eligible Members webpage.

Smile, California Campaign for Medi-Cal Dental Services

On February 1, the National Children's Dental Health Month promotion will launch, focusing on the importance of preventive dental care. The theme, Love Your Teeth, will be weaved into existing and new resources and messaging for promotion on SmileCalifornia.org and SonrieCalifornia.org.

Join Our Team 

DHCS is hiring! DHCS has an immediate opening for a new Chief Operating Officer for Programs. This senior executive position provides leadership and oversight for all aspects of three key areas of the Department's operations: Enterprise Data and Information Management, Enterprise Technology Services, and Program Operations.

DHCS is also hiring for our fiscal, human resources, legal, auditing, health policy, and information technology teams. For more information, please 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 equitable access to affordable, integrated, high-quality 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 

Department of Rehabilitation (DOR) State Appointments Workshop

On January 30, from 12 to 1 p.m., DOR Director Joe Xavier and Governor Newsom's Appointments Secretary Cathryn Rivera will host a virtual informational workshop (advance registration required) to provide an overview of the state appointments process and why it is important to have disability representation on state boards and commissions. For more information about state appointments, including a current list of state board and commission vacancies, please visit the Office of the Governor's Appointments webpage.

California Children's Services (CCS) Monitoring and Oversight Workgroup Webinar

On January 30, from 12 to 4 p.m., DHCS will virtually host the CCS Monitoring and Oversight Workgroup meeting (advance registration required) to develop and implement the CCS Compliance, Monitoring, and Oversight Program, a component of the CalAIM initiative. Agenda topics for discussion at this meeting include the Grievance Numbered Letter (NL), Training NL, Surveying NL, Memorandum of Understanding development, compliance activities, and enforcement proposal. Additional information is available on the CCS Compliance, Monitoring, and Oversight Program webpage.

CalAIM Skilled Nursing Facility (SNF) Carve-In Webinar: How Medi-Cal Managed Care Supports SNF Residents

On January 30, from 2 to 3 p.m., DHCS will virtually host the fourth in a series of public educational webinars for the SNF Carve-In (advance registration required) to support Medi-Cal MCPs and SNF providers as they implement Medi-Cal managed care coverage of SNFs statewide that began on January 1, 2023. The webinar will provide an overview of key Medi-Cal managed care benefits, services, and programs that supports current SNF residents and SNF residents transitioning back to their home or community. Additional details on upcoming webinars are available on the CalAIM LTC Carve-In transition webpage.

Overview of Updates to Drug Medi-Cal Organized Delivery System (DMC-ODS) Behavioral Health Information Notice (BHIN) Webinar

On January 31, from 11 a.m. to 12 p.m., DHCS will host a webinar (advance registration required) to provide an opportunity for stakeholders to learn about updates related to the DMC-ODS. Specifically, DHCS will discuss updates to BHIN 21-075. Time will be reserved at the end of the webinar for a questions and answers session. A recording of the webinar will be available following the webinar. For more information, visit the CalAIM Behavioral Health Initiative webpage. For questions, email BHCalAIM@dhcs.ca.gov. You will find a copy of the agenda here.

PATH Justice-Involved Initiative Round 2 Funding Informational Webinar

On January 31, from 10:30 a.m. to 2 p.m., DHCS will hold an information webinar (advanced registration required) to provide application support for interested entities ahead of the new March 31 application deadline for the PATH Justice-Involved Initiative Round 2 funding. The meeting invite and additional details will be available on the Justice-Involved Capacity Building Program website. Please contact CalAIMJusticePreReleaseApps@dhcs.ca.gov with any questions.

Nursing Facility Financing Reform Webinar

On February 1, from 1:30 to 2:30 p.m., DHCS will host a nursing facility financing reform webinar (advance registration required) discussing the development of the Workforce Standards Program authorized by Assembly Bill 186 (Chapter 46, Statutes of 2022). Additional information is available on Nursing Facility Financing Reform webpage.

Health Enrollment Navigators Webinar

On February 6, from 1 to 2:30 p.m., the Health Enrollment Navigators Project is virtually hosting a joint stakeholder meeting with county and community-based organization partners, advocates, and other interested individuals to provide updates and answer questions on the DHCS Navigators Project team. Information regarding this meeting, other general information, and updates will be available on the Health Enrollment Navigators Project webpage. Interested parties may also request to be added to the meeting notice by emailing HealthNavigators@dhcs.ca.gov.

Provider Enrollment Provider Bulletin Stakeholder Meetings

On February 9, DHCS will hold two public stakeholder meetings via webinar to discuss regulatory provider bulletins. The “Requirements and Procedures for the Medi-Cal Enrollment of Providers Offering Services Remotely or Indirectly from their Business Address," will be held from 10 to 11:30 a.m. The “Discontinuation of COVID-19 Emergency Fee-for-Service Medi-Cal Enrollment," will be held from 1:30 to 3 p.m. Stakeholders will have the opportunity to submit questions and suggestions during the hearing; written comments will be accepted on the day of the hearings until 5 p.m. Based on the public comments received, DHCS will publish the final bulletins on the Medi-Cal and DHCS websites. The changes will become effective 30 days after publication.

In Case You Missed It  

CalAIM Behavioral Health Administrative Integration Concept Paper Released for Public Comment and Webinar

DHCS has released a concept paper for the CalAIM Behavioral Health Administrative Integration initiative, which aims to consolidate Medi-Cal programs for Specialty Mental Health Services and Drug Medi-Cal or DMC-ODS services into a single county-based behavioral health program by 2027. DHCS is accepting stakeholder feedback on the approach described in the concept paper through February 21. Please submit all comments in writing to bhcalaim@dhcs.ca.gov. Although DHCS does not plan to release a revised concept paper, feedback received during the comment period will inform DHCS' policy decisions, implementation strategy, and consideration of potential guidance and other technical assistance materials. For more information, please visit the Behavioral Health CalAIM webpage.

Crisis Recovery Resources

If you or someone you know is feeling stressed, anxious, depressed, or in need of emotional support, help is available. Below is a list of resources, including mental health services, as well as support for those who have experienced a natural or human-caused disaster.

Emergency or Crisis Response (All states)

• 911: If you are experiencing an emergency and need immediate assistance, please call 911.
  

• 988: If you are experiencing a suicidal crisis or emotional distress and would like confidential emotional support, call or text 988 for help in English or Spanish. The 988 Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals in the United States. Chat services are available at 988lifeline.org.
  

Disaster Support (All states)

• SAMHSA Disaster Distress Helpline: If you've experienced a natural or human-caused disaster, you can call or text the SAMHSA Disaster Distress Helpline's toll-free number (1–800–985–5990) and receive immediate counseling. This free, confidential, multilingual crisis support service is available to anyone experiencing distress as a result of a natural or human-caused disaster. People who call and text are connected to trained, caring professionals from crisis counseling centers in the network. Helpline staff provide confidential counseling, referrals, and other needed support services.

• SAMHSA Disaster Resources for Service Providers and other Professionals: The United States Substance Abuse and Mental Health Services Administration (SAMHSA) also offers disaster support resources and technical assistance for behavioral health providers, first responders, and other professionals. Please visit:
  

                    SAMHSA Disaster Behavioral Health Resources

                    SAMHSA Disaster Technical Assistance Center

• Center for the Study of Traumatic Stress (CSTS): CSTS is a federal academic-based organization dedicated to advancing trauma-informed knowledge, leadership and methodologies. CSTS offers free fact sheets and resources for victims, family members, first responders, and community leaders.

 

Mental Health Resources (California)

• CalHOPE: CalHOPE provides no-cost support for individuals who are feeling stressed, anxious, depressed, or worried.  The CalHOPE.org website is a hub to access multiple CalHOPE resources.  There are online tools at Together for Wellness/Juntos por Nuestro Bienestar in 10 languages that have been selected to meet the needs of different cultural groups.  If you want to chat with someone, CalHOPE Connect is the place to go, and if you want to talk with someone the CalHOPE Warmline at 833 317-HOPE (4673) is there for you. 
• National Alliance for Mental Illness (NAMI) California: NAMI California is a grassroots organization of families and individuals whose lives have been affected by serious mental illness. Local NAMI affiliates in California offer free support groups and classes for those living with mental health conditions and their families. Find your local affiliate to find out more about how you can find help and hope.
  

• Family Urgent Response System for Current and Former Foster Youth (FURS): FURS is a free, statewide, 24-hour hotline for current or former foster youth and your caregivers to call and get immediate help for issues big or small. In addition to hotline assistance, mobile response teams are available to provide immediate trauma-informed support to current and former foster youth and their caregivers. If you are a current or former foster youth or a caregiver, call 833-939-3877 or visit cal-furs.org for assistance.

 
Mental Health and Substance Use Resources for Medi-Cal Beneficiaries (California)

If you are a Medi-Cal beneficiary, services for mental health and substance use conditions are covered benefits. You can access mental health or substance use supports through your Medi-Cal managed care plan or your county behavioral health program: 

• Medi-Cal Managed Care: If you are enrolled in Medi-Cal managed care, your Medi-Cal Managed Care Plan will connect you with mental health services for children and adults that are covered by Medi-Cal.
  

• County Mental Health Services: Your county mental health plan can also connect you to appropriate services, including treatment for adults with more severe mental health conditions. Specialty mental health services for children are also covered. Contact information for each county's Medi-Cal specialty mental health plan is available here: County Mental Health Access Lines.
  

• County Substance Use Services: If you need help with alcohol or drug use, your county can connect you to Medi-Cal services for substance use. You may contact your county for substance use information and services using the numbers available here: County Substance Use Disorder Access Lines.  

 

Specialty and non-specialty mental health services available through Medi-Cal include, but are not limited to:

• Assessment and treatment, including individual, group and family therapy
• Medications for mental health conditions and related support services
• Care coordination
• Crisis intervention and stabilization
• Residential or inpatient psychiatric hospital treatment

 

Substance use services covered under Medi-Cal include, but are not limited to:

• Assessment and treatment, including individual and group counseling
• Medications for Addiction Treatment (MAT)
• Intensive Outpatient Treatment
• Care coordination
• Residential treatment (for all youth under 21, during and immediately after pregnancy, and for adults in some counties)

 

Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Medi-Cal Benefit: The benefits covered under EPSDT provide comprehensive and preventive health care services for individuals younger than 21 years of age who are enrolled in Medi-Cal. These services are key to ensuring children and youth receive appropriate preventive medical, dental, vision, hearing, mental health, substance use disorder, developmental and specialty services, as well as all necessary services to address any defects, illnesses or conditions identified. Mental health and substance use services are covered as part of EPSDT benefits, along with physician, nurse practitioner and hospital services; physical, speech/language, and occupational therapies; home health services; and treatment for vision, hearing, and dental diseases and disorders.