DHCS Stakeholder News - September 16, 2022
The Department of Health Care Services (DHCS) is providing this update of significant developments regarding DHCS programs.
Top News
DHCS Website Down For Regular Scheduled Maintenance
On Saturday, September 17, beginning at 6 a.m., DHCS will perform scheduled server maintenance. Work may continue through midnight. During this time, the DHCS website (www.dhcs.ca.gov) will be unavailable. We apologize for any inconvenience as we perform this maintenance, and we appreciate your patience.
Population Health Management (PHM) Service Vendor Selected
DHCS recently announced its selection of Gainwell Technologies LLC as the PHM Service vendor as part of the California Advancing and Innovating Medi-Cal (CalAIM) initiative. The new PHM Service will be transformational for the Medi-Cal program. Gainwell has an integrated partnership with Healthwise, HealthTrio, Gainwell Care Management, Arcadia, and InterSystems. This Service will give DHCS, managed care plans, providers, and counties integrated, comprehensive, and accurate data that will help inform program improvements and to better understand population health trends, ultimately resulting in Medi-Cal members having access to a more comprehensive, equitable program that leads to longer, healthier lives.
ACEs Aware Awards $19.5 Million in Grant Funds
On September 16, DHCS awarded $19.5 million in ACEs Aware grant funding to 25 teams, from 15 counties across California, in partnership with the Office of the California Surgeon General, UCLA-UCSF ACEs Aware Family Resilience Network, and Population Health Innovation Lab, a program of the Public Health Institute. The goal of this third round of funding, is to increase the workforce and services needed for primary care clinics to expand and sustain screening and response to ACEs and toxic stress in local communities.
The funding is awarded to teams led by clinics and includes community-based organizations and Medi-Cal managed care plans that serve a wide range of diverse patient populations. Teams will identify gaps in their communities in care and services and, through a statewide learning collaborative build sustainable capacity to fill these gaps. For a complete list of grantees, visit the ACEs Aware website at https://www.acesaware.org/grants/.
Health Enrollment Navigators Project
On September 9, DHCS began notifying approved Health Enrollment Navigators Project applicants of their individual award amounts, and requested that tentative awardees confirm their acceptance or rejection of the award by September 13. Allocation agreements will be provided to approved applicants upon notice of acceptance of the award, in anticipation of an October 1 project start date.
The tentative county awardees ($35.9 million total allocated) include Alameda, Butte, Colusa, Fresno, Kern, Kings, Los Angeles, Lake, Madera, Merced, Napa, Nevada, Orange, Placer, Riverside, San Bernardino, San Diego, San Luis Obispo, San Mateo, Stanislaus, Trinity, Tuolumne, and Ventura. The tentative community-based organizations (CBOs) ($24.1 million total allocated) include Ampla Health, Bonita Family Resource Center, Catholic Charities of California, California Coverage and Health Initiatives, Community Service Solutions, Harwood/Family Resource Center Network, Innercare, Kaweah Delta Health Care, Marin Community Clinic, Sacramento Covered, and San Francisco Community Clinic Consortium.
Senate Bill 154 (Chapter 43, Statutes of 2022) provided $60 million to continue the efforts of Assembly Bill 74 (Chapter 23, Statutes of 2019) to enroll and retain hard-to-reach target populations and provide the following support to the targeted populations: outreach, application assistance, enrollment, assistance with accessing and utilizing health care services, assistance with troubleshooting, retention, and assistance with redeterminations. For more information, please visit the Medi-Cal Health Enrollment Navigators Project webpage.
Program Updates
Monthly Premium Reduction to Zero
On September 8, the Centers for Medicare & Medicaid Services (CMS) approved two of California's State Plan Amendments (SPAs) to reduce monthly premiums to zero, with a retroactive effective date of July 1, 2022. SPA 22-0042 applies to the Optional Targeted Low-Income Child group, which covers eligible children with a family income above 160 percent of the federal poverty level (FPL). SPA 22-0034 applies to the Working Disabled Program, which covers eligible working disabled individuals with a family income up to 250 percent of the FPL. The SPAs will be posted on the
2022 Approved SPA webpage.
Children's Health Insurance Program (CHIP) COVID-19 Vaccines
On September 1, CMS approved California's CHIP SPA 22-0033. This SPA has an effective date of March 11, 2021, and extends through the last day of the first calendar quarter that begins one year after the last day of the COVID-19 public health emergency period, as described in the Social Security Act (SSA). The American Rescue Plan Act of 2021 (ARP) amended sections of the SSA to mandate coverage of COVID-19 testing, treatment, and vaccines and their administration without cost-sharing or amount, duration, or scope limitations. The SSA also requires states to cover, without cost sharing, the treatment of conditions that may seriously complicate COVID-19 treatment during the period when a beneficiary is diagnosed with or is presumed to have COVID-19. Through this SPA, California has provided the necessary assurances and demonstrated compliance with the ARP by eliminating copayments to CHIP subscribers for COVID-19 vaccines. The SPA will be posted on the
Approved CHIP SPA webpage.
COVID-19 Therapeutic “Test to Treat" Equity Grants
The California Department of Public Health (CDPH) has established the COVID-19 Therapeutics Equity Grant Program to help safety net providers, including Medi-Cal providers, expeditiously connect patients who test positive for COVID-19 with therapeutic treatment to decrease related morbidity and mortality. CDPH allocated up to $59 million for this “Test to Treat" grant program, which over the next 10 months will support providers in operationalizing access to clinically appropriate COVID-19 therapeutics in a timely manner, with a focus on three key expedited elements of COVID-19 assessment and treatment: testing, prescribing, and therapeutics. Grants range from $50,000 to $1 million, and the deadline for applying is September 30. Additional information is available on the
Physicians for a Healthy California website.
CalHOPE Courage Award Winners
On September 12, DHCS recognized the September CalHOPE Courage Award winners at the San Francisco Giants' Suicide Prevention Awareness Night. The monthly award honors student-athletes at California colleges and universities for overcoming the stress, anxiety, and mental trauma associated with personal hardships and adversity.
The winners are Cameron Brink, a junior forward for the Stanford University women's basketball team, and Garrett Jenson, a redshirt sophomore pitcher for the San Francisco State University baseball team. The student-athletes were recognized on the field during a pregame ceremony. On September 13, the Governor's Council on Physical Fitness and Mental Well-Being acknowledged the awardees during their meeting in Sacramento.
Reinstatement of Several Prior Authorization (PA) Requirements
On September 16, PA requirements will be reinstated for 11 drug classes for new start medications for beneficiaries ages 22 and older. A
notice was sent to key stakeholders on August 16 reminding them of the upcoming change.
Upcoming Stakeholder Meetings and Webinars
Dental Provider Training Seminars
DHCS is hosting Basic and Electronic Data Interchange (EDI) and Advanced seminars to educate new and existing providers on standard billing requirements and use of EDI to submit electronic claims. Seminars will be held in Clovis on September 21-22, and a virtual webinar will be held on September 27. To register, and for a complete list of upcoming dental provider trainings, visit the Medi-Cal Dental provider training
webpage.
CalAIM MLTSS and Duals Integration September Workgroup Meeting
On September 22 at 10 a.m., DHCS will virtually host the CalAIM Managed Long-Term Services and Supports (MLTSS) and Duals Integration Workgroup meeting. The goal of this workgroup is to serve as a stakeholder collaboration hub for CalAIM MLTSS and integrated care for dual eligible beneficiaries, and to give stakeholders an opportunity to provide feedback and share information about policy, operations, and strategy for upcoming changes for Medicare and Medi-Cal. CalAIM MLTSS advance registration for this public meeting. Background materials, transcripts, and video recordings of the previous workgroup meetings, along with additional information about the workgroup, are posted on the
CalAIM MLTSS and Duals Integration Workgroup webpage.
CalAIM Office Hours: Enhance Care Management (ECM) Long-Term Care Populations of Focus
On September 22, from 2 p.m. to 3 p.m., DHCS will virtually host an “Office Hours" discussion on CalAIM ECM Long-Term Care Populations of Focus. This is a follow-up to the September 8 webinar on the ECM Long-Term Care Populations of Focus, and is part of a series of “Office Hours" events focused on answering implementation questions from the field. Advance registration for this discussion is required. Participants are invited to submit questions by September 19 to
CalAIMECMILOS@dhcs.ca.gov.
CDPH COVID-19 and Monkeypox (MPX) Therapeutics Provider Webinars
Beginning on September 23 at 9 a.m., CDPH will host a weekly 90-minute provider webinar series that covers vaccines and therapeutics for COVID-19 and MPX. Please
register in advance for these sessions.
Children and Youth Behavioral Health Initiative (CYBHI) Monthly Webinar
On September 26, DHCS will host a webinar to keep stakeholders apprised of its progress in implementing various work streams for the CYBHI. Key attendees include youth, parents, family members, behavioral health providers, Medi-Cal managed care plans, county behavioral health departments, commercial health plans, education and other cross-sector partners, and all interested Californians. Please
register in advance.
Dementia Care Aware Webinar
On September 27, from 12 p.m. to 1 p.m., DHCS and UCSF will co-host the second virtual Dementia Care Aware webinar, “The Impact of Early Detection in Primary Care“.
Please register in advance.
Smile, California Campaign for Medi-Cal Dental Services
DHCS will hold two Facebook Live member presentations this month. The
English presentation is scheduled for September 28 at 1 p.m., and the
Spanish presentation is scheduled for September 30 at 1 p.m.
CalAIM Office Hours: ECM and Community Supports Implementation in Rural Counties
On September 29 from 2 p.m. to 3 p.m., DHCS will virtually host an “Office Hours" discussion on ECM and Community Supports Implementation in Rural Counties.
Advance registration is required. Participants are invited to submit questions by September 26 to
CalAIMECMILOS@dhcs.ca.gov. Attendees will also have an opportunity to ask questions during the session.
Doula Stakeholder Meeting
On September 30, DHCS will host a virtual public stakeholder workgroup meeting about adding doula services as a covered Medi-Cal benefit, effective January 1, 2023. DHCS is engaging 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 on stakeholder feedback and provide input via email to
DoulaBenefit@dhcs.ca.gov. DHCS will also share an update on the status of formally submitting the SPA to CMS in October. The link to join the webinar will be available on the
doula webpage.
Published COVID-19 Information
