Medi-Cal Managed Care

5 Things To Know: CalAIM Incentive Program, Monoclonal Antibody Treatments, Resources For Front-Line Staff

MONOCLONAL ANTIBODIES: The California Department of Public Health (CDPH) has issued a COVID-19 Therapeutics Needs Assessment survey to understand how frequently antiviral medications and monoclonal antibody treatments are being used in each jurisdiction and/or health care facility. The survey is designed to help CDPH understand challenges and successes in outpatient treatment of COVID-19. As the landscape of outpatient therapeutics is changing rapidly, there have been several versions of this survey. Hospitals are encouraged to complete the survey even if another version was previously completed. More information on COVID-19 therapeutics options is available on the CDPH COVID-19 treatments page.

5 Things To Know: Workforce Council Meeting, Ambulance Patient Offload Times, Domestic Violence Training

MEDI-CAL MANAGED CARE RFP: On Feb. 9, the Department of Health Care Services (DHCS) released a request for proposal (RFP) for its commercial Medi-Cal managed care plan (MCP) contracts. While this RFP is only for commercial Medi-Cal MCPs, the updated contract will be executed with all Medi-Cal MCPs, including County Organized Health Systems, Local Initiatives, and the new Single Plan Model. The updated MCP contract, which is released with the RFP, also serves as the minimum definition of requirements. MCP proposals are due April 11, and DHCS expects to award contracts to selected plans in August. New contracts will become effective Jan. 1, 2024. A voluntary pre-proposal web conference will be held on Feb. 24 from 1 to 2:30 p.m. (PT). Pre-registration is required, and questions will be taken only via the webinar chat feature.

5 Things To Know: Medi-Cal RFP Update, Board Meeting Highlights, Key Messaging on Workforce Shortages

MANAGED CARE PLAN RFP UPDATE: The Department of Health Care Services (DHCS) has adjusted the release date of the Medi-Cal Managed Care Plan Request for Proposal (RFP) to Feb. 2, 2022. Although the RFP was scheduled to be released at the end of this year, the change will not affect the implementation date of Jan. 1, 2024. Additional time is needed to address stakeholder comments received during the comment period for the draft RFP. Updates to the RFP schedule will be posted on the DHCS website. HASD&IC will continue to engage with County of San Diego officials on the process. The Imperial County Board of Supervisors has approved the adoption of a single-managed care plan model through an 1115 Waiver.

5 Things To Know: Medi-Cal Managed Care, Behavioral Health Hearings, State Budget Agreement

San Diego County Board of Supervisors Address Medi-Cal Managed Care: Lask week, HASD&IC President & CEO Dimitrios Alexiou provided public comment (testimony starts at 4:08) in support of the Framework for the Future: Improving the County’s Wellness Care Delivery System to Address Health Disparities Exacerbated by the COVID-19 Pandemic and shared the HASD&IC Board of Directors guiding principles for new Medi-Cal managed care contracts. He emphasized the importance of using this opportunity to prioritize patients, strengthen local oversight, and increase accountability. HASD&IC will continue to engage with supervisors on the Medi-Cal managed care procurement process.

5 Things To Know: Disaster Planning, EMS Changes, Addressing Chronic Homelessness

Addressing Chronic Homelessness: On June 28, the first phase of a partnership between the City and County of San Diego launched, with outreach teams hitting the streets to address the immediate and long-term challenges faced by people experiencing homelessness. This month-long outreach campaign is designed to connect individuals to immediate shelter, housing navigation and behavioral health services, and medical care. The second phase, scheduled to launch in August, will address the struggle of those who experience chronic homelessness with severe substance use disorder. It will connect them with teams who can link them to health and social services, including specialized temporary housing, regardless of the status of their sobriety.

5 Things To Know: Hazard Pay, Imperial Valley Wellness Foundation, Medi-Cal CalAIM

Hazard Pay: The San Diego County Board of Supervisors voted to spend $36 million of American Rescue Plan funding on hazard pay for the county’s essential employees. Mandatory bonus pay has been the subject of much discussion around the state as we emerge from the pandemic. The Culver City Council has passed an ordinance that requires $5 per hour hero pay for employees at the city’s only hospital, and Assembly Bill (AB) 650 would mandate bonuses of up to $10,000 for hospital employees and contractors. However, AB 650 was moved to the Assembly Inactive File on June 3 and is now a two-year bill.

5 Things To Know: Cross-Border Vaccination Planning, Tiny Home Village, City Council Special Election

Medi-Cal Managed Care: Last fall, the Department of Health Care Services (DHCS) began the process of re-procuring Medi-Cal managed care plan contracts. At the end of April, DHCS provided updates on both San Diego and Imperial counties. Imperial County submitted a request to create a County Organized Health System with California Health and Wellness; San Diego County decided not to pursue a local health initiative model, and DHCS indicated that it will award no more than two Medi-Cal managed care contracts in San Diego County. The draft request for proposal is expected in the next few weeks, but the changes will not take place until 2024.