As California simultaneously advances several initiatives to improve care coordination and system transformation in health care, the Department of Health Care Services (DHCS) is providing funding and guidance to support their implementation. The ability for patient and client data to be shared between health and social services organizations is essential for this effort.
Linette Scott, MD, MPH, FACPM, deputy director and chief data officer at DHCS, joined the Connecting for Better Health (C4BH) coalition meeting on July 13 to provide an overview of how the current initiatives regarding data sharing at DHCS fit together.
In introducing the many ongoing initiatives at DHCS, Scott noted, “There’s a lot going on, and we get questions about how the different pieces fit together. So the goal here is to draw connections and show how these different pieces support each other.”
Scott provided updates on four current initiatives that address the data-sharing needs in California. These include:
- A critical initiative led by DHCS is California Advancing and Innovating Medi-Cal (CalAIM). Data exchange among different types of health and social services providers is necessary to implement the key components of CalAIM, including Population Health Management (PHM), Enhanced Care Management (ECM), Community Supports (CS), Justice-involved programs, and Behavioral Health Delivery System Transformation. These programs are policy drivers that require data sharing. For example, ECM and CS require data sharing for identifying eligible individuals, developing a care plan, coordinating care and services, conducting referrals, and monitoring and reporting. DHCS developed the CalAIM Data Sharing Authorization Guidance to provide a framework for organizations to work towards these goals.
- The Authorization to Share Confidential Medi-Cal Information (ASCMI) pilots are a collaboration between three counties to test a consent management service and a universal consent form. The pilots are gathering information about the key issues around consent, how to collect it, and how to construct a consent management service. As the pilots wrap up, DHCS is compiling lessons learned to inform the consent-to-share strategy going forward.
- To support the infrastructure updates required by these programs, DHCS is administering multiple funding sources:
- The Incentive Payment Program (IPP) is available for Managed Care Plans (MCPs) to reinvest in community organizations to help them meet CalAIM objectives.
- Providing Access and Transforming Health (PATH) Initiative provides funding to community based organizations (CBOs), public hospitals, county agencies, tribes, and others to build capacity and infrastructure to comply with CalAIM.
- Behavioral Health Quality Improvement Program (BHQIP) provides incentives to county behavioral health programs to meet CalAIM objectives.
4. The new Medi-Cal Managed Care contracts, which will go into effect in January 2024, require enhanced data exchange. These requirements include timely prior authorization, member and family consent, and transitional care management.
Across multiple initiatives, DHCS is supporting organizations statewide with tools, guidance, and funding in order to meet the requirements of CalAIM and the DxF.
For more information about DHCS, visit the DHCS website.