DHCS Proposes New Medi-Cal Long-Term Care at Home Benefit
Late last week, the Department of Health Care Services (DHCS) announced that it will embark on the development of a potential new “Long-Term Care at Home” benefit in the Medi-Cal program. This new benefit is intended to help address the COVID-19 pandemic and provide eligible beneficiaries with a coordinated and bundled set of home and community services to help vulnerable adults statewide stay healthy at home.
The proposed Long-Term Care at Home benefit will include: 1) individual, person-centered assessment; 2) transition services; 3) case management; and 4) home- and community-based services. The benefit is proposed to be bundled with existing Medi-Cal benefits and offered through both Medi-Cal managed care and fee-for-service delivery systems. The benefit is intended to support home care for individuals transferring from hospitals to home, from skilled nursing facilities to home or to prevent a skilled nursing facility stay. The benefit also aims to allow skilled nursing facilities and residential care facilities to decompress so fewer people are exposed to higher risks of viral infection in communal settings.
DHCS plans to develop this benefit in coordination with the Master Plan for Aging Stakeholder Advisory Committee, the California Department of Social Services, Department of Aging, Department of Public Health, Department of Developmental Services, and Department of Rehabilitation. DHCS will further seek approval from the U.S. Centers for Medicare and Medicaid Services (CMS) and aims to implement the benefit in early 2021. Notably, the benefit is intended to be cost-neutral for the state General Fund.
Additional information on DHCS’ proposed new benefit is expected to be posted online in the coming days.