Sacramento Medi-Cal Managed Care Advisory Committee

Size: px
Start display at page:

Download "Sacramento Medi-Cal Managed Care Advisory Committee"

Transcription

1 Meeting Minutes September 22, 2014, 3:00 PM 5:00 PM Sacramento Medi-Cal Managed Care Advisory Committee DHHS Administration 7001A East Parkway Sacramento, CA Conference Room 1 COMMITTEE MEMBERS x DHHS, Primary Health Sandy Damiano, PhD Chair x Hospital Rosemary Younts x Advocate Sujatha Branch Co-Chair x Hospital Tory Starr x Advocate Jenni Gomez x Hospital Laura Niznik Williams x Clinic J. Miguel Suarez, MD x IPA Sean Atha x Clinic Jonathan Porteus, PhD IPA Anna Berens - excused x DHA Mary Behnoud x PHAB Raquel Simental x DHHS Sherri Heller, EdD x Pharmacy Frank Cable x DHHS, Behavioral Health Uma Zykofsky x Physician Marvin Kamras, MD DHHS, Social Services Debbi Thomson - excused x Physician Nathan Allen, MD Health Plan Cathy Lumb-Edwards - excused EX-OFFICIO MEMBERS Health Plan Effie Ruggles - excused County Board of Supervisors Ted Wolter - excused x Health Plan Steve Soto x County Board of Supervisors Lisa Nava x Health Plan Scott Coffin x State DHCS Keith Parsley x Hospital Ellen Brown x Health Care Options Lili Zahedani MN MCMC Page 1 of 6

2 Committee in Attendance: 22 Public in Attendance: 30 Topic Welcome, Introductions and Opening Remarks Minutes Sandy Damiano, PhD, welcomed the committee and members of the public, facilitated introductions, reviewed the agenda and focus topic for today s meeting. Minutes for last month s presentation focused on Hospital Emergency Department Utilization Mental Health are posted on the website. State DHCS Update ACA Updates Keith Parsley reported: DHCS continues with rural conversion project of transitioning individuals with aid codes of Seniors and Persons with Disabilities (SPD) from Fee for Service (FFS) Medi-Cal to Managed Care Medi-Cal. Target is 12/1/2014. On 9/29/14 notices and contact information will be sent to 24,000 individuals. Stakeholder meetings have been held regularly through webinars. The last stakeholder meeting focused on reviewing the notices and process for noticing individuals. The plans, CBOs and Counties have worked with DHCS on this process and outreaching stakeholders. The next stakeholder meeting webinar is scheduled 9/25/2014. To register for the webinar: tp.gmc@dhcs.ca.gov. Request for Application (RFA) draft will combine San Diego and Sacramento and will be released within the next 30 days for review and public comment. DHCS will allow 2-4 weeks for comments. The final version will be released between by March DHCS continues work on the Coordinated Care Initiative (CCI) with Counties. ACA Updates Facilitated by Sujatha Branch Jenni Gomez reported that they are seeing clients whose applications are stuck. She asked Mary Behnoud to explain. Mary Behnoud reported: There are technical difficulties, called soft pause, resulting in applications being stuck between CALHEERS and CALWIN systems. There are procedures in place to address MN MCMC Page 2 of 6

3 the glitch. Since October 2013, DHA received 150,623 applications, processed 128,147 applications, and approximately 30,000 applications are backlogged. DHA plans to be caught up before next open enrollment. Prior to October 2013, DHA received 8,000 9,000 applications a month. Since then, DHA receives approximately 15,000 applications a month. See Enrollment Data 2014 and Monthly Default Average available on website under Health Plan Data Sandy Damiano reported: Medi-Cal Managed Care Enrollment Data as of September 1 st is now at a total enrollment of 352,422 beneficiaries. That is a 19,040 net gain last month which includes new enrollment and disenrollment. Since January 2014, GMC enrollment has increased by over 91,000 beneficiaries. The California Simulation of Insurance Markets (CalSIM) provides estimates for key populations including Medi-Cal. The 2014 estimates include a potential eligible population of 101,000 for Newly Eligible and 166,000 of Previously Eligible but not enrolled for the Sacramento Region (four counties). Scott Coffin, Anthem Blue Cross provided an overview of. Representatives from El Hogar Community Services (Alex Bolte), Sacramento Native American Health Center (Britta Guerrero), CARES Community Health (Bob Kamrath) and WellSpace Health Inc. (Jonathan Porteus) were present to contribute to the discussion. Network Capacity: Anthem Blue Cross continuously reviews network capacity and ratios of providers to members. Anthem contracts directly with independent providers, IPAs, health clinics, community organizations, and medical groups. Plans cannot easily estimate capacity at their providers when these providers contract with multiple plans. Network Access: Goal is to assign 100% members to a medical home. Newly enrolled members are assigned a medical home within the first 45 days of enrollment. When members are not able to access care in a timely fashion, Customer Care Center will assist members with securing timely medical appointments. For members requiring specialty care, the Access to Care Team will assist with finding a specialty provider. Network Capacity and Access for Specialty Care: Many specialists in Sacramento are no longer accepting Medi-Cal patients. For certain specialties, patients must seek care in other counties. Plans assist with transportation. MN MCMC Page 3 of 6

4 Committee Discussion Current Efforts/Future Plans: Customer service teams are available to assist members when facing access difficulties. Anthem is working with the safety net providers to assist members in changing behaviors from utilizing EDs as primary care provider instead of medical homes. Sandy Damiano reported that providers have access to care requirements: urgent care is 48 hours for services not requiring a pre-authorization, non-urgent 10 days. (Will provide detail regarding all access requirements on a document at a later date.) Sujatha Branch reported that many consumers have concerns with timely access requirements/ patient rights. Disability Rights of California created two publications available for consumers to download at Jenni Gomez reported that timely access to care has improved, but there continues to be some problems. She will continue to work with the health plan first to resolve issues. Sean Atha reported that a new challenge in access has occurred in that some providers no longer accept Medi-Cal. He requests that Plans and Hospitals work collaboratively for adequate specialists. Steve Soto commented that it is both a money issue and a supply issue. Many specialists associate only with certain hospital systems which reduces access for some plans. Jonathan Porteus reported that care coordination would improve if an electronic system was in place to find out when members are in EDs so that care coordination may readily occur between hospitals, health plans and medical homes. Sean Atha reported that River City actively uses nurses to provide case management and they are electronically connected to all EDs in the area. Rosemary Younts reported: Navigators are stationed at each Dignity hospital and are linking people to their PCPs and sending health data to medical homes. The navigators work closely with Health Net, who funds the project, to enhance the program. An identified problem is the volume. One MN MCMC Page 4 of 6

5 Committee Discussion navigator serving 20 patients per day is not sufficient. Hospital Data: 80% patients were given follow up appointments. 67% of them attended their appointments. Since navigators were implemented, 63% reduction in readmission in Dignity hospitals and urgent care reduced 23-27%. This means Navigators are successfully helping members to get to their medical home, with reminders and transportation assistance in getting to appointments. (Note: See July Meeting minutes for detailed information regarding the Dignity Health hospital navigator program.) Britta Guerrero, Representative from Native American Health Clinic, reported that receiving Utilization Reports from EDs helps clinics to assist members to engaging in follow-up care and linkage to medical home. Currently reports are provided approximately 1-2 times a year. More frequent utilization reports would be helpful. Steve Soto reported that Molina has an access to care team called Member Service Team. Molina is in the process of hiring navigators to identify individuals who use EDs often to redirect back to medical home. When members have transportation issues, individuals may call the health plan for assistance. Tory Starr indicated that Sutter Hospital has a navigator/ case manager program staffed 24 hours/7 days a week. An identified problem has been insufficient capacity to get individuals seen in a timely manner at their medical homes. Dr. Kamras reported that when clients have scheduled follow-up visits after being seen in the ED, half no show. Service authorization is approved by IPAs. Each IPA has different authorization standards. He recommends expedited referral for specialist when member is identified in the hospital as needing a specialist instead of having to return to medical home for referral. Ellen Brown, Kaiser, reported Patient Care Coordinators work at Kaiser. Dr. Miguel Suarez, HALO, reported doing the following to assist members to use care appropriately: Media in the lobby educates members about services their clinic providers. HALO contract with specialists who provide services on site. HALO patients get behavioral health services in collaboration with El Hogar. MN MCMC Page 5 of 6

6 Committee Discussion Public Comment Closing Remarks and Adjourn Scott Coffin reported that there is still confusion about how to access mental health benefit that went live Jan 1 st. Medical homes need to know what constitutes specialty MH care. Health Plans are working with County Behavioral Health Services Division on clarifying the access paths, what happens when consumers do noy know where to go. He suggested standardized scripts on how to access. Sandy Damiano noted some areas which areas for possible exploration: Health plans have different names for member services or other functions. Navigators need to know who to call for which service at each plan. IPAs and Health Plans have different rules for authorizing services, which is difficult for providers. Navigators are also working in the homeless community and with criminal justice populations. Clarification is needed to assist with those special populations. Time did not permit Scott and presenters to approach all areas they had planned. Janice Milligan, formerly with Health Net, now with River City, commented that the discussion today was excellent. She expressed her concern and interest in the Sacramento GMC RFA. The process in San Diego includes significant input from Healthy San Diego. She recommends stakeholders look at the RFA to ensure plans address the challenges that are unique to Sacramento County and that they work collaboratively. Sandy Damiano thanked everyone for attending and participating in today s meeting. With no additional business to discuss, the meeting adjourned. Next Meeting Monday, October 27, :00 5:00 PM DHHS Administrative Building 7001A East Parkway, Conference Room 1 Focus Continued discussion on network capacity and planning. Given there is considerable overlap, all three plans will join. Possible topics clinic expansion plans, tools for Navigators to access health plan services, and Mental Health benefit. MN MCMC Page 6 of 6

Sacramento Medi-Cal Managed Care Advisory Committee

Sacramento Medi-Cal Managed Care Advisory Committee Meeting Minutes January 22, 2018, 3:00 PM 5:00 PM DHHS Administration 7001-A East Parkway Sacramento, CA 95823 Conference Room 1 Sacramento Medi-Cal Managed Care Advisory Committee COMMITTEE MEMBERS X

More information

Sacramento Medi-Cal Managed Care Advisory Committee

Sacramento Medi-Cal Managed Care Advisory Committee Meeting Minutes February 26, 2018, 3:00 PM 5:00 PM DHHS Administration 7001-A East Parkway Sacramento, CA 95823 Conference Room 1 Sacramento Medi-Cal Managed Care Advisory Committee COMMITTEE MEMBERS X

More information

Care Coordination Work Group

Care Coordination Work Group Meeting Minutes October 24, 2016, 3:00 PM 5:00 PM DHHS Administration 7001-A East Parkway Sacramento, CA 95823 Conference Room 1 COMMITTEE MEMBERS X Advocate Jenni Gomez (LSNC) X Health Plan Steve Soto

More information

Sacramento Medi-Cal Managed Care Advisory Committee

Sacramento Medi-Cal Managed Care Advisory Committee Meeting Minutes October 22, 2012, 3:00 PM 5:00 PM Sacramento DHHS Administration 7001A East Parkway Sacramento, CA 95823 Conference Room COMMITTEE MEMBERS x Chair Sandy Damiano, PhD x Hospital Patricia

More information

Sacramento Medi-Cal Managed Care Advisory Committee

Sacramento Medi-Cal Managed Care Advisory Committee Meeting Minutes April 22, 2013, 3:00 PM 5:00 PM DHHS Administration 7001A East Parkway Sacramento, CA 95823 Conference Room 1 COMMITTEE MEMBERS X Chair Sandy Damiano, PhD Hospital Robert Waste, PhD X Advocate

More information

Care Coordination Work Group

Care Coordination Work Group Meeting Minutes May 22, 2017, 3:00 PM 5:00 PM DHHS Administration 7001-A East Parkway Sacramento, CA 95823 Conference Room 1 COMMITTEE MEMBERS X Advocate Jenni Gomez (LSNC) X Health Plan Steve Soto (Molina)

More information

Sacramento Medi-Cal Managed Care Advisory Committee

Sacramento Medi-Cal Managed Care Advisory Committee Meeting Minutes October 23, 2017, 3:00 PM 5:00 PM DHHS Administration 7001-A East Parkway Sacramento, CA 95823 Conference Room 1 COMMITTEE MEMBERS X DHHS, Primary Health PhD Chair X Hospital Rosemary Younts

More information

MEDI-CAL MANAGED CARE OVERVIEW

MEDI-CAL MANAGED CARE OVERVIEW MEDI-CAL MANAGED CARE OVERVIEW September 2016 Sandy Damiano, PhD Deputy Director DHHS Primary Health Eligibility & Enrollment Open year round Based on income and family size Simplified procedures Income

More information

MEDI-CAL MANAGED CARE OVERVIEW

MEDI-CAL MANAGED CARE OVERVIEW MEDI-CAL MANAGED CARE OVERVIEW July 2018 Sandy Damiano, PhD Deputy Director DHS Primary Health Eligibility & Enrollment Apply for Medi-Cal year round: County Department of Human Assistance (DHA) Online,

More information

County of Sacramento DHHS Health Center Co-Applicant Board (CAB)

County of Sacramento DHHS Health Center Co-Applicant Board (CAB) Meeting Minutes January 19, 2018, 9:30 AM 11:00 AM Meeting Location Sacramento County Health Center Primary Care Center Community Room 2020, 2 nd Floor 4600 Broadway Sacramento, CA 95820 CO-APPLICANT BOARD

More information

UPDATE ON THE IMPLEMENTATION OF CALIFORNIA S COORDINATED CARE INITIATIVE

UPDATE ON THE IMPLEMENTATION OF CALIFORNIA S COORDINATED CARE INITIATIVE UPDATE ON THE IMPLEMENTATION OF CALIFORNIA S COORDINATED CARE INITIATIVE Eileen Kunz Chief of Government Affairs & Compliance On Lok Carol Hubbard Executive Director of Home & Community Services St. Paul

More information

101 Grove Street, Room 308 San Francisco, California (415) MANAGED CARE UPDATE FY

101 Grove Street, Room 308 San Francisco, California (415) MANAGED CARE UPDATE FY 101 Grove Street, Room 308 San Francisco, California 94102 (415) 554-2610 www.sfdph.org MANAGED CARE UPDATE FY 2013-14 TABLE OF CONTENTS 1. DPH Enrollment 1 2. Low Income Health Program Transition 3 3.

More information

Mild-to-Moderate Mental Health Coverage in Medi-Cal: The Challenge and Promise of Coordination between Counties and Health Plans

Mild-to-Moderate Mental Health Coverage in Medi-Cal: The Challenge and Promise of Coordination between Counties and Health Plans Advancing innovations in health care delivery for low-income Americans Mild-to-Moderate Mental Health Coverage in Medi-Cal: The Challenge and Promise of Coordination between Counties and Health Plans December

More information

The Status of the Implementation of Medi-Cal Mental Health Services

The Status of the Implementation of Medi-Cal Mental Health Services FEBRUARY 2015 The Status of the Implementation of Medi-Cal Mental Health Services Background: Implementing Expanded Mental Health Services for Medi-Cal Beneficiaries Mental Health and Substance Use Disorder

More information

Understanding the Initiative Landscape in Medi-Cal. IHA Stakeholder Meeting September 23, 2016 Sarah Lally, Project Manager

Understanding the Initiative Landscape in Medi-Cal. IHA Stakeholder Meeting September 23, 2016 Sarah Lally, Project Manager Understanding the Initiative Landscape in Medi-Cal IHA Stakeholder Meeting September 23, 2016 Sarah Lally, Project Manager Agenda Welcome / Introduction Sarah Lally, Project Manager Inland Empire Health

More information

14. Health Care Options (HCO)/Managed Care

14. Health Care Options (HCO)/Managed Care Medi-Cal Handbook page 14-1 14. 14.1 Fee-For-Service Health care is provided to certain Medi-Cal beneficiaries through Fee-For-Service benefits. This means that some Medi-Cal clients may receive medical

More information

AGENDA. 10 a.m. Welcome and Introductions Kaying Hang, Senior Program Officer, Sierra Health Foundation

AGENDA. 10 a.m. Welcome and Introductions Kaying Hang, Senior Program Officer, Sierra Health Foundation Sacramento Region Health Care Partnership Safety Net Learning Institute Thursday, November 19, 2015 10 a.m. 3 p.m. Sierra Health Foundation Bannon Island Room AGENDA 10 a.m. Welcome and Introductions Kaying

More information

HEALTHY FAMILIES PROGRAM TRANSITION TO MEDI-CAL

HEALTHY FAMILIES PROGRAM TRANSITION TO MEDI-CAL HEALTHY FAMILIES PROGRAM TRANSITION TO MEDI-CAL NETWORK ADEQUACY ASSESSMENT REPORT PHASE 1 November 1, 2012 Submitted by the California Department of Managed Health Care in Fulfillment of the Requirements

More information

Presented to: The Sacramento Medi-Cal Managed Care Stakeholder s Advisory Committee

Presented to: The Sacramento Medi-Cal Managed Care Stakeholder s Advisory Committee The Health Plan/ IPA Relationship: P Partners in i Health H l h Care C Delivery D li Presented to: The Sacramento Medi-Cal Managed Care Stakeholder s Advisory Committee By: Anthem Blue Cross Health Net

More information

California ACA implementation and people with HIV

California ACA implementation and people with HIV California ACA implementation and people with HIV HIV advocacy: ACA implementation ACA implementation is not a point in time It is a long process of ensuring the programs will work for people with HIV

More information

Sacramento County Department of Health and Human Services MENTAL HEALTH BOARD (MHB)

Sacramento County Department of Health and Human Services MENTAL HEALTH BOARD (MHB) Sacramento County Department of Health and Human Services MENTAL HEALTH BOARD (MHB) MHB General Meeting February 5, 2014 Sacramento County Administration Building 700 H Street Sacramento, CA 95814 Hearing

More information

SB 75 Full Scope Medi-Cal for Children. SF Health Network - Community Behavioral Health Services June 21, 2016 Maria Jimenez Barteaux, CBHS Billing

SB 75 Full Scope Medi-Cal for Children. SF Health Network - Community Behavioral Health Services June 21, 2016 Maria Jimenez Barteaux, CBHS Billing SB 75 Full Scope Medi-Cal for Children SF Health Network - Community Behavioral Health Services June 21, 2016 Maria Jimenez Barteaux, CBHS Billing Senate Bill 75 Welfare & Institutions Code, Section 14007.8

More information

Assisting Medi-Cal Eligible Consumers FAQ Certified Enrollers

Assisting Medi-Cal Eligible Consumers FAQ Certified Enrollers Confused about the Medi-Cal enrollment process? Review frequently asked questions and glossary terms to understand the basics and learn how to seek help for difficult scenarios. Table of Contents FREQUENTLY

More information

July 13, RE: Comments on Whole Child Model Documents. Dear CCS Redesign Team:

July 13, RE: Comments on Whole Child Model Documents. Dear CCS Redesign Team: Children's Regional Integrated Service System Hemophilia Council of California July 13, 2016 California Children s Services Redesign Team California State Department of Health Care Services 1501 Capitol

More information

Sales Webinar #6 12/17/14

Sales Webinar #6 12/17/14 Sales Webinar #6 12/17/14 Agenda Welcome Sales Division Partner & Program Updates CalHEERS & System Updates Important Dates Q & A Sales Divison Enrollment Status 2014 Enrollment Status Covered CA Eligibility

More information

Improving Access to Specialty Care. Janet M. Coffman, MPP, PhD Center for the Health Professions Philip R. Lee Institute for Health Policy Studies

Improving Access to Specialty Care. Janet M. Coffman, MPP, PhD Center for the Health Professions Philip R. Lee Institute for Health Policy Studies Improving Access to Specialty Care Janet M. Coffman, MPP, PhD Center for the Health Professions Philip R. Lee Institute for Health Policy Studies Outline State of access to specialty care for low-income

More information

State of California Health and Human Services Agency Department of Health Care Services

State of California Health and Human Services Agency Department of Health Care Services State of California Health and Human Services Agency Department of Health Care Services TOBY DOUGLAS Director EDMUND G. BROWN JR. Governor DATE: FEBRUARY 8, 2013 ALL PLAN LETTER 13-003 SUPERSEDES ALL PLAN

More information

Date of Last Review. Policy applies to Medicaid products offered by health plans operating in the following State(s) Arkansas California

Date of Last Review. Policy applies to Medicaid products offered by health plans operating in the following State(s) Arkansas California POLICY: Anthem Medicaid (Anthem) is responsible for providing Access to Care/Continuity of Care and coordination of medically necessary medical and mental health services. Members who are, or will be,

More information

Joint Service Delivery/IT Committee Notes

Joint Service Delivery/IT Committee Notes Joint Service Delivery/IT Committee Notes Date: January 18, 2018 Time: 1:00-2:30 pm Location: City Hall Conference Room 1119, 915 I Street, Sacramento, CA 95814 Committee Members in Attendance: Ashley

More information

1500 Capitol Ave. Sacramento, CA 95814

1500 Capitol Ave. Sacramento, CA 95814 Health Net Community Solutions, Inc. Health Net of California, Inc. 1201 K Street, Ste. 1815 Sacramento, CA 95814 April 22, 2016 Ms. Sarah Brooks, Deputy Director Health Care Delivery Systems Department

More information

Medi-Cal Eligibility: History, ACA Changes and Challenges

Medi-Cal Eligibility: History, ACA Changes and Challenges Medi-Cal Eligibility: History, ACA Changes and Challenges PRESENTATION TO CAHP SEMINAR CATHY SENDERLING-MCDONALD, CWDA FEBRUARY 26, 2015 1 Presentation Overview What is CWDA? Medi-Cal Eligibility Overview

More information

Health Care Reform 1

Health Care Reform 1 Health Care Reform 1 Health Care Reform Covered California (Health Benefit Exchange) Medi-Cal Expansion Bridge Plan Proposal Gold Coast Readiness Outreach to the Eligible 2 Health Care Reform: What is

More information

Lessons Learned from the Dual Eligibles Demonstrations. Real-Life Takeaways from California and Other States

Lessons Learned from the Dual Eligibles Demonstrations. Real-Life Takeaways from California and Other States Lessons Learned from the Dual Eligibles Demonstrations 1 May 28, 2015 Real-Life Takeaways from California and Other States Introductions Toby Douglas Consultant, MAXIMUS Former Director of California Department

More information

Sacramento County Department of Health and Human Services Public Health Maternal Child and Adolescent Health Advisory Board

Sacramento County Department of Health and Human Services Public Health Maternal Child and Adolescent Health Advisory Board Meeting January 13, 2015 8:00 a.m. 10:00 a.m. Micron Conference Room 1 9616 Micron, Suite 900 Sacramento, CA 95827 Facilitator: Dr. Moynihan Scribe: Sharon Saffold Meeting Attendees: Robert Moynihan, M.D

More information

Preparing California s Community-Based Organizations to Partner with the Health Care Sector by Building Business Acumen:

Preparing California s Community-Based Organizations to Partner with the Health Care Sector by Building Business Acumen: Preparing California s Community-Based Organizations to Partner with the Health Care Sector by Building Business Acumen: Case Studies from the First Cohort of Linkage Lab Grantees August 2015 Authors:

More information

Molina Healthcare of California Provider/Practitioner Manual

Molina Healthcare of California Provider/Practitioner Manual Molina Healthcare of California Provider/Practitioner Manual Eligibility, Enrollment, and Disenrollment Section # Document Page # Section 3: Eligibility, Enrollment, and Disenrollment 2 8 SECTION 3: ELIGIBILITY,

More information

Department of Health Care Services

Department of Health Care Services State of California Department of Health Care Services Streamlining the Cal MediConnect Voluntary Enrollment Experience April 2016 This is one of three documents released by the Department of Health Care

More information

Executive Director s Report

Executive Director s Report Executive Director s Report Peter V. Lee Executive Director California Health Benefit Exchange Board Meeting December 18, 2012 Covered California Board Calendar 2013 Month / Date January 17 February 21

More information

California s Coordinated Care Initiative: An Update

California s Coordinated Care Initiative: An Update California s Coordinated Care Initiative: An Update Background On April 1, 2014, health plans in selected counties began enrolling beneficiaries as part of the Coordinated Care Initiative. This fact sheet

More information

Client-Provider Interactions About Screening and Referral to Primary Care Services and Health Insurance Programs

Client-Provider Interactions About Screening and Referral to Primary Care Services and Health Insurance Programs Research Brief on Client-Provider Interactions About Screening and Referral to Primary Care Services and Health Insurance Programs March 2014 Suggested citation: Sara Daniel, MPH; Antonia Biggs, PhD; Jan

More information

California s Health Homes Program

California s Health Homes Program California s Health Homes Program HPSM Network Webinar 9/05/18 Goals for Today: Health Homes Program overview CB-CME requirements Program readiness and implementation timeline Gather take-away questions

More information

Whole Person Care Pilot Update:

Whole Person Care Pilot Update: Whole Person Care Pilot Update: Alameda County Care Connect (AC 3 ) Kathleen A. Clanon, MD Alameda County Board of Supervisors Health Committee July 11, 2016 Sample Outcomes Create a countywide data-sharing

More information

FACT SHEET Low Income Assistance: Cal MediConnect (E-004) p. 1 of 6

FACT SHEET Low Income Assistance: Cal MediConnect (E-004) p. 1 of 6 FACT SHEET Low Income Assistance: Cal MediConnect (E-004) p. 1 of 6 Low Income Assistance: Cal MediConnect What is Cal MediConnect? California is one of 12 states that has signed a Memorandum of Understanding

More information

Low-Income Health Program (LIHP) Evaluation Proposal

Low-Income Health Program (LIHP) Evaluation Proposal Low-Income Health Program (LIHP) Evaluation Proposal UCLA Center for Health Policy Research & The California Medicaid Research Institute Background In November of 2010, California s Bridge to Reform 1115

More information

Medi-Cal Eligibility and Enrollment Overview. Sherri Chambers, Program Planner DHHS Primary Health Services March 2017

Medi-Cal Eligibility and Enrollment Overview. Sherri Chambers, Program Planner DHHS Primary Health Services March 2017 Medi-Cal Eligibility and Enrollment Overview Sherri Chambers, Program Planner DHHS Primary Health Services March 2017 Who Is Eligible for Medi-Cal? Low Income Different income limits based on program,

More information

Evolution of ACOs in California. Accountable Care Congress Los Angeles November 11, 2014 Jill Yegian, Ph.D.

Evolution of ACOs in California. Accountable Care Congress Los Angeles November 11, 2014 Jill Yegian, Ph.D. Evolution of ACOs in California Accountable Care Congress Los Angeles November 11, 2014 Jill Yegian, Ph.D. Integrated Healthcare Association Statewide multi stakeholder leadership group that promotes quality

More information

Coordinated Care Initiative (CCI) ADVANCED I: Benefit Package and Consumer Protections

Coordinated Care Initiative (CCI) ADVANCED I: Benefit Package and Consumer Protections July 29, 2014 Coordinated Care Initiative (CCI) ADVANCED I: Benefit Package and Consumer Protections Amber Cutler, Staff Attorney National Senior Citizens Law Center www.nsclc.org 1 The National Senior

More information

What an IPA does for Sacramento County Beneficiaries

What an IPA does for Sacramento County Beneficiaries What an IPA does for Sacramento County Beneficiaries What is an IPA (Reprise) Independent Practice Association consists of a network of physicians in a region or community solo practitioners or groups

More information

FACT SHEET Low Income Assistance: Cal MediConnect(E-004) p. 1 of 6

FACT SHEET Low Income Assistance: Cal MediConnect(E-004) p. 1 of 6 FACT SHEET Low Income Assistance: Cal MediConnect(E-004) p. 1 of 6 Low Income Assistance: Cal MediConnect What is Cal MediConnect? California is 1 of 15 states that has signed a Memorandum of Understanding

More information

Provider Guide. Medi-Cal Health Homes Program

Provider Guide. Medi-Cal Health Homes Program Medi-Cal Health Provider Guide This provider guide provides information on the California Medi-Cal Health (HHP) for Community-Based Care Management Entities (CB-CMEs), providers, community-based organizations,

More information

Whole Person Care Pilot Update

Whole Person Care Pilot Update Whole Person Care Pilot Update Kathleen A. Clanon, MD Alameda County Board of Supervisors Health Committee March 14, 2016 Whole Person Care Pilot in Alameda County Lead County Must match 50% Funding Statewide,

More information

Presentation to Family Voices of California Healthy Families Program Transition to Medi-Cal

Presentation to Family Voices of California Healthy Families Program Transition to Medi-Cal Presentation to Family Voices of California on Healthy Families Program Transition to Medi-Cal August 21, 2013 Agenda Overview of the Healthy Families Transition Brief Comparison of Benefits Between HFP

More information

PERSPECTIVES. Under Pressure: Front-Line Experiences of Medi-Cal Eligibility Workers. Overview. Current Environment

PERSPECTIVES. Under Pressure: Front-Line Experiences of Medi-Cal Eligibility Workers. Overview. Current Environment Under Pressure: Front-Line Experiences of Medi-Cal Eligibility Workers Overview The Affordable Care Act (ACA) significantly expands eligibility for health insurance and, at the same time, requires states

More information

Extended Continuity of Care for Seniors and Persons with Disabilities Frequently Asked Questions. September 2011

Extended Continuity of Care for Seniors and Persons with Disabilities Frequently Asked Questions. September 2011 Extended Continuity of Care for Seniors and Persons with Disabilities Frequently Asked Questions September 2011 Question #1: If a beneficiary s current fee-for-service (FFS) Medi-Cal doctor does not accept

More information

Transcript: Affordable Care Act for TB Services in California: Assessment by the California TB Controller s Association

Transcript: Affordable Care Act for TB Services in California: Assessment by the California TB Controller s Association Transcript: Affordable Care Act for TB Services in California: Assessment by the California TB Controller s Association Julie Higashi, MD, PhD TB Controller, Disease Prevention and Control Branch, Population

More information

Coming Changes for Adults Who Have Medicare and Medi-Cal

Coming Changes for Adults Who Have Medicare and Medi-Cal Coming Changes for Adults Who Have Medicare and Medi-Cal California Coordinated Care Initiative and the Cal MediConnect Program 1 Coming Changes for People with Medicare and Medi-Cal California Coordinated

More information

Population Health Management in the Safety Net Elaine Batchlor, MD, MPH CEO, Martin Luther King, Jr. Community Hospital

Population Health Management in the Safety Net Elaine Batchlor, MD, MPH CEO, Martin Luther King, Jr. Community Hospital Population Health Management in the Safety Net Elaine Batchlor, MD, MPH CEO, Martin Luther King, Jr. Community Hospital November 5, 2013 Martin Luther King, Jr. Community Hospital Page 1 11/05/2013 Agenda

More information

REQUEST FOR PROPOSALS CMSP Mini Grants Program Funding Round Two

REQUEST FOR PROPOSALS CMSP Mini Grants Program Funding Round Two REQUEST FOR PROPOSALS CMSP Mini Grants Program Funding Round Two COUNTY MEDICAL SERVICES PROGRAM GOVERNING BOARD I. ABOUT THE COUNTY MEDICAL SERVICES PROGRAM The County Medical Services Program (CMSP)

More information

Cindy Cameron Senior Director of Finance & Reimbursement LightBridge Hospice, LLC

Cindy Cameron Senior Director of Finance & Reimbursement LightBridge Hospice, LLC Cindy Cameron Senior Director of Finance & Reimbursement LightBridge Hospice, LLC Kristina Runnels Director Patient Financial Services VITAS Healthcare Corp Medi-Cal Managed Care Program The 3 models of

More information

Re: Comments on All Plan Letter: Continuity of Care: Definition and Practice

Re: Comments on All Plan Letter: Continuity of Care: Definition and Practice July 2, 2013 Department of Healthcare Services Delivered via email to: info@calduals.org, sarah.brooks@dhcs.ca.gov Cc: jane.ogle@dhcs.ca.gov margaret.tatar@dhcs.ca.gov melanie.bella@cms.hhs.gov Re: Comments

More information

California Program on Access to Care Findings

California Program on Access to Care Findings C P A C February California Program on Access to Care Findings 2008 Increasing Health Care Access for the Medically Underserved in Four California Counties Annette Gardner, PhD, MPH Some of the most active

More information

Sacramento County Public Health Advisory Board

Sacramento County Public Health Advisory Board Sacramento County Public Health Advisory Board Meeting Minutes February 1, 2017 (12:05 PM - 1:33 PM) Meeting Location Primary Care Center 4600 Broadway Sacramento, CA 95820 Conference Room 2020 Moderator:

More information

Coordinated Care Initiative DRAFT Assessment and Care Coordination Standards November 20, 2012

Coordinated Care Initiative DRAFT Assessment and Care Coordination Standards November 20, 2012 Coordinated Care Initiative DRAFT Assessment and Care Coordination Standards November 20, 2012 Table of Contents CARE COORDINATION GENERAL REQUIREMENTS...4 RISK STRATIFICATION AND HEALTH ASSESSMENT PROCESS...6

More information

State of California Health and Human Services Agency Department of Health Care Services

State of California Health and Human Services Agency Department of Health Care Services State of California Health and Human Services Agency Department of Health Care Services TOBY DOUGLAS Director EDMUND G. BROWN JR. Governor DATE: JUNE 26, 2014 ALL PLAN LETTER 14-007 TO: ALL MEDI-CAL MANAGED

More information

ALAMEDA ALLIANCE FOR HEALTH BOARD OF GOVERNORS REGULAR MEETING. September 9, :00 pm 2:00 pm 1240 South Loop Road, Alameda, CA

ALAMEDA ALLIANCE FOR HEALTH BOARD OF GOVERNORS REGULAR MEETING. September 9, :00 pm 2:00 pm 1240 South Loop Road, Alameda, CA ALAMEDA ALLIANCE FOR HEALTH BOARD OF GOVERNORS REGULAR MEETING September 9, 2016 12:00 pm 2:00 pm 1240 South Loop Road, Alameda, CA SUMMARY OF PROCEEDINGS Board Members Present: Jane Garcia (Chair),Marty

More information

Applying for Medi-Cal & Other Insurance Affordability Programs

Applying for Medi-Cal & Other Insurance Affordability Programs California s Protection & Advocacy System Toll-Free (800) 776-5746 Applying for Medi-Cal & Other Insurance Affordability Programs June 2017, Pub #5550.01 Medi-Cal is a health insurance program for people

More information

Quality Improvement Committee Minutes

Quality Improvement Committee Minutes Quality Improvement Committee Minutes Date: February 11, 2016 Meeting Place: San Francisco Health Plan, 50 Beale Street 13 th Floor, San Francisco, CA 94105 Meeting Time: 7:30-9:00 am Present: Edwin Batongbacal,

More information

Medi-Cal Expansion & Health4All Kids: Tools and Resources for Communities. April 20, 2016 health4allkids.org

Medi-Cal Expansion & Health4All Kids: Tools and Resources for Communities. April 20, 2016 health4allkids.org Medi-Cal Expansion & Health4All Kids: Tools and Resources for Communities April 20, 2016 health4allkids.org Introduction Mayra Alvarez President and CEO The Children s Partnership 2 Welcome Sponsored by:

More information

HEALTH CARE REFORM MAKING IT WORK FOR LA COUNTY DEPARTMENT OF HEALTH SERVICES AND SAFETY NET SYSTEM

HEALTH CARE REFORM MAKING IT WORK FOR LA COUNTY DEPARTMENT OF HEALTH SERVICES AND SAFETY NET SYSTEM HEALTH CARE REFORM MAKING IT WORK FOR LA COUNTY DEPARTMENT OF HEALTH SERVICES AND SAFETY NET SYSTEM July 15, 2013 Alexander Li, MD DHS Ambulatory Care Network Our Story Affordable Care Act (Obamacare)

More information

2015 CMS National Training Program Workshop Monika Vega, MSW Harbage Consulting, LLC Representing California s Department of Health Care Services

2015 CMS National Training Program Workshop Monika Vega, MSW Harbage Consulting, LLC Representing California s Department of Health Care Services California s Coordinated Care Initiative 2015 CMS National Training Program Workshop Monika Vega, MSW Harbage Consulting, LLC Representing California s Department of Health Care Services Roadmap Nationally

More information

The L.A. County Coordinated Care Initiative Stakeholder Workgroup. June 19, p.m.

The L.A. County Coordinated Care Initiative Stakeholder Workgroup. June 19, p.m. The L.A. County Coordinated Care Initiative Stakeholder Workgroup June 19, 2014 1 3 p.m. 1 Center for Health Care Rights (CHCR) The Center for Health Care Rights (CHCR) is a health care advocacy organization

More information

FOR IMMEDIATE RELEASE April 17, Media Line Contacts: Covered California (916)

FOR IMMEDIATE RELEASE April 17, Media Line Contacts: Covered California (916) FOR IMMEDIATE RELEASE April 17, 2014 Media Line Contacts: Covered California (916) 205-8403 California Department of Health Care Services (916) 440-7660 COVERED CALIFORNIA S HISTORIC FIRST OPEN ENROLLMENT

More information

The Impact of Cal MediConnect on Transitions from Institutional to Community-Based Settings

The Impact of Cal MediConnect on Transitions from Institutional to Community-Based Settings Research Brief The Impact of Cal MediConnect on Transitions from Institutional to Community-Based Settings Carrie Graham, PhD, MGS Mel Neri Edward Bozwell Bueno This evaluation was funded by The SCAN Foundation

More information

Medi-Cal 2020 Waiver - Whole Person Care Pilot. Frequently Asked Questions and Answers. March 16, 2016

Medi-Cal 2020 Waiver - Whole Person Care Pilot. Frequently Asked Questions and Answers. March 16, 2016 Medi-Cal 2020 Waiver - Whole Person Care Pilot Frequently Asked Questions and Answers March 16, 2016 This document is a compilation of frequently asked questions (FAQs) and responses regarding the Medi-Cal

More information

Medi-Cal and the Safety Net California Association of Health Plans Seminar Series Medi-Cal at its Core

Medi-Cal and the Safety Net California Association of Health Plans Seminar Series Medi-Cal at its Core Medi-Cal and the Safety Net California Association of Health Plans Seminar Series Medi-Cal at its Core August 3, 2017 Deborah Kelch Executive Director Insure the Uninsured Project 1 Safety-Net Definitions

More information

Re: California Health+ Advocates opposes the proposed state budget changes to the 340B program

Re: California Health+ Advocates opposes the proposed state budget changes to the 340B program May 2, 2017 René Mollow, Deputy Director Health Care Benefits and Eligibility Department of Health Care Services 1501 Capitol Avenues, MS 0007 P.O. Box 997413 Sacramento, CA 95899-7413 Re: California Health+

More information

Sacramento County Department of Health and Human Services Division of Public Health - Public Health Advisory Board

Sacramento County Department of Health and Human Services Division of Public Health - Public Health Advisory Board Meeting November 2, 2011, 12:00 1:35 p.m. Primary Care Center 4600 Broadway Sacramento, CA 95820 Conference Room 2020 Chair: Marty Keale (Chairing for Robert Meagher) Staff: Paula Gammell Board Attendees:

More information

A. Members Rights and Responsibilities

A. Members Rights and Responsibilities APPLIES TO: A. This policy applies to all IEHP Medi-Cal Members. POLICY: A. For the purpose of this policy, a Delegate is defined as a medical group, IPA or any contracted organization delegated to provide

More information

Comment Template for Care Coordination Standards

Comment Template for Care Coordination Standards GENERAL COMMENTS Thank you for the opportunity to provide input into these very important standards. We offer the following comments in the spirit of improving clarity, consistency, and ease of reading

More information

Medi-Cal Expansion Under Health Care Reform: Peter Winston Executive Vice President

Medi-Cal Expansion Under Health Care Reform: Peter Winston Executive Vice President Medi-Cal Expansion Under Health Care Reform: A Provider Perspective Peter Winston Executive Vice President Perceptions Medi-Cal was considered a different animal Ignored by mainstream medicine Medicaid

More information

DHCS Update: Major Initiatives and Strategies Towards Standardization

DHCS Update: Major Initiatives and Strategies Towards Standardization DHCS Update: Major Initiatives and Strategies Towards Standardization Javier Portela, Division Chief Managed Care Operations Department of Health Care Services ICE 2016 Annual Conference December 2016

More information

MAKING IT HAPPEN. WHAT IS MEDI-CAL? A Booklet for Regional Center Clients and Families

MAKING IT HAPPEN. WHAT IS MEDI-CAL? A Booklet for Regional Center Clients and Families MAKING IT HAPPEN WHAT IS MEDI-CAL? A Booklet for Regional Center Clients and Families INTRODUCTION This booklet contains information about the Medi-Cal program. It provides a general overview of the program

More information

Health Coverage for San Franciscans

Health Coverage for San Franciscans Health Coverage for San Franciscans SF FES Council Affordable Care Act Alejandro Salinas LaShenna Sirles July 16, 2014 The following presentation is not for consumer use and is for informational purposes

More information

The Budget: Maximizing Federal Reimbursement For Parolee Mental Health Care Summary

The Budget: Maximizing Federal Reimbursement For Parolee Mental Health Care Summary The 2013-14 Budget: Maximizing Federal Reimbursement For Parolee Mental Health Care MAC Taylor Legislative Analyst MAY 6, 2013 Summary Historically, the state has spent tens of millions of dollars annually

More information

Innovative and Outcome-Driven Practices and Systems Meaningful Prevention and Early Intervention Wellness, Recovery, & Resilience Focus

Innovative and Outcome-Driven Practices and Systems Meaningful Prevention and Early Intervention Wellness, Recovery, & Resilience Focus Our Mission: To provide a culturally competent system of care that promotes holistic recovery, optimum health, and resiliency. Our Vision: We envision a community where persons from diverse backgrounds

More information

Provider Relations Training

Provider Relations Training Cal MediConnect Provider Relations Training Presented by Victor Gonzalez and George Scolari Provider Relations Training Agenda Overview of Cal MediConnect Eligibility & Exclusions Enrollment & Disenrollment

More information

Medi-Cal. Member Handbook. A helpful guide to getting services (Combined Evidence of Coverage and Disclosure Form)

Medi-Cal. Member Handbook. A helpful guide to getting services (Combined Evidence of Coverage and Disclosure Form) Medi-Cal Member Handbook A helpful guide to getting services (Combined Evidence of Coverage and Disclosure Form) Benefit Year 2016 AS A HEALTH NET COMMUNITY SOLUTIONS MEMBER, YOU HAVE THE RIGHT TO Respectful

More information

Accountable Care Organization in California: Lessons for the National Debate on Delivery System Reform

Accountable Care Organization in California: Lessons for the National Debate on Delivery System Reform Accountable Care Organization in California: Lessons for the National Debate on Delivery System Reform James Robinson Professor and Director, Berkeley Center for Health Technology University of California,

More information

Other languages and formats

Other languages and formats Dear member, We re glad you re part of our health plan! It s important to us that you have the most up-to-date information about your benefits. We re sending you the following notices with this letter:

More information

California s Duals Demonstration: A Transparent and Inclusive Stakeholder Process. Peter Harbage President Harbage Consulting

California s Duals Demonstration: A Transparent and Inclusive Stakeholder Process. Peter Harbage President Harbage Consulting California s Duals Demonstration: A Transparent and Inclusive Stakeholder Process Peter Harbage President Harbage Consulting 1 Today s Agenda 1. California Context 1. California s Stakeholder Engagement

More information

Online Eligibility Training will be held via WebEx on

Online Eligibility Training will be held via WebEx on Online Eligibility Training will be held via WebEx on Thursday, August 4 th, 2016 at 02-3:00 PM or Tuesday, August 9 th, 2016 at 11-12:00 Noon Presented by BHS Billing Unit 1380 Howard Street, SF 94103

More information

Department of Health & Human Services Division of Behavioral Health Services Alcohol & Drug Services. Uma K. Zykofsky, LCSW Behavioral Health Director

Department of Health & Human Services Division of Behavioral Health Services Alcohol & Drug Services. Uma K. Zykofsky, LCSW Behavioral Health Director Department of Health & Human Services Division of Behavioral Health Services Alcohol & Drug Services April 24, 2017 Presentation to Geographic Managed Care Providers Uma K. Zykofsky, LCSW Behavioral Health

More information

Coordinated Care Initiative (CCI): An Update

Coordinated Care Initiative (CCI): An Update Coordinated Care Initiative (CCI): An Update Amber Christ, Senior Staff Attorney Tuesday, December 19, 2017 All on mute. Use Questions function for substantive questions and for technical concerns. Problems

More information

Market Analysis Findings and Key Opportunities

Market Analysis Findings and Key Opportunities Sacramento Region Health Care Partnership Market Analysis Findings and Key Opportunities Commissioned by Sierra Health Foundation Conducted by John Snow, Inc. February 2017 In partnership with Congresswoman

More information

Cal MediConnect Plan Choice Book. Medicare and Medi-Cal. To the addressee or guardian of: John B. Sample 1234 Any Street ANY CITY, CA 90000

Cal MediConnect Plan Choice Book. Medicare and Medi-Cal. To the addressee or guardian of: John B. Sample 1234 Any Street ANY CITY, CA 90000 CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES Health Care Options, P.O. Box 989009 West Sacramento, CA 95798-9860 To the addressee or guardian of: John B. Sample 1234 Any Street ANY CITY, CA 90000 Cal

More information

MINUTES. Santa Clara County Health Authority Annual Governing Board Retreat

MINUTES. Santa Clara County Health Authority Annual Governing Board Retreat Board members present: Ms. Michele Lew Dr. Dale Rai Dr. Wally Wenner Ms. Emily Harrison Ms. Laura Jones Mr. Daniel Peddycord Ms. Linda Williams Ms. Pattie DeMellopine Ms. Liz Kniss Ms. Dolores Alvarado

More information

ICE 2016 Annual Conference December 5, 2016

ICE 2016 Annual Conference December 5, 2016 ICE 2016 Annual Conference December 5, 2016 The Coded Division of Financial Responsibility (DOFR) Stephen J. Linesch S. Linesch and Associates Carol Wanke Vice President, Managed Care Operations Sharp

More information

Low-Income Health Program (LIHP) Evaluation Proposal

Low-Income Health Program (LIHP) Evaluation Proposal Low-Income Health Program (LIHP) Evaluation Proposal UCLA Center for Health Policy Research & The California Medicaid Research Institute BACKGROUND In November of 2010, California s Bridge to Reform 1115

More information

Ready, Set, Enroll. Community Health Center Enrollment Successes, Challenges and Lessons Learned During the First Phase of Coverage Expansion

Ready, Set, Enroll. Community Health Center Enrollment Successes, Challenges and Lessons Learned During the First Phase of Coverage Expansion Ready, Set, Enroll June 2014 Update Community Health Center Enrollment Successes, Challenges and Lessons Learned During the First Phase of Coverage Expansion Prepared by Rafael A. Gomez, MPP and Bobbie

More information

L.A. COUNTY COORDINATED CARE INITIATIVE (CCI) Stakeholder Workgroup MEETING MINUTES

L.A. COUNTY COORDINATED CARE INITIATIVE (CCI) Stakeholder Workgroup MEETING MINUTES L.A. COUNTY COORDINATED CARE INITIATIVE (CCI) Stakeholder Workgroup MEETING MINUTES Call-In: 1-888-584-2113 Code: 229-738-8378 Wednesday, May 14, 2014; 1-3 p.m. Cathedral of Our Lady of the Angels 555

More information