Cal MediConnect Providers Summit Wednesday, January 21, :00 AM - 4:00 PM 555 West Temple Street Los Angeles, CA

Transcription

1 Speaker Bios Breakout Session 1A: Best Practices for Integrated Care Teams Joseph Garcia Joseph Garcia is the Chief Operating Officer for Community Health Group, a not for-profit health plan in San Diego California. Mr. Garcia has been with the organization for almost 30 years and in the health care field for close to 40 years. As the Chief Operating Officer Mr. Garcia is responsible for the direction and coordination of the Operations Department to include a functionally sound operations structure and continued viability of the organization. Community Health Group has been providing services to Medi-Cal recipients for 32 years and currently serves 240,500 overall members in San Diego County including 5,170 Cal MediConnect members. Mr. Garcia and his team oversee the Integrated Care Programs and have implemented enhanced care management outreach for the Cal MediConnect membership. Dr. George Fields Dr. George Fields is CMO for the CareMore Essentials Line of Business. He came to CareMore in 2006, developing CareMore Touch, CareMore's Institutional Special Needs Plan. Dr. George Fields is a Board Certified Family Physician, practicing Family Medicine out of CareMore's Home Base in Cerritos, CA. Sunil Joshi Sunil Joshi is the Vice President of Managed Care at AltaMed Health Services Corp. He oversees contracting, provider and member services, and claims. He has been in the health care industry for the last 20+ years. He has worked on the health plan side, solutions vendor side, and on the provider side. He has an undergraduate degree in Economics from UCLA and a MBA from Pepperdine University.

2 Speaker Bios Breakout Session 1B: Delegation 101 Rita Lonzo Rita Lonzo is the Director of Delegation Oversight for Health Net. She joined Health Net in 2000 as a field auditor and has been the Director for ten years. Prior to joining Health Net she was a case manager for medical groups in the Inland Empire. A nurse by training, Rita was a critical care nurse for 20 years, including 16 years as an ER nurse. Kathy Hegstrom Kathy Hegstrom is the President of Advanced Medical Management, Inc. -- a company she and her husband Stephen formed in Kathy particularly enjoys reviewing claims and case management information. Because of her interest in the cultural differences of health care delivery, AMM specializes in cultural niche groups as a major part of their client base. Kathy is the Chair of CAPG s State Government Programs Committee.

3 Speaker Bios Breakout Session 2A: Medical Care Meets Behavioral Health Dr. Jerry Vaccaro Over the past 25 years, Dr. Jerry Vaccaro has led specialty healthcare companies that include CEO positions at APS Healthcare, United Behavioral Health, PacifiCare Behavioral Health, PacifiCare Specialty Companies, and several Community Mental Health Centers and programs. Currently, he serves as President of Ingenuity Health, a Division of Ameritox, which provides treatment monitoring programs and solutions to Community Mental Health Centers and other mental health programs serving seriously mentally ill people. His newest venture RIghtPath HC, is dedicated to facilitating changes in healthcare delivery models, specifically in the areas of aligning clinical and financial risk and accountability. Jerry lectures and consults extensively with healthcare and mental health organizations as they work to enact many of the provisions of healthcare reform, including Accountable Care initiatives, financial risk assumption, medical-behavioral integration, mental health parity, and more. Dr. Clayton Chau Dr. Clayton Chau joined LA Care Health Plan as the Medical Director for Behavioral Health Services in October Prior to joining LA Care he was briefly with CalOptima, another health plan in Orange County. Before 2013, he had worked for the Orange County Health Care Agency Behavioral Health Services for 13 years providing care to people living with severe persistent mental illness and integrated care for the county s Public Health HIV clinic. He was also the Director of the Center of Excellence in Education, Training, Research and Advocacy for Reducing Health Disparities. He obtained his MD degree from the University of Minnesota and PhD in Clinical Psychology from Chelsea University. Dr. Chau has conducted training in the areas of health care integration, health care reform, cultural competency, veteran s health, homelessness and mental health policy. Dr. James Pratty Dr. Pratty is the Senior Medical Officer of Behavioral Health for CareMore Medical Group. He is also a bilingual psychiatrist specializing in adolescent, adult and geriatric psychiatry with sub-specialties in Treatment Resistant Depression, Dementia, Schizophrenia, Affective Disorders and is a Board Certified Addictionologist. He was one of the principal designers of CareMore s Duals MOC. He oversees clinics throughout California, Arizona, Nevada, Richmond, Virginia, Memphis, Tennessee, Ohio, and now associated with Emory Healthcare in Georgia..

4 Speaker Bios Breakout Session 2B: Medical Care Meets Long-Term Services and Supports David Nolan David Nolan is the Director for Long-Term Services and Supports (LTSS) for California for Anthem Blue Cross, where he is responsible for developing, directing and overseeing the ongoing management of LTSS program operations. Prior to Anthem, David was the Executive Director for LTSS and the Duals Demonstration for Alameda Alliance for Health. David has extensive experience in long-term care integration, and has worked with the City and County of San Francisco and Colorado State Department of Health Care Planning and Finance, and led the team that wrote and implemented the Assisted Living Waiver for the CA Department of Health Care Services. Joe Diaz Joe Diaz has served as Regional Director for the California Association of Health Facilities for the past 32 years. Prior to that, he was the Director of the California Office of Health Planning and Development. Prior to that Joe served as the Under-Secretary of the California Health and Welfare Agency with 12 departments, 150,000 employees and a budget of 15 billion dollars. During that period, he was on loan on several occasions to the US State Department on missions to Argentina, Venezuela, Brazil, Honduras, Mexico, El Salvador, Peru and Guatemala. Rebecca Sussman Rebecca Sussman, M.P.H., is the Associate Director of Programs and Grants Management at St. John s Well Child and Family Center, a non-profit network of community health centers that provides medical, dental, mental health, and support services to low-income and uninsured residents of South Los Angeles. Rebecca s work focuses on the design, development, implementation, and evaluation of health and wellness programs. She also manages an array of innovative programs designed to better serve the specific needs of underrepresented groups in the community, including transgender and homeless. Prior to joining St. John s, Ms. Sussman worked in social work, health education and in data collection and management for federally funded research.

5 Speaker Bios Breakout Session 3A: Engaging Consumers in Care Toni Vargas Ms. Vargas has been a staff attorney with the Health Consumer Center (HCC) a project of Neighborhood Legal Services since As an attorney for the HCC, she assists clients who have legal issues involving access to healthcare. Ms. Vargas acted as the lead attorney for the implementation of the 2006 Medicare Part D benefit and has worked on issues affecting seniors and people with disabilities who were mandated to enroll into managed care beginning in Currently, she is working on the implementation of the Affordable Care Act as well as training and outreach activities related to the start-up of the Coordinated Care Initiative in Ms. Vargas received her Juris Doctor degree in 1997 from Thomas Jefferson School of Law in San Diego and also has a Masters of Science in Community Health Education and Biomedical Ethics. Jennifer Rasmussen Jennifer has worked in health care for over 25 years in a variety of settings and roles. In the early part of her career at the Veterans Administration Health System, she supported several research and innovative programs such as drug trials, problem behaviors in nursing homes, preferences in end-of-life care, provider training and case management for end-stage illnesses. She received a Master s in Public Health for while studying the effectiveness of treating depression in the primary care setting. Over the last 13 years, Jennifer has applied her skills in the managed care realm: as a case management supervisor, a health educator and Compliance Director. She joined Molina Healthcare of California in January of 2013 and currently serves as the Associate Vice President of Case Management. Daniel Frank Daniel Frank is a senior executive with 35 years of diversified experience in all areas of health care management ranging from hospital systems, ancillary/alternate site delivery, and physician practices. Currently, Dan serves as the Chief Operating Officer of Regal Medical Group, Lakeside Community Healthcare, and Affiliated Doctors of Orange County, three affiliated medical groups of Heritage Provider Network. Dan earned his bachelor s degree from University of California, Los Angeles and his dual degree in Master of Public Administration and Master of Health Administration from University of Southern California. Brenda Premo Brenda has been the Director & Founder of the Harris Family Center for Disability and Health Policy (HFCDHP), at the Western University of Health Sciences since The HFCDHP has worked on healthcare access for seniors and persons with disabilities, to bring an expanded understanding of the barriers seniors and people with disabilities experience every day. Brenda Premo has become a national disability and health policy expert who believes that each of us, must be a part of the change we want, or it will never happen. She is a graduate of California State University and also received her MBA from Pepperdine University.

6 Speaker Bios Breakout Session 3B: Understanding and Leveraging Continuity of Care Brian Hansen Brian Hansen has served with the Department of Health Care Services for nine years in the areas of new policy and program development in payment and delivery system reform. From , Brian worked for the DHCS Director s Office to coordinate aspects of Affordable Care Act and 1115 Waiver Demonstration Program implementation. For the past year, Brian has worked on specific policy areas within the Medi-Cal managed care program, including care continuity, nursing facility services, and Health Home program implementation. Bill Barcellona Bill Barcellona serves as the Senior Vice President for Government Affairs for CAPG, overseeing state and federal legislative and regulatory activities for the association in Sacramento and Washington, D.C. Bill is the former Deputy Director for Plan-Provider Relations for the California Department of Managed Health Care. In that capacity he oversaw health plan operational issues and handled policy matters for the Department. Bill enjoys teaching and lecturing across the country on health care management, operations and policy matters. He has practiced law for 28 years in California, and prior to his service at the DMHC he spent 16 years at two major law firms in Newport Beach and Sacramento, primarily as a civil litigator. His current legal experience includes general health law matters with an emphasis in Knox Keene Act and managed care issues. Bill serves as an adjunct faculty member at USC is a member of the USC Price School Health Advisory Board. David Kane David Kane is a Staff Attorney at Neighborhood Legal Services of Los Angeles County, which serves as the Cal MediConnect Ombudsman for Los Angeles County. He assists dual eligible consumers with their health coverage under Cal MediConnect and Medi-Cal managed care plans. A graduate of the UCLA School of Law, David is licensed to practice in California. Susan Bell Susan is the California Coordinate Care Initiative Director for Care 1st. Susan is an RN MBA with a diverse health care career built on a foundation of strong clinical experience in ambulatory care and over 20 years in managed care with expertise in HMO, Care Management, Program Development, Provider Services, Staff Development and Education. Susan has worked with multiple Health Plans, Provider Groups and Care Management Vendors in California, the U.S. and abroad.