Speakers<\/b><\/p>\n
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- Anastasia Dodson<\/b>, Deputy Director, Office of Medicare Innovation and Integration, Department of Health Care Services\u00a0<\/span><\/li>\n
- Dana Durham<\/b>, Chief, Managed Care Quality and Monitoring Division, Department of Health Care Services (not pictured)<\/span><\/li>\n
- Jenna LaPlante, <\/b>Senior Director of Care Management Programs, Institute on Aging\u00a0<\/span><\/li>\n
- Carrie Madden, <\/b>Aging and Disability Resource Connection of Central and South LA\u00a0<\/span><\/li>\n
- Keith Miller, <\/b>Executive Director, CALIF (Communities Actively Living Independent and Free)\u00a0<\/span><\/li>\n
- Lilly Sanchez, <\/b>Case Manager, CALIF\u00a0<\/span><\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n
\nDana Durham highlighted how Medi-Cal assists older and disabled Californians through Community Supports and Enhanced Care Management (ECM), programs addressing \u201csocial drivers of health\u201d \u2014 such as housing, healthy food, language access, and preventive health care \u2014 \u201cin people\u2019s communities so they can stay in the least restrictive setting possible.\u201d<\/p>\n
Community Supports encompass medically tailored meals, transportation to and from appointments, in-home care, home accessibility modifications, long-term care transition assistance, mental health care, substance abuse disorder treatment, and housing aid. \u201cHistorically, the healthcare system has been difficult to navigate,\u201d especially isolating seniors and people with disabilities, Durham noted.<\/p>\n
ECM assigns high-risk members a lead care manager to help them navigate the system and access Medi-Cal services. These care leads can travel to meet members when necessary, such as when patients are homeless, disabled, or isolated.<\/p>\n
For Californians eligible for both Medi-Cal and Medicare, there are now dual Medi-Medi Plans in 12 counties that cover copays and services across both programs, explained Anastasia Dodson. By 2026, Medi-Medi will be available statewide. Currently, of the 6.6 million Californians on Medicare, 1.6 million are also on Medi-Cal.<\/p>\n
Dodson also mentioned that in January 2024, Medi-Cal eliminated asset limits, meaning that bank accounts, property, or a second car won\u2019t affect eligibility; now, only income and household size count.<\/p>\n
From the Community<\/b><\/p>\n
Since the expansion of Medi-Cal began in 2022, \u201cWe went from three counties to nine statewide where we provide ECM and connection to community supports like doctors, caregivers, meals, transportation, residential care away from nursing homes, home accessibility modifications, housing navigation, and rent aid,\u201d said Jenna LaPlante. \u201cIt\u2019s more than we\u2019ve ever served, and we\u2019re in talks with health plans to expand more,\u201d she added.<\/p>\n
\u201cHiring bilingual, bicultural staff from the communities we serve has been key to reaching communities who weren\u2019t historically engaging with our services.\u201d LaPlante shared an example of hiring a Vietnamese-speaking care manager who went to community centers in San Jose and Santa Clara counties, resulting in a significant increase in engagement and referrals. Similar efforts are now being made in Merced County with Spanish-speaking staff.<\/p>\n
\u201cThis recent expansion to use Medicaid dollars for social determinants of health, like the first month\u2019s rent and a security deposit, is incredibly novel. I don\u2019t see it anywhere else,\u201d LaPlante noted. \u201cEach state can apply to waive how they use federal dollars for more than just medical services. Some do and some don\u2019t \u2026 but here in California, we\u2019re at the forefront.\u201d<\/p>\n
Carrie Madden emphasized that health risks for older and disabled Californians often overlap across many areas of life, not just physical health concerns. For instance, if \u201cthey\u2019re homeless with no income, no food, and they need a wheelchair.\u201d Madden noted that being able to coordinate and refer individuals to services addressing various needs has been very helpful. \u201cWe have no wrong door. People who call us will get some kind of referral \u2026 and we follow up to make sure they get the services they need to live out of nursing homes and treatment facilities, back in the community they came from \u2026 With the Medi-Cal change now, we\u2019re seeing individuals get this help much faster.\u201d<\/p>\n
ADRC partners with Communities Actively Living Independent and Free (CALIF), one of 28 independent living centers in California. Keith Miller stated, \u201cRecently we entered a contract with an insurance provider to provide these new Medi-Cal programs like housing navigation or retention, assistive technology, and ongoing case management,\u201d particularly for people frequently entering emergency rooms. At CALIF, where \u201c51% of our staff are people with disabilities,\u201d this transformation of Medi-Cal has been crucial in \u201ckeeping our clients out of institutions and nursing homes.\u201d<\/p>\n
Lilly Sanchez shared the story of a high-risk client who often visited the ER and was about to enter a nursing home before being referred to CALIF. Over three months, CALIF helped him enroll in Medi-Cal and stay in his community. \u201cWhen he came to us, he didn\u2019t have in-home support, no California ID, couldn\u2019t transport himself to and from the services he needed,\u201d Sanchez explained. \u201cWe were able to do the paperwork for him and coordinate our social services with medical care through the insurance plan.\u201d<\/p>\n
\u201cBecause of that coordination of care, he is currently housed, he has in-home support, he has food that nurtures him to stop needing the emergency room as much as he was before,\u201d Sanchez continued. \u201cThis speaks to how important it is not only to have medical care available but to coordinate it with all the other social services people need to be healthy,\u201d she added. \u201cMedi-Cal is making that coordination possible.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"
California is home to over six million people aged 65 and over, and the over seven and a half million with a disability, accessing necessary care has often been challenging. Medi-Cal has introduced new programs integrating in with Medicare, elimination of asset limits restricting eligibility, enhanced care management, and expanded community services such as housing…<\/p>\n
- Dana Durham<\/b>, Chief, Managed Care Quality and Monitoring Division, Department of Health Care Services (not pictured)<\/span><\/li>\n