As the Department of Health Care Services (DHCS) continues to reshape Medi-Cal, significant efforts are being made to ensure older adults and people with disabilities have access to high-quality, equitable care. The DHCS has expanded several programs to enhance care and support, including medically tailored meals, transportation to and from appointments, in-home care, home accessibility modifications, and long-term care transition assistance.
For those eligible for both Medi-Cal and Medicare, dual Medicare Medi-Cal Plans are now available in 12 counties, integrating services across both programs for a more comprehensive approach to care. The recent expansion of Medi-Cal and the elimination of asset limits, including bank accounts, property, and a second car, have also increased eligibility, allowing more people to qualify for coverage.
In a recent Ethnic Media Services (EMS) briefing, DHCS leaders and community healthcare providers discussed how these Medi-Cal programs are improving the lives of older and disabled Californians. This was the sixth briefing in a series exploring the ongoing Medi-Cal transformation aimed at providing whole-person health care for all Californians, addressing physical and mental health needs beyond the doctor’s office or hospital.
Anastasia Dodson, Deputy Director, Office of Medicare Innovation and Integration, DHCS, highlighted the integration of Medi-Cal and Medicare to better serve dual eligibles. She emphasized the importance of both programs in providing comprehensive care for low-income Californians, older adults, and people with disabilities. Dodson also discussed the elimination of asset limits for Medi-Cal eligibility and changes to the estate recovery program, reducing financial burdens on beneficiaries’ heirs. She explained the statewide expansion of Medicare Medi-Cal plans by 2026, which will streamline benefits into one coordinated plan.
Dana Durham, Chief, Managed Care Quality and Monitoring Division, DHCS, spoke about the importance of preventive care to keep members healthy and reduce the need for emergency room visits. She addressed the social drivers of health and the need for coordinated, tailored care that meets individuals where they live, work, and participate in their communities.
Jenna LaPlante, Senior Director of Care Management Programs, Institute on Aging, detailed the Institute’s expansion to serve adults with disabilities across nine counties. She emphasized the goal of keeping individuals in the least restrictive environments of their choice, despite the significant behind-the-scenes work required to adjust billing and program structures. LaPlante discussed the importance of hiring bilingual and bicultural staff to serve historically underserved communities and highlighted specific services like care coordination, community support, and home modifications.
Carrie Madden, Program Director of the Aging and Disability Resource Connection (ADRC) of Central and South LA, explained ADRC’s comprehensive services, including information and referral, options counseling, coordination of services, and transitional services. She discussed how CalAIM has accelerated the process of connecting individuals, particularly the homeless, with the services they need, making a significant impact on their well-being.
Keith Miller, Executive Director of CALIF (Communities Actively Living Independent and Free), emphasized the importance of providing supportive, culturally sensitive care for older Californians and people with disabilities. He highlighted CALIF’s partnership with ADRC and their contract with an HMO under CalAIM to support high utilizers of emergency rooms. Miller introduced his colleague, Lily Sanchez, who shared a compelling success story of a high-risk individual who received extensive support to avoid nursing home placement.
Enhanced Care Management (ECM), introduced statewide in January 2022, is available to members with complex needs. Members undergo a health risk assessment and are assigned a lead care manager to help navigate the healthcare system. This manager assists with arranging appointments, coordinating care, and ensuring access to necessary services, providing a personalized and supportive approach. New providers like promotoras (community health workers) have been added to assist with disease prevention, health promotion, and connecting individuals to needed services. Community supports include home safety modifications, medically tailored meals, and respite care, all designed to help individuals live in their preferred settings.
These efforts by DHCS represent a significant step towards creating a healthcare system that addresses the comprehensive needs of older and disabled Californians, ensuring they thrive in their communities.
These efforts by DHCS represent a significant step towards creating a healthcare system that addresses the comprehensive needs of older and disabled Californians, ensuring they thrive in their communities.
The Path Forward: Transforming Medi-Cal for a Healthier California
In summary, the transformation of Medi-Cal is more than just policy changes; it’s about fundamentally reshaping how we care for our most vulnerable populations. By expanding access, integrating services, and focusing on preventive and community-based care, the DHCS is working to ensure that older adults and people with disabilities receive the comprehensive, equitable care they deserve. This ongoing commitment to improving healthcare delivery highlights the importance of addressing social determinants of health, fostering independence, and enhancing the quality of life for all Californians. The collective insights and efforts shared during the EMS briefing underscore the vital role that coordinated, culturally sensitive care plays in building a healthier, more inclusive California.
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