{"id":61182,"date":"2023-11-20T16:25:28","date_gmt":"2023-11-21T00:25:28","guid":{"rendered":"https:\/\/lapost.us\/?p=61182"},"modified":"2023-11-20T16:25:28","modified_gmt":"2023-11-21T00:25:28","slug":"medi-cal-at-front-lines-of-sea-change-in-public-health","status":"publish","type":"post","link":"https:\/\/lapost.us\/?p=61182","title":{"rendered":"Medi-Cal at Front Lines of Sea Change in Public Health"},"content":{"rendered":"<div class=\"td_block_wrap tdb_single_author tdi_54 td-pb-border-top td_block_template_1 tdb-post-meta\" data-td-block-uid=\"tdi_54\">\n<div class=\"tdb-block-inner td-fix-index\">\n<div class=\"tdb-author-name-wrap\"><span class=\"tdb-author-by\">By<\/span><a class=\"tdb-author-name\" href=\"https:\/\/ethnicmediaservices.org\/author\/selen-ozturk\/\">Selen Ozturk<\/a><\/div>\n<\/div>\n<\/div>\n<div class=\"td_block_wrap tdb_single_date tdi_55 td-pb-border-top td_block_template_1 tdb-post-meta\" data-td-block-uid=\"tdi_55\">\n<div class=\"tdb-block-inner td-fix-index\"><time class=\"entry-date updated td-module-date\" datetime=\"2023-11-20T10:49:18-08:00\">Nov 20, 2023<\/time><\/div>\n<\/div>\n<div class=\"td_block_wrap tdb_single_subtitle tdi_56 td-pb-border-top td_block_template_1\" data-td-block-uid=\"tdi_56\">\n<div class=\"tdb-block-inner td-fix-index\">\n<p>California, which has the highest Medicaid caseload in the U.S., is set to dramatically expand access even as it continues to review eligibility post-pandemic.<\/p>\n<\/div>\n<\/div>\n<div class=\"td_block_wrap tdb_single_featured_image tdi_57 tdb-content-horiz-left td-pb-border-top td_block_template_1\" data-td-block-uid=\"tdi_57\">\n<div class=\"tdb-block-inner td-fix-index\"><img loading=\"lazy\" decoding=\"async\" class=\"entry-thumb td-animation-stack-type0-2\" title=\"Medi-Cal\" src=\"https:\/\/ethnicmediaservices.org\/wp-content\/uploads\/2023\/11\/Medi-Cal.jpg\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" srcset=\"https:\/\/ethnicmediaservices.org\/wp-content\/uploads\/2023\/11\/Medi-Cal.jpg 1200w, https:\/\/ethnicmediaservices.org\/wp-content\/uploads\/2023\/11\/Medi-Cal-300x163.jpg 300w, https:\/\/ethnicmediaservices.org\/wp-content\/uploads\/2023\/11\/Medi-Cal-1024x555.jpg 1024w, https:\/\/ethnicmediaservices.org\/wp-content\/uploads\/2023\/11\/Medi-Cal-768x416.jpg 768w, https:\/\/ethnicmediaservices.org\/wp-content\/uploads\/2023\/11\/Medi-Cal-150x81.jpg 150w, https:\/\/ethnicmediaservices.org\/wp-content\/uploads\/2023\/11\/Medi-Cal-696x377.jpg 696w, https:\/\/ethnicmediaservices.org\/wp-content\/uploads\/2023\/11\/Medi-Cal-1068x579.jpg 1068w\" alt=\"Medi-Cal\" width=\"1200\" height=\"650\" \/><\/div>\n<\/div>\n<div class=\"td_block_wrap tdb_single_content tdi_58 td-pb-border-top td_block_template_1 td-post-content tagdiv-type\" data-td-block-uid=\"tdi_58\">\n<div class=\"tdb-block-inner td-fix-index\">\n<p>As Medi-Cal expands next year to include all undocumented immigrants and new services well beyond the doctor\u2019s office, California is on the national front lines of transforming public health care.<\/p>\n<p>In a Wed., November 15 briefing co-hosted by Ethnic Media Services and the Department of Health Care Services, DHCS experts and ground-level community health workers discussed this expansion to include all immigrants and new services; the latest data on eligibility redetermination, and the transition to new care plans in 21 counties statewide.<\/p>\n<h2 class=\"wp-block-heading\">Where are we with Medi-Cal redetermination?<\/h2>\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\">\n<div class=\"td-video-replacer\" data-id=\"undefined\"><\/div>\n<div class=\"wp-block-embed__wrapper\"><iframe loading=\"lazy\" id=\"widget2\" title=\"California Keeping More People on Medicare as Compared to Other States as Redetermination Continues\" src=\"https:\/\/www.youtube.com\/embed\/hh8gyMxMEFE?feature=oembed\" width=\"100%\" height=\"392\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\" data-gtm-yt-inspected-10=\"true\" data-mce-fragment=\"1\"><\/iframe><\/div><figcaption class=\"wp-element-caption\"><em>Yingjia Huang, Assistant Deputy Director of Health Care Benefits and Eligibility, DHCS, breaks down data on disenrollment during the Medi-Cal redetermination process and notes that California is working hard to help people maintain coverage.<\/em><\/figcaption><\/figure>\n<p>Since the end of the federal COVID-19 emergency in May 2022, Medi-Cal has resumed its annual redetermination of enrollees\u2019 eligibility. Giving an overview of the latest\u00a0<a href=\"https:\/\/www.dhcs.ca.gov\/services\/Pages\/MngdCarePerformDashboard.aspx\">data<\/a>\u00a0on this yearlong process, Yingjia Huang said as of September 30, 15.2 million people \u201care on our case rolls\u201d \u2014 over a third of California\u2019s population. \u201cI\u2019m proud to report that, overall, we\u2019re holding steady as a state.\u201d<\/p>\n<p>Because California has the highest Medicaid caseload in the U.S., Huang \u2014 the Assistant Deputy Director of Health Care Benefits and Eligibility for DHCS \u2014 said over one million people have faced redetermination each month since June, the first month of actual disenrollments. In September, about 1.7 million were up for renewal.<\/p>\n<p>About 20% to 21% of these people are disenrolled each month, she continued \u2014 much lower than many other states like Texas, which saw a 73% disenrollment rate by the end of August.<\/p>\n<p>Hispanic individuals, making up the highest percentage of Medi-Cal enrollees, also make up the highest percentage \u2014 53% \u2014 of those disenrolled. However, Huang said, many of these disenrollments may owe to families who \u201cno longer need this coverage,\u201d having found employer insurance or surpassed income limits since the pandemic, when eligibility checks were paused.<\/p>\n<h2 class=\"wp-block-heading\">New managed care plans<\/h2>\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\">\n<div class=\"td-video-replacer\" data-id=\"undefined\"><\/div>\n<div class=\"wp-block-embed__wrapper\"><iframe loading=\"lazy\" id=\"widget4\" title=\"Navigating the County Health Plan Changes Coming in 2024\" src=\"https:\/\/www.youtube.com\/embed\/1ydiPdouqo4?feature=oembed\" width=\"100%\" height=\"392\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\" data-gtm-yt-inspected-10=\"true\" data-mce-fragment=\"1\"><\/iframe><\/div><figcaption class=\"wp-element-caption\"><em>Michelle Retke, Chief of Managed Care Operations, DHCS, discusses changes that are taking place to county health and provides steps for Medi-Cal enrollees to follow to ensure they get enrolled in a managed care plan.<\/em><\/figcaption><\/figure>\n<p>Those in the\u00a0<a href=\"https:\/\/www.dhcs.ca.gov\/MCP-Transition\/Pages\/Members.aspx\">21 counties<\/a>\u00a0transitioning to new managed care plans come January 1, 2024 will experience a change in the kind of health care they may be eligible for, said Michelle Retke, DHCS Chief of Managed Care Operations.<\/p>\n<p>For many of these counties, managed care \u2014 which uses health insurance plans, like Kaiser or Anthem, to provide primary care doctors picked from a network of local health centers \u2014 is transitioning to a single-plan model where previously multiple plans were offered, Retke explained. For other affected counties, different plans will replace those currently there.<\/p>\n<p>She emphasized that the main takeaway for Medi-Cal members in these counties,\u00a0<a href=\"https:\/\/www.dhcs.ca.gov\/MCP-Transition\/Pages\/Members.aspx\">listed here<\/a>, is \u201cPay attention to your mail; in October, November and December, you\u2019ll get a notice that your plan is changing, and an enrollment choice packet that you can fill out on paper or online.\u201d<\/p>\n<h2 class=\"wp-block-heading\">Medi-Cal expanding to undocumented immigrants<\/h2>\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\">\n<div class=\"td-video-replacer\" data-id=\"undefined\"><\/div>\n<div class=\"wp-block-embed__wrapper\"><iframe loading=\"lazy\" id=\"widget6\" title=\"California's &quot;Hardly Reached&quot; Communities Desperately Need Healthcare Services\" src=\"https:\/\/www.youtube.com\/embed\/l675h8Zp8ms?feature=oembed\" width=\"100%\" height=\"392\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\" data-gtm-yt-inspected-10=\"true\" data-mce-fragment=\"1\"><\/iframe><\/div><figcaption class=\"wp-element-caption\"><em>Dr. Sergio Aguilar-Gaxiola, Professor of Internal Medicine, UC Davis and Director, UC Davis Center for Reducing Health Disparities (CRHD) explains why outreach efforts are needed to ensure farmworkers get the healthcare they need.<\/em><\/figcaption><\/figure>\n<p>As this redetermination and transition happens, Medi-Cal is also expanding to all undocumented immigrants come January 1; currently, those under 26 and over 49 are eligible.<\/p>\n<p>Explaining the importance of this expansion to California\u2019s hardest-to-reach residents, Dr. Sergio Aguilar-Gaxiola said \u201cthis is a tremendous need. Meeting it requires more than goodwill and wanting to do the right thing. In order to reach these populations, building trust is front and center.\u201d<\/p>\n<p>Many undocumented Californians are (or are related to) farmworkers, a population which Aguilar-Gaxiola \u2014 Professor of Internal Medicine at UC Davis and Director of its Center for Reducing Health Disparities \u2014 has worked with for decades. There are approximately 600,000 to 700,000 farmworkers in California, he said, with 900,000 dependents \u2014 a total of 1.5 million, \u201cthe vast majority of which are Mexican or Central American.\u201d<\/p>\n<p>In the 1990s, in Fresno County, \u201cwe did a study of those with Mexican origin, including farmworkers, which continues to be the most comprehensive mental health population-based survey today,\u201d he said. \u201cAmong those who needed mental health services\u201d \u2014 say, due to depression, anxiety or substance abuse \u2014 \u201cone out of three of those U.S.-born were using them, one out of six (documented) immigrants were, and less than one in 10 of undocumented workers were. Almost half of them didn\u2019t know where to go, or couldn\u2019t go to clinic hours due to work. I believe that during the pandemic, this has gotten worse.\u201d<\/p>\n<p>The study illustrates a major challenge to Medi-Cal expansion, he continued: \u201cRather than \u2018hard to reach\u2019 populations, I prefer to think in terms of \u2018hardly reached,\u2019 because there isn\u2019t enough engagement \u2026 You\u2019re going to build this new health care like the Field of Dreams, but the question is: Will they come? They won\u2019t take advantage of these services unless you know how to communicate them.\u201d<\/p>\n<h2 class=\"wp-block-heading\">Communicating new community health services<\/h2>\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\">\n<div class=\"td-video-replacer\" data-id=\"undefined\"><\/div>\n<div class=\"wp-block-embed__wrapper\"><iframe loading=\"lazy\" id=\"widget8\" title=\"Ensuring People Exiting Correctional Facilities Have Access to Healthcare Benefits\" src=\"https:\/\/www.youtube.com\/embed\/DjMHOy7lLRg?feature=oembed\" width=\"100%\" height=\"392\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\" data-gtm-yt-inspected-10=\"true\" data-mce-fragment=\"1\"><\/iframe><\/div><figcaption class=\"wp-element-caption\"><em>Juan Avila Chief Operating Officer, Garden Pathways, explains how Medi-Cal expansion will help those exiting correctional facilities.<\/em><\/figcaption><\/figure>\n<p>Juan Avila, Chief Operating Officer of Bakersfield-based Garden Pathways, shared his experience of communicating health care newly offered under Medi-Cal to another hardly reached population: formerly incarcerated and \u201cjustice-involved youth and adults\u201d; in serving about 400 to 500 a year through his nonprofit, he learned quickly that \u201cif those we work with want to join the workforce again, they have to be healthy, and providing that care \u2014 preventative, mental health, dental, substance abuse \u2014 requires trust.\u201d<\/p>\n<p>Since 2017, Avila said he and his colleagues have built this trust by \u201cgoing inside the detention centers, the county jail, to enroll individuals in Medi-Cal before they\u2019re released back into their communities, as many reentry people won\u2019t have the same address and so won\u2019t get mail notices. This is the strength of community work, reaching them where they are \u2014 whether in the institutions or on the streets as peacekeepers \u2014 and building trust to get them the care they need, because they wouldn\u2019t otherwise come to the government to seek it out.\u201d<\/p>\n<p>This care, too, is expanding: come January 1, Medi-Cal will include new, community-based health services like reentry-related tattoo removal, housing aid \u201cfor those at risk of becoming homeless,\u201d community violence intervention, aftercare for violence victims, and \u201cintensive care management for higher-risk populations,\u201d e.g. substance abuse and home health care, he explained.<\/p>\n<p>In expanding to include these services, Avila said Medi-Cal is expanding the possibilities of health care itself: \u201cCalifornia is understanding now that health involves services that haven\u2019t traditionally been part of the old model of \u2018go to the doctor, get your medicine, go home.\u2019 Health is quality of life, and good healthcare treats barriers to it at the source.\u201d<\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>BySelen Ozturk Nov 20, 2023 California,&#46;&#46;&#46;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6,16],"tags":[],"class_list":["post-61182","post","type-post","status-publish","format-standard","hentry","category-ca-local","category-health"],"_links":{"self":[{"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/posts\/61182","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/lapost.us\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=61182"}],"version-history":[{"count":1,"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/posts\/61182\/revisions"}],"predecessor-version":[{"id":61183,"href":"https:\/\/lapost.us\/index.php?rest_route=\/wp\/v2\/posts\/61182\/revisions\/61183"}],"wp:attachment":[{"href":"https:\/\/lapost.us\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=61182"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/lapost.us\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=61182"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/lapost.us\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=61182"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}