WELCOME TO SUB THREE HEALTH AND
HUMAN SERVICES. WE WILL BE
BEGINNING TODAY. WHAT TODAY WILL
BE JUST BE FOCUSING ON ONE
DEPARTMENT, WHICH IS ALWAYS NICE
. KEEP IT ALL, UM, ORGANIZED
THAT WAY. WE'RE GONNA BE WORKING
WITH DEPARTMENT OF HEALTH CARE
SERVICES ON AN ARRAY OF THINGS
TODAY, SO THAT MEANS THAT PUBLIC
COMMENT WILL ONLY COME AT THE
END OF ISSUES ONE THROUGH 10. WE
WILL NOT BE DOING PUBLIC COMMENT
IN BETWEEN. UH, WE HAVE TWO MANY
PANELS WILL BE TALKING ABOUT
HEARING AIDS FOR KIDS, AND THEN
WE'LL JUST HAVE A BRIEF UPDATE
ON CAL AM, E, èC M AND HOW
THAT'S GOING AND HOW WE CAN DO
BETTER WITH THAT. SO LET'S GET
STARTED. I'LL ASK FOR, UM, ISSUE
ONE. IF I CAN HAVE THE
DEPARTMENT REPRESENTATIVES
DEPARTMENT OF FINANCE L A Ó
COME ON UP AND COURT. AND THE
STAKEHOLDER AS WELL. FROM
CHILDREN NOW.
GREAT. DIRECTOR WAS WITH WITH AN
OVERVIEW A BRIEF OVERVIEW OF THE
DEPARTMENT AND THEN WE'LL JUMP
INTO YOUR QUESTIONS ASSIGNED TO
YOU FOR CAP GREAT GOOD MORNING
MEMBERS. MICHELLE BOSS, DIRECTOR
OF THE DEPARTMENT OF HEALTH CARE
SERVICES. THE GOVERNOR'S BUDGET
INCLUDES A TOTAL OF 161.1
BILLION FOR THE DEPARTMENT OF
HEALTH CARE SERVICES OF THIS
AMOUNT. ABOUT ONE POINT THREE
BILLION IS FOR STATE OPERATIONS.
THIS INCLUDES THE SUPPORT FOR
ABOUT 4600 POSITIONS TO SUPPORT
THE DEPARTMENT'S PROGRAMS AND
SERVICES AS NÓ MEDICAL IS THE
LARGEST PROGRAM AT THE
DEPARTMENT. BUT WE ALSO
ADMINISTER, UH, COMMUNITY MENTAL
HEALTH AND SUBSTANCE USE
DISORDER PROGRAMS, GENETICALLY
HANDICAPPED PERSONS PROGRAM, THE
CHILDREN'S SERVICES PROGRAM AND
PRIMARY AND RURAL HEALTH
PROGRAMS SUCH AS THE INDIAN
HEALTH PROGRAM, AMERICAN INDIAN
MATERNAL SUPPORT SERVICES AND
THE TRIBAL EMERGENCY
PREPAREDNESS PROGRAM. UH, THE
BUDGET INCLUDES, UM SOME MAJOR
PROPOSALS AND ISSUES MOST
SIGNIFICANTLY THE MANAGED CARE
ORGANIZATION TAX, WHICH WE HAVE.
I THINK WE WILL BE AT A LATER
HEARING. WE ALSO INCLUDE ABOUT
1.4 BILLION TOTAL FUNDS IN 2020
THREE AND THREE 0.4 BILLION
TOTAL FUNDS IN 2425 TO MAINTAIN
THE EXPANSION OF FULL SCOPE
MEDICAL COVERAGE TO ADULTS,
REGARDLESS OF IMMIGRATION STATUS
THAT WENT INTO EFFECT IN JANUARY
. 1 2024 STINT WITH PREVIOUS
YEARS. ACTIONS WE'VE ALSO
REMOVED THE MEDICAL ASSET TEST.
UM, THAT ALSO WENT INTO EFFECT
JANUARY 1 2024. AND SO THE
BUDGET INCLUDES DOLLARS TO FUND
THAT WE HAVE 200 MILLION. WHICH
OF THAT 15 MILLION GENERAL FUND
FOR THE REPRODUCTIVE HEALTH
ACCESS DEMONSTRATION, 1115
WAIVER AND THEN WE ALSO HAVE
SOME, UH, BUDGET SOLUTIONS. SOME
OF THEM WILL BE DISCUSSED AT
THIS HEARING, AND I IMAGINE
OTHERS AT SUBSEQUENT HEARINGS
THE WITHDRAWAL OF 900 MILLION
SAFETY STATE SAFETY NET RESERVE
FUND, A REDUCTION OF 100 AND 90
THREE 0.4 MILLION IN PROPOSITION
56 SUPPLEMENTAL PAYMENTS FOR
PHYSICIAN SERVICES DELAYS IN
FUNDING FOR THE BEHAVIORAL
HEALTH, BRIDGE, HOUSING AND
BEHAVIORAL HEALTH INFRASTRUCTURE
CONTINUUM PROGRAM. AND THEN AS
WILL BE DISCUSSED LATER TODAY,
UH, THE TRANSFER OF MEDICAL DRUG
REBATE FUND FUND BALANCE TO THE
GENERAL FUND, THE, UM ELIMINATE
THE PREVIOUSLY PROPOSED BUYBACK
OF A TWO WEEK CHECK RIGHT HOLD
FOR FEE FOR SERVICE PAYMENTS AT
THE END OF EACH STATE. FISCAL
YEAR AND THE TRANSFER OF █14.09
MILLION IN UNSPENT CLINIC HEALTH
CLINIC WORKFORCE STABILIZATION
RETENTION PAYMENT FUNDING TO THE
GENERAL FUND. AND NOW I WILL
TURN IT OVER TO DEPUTY DIRECTOR
RENEE MALLOW TO DISCUSS THE
HEARING AID PROGRAM. THANK YOU
SO MUCH. DIRECTOR BOSS AND AGAIN
I'M RENEE MALO DEP. JUST QUICK
QUESTION BEFORE WE DIVE INTO
THAT, UM, IN, I KNOW THERE'S
OPPORTUNITIES TO LATER TALK
ABOUT IT, THE B HÌ AND THEN THE
OTHER ACRONYM THAT I DON'T KNOW.
THE BEHAVIOR HOUSING BRIDGE
HOUSING. THANK YOU. I KNOW WE'VE
PROPOSED FOR A DELAY. AND NOW
THAT PROP ONE WAS SUCCESSFUL. DO
WE ANTICIPATE THE NEED FOR THESE
TWO, POTENTIALLY MAYBE CUTTING
THEM, NOT DELAYING THEM AND
LEANING TOWARDS THE FUNDS THAT
ARE GOING TO COME OUT OF PROP
ONE, BUT I THINK THOSE ARE, UM
KIND OF POTENTIALS FOR FUTURE
CONVERSATIONS IS WHAT I JUST
DISCUSSED IS WHAT'S PROPOSED IN
GOVERNORS BUDGET. I THINK YOU
KNOW, PER MAY REVISION, I THINK,
YOU KNOW, OPPORTUNITIES TO
DISCUSS. UH, WE KNOW WE NEED TO
BUILD OUT THE INFRASTRUCTURE OF
BEHAVIORAL HEALTH, WHETHER IT'S
BRIDGE OR FACILITIES OR
RESIDENTIAL, UM, HOMES. I THINK
PART OF THAT IS WILL BE BUT YOU
KNOW PART OF FUTURE
CONVERSATIONS. OK, THANK YOU,
MAN. IF I IF I COULD JUST JUST
WEIGH IN ON ON THAT, UM, I THINK
IF WE'RE GONNA CUT ANYTHING, WE
NEED TO BE VERY STRATEGIC ABOUT
IT BECAUSE I DON'T THINK THERE'S
ANY QUESTION THAT WE NEED TO
FOLLOW THROUGH ON OUR COMMITMENT
TO VOTERS AND TO FOLKS THAT
WE'VE ALREADY ALLOCATED THIS
MONEY, AND WE KNOW IT'S GETTING
OUT. WE JUST NEED IT TO BE
SUCCESSFUL. SO I IF WE CUT
ANYTHING, IT SHOULD BE VERY
STRATEGIC AND NOT TAKE US
ANYWHERE BACKWARDS. WE NEED TO
CONTINUE TO MOVE FORWARD ON
THIS. HE MAY PROCEED. OK, THANK
YOU SO MUCH SO AGAIN. RENE MALO,
DEPUTY DIRECTOR, HEALTHCARE
BENEFITS AND ELIGIBILITY WITH
THE DEPARTMENT. SO I'M HERE TO
PRESENT ON THE, UM HEARING AID,
UH, COVERAGE PROGRAM FOR
CHILDREN THAT WE ADMINISTER. SO
AS NOTED IN THE AGENDA, WE DID
LAUNCH THIS PROGRAM, UM, IN JULY
OF 2021 TO FUND HEARING AID
BENEFITS AND RELATED SERVICES
FOR CHILDREN AGES 0 TO 17, WHO
DO NOT OTHERWISE HAVE COVERAGE
FOR THESE SERVICES AND SUPPORTS.
UH, WE DO SUPPORT INDIVIDUALS
THAT HAVE, UM FAMILY HOUSEHOLD
INCOMES THAT ARE LESS THAN 600%
OF THE FEDERAL POVERTY LEVEL,
AND THEY CANNOT. OTHERWISE BE
ELIGIBLE FOR THE MEDICAL PROGRAM
OR BE ENROLLED IN THE CALIFORNIA
CHILDREN'S SERVICES PROGRAM FOR
HEARING AIDS SERVICES. SO
EFFECTIVE JANUARY 1 OF 2020
THREE, WE DID EXPAND OUR PROGRAM
ELIGIBILITY TO INCLUDE
INDIVIDUALS BETWEEN THE AGES OF
18 TO 20, THEN WE ALSO PROVIDE
SUPPLEMENTAL COVERAGE FOR THOSE
WITH, UM, COVERAGE THAT IS
PARTIAL COVERAGE UP TO $1500 A
YEAR FOR A HEARING AIDS. AGAIN
OUR CURRENT BENEFITS INCLUDE THE
HEARING AIDS AND ASSISTIVE
DEVICES FOR LISTENING AND, UM
SURFACE WARM, WARM CON BONE
CONDUCTION HEARING DEVICES. AND
WE ALSO, UH, PROVIDE THE HEARING
SUPPLIES AND ACCESSORIES AND
THEN HEARING RELATED AUDIOLOGY
AND POST EVALUATION SERVICES. SO
AS OF AND I'M GONNA COVER ALL
THE QUESTIONS THAT YOU HAD IN
THE AGENDA AND MY REMARKS. SO AS
OF MARCH OF THIS YEAR, UH, WE
HAVE RECEIVED 612 TOTAL
APPLICATIONS AND OF THOSE 350
THREE APPLICATIONS HAVE RESULTED
IN ENROLLMENT IN THE PROGRAM
SINCE THE BEGINNING OF THE
PROGRAM SO TODAY. 422
INDIVIDUALS HAVE BEEN ENROLLED
IN THE HEARING AID COVERAGE
PROGRAM AND OF THOSE INDIVIDUALS
. WE ARE CURRENTLY SERVING 100
AND 90 THREE INDIVIDUALS SO AT A
HIGH LEVEL IN 2122, WE SERVED
100 AND THREE INDIVIDUALS IN 22,
23, 100 AND 71 INDIVIDUALS AND
THEN IN FISCAL YEAR 23, 24 100
AND 48 INDIVIDUALS. IN TERMS OF
THE COVERED BENEFITS UNDER THE
HEARING AID PROGRAM AND THE
ASSOCIATED REIMBURSEMENT RATES.
THOSE RATES AND THE PROCEDURE
CODES THAT ARE USED FOR THE
PROGRAM ARE THE SAME
REIMBURSEMENT RATES AND CODES
THAT ARE USED UNDER ME AND THE,
UH èC èC S¼ PROGRAM. THERE ARE
NÓ DIFFERENCES IN THOSE RATES,
AND SO FOR ANY ASSOCIATED RATE
INCREASES THAT ARE BEING
PROPOSED AS PART OF THE M èC Ó
TAX PROPOSAL. THOSE RATES WOULD
ALSO APPLY TO THOSE BENEFITS
THAT WOULD BE MADE AVAILABLE TO
INDIVIDUAL ET CETERA AND MOLD IN
THE PROGRAM. AS OF FEBRUARY OF
THIS YEAR, WE HAVE 68 TOTAL
PROVIDERS THAT HAVE OPTED INTO
THE, UM, HEARING AID PROVIDER
LOCATOR. THAT JUST MEANS THAT
THOSE ARE THE PROVIDERS THAT
HAVE AGREED TO HAVE THEIR
INFORMATION OUT THERE PUBLICLY
FOR INDIVIDUALS TO FIND THEM,
UM, TO HAVE THESE SERVICES
PROVIDED TO THEM. WE ARE WORKING
ON PULLING DATA FOR THE NUMBER
OF PROVIDERS WHO WERE ADDED TO
THE PROGRAM FOR THIS YEAR. UM
AND ALSO NOTE THAT THERE ARE OF
THE PROVIDERS THAT ARE INDICATED
ON THE LOCATOR. THEY COULD
INCLUDE INDIVIDUAL CLINICIANS
AND OR FACILITIES THAT MAY HAVE
MULTIPLE CLINICAL STAFF. UM ON
BOARD. I DO WANT TO NOTE THAT WE
DO HAVE TOP PEDIATRIC
INSTITUTIONS ACROSS THE STATE
THAT ARE ALSO PARTICIPATING IN
THE PROGRAM. THESE INSTITUTIONS
INCLUDE THE CENTER FOR EARLY
INTERVENTION ON DEAFNESS IN
BERKELEY, THE CHILDREN'S
HOSPITAL OF ORANGE COUNTY
PROVIDENCE SPEECH AND HEARING
CENTER, BRADY'S CHILDREN
HOSPITAL OF SAN DIEGO AND HOUSE
CHILDREN'S CENTER IN LOS
ANGELES. IN FEBRUARY OF 2024. WE
HAD ALSO PUBLISHED AN UPDATED
ACTION PLAN TO HIGHLIGHT SOME OF
THE KEY PROGRAMMATIC ACTIVITIES
AND POLICY UPDATES IN THE
FOLLOWING AREAS, SO WE HAVE
BEGAN PARTNERING WITH OTHER
STATE ENTITIES TO HELP PROMOTE
THE PARTICIPATION AND AWARENESS
OF THE HEARING AID PROGRAM,
WHICH INCLUDES THE PLACEMENT OF
HEARING AID PROGRAM INFORMATION
ON WEBSITES AND THEN EVIDENCE OF
COVERAGE MATERIALS AS APPLICABLE
. THAT OUTREACH HAS BEEN MADE TO
COVER. YEAH DEPARTMENT OF
MANAGED HEALTHCARE DEPARTMENT OF
EDUCATION DEPARTMENT OF PUBLIC
HEALTH, DEVELOPMENTAL SERVICES,
UH, SOCIAL SERVICES AND THEN
ALSO FIRST FIVE, SO WE ARE
WORKING STRATEGICALLY WITH THEM
TO MAKE AVAILABLE OUR
INFORMATION AND THEN AS
APPROPRIATE TO PARTICIPATE IN
ASSOCIATED MEETINGS, WEBINARS
TRAININGS REGARDING THE HEARING
AID PROGRAM. WE HAVE ALSO
COMPLETED THE TRANSLATIONS OF
THE HEARING AID RELATED
MATERIALS INTO THE MEDICAL
THRESHOLD LANGUAGES. AND THAT
INFORMATION IS, UH, LOCATED ON
OUR WEBSITE FOR THIS PROGRAM. WE
HAVE ALSO IMPLEMENTED. UH, WE
WILL BE IMPLEMENTING A
STREAMLINE ANNUAL ELIGIBILITY
REVIEW PROCESS TO HELP SIMPLIFY
THE ENROLLMENT INTO THE PROGRAM.
SO THE REVIEW FORM, UH, WILL BE
RELEASED IN SPRING OF THIS YEAR
TO HELP, UH IMPROVE CONSUMER
EXPERIENCES, BOTH WITH THE
APPLICATION AND THE ANNUAL
ELIGIBILITY REVIEW, AND WE'RE
ALSO WORKING ON REFINEMENTS FOR
THOSE MATERIALS AND PROCESSES
WITH OUR STAKEHOLDER PARTNERS.
UH, WE'RE ALSO CONTINUING TO
CONDUCT OUTREACH TO MEDICAL
PROVIDERS WHO ARE NOT YET
PARTICIPATING IN THE HEARING AID
PROGRAM TO HELP SUPPORT THEIR
PARTICIPATION. WE WILL BE USING
DATA TO HELP CONDUCT ADDITIONAL,
UH, PROVIDER OUTREACH EFFORTS TO
HELP INCREASE THE AWARENESS AND
WHAT WE, UM THOSE PROVIDER. UM
UH, ENGAGEMENTS, UH, WILL BE ON
A QUARTERLY BASIS. THOSE UM
ENGAGEMENTS ARE NOTED ON OUR
WEBSITE. AND WE DO HAVE, UM,
EVENTS THAT OCCURRED IN JANUARY.
1 WILL BE IN APRIL JULY IN A IN
OCTOBER AND THEN WE CONTINUE TO
HOST A QUARTERLY WEBINARS WITH
PROVIDERS AND STAKEHOLDERS AND
THEN WE DO HAVE A SMALL SUBSET
OF VERY INTERESTED STAKEHOLDERS
THAT WE MEET WITH ON A MONTHLY
BASIS TO SHARE OUR PROGRESS AND
TO ADDRESS ANY, UH, CONCERNS
THAT THEY MAY HAVE WE'RE ALSO
CONTINUING TO MONITOR OUR
OVERALL ENROLLMENT IN THE
PROGRAM, WHICH HAS BEEN TRENDING
UPWARDS. UM AND SO WE'LL BE
LOOKING TO, UM, UPDATE
PROJECTIONS OF ENROLLMENT AS
APPROPRIATE. UM TO HELP? UH UH
TOWARDS YOU KNOW, GETTING PEOPLE
ENROLLED IN THE PROGRAM WHO ARE
ELIGIBLE FOR THE PROGRAM. WE DO
RECOGNIZE THAT THERE HAVE BEEN
CONCERNS RAISED REGARDING THE
PARTICIPATION OF KAISER. UM AND
WE HAVE BEEN ENGAGING WITH
KAISER, BOTH IN UH, SOUTHERN
CALIFORNIA AND NORTHERN
CALIFORNIA TO DISCUSS PROCESSES
FOR HELPING TO REFER INDIVIDUALS
INTO HEARING AID COVERAGE. IN
TERMS OF A QUESTION ABOUT
GEOGRAPHIC ANALYSIS OF THE
HEARING AID PROVIDERS WE HAVE
NOT YET DONE, UM, A GEOGRAPHIC
ANALYSIS OF PARTICIPATING HERE
IN AID PROVIDERS, BUT OUR
PROVIDER LOCATOR TOOL DOES ALLOW
THE FAMILIES TO SEARCH BY ZIP
CODE FOR PEDIATRIC AUDIOLOGIST
OF THE PROVIDERS THAT HAVE OPTED
IN TO USE THE LOCATOR TOOL. MOST
ARE CONCENTRATED IN SOUTHERN
CALIFORNIA AND LOS ANGELES AND
SAN DIEGO AS WELL AS IN NORTHERN
CALIFORNIA IN THE BAY AREA, AND
THESE ARE THE TWO AREAS THAT WE
HAVE OBSERVED THE LARGEST
CONCENTRATION OF INDIVIDUALS
THAT ARE POTENTIALLY ELIGIBLE
FOR OUR PROGRAM. AND THEN IN
TERMS OF THE REIMBURSEMENT RATES
, I ADDRESSED THAT EARLIER THAT
AGAIN, WE WILL BE USING THE
TARGETED RATE INCREASES FOR THIS
PROGRAM AND FOR, UM THE HEARING
AID PROGRAM SPECIFICALLY, UM WE
FOR THE TARGETED RATE INCREASES
THEY WILL BE TARGETED AT 80% OF
MEDICARE. FOR MOST OF THE
SERVICES THAT ARE OUTSIDE OF THE
EVALUATION AND MANAGEMENT CODES,
BUT FOR AUDIOLOGY SERVICES, THEY
DO NOT HAVE ASSOCIATED MEDICARE
RATES BECAUSE TYPICALLY WE PACK
OUR RATES TO MEDICARE. SO THERE
ARE NOT MEDICARE RATES FOR THESE
SERVICES. SO FOR THAT PURPOSE,
WE WILL BE DOING REVIEW RATES
FOR COMMERCIAL PAYERS AND FOR
OTHER PROGRAMS TO ESTABLISH AN
80% MEDICARE EQUIVALENT FOR
THESE SERVICES, AND THEN AGAIN
SINCE WE USE THE EXISTING
MEDICAL CODES, UH, FOR HEARING
AID SERVICES, BOTH FOR UM
MEDICAL FEE FOR SERVICE AND FOR
OUR èC èC S¼ PROGRAM, THESE
CODES OUT WOULD BE SUBJECTED TO
THE RATE INCREASES. THE TARGETED
RATE INCREASES WOULD ALSO APPLY
TO THE HEARING AID COVERAGE
PROGRAM. AND THIS CONCLUDES MY
REMARKS REGARDING THIS PROGRAM
AND HAPPY TO ANSWER ANY
QUESTIONS THAT YOU MAY HAVE.
THANK YOU. THANK YOU SO MUCH. UM
BEFORE WE JUMP INTO QUESTIONS, I
I'LL TURN NOW TO CHILDREN NOW,
NORA LYNN TO PROVIDE HER
REMARKS. THANK YOU, SENATOR
MENJIVAR AND SUB COMMITTEE
MEMBERS FOR INVITING ME TO SPEAK
TODAY. I AM NORA LYNN, WITH
CHILDREN NOW SPEAKING ON BEHALF
OF CHILDREN NOW AND OUR PARTNER,
LET CALIFORNIA KIDS HERE. HCC P
WAS CREATED BY THE
ADMINISTRATION NEARLY THREE
YEARS AGO IN RESPONSE TO A
COVERAGE GAP THAT LEAVES MORE
THAN 20,000 DEAF AND HARD OF
HEARING CHILDREN WITHOUT
COVERAGE FOR HEARING AIDS,
DESPITE MILLIONS OF DOLLARS
ALLOCATED TO THE PROGRAM, IT IS
BARELY NEED 2% OF THE CHILDREN
IN NEED OF THIS COVERAGE. THE
LACK OF PROGRESS IS ALARMING AND
HAS BEEN DESCRIBED BY EXPERTS AS
A DEVELOPMENTAL EMERGENCY FOR
CHILDREN THAT HAS BEEN UNFOLDING
FOR YEARS IN THE STATE OF
CALIFORNIA. THIS LEGISLATIVE
BODY HAS HELD MANY OVERSIGHT
HEARINGS ON THE HÌ, A èC P
PROGRAM SINCE ITS INCEPTION, BUT
UNFORTUNATELY, HÌ A èC èC P IS
STILL PLAGUED BY SEVERAL PROGRAM
DESIGN FLAWS. I WOULD LIKE TO
UPLIFT RECOMMENDATIONS WE'VE
MADE TO THE DEPARTMENT AROUND
TWO KEY ISSUES THAT WE THINK ARE
NEEDED TO BETTER ENSURE KIDS CAN
ACCESS CARE. THE FIRST IS
REGARDING REIMBURSEMENT. THERE
ARE TWO REIMBURSEMENT ISSUES
THAT PARTICULARLY AFFECT YOUNGER
CHILDREN. PROVIDERS LOSE MONEY
ON EAR MOLDS, WHICH MUST BE
TAKEN MORE FREQUENTLY AS
CHILDREN GROW AND NEED TO BE
REFITTED FOR HEARING AIDS, AND
THAT PROVIDERS DO NOT HAVE THE
SUPPORT AND ASSISTANCE THEY NEED
FOR HEARING AID TESTING FOR VERY
YOUNG CHILDREN, A BEST CLINICAL
PRACTICE THAT SHOULD BE A
COVERED SERVICE. WE CALL ON DHCS
TO USE THEIR AUTHORITY AND
RESOURCES AVAILABLE TO THEM TO
UPDATE REIMBURSEMENT POLICIES
FOR EAR MOLDS AND TESTING
ASSISTANCE SO THAT KIDS IN HÌ P
CAN BE ADEQUATELY AND
APPROPRIATELY SERVED. THE SECOND
ISSUE I WOULD LIKE TO RAISE IS
THE FACT THAT TOO FEW PEDIATRIC
AUDIOLOGISTS ARE CURRENTLY IN
PROACTIVELY PARTICIPATING IN HÌ
ACC. èC P, RESULTING IN LONG
APPOINTMENT WAIT TIMES. THAT'S
WHY MAKING KAISER'S NETWORK OF
QUALIFIED PEDIATRIC AUDIOLOGISTS
AVAILABLE TO HCC P IS AN
ABSOLUTE AND LONG OVERDUE
NECESSITY IN ENSURING TIMELY
ACCESS. GIVEN THE OUTSIZED ROLE
THAT KAISER PLAYS IN THE
COMMERCIAL MARKET, AND NOW IN
THE MEDICAL SPACE, IT IS
UNACCEPTABLE THAT KAISER
PROVIDERS ARE STILL NOT
PARTICIPATING IN HÌ, A P. WE
WOULD LIKE TO SEE DHCS DELIVER
RESULTS BASED ON ONGOING
CONVERSATIONS WITH AND FEEDBACK
FROM KAISER, WHICH HAVE BEEN
TAKING PLACE FOR YEARS. THE
DESIGN FLAWS IN THIS PROGRAM ARE
FURTHER EXACERBATED BY THE
EXORBITANT SPENDING ON PROGRAM
ADMINISTRATION PAID TO AN
OUTSIDE VENDOR RATHER THAN
SPENDING ON ACTUAL HEARING AIDS
FOR KIDS. KIDS DESERVE ACCESS TO
CARE, AND WE EXPECT THE
ADMINISTRATION TO DO BETTER.
THANK YOU FOR YOUR TIME AND
ATTENTION. THANK YOU SO MUCH.
NORA DEPARTMENT OF FINANCE. DO
YOU HAVE ANY ADDITIONAL COMMONS
TO ADD? A DETAIL ANY DEPARTMENT
OF FINANCE NOTHING FURTHER TO
ADD AT THIS TIME. RYAN MILLER L
A Ó. NOTHING TO ADD, BUT
AVAILABLE FOR QUESTIONS. THANK
YOU SO MUCH. UM OK COLLEAGUES,
LET'S JUMP INTO SOME QUESTIONS
HERE. I REALLY APPRECIATE THE
DETAILED ANSWERS TO EACH
QUESTIONS. UH, LET'S DIVE A
LITTLE LITTLE BIT MORE INTO
THAT. I THINK THE FIRST ONE IS
NEAR CLOSE TO 20,000 KIDS ARE
ELIGIBLE FOR THIS. AND DEPUTY
DIRECTOR AND DIRECTOR. WE'RE
HEARING THAT 193 101, 103, 171
AND 148 ARE OUR NUMBERS FOR THE
PAST COUPLE OF YEARS. WE 2%
WE'RE MEETING CLOSE TO ONLY 2%
OF THE ELIGIBLE KIDS AND ONLY 68
. TOTAL PROVIDERS HAVE AGREED TO
BE LISTED AS A PROVIDER ELIGIBLE
WHO WILL BE TAKING ON THIS MOST
OF THEM IN URBAN AREAS. THAT'S
WHAT I HEARD FROM YOU
CONCENTRATIONS IN L, A THE BAY
AREA 68 PROVIDERS DOESN'T EVEN
COVER ONE COMMUNITY IN LAII. I
SEE THIS AS A COMPLETE FAILURE.
COMPLETE FAILURE OF A PROGRAM
THAT IT'S NOT EVEN MEETING WHERE
IT'S IN GOOD FAITH. WE'RE AT 50%
WE HAVE INCREASED A LITTLE BIT
MORE. HOW DO WE JUSTIFY ONLY
MEETING 2% OF THE POPULATION'S
NEEDS IN THIS AND NOT HAVING
EVEN BIGGER URGENCY? I THINK
ACTION PLANS ARE GREAT, BUT
THEY'RE THEY'RE JUST PLANS LIKE
WHAT ARE WE DOING TO REALLY SAY?
HEY UM, LEGISLATORS. THIS IS HOW
MUCH WE'VE IMPROVED. WE HAVE NOW
200 PROVIDERS. YOU KNOW, WE'VE
CLOSED THE GAP FROM 2% TO 50% OF
KIDS WHO HAVE NOW BEEN TREATED.
KAISER ONE OF THE BIGGEST
PROVIDERS IS GETTING TO GET OUT
OF SCOT FREE. UM AND I'M
WONDERING WHAT YOU KNOW WHAT?
THAT'S ANOTHER QUESTION. SO
LET'S START WITH THIS. HOW CAN
WE JUSTIFY THIS? UM, IN ALL DUE
RESPECT, I WISH I HAD THE
GOVERNOR HERE, RIGHT? HE'S THE
ONE WHO BE VETOED THIS. I PUT
THIS BACK ON THE DEPARTMENT. SAY
THAT THIS PROGRAM IS BETTER THAN
HAVING EVERY COMMERCIAL PLANS.
COVER IT. HOW DO WE JUSTIFY THIS
PROGRAM BEING SUCCESSFUL OR
STILL SURVIVING? SO THANK YOU
FOR THE QUESTION, SO TO START
OFF, UM, IN TERMS OF THE NUMBER
OF PROVIDERS, THE 68 THAT WERE
REFERENCED ARE THE PROVIDERS
THAT HAVE HAVE, UM, OPTED INTO
THE LOCATOR TOOL? THAT DOESN'T
MEAN THAT THO. THOSE ARE THE
ONLY PROVIDERS PARTICIPATING.
ONE OF THE THINGS THAT WE HAD
HEARD DURING, UM, THE WORK THAT
WE HAVE BEEN DOING TO TALK WITH
THE, UM, PEDIATRIC COMMUNITY.
UM, IN THIS SPACE IS THAT A LOT
OF PROVIDERS WERE UNSURE THEY
WERE UNSURE ABOUT THE VOLUME
THAT THEY RECEIVE, SO WE HAVE
BEEN TALKING WITH THEM ABOUT
WHAT TO EXPECT WHERE WE HEAR
CHALLENGES THAT THEY MAY HAVE
WITH OUR PROGRAM IN TERMS OF,
YOU KNOW, ADMINISTRATIVE. UH UH,
BURDENS OR BARRIERS. WE ARE THEN
WORKING TO TRY TO ADDRESS THOSE
TO GIVE THEM CLEAR GUIDANCE AND
INFORMATION. BUT AGAIN WHEN THE
PROGRAM WAS CONSTRUCTED, IT WAS
BUILT ON THE USE OF THE MEDICAL
NETWORK AND PROVIDING THESE
SERVICES SO IT'S THE SAME
NETWORK OF PROVIDERS, NOT JUST
THE 68. BUT PROVIDERS THAT ARE
PARTICIPATING IN OUR PROGRAM
THAT CAN SERVE THESE KIDS, SO
WE'RE TRYING TO DO ALL THAT WE
CAN IN TERMS OF EDUCATION,
REACHING OUT TO THE SCHOOLS, YOU
KNOW, WORKING WITH, UM,
PEDIATRIC AUDIOLOGIST IN THIS
SPACE. ALSO GETTING SOME, UH,
LESSONS LEARNED FROM THEM AREAS
OF BEST PRACTICES AND
INFORMATION THAT WOULD BE
HELPFUL TO THE PROVIDER
COMMUNITY IN TERMS OF THEIR
PARTICIPATION IN THE PROGRAM IN
TERMS OF THE NUMBER OF
INDIVIDUALS THAT HAVE BEEN BY
THE PROGRAM. WE DO UNDERSTAND
AND RECOGNIZE THAT THE RAMP UP
HAS BEEN SLOW, BUT WE'RE ALSO
LOOKING AT OTHER TOUCH POINTS
THAT WE CAN MAKE IN TERMS OF
EDUCATING PEOPLE AND MAKING THEM
AWARE ABOUT THESE SERVICES. SO
IN WORKING WITH DEPARTMENT UH UH
, MANAGED HEALTH CARE COVER
CALIFORNIA PUTTING INFORMATION
OUT ON THEIR WEBSITES PUTTING
INFORMATION ABOUT THIS BENEFIT
AND THEIR, UM, COVERAGE OF
BENEFIT. UH, DISCLOSURES. WE'RE
LOOKING AT DOING THAT, AND THEN
ALSO FOR THE NEW BORN, UH,
SCREENING PROGRAM THROUGH
DEPARTMENT OF PUBLIC HEALTH, AS
WELL AS THROUGH THE NEWBORN
HEARING SCREEN SCREENING PROGRAM
THAT IS ADMINISTERED BY THE
DEPARTMENT, ALSO PROVIDING
ADDITIONAL INFORMATION AND
OUTREACH, UM, MATERIALS THAT ARE
GOING OUT AND DOING CALLS TO
PEOPLE TO MAKE THEM AWARE OF
THIS PROGRAM SO THAT WE CAN HELP
TO INCREASE THE PARTICIPATION IN
THIS PROGRAM. SO WE DO RECOGNIZE
THAT THOSE ARE INCREMENTAL
STEPS. BUT WE DO BELIEVE THAT
COLLECTIVELY WITH THOSE THAT
WE'RE LOOKING AT, UM, DEPLOYING
THAT IT WILL HELP TO INCREASE
THE NUMBER OF INDIVIDUALS THAT
ARE PARTICIPATING IN THIS
PROGRAM. WE'RE ALSO WORKING WITH
DEPARTMENT OF EDUCATION TO SHARE
INFORMATION AND HOW THAT
INFORMATION CAN BE DISSEMINATED
THROUGH SCHOOLS AGAIN TO MAKE
PEOPLE AWARE ABOUT THIS BENEFIT
THROUGH, UM THE DEPARTMENT.
THANK YOU FOR THAT PART BECAUSE
I WAS GOING TO ASK WHAT ABOUT
DEPARTMENT OF EDUCATION BECAUSE
I DON'T THINK ORIGINALLY SAID
IT, BUT THANK YOU FOR TOUCHING
ON THAT POINT. DO WE FEEL THAT
NOW THERE IS AN URGENCY BECAUSE
THIS PROGRAM HAS BEEN GOING ON
FOR THREE GOING ON FOUR YEARS
NOW THAT NOW WE HAVE DIRECT
CLARITY. UM GOALS THAT WE CANNOT
REALLY FLIP THIS PROGRAM. I DO.
BUT AS WITH ANY AND I RECOGNIZE
THE TIMING FOR WHEN THE PROGRAM
WAS ESTABLISHED, BUT ONE OF THE
THINGS THAT WE HAVE LEARNED, UM,
JUST IN GENERALLY SPEAKING WHEN
WE CREATE NEW PROGRAMS, NEW
BENEFITS RAMP UP DOES TAKE TIME,
EVEN DESPITE OUR BEST EFFORTS IN
EDUCATING PEOPLE PUTTING
INFORMATION OUT AND EMAIL BLAST,
YOU KNOW, WE PUT INFORMATION OUT
IN OUR, UM STAKEHOLDER UPDATES
ON THE PROGRAM AND ALL IT JUST
TAKES TIME. IT TAKES TIME TO
EDUCATE PEOPLE TO BRING PEOPLE
TO THE TABLE. WE USE OUR
ADVOCATE VOICES TO HELP WITH
THAT COMMUNICATION, BUT WE
RECOGNIZE IT'S NOT JUST ONE
SINGLE THING THAT WILL HELP
BRING PEOPLE TO THE TABLE. IT'S
A MULTITUDE OF DIFFERENT
ACTIVITIES THAT WE HAVE TO
COALESCE AROUND TO HELP THEM
INCREASE, UM, AWARENESS AND
PARTICIPATION IN THE PROGRAM.
TWO MORE QUESTIONS, AND I'LL
TURN TO MY COLLEAGUES. ONE IS
WHAT ARE THE BARRIERS THAT
KAISER HAS SHARED WITH YOU AS TO
WHY THEY'RE NOT PARTICIPATING? I
KNOW YOU SHARED IT RECENTLY THAT
SOME CONCERNS OF PROVIDERS
THINKING THE INFLUX. THEY DIDN'T
IS THAT THE BARRIER KAISER HAS
PROPOSED. I MEAN, THEY THEY
COULD TAKE CARE OF THEIR BABY.
WE KNOW AND WE HAVE SHARED OUR
CONCERNS AND OUR DESIRE TO WORK
WITH THEM. PART OF IT IS THEIR
INFRASTRUCTURE AND HOW THEY ARE
SET UP TO PROVIDE THESE SERVICES
AND SUPPORTS SO THEY HAVE TWO
DISTINCT, UM, INFRASTRUCTURES IN
NORTHERN CALIFORNIA VERSUS
SOUTHERN CALIFORNIA, SO WE'RE
WORKING WITH THEM TO TRY TO SEE
WHERE WE CAN OFFER. SOME, UM
ADMINISTRATIVE RELIEF BECAUSE OF
THE WAY OF THEIR INFRASTRUCTURES
AND THEIR BILLING, BECAUSE PART
OF IT HAS TO DO WITH THE
BILLING. AND HOW ARE THEY GONNA
THEN BE ABLE TO BILL FOR THE
SERVICES AND SUPPORT WE HAVE
RECEIVED COMMITMENT? I'LL BE
HONEST HERE. WE HAVE RECEIVED
COMMITMENT FROM THEM AND WORKING
WITH US ON THIS PROGRAM, AND
THEY DO RECOGNIZE THE IMPORTANCE
AND THE ROLE THAT THEY DO PLAY
IN PROVIDING THESE SERVICES AND
SUPPORT. AND SO THAT IS
SOMETHING THAT WE'RE CONTINUING
TO WORK ON. AND AS WE, UM YOU
KNOW, GET FURTHER ALONG IN THAT
PROCESS. WE WILL THEN MAKE SURE
THAT PEOPLE ARE AWARE OF NEXT
STEPS AS IT RELATES TO KAISER,
BUT THEY ARE COMMITTED AND
WILLING PARTNERS AND WORKING
WITH US IN TERMS OF TRYING TO
OVERCOME WITH THE BARRIERS THAT
THEY MAY HAVE BETWEEN THEIR TWO
ORGANIZATIONAL STRUCTURES. THANK
YOU AND THIS QUESTION, PERHAPS
MAYBE DEPARTMENT OF FINANCE OR
IF YOU HAVE THE ANSWERS, UM,
DEPUTY DIRECTOR IS WE'VE
ALLOCATED A LOT OF MONEY FOR
THIS. I'LL JUST THROW OUT A
BUNCH OF THESE NUMBERS 400,000.
2120 TO 2115 POINT 1,000,021 TO
22 14.5 MILLION THEREAFTER AND
NOW WE'RE REQUESTING A COUPLE
MORE MILLIONS. BUT WHAT WE'VE
ALLOCATED IN SERVICES CORRECT ME
IF I'M WRONG DOESN'T AMOUNT TO
WHEN THE MONEY WE'VE ALLOCATED
FOR THIS PROGRAM, SO I'M
WONDERING WHERE WHERE IS THE
REST OF THE MONEY? A DEPARTMENT
OF FINANCE. UM SO WE THE
GOVERNOR'S BUDGET. UM IN THE
MEDICAL ASSISTANT ESTIMATE, UM,
PROJECTS CURRENT EXPENDITURES
FOR THIS PROGRAM TO BE 645,000
GENERAL FUND. UM AND, UH, 100
SORRY, 1.6 MILLION GENERAL
FUNDED BUDGET YEAR FOR THIS, AND
THAT IS AN ESTIMATE. UM FOR
WHAT? WE THINK THE USAGE WILL BE
. SO IF THE I'M SORRY, BUT
PREVIOUS YEARS, IF WE NEVER GOT
NEAR THE AMOUNT OF 15 POINT
█1,000,014.05 MILLION AND WE'VE
ONLY SERVED LESS THAN 2% WHERE
IS THE REST OF THE MILLIONS OF
DOLLARS? WHY ARE WE ALLOCATING
MORE MONEY TO THIS? SHOULDN'T WE
HAVE LEFT OVER FROM THE PREVIOUS
YEAR? SINCE WE DIDN'T USE ALL OF
IT, SO WE, UM BECAUSE THOSE WERE
JUST ESTIMATES. WE DO, UM, YOU
KNOW, LIKE, MAKE THE ALLOCATION
WE LOWER THE ALLOCATION LIKE NOW
IT'S 1.6 MILLION. WE LIKE LOWER
THE ALLOCATION BASED ON UPDATED
ESTIMATES AS THE THROUGH THE
BUDGET PROCESS, EVERY GOVERNOR
BUDGET MAY REVISE AND THEN IN
THE BUDGET ACT, SO WERE THE
PREVIOUS ALLOCATIONS OF 15.1 AND
14.5 CLAWED BACK. BECAUSE THEY
DIDN'T GET AND I DON'T KNOW IF
YOU HAVE MORE INFORMATION, BUT
IT SEEMS LIKE THE MONEY WASN'T
COMPLETELY UTILIZED. YEAH IF,
UH, IF ANY, IF ANY PROGRAM COMES
IN, LIKE, NOT AT THE ESTIMATE,
WE DO JUST RE UP THE ESTIMATE
WHEN WE PASS THE NEXT BUDGET
ACT. I'M GONNA NEED A LITTLE BIT
MORE CLARIFICATION. I GIVE A
DEPARTMENT 14.5 MILLION AND 2%
OF IT IS USED. WHAT HAPPENS TO
THE REST? SO THEN, LIKE NEXT
NEXT YEAR, LIKE, YOU KNOW, IF WE
SO IF WE I DON'T HAVE THE, UM
PRIOR YEAR NUMBERS IN FRONT OF
ME, BUT LIKE, THEN, THE NEXT
YEAR, WE WOULD JUST AS WE WOULD,
UH RIGHT SIDE THE DOLLARS TO THE
WE NEED TO RIGHT SIZE. IF WHY
WOULD WE NEED TO GIVE MORE MONEY
IF NOT ALL THE FUNDS WERE
UTILIZED? WHY ARE WE ADDING MORE
MONEY? YES WHERE'S THE MONEY? IT
SEEMS LIKE IN THE BUCKET. THERE
IS 15 PLUS 14. THAT'S 29 29.6.
PLUS $400,030 MILLION IN THE
BUCKET. UM, AND FOR THE PAST
THREE YEARS THERE IS UM, YOU
CAN'T JUST LIKE ADD UP THE
NUMBERS EACH OF THE YEAR, SO
IT'S AN ESTIMATE. WHY NOT? IT'S
A MEDICAL IS ON A, UM, CASH
BASIS. SO YOU SO WHAT'S
AVAILABLE RIGHT NOW IN THE
GOVERNOR'S BUDGET, IT PROPOSES
1.6 MILLION. WHAT'S THIS PROGRAM
RIGHT NOW? UM FOR THE LOCAL
ASSISTANCE EXPENDITURES IS 1.6
MILLION GENERAL FUND FOR THE
BUDGET YEAR, BUT THAT'S WHAT HE
WANTS TO PUT IN. RIGHT THAT'S
WHAT YOU WANT TO ADD NÓ. THAT'S
LIKE THAT'S WHAT THEY HAVE, UM
ESTIMATED FOR THE EXPENDITURES
FOR THE EXPENDITURES, SO THE
PREVIOUS ESTIMATES WERE 15.1 AND
14.5. AND WE DIDN'T SCRATCH THE
SURFACE THERE. SO WHAT HAPPENED
TO THOSE DOLLARS? UM THOSE
DOLLARS. UM ARE NOT LIKE IT'S
NOW 1.6 MILLION THOSE DOLLARS. I
DON'T THINK WE SHOULD I PHRASE
IT LIKE THEY WEREN'T AGNES, IS
IT THE DIFFERENCE BETWEEN THE
STATE MATCH AND THE FEDERAL
MONEY ON ME? NÓ THAT HAS NOTHING
TO DO WITH IT. BUT WE BUDGET ON
A ROLLING WE BUDGET ON A THREE
YEAR BASIS. UH, YEAH. UH, RYAN
MILLER EARLIER AGAIN. UH, MAYBE
MAYBE IF WE BACKED UP, I COULD
MAYBE, UH, OFFER ANOTHER WAY OF
APPROACHING IT. SO UM, THE ISSUE
THAT WE'RE ACTUALLY GONNA BE
DISCUSSING IN THE NEXT ITEM IS
THE OVERALL MEDICAL ESTIMATE AND
THERE ARE, YOU KNOW, DOZENS OF
INDIVIDUAL ITEMS THAT ALL ADD UP
TO ONE NUMBER, AND THAT NUMBER
CORRESPONDS TO THE APPROPRIATION
IN THE BUDGET, AND SO EVERY
CYCLE WHEN WE HAVE A NEW
ESTIMATE FOR THIS PROGRAM, BUT
FOR YOU KNOW, LIKE I SAID,
DOZENS OF OTHERS, THE
ADMINISTRATION UPDATES ITS
ESTIMATES FOR CASE LOAD AND FOR,
YOU KNOW, PER MEMBER COSTS AND
ALL KINDS OF THINGS. AND UH,
INDIVIDUALLY. A LOT OF THOSE
ESTIMATES WILL GO UP AND DOWN,
BUT THEN THEY ALL KIND OF ADD UP
IN INTO THAT ONE OVERALL NUMBER.
AND SO I THINK THAT, UH, THAT'S
A VERY TECHNICAL WAY OF
EXPLAINING, OF COURSE, THAT
ESSENTIALLY BECAUSE OF LOWER
UTILIZATION, IT SOUNDS LIKE THE
FUNDING WASN'T REQUIRED AND THE
AMOUNT FOR THIS PROGRAM I JUST
GET ABSORBED BACK INTO THE
BIGGER MEDI BUDGET. I. I THINK
THAT'S PROBABLY A FAIR WAY. SO
WE DON'T HAVE A BUCKET JUST FOR
THIS PROGRAM, NÓ. WHATEVER IS IN
USE GETS CLOGGED. JUST
ESSENTIALLY GET BACK IN THE
BIGGER BUCKET. OK AND SO FOR
THIS YEAR, UM WE'RE ONLY ASKING
TO PUT $1.6 MILLION INTO THE
BUCKET. YES. THAT'S A DRASTIC
CUT. WHY I MEAN, THAT FEELS LIKE
THAT DOESN'T GIVE US FAITH THAT
WE'RE GONNA REALLY INCREASE
ENROLLMENT. AND SECONDLY, IT
SEEMS LIKE THE ALLOCATION FOR
ADMIN FUNDING OF THIS PROGRAM IS
HIGHER THAN ALLOCATION FOR
ACTUAL SERVICES OF THIS PROGRAM.
AM I RIGHT TO SAY THAT SO THE SO
11 OF THE THINGS UM TO BE CLEAR.
IS THAT LIKE THE JUST BECAUSE
THERE'S 1.6 MILLION ESTIMATED IN
THE GOVERNOR'S BUDGET FOR THIS
PROGRAM DOESN'T MEAN THAT, UM
ANYONE'S GOING TO GET LIKE
TURNED AWAY OR, UM, GET DENIED
HEARING AIDS. SO LIKE IF, FOR
EXAMPLE, YOU KNOW THE CASE LOAD
FOR THIS PROGRAM WAS TO TRIPLE
QUADRUPLE RIGHT? LIKE WE WERE
JUST RE UP THE ESTIMATE. YOU
KNOW, SO NÓ ONE'S GONNA GET
DENIED. THIS IS JUST AN ESTIMATE
FOR WHAT WE PROJECT MIGHT, UM
YOU KNOW, WOULD BE ALLOCATED FOR
THIS PROGRAM, SO IT'S SO IT'S
NOT LIKE A CUT. NECESSARILY OK,
UM, FINAL FINAL FINAL. UM SAYS
HERE WHERE THE GENERAL FUND
EXPENDITURE AUTHORITY OF $4
MILLION FOR THE 20 THREE 24.
THREE 0.7. IN 2024. IT'S OK. I'M
GOOD WITH THIS. I THINK I ASKED
THE QUESTION ALREADY. I'M GONNA
TURN TO MY COLLEAGUES. HER OFF.
I APOLOGIZE FOR COMING LATE TO
THE PROCESS. WE HAD A ANOTHER
MEETING GOING ON. SO IN LOOKING
AT THE DHCS IS, UH APPS IN THE
FUTURE STEPS TO HELP PATIENTS
MAXIMIZE BENEFITS, AND THERE ARE
SIX OF THEM. IN ADDITION TO
DEVELOPING THESE SIX STEPS, HAVE
YOU DEVELOPED A SPECIFIC
PROJECTION ON HOW THESE SIX
STEPS ARE GOING TO HELP INCREASE
PARTICIPATION AND MAXIMIZE
BENEFITS? I'M TALKING ABOUT
HEARING AIDS FOR KIDS. SERVICES.
WHAT'S THE GOAL? IN TERMS OF
INCREASED PARTICIPATION? IS IT
20% IS IT FOR YOU THINK THESE
SIX STEPS WILL RESULT IN A 40%
INCREASE IN THE TAKE RATE? ARE
THESE REALLY THE STEPS THAT ARE
GOING TO BE REQUIRED TO GET TO
THAT? 40% OR 50. OR IS THERE
SOMETHING ELSE? SO WE SO IN
LOOKING AT THE DIFFERENT STEPS
THAT WE HAVE IDENTIFIED. WE
HAVEN'T LIKE PEGGED IT TO A
CERTAIN PERCENTAGE OR NUMBER.
WE'RE GOING TO BE MEASURING THAT
BASED UPON WHAT WE START TO SEE
IN TERMS OF UTILIZATION, SO IT'S
KIND OF A BIFURCATED PROCESS.
BUT BASED UPON THE ACTIONS THAT
WE HAVE TAKEN BASED UPON
FEEDBACK THAT WE HAVE BEEN
RECEIVING FROM STAKEHOLDERS AND
THINGS THAT THEY HAVE ASKED US
TO COMMIT TO DOING WE BELIEVE
THAT THOSE THINGS COLLECTIVELY
WILL HELP TO INCREASE THE UTIL.
OF THE PROGRAM, AS WE DO WITH
EACH CYCLE IN THE BUDGET WILL BE
COMING BACK WITH UPDATED
ESTIMATES, BUT PART OF IT WILL
BE BASED UPON THE UTILIZATION
THAT WE ARE SEEING AND THEN
TRENDS THAT WE PROJECT FOR
FUTURE FORWARD IN TERMS OF THE
NUMBER OF INDIVIDUALS SERVED BY
THE PROGRAM. WE I DON'T WANNA BE
. I'M NOT BEING CRITICAL. I
WE'RE TALKING ABOUT HEARING
AIDS. SO YOU KNOW, HEARING
IMPAIRED AND YOUNG PEOPLE, AND
THAT PROBABLY TRANSLATES INTO
THE ABILITY TO LEARN OR NOT, UM,
AS CRITICAL AGES, PARTICULARLY
THE AGES. WE'RE TALKING HERE AND
I'M NORMALLY IN THE BUSINESS
WORLD WE'RE NORMALLY ACCUSTOMED
TO. IF WE HAVE PLAN, THE PLAN IS
TIED TO, UM SOMETHING THAT'S
GOING TO HAPPEN AT THE END OF
THE PLAN, AND THEN PEOPLE ARE
GRADED BASED ON PLAN. OBJECTIVE
ATTAINMENT, AND IT'S SORT OF
HARD TO APPLY ANY OF THAT IF WE
DON'T HAVE SOMETHING THAT'S
GONNA THAT WE THINK IS GOING TO
HAPPEN BASED ON OUR ACTIONS. BUT
WE DON'T HAVE THAT. I MEAN, I
DON'T I DON'T HAVE THOSE NUMBERS
AT THE READY. I KNOW WE ARE
LOOKING AT OUR UTILIZATION
PATTERNS RIGHT NOW, AND WE'LL BE
WORKING ON MAKING UPDATES TO THE
UTILIZATION AND WHAT WE'RE
EXPECTING TO SEE. SO WE'RE
LOOKING AT ASK PEOPLE HAVE BEEN
COMING INTO THE PROGRAM
REMAINING ON THE PROGRAM AND THE
TIME AT WHICH THEY COME IN,
BASED UPON WHAT THEIR NEEDS ARE
AND USING THAT INFORMATION TO
THEN PROJECT FUTURE FORWARD IN
TERMS OF WHAT WE ANTICIPATE TO
SEE FROM UTILIZATION, UM AS
DEPARTMENT OF FINANCE HAD
ALLUDED TO THEIR ASSUMPTIONS,
AND SO WE'LL WE'LL VALIDATE THAT
. OR CHECK THAT ON A GO FOR
BASIS, SO WE'RE MAKING
ASSUMPTIONS ABOUT WHAT WE
BELIEVE WILL HAPPEN BASED UPON
INFORMATION THAT WE HAVE FROM
UTILIZATION PARTICIPATION IN THE
PROGRAM. AND THEN AS WE'RE
LOOKING AT THE VARIOUS
STRATEGIES WE HAVE NOT, YOU
KNOW, LIKE I INDICATED EARLIER.
WE HAVEN'T PEGGED THE STRATEGIES
THAT SAY BY US DOING XY AND Z.
IT'S NOW GOING TO NET US SO MANY
INDIVIDUALS BUT AGAIN.
COLLECTIVE EFFORT WE BELIEVE
WILL HELP TO INCREASE THE
UTILIZATION IN THIS, FOR
EXAMPLE, BY STREAMLINING THIS
SIMPLIFYING PROVIDER ENROLLMENT
BASED ON YOUR CONTACT WITH
PROVIDER AND PROVIDER
ORGANIZATIONS. I MEAN, DO WE
EVEN KNOW THAT IF WE SIMPLIFY IT
THAT THERE WERE 20 PROVIDERS
THAT COMPLAINED THAT THEY DIDN'T
DO IT? BECAUSE IT WAS TOO
COMPLICATED, AND IF WE
SIMPLIFIED IT, THEY'D SIGN UP SO
WE COULD SAY, OH, WELL, IF WE
SIMPLIFY IT, WE'RE GOING TO GET
20 MORE PROVIDERS IN THE SYSTEM.
I I DON'T HAVE THE MAGIC BALL TO
SAY WHAT THAT WOULD BE. I MEAN,
WE ARE WORKING AS DILIGENTLY AS
WE CAN TO EDUCATE THE PROVIDERS,
THEIR PROVIDERS THAT ARE IN OUR
PROGRAM TODAY, UM, THAT CAN
PROVIDE THESE SERVICES BASED
UPON THEIR, UH, THEIR SKILL SET.
WHAT I THINK PEOPLE HAVE BEEN
LOOKING AT IS THAT PROVIDER
LOCATOR TOOL THAT PEOPLE HAVE
NOW SAID I'M GONNA PUT MY NAME
OUT HERE BECAUSE NOW WHEN PEOPLE
ARE LOOKING FOR THESE SERVICES,
I AM NOW PUTTING MY OUT HERE TO
SAY, YOU KNOW, COME. I CAN
PROVIDE SERVICES TO YOU WHAT WE
HAD HEARD PREVIOUSLY WHY WE
WEREN'T HAVING SO MUCH UPTAKE IS
, PEOPLE WERE UNSURE WHAT THE
NUMBERS WERE. THESE PROVIDE THE
PROVIDE THE PROVIDE NOT PEOPLE
SEEKING HEARING AID NÓ THE
PROVIDERS AND JUST THEIR
CAPACITY TO SERVE THOSE
INDIVIDUALS. WELL AGAIN. I'M NOT
BEING CRITICAL. IT'S VERY
COMPLICATED ISSUE. I'M SURE AND
I'M I HAVE TO DEFER TO YOU ALL.
WHO ARE THE EXPERTS? I AM A
LITTLE DISAPPOINTED IN KAISER.
SEEMS TO ME, YOU KNOW, GIVEN ALL
THAT WE'VE GONE THROUGH WITH
KAISER, INCLUDING SOME MASSIVE
CONTRACT AND ALL OF THAT
CONVERSATION THAT YOU WOULD
THINK THEY WOULD. KAISER IS AN
ENTITY WITH ALL THE PEOPLE AND
ALL THE MONEY THAT FLOW THROUGH
THAT OPERATION THAT THEY WOULD
BE ABLE TO FIGURE OUT HOW THEY
COULD DO A BETTER JOB WITH
RESPECT TO SOMETHING THAT IS
PRETTY CRITICAL TO YOUNG PEOPLE
WHO AREN'T ABLE TO HEAR. SO UM,
I'M HOPING THAT YOU ALL CAN
HELP. BIG KAISER FIGURE OUT THE
ANSWER TO THIS PROBLEM. WE ARE
WORKING ON IT. I'M SURE YOU ARE
AND HOPEFULLY THEY ARE TOO.
THANK YOU VERY MUCH. THANK YOU,
MADAM CHAIR. THANK YOU. AND TO
FOLLOW UP ON, UH ON, UH, SENATOR
ROSS QUESTIONS? YEAH, IT'S
SURPRISING THAT KAISER IS I
MEAN, HOW HOW AT SOME POINT DO
WE THINK ABOUT USING STICKS
INSTEAD OF CARROTS WITH KAISER?
AS IT RELATES TO THIS AS AS THEY
THEY PROVIDE A LOT. WE
UNDERSTAND. I MEAN, IT'S A
PROGRAM THAT'S OUTSIDE OF
MEDICAL. BUT AGAIN, WE HAVE, YOU
KNOW, TALKED WITH THEM ABOUT THE
IMPORTANCE AND THEIR ROLE IN THE
PARTICIPATION IN THIS PROGRAM,
SO THEY ARE GETTING THE I'LL SAY
THE PRESSURE FROM THE DEPARTMENT
BUT THEY HAVE BEEN WORKING WITH
US. PART OF IT IS AN
ADMINISTRATIVE COMPLEXITY IN
TERMS OF THE BILLING, AND ALSO
WE ARE WILLING TO COME TO THE
TABLE TO LOOK AT OPPORTUNITIES
FOR HOW THAT CAN BE STREAMLINED.
BUT THERE'S INFORMATION WE'RE
GONNA NEED FROM THEM. AND IT'S
JUST HAVING THOSE SYSTEMS AND
THOSE ABILITIES TO FOR THOSE
SYSTEMS TO COMMUNICATE WITH US
AND OUR, UM, BILLING PROCESSES
FOR REIMBURSEMENT PURPOSES. THEY
HAVE BEEN CRYSTAL CLEAR ABOUT
THEIR DESIRE TO WANT TO WORK
WITH US. IT'S JUST THE MECHANICS
OF HOW AND SO THAT IS WHAT MY
TEAM IS CURRENTLY WORKING
THROUGH WITH HIM IN TERMS OF THE
HOW TO MAKE THIS HAPPEN. SEEMS
LIKE THEY'RE PRETTY
SOPHISTICATED IN A LOT OF THE
HOUSE, UM MAYBE THIS COMMITTEE
COULD TALK WITH KAISER AS WELL,
JUST JUST TO GET THEIR
PERSPECTIVE ON WHY THIS IS SO
COMPLICATED FOR THEM. AND THEN
MY NOTES, LET'S HAVE A
CONVERSATION WITH KAISER SO THEY
CAN EXPLAIN IT TO US. WHY? IT'S
TOO HARD. UM AND I, YOU KNOW,
THE WEEKEND'S COMING HERE AND
I'M THINKING WEATHER IS NOT TOO
BAD, I MIGHT DO A LITTLE
FISHING. AND I JUST WONDER WHAT
THE PROGRAM LIKE THIS IS THERE A
POINT WILL WE CUT BAIT? WHERE
IT'S NOT WORKING. AND WHAT IS
THAT? WHAT WHAT DO THOSE
INDICATORS LOOK LIKE TO US? THAT
WOULD TELL US FOUR YEARS IN 567.
I MEAN, HOW LONG DO WE DO THIS
RIGHT THAT THIS PROGRAM IS NOT
GONNA WORK, AND WE SHIFT TO
ANOTHER MODEL THAT'S ALREADY
BEEN SUGGESTED. FAIR QUESTION.
UM AND ONE THAT YOU KNOW FOR US.
OUR INTENT HERE IS TO TRY TO
MAKE THIS PROGRAM AS SUCCESSFUL
AS WE CAN. SO WE'RE NOT LOOKING
AT THIS THAT, UM WE'RE GONNA GET
TO THIS POINT AND THEN WE'RE
GONNA STOP, YOU KNOW, THROW OUR
HANDS UP. OUR GOAL HERE IS TO
MAKE THE PROGRAM SUCCESSFUL, SO
THAT'S WHAT WE'RE GOING TO
CONTINUE TO WORK TOWARDS AND
WORK IN COLLABORATION WITH THE
LEGISLATURE ON OUR INTERESTED
PARTIES. I, I WOULD PUSH BACK.
MY GOAL IS IN HERE TO MAKE THIS
PROGRAM WORK. MY GOAL HERE IS TO
GET HEARING AIDS TO KIDS.
WHETHER IT'S THROUGH THIS
PROGRAM OR SOMETHING ELSE. YOU
KNOW, I DON'T I. I DON'T CARE.
UM, BUT I WANT US TO ALSO WE
HAVE TO ACCEPT THAT THIS PROGRAM
DOESN'T WORK. THAT'S THE THING.
I'M STRUGGLING WITH THAT NEXT
YEAR. WE'RE AT THE SAME NUMBERS.
ARE WE STILL GOING TO SAY OH NÓ,
PLEASE GIVE US ANOTHER YEAR.
WE'RE GOING TO TRY AGAIN. IT'S
AN ACTION PLAN 2.0. LIKE I WANT
US TO BE ABLE TO BE ON THE SAME
PAGE THAT EXCEPT OUR LOSSES. IT
IS NOT US THAT ARE SUFFERING.
YOU KNOW, UM AND PUT OUR EGO
ASIDE AND SAY, HEY, WE TRIED IT
THIS WAY. LET'S TRY A DIFFERENT
WAY. UM, SO I AM HOPEFUL. NOT
ALL ADVOCATES ARE HOPEFUL
BECAUSE THEY THEY'VE BEEN IN
THIS FIGHT LONGER THAN I HAVE.
RIGHT UM SO I AM HOPEFUL THAT WE
CAN CHANGE. BUT I WANNA SUE. I
HAVE A LITTLE BIT MORE TEETH ON
THIS. UM I DON'T KNOW IF THERE'S
A DEADLINE FOR KAISER
PARTICIPATION. I AGREE WITH THE
SENATOR. WE SHOULDN'T NÓ MORE
BAIT, AND I ALSO KIND OF WANNA
GO BACK ON WHAT SENATOR ROTH
SAID IF WE DON'T HAVE MILES, SO
HOW DO WE KNOW WE'RE IN THE
RIGHT? PATH SO IF WE HEAR FROM
10 PROVIDERS SAY, HEY, 10,
PROVIDERS SAY I. I HAVE NOT
JOINED BECAUSE I DON'T HAVE
INTERNET THEN WE KNOW THAT FOR
TEMP PROVIDERS. WE NEED TO HELP
CONNECT THEM TO THE INTERNET.
AND WE KNOW THAT NEXT YEAR WE'LL
HAVE 10 MORE PROVIDERS. HOW DO
WE KNOW THAT WE'RE SCRATCHING
OFF THE BARRIERS FOR US TO
ESTIMATE NEXT YEAR? HOW MANY
PROVIDERS WE HAVE? I DON'T THINK
YOU'RE RIGHT. WE DON'T HAVE A
MAGIC BALL. UH A BAR, BUT WE
SHOULD HAVE AN UNDERSTANDING OF
THE BARRIERS THAT ARE COMMON AND
EASY TO OVERCOME. IT BE SHARED
WITH ME. ONE OF THE BIG ONES IS
THE CONCERN OF A HUGE INFLUX.
THEN YOU TALK TO 20 PROVIDERS,
AND YOU MADE THEM FEEL
COMFORTABLE THAT TO I SHOULD SAY
THOSE 20 PROVIDERS ARE GOING TO
BE ON THAT LIST NEXT YEAR. SO
THAT'S WHAT I WANT TO HEAR OF
THOSE ACTION PLANS. HAVING THESE
MILESTONES THAT WE'RE GONNA
WE'RE GONNA REACH WHEN IT COMES
TO THE GEOGRAPHIC ANALYSIS. I
KNOW YOU MENTIONED WE HAVEN'T
DONE THIS. BUT WOULDN'T THAT
TELL US WHERE WE NEED TO PUT
MORE ENERGY? OF IF THE 68 OR 32
IN L, A AND 3036 AND THE BAY
AREA, THEN WE SHOULD FOCUS OUR
ENERGY IN THOSE OTHER AREAS. I'D
LIKE TO PROVIDE YOUR OPPORTUNITY
TO RESPOND TO THE TWO
RECOMMENDATIONS THAT NORA
MENTIONED OF, IF YOU COULD SPEAK
TO REGARDING THE PEDIATRIC CODES
AROUND MODES HERE, MODES. AND
THE SUPPORT FOR HEARING TEST
ASSISTANCE. WHAT WORK WE'VE DONE
THAT AND WHAT BARRIERS TO US
STILL EXIST? AND IN THE LONG
LIST THAT EVEN OF THE PROVIDERS
THAT WE HAVE, UH KIDS ARE STILL
WAITING ON THAT LONG LIST. UH,
DUE TO YOU MENTIONED TOO FEW
PEDIATRIC AIST. SO IN TERMS OF
THE SO ONE. THANK YOU FOR YOUR
COMMENTS IN TERMS OF, YOU KNOW
SOME FUTURE FOR NEXT STEPS, UM,
IN TERMS OF THE MO MOLES ARE
COVERED. WE HAVE HEARD THE
CONCERNS ABOUT, UM, JUST THE
POLICIES AND WE UNDERSTAND FOR
THE YOUNGER KIDS. THERE'S
FREQUENCIES BECAUSE AS THEY GROW
, THEY HAVE TO GET YOU KNOW,
UPDATED MOLES. THOSE THINGS ARE
COVERED. I THINK ONE OF THE
THINGS THAT WE HAVE RECOGNIZED
FROM FEEDBACK WE'VE RECEIVED IS
HOW CAN WE MAKE SURE THAT THAT
IS EXPLICITLY SPELLED OUT IN OUR
PROVIDER MANUALS AND THEN ON THE
OTHER ONE. IT'S JUST A MATTER OF
ME. UM GOING, I'D HAVE TO GO
BACK TO LOOK AT YOU KNOW WHAT
CODES ARE, UM, IN TERMS OF THE
SERVICES THAT YOU WERE
REFERENCING LIKE FOR THE
TRAINING AND ALL? UM SO WE WILL
TAKE I. I WILL TAKE THAT BACK.
BUT THE CO YOU KNOW, LIKE ALL
THE THINGS THAT WE COVER UNDER
THE MEDI CAL PROGRAM, THEY'RE
COVERED MY UNDERSTANDING. FROM
WHAT WE HAVE HEARD, UM, FROM THE
STAKEHOLDERS THAT WE HAVE BEEN
WORKING WITH IS NOT THAT
ANYTHING HAS NOT BEEN COVERED.
WE DO COVER THEM. IT'S JUST OR
IF THOSE, UH, SERVICE SERVICES
AND SUPPORTS ARE IF THEY REQUIRE
PRIOR AUTHORIZATION OR NOT, BUT
WHERE WE HAD LEARNED IN OUR, UM,
EARLY EFFORTS WE HAD LEARNED
THAT THERE WERE SOME, UM,
PROCEDURES THAT IT WAS NOT CLEAR
THAT WE COVERED SO WE DID
CLARIFY OUR COVERAGE POLICIES IN
TERMS OF ALL THE TYPES OF
SERVICES AND SUPPORTS THAT ARE
NEEDED. UM FOR THE POPULATION TO
HELP, YOU KNOW, UM, AID IN THEIR
HEARING, SO WE HAVE ADDRESSED
THAT, BUT I'LL HAVE TO JUST LOOK
AT THE ONE CODE THAT YOU'RE
REFERENCING IN TERMS OF
TRAINING. AND IF THAT WAS ADDED
OR NOT, NORA, I I'D LIKE TO
BECAUSE I REALLY APPRECIATE
KEEPING TWO OR THREE MINUTES.
MOST PANELISTS, DON SO ANY
ADDITIONAL COMMENTS. I'D LIKE TO
HEAR MORE ABOUT THE STAKEHOLDER
ENGAGEMENT. UM AND THEN ALSO
ABOUT YOU KNOW, WE ESTIMATE A
CERTAIN AMOUNT OF CASE LOAD DUE
TO A LOT OF BERRIES THAT EXIST.
IS THERE ANY ADDITIONAL BARRIERS
THAT WE DID NOT TALK ABOUT AS TO
WHY? UH UH, A FAMILY IS NOT
ENROLLING THEIR CHILD INTO THIS
PROGRAM. I THINK THE LACK OF
PEDIATRIC AUDIOLOGISTS IS KEY.
AND UM, I WOULD DISAGREE A BIT
WITH THE COVERAGE OF EAR MOLDS,
FOR EXAMPLE, UM, WE TALKED TO
RADY CHILDREN'S HOSPITAL IN SAN
DIEGO, AND I'M GOING TO QUOTE
FROM WHAT THEY TOLD US. UM IN
TERMS OF COSTS. OUR FEBRUARY
COST ANALYSIS FOR 2022 WAS JUST
COMPLETED AND OUR BREAK EVEN
COST FOR AUDIOLOGY IS $141.89
PER HOUR FOR AN EAR MOLD. WE
SCHEDULE A HALF HOUR TO TAKE THE
IMPRESSION A HALF HOUR FOR
PAPERWORK AND A HALF HOUR FOR
THE FITTING, MEANING THAT OUR
BREAK EVEN COST IS $211.34 IN
SERVICES, PLUS THE COST OF THE
IMPRESSION MATERIAL, WHICH IS
ABOUT A DOLLAR PER IMPRESSION.
SO THE BREAK EVEN POINT WOULD BE
244 34 AND THE MEDICAL
REIMBURSEMENT IS $27.52. SO THAT
IS A CHALLENGE FOR THE
AUDIOLOGIST TO PARTICIPATE. BUT
THEY'RE INCLUDED IN THE M èC Ó
TAX. RIGHT. SO IS THIS GONNA
MATCH THE 244 IT JUST GOING TO
GET CLOSER TO IT? THE 80% YOU
MENTIONED? I DON'T KNOW THAT WE
KNOW EXACTLY WHAT THE RATE WILL
BE COMPARED TO WHAT SHE JUST
MENTIONED, BUT IT IS PART OF
TRACK AND IT IT WILL BE PART OF
WHAT THEY'RE GONNA BE DOING IS
ALSO LOOKING AT COMMERCIAL
PAYERS AND WHAT THEY'RE PAYING,
AND THEN OTHER PUBLIC PROGRAMS
TO USE THAT INFORMATION TO THEN
HELP US TO GET TO AN 80%
MEDICARE EQUIVALENT. THESE
SERVICES. UM MY FINAL THOUGHT ON
THIS, SENATOR ROTH, YOU HAVE
SOMETHING FOR YOU? OH, WELL. IT.
HOW DOES THE HOW IS THE COST OF
THE APPARATUS ITSELF? THE
HEARING AID COVERED IS THAT A
FAIR QUESTION? WE'RE TALKING
ABOUT HEARING AIDS. YEAH, WE
COVER THE HEARING AIDS, SO
THAT'S NOT WHAT WE'RE TALKING
ABOUT HERE. STATE PAYS FOR THE
HEARING AID. WE PAY FOR THE
HEARING AIDS WE PAY FOR THE
MOLES WE PAY FOR, UM, THE VISITS
TO THE PROVIDERS. I MEAN, BUT IS
IT THE FULL COST OF THE MOLDS
AND THE FULL COST OF THE HEARING
AID? WELL, I THINK THAT'S THE
QUESTION AT HAND IN TERMS OF THE
REIMBURSEMENT RATES. WELL, YOU
KNOW, AND BECAUSE THE
REIMBURSEMENT FOR SERVICES
RENDERED IN THE HOURLY RATE
THAT'S A DIFFERENT ISSUE. I MEAN
FOR ME WHEN IT'S IMPORTANT TO
THE STATE, WE DO IT RIGHT. WE
MAKE VACCINES. SHOTS. MEDICINE
YOU KNOW, MAYBE WE MAKE HEARING
AIDS. I MEAN, I THINK WE NEED TO
DECIDE IF THIS IS IMPORTANT TO
US TO MAKE SURE KIDS HERE. AND
THEN WE NEED TO FIGURE OUT HOW
WE REIMBURSE THE AUDIOLOGISTS
WHO ACTUALLY HAVE TO PAY THE
SERVICES AND THAT'S WHY I WAS
ASKING. I WAS GETTING A I WANNA
MAKE SURE THIS IS THE EQUIPMENT
APPARATUS IS ONE ISSUE AND THE
HOURLY RATE FOR THE AUDIOLOGIST
IS ANOTHER. AND I GUESS IT IS.
OK? IT'S AN IMPORTANT ISSUE TO.
OBVIOUSLY YOU CAN TELL THIS IS
IMPORTANT TO US BECAUSE WE HAVE
TO GO BACK TO OUR DISTRICTS, AND
WE HAVE TO YOU MAY KNOW I HAVE A
STATE SCHOOL FOR THE DEAF AND MY
DISTRICT, SO IT'S A PRETTY BIG
DEAL. UNDERSTOOD ONE OF THE MORE
EMOTIONAL TOPICS TO TALK ABOUT.
I'M WHAT I WAS TRYING MY
BLUBBERING BEFORE WAS TRYING TO
ASK THIS ONE QUESTION REGARDING
THE ALLOCATION FOR THIS YEAR,
UM, WHAT'S PROPOSED IN THE
GOVERNOR'S BUDGET? AND THAT IS
2.6 MILLION FOR EXPECTED
EXPENDITURES. BUT 3.7 MILLION
FOR ADMINISTRATION. HOW DO WE
JUSTIFY █1.01 MILLION MORE FOR
ADMIN? THAN FOR THE ACTUAL
SERVICES. HE SAID ONE THING
BEFORE. SORRY UM, I JUST WANTED
TO JUMP IN AND JUST SAY THAT
IT'S UH, IT'S 1.6 MILLION
GENERAL FUND FOR 2425 FOR THE
BENEFITS. NOT 2.6, I THINK,
WHICH IS WHAT YOU SAID. UM, I'M
LOOKING AT THE AGENDA. OH, OK.
ON THE AGENDA ON PAGE SIX. IT'S
THE THAT SAYS. 0.6 MILLION. THE
ESTIMATE █2.06 MILLION FOR 2425.
YEP HEARING AID 2.6 MILLION IT'S
ON. STRAIGHT FROM MEDICAL
MEDICAL MENT. OK? 3.6 AND THEN
THREE 0.7 PER ADMIN. STAY HOME.
YEAH. OK YEAH. YEAH OK, THAT'S
FINE. SORRY. MY MISTAKE. I GOT.
I GOT A GOOD TEAM. I GOTTA GOTTA
TRUST SCOTT. UM AND THEN SO AND
THEN THREE 0.7 FOR ADMIN. SO
EVEN IF IT WAS 1.6, THAT'D BE
WORSE. RIGHT UM, SO HOW DO WE
JUSTIFY MORE I ALWAYS THINK
ABOUT LIKE OVERHEAD SHOULD NEVER
BE MORE. 10% WHAT'S GOING ON
THERE. NOW UNDERSTOOD. BUT IN
PART OF THE FOR THE
ADMINISTRATIVE SERVICES, SO
THERE IS A VENDOR THAT HELPS UM
THIS PROGRAM IN TERMS OF THE
WORK THAT THEY DO FOR THE
ENROLLMENT, THE APPLICATIONS,
THE ANNUAL RENEWAL, SO THOSE ARE
VENDORED COST, AND SO THEY DO
HAVE A COST. YOU KNOW, IN TERMS
OF CASE LOAD THAT, UH, WE'RE
PAYING THEM FOR THEIR THEIR
VENDORED COST DID COME DOWN FROM
WHAT THEY WERE, UM, PREVIOUSLY
SO WE DID NEGOTIATE. WITH A
LOWER REIMBURSEMENT RATE FOR
THEM, BUT THEIR COSTS ARE SPREAD
BASED UPON THE INFRASTRUCTURE
THAT THEY HAVE TO HAVE IN PLACE
IN TERMS OF ADMINISTERING THE
PROGRAM BECAUSE IT'S NOT JUST
YOU KNOW, THEY HAVE TEAMS. YOU
KNOW, AS YOU UNDERSTAND, UH,
WORKING ON THE PROGRAM, BUT
THERE ARE TO YOUR POINT, UM,
ADMINISTRATIVE COSTS IN TERMS OF
HAVING THAT TEAM ON BOARD, DOING
THE A CALL CENTER AND BEING
AVAILABLE FOR INQUIRIES, BUT
THEY DO ALL OF THE ELIGIBILITY
WORK FOR THE DEPARTMENT. HALF OF
THIS PROGRAM AS WELL AS THE
ANNUAL RENEWALS AND THEN THE
NECESSARY FOLLOW UPS FOR, UM,
APPLICATIONS THAT MAY COME IN
THAT ARE INCOMPLETE. I WON'T
CONTRADICT THAT. IT'S JUST YOU
CAN SEE HOW THIS ADS FUEL TO
THIS THIS TOPIC, RIGHT? IT'S
JUST IT'S HARD. I THINK IT'S
HARD FOR ME TO GO BACK TO THE
SAKE HOLDS CONSTITUENTS AND SAY.
TH IS ON THIS. WE'RE SPENDING
MORE MONEY ON VENDORS THAN THIS
BECAUSE YOU USUALLY DO NOT SEE
THIS IN OTHER PROGRAMS. YEAH,
BUT BUT ALSO THE EXPENDITURES
ARE BASED UPON THE UTILIZATION
AND PEOPLE COMING IN. SO I THINK
TO THE EARLIER POINT MADE THAT
TO THE EXTENT WE WON'T TURN
ANYONE AWAY, RIGHT? NÓ ONE'S
GONNA BE TURNED AWAY, SO AS MORE
PEOPLE ARE COMING IN MORE
SERVICES ARE BEING PROVIDED.
THEN YOU'RE GONNA SEE THOSE
EXPENDITURES INCREASING OK, OK.
NORA I ANY FINAL FINAL THOUGHTS?
OK THANK YOU SO MUCH FOR THIS. I
APPRECIATE IT. WE'LL CONTINUE TO
BE IN TOUCH ON THIS. THANK YOU.
THANK YOU VERY MUCH. WE'RE NOW
MOVING ON TO ISSUE NUMBER TWO
WHAT WE TALK ABOUT, AND THE
MEDICAL LOCAL ASSISTANCE
ESTIMATE. ARE YOU DOING THIS
ONE? YES. SO THE MEDICAL LOCAL
ASSISTANCE ESTIMATE INCLUDES
EXPENDITURES OF 100 AND 56 POINT
6,000,000,035 0.9 BILLION OF
THAT IS GENERAL FUND AND 97.6
BILLION FEDERAL FUNDS AND THEN
FINALLY, 23.2 BILLION SPECIAL
FUNDS AND REIMBURSEMENTS. FOR
THE CURRENT YEAR UNTIL 2324 THE
GOVERNOR'S BUDGET PROJECTS.
GENERAL FUND SPENDING IN MEDI
CAL WILL BE 190 MILLION LESS, OR
ABOUT A HALF A PERCENT LESS THAN
WHAT WHAT THAT WAS APPROVED IN
THE 23 BUDGET ACT. THIS IS A NET
RESULT OF SOME, UM UH, SEVERAL
FACTORS, INCLUDING ADDITIONAL
REVENUES FROM THE M èC Ó TAX
RECOVERIES FOR MANAGED CARE
PLANS RELATED TO LOWER THAN
PREVIOUSLY ASSUMED SUPPLEMENTAL
PAYMENT COSTS DURING THE PUBLIC
HEALTH EMERGENCY PERIOD. UM AND
THE PROPOSED SWEEP OF THE
MEDICAL, UH, DRUG REBATE FUND.
TO HELP ADDRESS THE GENERAL FUN
SHORTFALL. UM THESE IMPACTS ARE
PARTIALLY OFFSET BY INCREASED
CASE LOAD COSTS AS MORE MEMBERS
REMAIN ENROLLED DURING THE
PUBLIC HEALTH EMERGENCY
UNWINDING THAN PREVIOUSLY
PROJECTED AND THEN AN INCREASE
IN ONE TIME STATE ONLY CLAIMING
RETROACTIVE PAYMENTS TO THE
FEDERAL GOVERNMENT. FOR THE
UPCOMING FISCAL YEAR. 2425 THE
BUDGET PROJECTS GENERAL FUND
SPENDING IN ME WILL DECREASE BY
1.4 BILLION COMPARED TO THE 2324
MAIN FACTORS DRIVING THIS CHANGE
INCLUDE THE FULL YEAR IMPACT OF
EXPANDING FULL SCOPE COVERAGE TO
ELIGIBLE INDIVIDUALS AGED 26 TO
49 WITHOUT REGARD TO IMMIGRATION
STATUS. TYPICAL GROWTH IN RATES
PAID TO MANAGED CARE PLANS AND
PROVIDERS. THE END OF THE
INCREASED FEDERAL MATCHING FROM
THE PUBLIC HEALTH EMERGENCY
PERIOD. UH, SAVINGS FROM LARGE
ONE TIME PAYMENTS IN 23 TO 24
THAT DO NOT CONTINUE IN 2425 AND
ADDITIONAL KIND OF SWINGS AND
CASE LOAD AND THEN ADDITIONAL
SAVINGS. UH FROM THE M èC Ó
TAX REVENUE. ME TO ANSWER ANY
QUESTIONS. YEAH. I JUST HAVE TWO
QUESTIONS ON, UH, CARE. SAD.
ALLOCATING 65 POINT THREE
MILLION DOLLARS TO THE CARE ACT.
IS GETTING DISTRIBUTED TO WHAT
IS IT JUST EVENLY THROUGH ALL
THE COUNTIES THAT HAVE STARTED
OR IT'S BASED ON KIND OF THE
PHASING OF THE COUNTIES AND KIND
OF THE PROJECTED CASELOAD BY THE
COUNTIES. IS THIS ONLY FOR THE
COUNTIES THAT HAVE ALREADY
STARTED OR IS THIS FOR THE PHASE
TWO? THE SECOND, THE BUDGET.
YOUR DOLLARS WOULD INCLUDE PHASE
TWO AS WELL. YEAH. AND THEN MY
OTHER QUESTION WAS REGARDING, UM
DO WE NOT CREDIT. BUT DO WE
ASSUME THAT PART OF THE DROP IN
THE ME IS DUE TO THE
REDETERMINING. IN TERMS. I MEAN,
WE DO YOU KNOW, CASE LOAD IS
GOING DOWN. BUT THERE'S ALSO
CORRESPONDING INCREASES IN CASE
LOAD AS A RESULT OF NEW
APPLICATIONS. AND SO, UM, SO YOU
KNOW, IT'S KIND OF UP AND DOWN.
AND SO THERE ARE CHANGES IN OUR
ESTIMATES REGARDING CASE LOAD.
UM AND SO I THINK THAT WE ARE
LEARNING MORE AND I THINK, UM,
ACCEPTABLE DROP, YOU WOULD SAY
PARDON ME. IS THIS AN ACCEPTABLE
COMING? DROP OR ARE WE SKEWED A
LITTLE BIT? SO UH, I WOULD SAY
THE DISENROLLED, UM, SINCE THE
UNWINDING THE REDETERMINING.
PROCESS HAS STARTED. WE'VE BEEN
AT ABOUT 20% IN THIS ENROLLMENT,
YOU KNOW, PLUS MINUS A LITTLE
BIT HERE AND THERE, AND THAT IS
PRETTY CONSISTENT TO PRE COVID.
I WILL SAY THE LAST COUPLE OF
MONTHS WHERE WE'VE AUTOMATED
SOME OF OUR PARTE RULES. UH,
WITH REGARD TO SOME OF THE
FEDERAL FLEXIBILITIES ARE DIS
ENROLLMENT RATE HAS
SIGNIFICANTLY BEEN REDUCED TO
ABOUT 8 9% AND SO YOU KNOW,
WE'RE THE KIND OF THE REGION
TERMINATION PROCESS YOU KNOW,
INDIVIDUALS HADN'T HAD TO DO A
RED DETERMINATION OR SEND IN
THEIR PACKET FOR THREE YEARS. SO
LOTS OF KIND OF, UM CHANGES IN
THE PROCESSING AND THE UP AND
DOWN AND THE CASE LOAD. UM AND
SO I THINK, UH, THINK SOME OF
THESE ARE SOME TYPICAL CASE LOAD
, YOU KNOW, UPS AND DOWNS BASED
EVEN ON A CODE IN TERMS OF SOME
THAT ARE, YOU KNOW,
CONSISTENTLY, UH, TRENDING UP,
AND OTHERS ARE TRENDING DOWN
DEPARTMENT FINANCE ANY
ADDITIONAL COMMENT. NÓ
ADDITIONAL COMMENTS. YOU TELL ME
YOUR NAME, SIR. THE VALET
DEPARTMENT OF FINANCE NÓ
ADDITIONAL COMMENTS. RYAN MILLER
. I JUST THINK WE WOULD ADD ON
TO WHAT DIRECTOR BOSS SAID THAT,
UM AND SHE HIT ON IT EARLIER IN
IN IN HER INITIAL COMMENTS ON
THE ESTIMATE. THE CASE LOAD NOW
BEING PROJECTED TO BE QUITE A
BIT HIGHER THAN WAS PREVIOUSLY
PROJECTED BY THE ADMINISTRATION
AND OUR OFFICE AND JUST KIND OF
REPEATING SOME OF THE NUMBERS
THAT DIRECTOR BOSS MENTIONED ON
THE REMIN IS NOT TO NOT TO LOSE
IN THE CONVERSATION. YOU KNOW,
FOLKS WHO HAVE BEEN DISENROLLED
FROM THE PROGRAM, BUT I THINK
THAT OUR ASSESSMENT IS THAT THE
REDETERMINING PROCESS HAS HAD
MUCH LESS OF AN EFFECT ON
ENROLLEES. THEN WE HAD PREDICTED
CERTAINLY LAST A LAST NOVEMBER
AND SO JUST WANTED TO KIND OF,
YOU KNOW, OFFER THAT. UM IN
ADDITION, I, I THINK WE WOULD
JUST ALSO SAY THAT, UM YOU KNOW,
THERE WAS A HUGE DEAL OF
UNCERTAINTY ABOUT HOW THAT
PROCESS WOULD UNFOLD AND YOU
KNOW WHERE THERE IS NORMALLY A
LOT OF VOLATILITY IN THE MEDICAL
ESTIMATE FROM CYCLE TO CYCLE AND
IN MAY WE CAN OFTEN SEE PRETTY
BIG DIFFERENCES. IT SEEMS LIKE
PARTICULARLY, YOU KNOW POSSIBLE
THIS YEAR THAT WE COULD SEE A
BIG SWING. SO IT'S SOMETHING
THAT WE, YOU KNOW, WE'LL BE
KEEPING OUR EYE ON AND WE'LL
PROVIDE SORT OF FINAL ASSESSMENT
ON THE ESTIMATES OF THE
LEGISLATURE AFTER THE MAY
REVISION BECAUSE IT'S IT GOES
THROUGH JUNE OR JULY RED
DETERMINATION. SO THE UNWINDING
PERIOD JUNE WOULD BE KIND OF THE
LAST, SO WE'LL HAVE A CLOSER
UNDERSTANDING. COME MAY REVISE.
WE CONTINUE TO GET THE REAL
NUMBERS. YEAH, COLLEAGUES ANY
QUESTIONS ON THIS? GREAT THANK
YOU SO MUCH. WE'RE GONNA HOLD
THAT ITEM OPEN MOVE ON TO ISSUE
NUMBER THREE FAMILY HEALTH,
LOCAL ASSISTANCE. ESTIMATE.
EITHER. UM SORRY ABOUT THAT. UH
GOOD MORNING. UH, MADAM CHAIR
AND, UM MADAM CHAIR AND MEMBERS
OF THE COMMITTEE. SARAH BROOKS,
UH, CHIEF DEPUTY DIRECTOR OF THE
FROM THE DEPARTMENT OF
HEALTHCARE SERVICES FOR HEALTH
CARE PROGRAMS. I'M HERE TO TALK
WITH YOU TODAY ABOUT THE FAMILY
HEALTH ESTIMATE AND PROVIDE AN
UPDATE ON THE CDP TRANSITION,
ALL RIGHT? SO THE GOVERNOR'S
BUDGET PROJECTS THAT SPENDING ON
FAMILY HEALTH ESTIMATE PROGRAMS
WILL BE VERY CLOSE TO WHAT WAS
APPROVED IN THE 2020 THREE
BUDGET ACT. WITH NÓ SIGNIFICANT
SIGNIFICANT CHANGES OR NEW
PROPOSALS HAPPY TO ANSWER ANY
QUESTIONS? ALL RIGHT. SO WITH
THAT, I'LL MOVE INTO THE èC HÌ
Dð P UPDATE. ALL RIGHT. SO DHCS
ISSUED AND POSTED THE FINAL èC
èC P TRANSITION PLAN ON ITS
WEBSITE ON MARCH 29TH 2024 UM,
WE ALSO POSTED THE ACCOMPANYING
DECLARATION REQUIRED BY S¼ B 184
CERTIFYING THE DATE THAT ALL
ACTIVITIES REQUIRED PURSUANT TO
SUBDIVISION. OF HEALTH AND
SAFETY CODE SECTION 124024 HAVE
BEEN COMPLETED. SO THAT WAS
POSTED AS WELL. UH Dð HÌ èC S¼
WENT THROUGH AN EXTENSIVE
STAKEHOLDER PROCESS TO INFORM
DEVELOPMENT OF èC HÌ Tð P
TRANSITION PLAN. SO WE DID
CONDUCT SIX DIFFERENT, UH,
STAKEHOLDER CONVENINGS AND
BROUGHT TOGETHER MEMBERS OF, UM
THE PUBLIC, WHICH INCLUDED
COUNTIES, UM MEMBERS FROM
VARIOUS STAKEHOLDER WORK GROUPS
AND OTHER ENTITIES TO ENGAGE IN
DIFFERENT DISCUSSIONS THROUGHOUT
THE PROCESS. UM, AND SO WE HAD
MUCH. DISCUSSION ALONG THE WAY.
UH A DRAFT OF THE TRANSITION
PLAN WAS PREVIOUSLY RELEASED FOR
PUBLIC COMMENT FROM SEPTEMBER.
27TH 2020 THREE THROUGH OCTOBER
11TH 2020 THREE AND RECEIVED A
LARGE VOLUME OF STAKEHOLDER
INPUT. I BELIEVE WE RECEIVED
OVER 1000 COMMENTS AND
INCORPORATED THOSE INTO THE
STAKEHOLDER, UM, TRANSITION PLAN
AND UPDATED, SO IT TOOK SOME
TIME FOR US TO UPDATE IT, BUT
CERTAINLY WANTED TO GO THROUGH
ALL THOSE DIFFERENT COMMENTS AND
MAKE SURE WE TOOK THEM INTO
ACCOUNT. UH, SO THOSE COMMENTS
IN ADDITION TO THE FEEDBACK
COMPILED THROUGHOUT THE WORK
GROUP MEETINGS, INFORMED UPDATES
TO THE TRANSITION PLAN ITSELF.
IN ADDITION TO ISSUING THE CDB
TRANSITION PLAN, Dð HÌ èC S¼
HAS AND CONTINUES TO ISSUE
TARGETED GUIDANCE TO THE
COUNTIES RELATED TO
TRANSITIONING CDB PROGRAM
FUNCTIONS AND STANDING UP THE
HEALTH CARE PROGRAM FOR CHILDREN
IN FOSTER CARE, SO ALSO KNOWN AS
HICK PICK FICK, THE BEST ACRONYM
EVER. UM SO, UH, I WANTED TO
TALK TO YOU A LITTLE BIT ABOUT
THAT. SO WE HAVE SOME GUIDANCE
OUT RIGHT NOW FOR COMMENTS, UH,
WITH THE COUNTY. UM IN, UM,
INCLUDING TWO DIFFERENT
DOCUMENTS RELATED TO HICK PICK
FIC, UM ADDITION, WE HAVE ISSUED
GUIDANCE TO THE COUNTY, STARTING
UH, UH, BACK IN DECEMBER. 14TH I
BELIEVE IT WAS 2023 THAT
PROVIDED GUIDANCE TO THE
COUNTIES THAT REALLY ISSUED
DIRECTION TO THEM IN TERMS OF
WHAT THEY SHOULD DO, UH, ONCE
THE èC HÌ Dð P TRANSITION
OCCURRED, WHICH WILL BE AT THE
END OF JUNE 30TH 2024 OF THIS
YEAR. UM SO REALLY HAVE WORKED
CLOSELY WITH THE COUNTIES TO,
UH, PROVIDE DIRECTION TO THEM IN
TERMS OF WHAT THEY SHOULD DO
WITH THE END OF THE èC HÌ Dð B
TRANSITION, NOTING THAT THE
TRANSITION PLAN IS ITSELF IS
REALLY A DOCUMENT THAT PROVIDES
GUIDANCE TO THE DOC, UH, TO THE
PUBLIC, BUT ALSO TO THE
LEGISLATURE ITSELF ABOUT KIND OF
THE OVERALL DIRECTION THAT THE
DEPARTMENT IS GOING IN. BUT UM,
RECOGNIZING THAT WE'VE ISSUED
GUIDANCE TO THE COUNTIES AS WELL
ALONG THE WAY AND HAD MANY
DISCUSSIONS WITH THEM DURING THE
PROCESS, SO HAPPY TO ANSWER ANY
QUESTIONS IF YOU MAY HAVE SOME,
I KNOW THAT, UM THIS HAS BEEN AN
ISSUE OF TOPIC. NÓ QUESTION. ALL
RIGHT. THANK YOU. WE'RE GONNA
HOLD THE ITEM OPEN. AND MOVE ON
TO ISSUE NUMBER FOUR. SORRY.
BRINGS US UP TO OUR, UM NEXT.
MINI PANEL. ALL RIGHT, SO WE'RE
GOING TO TALK A LITTLE BIT ABOUT
THE REST OF THE OK, THANK YOU.
SORRY ABOUT THAT COMES UP. SO
WE'RE GONNA DO A LEGISLATIVE
OVERSIGHT PANEL ON CAL AIM
ENHANCED CARE, MANAGEMENT AND
COMMUNITY SUPPORT. WE'RE GONNA
BE LED BY OUR DEPARTMENT. THEN
WE'LL DIVE INTO THE POUND
DISCUSSION. I'LL HAVE THE ON
CALL. UM WE HAVE JOINING US
TODAY AND I'LL HAVE YOU
INTRODUCE YOUR NAMES. BUT WE
HAVE, UM, SOMEONE FROM THE LOCAL
HEALTH PLANS OF CALIFORNIA. AND
DEL BARRIO AND FROM WESTERN
CENTER ON LAW AND POVERTY, YOU
MAY BEGIN GOOD AFTERNOON, SARAH
BROOKS WITH THE DEPARTMENT OF
HEALTH CARE SERVICES. I AM THE
CHIEF DEPUTY DIRECTOR FOR HEALTH
CARE PROGRAMS. I'M GONNA GO
THROUGH ALL OF THE DIFFERENT
QUESTIONS. THERE WERE A NUMBER
OF QUESTIONS. I BELIEVE. EIGHT
WITH A LOT OF A B èC Dð EFG S¼
INCLUDED. SO I MAY TAKE A MOMENT
TO GET THROUGH MY, UH, COMMENTS
HERE. BUT I WILL ANSWER ALL OF
YOUR QUESTIONS IN THE DIALOGUE
THAT I DO PRESENT TODAY. SO
AGAIN. THANK YOU FOR THE
OPPORTUNITY TO TALK WITH YOU A
LITTLE BIT ABOUT ENHANCED CARE
MANAGEMENT OR E èC M AS I MAY
REFERENCE IT TODAY AND COMMUNITY
SUPPORT. SO I'LL SPEAK ABOUT ECM
TO START TO START SO AS OF
QUARTER 3 2020 THREE, WE HAD 100
AND 20 THREE 1001 100 UNIQUE
MEMBERS THAT HAD RECEIVED EM IN
THE PRIOR 12 MONTH PERIOD.
FURTHER IN QUARTER. 3 2023,
WHICH IS JULY THROUGH SEPTEMBER
OF 2020, THREE, THERE WERE 1301
TOTAL M PROVIDERS IN THE STATE.
FINALLY IN QUARTER. 3 2023, THE
Tð, THE TOP THREE GROUPS
ENROLLED AS E èC M PROVIDERS
WERE OTHER QUALIFIED PROVIDER OR
ENTITY, WHICH IS, YOU KNOW,
ALWAYS KIND OF LIKE THE CATCH
ALL SO TO DESCRIBE WHO THOSE
ENTITIES ARE. THEY'RE REALLY
KIND OF COMMUNITY BASED
ORGANIZATIONS, UM, FEDERALLY
QUALIFIED HEALTH CENTERS AND
THEN BEHAVIORAL HEALTH ENTITIES.
SO THAT REALLY MADE UP THE
MAJORITY OF OUR MOST OF THE
PROVIDERS THEMSELVES. UM TO BE
ELIGIBLE FOR E èC M MEMBERS
MUST BE ENROLLED IN A MEDICAL
MAN. CARE PLAN OR AN M èC P AS
I MAY REFER TO THEM TODAY, UM
I'LL USE THOSE INTERCHANGEABLY
LIKELY DURING THE PRESENTATION
AND MEET AT LEAST ONE OF THE
FOLLOWING NINE M POPULATIONS OF
FOCUSED DEFINITIONS, SO I'LL RUN
THROUGH THESE PRETTY QUICKLY AS
THEY ARE A LONG LIST. UM,
INDIVIDUALLY, UH, INDIVIDUALS
EXPERIENCING HOMELESSNESS,
INDIVIDUALS AT RISK FOR
AVOIDABLE HOSPITALIZATION OR
IZATION INDIVIDUALS WITH S¼ M I
AND OR S¼ U Dð NEEDS INDIVIDUALS
TRANSITIONING FROM
INCARCERATION. ADULTS LIVING IN
THE COMMUNITY AND AT RISK FOR
LONG TERM CARE INSTITUTION
INSTITUTIONALIZATION. THAT'S A
GOOD ONE ADULT NURSING FACILITY
RESIDENCE, TRANSITIONING TO THE
COMMUNITY, CHILDREN AND YOUTH
ENROLLED IN èC S¼ OR CðC, èC M
èC èC S¼ WHOLE CHILD MODEL
WITH ADDITIONAL NEEDS BEYOND THE
èC S¼ CONDITION, CHILDREN AND
YOUTH INVOLVED IN CHILD WELFARE
AND BIRTH EQUITY POPULATIONS. UH
FOR FURTHER INFORMATION ABOUT
THESE POPULATIONS OF FOCUS, I
WOULD REFER YOU TO OUR, UH E èC
M POLICY. WHICH IS POSTED ON THE
DHCS WEBSITE. UM M èC P S¼ MUST
USE THE ELIGIBILITY CRITERIA
PROVIDED BY DHCS TO EVALUATE
MEMBERS AND MAY NOT IMPOSE
ADDITIONAL ELIGIBILITY
REQUIREMENTS FOR AUTHORIZATION
OF ECM. THERE ARE SEVERAL
PATHWAYS TO OBTAIN M
AUTHORIZATION, SO THREE
SPECIFICALLY PLANS CAN QUERY
THEIR OWN DATA PROVIDERS CAN
REFER A MEMBER TO THE PLAN, AND
MEMBERS CAN SELF REFER
THEMSELVES TO THE PLAN AS WELL.
M èC P S¼ MAY BROADEN CRITERIA
TO INCLUDE MEMBERS WHO MAY NOT
FIT THE ELIGIBILITY CRITERIA,
BUT THEY CAN'T NARROW IT SO THEY
CAN EXPAND AND ADD ADDITIONAL
INDIVIDUALS. BUT THEY CAN'T
NARROW AND, UH UH, THEY CANNOT
NARROW IT. UM Dð HÌ èC S¼ DOES
HAVE STATUTORY AUTHORITY TO
DETERMINE ADDITIONAL E èC M
POPULATIONS OF FOCUS, BUT I
THINK I WANT TO NOTE THAT AT
THIS TIME WE'RE REALLY FOCUSING
ON THE NINE POPULATIONS OF
FOCUSES THAT WE HAVE TO ENSURE
THAT THEY ARE BEING SUCCESSFUL,
UM, NOTING THAT WE ARE, UH,
NOTING THAT WE WANT TO PRAY TO
PRIORITIZE AND SEE WHAT HAPPENS
WITH THEM. UM YOU KNOW, WE HAVE
ISSUED RECENTLY AND I'LL TALK
ABOUT THIS IN A LITTLE BIT. DATA
SPECIFIC TO, UM E, èC M AND
ALSO COMMUNITY SUPPORTS, UM AND
SO, LOOKING AT THAT DATA CLOSELY
TO ENSURE THAT, UM WE'RE
TRACKING IT AND MAKING SURE THAT
THINGS ARE ARE WORKING AND IN
THE MANNER THAT THEY SHOULD BE.
AND AN EXAMPLE AND SO I'LL TALK
A LITTLE BIT ABOUT COMMUNITY
SUPPORTS NOW. SO THERE'S BEEN
CONTINUED GROWTH IN THE NUMBER
OF COMMUNITY SUPPORTS OFFERED BY
M èC P S¼ SINCE THE LAUNCH, AND
WE'RE REALLY EXCITED ABOUT THAT,
UM AS OF JANUARY, 2024 23
COUNTIES HAD ALL 14 AVAILABLE
COMPARED WITH THE END OF 2022
WHEN ONLY THREE COUNTIES HAD ALL
14 COMMUNITY SUPPORTS AVAILABLE.
THE TOTAL NUMBER OF ME MEMBERS
WHO RECEIVED COMMUNITY SUPPORT
SERVICES IN THE LAST 12 MONTHS
IS 94,144. THIS IS BASED ON THE
MOST RECENT AVAILABLE TIME
PERIOD OF DATA. FOR CONTEXT, THE
TOTAL NUMBER OF ME MEMBERS WHO
RECEIVE COMMUNITY SUPPORT
SERVICES IN 2022 WAS ONLY 36,000
THREE 191 SO A SIGNIFICANT
INCREASE FOR US FROM QUARTER 20
QUARTER 2 2022 TO QUARTER 3 2020
THREE. I APOLOGIZE, THROWING OUT
ALL THESE QUARTERS AND NUMBERS.
UH, THE MOST COMMON COMMUNITY
SUPPORT SERVICES RECEIVED WERE
HOUSING, TRANSITION AND
NAVIGATION SERVICES, HOUSING,
TENANCY AND SUSTAINING SERVICES
AND MEDICALLY TAILORED MEALS OR
MEDICALLY SUPPORTIVE FOODS AND
HAVE NUMBERS TO BACK THAT UP. IF
YOU'RE INTERESTED TO HEAR A
LITTLE BIT MORE ABOUT THOSE FROM
QUARTER TO OR IN THAT SAME TIME
PERIOD, THE LEAST COMMON
COMMUNITY SUPPORT SERVICES WERE
NURSING FACILITY TRANSITION
DIVERSION TO ASSISTED LIVING
FACILITIES. COMMUNITY TRANSITION
SERVICES, UH, NURSING FACILITY
TRANSITION TO A HOME AND THEN
ENVIRONMENTALLY ACCESSIBILITY
ADAPTION. SO THOSE WERE THE ONES
THAT WE DIDN'T SEE AS MUCH OF UM
, NOTING, HOWEVER, THAT M LONG
TERM CARE POPULATIONS OF FOCUS
WENT LIVE IN JANUARY OF 23, SO
WE MAY SEE MORE UPTAKE OF THESE
LESS COMMON COMMUNITY SERVICE
SUPPORT SERVICES AS THAT
POPULATION OF FOCUS BECOMES MORE
ESTABLISHED, UM, SOME IMPORTANT
THINGS TO NOTE FOR COMMUNITY
SPORTS. SPECIFICALLY SO, UM, A
MEMBER DOES NOT HAVE TO BE
ENROLLED IN M TO RECEIVE A
COMMUNITY SUPPORT. SO WANTED TO
MAKE SURE THAT THAT WAS CLEAR.
HOWEVER, THEY MUST MEET CRITERIA
FOR EACH COMMUNITY SUPPORT THAT
THEY RECEIVE A KEY GOAL OF
COMMUNITY SUPPORT IS TO ALLOW
MEMBERS TO OBTAIN CARE IN THE
LEAST RESTRICTIVE SETTING
POSSIBLE AND TO KEEP THEM IN THE
COMMUNITY AS MEDICALLY
APPROPRIATE. SO THAT'S AN
IMPORTANT GOAL OF THE DEPARTMENT
. UM M èC P S¼ MUST EXPEDITE
CERTAIN COMMUNITY SUPPORT
SERVICES, INCLUDING RECUPERATIVE
CARE, SHORT TERM POST
HOSPITALIZATION, HOUSING,
SOBERING CENTERS AND MEDICALLY
TAILORED MEAL BEING OFFERED
AFTER DISCHARGE FROM AN ACUTE
CARE SETTING. SO YOU KNOW, JUST
WANTED FLAG THAT AS WE HAVE
LOOKED AT AND WORKED ON, UM,
COMMUNITY SUPPORTS. WE'VE LOOKED
AT WHAT ARE SOME THINGS THAT WE
NEED TO PUT IN PLACE TO MAKE
THEM MORE EFFECTIVE. AND SO WE
IDENTIFIED THAT THERE ARE SOME
COMMUNITY SUPPORTS THAT NEED TO
HAPPEN IMMEDIATELY UP FRONT. UM
BECAUSE THEY ARE MORE EFFECTIVE
IN THAT MANNER. SO, FOR EXAMPLE,
IF YOU SEND SOMEBODY HOME FROM
THE EMERGENCY ROOM WITHOUT FOOD
FOR A WEEK, THAT'S NOT EFFECTIVE
, SO WE NEED TO MAKE SURE THAT
WE GET THE FOOD MEDICALLY
TAILORED MEALS, FOR EXAMPLE, IN
PLACE IMMEDIATELY, AND SO THAT'S
AN EXAMPLE OF THAT HAPPENING.
SOME M èC N S¼ CAN DO THAT,
UM, THE FOR EXAMPLE. IN THIS
CASE, THE HEALTH PLAN WOULD COME
IN AND THEY WOULD SO THIS WOULD
BE THE RESPONSIBLE OF THE HEALTH
PLAN THAT WOULD THAT THAT WOULD
BE THE RESPONSIBILITY OF THE
HEALTH PLAN. UM WHEN THEY ARE
ORDERING THE COMMUNITY SUPPORT
OR PUTTING THE COMMUNITY SUPPORT
IN PLACE? YEAH, OK. SOME M èC P
S¼ HAVE IMPLEMENTED PRESUMPTIVE
AUTHORIZATIONS. SO THAT'S
EXCITING FOR US TO SEE IS THAT
THEY'VE, YOU KNOW, PUT IN PLACE
THAT YOU CAN KIND OF GET
STRAIGHT THROUGH AND GET THE
COMMUNITY SUPPORT WITHOUT HAVING
TO HAVE AN AUTHORIZATION IN
PLACE. WE'VE SEEN THAT HAPPENING
IN LOS ANGELES, FOR EXAMPLE.
SIMILAR TO ECM MCPS MAY
DETERMINE ELIGIBILITY FOR
MEMBERS FOR COMMUNITY SUPPORTS.
AS PART OF THEIR AUTHORIZATION
PROCESS. M èC P S¼ ARE TO
ENSURE DOCUMENTATION THAT THE
COMMITTEE SUPPORT SERVICE IS
MEDICALLY APPROPRIATE FOR THAT
MEMBER AS RECOMMENDED BY THE
PROVIDER USING THEIR
PROFESSIONAL JUDGMENT. THE
PROCESS MAY BE INCORPORATED INTO
THE MCPS UTILIZATION MANAGEMENT
PROCESS OR MAY INCLUDE PROVIDER
LEVEL DOCUMENTATION IN AN
INDIVIDUAL'S CARE PLAN OR OTHER
RECORD. SO TO TALK A LITTLE BIT
ABOUT NETWORK SUFFICIENCY.
CONTINUE TO BE OPPORTUNITIES FOR
IMPROVEMENT FOR BOTH ECM AND
COMMUNITY SUPPORTS AND NETWORK
SUFFICIENCY. HOWEVER IT IS
IMPORTANT TO NOTE THAT IT TAKES
TIME TO BUILD EXPERTISE AND
CAPACITY IN THE DELIVERY SYSTEM.
WE DO SEE THAT WHOLE PERSON CARE
AND HEALTH HOMES PROGRAMS,
COUNTIES HAD A SIGNIFICANT HEAD
START IN NETWORK CAPACITY
DEVELOPMENT. THIS IS REFLECTED
IN THE DATA, WHICH SHOWS SLOWER
UPTAKE FOR NON WHOLE PERSON CARE
AND HEALTH HOME, UH, PROGRAM
COUNTIES AND IN WITH NEW
POPULATIONS OF FOCUS, SO WITH
THE JUSTICE INVOLVED OR CHILDREN
AND YOUTH POPULATIONS, WHERE WE
SEE THAT NETWORKS ARE SLOWER TO
UPTAKE WITH THOSE POPULATIONS OF
FOCUS BECAUSE THEY'RE NEW, AND
THEY WEREN'T IN EXISTENCE AND
NECESSARILY THOSE HEALTH HOMES,
UM AND WHOLE PERSON CARE
COUNTIES. BUILDING CAPACITY AT
THE DELIVERY SYSTEM LEVEL TO
REALLY SUPPORT COMMUNITY BASED
ORGANIZATIONS AND PROVIDERS TO
WORK WITH ME TAKES TIME AND
INVESTMENT. THAT IS THE REASON
WE HAVE MADE AVAILABLE INCENTIVE
PAYMENT PROGRAM, UH OR THE
INCENTIVE PAYMENT PROGRAM
THROUGH MANAGED CARE PLANS AND
PATH FUNDING AVAILABILITY
DIRECTLY TO PROVIDERS AND CBOS,
AND I'M GOING TO TALK A LITTLE
BIT ABOUT WHAT THAT IS AND WHAT
THAT OPPORTUNITY IS FOR, UM
PROVIDERS AND SUCH AND JUST A
MINUTE UNDER PATH. THERE IS
FUNDING FOR INFRASTRUCTURE AND
CAPACITY BUILDING UNDER THE
CITED INITIATIVE, AND THERE IS
TECHNICAL ASSISTANCE FOR èC, B,
S¼ AND PROVIDERS INTERESTED IN
BECOMING PROVIDERS OR EXPANDING
CAPACITY. ADDITIONALLY THEY
CONTINUE TO BE OPPORTUNITIES TO
IMPROVE MEMBER AND PROVIDE
AWARENESS ABOUT ECM AND
COMMUNITY SUPPORTS TO IMPROVE
RATES OF REFERRALS FOR THESE
CRITICAL SERVICES. THE Dð HÌ
èC, S¼, E, èC M AND COMMUNITY
SUPPORTS ACTION PLAN HAS BEEN
ACTIVELY STREAMLINING REFERRAL
AND AUTHORIZATION PROCESSES TO
HELP IMPROVE MEMBER AND PROVIDER
REFERRALS. SO WE HAVE AN ACTION
PLAN THAT WE'VE PUT IN PLACE
THAT REALLY KIND OF STREAMLINES
AND ALIGNS THINGS ACROSS
COMMUNITY SUPPORTS. AND SO THAT,
FOR EXAMPLE, UM, WHEN I TALKED
BEFORE ABOUT, UM, LOOKING AT
WHAT'S HAPPENING IN LOS ANGELES
WITH THE PRIOR AUTHORIZATIONS OR
LOOKING AT, UM THE DIRECT, UH,
MEDICALLY TAILORED MEALS, UM,
HAVING DIRECT, UH, SERVICES
HAPPENING IMMEDIATELY. THAT'S AN
EXAMPLE OF WHAT'S HAPPENING IN
THE ACTION PLAN THAT WE'VE PUT
FORTH FOR OUR HEALTH PLANS. UM
SO TALKING A LITTLE BIT ABOUT
OUTREACH. I SAID I'D TALK A
LITTLE BIT ABOUT SOME OF THE
OUTREACH THAT WE'RE DOING SO Dð
HÌ èC S¼ HAS A MULTI PRONGED
APPROACH. UH UM UH, HAS A MULTI
PRONGED APPROACH FOR SHARING
GUIDANCE, PROVIDING OUTREACH AND
OFFERING Tð TO PROVIDERS. THIS
INCLUDES THE DEVELOPMENT OF
GUIDANCE DOCUMENTS, TOOLKITS AND
OTHER RESOURCES AVAILABLE ON THE
DHCS WEBSITE, HOSTING VARIOUS
INFORMATIONAL WEBINARS ON E, èC
M AND COMMUNITY SUPPORTS WITH
TOPICS INCLUDING SPECIFIC P, UH
P, Ó, F S¼ OR OF FOCUS
COMMUNITY SUPPORTS BILLING AND
REPORTING REQUIREMENTS AND BEST
PRACTICES FROM MCPS AND THEIR
CONTRACTED PROVIDERS. WE HAVE
SEVERAL INITIATIVES INTENDED TO
HELP BUILD UP THE CAPACITY AND
INFRASTRUCTURE ON THE GROUND FOR
OUR OF OUR ON THE GROUND
PARTNERS TO SUCCESSFULLY
PARTICIPATE IN THE MEDICAL
DELIVERY SYSTEM. SO ONE OF THOSE
IS PATH OR PROVIDING ACCESS AND
TRANSFORMING HEALTH, WHICH
INCLUDES THREE DIFFERENT PARTS
THAT I'LL TALK ABOUT ONE IS
COLLABORATIVE PLANNING AND
IMPLEMENTATION. ALSO KNOWN AS
èC. P I, UM THIS IS LOCAL
WORKSHOPS THAT PROVIDE A FORUM
FOR PROVIDERS IN CPS AND OTHER
STAKEHOLDERS TO IDENTIFY AND
ADDRESS IMPLEMENTATION GAPS AT
THE LOCAL LEVEL. ANOTHER IS THE
Tð A MARKETPLACE WHICH IS REALLY
A ONE STOP KIND OF SITE OF
VARIOUS OFF THE SHELF PROJECTS
AND CURATED VENDORS THAT CAN
PROVIDE CUSTOMIZED Tð TO
CONTRACT IT OR PROSPECTIVE èC M
COMMUNITY SUPPORT PROVIDERS. AND
THE THIRD IS CITED CAPACITY AND
AN INFRASTRUCTURE TRANSITION,
EXPANSION AND DEVELOPMENT.
THAT'S WHAT THE CITED STANDS
FOR, WHICH IS DIRECT FUNDING TO
BUILD CAPACITY AND
INFRASTRUCTURE TO PROVIDE èC M
AND COMMUNITY SUPPORTS. THE WE
DO EXPECT, UH, MANAGED CARE
PLANS TO ALSO WORK WITH THEIR
CONTRACTOR PROVIDER NETWORKS TO
TRAIN PROVIDERS ON èC M AND
COMMUNITY SUPPORT, SO WE DO
EXPECT THAT THEY WORK REGULARLY
WITH THEIR NETWORKS. THROUGH I
PM èC P'S REPORT ON MEASURES
TIED TO PROVIDER EDUCATION, UM,
ON E, èC M AND COMMUNITY
SUPPORTS AVAILABILITY,
ELIGIBILITY REQUIREMENTS,
SERVICE DEFINITIONS AND MEMBER
ENGAGEMENT. MANY HEALTH PLANS
HAVE DEVELOPED FLYERS TRAINING
AND OTHER RESOURCES TO SUPPORT
THEIR NETWORK PROVIDERS AND TO
SHARE AWARENESS OF SERVICES WITH
MEMBERS. M èC, PLEASE M èC P
S¼ INCLUDE PROVIDER FACING
RESOURCES ON THEIR WEBSITES TO
SUPPORT REFERRALS AND UNDERSTAND
ELIGIBILITY REQUIREMENTS. THEY
ALSO INCLUDE INFORMATION ON ECM
AND COMMITTEE SUPPORTS ON THEIR
MEMBER FACING WEBSITES WITH
GUIDANCE ON HOW TO REACH OUT TO
THEIR M, èC P OR P èC P FOR
MORE INFORMATION. FINALLY DHCS
TEAMS INTERFACE WITH MULTIPLE
ADVOCACY ADVOCACY GROUPS TO HELP
THEM BETTER UNDERSTAND M, S¼
èC, M AND COMMUNITY SUPPORTS
AND HAND AND HENCE KIND OF
COMMUNICATE THIS TO THEIR
CONSTITUENTS, SO WE REALLY RELY
ON STAKEHOLDER STAKEHOLDER
GROUPS. THEY'RE ON THE GROUND
AND ARE ABLE TO COMMUNICATE THAT
INFORMATION OUT. AND SO WE
REALLY RELY ON THOSE
PARTNERSHIPS TO GET THE WORD OUT
FOR US. UM AND AS I DESCRIBED
BEFORE, THIS REMAINS AN AREA OF
OPPORTUNITY. UH, FOR Dð HÌ èC
S¼ IN ACTIVELY WORKING WITH OUR
HEALTH PLANS TO IMPROVE MEMBER
AND PROVIDER EDUCATION, AS WELL
AS TO STREAMLINE REFERRAL AND
AUTHORIZATION PROCESSES TO MOVE
TO A STATE WHERE MOST REFERRALS
COME FROM COMMUNITY BASED
RESOURCES. UM TO TALK ABOUT
OUTCOMES AND DATA. SO DATA TELLS
THE STORY, RIGHT? UM CURRENTLY
THE DATA Dð HÌ èC S¼ IS
TRACKING FOCUSES ON ACCESS AND
USE OF E, èC M AND COMMUNITY
SUPPORT. WE'RE ABLE TO ACCESS
UTILIZATION OF èC M FOR
SPECIFIC POPULATIONS OF FOCUS,
WHICH BY DEFINITION ARE HIGH
NEEDS BENEFICIARIES. UH Dð HÌ
èC S¼ ALSO HAS AN INTERNAL A
èC M AND COMMITTEE SUPPORTS
DASHBOARD THAT ANALYZES DATA
FROM THE QUARTERLY
IMPLEMENTATION MONITORING
REPORTS, SO WE UTILIZE THAT TO
MONITOR TREND. AND TO LOOK AT
WHAT'S HAPPENING WITH THE
PROGRAM. THE PUBLIC VERSION OF
THIS WAS RELEASED EARLIER THIS
WEEK. I BELIEVE MAYBE IT WAS
JUST YESTERDAY. YEAH SO JUST
YESTERDAY WE RELEASED NEW DATA,
UM AND IS AVAILABLE ON OUR
WEBSITE. IT SHOWS DATA THROUGH
QUARTER 3 2020 THREE AND
PROVIDES A VARIETY OF CUTS,
INCLUDING BY POPULATION OF FOCUS
. COMMUNITY SUPPORT. UM SERVICES
BY PLANNING, COUNTY OR DATA ARE
AVAILABLE. WE'RE ALSO DEEPENING
OUR MONITORING AND PROGRAM
EVALUATION FOR E èC M BY
DEFINING PERFORMANCE MEANT
INDICATORS AND QUALITY OUTCOMES
SO THAT WE CAN ASSESS THE
QUALITY OF E èC M BEING
PROVIDED IN ADDITION TO
UTILIZATION SO LESSONS LEARNED.
THAT'S ALWAYS IMPORTANT. SO WHAT
CAN WE TAKE AWAY FROM THIS? AND
WHAT CAN WE? UH WHAT CAN WE TAKE
MOVING FORWARD AS WE MOVE INTO,
UH, AS WE CONTINUE WITH THE
PROGRAM SO DHCS IS INTERESTED IN
MAKING COMMUNITY SUPPORT
SERVICES, A STATEWIDE BENEFIT IN
FUTURE WAIVER PERIODS. AS WE'VE
TALKED ABOUT PRACTICALLY
SPEAKING, THIS MEANS THAT
MANAGED CARE PLANS WILL BE
REQUIRED TO COVER COMMUNITY
SUPPORTS AS A BENEFIT IN THE
SAME WAY THAT THAT, UM THEY
COVER E èC M. SO èC M IS A
ENTITLEMENT TODAY FOR ALL
MEMBERS, UM, WE WOULD. TODAY
IT'S A COMMUNITY SUPPORTS OUR
VOLUNTARY AS YOU KNOW. MOVING
INTO THIS FUTURE STATE WILL
DEPEND ON HOW ROBUST OUR
DELIVERY SYSTEM IS IN MEETING
THE NEEDS OF OUR COMMUNITY.
AVAILABILITY AND CAPACITY OF
EACH COMMUNITY'S SUPPORT, AND
THE RELEVANT PROVIDER NETWORK
DOES VARY AS MENTIONED EARLIER.
WE HAVE SEEN WIDE AVAILABILITY
AND UPTAKE OF THE HOUSING SUITE
OF COMMUNITY SUPPORT SERVICES,
SO WE'VE SEEN A BIG UPTAKE IN
THOSE SERVICES. WE'VE ALSO SEEN
OFFERING OF MEDICAL RESPITE AS A
COMMUNITY SUPPORT SERVICE. AS OF
JANUARY. WE HAVE 53 OF 58
COUNTIES, OFFERING MEDICAL
RESPITE AVAILABLE IN THEIR
COUNTY, WHICH IS JUST GREAT
NEWS. WE'RE REALLY PROUD OF
THAT. UM WILL MONITOR AND
SUPPORT IMPLEMENTATION EFFORTS
TO INCREASE USE OF THOSE
PROVIDERS AND ENSURE MEMBERS WHO
NEED THOSE SERVICES CAN ACCESS
THEM IN A TIMELY MANNER. THESE
ARE LESSONS LEARNED FROM
IMPLEMENTATION, BUT WE'RE NOT
WAITING IN THE NEXT WAIVER UNTIL
THE NEXT WAIVER PERIOD TO APPLY
THOSE LESSONS LEARNED AS WE ARE
TAKING A CONTINUOUS IMPROVEMENT
APPROACH. SO WHERE, AS I SAID,
WE'RE KIND OF TAKING LESSONS
LEARNED IN APPLYING THEM AS WE
GO, UM, AS PART OF OUR
CONTINUOUS IMPROVEMENT APPROACH,
WE CONSIDER STAKEHOLDER INPUT
AND DATA IN TERMS OF THE
STAKEHOLDER INPUT. WE LISTEN TO
OUR STAKEHOLDERS AND ADJUST WHEN
APPROPRIATE. IN 2023. THE
DEPARTMENT TOOK THE OPPORTUNITY
TO ENGAGE AND I BELIEVE MY
DIRECTOR WAS A PART OF THIS. TO
CONDUCT LISTENING TOURS AND
SURVEY PROVIDERS. WE HEARD
ACCOUNTS FROM MULTIPLE
STAKEHOLDER CONVERSATIONS ABOUT
IMPLEMENTATION CHALLENGES THAT
HAD TO DO WITH UNNECESSARY
BARRIERS. UM, SO WE DID TAKE, UM
, AWAY FROM THOSE LISTENING
SESSIONS AND, UH, TOOK REAL TIME
ACTION AND IMPLEMENTED CHANGES
BASED ON THAT INTO OUR PROGRAM,
AND, FOR EXAMPLE, THAT ACTION
PLAN THAT I TALKED ABOUT CAME
OUT OF THE, UM CAME OUT OF THAT
LISTENING TOUR AND WE MADE
MODIFICATIONS TO THE PROGRAM AS
A RESULT THAT WE BELIEVE HAVE
HELPED WITH INCREASE. IN BOTH
THE NETWORKS AND THE ENROLLMENT
INTO THE PROGRAMS. SO I'VE
SPOKEN QUITE A BIT TODAY ALREADY
, AND I'M SURE THAT YOU MAY HAVE
QUESTIONS AND THERE ARE OTHERS
HERE TO SPEAK AS WELL. SO UM,
WITH THAT I WILL AND THANK YOU
FOR THE OPPORTUNITY TO SPEAK
WITH YOU TODAY. APPRECIATE THAT.
YES A LOT OF GREAT INFORMATION,
THOUGH. UM, WE'RE GONNA HOLD
QUESTIONS UNTIL WE HEAR FROM
EVERYBODY. SO I'D LIKE TO MOVE
ON TO OUR NEXT PANELIST. UH,
KATIE ANDREW. WELL I SAID I WAS
GONNA HAVE YOU INTRODUCE
YOURSELF, BUT I CAN PRONOUNCE
THAT ONE, OK? OH IT'S ON. GREAT
UM, WELL, THEN I WILL SKIP
INTRODUCING MYSELF. IN THE
INTEREST OF TIME. UM I'LL JUST
QUICKLY SAY, UM, LOCAL HEALTH
PLANS OF CALIFORNIA REPRESENTS
17 MISSION DRIVEN NOT FOR PROFIT
COMMUNITY BASED, UM, PLANS THAT
DELIVER EQUITABLE AND ACCESSIBLE
HEALTH CARE TO OVER 70% OF THE
15 MILLION MET MEMBERS
THROUGHOUT THE STATE. SINCE THE
LAUNCH OF THE ENHANCED CARE
MANAGEMENT COMMUNITY SUPPORTS
BENEFIT LOCAL PLANS HAVE BEEN AT
THE FRONT LINES OF
IMPLEMENTATION IDENTIFYING
PROVIDER PARTNERS ASSESSING GAPS
, TROUBLESHOOTING BARRIERS AND
WHERE POSSIBLE, STREAMLINING
PROCESSES. LOCAL PLANS HAVE
FULLY EMBRACED Kò AND THE E èC
M AND COMMUNITY SUPPORTS
BENEFITS AND BELIEVE IN THE
VALUE AND KNOW THE IMPACT THAT
COMPREHENSIVE SUPPORTS AND
SERVICES OFFERED THROUGH THESE
BENEFITS CAN MAKE NOT ONLY TO
THEIR HEALTH AND WELL BEING, BUT
IN HELPING TO PULL THEM, UH, PUT
THEM EXCUSE ME ON A BETTER LIFE
TRAJECTORY. OVERALL THE
IMPLEMENTATION OF THE ECM AND
COMMUNITY SUPPORTS BENEFITS HAS
BEEN VERY POSITIVE. LOCAL PLANS
AGAIN UNDERSTAND THE IMPORTANCE
OF THE BENEFITS TO IMPROVING
HEALTH OUTCOMES AND REDUCING
DISPARITIES FOR THEIR MEMBERS.
BUT OF COURSE, THE
IMPLEMENTATION OF NEW BENEFITS
IS NEVER WITHOUT CHALLENGES,
LAUNCHING THESE SERVICES AND
BUILDING THE NETWORKS TO SUPPORT
THEM IS A SIGNIFICANT LIFT,
HOWEVER, OVER TIME AND AS THE
BENEFITS MATURE, THE STATE AND
ME MEMBERS ALIKE WILL BEGIN TO
REALIZE THEIR FULL IMPACT. THAT
SAID THE PROGRESS OVER THE LAST
21 MONTHS OR SO, UM UH, SINCE I
BEGAN IS PROMISING, VERY
PROMISING AND, AS WAS
HIGHLIGHTED BY MY DHCS COLLEAGUE
HERE, UM, THE NUMBERS SORT OF
SPEAK FOR THEMSELVES. YOU SEE IN
THE LAST QUARTER, A SIGNIFICANT
INCREASE IN THE UNIQUE UM
MEMBERS BEING SERVED BY BOTH
BENEFITS, AND SO WE'RE REALLY
ENCOURAGED BY THAT, AND I'LL
JUST ALSO SAY THAT ON, UM FOR
LOCAL PLANS IN TERMS OF
COMMUNITY SUPPORTS, UH MOST OF
OUR PLANS ARE OFFERING 10 OF THE
14 COMMUNITY SUPPORTS AVAILABLE,
UM, AND MANY ARE OFFERING ALL SO
, UM, WE ARE SEEING AN INCREASE
IN THE COMMUNITY SUPPORTS BEING
OFFERED ACROSS THE BOARD. IN
TERMS OF PROVIDER NETWORK AND
BUILDING THAT CAPACITY. UM PLANS
OFTEN HAVE STARTED WITH
LEVERAGING EXISTING
RELATIONSHIPS, SUCH AS THOSE
ESTABLISHED THROUGH THE HEALTH
HOMES, PROJECT AND WHOLE PERSON
CARE PILOTS AS YOU HEARD ALREADY
HEARD, UM, THOSE WERE LOW
HANGING FRUIT TO BUILD THOSE
RELATIONSHIPS AND PUT THOSE
THOSE CONTRACTS IN PLACE. UM SO
FOR YOU KNOW INVESTMENTS AND
SUPPORTIVE SERVICES LIKE
MEDICALLY TAILORED MEALS. UM,
RECUPERATIVE CARE, NURSING HOME
TRANSITIONS, HOUSING INVESTMENTS
. THERE WERE ALSO RELATIONSHIPS
THAT WERE ALREADY IN PLACE THERE
FOR THOSE SERVICES AS WELL AND
THAT WAS USUALLY COMING OUT OF
STAND ALONE PILOTS OR
INVESTMENTS THAT LOCAL PLANS
WERE DOING ON THEIR OWN. UM, TO
EXPAND THE NETWORK BEYOND
EXISTING RELATIONSHIPS. PLANS
BEGAN TO IDENTIFY PROVIDERS
ALREADY SERVING E èC M,
ELIGIBLE MEMBERS AND POPULATIONS
OF FOCUS, INCLUDING COUNTY
BEHAVIORAL, HEALTH AND OTHERS.
LOCAL PLANS ALSO BEGAN
CONNECTING WITH COMMUNITY
PROVIDERS DELIVERING COMMUNITY
SUPPORT LIKE SERVICES, WHICH I
ALREADY SPOKE TO A LITTLE BIT.
ONCE POTENTIAL PROVIDERS ARE
IDENTIFIED. LOCAL PLANS PROVIDE
EDUCATION AND TRAINING. UM
PROVIDE MAKE SURE THAT
CONSISTENT MEETINGS ARE
HAPPENING WITH PROVIDERS,
OUTREACH AND TRAINING AS WELL,
UM, FOR THOSE WHO MAY BE
INTERESTED IN CONTRACTING SORT
OF GIVE THEM A LAY OF THE LAND.
UM IN THIS WORK THE ABILITY FOR
LOCAL PLANS TO LEVERAGE
INCENTIVE PAYMENT PROGRAM
DOLLARS, AS WE'VE HEARD WAS
INCREDIBLY CRITICAL OF SPORT
NETWORK DEVELOPMENT. UM AND
DEVELOPING THE INFRASTRUCTURE
AND BUILDING OUT THE CAPACITY OF
PROVIDERS FOR THESE SERVICES. SO
FOR EXAMPLE, DEVELOPING DATA
EXCHANGE CAPABILITIES, FUNDING
FOR STAFFING, ETCETERA. UH, IN
ADDITION, THE HOUSING AND
HOMELESSNESS INCENTIVE PROGRAM
FUNDING HAS HELPED ADDRESS LOCAL
HOUSING AND HOMELESSNESS NEEDS
BY WORKING CLOSELY WITH COUNTY
PARTNERS TO PROVIDE HOUSING
SERVICES, TECHNICAL ENHANCEMENTS
AND INFRASTRUCTURE. THESE FUNDS
HAVE ALSO ALLOWED LOCAL PLANS TO
MAKE CREATIVE INVESTMENTS AND
PERMANENT SUPPORTIVE HOUSING,
GIVE EQUITY GRANTS TO SMALLER
NONPROFITS AND CREATE SYSTEM
CHANGE GRANTS. BUILDING OUT THE
ECM AND COMMUNITY SUPPORTS
PROVIDER NETWORKS, HOWEVER, HAS
NOT BEEN WITHOUT LIMITATIONS OR
CHALLENGES. SO ONE EXAMPLE OF
THAT IS WORKFORCE SHORTAGES. UM
AND THIS HAS IMPACTED PROVIDERS.
CAPACITY TO CONTRACT. UM OR THE
VOLUME OF ME MEMBERS THAT THESE
PROVIDERS CAN SERVE. THEY ARE
ALSO GEOGRAPHIC CONSTRAINTS, SO,
PARTICULARLY IN VERY RURAL AREAS
, WHERE THERE ARE VERY FEW
PROVIDERS OR èC, B S¼ THAT CAN
BE A CHALLENGE. NEW PROVIDERS
THAT HAVE NEVER CONTRACTED WITH
ME. MANAGED CARE OFTEN GRAPPLE
WITH NEW THE NEW PROCESSES AS
WELL. SO TO MOVE BEYOND THOSE
CHALLENGES, NEW PROVIDERS
REQUIRE SUPPORT, TECHNICAL
ASSISTANCE AND GUIDANCE AROUND
STRATEGIES FOR BREEDING FUNDING,
DEVELOPING IN INFRASTRUCTURE AND
INCREASING CAPACITY IN MANY OF
OUR LOCAL PLANS ARE ENGAGED IN
THOSE ACTIVITIES TO SUPPORT
THEM. AND DESPITE THESE
CHALLENGES, HOWEVER, PLANS
REMAIN COMMITTED TO
TROUBLESHOOTING BARRIERS AND
PROVIDING TECHNICAL ASSISTANCE
TO PROVIDERS WITH THE GOAL OF
CONTINUING TO GROW AND EXPAND
THEIR NETWORKS AND TO PROVIDE
QUALITY CARE AND SUPPORT TO
MEMBERS. IN TERMS OF IDENTIFYING
, UH, POPULATIONS OF FOCUS AND
DETERMINING ELIGIBILITY FOR
THESE BENEFITS. UM PLANS, UH,
ARE OFTEN RELYING ON AVAILABLE
DATA SUCH AS CLAIMS AND
UTILIZATION DATA, DEMOGRAPHIC
DATA SOCIAL DETERMINANTS OF
HEALTH DATA AS IT IS AVAILABLE
SCREENINGS AND MEMBER
ASSESSMENTS AND GAPS IN CARE
REPORTS. THIS DATA IS USED TO
IDENTIFY MEMBERS THAT ARE WITHIN
SPECIFIC POPULATIONS OF FOCUS
AND ASSESSMENT. FIRST RISK LEVEL
BASED ON THAT ASSESSMENT. LOCAL
PLANS, THEN CONNECT THEM WITH
NEEDED SERVICES AND THE
APPROPRIATE LEVEL OF CARE
MANAGEMENT. FOR MEMBERS THAT
YEAH, I THANK YOU VERY MUCH, UM
SO, UH, LET ME JUST QUICKLY
TOUCH ON OUTREACH TO, UH MEMBER
AND MEMBERS AND PROVIDERS, SO
LOCAL PLANS HAVE USED SEVERAL
METHODS TO EDUCATE MEMBERS. UM
TRADITIONAL METHODS LIKE
UPDATING MEMBER HANDBOOKS,
SENDING OUT LETTERS. UM AND
INFORMATION ON PLANNED WEBSITES
AND THROUGH MEMBER PORTALS.
SIMILARLY UM, MEMBERS OR PLANS
HAVE ALSO DONE A LOT OF OUTREACH
TO, UM, PROVIDERS BY
DISSEMINATING INFORMATION, UM,
DOING WEBINARS TRAININGS, THAT
SORT OF THING, UM, PROVIDING
INFORMATION. THROUGH PORTALS. UM
SO I AND ALSO A LOT OF, UM,
PARTNERSHIP WITH COMMUNITY BASED
ORGANIZATIONS AS WELL, UM, YOU
KNOW, MEETING MEMBERS WHERE THEY
ARE BY, UM, AND WORKING THROUGH
ORGANIZATIONS THAT ARE ALREADY
SERVING THEM TO MAKE SURE THAT
THEY'RE RECEIVING INFORMATION
THAT WAY AS WELL. FINAL
THOUGHTS. FINAL THOUGHTS. UM SO
I'LL JUST SAY THAT WHILE LOCAL
PLANTS HAVE EXPERIENCED SOME
CHALLENGES IN THE IMPLEMENTATION
, EXPANSION OF èC, M AND
COMMUNITY SUPPORTS PLANS
CONTINUE TO EXPAND THEIR
PROVIDER NETWORKS, UM, CONTINUE
TO SEE AN UPTAKE IN THE BENEFITS
AND HAVE WITNESSED THE REAL LIFE
IMPACT OF THESE BENEFITS ON
THEIR MEMBERS, HEALTH AND WELL
BEING. THE IMPLEMENTATION OF NEW
BENEFITS TAKES TIME TAKES TIME
TO EDUCATE MEMBERS AND PROVIDERS
ABOUT THE AVAILABILITY OF NEW
BENEFITS TO BUILD TRUST AND
CAPACITY AND NONTRADITIONAL
PROVIDERS AND TO FIND WAYS TO
STREAMLINE PROCESSES. AND HIS
LOCAL PLANS CONTINUE THIS WORK.
WE WILL CONTINUE TO WORK WITH Dð
HÌ èC S¼ AND PROVIDERS PROVIDE
TECHNICAL ASSISTANCE. THANK YOU.
SUPPORT RESOURCES. THANK YOU. OF
COURSE. THANK YOU. THANK YOU. OK
WE'RE GONNA BE MOVING ON. AND
BEFORE THAT. I JUST WANNA MAKE
SURE THERE'S IN THE
REPRESENTATIVE FROM SACRAMENTO
NATIVE AMERICAN HEALTH CENTER IN
THE AUDIENCE. OK, JUST WANT TO
CLARIFY. STORIES OK, WE'RE GOING
TO MOVE ON TO RUTH FROM EL P DEL
BARRIO. YEAH, YOU'RE CLOSER. ALL
RIGHT. YOU MIGHT WANNA PUT YEAH,
YEAH. MY NAME IS RUTH LOPEZ,
NOVA AND RUTH. I'M ACTUALLY
GOING TO HAVE THE MICROPHONE. BE
RIGHT IN LIKE MAYBE TO YOUR SIDE
SO WE CAN HEAR YOU ABOUT HOW TO
MY SIDE. IS THAT OK? ALL RIGHT,
HERE WE GO. PERFECT ALL RIGHT.
UM THANK YOU. HONORABLE CAROLYN.
UH BEAR FOR INVITING US TO THIS
SESSION. MY NAME IS RUTH LOPEZ
NOVA AND I'M REPRESENTING KIN
SANCHEZ, ESQUIRE PRESIDENT èC E
Ó OF EL PROO DELRIO. CURRENTLY
UNFORTUNATELY, EL PROO IS STILL
NOT A CALM A PARTICIPANT. WE
HAVE PERFORMED CAL AIM LIKE
SERVICES. BUT IF NOT HEARD A
RESPONSE FROM THE PLANS FOR OUR
REQUEST TO PARTICIPATE SINCE
SINCE, UM 23 EXCUSE ME, 22
DECEMBER OF 22. SO EXCUSE ME.
JANUARY OF 20 THREE. PARDON ME.
UH, PROJECT WAS FOUNDED IN 1971
TO PROVIDE SUBSTANCE ABUSE
SERVICES WITH BEHAVIORAL HEALTH
COUNSELING. BILINGUALLY
BICULTURAL SPANISH FOR THE
POOREST NEIGHBORHOODS IN THE SAN
FERNANDO VALLEY FOR OVER 50
YEARS, OUR BEHAVIORAL HEALTH
PROGRAM HAS PROVIDED COUNSELING
AND REFERRAL SERVICES TO MEN AND
WOMEN, INCLUDING SPECIALIZED
SERVICES FOR WOMEN WHO ARE
PREGNANT, POSTPARTUM AND
PARENTING. EL PROJECT FOR OVER
30 YEARS IS PROVIDED PRIMARY
HEALTH CARE, JOB TRAINING AND
PLACEMENT AND CHILD. SERVICES
FOR THE UNDERSERVED COMMUNITIES
OF THE SAN FERNANDO VALLEY. IT
WAS A LACK OF AVAILABLE MEDICAL
SERVICES FOR THE LATINA
EXPECTANT MOTHER USERS. THAT
PROMPTED EL PRIETO TO BECOME A
FEDERALLY QUALIFIED HEALTH
CLINIC AND RECOGNIZED AS A
PATIENT CENTERED MEDICAL HOME BY
THE N èC Q A, WHICH PROVIDES
CARE THROUGH AN EXTENDED MANAGED
CARE NETWORK TO THE SAN FERNANDO
AND SAN GABRIEL VALLEYS. WE ARE
HERE TO SHARE OUR EXPERIENCE
WITH Kò A E èC M AND PROVIDE
SOME INSIGHT OF THE EXPERIENCE
OF A SMALLER FQ HÌ èC IN THE
COMMUNITY THAT'S BEEN
ESTABLISHED FOR 50 YEARS. DEL
BARRIO LEADERSHIP. TOOK
IMMEDIATE ACTION. TO INFORM,
TRAIN AND PLAN FOR WHAT APPEARED
TO BE A NUMBER OF SUBSTANTIVE
CHANGES RESULTING FROM THE
CALAIS INITIATIVE. THE BOARD OF
DIRECTORS WELCOMED AND ADOPTED
THE PROMISE AND CHALLENGE OF THE
CALAIS INITIATIVE PRESENTED BY
Dð HÌ èC S¼. REAL PROJECT
PRESIDENT MADE IT CLEAR THAT ALL
TRAINING AVAILABLE SHOULD BE
MADE TO EXECUTIVES AND
APPROPRIATE MANAGEMENT TO
PREPARE FOR THE COLLABORATION OF
SOME OF OUR NON CLINIC SERVICES
WITH THE HEALTH PLANS AS PER THE
CAL INITIATIVE. THIS IS IN FULL
COMPLIANCE WITH OUR MISSION AND
OUR GREATEST EXPERIENCE BASE 50
YEARS. NEEDLESS TO SAY, UM,
THANKS TO THE AGENCIES OF
CALIFORNIA PRIMARY CARE
ASSOCIATION AND THE COMMUNITY
CLINIC ASSOCIATION OF LOS
ANGELES COUNTY. MOMENTUM BEGAN
AT THE BEGINNING OF 2020 THREE
OR 2022 MOMENTUM BEGAN WITH
MULTIPLE TRAININGS FOR A PM
CALAIS, MEP, Tð, ET CETERA. AND
DURING THE TRAINING WE WERE
WORKING ON THE RECOMMENDED
TIMELINES TO SEND AND
APPLICATIONS WE MANAGED TO NOT
ONLY SEND A PM APPLICATION BUT
MANAGED L Ó I, BUT WE GOT A
RESPONSE AND WE'RE ULTIMATELY
INVITED TO PARTICIPATE. UM BUT
WE DECLINED FOR PER FOR SPECIFIC
REASONS. HOWEVER ALL OF THIS WAS
A LITTLE BIT SURPRISING WHEN WE
GOT TO THE FIRST QUARTER AND
WANTED TO SEE WHAT OUR STATUS
WAS WITH THE L OIS WITH THE
PLANS. WITH THE KEY PLAN THAT WE
WANTED TO WORK WITH, AND WE WERE
TOLD WE CAN'T BE REACHED. WE
USED A VERY WELL KNOWN
CONSULTANT TO HELP US BECAUSE AT
THAT QUARTER IN 2023 AH! OUR
SHIP. OUR ATTENTION SHIFTED
IMMEDIATELY FOR TRANSITION
PROJECTS TO FINANCIAL
OPERATIONAL CHALLENGES DUE TO
IMPERATIVE AND URGENT NEEDED
OUTREACH TO OUR MEMBERS
REGARDING RED DETERMINATION. MLA
TRANSITION MOLINA VERSUS HEALTH
NET TRANSITIONS. HEALTH NET AND
TRANSITIONS SO I'M GOING THROUGH
THIS FOR A REASON. MIDYEAR THERE
WAS STILL NÓ RESPONSE FROM THE
FIRST èC ML Ó. I AND SEVERAL
ATTEMPTS WERE MADE TO REACH THE
PLAN FOR STATUS TO NÓ AVAIL.
PARTIES IN THE THAT WE WERE
FAMILIAR WITH THROUGH
CONTRACTING DID NOT KNOW WHO TO
REFER TO AND, UM WE SUBMITTED
OTHER ANOTHER L TO ANOTHER PLAN,
AND I RECEIVED NÓ RESPONSE AND
WE ARE FOLLOWING THEM UP
REGULARLY, AND WE USE THE SAME
CONSULTANT FOR THAT ONE, AND I
DON'T THINK IT'S THE ON THE PART
OF THE CONSULTANT. FINALLY A
YEAR AND A HALF YEAR LATER
BECAUSE OF A CONNECTION THROUGH
ANOTHER PARTY THAT'S ALREADY IN
UH, ECM PARTICIPATION. WE WERE
CONNECTED TO THE DIRECTOR OF
THIS FIRST APPLICANT OR THE
FIRST ALL A REQUEST AND CAN
AFFIRM THAT WE ARE FINALLY
COMPLETING THE APPLICATION.
WHICH WILL TAKE 90 DAYS TO FIND
OUT IF WE ARE ACCEPTED MINIMUM
OF 90 DAYS, UH TO CALAIS E èC M
PROGRAM OR NOT. SO I HAVE TO
APOLOGIZE. HONORABLE CAROLYN
MINAR. WHEN YOU CAME AND ASKED,
ARE WE INVOLVED IN E èC M. I
THAT FOR SURE THAT WE WOULD BE
INVOLVED IF WE'RE NOT INVOLVED
NOW BECAUSE WE HAD AN L Ó I
SINCE LAST YEAR. WHY DID THE
DELAY HAPPEN? EVEN AFTER
SPEAKING WITH SEVERAL
PARTICIPANTS AND ADVISORS AND
THE PLANS THEMSELVES. THERE IS
NÓ CLEAR ANSWER, HOWEVER.
COMMENTS AROUND COMPETING
PRIORITIES. FINDING APPROPRIATE
STAFFING. AND THE DEVELOPMENT OF
COMPETING PRIORITIES. ALL CAME
UP. SHREVEPORT DOES NOT PUT
BLAME ON ANYONE. BUT ONLY
HIGHLIGHTS THE NEED. FOR WHEN
THERE ARE MULTIPLE CHANGE
PROJECTS. THERE WILL BE GAPS AND
UNINTENDED. CONSEQUENCES AND
PEOPLE START WRAPPING UP,
PLEASE. THEREFORE THE PROPOSALS
FOR FROM CALIFORNIA PRIMARY CARE
ASSOCIATION FOR PROVIDING
CONSISTENCY THROUGHOUT THE
COUNTY IN TERMS OF APPLICATION
FOR A èC M AND FINANCING, UH,
ISSUES IS SUPPORTED, FULLY
SUPPORTED BY EL PROO DEL BARRIO
OVERALL, SENATOR MENJIVAR. WE
ARE PROUD OF THE WORK THAT
YOU'RE DOING TO PUSH THIS
FORWARD AND WE CAN'T WAIT TO BE
A PART OF IT COMPLETELY. THANK
YOU FOR ALLOWING YOUR PRE TO DEL
BAR TO SERVE BY SHARING OUR
EXPERIENCE WITH YOU. THANK YOU
SO MUCH. LINDA GOOD MORNING,
LINDA. WE WITH WESTERN CENTER ON
LAW AND POVERTY, ENHANCED CARE
MANAGEMENT AND COMMUNITY
SUPPORTS CAN BE LIFE CHANGING
FOR ME MEMBERS. HOWEVER OUR
LEGAL AID ADVOCATES REPORT
CHALLENGES ACCESSING BOTH
ENHANCED CARE MANAGEMENT AND
COMMUNITY SUPPORTS, ALTHOUGH THE
NUMBER OF PEOPLE RECEIVING BOTH
SERVICES HAS STEADILY INCREASED,
AND WE'RE PLEASED TO SEE THAT
ONLY ABOUT 1% OF MEDI MEMBERS
HAVE RECEIVED ENHANCED CARE
MANAGEMENT, UH OVER THE PAST TWO
YEARS ABOUT AND 60,000. AND IT'S
ABOUT 100,000 FOR A COMMUNITY
SUPPORTS CLIENTS. REPORT
DIFFICULTY ACCESSING AND BEING
ASSESSED FOR ENHANCED CARE
MANAGEMENT, WHICH DIFFERS FROM
COMMUNITY SUPPORT IN THAT IT IS
A BENEFIT, NOT A PLAN OPTION FOR
ANY MEMBER WHO QUALIFIES. IN
ADDITION, ENHANCED CARE
MANAGEMENT AUTHORIZATION
TIMELINES CAN TAKE LONGER THAN
THE MANDATED FIVE DAYS AT THE
SAME TIME, THERE HAVE BEEN SOME
QUALITY OF CARE CONCERNS.
CLIENTS WITH ENHANCED CARE
MANAGEMENT OFTEN ARE AWARE OF
WHO THEIR M PROVIDER IS A SIGN
THAT THE ANTICIPATED LEVEL OF
MEANINGFUL ENGAGEMENT IN THIS
INTENSE AND MOSTLY IN PERSON
SERVICE IS NOT CONSISTENTLY
HAPPENING. CLIENTS ALSO REPORT
THAT THEIR M PROVIDER ARE NOT
TRAINED TO PROVIDE THE INTENDED
SERVICE THAT IS COORDINATING
CARE AMONG DIFFERENT PROVIDERS.
WE APPRECIATE THAT THE
DEPARTMENT IS SEEKING TO
INCREASE STANDARDIZATION FOR
COMMUNITY SUPPORTS, BUT OUR
ADVOCATES REPORT PLANS STILL
NARROW ELIGIBILITY CRITERIA OR
IMPOSE ADDITIONAL LIMITS. FOR
INSTANCE, WE HAVE CLIENTS WHO
REQUEST HOUSING DEPOSITS BUT ARE
TOLD THAT THEY MUST FIRST
REQUEST AND RECEIVE HOUSING
NAVIGATION SERVICES. UM AND ONCE
THEY'VE GONE THROUGH THAT
PROCESS, THE HOUSING DEPOSITS UM
AND THE HOUSING DEPOSITS ARE
APPROVED THE HOUSING UNIT IS
OFTEN NÓ LONGER AVAILABLE. UH,
WE'VE ALSO HEARD HOUSING SUPPORT
SERVICE PROVIDERS SHARE THAT THE
RATES ARE INADEQUATE AND THAT
THEY DON'T ACTUALLY COVER THE
COST OF CARE. UH, IN SOME
INSTANCES, THEY'VE JUST STOPPED
OFFERING CERTAIN SERVICES LIKE
HOUSING DEPOSIT SAVING, UH,
SAVING, UH, REIMBURSEMENT ISSUES
, UM, OF THE DATA AVAILABLE. UH
UM THERE IS CONTINUING EVIDENCE
THAT LIMITED ENGLISH PROFICIENT
AND LATINX POPULATIONS ARE
DISPROPORTIONATELY UNDER
UTILIZING BOTH ENHANCED CARE
MANAGEMENT AND COMMUNITY
SUPPORTS. UH, UNFORTUNATELY, WE
DON'T HAVE TIMELY ACCESS TO
DISAGGREGATED DATA ON èC M
ENROLLMENT AND PROVIDER
SPECIFICALLY, UM, THE MOST
RECENT DATA, WHICH WE'RE VERY
PLEASED TO SEE YESTERDAY IS
THROUGH SEPTEMBER 2020 THREE.
AND SO WE WOULD THIS DAY. BE
UPDATED MORE TIMELY AND BE
DISAGGREGATED BY POPULATIONS OF
FOCUS PROVIDED DEMOGRAPHIC
INFORMATION, WHICH WE THINK IS A
FACTOR IN MEMBER. UH OUTREACH
AND UTILIZATION AS WELL AS
INDICATOR OF DUAL STATUS THAT
THAT IS INDIVIDUALS WHO ARE BOTH
ELIGIBLE FOR MEDICAL AND
MEDICARE. UH WE HAVE NÓ WAY OF
DETERMINING DUAL ELIGIBLE
UTILIZATION AND IF THEIR METHOD
OF ENROLLMENT IS AFFECTING
ACCESS, SO THAT ADDITIONAL
BREAKDOWN IT WOULD BE HELPFUL.
UM THE DEPARTMENT HAS SHARED ITS
GOAL TO MAKE ALL COMMUNITIES
SUPPORTS A STATEWIDE MEDICAL
BENEFIT WITH HOUSING SUPPORT
SERVICES AND MEDICALLY TAILORED
SUPPORT OF FOOD BEING THE
FARTHEST ALONG AND SO WE
RECOMMEND REQUIRING THE STATE
MOVE FORWARD WITH SEEKING
FEDERAL APPROVAL TO MAKE THESE
SERVICES A BENEFIT. HOUSING
SUPPORT SERVICES, IN PARTICULAR,
HAS BEEN SHOWN TO IMPROVE HEALTH
OUTCOMES AND OUR PARTICULARLY
IMPORTANT CONSIDERING THE RISE
IN HOMELESSNESS. UH ESPECIALLY
AMONG THOSE, UM, EXPERIENCING
HOMELESSNESS. A DISABILITY. UM
AND FINALLY, WE WOULD RECOMMEND
THE DEPARTMENT ARTICULATE. UM
SOME SPECIFIC MEASURABLE TARGETS
, UM, TO HOLD PLANS ACCOUNTABLE
AND PUBLICLY REPORT THE PROGRESS
ON THESE THESE TARGETS, AND
THESE MEASURES SHOULD INCLUDE
PROVIDERS SPECIFICALLY TRUSTED
COMMUNITY PARTNERS WHO HAVE
EXPERIENCING PROVIDING SERVICES
AND AS WELL AS, UM, THE UNI
NUMBER OF UNIQUE MEMBERS
RECEIVING ENHANCED CARE
MANAGEMENT AND COMMUNITY
SUPPORTS WHICH THE DEPARTMENT
HAS STARTED TO DO SO. THANK YOU.
YOU'RE SUCH A PRO AT THIS. YOU
BETTER PANEL SO MANY TIMES, YOU
KNOW, YOU STICK TO THE TIME
FRAME. I LOVE IT, UM, DEPARTMENT
OF FINANCE. WOULD YOU LIKE TO
ADD ANYTHING? I ALREADY
DEPARTMENT OF FINANCE. WE HAVE
NOTHING TO ADD. OK, GREAT. UH,
SO LET'S START. THE FIRST
QUESTION. DO WE HAVE A RESPONSE
AS TO WHY EL PRODUCT DEL BARRIO
HAS HEARD BACK ON THEIR
APPLICATION TO BE PROVIDERS. HØI
THERE. I AM. SARAH BROOKS WITH
THE DEPARTMENT OF HEALTHCARE
SERVICES. UM SO WE WERE FOR NOT
FRANTICALLY, BUT WE WERE. WE
WERE LOOKING INTO, UH, WHETHER
OR NOT WE COULD IDENTIFY WHAT
THE WHAT THE ISSUE OR CONCERN
WAS AND WE'LL NEED TO FOLLOW UP
ON THAT. AND WE'LL FOLLOW UP
WITH YOU DIRECTLY. SO I DIDN'T
KNOW YOU KNOW, WE I WOULD NOT
BECAUSE I THOUGHT I MEAN, WE DO
NEED INFORMATION, ALSO FROM FROM
BECAUSE THIS IS THE PLAN, RIGHT?
IS THE PLAN. THE LETTER OF
INTEREST IS WITH THE PLAN, NOT
WITH THE DEPARTMENT. AND SO WE
NEED TO UNDERSTAND THE
COMMUNICATION BETWEEN THE PLAN
WHICH PLANS AND THE CLINIC SO IT
IS. YOU KNOW, WE BOTH WERE
TRYING TO FIND OUT IF WE'LL GET
YOU INFORMATION. YEAH, WE'RE
HAPPY TO YEAH, WE'RE HAPPY TO
LOOK INTO IT. WHAT? WHAT IS THE
I MEAN, I IDEAL TIME FRAME LIKE
YOU SUBMIT AN INTENTION. L Ó Y.
AND THEN WHAT'S THE TIME FRAME?
MAYBE THE PLANS ANSWER THAT
BECAUSE LY GOES TO THE PLAN.
SORRY UM YES. SO THE TIMELINE IT
SHOULD BE WITHIN. UM 30 DAYS. I
BELIEVE, UH OR NOT FOR THE L Ó
I EXCUSE ME FOR THE L Ó I. I
BELIEVE THAT IS 90 DAYS. IF I'M
NOT MISTAKEN, SHOULD I? YEAH I
THINK THAT THE L Ó I THE
TIMELINES LIKELY VÀ VARY BETWEEN
HEALTH PLANS. UM YOU KNOW,
THERE'S A DIFFERENT APPLICATION
PROCESS FOR EACH HEALTH PLAN,
BUT, UM, CERTAINLY THEY NEED TO
BE REASONABLE. UM AND SO, UM,
WE'RE HAPPY TO FOLLOW UP WITH
YOU ALL WHAT? SPECIFICS ON THE
TIMELINES, IF THAT WOULD BE
HELPFUL. THANK YOU, KATIE. A
QUESTION FOR YOU. WHICH
COMMUNITY SUPPORTS OUR HARDER TO
PROVIDE YEAH. SO UM, IT VARIES
BY REGION. UM SO IT IT IS REALLY
DEPENDENT ON THE REGION. UM I
WOULD SAY THAT THE HOUSING
SUPPORTS ARE ARE, UM, FOR SOME,
UM, THOSE ARE COMMUNITY SPORT
THAT ARE EASIER TO PROVIDE IN
SOME AREAS, BUT VERY, VERY
CHALLENGING AND OTHERS SOBERING
CENTERS. UM, IS ANOTHER ONE THAT
HAS COME UP AS A CHALLENGING,
UM, WHAT WAS THAT ONE? SO BEN
CENTERS? YES. UM AND THAT'S JUST
BECAUSE OF CAPACITY AND ACCESS
ISSUES. SO AGAIN, IT REALLY IS
DEPENDENT ON THE COUNTY IN THE
REGION THAT WE'RE TALKING ABOUT.
ON THE HOUSING CHALLENGES IN
SOME AREAS. IS THERE A COMMON
GEOGRAPHIC THEME TO THEM? IS IT
HARDER IN RURAL AREAS? COASTAL
AREAS? YEAH I WOULD SAY IT'S
MORE DIFFICULT IN RURAL RURAL IS
THE LACK OF PLACEMENT. THAT'S
RIGHT. YES. OK? AND THE
SOVEREIGN CENTERS IS JUST LACK
OF EXISTENCE OF THEM. OF COURSE,
MA'AM. THANK YOU, UM YOU AND I
APOLOGIZE. I FORGOT YOUR YOUR
TITLE. OH, THAT'S OK. SARAH
BROOKS. I'M THE CHIEF DEPUTY
DIRECTOR FOR HEALTH CARE
PROGRAMS AND FAIRLY NEW THANK
YOU. OK, UM YOU. ONE OF THE
EARLIER QUESTIONS YOU ANSWERED,
WAS REGARDING THE FLEXIBILITY.
LOCAL PLANS CANNOT REMOVE TARGET
POPULATIONS THAT CAN ADD SOAK IN
THE DEPARTMENT. BUT YOU'RE
REALLY FOCUSED ON THE NINE I WAS
TRYING TO COUNT. I COUNTED SIX
FOR ME. MAYBE I MISS THREE OTHER
ONES. SURE LET ME AND WHY YOU DO
THAT. THE REASON WHY I'M AT I'M
ASKING, AT LEAST IN MY DISTRICT
I'VE BEEN APPROACHED REGARDING,
UH AND I BROUGHT BRIEFLY, YOU
KNOW, UH, SURVIVORS OF CRIME,
VIOLENT CRIME, SPECIFICALLY
DOMESTIC VIOLENCE. SURVIVOR. I
COULD POTENTIALLY SAY THEY COULD
BE AT RISK OF HOMELESSNESS
RIGHT? BECAUSE THAT'S THE
HARDEST. MOST DIFFICULT TIME IS
WHEN YOU LEAVE, AND SOMETIMES
YOU DON'T LEAVE BECAUSE YOU
DON'T HAVE A PLACE TO GO LIVE.
WONDERING IF THERE'S IT SOUNDS
LIKE THERE'S FLEXIBILITY. WHAT
WOULD BE THE PROCESS? UM IF WE
WANTED TO ADD ANOTHER TARGET
POPULATION OR ARE WE AND IT
SOUNDED LIKE WE JUST WANT TO
REALLY FOCUS ON THE POPULATIONS
NOW AND MAY COME BACK TO THAT
QUESTION LATER DOWN THE LINE.
YEAH, NÓ. I THINK EXCELLENT
QUESTION. AND I WILL GET YOU THE
NINE SO THAT I DON'T HAVE TO
READ THROUGH THEM ALL AGAIN BACK
AND FORTH WITH YOU, BUT, UM UH,
WE AND JUST TO BE CLEAR WE HAVE
NINE. RIGHT NOW. WE HAVE THE
AUTHORITY TO ADD AN ADDITIONAL
AND WHEN I SAID THAT THE PLANS
HAVE THE PLANS CAN ADD. YOU KNOW
THE PLANTS CAN ADDITIONAL ADD
ADDITIONAL, UM, I THINK WHEN I
WAS, BUT ANYWAY TO ANSWER
QUESTION TO BE CLEAR. UM, SO WE
ARE REALLY FOCUSED RIGHT NOW ON
OUR NINE POPULATIONS OF FOCUS. I
THINK WE WANT TO MAKE SURE THAT
KELLY AND COMMUNITY SUPPORTS, UM
E èC M ARE ARE WORKING IN THE
WAY THAT THEY THAT THEY NEED TO
BE WORKING. YOU KNOW, WE'RE
TRACKING AND MONITORING THEM
CLOSELY. I THINK RECOGNIZING
THAT THE POPULATION THAT YOU'RE
FLAGGING IS IMPORTANT IN A
SIGNIFICANTLY IMPORTANT
POPULATION, BUT THAT WE DO TOUCH
ON THAT POPULATION AS YOU KIND
OF REFERENCE TO ACTUALLY,
SPECIFICALLY, UM, IN OUR
POPULATIONS OF FOCUS THAT WE
HAVE TODAY. I THINK REALLY
FOCUSING TODAY ON KIND OF THE
PROGRAM THAT WE HAVE AND THAT
WE'VE IMPLEMENTED TO MAKE SURE
THAT IT'S SUCCESSFUL. AND THEN
AS WE SEE THE SUCCESSES THAT WE
HAVE, UM, YOU KNOW, LATER ON
DOWN THE LINE, LOOKING TO
POTENTIALLY ADD ADDITIONAL
POPULATIONS OF FOCUS. OK? OK
THANK YOU. UM, I'VE HEARD FROM
SOME FQ HÌ èC S¼ WHO ARE
PROVIDERS? YOU TALKED REGARDING
GUIDELINES? YOU TALKED ABOUT THE
GUIDELINES THAT COME OUT. UM
SOME CONCERNS FROM A QF èC IS
THAT, UM, BENEFITS ROLLED OUT
ABOUT TWO YEARS AGO. BUT THE
GUIDELINES CAME OUT JUST IN
FEBRUARY OF SOME GUIDELINES CAME
OUT JUST IN FEBRUARY. NOW M èC
P S¼ ARE ASKING FOR MONEY BACK
BECAUSE RULES WEREN'T FOLLOWED
TO THE GUIDELINES. IT'S KIND OF
LIKE YOU DIDN'T FOLLOW THE RULES
TO A GUIDELINE THAT JUST CAME
OUT. AND THAT THEIR FQ HÌ èC S¼
ARE HAVING TO NOW PAY BACK. SOME
OF THE FUNDING THAT THEY WERE
GIVEN WHEN THEY HAD NÓ IDEA THEY
WEREN'T FOLLOWING A GUIDELINE
THAT HADN'T COME OUT YET, AND I
HOPE I EXPLAINED THAT IN A WAY
THAT WAS DIGESTIBLE. HAVE YOU
HEARD THIS? CONCERN. I HAVE NOT
BEEN MADE AWARE OF THAT CONCERN.
CERTAINLY IT'S SOMETHING THAT WE
WOULD WANT TO LOOK INTO AND
FURTHER EXPLORE. UM YOU KNOW,
CAR LINES COME OUT JUST IN
FEBRUARY OR LETTER OF, UM WELL,
WHAT I WOULD SAY IS THAT WE ARE,
UM, CONSTANTLY REFINING OUR
POLICY GUIDANCE THAT WE PUT OUT
AS I MENTIONED OUR ACTION PLAN
THAT WE, UM, PUT OUT WE ARE
CONSTANTLY AS WE, UM, LISTEN TO
STAKEHOLDERS AS WE GATHER
ADDITIONAL INFORMATION AS WE
MONITOR AND LOOK AT AND OVERSEE.
PROGRAM WE ARE CONSTANTLY
REFINING OUR GUIDELINES AND OUR
GUIDANCE THAT WE PUT OUT TO THE
PLANS, BUT IT'S NEVER OUR INTENT
TO, YOU KNOW, CHANGE. UM UM OR
CAUSE SOME SORT OF RECOUPMENT OF
SOME SORT. SO CERTAINLY WE WILL
FOLLOW UP ON WHAT YOU'RE STATING
AND LOOK INTO IT. OK, LOCAL
PLANS. DO YOU HAVE ANYTHING TO
SAY ON THIS? DO YOU HAVE YOU?
HAVE YOU SEEN ANY PLANS? GO BACK
AND ASK FOR FUNDING BACK. UH
THAT WOULD BE SOMETHING I'D HAVE
TO ALSO LOOK INTO. BUT HAPPY TO
DO THAT AND BRING IT BACK. I
WOULD REALLY LIKE, YEAH. IF I
CAN GET A FOLLOW UP ON THIS, AND
IT'D BE MORE THAN HAPPY TO SHARE
SOME OF THE FQ HÌ èC S¼ THAT
HAVE THAT WOULD BE GREAT, VERY
HELPFUL THAT INFORMATION TO YOU.
AND THEN I JUST WANT TO BRING UP
WHAT I BROUGHT UP LAST TIME
DIRECTOR, UM IN THE BEHAVIOR
SIDE OF THIS HEARING WAS
REGARDING NEW BENEFITS COMING
OUT AND JUST HONING IN ON THAT
NEW BENEFITS COMING OUT. UH A
CLIENT GOES TO THE TO A CENTER
AND SO FORTH AND SAYS, HEY, THIS
IS I'M ELIGIBLE FOR THIS. WHERE
IS MY BENEFIT TO THIS? AND THEN
THE CENTER NOT BEING UP TO SPEED
ON PROVIDING AND SO FORTH. JUST
WANNA REITERATE THAT I KNOW WE
CAN'T ALWAYS WE WANNA, YOU KNOW,
GET THAT OUT THERE BUT TRY TO
WORK AS MUCH WHERE WE CAN ALIGN
WHAT WE GET OUT THERE AS A
HEADLINE, AND IT'S READY TO GO
DOWN ON THE GROUND AS WELL. OK?
I'LL TURN TO MY COLLEAGUES RIGHT
NOW. SENATOR EGGMAN. I JUST HAD
A FEW QUESTIONS, BUT, WELL, ONE
JUST A DISTINCTION. ONE OF THE
THINGS THAT WE HEARD WHEN WE
WERE DOING CARE COURT AND SOME
OF OUR WHEN WE WERE DOING CARE
COURT AND SOME OF OUR OTHER
IMPROMPT NEED AS MUCH FUNDING
FOR HOUSING BECAUSE IT WASN'T AS
BIG AN ISSUE. NOW I HEAR YOU
SAYING THE SMALLER COUNTIES ARE
THE ONES WHO ARE HAVING ISSUES
WITH BEING ABLE TO PLACE PEOPLE
ON HOUSING. SO IF I COULD
UNDERSTAND THAT DISCREPANCY
COULD YOU THINK L A COUNTY WOULD
BE A HARDER PLACE TO BE ABLE TO
FIND ENOUGH HOUSING? OH I THINK
HOUSING IS A PROBLEM ACROSS THE
STATE. I'M SORRY. I'M TRYING TO
LOOK AT YOU AND TALK INTO THE
MICROPHONE AT THE SAME TIME.
YOU'RE ON Tð VÆ SO I CAN SEE. UM
UH, YES. I MEAN HOUSING IS AN
ISSUE ACROSS THE STATE. SO AGAIN
, I THINK, UM I CAN'T SAY THAT
SMALL COUNTIES DO OR DO NOT
ACROSS THE BOARD HAVE ISSUES
WITH HOUSING. UM BUT YOU KNOW IT
, IT IT IT JUST REALLY DEPENDS
ON THE COUNTY. UM AND THE, UM,
AVAILABILITY OF HOUSING.
OBVIOUSLY. SO I'M SORRY THAT I'M
NOT ABLE TO PROVIDE MORE OF A
DIRECT ANSWER, BUT I APPRECIATE
THE QUESTION AND HAPPY TO LOOK
INTO IT MORE IF WE COULD, JUST
BECAUSE BECAUSE THAT'S
DIAMETRICALLY OPPOSED TO WHAT
WE'VE HEARD BEFORE. OR I HAVE
HEARD BEFORE, ANYWAY, THE OTHER
THING IF WE LOOK AT THE COUNTIES
STILL NOT PROVIDING SOME OF THE
SERVICES THEY THEY ARE THE SMALL
ONES. SO WHAT ARE WE DOING? SOME
OF THE SMALL ONES, WHAT ARE WE
DOING TO HELP THEM RIGHT.
EVERYTHING LIKE IT'S BE COLUSA
DEL NORTE, BLAH, BLAH, BLAH. HOW
ARE WE? HOW ARE WE ASSISTING
THEM AND BEING ABLE TO BUILD OUT
THERE? I WILL JUST SAY, AS SARAH
MOVES LIKE MICROPHONE IS PART OF
THE PATH INFRASTRUCTURE DOLLARS.
WE ARE KIND OF PRIORITIZING SOME
OF THE RURAL COUNTIES WHERE
WE'RE SEE THE COMMUNITY SUPPORTS
. UPTAKE IS NOT THERE. THE PLAN
HASN'T ELECTED TO IMPLEMENT THAT
YET. SO TRYING TO LOOK AT WHERE
IN THE STATE WE KNOW WE NEED TO
BUILD SOME OF THE CAPACITY AND
USE SOME OF THE PATH DOLLARS TO
BUILD THAT OUT, AND WE'RE STILL
LOOKING AT COUNTIES BEING ABLE
TO DO SOME COLLABORATIVE THINGS
TOGETHER, AND SOME OF THE
SMALLER COURSES OK? OK, THANK
YOU. TWO THINGS. UM ALSO VOICING
SOME OF THE THINGS THAT I HEAR
FROM THE COMMUNITY. SO THEY'RE
THE PLANS PROVIDE A LIST OF
ELIGIBLE MEMBERS TO CALL TO
ENROLL AND SO FORTH. AND THERE'S
A LOT OF DIFFICULTY IN INCORRECT
CONTACT INFORMATION ON THERE. UM
WHAT KIND OF Tð A IS BEING
PROVIDED TO BE ABLE TO FIND THE
INDIVIDUALS TO ENROLL THEM IN
SOME CULTURAL THINGS ARE ALSO
COMING UP WITH A LOT OF OUR, UM
MINORITY GROUPS REGARDING THE
DISTRUST. WHY THIS IS A SCAM.
YOU KNOW A LOT OF ELDER
POPULATIONS LIKE NÓ. THIS IS A
SCAM AND THEN ALSO THE NOTE,
TALK TO MY CHILD TO MY CHILDREN.
AND TO ENROLL ME IN THERE. I'D
LIKE TO ONE. ARE THEY ELIGIBLE?
TO TALK TO IS A PROVIDER
ELIGIBLE TO TALK TO A CHILD
FIRST TO TALK ABOUT PROGRAMS OR
JUST HAVE TO BE WITHOUT ACTUAL
BENEFICIARY AND TWO WHAT ARE WE
DOING TO UPDATE SOME OF THESE
CONTACT LISTS TO FIND THE
INDIVIDUAL. SO WITH WITH RESPECT
TO YOUR QUESTION ABOUT CONTACT
INFORMATION, THIS IS AN ISSUE
THAT THE DEPARTMENT IS FOCUSED
ON AT THIS TIME. UM WE RECOGNIZE
THAT IT IS AN AREA OF CONCERN
AND SOMETHING THAT WE ARE
COMMITTED TO WORKING TO IMPROVE.
UM YOU KNOW, IT'S SOMETHING THAT
THE PLANS, UM AND THE DEPARTMENT
HAVE BEEN PARTNERING ON, UM WE
HAVE OUR WE HAVE A OH, I'M
TRYING TO REMEMBER THE NAME OF
THE, UH, THE INITIATIVE. I
APOLOGIZE. IT'S SLIPPING MY
HEAD, BUT WE HAVE AN INITIATIVE
AT THE DEPARTMENT. THAT'S
FOCUSED ON THIS ISSUE. UM AND IT
IS REALLY FOCUSED ON LOOKING AT.
WHERE ARE THE OPPORTUNITIES FOR
US TO KIND OF, UM, LOOK TO
IMPROVE CONTACT INFORMATION. AS
YOU KNOW, OUR OUR POPULATION
SOMETIMES MOVES AND CHANGES,
ADDRESSES AND PHONE NUMBERS
FREQUENTLY, AND SO WE WANNA MAKE
SURE THAT WE HAVE THE MOST UP TO
DATE INFORMATION AS IS POSSIBLE
SO THAT WE'RE FOCUSED ON THAT IS
WHAT I WANTED TO SAY. AND
MICHELLE MAY WANT TO ADD TO
THAT. I WOULD ALSO JUST ADD AS
PART OF THE REDERMIC PROCESS.
BEFORE THAT PROCESS STARTED. WE
MADE A VERY FOCUSED EFFORT IN
TERMS OF THE FIRST MESSAGING WAS
UPDATE YOUR CONTACT INFORMATION.
MAKE SURE THE COUNTY YOUR
APPLICATION THAT THAT IS CORRECT
BECAUSE WE WANTED TO GET THE
REDE TERMINATION PACKETS TO THE
INDIVIDUALS. AND SO IT'S BEEN
KIND OF A FOCUS AN INTENSE FOCUS
ACTUALLY, OVER THE LAST 14
MONTHS OR SO AND THEN AS PART OF
OUR POPULATION HEALTH MANAGEMENT
SERVICE, YOU KNOW, ULTIMATELY
HAVING THE ABILITY FOR A MEMBER
TO UPDATE THEIR OWN INFORMATION.
I MEAN, THAT'S THE GOAL, SO IT
KIND OF THE OPPORTUNITY JUST TO
DO THAT LIVE AND THAT GETS KIND
OF, UM, SPREAD THROUGHOUT, KIND
OF ALL THE SYSTEMS TO TAKE THAT
INTO ACCOUNT, BUT IT IS
SOMETHING THAT WE ARE, UH,
REALLY FOCUSING ON UM AND THEN,
JUST WITH REGARD TO, I THINK IN
TERMS OF JUST UNDERSTANDING OF
WHAT THE BENEFITS ARE OUT THERE
WE HAVE A MEDICAL MEMBER
ADVISORY GROUP. UM AND ONE OF
THE THINGS THAT REALLY TRYING TO
GET THERE KIND OF TAKE ON. HOW
DO WE BETTER COMMUNICATE SOME OF
THESE OPPORTUNITIES AND BENEFITS
TO OUR MEMBERS? YOU KNOW, WE
TALKED TO THEM ABOUT OUR
COMMUNITY. AND MANY OF THEM HAD
NOT HEARD OF THOSE BENEFITS AND
THAT THEY HAD ACCESS TO THIS. SO
WE'RE TRYING TO FIND ALL THE
WAYS WE CAN TO EVEN THINK
CREATIVELY OF. HOW DO WE
DIRECTLY ENGAGE WITH OUR
MEMBERS? OFTEN YOU KNOW THE
PLANS DO THAT. WE HAVE OUR
DIRECT MAILINGS. BUT WHAT ARE
THE WAYS WE CAN IN IN A SIMPLE
WAY AS WELL? UM NOT LIKE IN OUR
TECHNICAL SPEAK, UH, COMMUNICATE
WHAT'S AVAILABLE AND SO I, IT'S
IT IS SOMETHING THAT'S TOP OF
MIND FOR US. UM BECAUSE WE WANT
TO ENSURE THAT OUR MEMBERS HAVE
ACCESS TO THESE SERVICES AND CAN
ONLY HEALTH CARE ENTITIES BE
PROVIDERS. UM COMMUNITY SUPPORTS
AND OH, NÓ, UM, SO ALL KINDS OF
ENTITIES CAN BE PROVIDERS FOR SO
WE HAVE COMMUNITY BASED
ORGANIZATIONS. SO UM, THERE ARE
ALL KINDS OF ANY. I MEAN, THE
LIST CAN GO ON AND ON IN TERMS
OF THE TYPES OF ENTITIES THAT
ARE CONSIDERED COMMUNITY BASED
ORGANIZATIONS. THESE ARE ON THE
GROUND PROVIDERS THAT ARE
OFFERING SERVICES TO OUR MEMBERS
. AND THIS IS ACTUALLY THE ONE
OF THE KIND OF THE CHALLENGES
RIGHT IS THAT THEY DO HAVE TO
KIND OF BECOME MEDICAL PROVIDERS
RIGHT IN TERMS OF UNDERSTANDING
THE MEDICAL SYSTEM AND THEY'RE
THEY'RE NOT THE TRADITIONAL
PARTNERS THAT WE'VE BEEN WORKING
WITH FOR DECADES. RIGHT AND SO
HOW DO WE, AND THAT'S THE INTENT
OF SOME OF THE PATH DOLLARS IS
TO BUILD OUT THEIR CAPACITY TO
BECOME BECAUSE THEY'RE FEDERAL
RULES THAT HAVE TO BE FOLLOWED.
SO THEY DO HAVE TO KIND OF HAVE
SOME OF THE INFRASTRUCTURE
NEEDED TO PARTICIPATE IN ME. I'D
LIKE TO TURN BACK TO WHAT LINDA
MENTIONED REGARDING SOME
POTENTIALLY IN SOME HEALTH PLANS
, CREATING ADDITIONAL STEPS, UM,
IN RELATION TO THE HOUSING. UM
BENEFIT WHERE ALL YOU HAVE TO DO
THIS STEP. AND THEN GET TO THAT
ONE. I KNOW WHAT THE LOCAL PLANS
CAN SPEAK TO OUR DEPARTMENT.
SURE UM, SO MY UNDERSTANDING
HAVING REACHED OUT TO OUR PLANS
PRIOR TO THIS HEARING, IS THAT
SO? THAT WAS THE FIRST THAT I
HAVE HEARD OF THAT, UM, WE, UM,
FOLLOW THE ELIGIBILITY THAT'S
SET BY THE STATE AND IN SOME
CASES WE CAN. MAYBE THERE'S SOME
FLEXIBILITY IN TERMS OF
EXPANDING UPON THAT, BUT NOT
NARROWING. AND SO I I'M HAPPY TO
LOOK INTO THAT. AND I'M HAPPY TO
TOUCH BASE WITH LINDA, IF YOU
HAVE A SPECIFIC EXAMPLE. WHERE
DO WE DO DIRECT THESE KIND OF
GREEN BIT AND COMPLAINTS LIKE
YEAH, DIRECTLY TO. I MEAN, THE
DEPARTMENT WANTS THIS
INFORMATION. THIS IS HOW WE CAN
UNDERSTAND KIND OF THE ISSUES
AND WHAT NEEDS TO BE CONSIDERED
AND ADDRESSED. SO YEAH, I WAS
GONNA SAY LIN, LINDA, WE ALL
KNOW EACH OTHER. IT. PLEASE
REACH OUT TO ME, LINDA. I WOULD
STEP AUTHORIZATION SHOULD NOT BE
IN PLACE. AND SO IF THERE ARE
EXAMPLES THAT YOU HAVE PLEASE
REACH OUT AND PROVIDE THEM TO US
SO THAT WE CAN LOOK INTO THEM
DIRECTLY. AND IS THERE A MAX
DOLLAR AMOUNT FOR EVERY
COMMUNITY SERVICE? THAT'S A
GREAT QUESTION. UM SO A MAX
DOLLAR AMOUNT FOR EVERY
COMMUNITY SERVICE. SO, UM IT
WOULD NEED TO BE SO WHAT? WHAT
WOULD NEED TO BE PROVIDED WOULD
NEED TO BE WOULD NEED TO WORK
WITHIN OUR ACTUARIAL SOUNDNESS.
UM, WHICH IS I KNOW A VERY
TECHNICAL TERM. UM AND, UM, BUT
I THINK WHAT WE WOULD NEED TO DO
IS FOLLOW UP WITH YOU ON THAT
QUESTION. IF THAT'S OK,
SPECIFICALLY, UM, I'M WONDERING
LIKE I FEEL LIKE THIS IS I MEAN
THE HOUSING ASSISTANCE, RIGHT?
NOT JUST THE NAVIGATION, BUT
LIKE THE DOWN PAYMENT. I THINK
THAT THE DEPOSIT. I THINK THERE
MAY BE A DOLLAR AMOUNT, BUT
THAT'S THE ONLY ONE. I THINK IN
TERMS OF THE 14. THAT WOULD
REALLY BE SPECIFIC TO A KIND OF
A AND WE WOULD HAVE TO FOLLOW UP
ON THAT THE ENVIRONMENTAL
MODIFICATIONS WHAT DOES THAT
ENTAIL? OH IT MIGHT BE LIKE A
FOR ASTHMA MODIFICATIONS LIKE IF
THERE'S MOLD OR OR YOU MIGHT
NEED TO, UM, NEW AIR
CONDITIONING UNIT OF SOME SORT
THAT MIGHT HELP WITH, UM AIR CIR
CIRCULATION IN THE HOME BECAUSE
OF THE CHILD'S, UM, AND IT'S THE
LEAST AMOUNT OF COMMUNITY
SUPPORTS. WE'RE SEEING UTILIZED
ONE OF THE THREE TIME YES. IF I
MAY PROVIDE A SPECIFIC EXAMPLE
AND THIS IS FROM INLAND EMPIRE
HEALTH PLAN THAT WOULD SHARE
WITH ME RECENTLY, A WOMAN WAS
HIT BY A CAR BECAME PARALYZED AS
PART OF THE HOME MODIFICATION
COMMUNITY SUPPORT, THEY ACTUALLY
WENT INTO THE HOME AT A
DIFFERENT GUARD RAILS. MOVE THE
LEVEL OF THE SINK THE YOU KNOW
THE SINK LEVEL SO THAT IT WAS
APPROPRIATE FOR A WHEELCHAIR.
BUT THAT'S KIND OF WHAT THAT IS
ENVISIONED BY THAT TYPE OF
BENEFIT. OK THAT'S REALLY GREAT.
I JUST I FEEL LIKE THERE'S SO
MANY GREAT THINGS IN HERE AND
NOT A LOT OF PEOPLE KNOW THIS
EXISTS. UM AND THIS WOULD SOLVE
SO MANY ISSUES. AND I KNOW YOU
SHARED A LOT OF YOUR THINGS.
WEBINARS WHAT ARE WE DOING? I
MEAN, WHAT CREATIVE THINGS ARE
WE REALLY DOING? I MEAN TO SHARE
THIS. YEAH SO I MEAN, THERE ARE
A FEW EXAMPLES OF PLANS ALSO
WORKING THROUGH COMMUNITY HEALTH
WORKERS AS WELL TO HELP SPREAD
THE WORD, SO THERE'S A LOT OF
DIFFERENT METHODS WORKING WITH
COMMUNITY BASED ORGANIZATIONS IS
HUGE FOR OUR PLANS. UM AND THEN,
OF COURSE, YOU KNOW, THERE'S THE
TRADITIONAL, UM, COMMUNICATIONS,
BUT, UM, WE'RE TRYING TO THINK
OUTSIDE OF THE BOX, UM, IN TERMS
OF HOW TO REACH MEMBERS AND LET
THEM KNOW ABOUT THESE BENEFITS
AND HERE THAT FOLKS MIGHT THINK
THAT THIS IS A SCAM IS REALLY,
UM UH, CONCERN AND SO, UH, YOU
KNOW, FINDING WAYS TO MAKE SURE
THAT THEY FEEL THAT IT'S
AUTHENTIC. UM AND REAL IS
SOMETHING THAT OUR PLANS ARE
REALLY, REALLY FOCUSED ON AND
DEDICATED TO DOING. AND SO I
THINK, YOU KNOW, IT'S PART OF IT
IS JUST TIME. UM PART OF IT IS
WORKING THROUGH OUR PROVIDERS
AND WHO ARE ALREADY WORKING IN
THE COMMUNITY TO REALLY SPREAD
THE WORD AND YEAH. SOMETIMES
THAT MIGHT TAKE LONGER THAN WE
LIKE. UNFORTUNATELY. SENATOR
AUGMENT JUST TO ADD AS SOMEBODY
WHO'S WORKED IN A LOT OF
TREATMENT PROGRAMS. YOU KNOW,
THE FIRST THE BEST WAY TO GET
NEWS OUT IS TO HAVE A CLIENT
HAVE THAT NEWS UNTIL EVERYONE
ELSE THAT THEY HAVE SOMETHING
AND SOMEBODY ELSE IS GONNA WANT
THAT SAME THING SO AS MUCH AS
YOU CAN USE, NOT JUST NOT JUST
PROVIDERS, BUT ACTUAL RECIPIENTS
AND CLIENTS TO BE ABLE TO GO OUT
AND SPREAD THAT WORD IN CREATIVE
KINDS OF WAYS, I THINK IS A GOOD
WAY TO GO TO, AND I APPRECIATE
THAT. AND UM, YOU KNOW, JUST IN
TALKING WITH OUR PLANS, IT WAS
REALLY, UH, THERE ARE OF
EXAMPLES SUCCESS EXAMPLES WHERE
THEY HAVE THEIR LIVES AND THEIR
HEALTH AND WELL BEING OF REALLY
BEEN IMPACTED BY THESE BENEFITS,
SO FIGURING OUT WAYS TO LIFT UP
THOSE STORIES IS IMPORTANT. AND
I AGREE. I THINK I THINK NÓ
SORRY. I THINK THE ONE THING I
WOULD JUST ADD IS, YOU KNOW
SIMILAR TO WHAT MY COLLEAGUE
EARLIER SAID, IS THAT YOU KNOW
UP UPTICK IS SLOWER AND, UM, AS
WE TALKED AS I TALKED ABOUT MY
TALKING POINTS WE SAW IN HEALTH
HOLMES COUNTIES IN THE WHOLE
PERSON COUNTIES A WHOLE PERSON
CARE COUNTIES WHERE THERE WAS
ALREADY INFRASTRUCTURE THAT WE
SEE WE'VE SEEN MORE GROWTH IN
TERMS OF INDIVIDUALS ACCESSING
THESE SERVICES WILL CONTINUE TO
SEE MORE UPTICK. WE'VE SEEN THE
NUMBERS GROW. WE'LL CONTINUE TO
SEE THE NUMBERS GROW. WE'RE
EXCITED ABOUT THAT. BUT I THINK
THE MORE WE CAN GET THE WORD OUT
THE BETTER. IS THERE ANY
DOWNFALL TO A PROVIDER
PARTICIPATING IN THIS? ARE THERE
ANY? WHY WOULDN'T WE WHY
WOULDN'T A POTENTIALLY KNOW
RIGHT? DON'T THINK THERE IS ANY
DOWNFALL. OK, WE WELCOME ALL THE
PROVIDERS WE CAN GET. PERFECT.
OPPORTUNITY FOR ANY OF THE PANEL
TO SPEAK, UH, SHARE ANY LAST
FINAL THOUGHTS BEFORE WE CLOSE
OUT. COLLEAGUES. THANK YOU SO
MUCH. I APPRECIATE YOU JOINING
US. WE WILL GET YOU AN ANSWER.
THANK YOU. MOVING ON TO ISSUE
NUMBER FIVE. THIS IS FUNDING
TRANSITION TO STATE OPERATIONS
FOR CAL AM ML Tð, S¼ S¼ AND Dð
N S¼ S¼ MP INTEGRATION. SAY
THAT 10 TIMES GOOD AFTERNOON.
I'M LAURA WALKER. I'M THE CHIEF
FINANCIAL OFFICER FOR THE
DEPARTMENT OF HEALTH CARE
SERVICES. THE DEPARTMENT IS
PROPOSING A TECHNICAL ADJUSTMENT
TO TRANSFER $6.6 MILLION.03
POINT THREE MILLION DOLLARS
GENERAL FUND FROM LOCAL
ASSISTANCE TO STATE OPERATIONS
WITH NÓ. NET GENERAL FUND
IMPACT. THE FUNDING FOR AN
EXISTING CONTRACT TO SUPPORT A
KI¾M STAKEHOLDER ENGAGEMENT,
PROJECT MANAGEMENT AND TECHNICAL
ASSISTANCE RELATED TO POLICIES
FOR OLDER ADULTS AND PEOPLE WITH
DISABILITIES. ADDITIONALLY THESE
RESOURCES CONTINUE TO ASSIST THE
DEPARTMENT IN THE PREPARATION
FOR THE 2026 STATEWIDE EXPANSION
OF MANY, MANY PLANS. MOVING THE
FUNDING TO STATE OPERATION
ALLOWS THE DEPARTMENT TO
CONTINUE TO MOVE TOWARDS
CONSISTENT TREATMENT OF SIMILAR
TECHNICAL ASSISTANCE CONTRACTS.
HAPPY TO ANSWER QUESTIONS.
DEPARTMENT OF FINE. HØI, UH,
ISABELLA LIETO DEPARTMENT OF
FINANCE. UH, I HAVE NOTHING TO
ADD AT THIS TIME, OK? KARINA
HENDRA. WE'VE REVIEWED THE B èC
P AND HAVE NÓ CONCERNS. HAVE YOU
HAD ANY CHAIR MEMORIZED EVERY
SINGLE NAME? I FEEL LIKE I'M A
FAILING WITH DEPARTMENT OF
FINANCE IN LAL NÓ. IT'S OK.
THERE'S A LOT OF US, OK? OK?
WE'RE GONNA HOLD THE ITEM OPEN
AND MOVE ON TO ISSUE NUMBER SIX.
MANAGE CARE CAPITATION PAYMENT
SYSTEM SUPPORT. THANK YOU. THE
DEPARTMENT'S REQUESTING FIVE
PERMANENT POSITIONS AND
EXPENDITURE AUTHORITY OF
$926,000 230 THREE $1000 GENERAL
FUND AND BUDGET YEAR TO MEET THE
SIGNIFICANT GROWTH IN DEMAND OF
INFORMATION TECHNOLOGY SYSTEM
CHANGES THE INCREASED COMPLEXITY
OF INVOICES FOR MANAGED CARE
PLAN SERVICES AND HIGHER DEMANDS
FOR DATA AND COST TRANSPARENCY.
THESE RESOURCES WILL OPERATE AND
SUPPORT CRITICAL APPLICATIONS,
INCLUDING THE CAPITATION PAYMENT
MANAGEMENT SYSTEM. WE LOVINGLY
CALL CATMAN AND THE ELECTRONIC
ACCOUNTING MANAGEMENT INTERFACE
SYSTEM. WE CALL ME E, THE
MANAGED CARE PLAN MEMBER
POPULATIONS GROWN SUBSTANTIALLY
TO APPROXIMATELY $13.7 MILLION
OR A MILLION PEOPLE BASED ON OUR
NOVEMBER ESTIMATE, RESULTING IN
MORE CAPITATION PAYMENTS BEING
PROCESSED BY BOTH CATMAN AND ME.
COMPARED TO HISTORICAL TRENDS.
THESE CRITICAL SYSTEMS ARE, UM,
PROCESS APPROXIMATELY $80
BILLION IN PAYMENTS AND THE
PAYMENT METHODOLOGY AND
CALCULATIONS IN THESE SYSTEMS
HAVE BECOME MORE COMPLEX DUE TO
THE GROWTH IN MANAGED CARE AND
THE COMPLEXITY OF THE ACTUAL
CALCULATIONS. THE NUMBER OF
SYSTEMS SUPPORT REQUESTS FOR
CATMAN AND EMMY INCREASES
SIGNIFICANTLY EVERY YEAR AND
DENIAL OF THESE RESOURCES COULD
IMPACT THE DEPARTMENT'S ABILITY
TO CORRECTLY PROCESS ACCURATE
PAYMENTS TO MANAGE CARE PLANS,
CORRECT HISTORICAL PAYMENT
ISSUES AND RESOLVE SYSTEM DATA
ERRORS IMPACTING THE ABILITY TO
MEET FEDERAL AND STATE AUDIT
REQUIREMENTS AND REPORTING HAPPY
TO ANSWER QUESTIONS. DO YOU USE
THIS SYSTEM FOR M èC PAYMENTS
ONCE YES. UM SINCE THIS IS GOING
TO BE ONE OF THE FIRST TIMES
WE'RE GOING TO BE DOING THIS. DO
WE HAVE THIS WOULD BE ENOUGH TO
FOR THAT FOR THAT CAPACITY. THIS
CAPACITY IS ACTUALLY HELPING
WITH A BACKLOG CAPACITY THAT WE
HAVE SO WE WILL LIKELY MIGHT
HAVE FUTURE PLANS FOR RESOURCE
NEEDS IN THE FUTURE. BUT FOR
RIGHT NOW, JUST THESE RESOURCES
ARE HELPING TO RESOLVE A BACKLOG
OF ISSUES, OK? ANY FURTHER
COMMENT. DEPARTMENT OF FINANCE A
DETAILED DEPARTMENT OF FINANCE
NOTHING FURTHER TO ADD AT THIS
TIME. THANK YOU. JASON KUROS
LEGISLATIVE ANALYST'S OFFICE. WE
HAVE NOT RAISED CONCERNS WITH
THIS PROPOSAL. AS YOU CAN SEE ON
PAGE 30 OF YOUR AGENDA THERE IS
A GENERAL FUND COST ASSOCIATED
WITH IT. OUR OFFICE HAS A
GENERAL, UH, RECOMMENDATION TO
THE LEGISLATURE THAT IT APPLY A
HIGHER STANDARD THIS YEAR FOR
ANY NEW PROPOSALS. AS YOU CAN
SEE, IT'S THE COST IS JUST A
LITTLE OVER $200,000 ANNUALLY
AND THAT THE BUDGET PROBLEMS AND
THE TENS OF BILLIONS OF DOLLARS,
SO THIS ONE PROPOSAL DOESN'T
HAVE THAT BIG OF AN IMPACT ON
THE BUDGET PROBLEM. I ALSO
WANTED NOTE. YOU ASKED ABOUT THE
M èC Ó TAX PROPOSAL AND HOW
THERE'S ALSO ADDED
ADMINISTRATIVE COST THERE. THERE
IS A SEPARATE BUDGET CHANGE
PROPOSAL. THAT IS NOT ON THE
AGENDA TODAY, BUT BUT LIKELY
WILL BE WHEN YOU WHEN YOU TALK
ABOUT THE M èC Ó TAX WELL,
THAT ADDS MORE STAFFING TO
ASSOCIATED WITH THAT. SO THERE
THERE IS, UM THERE IS A PROPOSAL
FOR ADDITIONAL ADMINISTRATIVE
COSTS ASSOCIATED WITH THAT. OK,
THANK YOU SO MUCH. THANK YOU NÓ
FOR THE QUESTIONS. WE'RE GOING
TO HOLD THE ITEM OPEN AND MOVE
ON TO ISSUE NUMBER SEVEN. MEDIC
DRUG REBATE SPECIAL FUND RESERVE
SHIPPED THANK YOU. THE
DEPARTMENT PROPOSES TO TRANSFER
RESERVE BALANCES IN THE MEDICAL
DRUG REBATE FUND OF 101 $135.1
MILLION IN THE CURRENT YEAR,
27.6 MILLION IN BUDGET YEAR TO
THE GENERAL FUND. THIS TRANSFER
IS INTENDED TO HELP ADDRESS THE
STATE'S GENERAL FUND SHORTFALL
UNDER NORMAL CONDITIONS, THE
VAST MAJORITY OF DEPOSITS INTO
THE MEDICAL DRUG REBATE FUND OR
TRANSFERRED ANNUALLY INTO THE
GENERAL FUND. TYPICALLY ONLY A
SMALL PERCENTAGE OF THE FUND
REMAINS AS A RESERVE THE
GOVERNOR'S BUDGET PROPOSES TO
AND PROPOSES TO INSTEAD ALLOW
ALL REBATE COLLECTIONS TO BE
TRANSFERRED TO THE GENERAL FUND.
WHEN THE BUDGET CONDITIONS
APPROVE, IMPROVE, THE DEPARTMENT
WOULD PROPOSE TO ALLOW TO GO
BACK TO HAVING A RESERVE IN THE
DRUG REBATE FUND. ANY ADDITIONAL
COMMENT. A DETAILED DEPARTMENT
OF FINANCE. WE NOTICED ON THE
AGENDA THAT THERE WAS A QUESTION
ON WHY THIS WAS NOT A LOAN, AS
OPPOSED TO, UM, JUST
TRANSFERRING THE FUND BALANCE.
UM TO ANSWER THAT QUESTION. UH,
A GENERAL FUND LOAN OUT OF THIS
FUND DOESN'T MAKE A LOT OF
STRUCTURAL SENSE BECAUSE THE
MEDICAL DRUG REBATE FUND SERVES
AS A PATH TO THE GENERAL FUND
ALREADY, SO ALL OF THE FUNDS IN
IT WOULD HAVE JUST GOTTEN TO THE
GENERAL FUND. UM YEAH. AYE WE
HAVEN'T. UH, GIVEN THAT IN LIGHT
OF THE BUDGET PROBLEM, WE FIND
THIS PROPOSAL TO BE REASONABLE.
THANKS JASON. SO, JUST FOR MY
UNDERSTANDING, THIS ALWAYS GOES
TO THE GENERAL FUND. EXCEPT WE
LEAVE A LITTLE BIT IN THE FUND.
THIS TIME. WE'RE JUST NOT
LEAVING ANYTHING IN THE FUND,
AND IT'S NOT GOING TO IMPACT ANY
PROGRAMS. YES WE TYPICALLY
MAINTAIN A SMALL RESERVE ABOUT
220 MILLION IS WHERE WE'VE
LANDED IN HISTORIC IN THE PAST
COUPLE OF YEARS AS A RESERVE
THAT WE WILL NOT HAVE GOING
FORWARD AND THEN THIS IS A FUND
THAT WILL CONTINUE TO GET
CONTINUES. WE CONTINUE COLLECT
DRUG REBATE. FURTHER QUESTIONS.
HOLDING THE ITEM OPEN, MOVING ON
TO ISSUE NUMBER EIGHT CLINIC
WORKFORCE STABILIZATION PAYMENTS
. THIS IS A Tð VÆ. THE BUDGET
ACT OF 2022 PROVIDED 70 MILLION
GENERAL FUND FOR WORKFORCE
STABILIZATION PAYMENTS TO
CLINICS WITH ANY UNSPENT FUNDS
TO BE TRANSFERRED TO THE
DEPARTMENT OF HEALTH CARE,
ACCESS AND INFORMATION TO BE
USED FOR WORKFORCE PURPOSES. THE
CLINIC WORKFORCE STABILIZATION
PAYMENTS WERE PROVIDED TO MORE
THAN 56,000 CLINIC, HEALTH CARE
WORKFORCE, EMPLOYEES OR WORKERS
BETWEEN APRIL AND AUGUST OF 20.
2020 THREE TO HELP ASSIST WITH
THE STATE'S GENERAL FUND
SHORTFALL. THE DEPARTMENT
PROPOSES VIA TRAILER BUILDING
WHICH TO FOREGO THE TRANSFER OF
THE 14.9 MILLION IN UNSPENT
FUNDS. DEPARTMENT OF FINANCE.
ANDREW HEWITT DEPARTMENT OF
FINANCE NOTHING FURTHER TO ADD
JASON WE ALSO FOUND THIS
PROPOSAL REASONABLE IN LIGHT OF
THE BUDGET PROBLEM. UM OF
COURSE, IN LIGHT OF THE BUDGET
PROBLEM, REASONABLE. I JUST I
THINK I THINK THE CLINICS GET
SOMETIMES BULLIED. UH, BY THE BY
THE ADMINISTRATION AT TIMES, AND
, UM, I KNOW YOU KNOW THAT HIS
GIVING THE HISTORY OF THIS AND
THE FIGHT THAT WAS THAT ENTAILED
IN THEM GETTING A LITTLE PIECE
OF THEIR PIE. AND THEN NOW
BECAUSE WE TOOK SO LONG, IT'S
GETTING CLAW BACK. IT'S
UNFORTUNATE. OF COURSE, WE GOTTA
DO WHAT WE NEED TO DO. UM, BUT I
AM. I THINK THIS TEES UP TO MY
TO THE CONVERSATION IN THE M èC
Ó TAX. UM, I JUST WANTED TO
THAT THOSE CONCERNS BUT FOR
SHADOW FORESHADOWING? YES.
SENATOR. I I'M JUST, UM MAYBE
MAYBE SOMEBODY SAID IT AND I WAS
ASLEEP. WHY IS WHY WAS THE MONEY
UNSPENT? GIVEN THE FACT THAT WE
HAVE, UM WORKFORCE SHORTAGE AND
WE'RE TALKING ABOUT P, A
POSTGRADUATE WORKFORCE TRAINING
SLOTS. HEALTH CENTER RESIDENCY
PROGRAMS, NURSE PRACTITIONER
POSTGRADUATE WORKFORCE TRAINING
SITES. IS THERE NOBODY TO TAKE
THEM. SO THESE THIS PARTICULAR
PROGRAM WAS FOR DIRECT PAYMENTS
TO A CLINIC WORKFORCE IS OR THE
RETENTION PAYMENTS KIND OF WHAT
WE DID WITH SKILLED NURSING
FACILITY AND HOSPITAL PAYMENTS.
YOU KNOW, TO RECOGNIZE THEIR
CONTRIBUTIONS DURING COVID.
THESE WERE DIRECT PAYMENTS TO
THE WORKFORCE AND THE MONEY THAT
WAS NOT USED BECAUSE WE YOU
KNOW, DID PROJECTIONS IN TERMS
OF HOW MUCH WAS USED, AND SO WE
USED UM, CLOSE TO 55 MILLION OF
IT. UM AND SO THE REMAINING 14
9.14 0.9 MILLION WAS NOT USED
FOR THESE PAYMENTS. UM, BECAUSE
WE CLOSED OUR BOOKS ON THIS IN
NOVEMBER OF 2023. AFTER ALL THE
RECONCILIATION AND THAT WAS THE
LEFTOVER AMOUNT AND SO, UM,
PROPOSING TO USE IT IN TERMS OF
GENERAL FUNDS SOLUTION INSTEAD
OF TO DEPARTMENT OF HEALTH CARE,
ACCESS AND INFORMATION, SO
EVERYBODY WHO NEEDED THE MONEY
GOT PAID. RECEIVED IT? YES. FOR
THIS PARTICULAR PROGRAM. WAIT.
WE'RE GONNA HOLD THE ITEM OPEN
AND MOVE ON TO OUR LAST ISSUE BY
THE DEPARTMENT. ELIMINATE TWO
WEEK CHECK RIGHT HOLD, BUY BAG.
THE FUNNIEST THING EVER. WHAT A
LOOPHOLE Y'ALL. THANK YOU. THE
DEPARTMENT PROPOSES TO ELIMINATE
A PREVIOUSLY APPROVED TWO WEEK
CHECK RATE HOLD BUYBACK,
RESULTING IN GENERAL FUND
SAVINGS OF 532.5 MILLION IN
FISCAL YEAR 2425. AS YOU RECALL,
THE 2022 BUDGET ACT INCLUDED
FUNDING TO BUY BACK AN EXISTING
TWO WEEK HOLD ON FIFA SERVICE
MEDICAL PAYMENTS EACH JUNE UNTIL
THE FOLLOWING FISCAL YEAR. THE
2020 THREE BUDGET DELAYED THE
BUYBACK UNTIL 2024 SHOULD THE
GENERAL FUND CONDITIONS IMPROVE
THE DEPARTMENT BE WILLING TO
REVISIT THIS ISSUE AT A FUTURE
TIME. DEPARTMENT OF FINANCE ANY
FOR THE COMMENT. ANDREW HEWITT
DEPARTMENT OF FINANCE NOTHING
FURTHER TO ADD. THANK YOU. TELE
KINA HENDRA, A Ó. GIVEN THE
BUDGET PROBLEM WE FIND THE
PROPOSED SOLUTION IS WARRANTED.
WE'RE GOING TO HOLD THAT ITEM
OPEN AND THAT CONCLUDES OUR
DEPARTMENT. CONVERSATIONS I
WOULD ASK IF STICK AROUND
APARTMENTS SO WE CAN HEAR THESE
PROPOSALS. TURN IT ON PROPOSALS
FOR INVESTMENT. I HAVE TWO FOR
PRESENTATION. NOT WE HAVE WE
HAVE ONE FOR PRESENTATION. AND
ONE FOR NOT FOR PRESENTATION.
TWO FOR NOT FOR PRESENTATION. SO
THE VERY FIRST ONE. THE ONES WE
WOULD NOT BE HEARING TODAY ARE
BUT ON THE AGENDA IS THE MONTA
YEAR. CONTINUOUS MEDICO ROLL FOR
YOUNG CHILDREN 0 TO 5, AS WELL
AS THE MEDICAL COVERAGE FOR
DENTAL IMPLANTS. BUT THE
COMMITTEE HAS NOTED THAT THESE
HAVE BEEN RECEIVED. WE WILL BE
HEARING, HOWEVER, FOR
PRESENTATION, MEDI OUTREACH AND
ENROLLMENT FOR OLDER ADULTS
PROJECT WHO IS WHOEVER IS GIVING
THAT PRESENTATION MAY COME UP TO
THE WELL. YES. I'LL BE NICE
TODAY. IT'S USUALLY THREE
MINUTES PER PERSON. BOTH OF YOU
ARE SPEAKING. OK, GREAT. THEN
YOU DO HAVE THREE MINUTES. MADAM
CHAIR AND TEAM MEMBERS OF THE
COMMITTEE. THANK YOU FOR
ALLOWING ME TO PRESENT TODAY. I
WANT TO THANK SENATOR DODD FOR
SUPPORTING THIS REQUEST. MY NAME
IS GEORGINA MALDONADO. AND I AM
THE EXECUTIVE DIRECTOR AT
COMMUNITY HEALTH INITIATIVE OF
ORANGE COUNTY. I AM HERE ON
BEHALF OF THE MEDICAL FOR OLDER
ADULTS COALITION REPRESENTING
THE COALITION AND OUR REQUEST
FOR REAUTHORIZATION. WITH THIS
WE AUTHORIZATION. WE AIM TO
EXPAND OUR CURRENT 11 COUNTIES.
ALAMEDA KERN, LOS ANGELES
ORANGE, RIVERSIDE. BERNARDINO
SAN DIEGO, SAN MATEO, SANTA
CLARA, SOLANO AND NAPA COUNTY
INTO ADDITIONAL COUNTIES
ENCOMPASSING SACRAMENTO, FRESNO,
SAN JOAQUIN, STANISLAUS, EL
DORADO, SAN FRANCISCO AND
VENTURA FOR A TOTAL SCOPE OF 18
COUNTIES. CLEARLY THIS PROGRAM
FOCUSES ON PROVIDING OUTREACH,
ENROLLMENT, RETENTION AND
UTILIZATION SERVICES. OLDER
ADULTS AND DUAL ELIGIBLE SENIORS
AND ELDERLY, DISABLED BLIND AND
THOSE IN POVERTY. IN THE PAST
YEAR ALONE, WE HAVE CONNECTED
WITH 2 218,000 INDIVIDUALS
THROUGH OUTREACH AT LOCAL
COMMUNITY EVENTS AND ORGANIZED
PARTNERSHIPS WITH THE COMMUNITY
WE SENT OVER 1.2 MILLION TEXTS
AND 6.6 MILLION VIDEO ADS TO THE
ELDERLY BY THE END OF YEAR ONE
ON THIS PROJECT, IT HAS EXPECTED
THAT 21,000 PEOPLE WILL ENROLLED
, ACCORDING TO DHCS. THERE ARE
100 AND 2000. DUAL ELIGIBLE
INDIVIDUALS RESIDING WITHIN THE
COUNTY OF ORANGE, WHICH IS THE
COUNTY THAT I REPRESENT. THIS
TRANSLATES TO 19.7% OF ORANGE
COUNTY'S POPULATION. THIS DOES
NOT INCLUDE THE ADDITIONAL OLDER
ADULTS THAT ARE EXCLUSIVELY
ELIGIBLE FOR ME IN MY COUNTY,
ONLY 45% OF THE OLDER ADULT
POPULATION IS ELIGIBLE FOR
MEDICARE ONLY OVER HALF OF THE
OLDER ADULTS IN MY COMMUNITY ARE
LIVING IN POVERTY AND ARE IN
NEED OF THE SERVICES. THIS
REAUTHORIZATION AIMS TO CONTINUE
OUR CURRENT SERVICES AND EXPAND
THEM INTO ADDITIONAL COUNTIES,
PROVIDING COST EFFECTIVE
ASSISTANCE TO OVER 100,000
VULNERABLE DUAL ELIGIBLES AND
OLDER ADULTS WITH OVER 500,000
INDIVIDUALS RECEIVING ENROLLMENT
NAVIGATION UTILIZATION SERVICES
AND SUPPORT THIS EXPANSION IS
CRUCIAL. THE 1.6 MILLION DUAL
ELIGIBLES IN THE STATE AND
INCREASING NUMBER OF
CALIFORNIANS TURNING 65 DAILY
NAVIGATING THE COMPLEX MEDICAL
SYSTEM, PARTICULARLY
PARTICULARLY FOR THE ELDERLY,
DISABLED BLIND AND THOSE IN
POVERTY IS CHALLENGING IN LOS
ANGELES ALONE. THERE ARE OVER
100 AND 65 ME AND MEDICARE
COMBINATIONS AVAILABLE.
THEREFORE THE CRUCIAL WORK OF
ASSISTING THE MOST VULNERABLE IN
ACCESSING AND UTILIZING THESE IT
CANNOT BE OVERSTATED. THE BUDGET
REQUEST SEEKS AN ALLOCATION OF
10 MILLION ANNUALLY FOR FOUR
YEARS FROM THE PROPOSED FISCAL
YEAR. 2425 STATE BUDGET GENERAL
FUND AND NAMES TO DRAW DOWN AN
EQUAL MATCH IN FEDERAL FUNDING,
TOTALING 40 MILLION GENERAL FUND
AND 80 MILLION TOTAL FUND. THIS
SIGNIFICANT INVESTMENT HAS
ALREADY BEEN MADE IN
ESTABLISHING THE INFRASTRUCTURE
FOR THIS PROJECT, REINVESTING IN
PHASE TWO WILL ALLOW US TO BUILD
UPON THE OF THE EXISTING PROJECT
FRAMEWORK AND BETTER SERVE THOSE
WHO ARE MOST VULNERABLE. THANK
YOU FOR ALLOWING ME TO PRESENT
TODAY. I WANT TO THANK SENATOR
DODD FOR CHAMPIONING THIS
REQUEST. THANK YOU SO MUCH, UH,
DIRECTOR THIS. WE'VE BEEN
FUNDING. IT IS THE LAST YEAR
THAT WE'RE NOT FUNDING THIS
PROGRAM ANYMORE. OR MAYBE YOU
HAVE THE ANSWER. YES, SOME. MY
NAME IS MARK D¯ÚI. I'M WITH
CALIFORNIA COVERAGE AND HEALTH
INITIATIVES ON THE èC E Ó.
THIS HAS BEEN A TWO YEAR FUNDED
PROJECT AND THE FUNDING ENDS ON
JUNE 30TH OF THIS YEAR. 2024 WAS
IT INTENDED TO BE A TWO YEAR
PROGRAM? THE GOAL WAS TO
CONTINUE THE PROGRAM. BUT IT
WASN'T IN THE DHCS BUDGET. WE
SUBMITTED A BUDGET REQUEST AND,
UM WE WERE ABLE TO GET FUNDED
FOR TWO YEARS TO GET US STARTED
AND SEE HOW THE PROGRAM WENT.
BEEN MUCH MORE SUCCESSFUL THAN
WE ORIGINALLY ANTICIPATED. AND
THE REASON WE WANT ADDITIONAL
COUNTIES BECAUSE WE'RE HAVING
GOT THEIR COUNTIES ASK US TO
EXPAND THESE SERVICES TO THOSE
COUNTIES, TOO. OK, SO WOULD YOU
STOP THE SERVICE TO THE
COUNTIES? YOU'RE ALREADY IN LIKE
THAT? NÓ IT JUST EXPAND TO
ADDITIONAL COUNTIES. SO YOU HAVE
ENOUGH FUNDING RYAN, YOU WOULD
HAVE ENOUGH FUNDING TO CONTINUE
DOING THE WORK YOU'RE DOING WITH
THIS REQUEST. OH SO WITHOUT THIS
REQUEST, EVERYTHING ENDS JUNE
30TH. WITHOUT ADDITIONAL
FUNDING. WHY WOULD WE SET UP A
PROGRAM WITH ONE TIME MONEY?
WHAT WAS THE ANTI? WHAT WAS THE
GAME PLAN? SOMEBODY ELSE WAS
GOING TO FUND IT. WELL THERE IS
A SMALL AMOUNT OF FUNDING THAT
COMES THROUGH ANY COMMISSIONABLE
REVENUE THAT'S RUN DOWN FOR THE
DUAL ELIGIBLE SPECIAL NEEDS AND
OTHER MEDICARE ADVANTAGE
ENROLMENTS TO CONTINUE FUNDING
THIS PROJECT. UM, AGAIN, IT'S
NOT NEARLY AT THE LEVEL OF
FUNDING THAT TAKES, UH, STAFF
AND PROVIDE THE SERVICES IN THE
COMMUNITY. THE REASON I MEAN, I
MUST HAVE BEEN ASLEEP FOR 12
YEARS. I MEAN ON THE BUDGET
COMMITTEE, TYPICALLY WHEN WE ARE
TALKING ABOUT ONE TIME MONEY
WE'RE NOT TALKING ABOUT FUNDING
A PROGRAM FOR CORE SERVICES THAT
WHERE THE NEED FOR THE SERVICES.
CONTINUES. OUTRAGE THIS IS FOR
OUTREACH AND ENROLLMENT. RIGHT?
SO THE IDEA IS THERE WAS A
POPULATION OUT THERE THAT WASN'T
ENROLLED, AND SO THEN YOU SPEND
AN AMOUNT OF TIME GETTING THEM
ENROLLED. AND THEN YOU WOULD
NEED THE PROGRAM. SO OH, I SEE.
SO WE'VE ENROLLED EVERYBODY THAT
NEEDS TO BE ENROLLED IN
RIVERSIDE COUNTY AND ORANGE
COUNTY, AND THERE'S A LOT MORE
NEED THAN FUNDING AVAILABLE. A
EVEN WITH THIS FUNDING, WE'RE
TALKING ABOUT ENROLLING 100 AND
7000. PEOPLE WILL PROBABLY
ASSIST CLOSER TO A MILLION
PEOPLE NAVIGATING THEIR
COVERAGE. BUT THERE'S 1.6
MILLION DUAL ELIGIBLES IN THE
STATE RIGHT NOW, AND THE NUMBERS
GROWING. SO IT'S THIS. THERE'S A
FRACTION OF THE TOTAL POPULATION
THAT NEEDS SERVICES. BUT IT'S A
SIGNIFICANT AMOUNT AND WE'RE
SERVING THE MOST VULNERABLE
RESIDENTS IN EACH OF THESE
COMMUNITIES TO ENROLL THEM. TO
ENROLL SO HELPING WITH THE
MEDICAL AND MEDICARE COVERAGE
BECAUSE THEY CURRENTLY ARE
ENROLLED TO EITHER. SOME PEOPLE
WILL BE ENROLLED IN JUST
MEDICARE AND NOT KNOW THAT THEY
SHOULD ALSO HAVE ME BECAUSE IF
THEY HAVE ME, THEY GET
ADDITIONAL BENEFITS. THEY HAVE
NÓ OUT OF POCKET COSTS. RIGHT,
AND IT'S PEOPLE THAT ARE, UH,
ELDERLY, BLIND, DISABLED LIVING
IN POVERTY. THERE'S ALSO PEOPLE
THAT MISS KEY OPPORTUNITIES TO
ENROLL IN MEDICARE. OUR MEDICAL
AND THEN THEY END UP WITH
LIFETIME PREMIUM PENALTIES
BECAUSE THEY'RE MISSING KEY Q MÀ
MARKERS TO GET THOSE ENROLLED.
THEN SOME PEOPLE, OF COURSE, ARE
UNINSURED. SOME PEOPLE ARE ONLY
INSURED IN ONE PROGRAM AND JUST
STAY THAT WAY. THE DEPARTMENT. I
DON'T KNOW IF YOU COULD SHARE
SOME OF THE DEPARTMENT'S VISION
ON HOW WE'RE ADDRESSING, UM,
MISSING A LOT OF INDIVIDUALS IN
GETTING ENROLLED. WHAT ARE THE
PRO PROJECTS WE MAY HAVE OR
PROGRAMS THAT EXIST? THAT IS
HELPING ADDRESS, UM INDIVIDUALS
THAT ARE NOT ENROLLED. AND ME.
IS THERE ANYTHING THAT COMES TO
MIND DIRECTOR A LOT OF OUTREACH.
I WOULD JUST LIKE JUST THE
GENERAL OUTREACH AND
COMMUNICATION KIND OF BROADLY,
UH, YOU KNOW, EVEN JUST THE
NAVIGATOR PROGRAM. YOU KNOW,
THOSE WERE ALSO KIND OF SHORT OR
INVESTMENTS, NOT ONGOING DOLLARS
THAT WE INCLUDED AS PART OF KIND
OF THE REDE PROCESS, THE
UNDOCUMENTED EXPANSION SOME KIND
OF ONE TIME BIG PUSHES, AND I
THINK THIS WAS A SIMILAR, OK.
JUST SO I'M CLEAR. HOW MUCH
MONEY WOULD IT TAKE TO CONTINUE
YOUR PROGRAM AND THE EXISTING
COUNTIES IF THERE ARE PEOPLE YET
TO BE REACHED? IS IT? DID YOU
TELL ME THAT AND I JUST NÓ. I
THINK THEY'RE ASKING. THERE ARE
FOUR COUNTIES MORE COUNTIES. BUT
THE CURRENT AND ADDITIONAL HOW
MUCH SO MY QUESTION? I MEAN, THE
WHOLE THING ENDS, RIGHT. SO HOW
MUCH MONEY DO YOU NEED TO
CONTINUE YOUR EFFORT IN THE
COUNTIES? YOU'RE IN? GETTING AN
EXPANSION IF WE DIDN'T DO AN
EXPANSION, THE SAME LEVEL OF
FUNDING WE CURRENTLY HAVE SO 6
MILLION GENERAL FUNDS 6 MILLION
MATCH YEAR. TO 12 MILLION A
YEAR. AND I JUST WANT TO MAKE
SURE THAT'S ON THE RECORD OF A
BUDGET QUESTION SORT OF AN
INTERESTING BUDGET YEAR FOR
EXPANSIONS OF ANYTHING BUT FOR
SURE. THANK YOU, MADAM CHAIR.
WOULD YOU LIKE TO ADD ANYTHING
TO THIS? KINA HENDRON L? A Ó,
UM, JUST WANTED TO KNOW SINCE
THIS PROPOSAL WAS NOT INCLUDED
IN THE GOVERNOR'S BUDGET, WE
HAVE NOT ANALYZED IT. BUT WE ARE
AVAILABLE TO ASSIST THE
COMMITTEE IF ANY QUESTIONS ARISE
DURING ITS REVIEW. I'M I'M
HOPING YOU HAVE SOMETHING TO SAY
IF IT CAME UP HERE. YOU COULD
HAVE WAVED THE WAY. MAKE IT GOOD
BROTHER. MAKE IT GOOD. I THINK
YOU LIKE THAT ONE OVER THERE.
CHAIR IF I MAY, ANDREW, WITH
DEPARTMENT OF FINANCE, UH, FOR
THE RECORD, THESE PROPOSALS ARE
NOT INCLUDED IN THE GOVERNOR'S
BUDGET, BUT THE ADMINISTRATION
IS AWARE OF THESE ISSUES. WE ARE
CONTINUING TO EVALUATE THESE
PROPOSALS AND LOOK FORWARD TO
WORKING WITH THE LEGISLATURE ON
THESE ISSUES AS WE MOVE FORWARD
IN THIS THROUGHOUT THE SPRING
PROCESS. I KNEW THAT. THANK YOU
SO MUCH. THANK YOU FOR
PRESENTING. THANK YOU. ALL
RIGHT. THAT CONCLUDES ALL OUR
PRESENTATIONS MOVING ON TO
PUBLIC COMMENT. HE MADE IT HAVE
A GOOD WEEKEND. FISH. SHE IS.
YOU MAY PROCEED. THANK YOU, UH,
NEW ORLEANS WITH CHILDREN NOW.
ON ISSUE THREE. WE HAVE BEEN
WORKING IN COALITION WITH GROUPS
TO DETERMINE OUR THOUGHTS ON THE
CDP TRANSITION PLAN THAT WAS
JUST RELEASED LAST FRIDAY. WE
ARE STILL REVIEWING THE PLAN AND
REMAIN CONCERNED ABOUT THE
COMPRESSED TIMELINE SPECIFICALLY
THAT LOCAL HEALTH JURISDICTIONS
HAVE THREE MONTHS TO EFFECTIVELY
CLOSE OUT CHP AND ESTABLISH HICK
PICK FIC AS A STAND ALONE
PROGRAM. BETWEEN THIS PLAN AND
OTHER RECENT GUIDANCE ISSUED AT
THE END OF MARCH TO ESTABLISH
HICK PICK FICK AS A STAND ALONE
PROGRAM. WE RESPECTFULLY REQUEST
THIS COMMITTEE TO ALLOW OUR
GROUPS TIME TO FULLY REVIEW THE
TRANSITION PLAN AND HIC PICK FIC
GUIDANCE DOCUMENTS AND TO
COLLECT FEEDBACK FROM OUR
MEMBERS. WE WOULD APPRECIATE THE
OPPORTUNITY TO SHARE OUR
THOUGHTS AFTER WE HAVE
SUFFICIENT TIME TO REVIEW AND
COLLECT THIS FEEDBACK. LAST
UNDER ISSUE 10 UNDER PROPOSALS
FOR INVESTMENT, THE MULTIYEAR
CONTINUOUS COVERAGE PROPOSAL WE
WANTED TO EXPRESS OUR SUPPORT
FOR THE COALITION PROPOSAL.
THANK YOU. THANK YOU SO MUCH.
GOOD AFTERNOON, LINDA WAY WITH
WESTERN CENTER ON LAW AND
POVERTY. UH IN REGARDS TO ISSUE
10. WE REQUEST TIMELY
IMPLEMENTATION OF BOTH SHARE OF
COSTS, REFORMS SO THAT SENIORS
AND PERSONS WITH DISABILITY ARE
ABLE TO ACCESS NEEDED MEDICAL
SERVICES AS WELL AS MULTIYEAR,
CONTINUOUS ENROLLMENT SO THAT
CHILDREN CAN KEEP THEIR NEEDED
HEALTH COVERAGE AT A CRITICAL
TIME IN THEIR DEVELOPMENT, WHICH
IS ESPECIALLY TIMELY IN LIGHT OF
THE HIGH PROCEDURAL TERMINATION
RATE. WE ALSO SUPPORT UM,
FUNDING, OUTREACH AND ENROLLMENT
FOR OLD ADULTS AND DENTAL
IMPLANTS. THANK YOU, LINDA.
NICOLE WEDMAN ON BEHALF OF THE
CHILDREN'S PARTNERSHIP, ALSO IN
SUPPORT OF ITEM 10, THE
CONTINUOUS ENROLLMENT IN MEDI
CAL FOR CHILDREN BETWEEN ZERO
AND FIVE. MORE THAN HALF OF
CALIFORNIA'S CHILDREN UNDER THE
AGE OF FIVE ARE ENROLLED IN ME
AND THROUGH THE 2022 BUDGET.
CALIFORNIA WAS ONE OF THE FIRST
STATES TO VOTE TO IMPLEMENT MEDI
ENROLMENT, CONTINUOUS COVERAGE.
WE'RE WAITING FOR THE GREEN
LIGHT FROM THE DEPARTMENT OF
FINANCE TO IMPLEMENT THE POLICY.
BUT SINCE THEN OREGON 10,
MASSACHUSETTS, NEW MEXICO, NORTH
CAROLINA, NEW YORK, ARIZONA,
HAWAII AND PENNSYLVANIA HAVE
ALSO ADOPTED THE POLICY SINCE
THE END OF THE PUBLIC HEALTH
EMERGENCY WHEN EVERYONE HAD
CONTINUOUS COVERAGE BETWEEN JUNE
AND JANUARY. 2024 284,000
CHILDREN WERE DROPPED FROM ME,
LARGELY DUE TO ADMINISTRATIVE
HURDLES. CONTINUOUS COVERAGE IS
ESPECIALLY IMPACTFUL FOR
CHILDREN OF COLOR. ALMOST 3/4 OF
MEDICAL CHILDREN ARE CHILDREN OF
COLOR AND MEDICAL IS THE PRIMARY
SOURCE OF COVERAGE FOR
CALIFORNIA LATINX AND BLACK
CHILDREN. THEREFORE CAN PLAY A
PIVOTAL ROLE IN ADVANCING EQUITY
BY ENSURING THAT BI PARK
CHILDREN CAN HAVE A HEALTHY
START, BEGINNING WITH ENSURING
THEIR HEALTH COVERAGE IS STABLE
AND CONTINUOUS TO MEET THE
JANUARY 2025 PLAN START DATE.
THIS NEEDS TO BE IMPLEMENTED AS
SOON AS POSSIBLE AND FUNDED IN
THIS YEAR'S BUDGET BEFORE
DIRECTORS. I KNOW WE TALKED
ABOUT THIS LAST YEAR IS FUNDING
THE ONLY ISSUE WITH THIS PROGRAM
, I THINK, REMEMBER IF MY MEMORY
SERVES ME RIGHT? WE HAD TO
SUBMIT A LETTER A WAIVER THE
TRIGGER. TRIGGER IT. YES. WHERE
ARE WE AT WITH THIS? I GUESS SO.
IT WILL REQUIRE AN 1115 WAIVER
TO THE FEDERAL GOVERNMENT AND WE
WENT THROUGH THE PUBLIC COMMENT
PERIOD. UM, JUST TO BE READY TO
DO SO, BUT I MEAN IT. IT'S ALL
CONTINGENT ON FUNDING AVAILABLE
IN THE BUDGET TO PAY IS THAT THE
ONLY THING HOLDING US BACK AND
THEN WE WILL HAVE TO DO SYSTEM
CHANGES AS WELL. BUT THE KIND OF
THE 1115 WAIVER PROCESS WE
SUBMITTED THE WAIVER ALREADY.
WE'VE WE'RE READY TO GO. WE DID
THE PUBLIC COMMENT PERIOD, SO WE
WILL BE READY TO GO. UM AND THAT
PROCESS IS BECAUSE WE CAN SUBMIT
THE WAIVER WITHOUT HAVING
FUNDING RIGHT? BECAUSE THEN WE
CAN FIGURE THE FUNDING PART OR
DOES SOMEBODY THE WAIVER
CONTINGENT ON HAVING THE FUNDING
WILL GENERALLY I MEAN FROM FROM
A FEDERAL PERSPECTIVE, THEY WANT
TO KNOW WHAT WE WILL BE
IMPLEMENTING. UM, BUT YOU KNOW,
WE COULD SUBMIT I WOULD HAVE TO
CHECK WITH MY MEDICAID DIRECTOR
IN TERMS OF BUT WE DID LIKE THE
WAIVER PROCESS IS READY TO GO.
THAT IS NOT THE KIND OF A
BARRIER IN THE PROCESS BECAUSE
WE'RE SUPPOSED TO START THIS
NEXT YEAR. THAT IS, UH, THAT IS,
UH, WHAT THE STATUTE SAYS. IF
THE, UM THE FINANCE. UM UH,
PROVIDES THAT THERE'S
EXPENDITURE AUTHORITY. SO WHAT
HAPPENS IF MAYBE IF WE DO NOT
HAVE EXPENDITURE AUTHORITY. WE
ARE ALLOWED TO BYPASS THE
STATUE. OF THE ST TIME OF
JANUARY 2025. RIGHT. IF WE DON'T
HAVE A DOLLARS TO PAY FOR THE,
UM, THE POLICY THAT WE WOULD NOT
BE ABLE TO IMPLEMENT IT. HOW ARE
WE GETTING, SO THERE'S A
LOOPHOLE FOR US TO GET AWAY TO
GET AROUND. I'M HEARING YES. AND
SO IT'S SO IF WE DON'T HAVE
DOLLARS SUBJECT TO IT. YEAH SO
IT'S KIND OF HARD. I GOT IT.
THANK YOU SO MUCH. THAT'S THE
CORRECT TERM I WAS LOOKING FOR.
I DIDN'T MEAN TO ANSWER THE
DIRECTOR'S QUESTIONS. UM KATHY
MOSSBERG ON BEHALF OF THE FIRST
FIVE ASSOCIATION ON THIS ISSUE,
INCREDIBLY SUPPORTIVE. I
APPRECIATE THE LEADERSHIP OF
YOUR COMMITTEE. YOUR SUBCOMITTEE
AND THE LEGISLATURE. GENERALLY
YES, THAT IS OUR CONCERN. WE
KNOW THAT THE STAKEHOLDER
PROCESS HAS OCCURRED. WE'RE VERY
CONCERNED ABOUT THE WAIVER. NOT
GOING TO THE FEDS. WE HAVE. WE
HAVE THINGS COMING UP IN
NOVEMBER THAT WE ARE CONCERNED
ABOUT HOW ANOTHER, UH,
ADMINISTRATION WILL LOOK ON ON
THIS. WE KNOW OTHER STATES HAVE
DONE THIS. WE KNOW A NUMBER OF
CHILDREN TO THE POINT RAISED BY
MY PARTNERS HERE THAT OVER
270,000 KIDS HAVE FALLEN OFF. WE
KNOW HOW IMPORTANT 0 TO 5 IS,
AND THIS IS INCREDIBLY COST
SAVING AND IS VERY SMART POLICY.
WE ENCOURAGE YOU TO SUPPORT
THANK YOU. THANK YOU. GOOD
AFTERNOON, MADAM CHAIR MEMBERS
JOLI AND ADA WITH THE CALIFORNIA
STATE ASSOCIATION OF COUNTIES ON
BEHALF OF ALL 58 COUNTIES HERE
IN SUPPORT OF ISSUE 10 THE
PROPOSALS FOR INVESTMENT, THE
PRESENTATION YOU JUST HEARD FOR
CONTINUED FUNDING FOR THE
MEDICAL OUTREACH AND ENROLLMENT
FOR OLDER ADULTS PROJECT. THANK
YOU. THANK YOU SO MUCH. MADAM
CHAIR AND BUDGET COMMITTEE
MEMBERS. THANK YOU FOR THE
OPPORTUNITY TO SPEAK ON THE
CONTINUATION OF ME FOR OLDER
ADULTS AND WHEN I ALSO THANK
SENATOR DODD FOR CHAMPIONING
THIS REQUEST. I'M ELBA GONZALEZ
MARRI. I'M THE EXECUTIVE
DIRECTOR OF COMMUNITY HEALTH
INITIATIVE, UH, OR ORGANIZATION
PROVIDES SERVICES IN THE AREAS
OF LOS ANGELES, NAPA, SOLANO AND
SANTA CLARA COUNTIES. AND WE ARE
HERE TO UH UH, WE'RE THERE TO
SUPPORT THE ELDER, ELDERLY,
DISABLED, BLIND AND THOSE IN
POVERTY. I'M HERE IN THAT, UM,
REQUEST TO, UH, UH, TO CONSIDER
THE RECOMMENDATION TO REINVEST
IN THE CURRENT PROGRAM IN THE
EXPANSION OF THE PROGRAM FOR
ADDITIONAL COUNTIES, WHERE
THERE'S MUCH ADDITIONAL NEED.
THIS PROVIDES COST-EFFECTIVE
ASSISTANCE FOR OVER 107,000
VULNERABLE DUAL ELIGIBLES AND
OLDER ADULTS. THIS EXPANSION IS
CRUCIAL CONSIDERING THE 1.6
MILLION DUAL ELIGIBLE
INDIVIDUALS IN THE STATE AND THE
INCREASING NUMBER OF
CALIFORNIANS TURNING 65. WE
APPRECIATE YOUR CONSIDERATION TO
BUILD UPON THE EXISTING PROJECT
AND BETTER SERVE THOSE WHO ARE
MOST VULNERABLE. THANK YOU.
THANK YOU. KELLY BROOKS ON
BEHALF OF THE COUNTY HEALTH
EXECUTIVES ASSOCIATION OF
CALIFORNIA. WE HAVE COMMENTS ON
TWO ITEMS. FIRST WE HAVE
CONCERNS ABOUT THE èC Dð P
TRANSITION TO THE HEALTH CARE
PROGRAM FOR CHILDREN IN FOSTER
CARE. THE TRANSITION PLAN WAS
RELEASED JUST LAST FRIDAY. UH,
LOCAL PROGRAMS WILL NEED TIME TO
DIGEST THE PLAN AND MAY NEED
ADDITIONAL TIMES TO SUCCESSFULLY
TRANSITION AND STAND UP A STAND
ALONE. HICK PICK THICK PROGRAM
WE LOOK FORWARD TO ENGAGING WITH
THE LEGISLATURE AND
ADMINISTRATION TO ENSURE A
SEAMLESS TRANSITION. SECOND
REGARDING KI¾M IMPLEMENTATION WE
WANT HIGHLIGHT THAT THERE WAS NÓ
PATH FUNDING OPPORTUNITY FOR THE
POPULATION. HEALTH MANAGEMENT
STRATEGY SPECIFICALLY, ARE WE
ARE REQUESTING THAT UNEXPENDED
PUBLIC HEALTH WORKFORCE FUNDS BE
RE APPROPRIATED TO SUPPORT THE
POPULATION NEEDS ASSESSMENT
REQUIRED OF PUBLIC HEALTH
DEPARTMENTS AND MANAGED CARE
PLANS. LOCAL HEALTH DEPARTMENTS
DO NOT HAVE DEDICATED FUNDS TO
SUPPORT THIS NEW WORK WITH
MEDICAL MANAGED CARE PLANS.
THANK YOU, AND WE LOOK FORWARD
TO WORKING WITH THE
ADMINISTRATION AND LEGISLATURE.
THANK YOU. HØI GOOD AFTERNOON,
BETH MON OWSKI OF THE S¼ E, A
CALIFORNIA CAN MEMBERS WANT TO
START BY ACKNOWLEDGING Dð HÌ S¼
TIMELY ADMINISTRATION OF THE
CLINIC WORKFORCE STABILIZATION.
I HAVE SOME QUESTIONS WERE
RAISED ABOUT THE FUND SHOULD
ACKNOWLEDGE THAT WE ARE
SUPPORTIVE OF THE
ADMINISTRATION'S PROPOSAL TO
UTILIZE THE UNSPENT FUNDS TO
ADDRESS GENERAL FUND SHORTFALLS.
UM MOVING ON TO ISSUE FOUR. I
JUST APPRECIATE THE DEDICATED
TIME TODAY ON CAL AIM DID WANT
TO ACKNOWLEDGE THE ONGOING
DIALOGUE BETWEEN Dð HÌ èC S¼
COUNTY BEAVER HEALTH PROGRAMS
AND COMMUNITY BASED BEHAVIORAL
HEALTH PROVIDES REGARDING CAL, A
BEHAVIORAL HEALTH PAYMENT REFORM
. THERE WERE SOME CHALLENGES
AROUND THE RATE SETTING. UM
THERE ARE SOME IMMEDIATE
SOLUTIONS HAVE COME FORWARD
INTERIM SOLUTIONS THAT HAVE BEEN
PUT IN PLACE. WE APPRECIATE THAT
AND LOOK FORWARD TO WORKING WITH
THE DEPARTMENT ON KIND OF LONGER
TERM SOLUTIONS IN THAT AREA. UM
LASTLY, DO YOU WANNA JUST A
SECOND AND ACKNOWLEDGE THE
COMMENTS MADE BY MY COLLEAGUES
AT CHILDREN NOW? AND CIA, UM
WITH REGARDS TO THE èC HÌ èC P
TRANSITION, AS ACKNOWLEDGED, WE
ARE ACTIVELY REVIEWING THE
TRADITION PLAN THAT JUST CAME
OUT WHEN THIS WAS SET IN MOTION
IN FY 2120. WE ALWAYS HOPED THAT
IT WOULD COME BACK TO THIS BODY
BEFORE THE TRANSITION PLAN MOVED
FORWARD IN JULY 1 AND JUST
WELCOME ADDITIONAL SPACE AND
TIME TO DIALOGUE. ANY CONCERNS
WE HAVE REGARDING THE TRANSITION
PLAN AND CONTINUING DIALOGUE
WITH THE ADMINISTRATION AS WELL
ON THAT, SO THANK YOU. THANK
YOU. GOOD AFTERNOON, MADAM. I'M
SORRY. JESSICA RAN OF THE
CALIFORNIA DENTAL ASSOCIATION
HERE TO GIVE COMMENT ON ISSUE
NUMBER 10. IT WAS NOT FOR
PRESENTATION, BUT THE MEDICAL
EXPANSION FOR ADULT IMPLANTS.
UH, JUST WANTED TO MAKE COMMENT
THAT YOU KNOW, WE APPLAUD THE
SPONSORS FOR BRINGING THIS ISSUE
UP AND THEIR FOCUS ON THE
IMPROVING THE MEDICAL DENTAL
PROGRAM BUT WITHOUT ADDITIONAL
BUDGETARY INVESTMENTS TO MAKE
SURE THAT THE REIMBURSEMENT RATE
IS ADEQUATE. WE DO HAVE CONCERNS
ABOUT WHAT AN EXPANSION WOULD
LOOK LIKE WITHOUT ENSURING
PROPER ACCESS TO CARE. UM,
ADDITIONALLY, WE'D LIKE TO URGE
A SUB NEED TO EXPLORE OTHER
IMPORTANT AND CURRENTLY LACKING
BENEFITS. UM THAT WOULD THAT
COULD BE ADDRESSED BEFORE WE
EXPAND TO IMPLANTS. THERE ARE
STILL BASIC PREVENTIVE, UM, AND
TREATMENTS THAT COULD BE BETTER
SERVED MEDICAL ADULTS BEFORE
THEY, UM, TO HELP THEM MAINTAIN
THEIR EXISTING TEETH BEFORE
NEEDING TO GET TO THE POINT OF
AN IMPLANT. SO LOOKING FORWARD
TO WORKING WITH THE SUBCOMITTEE
ON THIS ISSUE, DO YOU KNOW I'M
TRYING TO FIND A PRICE TAG FOR
THIS? I I DON'T KNOW. IF ANYONE
IN YOUR GROUP HAS WE DO NOT HAVE
A PRICE TAG. I DON'T KNOW IF THE
èC S¼ HAS A PRICE TAG
AVAILABLE. UM OK. NÓ NÓ WORRIES.
THANK YOU. THANK YOU. GOOD
AFTERNOON CHAIR AND MEMBERS
KATIE LEIGHTON ON BEHALF OF THE
CHILDREN'S SPECIALTY CARE
COALITION. I JUST WANTED TO ECHO
SOME OF THE COMMENTS THAT WERE
ALREADY MADE ON THE 0 TO 5
CONTINUOUS COVERAGE PROPOSAL AND
JUST EXPRESS OUR SUPPORT. UH,
STRONG SUPPORT FOR THAT AS WELL
SO THAT, UM YOUNG CHILDREN CAN
HAVE ACCESS TO STABLE COVERAGE
WITHOUT THE WORRY OF
INTERRUPTION THROUGHOUT THESE
CRITICAL DEVELOPMENTAL YEARS.
UM, ALSO ON ME ENROLLMENT. WE'RE
CONCERNED ABOUT THE HIGH VOLUME
OF PROCEDURAL DISENROLLED THAT
HAVE TAKEN PLACE SINCE REDERMIC
RESUMED LAST YEAR. THIS HAS
AFFECTED THOUSANDS OF CHILDREN,
INCLUDING A DROP IN ENROLLMENT
FOR THE CALIFORNIA CHILDREN'S
SERVICES PROGRAM, SO WE JUST
WOULD URGE THE STATE TO DO
EVERYTHING POSSIBLE TO ENSURE
THAT THOSE WHO ARE ELIGIBLE FOR
MEDICAL AND èC èC S¼ MAINTAIN
THEIR COVERAGE. UM, LASTLY, I
JUST WANT TO THANK YOU FOR THE
CONVERSATION TODAY. IN YOUR
CONTINUED ATTENTION TO THE
HEARING AID PROGRAM AS WELL AS
ENHANCED CARE MANAGEMENT. UM, WE
KNOW THAT THE BUILDING OUT OF
THE NETWORK OF PEDIATRIC
PROVIDERS FOR èC M HAS BEEN
CHALLENGING, BUT WE THINK THE
DEPARTMENT FOR THEIR ONGOING
ATTENTION TO THIS ISSUE, UM AND
JUST ENCOURAGE CONTINUED PROBLEM
SOLVING ON HOW TO STREAMLINE THE
PROCESS FOR THOSE THAT MAY BE
INTERESTED IN PROVIDING SERVICES
TO CHILDREN AND YOUTH. THANK
YOU. THANK YOU. HELLO MADAM
CHAIR. HELLO SENATOR ROCK? UM
CHRISTINA ABBS HAMILTON HERE ON
BEHALF OF THE ASSOCIATION FOR
ADULT DAY SERVICES, AND I'VE
COME SEVERAL TIMES TO OTHER
HEARINGS, TALKING ABOUT THE
ISSUES WITH SEA BASS COMMUNITY
BASED ADULT SERVICES HOW THE
INDUSTRY IS BARELY STAYING
AFLOAT DUE TO ARTIFICIALLY LOW
REIMBURSEMENT RATES, AND WE HAVE
PROVIDED TO THE COMMITTEE A
PROPOSAL BASICALLY CREATE A
MINIMUM FLOOR OF WHAT? HÌ M Ó
REIMBURSEMENT RATES TO èC BASS
CAN BE BECAUSE RIGHT NOW WE HAVE
FOUR PLANS THAT NEVER RESTORED
THE 10% RATE CUT FROM BACK
DURING THE GREAT RECESSION SO
AND ALREADY LOW REIMBURSEMENT
RATE OF $78.76 DOLLARS A DAY.
SOME PLANS. I'M SORRY. SOME CVAS
CENTERS ARE GETTING $68 A DAY SO
THAT IT'S EVEN LESS FOR THEM TO
BE ABLE TO PROVIDE THESE
SERVICES. WE JUST ARE LOOKING
FOR LIKE A FLOOR. YOU CANNOT PAY
LESS THAN THE MEDICAL FEE FOR
SERVICE RATE JUST TO BRING SOME
STABILITY TO THIS. VERY UM,
INDUSTRY IN CRISIS AND THANK YOU
FOR VISITING A FACILITY IN YOUR
DISTRICT. YEAH ABSOLUTELY. THEY
WERE. THEY WERE SO HAPPY TO SEE
YOU. WE'LL BE TALKING MORE ABOUT
THIS TOPIC DURING OUR APRIL 18TH
MEETING. PERFECT. THANK YOU SO
MUCH. OK, I'M THE LAST ONE, SO
I'LL KEEP IT SHORT AND SWEET
MADAM CHAIR AND ESTEEMED MEMBERS
OF THE COMMITTEE. MY NAME IS
ALEXIS HEATON AND I AM WITH
CALIFORNIA COVERAGE AND HEALTH
INITIATIVES ON BEHALF OF THE
MEDI CAL FOR OLDER ADULTS
COALITION REPRESENTING THE
COALITION AND OUR REQUEST FOR
REAUTHORIZATION. WE THANK YOU
FOR YOUR TIME AND YOUR
CONSIDERATION. THANK YOU.
RECORD. TRUMP IN A PLAQUE BACK
HERE. YOU KNOW, TRY TO BREAK MY
RECORD. UH, WELL, UH, NÓ I SEE
NÓ OTHER PUBLIC COMMENT. THANK
YOU SO MUCH FOR JOINING US TODAY
THAT CONCLUDES BUDGET
SUBCOMITTEE NUMBER THREE ON
HEALTH AND HUMAN SERVICES.