By: Nathaniel J. Greene, Community & Culture Reporter

In an effort to ensure older adults and people with disabilities in California have access to quality, equitable care, the Department of Health Care Services (DHCS) has significantly expanded Medi-Cal programs. These initiatives were detailed during a briefing hosted by Ethnic Media Services on July 10, titled “Transforming Medi-Cal for Holistic Health Care.”

The transformation of Medi-Cal includes a range of new services designed to provide comprehensive, holistic care.

Anastasia Dodson, Deputy Director of the Office of Medicare Innovation and Integration at DHCS, emphasized the importance of integrating services across both Medi-Cal and Medicare.

“People who have Medicare can qualify for Medi-Cal also, and it helps them to afford their Medicare benefits,” said Dodson. “In California, there are about 6.6 million people with Medicare, and of those, 1.6 million have both Medicare and Medi-Cal. These dual-eligible individuals often have complex health conditions involving physical, behavioral health, or social needs.”

Dana Durham, Chief of the Managed Care Quality and Monitoring Division at DHCS, highlighted how the division ensures high-quality services for Medi-Cal members.

“Our division makes sure that managed care plans or Medi-Cal health plans provide high quality, accessible, and affordable services to Medi-Cal members,” Durham explained. “We are transforming Medi-Cal to provide more supportive and culturally sensitive care that supports older Californians and people with disabilities.”

One of the key initiatives is the Enhanced Care Management (ECM) program and its companion, Community Supports.

“ECM provides coordinated access to care, culturally competent care, better behavioral and physical health integration, and increased transparency,” Durham noted. “Community Supports offer services like home safety modifications, medically tailored meals, and respite care.”

Jenna LaPlante, Senior Director of Care Management Programs at the Institute on Aging, discussed how her organization transitioned to these new Medi-Cal services.

“Our goal is to maintain people in the least restrictive environment that they choose to be in,” said LaPlante. “We hired bilingual and bicultural staff to reflect the demographics of the communities we serve. For example, we hired Vietnamese-speaking care managers in San Jose, leading to a significant increase in engagement from that community.”

LaPlante also emphasized the importance of addressing social determinants of health.

“The goal is to use historically earmarked medical funding dollars to address larger issues like housing and mental health,” she explained. “We have funding to help with first month’s rent and security deposit for people finding housing and to make environmental modifications to homes, such as installing ramps and grab bars.”

Carrie Madden, Program Director of the Aging and Disability Resource Connection (ADRC) of Central and South LA, described how the ADRC operates a “no wrong door” system to assist callers with their needs.

“Our core services include information and referral, options counseling, and coordination of services,” Madden said. “Medi-Cal is helping move people off the streets and into stable housing.”

Keith Miller, Executive Director of CALIF (Communities Actively Living Independent and Free), elaborated on the impact of these services on the homeless population.

“We see things that no one should ever see here in Los Angeles,” Miller stated. “This reform is crucial. Providing first month’s rent and working with HMO partners to connect with social service agencies is very important.”

Lilly Sanchez, Case Manager at CALIF, shared a success story highlighting the real-world impact of these services.

“We helped a high-risk individual avoid entering a nursing home by coordinating care with his HMO and providing necessary social services,” Sanchez recounted. “Through our center, he received housing, in-home support services, and food, significantly reducing his emergency room visits.”

The transformation of Medi-Cal services represents a significant shift in how healthcare is delivered to older adults and people with disabilities in California. By integrating medical and social services and addressing social determinants of health, DHCS aims to improve long-term health outcomes and enhance the quality of life for Medi-Cal beneficiaries. This innovative approach sets a precedent for comprehensive, community-based care nationwide.