DATE:
December 10, 2024
31
TO:
Board of Supervisors
SUBJECT
Title
AN ANALYSIS OF BARRIERS TO OPTIMAL MEDI-CAL TRANSFORMATION IMPLEMENTATION, A FEASIBILITY ASSESSMENT FOR A PUBLIC AWARENESS CAMPAIGN, AND DEVELOPMENT OF A HEALTHY SAN DIEGO TASKFORCE (DISTRICTS: ALL)
Body
OVERVIEW
Medi-Cal is a vital government program that provides healthcare coverage to low-income individuals and families throughout the state. Medi-Cal serves nearly a million people in San Diego County and continues to grow with the eligible population doubling over the past decade. Medi-Cal Transformation (formerly known as CalAIM) is an initiative under the Department of Health Care Services (DHCS) that includes broad reforms to the Medi-Cal system. This initiative seeks to advance positive social and health outcomes by addressing the social drivers of health and connecting individuals with community resources and services that support their overall well-being beyond simply access to medical treatment. Several Medi-Cal Transformation programs are targeted at providing specialty services for the most medically complex individuals as 5% of the highest need Medi-Cal members account for nearly half of all Medi-Cal spending.1 The primary programs within Medi-Cal Transformation that will facilitate the connection of these individuals with the services and supports they need are Enhanced Care Management (ECM) and Community Supports (CS). ECM and CS were developed with the intention that these services would be delivered by local providers who have experience and specialized knowledge about their communities and can provide services in the most accessible and culturally appropriate way.
Enhanced Care Management (ECM) supports members with complex clinical or non-clinical needs by connecting them with a lead care manager. ECM is intended to serve individuals from populations of focus including, but not limited to, individuals who are unhoused, have a diagnosis of a serious mental illness or ...
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