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Medi-Cal: New opportunities to bring quality health care to communities

Medi-Cal Changes: New Opportunities to Bring Quality Health Care to Communities
Given the transformation and changes to Medi-Cal, many vulnerable communities have been left without services due to non-renewal, but today they seek to expand services that go beyond the doctor's office, by offering to also address social needs related to a healthier life.

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Medical care is a right for everyone, however, given the transformation and changes of Medi-Cal, many vulnerable communities have been left without services due to non-renewal, but today efforts are being made to expand services that go beyond the consultation of the medical, by offering to also address social needs related to a healthier life. 

And the California Department of Health Care Services (DHCS) is transforming Medi-Cal so that Californians can receive the care they need to live healthier lives, as community supports aim to improve health and general well-being of members, addressing medical and social factors that may affect a person's health through programs such as: housing supports, home accessibility modifications, home care, sober living centers, asthma remediation, and nutritious, medically tailored meals.

A current Medi-Cal option is Enhanced Care Management (ECM), a new benefit that provides person-centered care management to members with the most complex needs.

Sarah Brooks, deputy director of health care programs at the California Department of Health Care Services, explained during a briefing rcarried out by Ethnic Media Services, which is working to ensure a better-functioning healthcare delivery system, with the help of various medical partners to transform the program and improve the lives and health of medical members.

?We work to ensure quality care for our physician members to achieve this, we are introducing and implementing several initiatives including new and improved services that go beyond the traditional doctor's office or hospital setting to address social physical and mental health needs. ?, commented Brooks.

In addition, he stated that they are working hard to standardize, simplify and streamline the way members across the state access care, no matter where they live, what language they speak or the complexity of their needs, with the goal that all Californians regardless of their ethnicity, gender, sexual orientation, disability, age, immigration status and health needs, can live healthier lives

She explained that care managers are supported to ensure that they receive the services they need in their communities, no matter where they are, whether at home, in a care facility, in a doctor's office or even in streets. These care managers help physician members navigate substitute treatment care for mental health, dental, basic, and specialty disorders.  

To ensure service, if a member moves from one county to another, has the same benefits when accessing care from one health plan to another, partners with local agencies such as health department school systems, school services, child welfare and justice, among others, he stressed. 

He stated that more Californians are eligible to enroll in health care.

?If you know someone who used to be enrolled in healthcare but lost the company, didn't qualify for coverage, help encourage them to reapply, you can do this by mail or online https://www.dhcs.ca.gov/ ?, ended Sarah Brooks. 

For her part, Rachelle Grant, senior clinical director of Pacific Clinics, California's largest providers of community-based behavioral health and support services, with more than 2,000 employees, explained that they provide services in more than 22 languages. people of all ages, in addition to serving the entire behavioral health spectrum. 

He recalled that they also support those who are homeless, since they are the ones who frequently hospitalize those who have mental health and substance problems.  

?We're now serving 20 counties, with eight health plans, so it's very exciting for us. There are three specific housing topics that help people find a home and get their deposit?, commented Rachelle Grant.

He added that they have made 27,000 contacts with eligible members since the beginning of Enhanced Care Management (ECM), they have also provided services to 1,600 clients in ECM and 600 more in housing programs for California.  

Agnes Hajek, director of health equity services, Somali Family Services of San Diego, said they have multilingual community health workers who provide health information and education to people.

One of the ways they have implemented is that 20 people come every week to be part of the town hall meeting, seeking to educate and provide a support system to the population where they feel that they belong, because when they leave they are able to communicate with their community. in your own language.

?It's also core to the way we do things, that we're building and maintaining interpersonal relationships with the community to be able to help them address their concerns and their issues in all of these things.?, Agnes Hajek added.

Angélica Rodríguez, program director at Umma Community Clinic, explained that they primarily work south of Los Angeles in family-friendly communities known as South Central communities, which are predominantly low-income, black communities that have historically been underfunded.  

So, Uma provides high-quality medical, behavioral and dental care, regardless of ability to pay.

?There are cultural barriers with providers that can develop misunderstandings or frustration, which can then affect the patient following their care plan or even abandoning it, so it is important to develop a care plan. Others may have difficulty with transportation and have to take more than two buses to get to the healthcare clinic closest to their home, another factor to consider.?, Rodríguez emphasized.

Mari Pérez Ruíz, executive director of the Central Valley Empowerment Alliance, shared that Tulare County is one of the poorest communities in California and the areas they are working in are often at the highest level of child poverty. . 

?Approximately 90 percent of the members of our community are agricultural workers, and in our organization we have been able to identify that 99 percent of the homes in Tulare located in rural communities are not habitable.?, Perez added. 

Pérez explained that they are working with the community from the Philippines in Tulare, which has the highest poverty rate, so they have sought to associate them with the county's Public Health Equity initiative, to improve their conditions and give them more opportunities.

?We have seen that the crisis in our global community is so deep that, in fact, we have identified community members who are coming because they no longer know they have a serious condition and we were able to connect them with a healthcare provider until the next day,? Perez concluded.

You may be interested in: Children's health services in California at risk due to lack of funding

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