L.A. Care supporting unhoused members through work on the ground

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State of Reform

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In its ongoing efforts to support members who are experiencing homelessness, L.A. Care launched a new program that deploys staff to temporary housing locations. They assist members with housing navigation and enhanced care management (ECM). 

The health plan launched the effort in March. Charlie Robinson, senior director of community health at L.A. Care, said the plan covers many individuals who are experiencing homelessness, and a primary challenge has been trying to engage many members who are spread throughout the county. 

“With interim housing, in particular, as several interim housing programs have been ramping up to address the crisis, interim housing emerged as a really good opportunity for us to engage members when they move into interim housing sites,” Robinson said. 

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Interim housing presents an important opportunity for L.A. Care, Robinson said, because the plan can work with city, county, and other municipalities to meet people when they first move in. He said L.A. Care social workers are primarily focused on housing-related support, resources, and ECM, but will offer all services members are authorized to receive under Medi-Cal. 

ECM is a statewide Medi-Cal benefit that launched in 2022, and focuses on providing whole-person care to tackle both clinical and nonclinical needs. Medi-Cal beneficiaries who qualify for ECM will be connected to a lead care manager who serves as a primary contact point in connecting a member to the proper and tailored care that fits their needs. 

“When they move into an interim housing site, we know where they are, (and)we know where they’re going to be for a certain period of time,” Robinson said. “We can actually meet them where they are and engage them in these services.”

The housing navigation initiative aims to move beneficiaries from interim housing to permanent supportive housing. Robinson said L.A. Care will continue to expand the program, and staff have visited about 17 sites since March. This in-person engagement has led to about 100 referrals for services, Robinson added. 

“We’re on track to hit 200 at the end of the year, but that’s only a small portion of what’s needed,” Robinson said. “We’re just getting started. We recognize there’s a lot of need out there.” 

L.A. Care updates prior authorization codes, giving physicians more flexibility

L.A. Care also recently announced an updated list of codes that require prior authorization, which will allow greater flexibility among physicians to create member-focused and medically-appropriate decisions in a timely fashion. To date, the health plan has removed 24 percent of the existing codes to help avoid delays in care, speed up discharge requests, and decrease the administrative burden among providers. 

Over 50 percent of all laboratory tests and radiology codes, most specialty care office visits, durable medical equipment, and catheter supplies will no longer require prior authorization.

Removing these codes gives physicians the flexibility to make member-centric and medically-appropriate decisions in a timely manner. 

Readers interested in learning more about California health policy can register to attend the 2024 Southern California State of Reform Health Policy Conference on Sept. 11 at the Westin Pasadena Hotel. An “Innovations in Care Coordination” panel will be held at 1 p.m. 

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