New CalAIM-focused position at CalOptima will prioritize culturally appropriate Community Supports delivery

Aiming to improve the delivery of CalAIM services to beneficiaries, CalOptima, the public entity overseeing Medi-Cal in Orange County, recently created a new position titled “Executive Director of Medi-Cal/CalAIM.” According to CalOptima representatives, the position is the first of its kind to be rolled out by a health plan in the state.

 

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The position was given to Kelly Bruno-Nelson, who formerly served as President and CEO of National Health Foundation (NHF), a Los Angeles-based nonprofit organization working to improve the health of underserved communities. Bruno-Nelson says this new leadership position will help further CalOptima’s role in fulfilling the goals of the statewide CalAIM initiative, particularly regarding the Community Supports to address beneficiaries’ social determinants of health.

With CalOptima being one of the few state health plans to offer all 14 of CalAIM’s Community Supports, Bruno-Nelson says the creation of a team within CalOptima devoted solely to overseeing the rollout of CalAIM will help ensure that CalOptima is in alignment with the Department of Health Care Services’ (DHCS) rules and guidelines, as well as constantly advancing to better meet the needs of members.

“[CalOptima] is a health plan recognizing that the social determinants of health, which are 80% of our ability to be healthy, really should be front and center,” Bruno-Nelson said. “Health plans really have put direct health care at the center of everything, and that philosophical switch has been very difficult to make, and I think CalOptima, by creating this position, is really setting the bar on what that looks like.”

She said her position will be focused on applying research and developing best practices to expand on the basic guidelines and services outlined by DHCS, and to make implementation of CalAIM as smooth as possible. Community Supports Liaisons, for example, will be appointed for the sole purpose of helping CalOptima’s Community Supports providers.

“[We will be] looking at each one of those 14 Community Supports and saying, ‘What are the minimums? What are the parameters? What do our members need, and how can we expand those services?’” Bruno-Nelson said.

“It’s quite literally engaging the [Community Supports providers] in those discussions, and then trying to develop services within each of those parameters that are more reflective of the needs of our members … It’s just taking a program that could be implemented in a meat and potatoes way, and really just trying to expand our thinking, and the best way to do that is to engage the community based organizations that are providing the services.”

She emphasized her excitement to expand beyond the services outlined by DHCS to better tailor services to CalOptima members, and to root the delivery of each of the Community Supports in the dignity of members.

“For example, [with medically tailored meals], do those medically tailored meals need to be provided in the traditional way? Do they have to be a Meals-On-Wheels service? Could it be a food pharmacy? There’s a lot of different ways to provide meals that are culturally more appropriate and ultimately more dignified.

That’s the dignity behind the services, is not to just go the easy route, but to go the dignified route that makes our members feel more human and just feel equitable.”

Bruno-Nelson added that she hopes to collaborate and share ideas with other health plans as CalOptima’s work in this space continues.

“I hope that we can be a role model, I hope we can provide assistance. I don’t think that CalOptima is going to do all this work and then keep all these great ideas close to us … The more people that learn what we’re doing and we can partner with, the better.”