5 Things California: Q&A w/Jacey Cooper, Topical Agenda, Medi-Cal Rx


Eli Kirshbaum


It’s an odd time in COVID. Public opinion has turned gloomy, with Gallup reporting that more people are pessimistic about the future of COVID and getting the disease than are optimistic. That’s the first time since January that more folks are worried than hopeful.

Moreover, 1 in 3 vaccinated individuals are now “somewhat” or “very worried” about getting COVID. Thanks for hyping that 0.1% chance, media. Hope it was worth it.

Meanwhile 20% of unvaccinated individuals are “somewhat” or “very worried” about getting COVID. Maybe 80% of unvaccinated folks are a bit overconfident here. But, for those 20% that are worried, there is a vaccine. It will keep you from getting sick, and almost absolutely keep you out of the hospital. You’ll have less worry by getting it — trust me on this…




                                                                                          With help from Emily Boerger

1. Q&A: Jacey Cooper talks Medi-Cal, CalAIM, and federal support

“California likes to lead naturally,” said Medicaid Director Jacey Cooper when asked about the significance of the state’s recent Medi-Cal expansions. In this Q&A, Cooper describes the expansion of coverage to undocumented individuals over 50 and the elimination of the Medi-Cal asset test as “big steps” toward the state’s goals of universal health care coverage and closing equity gaps.

Cooper also shared her thoughts on the Biden administration’s “remarkable” financial support during the pandemic. “I think if COVID has really taught us anything, it’s that we need to invest in HCBS (home and community based services), social determinants of health, and closing equity gaps. Those are three clear things that COVID has highlighted in regards to policy priorities. As you can see, those are very clear policy priorities of the Biden-Harris administration.”


2. LA Topical Agenda now available

In case you missed it, we recently released the Topical Agenda for the 2021 Los Angeles State of Reform Health Policy Conference coming up on September 23rd! It’s a set of topics pulled together from scores of hours of conversations with our Convening Panel, key stakeholders, and sponsors. Panels will discuss how safety net providers are faring during the pandemic, health care affordability, the digital divide, and much more.

You can view the Topical Agenda here for a sense of the conversations we have teed up, and if you have suggestions for speakers let us know. If you haven’t already registered, we’d be honored to have you join us!


3. Medi-Cal Rx to be implemented Jan. 2022

After considerable delay, DHCS announced last week it will implement its Medi-Cal Rx program in January 2022. The program – which will transition Medi-Cal pharmacy services from a managed care to a fee-for-service delivery system – was initially slated to begin in January 2021, but was later delayed when Centene Corporation announced its acquisition of Magellan Health, Inc. Magellan had previously won a competitive RFP to be the primary vendor to the Medi-Cal Rx program.

The announcement came after DHCS accepted a Conflict Avoidance Plan from Magellan, which addresses DHCS’s conflict of interest concerns about the acquisition, since Centene oversees managed care plans and pharmacies that participate in Medi-Cal. The avoidance plan affirms that Magellan’s health data will be kept completely separate from Centene.


4. Nurses and hospitals disagree on staffing oversight

In an effort to prevent severe nurse burnouts from happening again, California nurses are supporting a bill to mandate that hospitals regularly report their nurse staffing levels. The CNA-backed SB 637, introduced by Sen. Newman, would require hospitals to provide CDPH information on nurse staffing shortages on a weekly basis during statewide public health emergencies, and on a monthly basis at all other times. The bill passed the Senate and awaits action in the Assembly.

The bill is in response to Newsom’s relaxation of nurse-to-patient ratios during the pandemic, which CNA says burdened the state’s nurses with more patients than they could handle. “With the submission of a form, hospitals were allowed to assign nurses in all units, including the ICU, more patients than studies have shown to be safe,” said a CNA representative. Hospital are opposed to the initiative, with CHA saying the proposed reporting requirements will impede hospitals’ ability to care for patients.


5. Omnibus health trailer bill becomes law

Last week, Gov. Newsom signed AB 133, an omnibus trailer bill, into law. The broad health bill’s passage solidifies policies that were previously agreed upon in budget negotiations including broad Medi-Cal expansions, a framework for a statewide health information exchange, $4 billion to establish a youth behavioral health system, and a Behavioral Health Infrastructure Program.

The bill was sponsored by Asm. Arambula, a strong advocate of Medi-Cal expansion. Newsom said in a statement: “I thank the Legislature for its steadfast partnership to bring California closer to universal health care coverage and advance comprehensive initiatives to ensure California’s communities come back from the pandemic stronger and healthier than before.”