This edition of “5 Things We’re Watching” features stakeholder thoughts on Newsom’s vetoes of well-supported bills, a conversation on CalAIM with Local Health Plans of California CEO Linnea Koopmans, and a look at how CalOptima is leveraging text messaging to get more Medi-Cal members vaccinated.
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Health Policy Reporter
State of Reform
With help from Soraya Marashi
1. Newsom vetoes several widely supported health bills
During a flurry of bill signings in the first half of October, Gov. Newsom vetoed several bills that received ample support in the legislature. Sen. Eggman told State of Reform the veto of her bipartisan-backed bill to create a Rare Disease Advisory Council was “disappointing” and that she will continue to advocate for the rare disease community, although she said she’s still evaluating what legislation she will sponsor next year.
Following the veto of Sen. Skinner’s bill to prohibit patient steering, in which Newsom claimed the bill’s language was unclear, CPhA said California missed an opportunity to show that it “… believes in protecting the rights of patients over the profit-driven motives of multi-billion corporations.” After Newsom vetoed her bill to cover street medicine workers through Medi-Cal, arguing CalAIM would address the issue, Sen. Kamlager said: “Waiting for [CalAIM] to get up and running … means that we are kicking the proverbial can down the road, as it relates to addressing street medicine for the unhoused.”
2. Q&A: Local Health Plans of California CEO Linnea Koopmans talks CalAIM
Local health plans are focused on ensuring there is a smooth transition from providing whole-person care through pilot programs to making these services a standardized, statewide benefit through enhanced care management (ECM), according to Linnea Koopmans. Having recently assumed the role of CEO at Local Health Plans of California, Koopmans spoke with State of Reform about ECM, Medi-Cal Rx, RFP procurement, and what local health plans are focusing on in anticipation of the beginning of CalAIM’s rollout in Jan. 2022.
In this Q&A, Koopmans told State of Reform it’s important to not view CalAIM as a set of separate initiatives but as a cumulative effort to address social determinants of health in California — the results of which won’t be clear for the next year or so. “All of these significant changes and proposals will be happening at the same time, the point being, the work will be immediate, but the transformation will take time,” she said.
3. Topical Agenda for So-Cal conference now available!
In case you missed it, we released the Topical Agenda for our 2021 Southern California State of Reform Health Policy Conference a couple weeks ago! Our first in-person event since the beginning of the pandemic, this conference will be held at the Hilton San Diego Bayfront on Dec. 2nd.
To ensure the event is as safe as possible, we will be requiring proof of vaccination as well as mandatory mask-wearing for all attendees. Special thanks to our Convening Panel, who helped us identify pertinent panel topics including a “deep dive” into CalAIM, how population health management is changing, and the impacts of ARPA funding. Register to join us here!
4. CalOptima uses texting to boost Medi-Cal vaccination rates
After receiving special authorization from DHCS to send text messages to its members, CalOptima is conducting text messaging campaigns to bolster lagging vaccination rates among California’s Medi-Cal population. DHCS data shows vaccination rates of Medi-Cal beneficiaries lag far behind those of Medicaid members in other states.
Through campaigns that correct vaccine misinformation and a rewards program for members who get vaccinated, CalOptima’s text messaging initiatives have successfully boosted Medi-Cal vaccination rates. Pshyra Jones, CalOptima’s director of population health management, said TCPA restrictions should be removed to allow health plans to text their members outside of public health emergencies, saying: “… there are so many other things that we can do around texting. We can talk to our members about their gaps in care, give them some reminders or tell them about the importance of having their kids in for those well-child visits, or getting those preventative screenings.”
5. “Promotores” will play key role in CalAIM implementation
Community health workers — or “promotores” — will be instrumental in California’s CalAIM transition, according to leaders of CHCF’s “Advancing California’s Community Health Worker & Promotor Workforce in Medi-Cal” project. In a recent webinar, the project’s contributors discussed how their new online resource center can help Medi-Cal managed care plans integrate CHWs into their services as CalAIM starts to roll out next year.
Shannon Mong, managing consultant at In-Sight Associates, explained that CHWs’ unique connections to their communities make them “well-positioned to play a key role” in CalAIM service delivery. CalAIM’s enhanced care management program, for instance, will benefit from the help of these CHWs who already have strong ties with community members in need of these services, said Carlina Hansen, senior program officer at CHCF.