5 Things California: Medi-Cal redeterminations, Older adult homelessness, Naloxone vending machines


Eli Kirshbaum


In this edition, we provide an update on some of the work underway to prepare for Medi-Cal redeterminations, conversations in the legislature about how to respond to the high rate of older adults experiencing homelessness, information about San Diego County’s first naloxone vending machine, and more.

We recently released the Topical Agenda for the 2023 Northern California State of Reform Health Policy Conference! Take a look to see the conversations we have scheduled for the event in Sacramento on May 23rd. You can register here!

Thanks for reading!


Eli Kirshbaum
State of Reform 

1. As Medi-Cal redeterminations draw near, stakeholders work to prevent coverage loss

California’s health sector is hard at work preparing to minimize the negative impacts of Medicaid redeterminations. The state will begin the eligibility renewal process next month, is using the full 14 months allowed by the federal government, and is assigning each beneficiary a renewal month, with the longest-enrolled individuals being reviewed first. The first disenrollments from the program—for those among the first-evaluated group who are deemed ineligible—are set to occur in July.

Health Net recently spoke with State of Reform about their new “Review to Renew” campaign, which disseminates information and resources about redeterminations to enrollees. The health plan’s main priority is ensuring members who remain eligible update their contact information so they’re able to renew and don’t lose coverage, and making sure those no longer eligible are connected to alternative coverage options. The health plan is also driving RVs to connect with enrollees who don’t have internet access and providing CBOs with informational materials to disperse among the community.


2. State leaders discuss how to address growing number of homeless older adults

State lawmakers heard from stakeholders earlier this month about the increasing number of older Californians experiencing homelessness. Patti Prunhuber, director of housing advocacy for the advocacy group Justice in Aging, said adults older than 55 are the fastest growing population experiencing homelessness in California. The number of Californians over 65 experiencing homelessness more than doubled from 2017-2021. “This trend will continue unless we swiftly take steps to reverse it,” she said.

Potential solutions include interventions like the state’s Housing and Disability Advocacy Program, which assists individuals experiencing homelessness who are also likely receiving SSI benefits. According to Prunhuber, 36% of the state’s homeless population has disabling conditions. The California Dept. of Social Services is also recommending solutions through this year’s budget, including $3.5 million in ongoing funds to fund permanent staff positions in its Housing and Homelessness Division.


3. San Diego County installs first naloxone vending machine

San Diego County recently installed its first naloxone vending machine as part of the region’s response to high opioid overdose rates. In a statement to State of Reform, Anita Lightfoot from the county’s health agency noted the machine isn’t intended as an emergency resource (those experiencing or witnessing overdoses should instead call 911), but rather to provide naloxone access to individuals in need before an overdose even happens.

The machine can hold up to 180 naloxone kits, each of which has two four-milligram doses of naloxone. Individuals must go through online training in order to access the machines. According to Kattan, the second machine will be installed in the coming months, with 10 additional machines planned to be installed throughout the county over the rest of the year. Our goal is to provide multiple points of distribution … to get this life-saving medication smartly distributed throughout our community,” Kattan said.


4. Top bills to watch for California physicians

The California Medical Association recently announced its priority legislation for this year’s legislative session, which includes bills that aim to further protect abortion rights in the state. One of these would ensure that providers of abortions in the state have access to insurance liability coverage, and another would protect these providers from civil action for conducting the procedure.

CMA is also supporting bills to create exemptions for the prior authorization process, increase linguistic/cultural competency in the state medical board’s promotion of continuing medical education, and promote transparency in medical advertising. “Healthcare consumers need increased clarity and transparency in the education and training of their healthcare providers,” CMA said of the latter bill. “Confusing or misleading healthcare advertising and communications has the potential to put patient safety at risk.”


5. Advocates say CalWORKS program needs improvement

Some California health leaders are saying CalWORKS, the state’s main program for providing cash aid to in-need families, is in critical need of reform. Linda Nguy, senior policy advocate at the Western Center on Law and Poverty, said during a recent committee meeting on CalWORKS that the program is “deeply flawed” and advocated for the removal of sanctions for parents who don’t complete CalWORKS paperwork.

In response to these alleged flaws, several advocacy groups are supporting a proposal package that includes calls to remove pejorative/racist language in the program’s statute and replace it with more positive, family-centered language; remove the penalty-focused aspect of CalWORKs’ Welfare-to-Work requirement; and offering families resources like housing support and mental health services at the time of application.