Overview and Children’s Advocates’ Response The Healthy Families Program Transition into...

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Overview and Children’s Advocates’ Response The Healthy Families Program Transition into Medi-Cal Christine Sebastian Health Program Associate The Children’s Partnership ITUP Inland Empire Regional Meeting October 19, 2012 www.childrenspartnership.org

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Page 1: Overview and Children’s Advocates’ Response The Healthy Families Program Transition into Medi-Cal Christine Sebastian Health Program Associate The Children’s.

Overview and Children’s Advocates’ Response

The Healthy Families Program Transition into Medi-Cal

Christine SebastianHealth Program AssociateThe Children’s Partnership

ITUP Inland Empire Regional MeetingOctober 19, 2012

www.childrenspartnership.org

Page 2: Overview and Children’s Advocates’ Response The Healthy Families Program Transition into Medi-Cal Christine Sebastian Health Program Associate The Children’s.

Budget Decision

The Governor’s budget for FY 2012/13 eliminated the Healthy Families Program (HFP) and will transfer all HFP enrollees to Medi-Cal beginning no sooner than January 1, 2013.

Page 3: Overview and Children’s Advocates’ Response The Healthy Families Program Transition into Medi-Cal Christine Sebastian Health Program Associate The Children’s.

Basics of the Transition

Transfer nearly 900,000 HFP children to Medi-Cal no sooner than January 1, 2013, over 4 phases

Strategic plan

Stakeholder engagement with DHCS and DMHC Legislative oversight

Consultation with CMS

MRMIB board meetings

Page 4: Overview and Children’s Advocates’ Response The Healthy Families Program Transition into Medi-Cal Christine Sebastian Health Program Associate The Children’s.

Phases of the Transition

Phase 1 (No sooner than January 1, 2013) Broken into 2 sub-phases

Phase 2 (No sooner than April 1, 2013)

Phase 3 (No sooner than August 1, 2013)

Phase 4 (No sooner than September 1, 2013)

Page 5: Overview and Children’s Advocates’ Response The Healthy Families Program Transition into Medi-Cal Christine Sebastian Health Program Associate The Children’s.

County-by-County Numbers on the Transition Number of children who will transition per phase

for Imperial, Riverside, and San Bernardino counties

County Phase 1 Phase 2 Phase 3 Phase 4

Imperial 0 0 0 4,373

Riverside 37,414 24,194 13,535 0

San Bernardino

29,742 21,603 9,939 0

Page 6: Overview and Children’s Advocates’ Response The Healthy Families Program Transition into Medi-Cal Christine Sebastian Health Program Associate The Children’s.

Pre-requisites for an Effective, Responsible Transition

1. Implementation timeline must be flexible

2. Implementation plan must be submitted and reviewed

3. Performance and monitoring standards must be created

Page 7: Overview and Children’s Advocates’ Response The Healthy Families Program Transition into Medi-Cal Christine Sebastian Health Program Associate The Children’s.

Pre-requisites for an Effective, Responsible Transition

4. Provider network adequacy report must be submitted

5. Federal approvals and guidance must be confirmed

6. Outreach and communication must be coordinated and comprehensive

Page 8: Overview and Children’s Advocates’ Response The Healthy Families Program Transition into Medi-Cal Christine Sebastian Health Program Associate The Children’s.

Concerns

Readiness

Federal approval

Lack of an implementation plan

Network adequacy/access

Page 9: Overview and Children’s Advocates’ Response The Healthy Families Program Transition into Medi-Cal Christine Sebastian Health Program Associate The Children’s.

What Families Should Expect

General notice 60 and 30 day notices for Phase 1 90, 60, and 30 day notices for Phases 2-4 Medi-Cal welcome packet Benefit Identification Card (BIC) Packet from managed care plan (and dental

managed care plan, where relevant)

Page 10: Overview and Children’s Advocates’ Response The Healthy Families Program Transition into Medi-Cal Christine Sebastian Health Program Associate The Children’s.

Next Steps

Continue to monitor transition implementation

Ensure that pre-requisites for an effective, responsible transition are met

Page 11: Overview and Children’s Advocates’ Response The Healthy Families Program Transition into Medi-Cal Christine Sebastian Health Program Associate The Children’s.

Key Upcoming Dates

Network adequacy assessment targeted to be released by November 1

Upcoming Stakeholder Webinars: October 23, 2-4pm

December 7, 1-3pm

Upcoming Legislative Oversight Hearings: Assembly Health hearing on HFP transition and other issues, October 25, 1:30-4:30pm

Assembly Budget hearing on Denti-Cal in Los Angeles, November 9

Page 12: Overview and Children’s Advocates’ Response The Healthy Families Program Transition into Medi-Cal Christine Sebastian Health Program Associate The Children’s.

Key Websites on the Transition

MRMIB http://www.mrmib.ca.gov/MRMIB/

HFPTransition.html

DHCS http://www.dhcs.ca.gov/services/Pages/

HealthyFamiliesTransition.aspx

Page 13: Overview and Children’s Advocates’ Response The Healthy Families Program Transition into Medi-Cal Christine Sebastian Health Program Associate The Children’s.

For More Information

TCP’s Website: www.childrenspartnership.org

Contact me: Christine Sebastian

Health Program AssociateThe Children’s [email protected]


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