December’s Outreach Events Recap

December 9, 2016

Highlighted Outreach Events

San Diego County

11/3 – The Mira Mesa Senior Center sponsored a town hall meeting that featured a panel of experts who discussed the CCI. The panel included a state outreach coordinator, a primary care physician from a Federally Qualified Health Clinic (FQHC), a staff lawyer, a Community Health Group plan manager, and an outreach coordinator from Consumer Center for Health Education and Advocacy (CCHEA) and Legal Aid in San Diego. The panel covered the value of care coordination and plan options available to beneficiaries who qualify. CCHEA’s representative focused on issues that beneficiaries had previously reported and offered resources to help address issues including balance billing, gaps in eligibility, and benefit coverage. The panelists also addressed the audience’s individual questions.

Orange County

golden-future 11/5 – During the 6th Annual Orange County’s ‘Golden Future 50+ Senior Expo’, a diverse group of attendees heard a presentation on Cal MediConnect. Seniors, adults with disabilities, caregivers, and social workers from Orange and Los Angeles counties learned about plan benefits and the enrollment process. Attendees asked many questions about the program’s procedures and more specific questions about their own health plan concerns. Patrons also collected copies of the Cal MediConnect Beneficiary Toolkit, along with other information in Vietnamese, Tagalog, Spanish, and Korean. This event drew hundreds of people and provided the community at-large access to over six healthcare-related vendors.

San Diego County

natlcitymtg 11/7 – Representatives from Federally Qualified Health Clinics (FQHCs), Meals on Wheels, the Aging & Independent Services Team, Program of All Inclusive Care for the Elderly (PACE), and local non-profit organizations took part in a CCI presentation at the National City Collaborative Partners’ Meeting. The presentation covered the value of coordinated care, the latest data showing Cal MediConnect’s positive impact on beneficiary / provider interaction, and the additional benefits (vision, transportation, and care coordination) that Cal MediConnect provides its enrollees. Following the presentation, attendees had the opportunity to get their questions answered and they received fact sheets with more information.

San Bernardino County

11/19 – English- and Spanish-speaking seniors alike participated in a Cal MediConnect Town Hall event in San Bernardino County. Presentations in English and Spanish explained the CCI’s elements, value proposition, and available health plans, and a panel of experts answered the audience’s specific questions. The panel included a state outreach staff member, and representatives from the CCI Advisory Committee Board, the Health Insurance Counseling and Advocacy program, Inland Empire Health Plan, Inland Counties Legal Services, InnovAge Greater California PACE, and Molina Healthcare. The event was co-hosted by Fifth Street Senior Center, Regal Medical Group, Senator Connie M. Leyva, and Assemblymember Cheryl R. Brown.

San Diego County

sd-psych-02 11/16 – Social workers and case managers at the San Diego County Psychiatric Hospital learned about the CCI during a presentation. The discussion focused on the value of coordinated care for beneficiaries with mental & behavioral health conditions and the providers who see them. The state outreach coordinator who led the presentation discussed the care coordinator’s role in a patient-centric and inter-disciplinary care team. Social workers were interested in how Cal MediConnect care coordinators can assist beneficiaries who are transitioning from a hospital to a long-term care home or assisted living facility. Following the presentation and question-and-answer session, copies of the Physician Toolkit and Case Manager’s Toolkit were distributed.

Los Angeles County

altamed 11/19 – Representatives from Neighborhood Legal Services, the Department of Public Social Services, the Personal Assistance Services Council (PASC), advocacy agencies, medical group staff, local community clinics, and Good Samaritan Hospital employees attended a CCI Informational Forum and Resource Fair, which was hosted by AltaMed Medical Group and the AltaMed PACE Program. The event included a CCI presentation, which covered plan benefits, enrollment, care coordination, authorizations, and continuity of care. The subsequent question-and-answer session gave participants to ask questions from Neighborhood Legal Services, AltaMed Medical Group, AltaMed PACE Program, PASC, and others.

Other Recent Outreach Events

Los Angeles County:

11/5 – Informational table for seniors and caregivers at the San Gabriel Valley Disability Collaborative Senior Resource Fair
11/12 – Informational table for seniors and caregivers at the Health Fair at Chinatown Service Center in Chinatown
11/12 – Informational table for seniors and caregivers at the 2016 Fall Health Awareness Community Fair
11/17 – Webinar for advocates and administrators
11/18 – Webinar for physicians and billing staff
11/19 – Informational table for beneficiaries, caregivers, and families at Celebrando Su Salud en Familia Health Fair

Orange County

11/29 – Webinar for advocates and caregivers
11/30 – Webinar for providers and staff

Riverside and San Bernardino Counties

11/3 – 2016 Caregiver Training, Appreciation, and Resource Fair in Riverside County
11/3 – Presentation for staff and beneficiaries at the Consulate of Guatemala in San Bernardino County
11/3 – Presentation to SEIU long-term care workers
11/15 – Webinar for advocates and administrators
11/16 – Webinar for physicians and billing staff
11/16 – Informational table for seniors and caregivers the National Caregiver Appreciation Day
11/18 – Informational table for seniors and caregivers at the Caregiver Appreciation, Training & Resource Fair
11/30 – Presentation for seniors and caregivers at the Caregiver Appreciation Celebration in Riverside

San Diego County

11/15 – Webinar for physicians and billing staff
11/22 – Presentation for representatives of the San Diego County Health & Human Services Agency and local senior-service organizations

Santa Clara County

11/3 – Informational table for seniors at the San Jose Library
11/4 – Informational table for seniors at the Morgan Hill Senior Café
11/5 – Presentation for seniors and their caregivers at Tzu Chi Buddhist Community Center
11/7 – Informational table for seniors at Campbell Community Center
11/8 – Presentation for seniors and caregivers at the Mountain View Senior Center
11/9 – Informational table for seniors and their families at San Jose Library
11/10 – Presentation for seniors at McLaughlin Corridor Neighborhood Association
11/10 – Informational table for seniors at Alviso Senior Center
11/11 – Presentation for seniors at the Berryessa Community Center
11/14 – Informational table for homeless seniors and advocates at the Winter Faith Collaborative Meeting
11/16 – Presentation for seniors at the Mountain View Senior Center (Chinese and English)
11/16 – Informational table for seniors and caregivers at the King Library
11/17 – Informational table for seniors at the Campbell Adult Center
11/22 – Informational table for seniors and caregivers at Live Oak Adult Center
11/30 – Presentation for seniors at the Esperanza Self-Help Center

November’s Outreach Events Recap

November 28, 2016

Highlighted Outreach Events

Los Angeles County

10-1-montebello-sr-ctr 10/1 – Members of the Latino Club at the Montebello Senior Center learned about the requirements and benefits of Cal MediConnect during an informational presentation. Over 100 people attended and asked a range of follow-up questions about topics including continuity of care, benefits of the program, and how coverage works.

Los Angeles County

10/11 – Grand Plaza Apartments, in collaboration with state outreach staff and Good Samaritan Hospital, hosted a CCI health and resource fair for seniors and their family members. The event featured CCI presentations in Mandarin, Cantonese, and English; CCI-related informational booths; and free health screenings. Thanks to the diverse language capacities of volunteers and participating organizations, many seniors learned about the CCI’s components in a language that was most familiar to them.

Los Angeles County

10-17-st-barnabas 10/17 – English- and Spanish-speaking seniors learned about the CCI at St. Barnabas Senior Services Center Echo Park during a town hall event. Participants learned about Cal MediConnect plan benefits, continuity of care, balance billing, and the enrollment process. Following the presentation, three state outreach staff were on hand to answer specific questions about the program and distribute CCI fact sheets.

Los Angeles County

10-21-via-care 10/21 – Doctors, nurse practitioners, and the Chief Medical Officer of Via Care Community Health Center learned more about the CCI from state outreach staff during a presentation. Attendees heard about the CCI’s purpose, plan options and benefits, and the enrollment process. Following the presentation, audience members asked questions about communicating with Cal MediConnect care coordinators, working within an interdisciplinary care team, and accessing Cal MediConnect provider resources.

San Diego County

10-24-gary-and-mary-west-sr-ctr 10/24 – Seniors at the Gary & Mary West Senior Center participated in a town hall event co-sponsored by Serving Seniors, the Consumer Center for Health Education and Advocacy, and the office of Representative Scott Peters. Following the CCI presentation, participants had their questions answered about eligibility, balance billing, and enrolling into different health plans.

Santa Clara County

10-28-lytton-gardens-assisted-living 10/28 – Residents at Lytton Gardens Assisted Living learned about the CCI during a presentation delivered in English and Chinese. State outreach staff shared information about plan benefits, continuity of care, and care coordination with Chinese- and English-speaking residents. Attendees learned how a Cal MediConnect care coordinator can help manage their services, help with arranging transportation and other services, and can foster communication among their providers.

Other Recent Outreach Events

Los Angeles County:

10/1 – Informational table for seniors and their families at the 20th Korean Health Festival at Good Samaritan Hospital
10/8 – Informational table for beneficiaries and their families at the Festival of Philippine Arts and Culture
10/12 – Presentation for seniors at St. Barnabas Senior Services Senior Center Echo Park
10/15 – Presentation and informational table for seniors and caregivers at the Golden Future 50+ Senior Expo
10/15 – Presentation to providers and advocates at The City of San Fernando Recreation and Community Services’ Indigenous Peoples Day Celebration
10/20 – Webinar for Los Angeles County advocates
10/21 – Webinar for Los Angeles County providers
10/22 – Informational table for seniors and their families at the annual Larry Itilong Day Parade and Festival
10/24 – Informational table for seniors attending the Baldwin Park Health and Safety Fair
10/28 – Presentation for hospital case managers at the Hospital Association of Southern California
10/26 – Informational table for seniors at the Pasadena Senior Center’s Medicare Resource Fair

Orange County

10/1 – Informational table for seniors during the Center for Successful Aging 2nd Annual Conference & Expo
10/24 – Presentation for Latino Health Access Board members
10/25 – Webinar for Advocates, Stakeholders and Caregivers in Orange County
10/26 – Webinar for Orange County providers

Riverside & San Bernardino Counties

10/7 –Informational table for seniors at a health fair in Hisperia
10/15 – Informational table for seniors and caregivers at Indio Medical Clinic’s health fair
10/18 – Webinar for Inland Empire advocates
10/19 – Webinar for Inland Empire providers and billing staff
10/21 – Informational table for seniors at the Fontana Community Senior Center Open Enrollment Fair
10/22 – Informational table for seniors at the Inland Empire Disability Expo 10-Year Anniversary
10/23 – Informational table for seniors during a health fair in the Mexican Consulate

San Diego County

10/6 – Presentation for attendees of the Healthy San Diego Behavioral Health Workgroup
10/13 – Presentation for staff at Sol Transportation Services

Santa Clara County

10/7 – Presentation for seniors at the Alma Neighborhood Senior Boards
10/11 – Presentation for seniors and their caregivers at the Mountain View Senior Center
10/16 – Informational table for seniors and caregivers at a health fair sponsored by the International Buddhist Society, Tzu Chi

September Outreach Events Recap

September 21, 2016

Highlighted Outreach Events

Riverside County

8/4 – In partnership with California State Council on Developmental Disabilities (SCDD) and HICAP, state outreach staff provided a presentation for case managers and social workers from the Inland Regional Center. Following the presentation, attendees participated in conversations and asked questions about real cases and questions they encounter through their work. Future collaborative presentations are scheduled this year, see the CalDuals.org outreach calendar for more details.

Santa Clara County

8/10 – Caregivers at the Alzheimer’s Activity Center learned more about the CCI during a presentation that included information on benefits, how to join, and eligibility. Attendees asked questions about the program, the benefits of joining Cal MediConnect, and how the program works with adult day centers and other long-term services and supports.

Riverside County

8/16 – In collaboration with Molina Healthcare, state outreach staff educated beneficiaries about the CCI at the City of Perris Senior Center. Over a dozen seniors, including a monolingual Spanish-speaking group, gathered to learn more about Cal MediConnect, care coordination, the benefits of joining, and how the program works with their current providers.

San Diego County

8/22 – Outreach coordinators and certified enrollment counselors with Health Quality Partners (HQP) learned more about the CCI during a presentation which covered Cal MediConnect, recent changes to the continuity of care policy, and the value of coordinated care. Attendees asked questions that about topics they encounter as they work with beneficiaries, such as eligibility, the enrollment process, and the benefits of joining the program.

Los Angeles County

8/27 – Seniors and their family members attended the 48^th Assembly District Community Health Fair to learn about Cal MediConnect and other health services available in their district. A presentation focused on Cal MediConnect eligibility, the terms of continuity of care, care coordination, and the health plans available to beneficiaries. The health fair also featured free health screenings and other healthy activities. The event was hosted by Assemblymember Roger Hernandez.

San Diego County

8/31 – Congregational Community Church organized a Cal MediConnect outreach session for its members who qualify for the program. The discussion focused on the importance of care coordination, the benefits available through Cal MediConnect, continuity of care, and how to join. The group asked many questions about eligibility, balance billing, and the available health plans. Attendees received copies of the new Beneficiary Toolkit and people reported the material was easy to understand and helpful.

Other Recent Outreach Events

Los Angeles County:

August 12: Informational table for beneficiaries at Homeless Care Days Resource Fair.

August 15: Informational table for seniors and their family members during Promotion Day at Anderson Munger Family YMCA.

August 18: Webinar for Los Angeles County advocates.

August 19: Webinar for Los Angeles County providers.

August 23: Presentation for psychiatric social workers at the Los Angeles County Department of Mental Health.

August 23: Presentation for billing staff at the Los Angeles County Department of Mental Health.

August 25: Presentation to seniors at El Monte Senior Center.

August 31: Presentation for members of the East Los Angeles Disability and Senior Collaborative.

August 31: Presentation for seniors at City of Montebello Senior Center.

August 31: Presentation to Molina Healthcare Provider Outreach Staff at its headquarters in Long Beach.

August 26: Informational table for seniors at Homeless Care Days Resource Fair.

Orange County:

August 20: Informational table at the Super Senior Saturday Resource Fair.

August 24: Presentation for staff and beneficiaries at Give for a Smile.

August 30: Webinar for Orange County advocates, stakeholders and caregivers.

August 31: Webinar for Orange County Providers.

Riverside and San Bernardino Counties:

August 16: Webinar for Inland Empire advocates.

August 17: Webinar for Inland Empire providers.

August 23: Informational table for seniors at the Eastside Senior Fitness Fair Expo.

San Diego County:

August 1: Presentation for providers at the monthly National City Collaborative Partners meeting.

August 2: Presentation for Filipino-American seniors at the Paradise Valley Community Church & Services Food Distribution event.

August 11: Community Health Improvement Partners Behavioral Work Group meeting.

August 16: Presentation for volunteers at the AARP Chula Vista Community Action Team meeting.

August 30: Webinar for San Diego providers.

Santa Clara County:

August 18: Webinar for Santa Clara Physicians and other medical providers.

August 19: Webinar for Omayra Ortega.

August 22: Informational table for homeless advocates at the Winter Faith Collaborative.

Updated Continuity of Care Provider Bulletin

July 25, 2016

Today, DHCS is issuing an updated continuity of care provider bulletin, which explains how current out-of-network physicians can continue seeing Cal MediConnect beneficiaries and the process for billing the correct entity for payment. It also provides information to help combat balance billing.

Earlier this year, DHCS announced that it would extend the continuity of care period for Medicare services from six months to 12 months to match the Medi-Cal continuity of care period, and modify requirements to just one visit with a specialist within the past 12 months, as is the case with primary care physicians. These policy changes will be effective starting October 1, 2016. DHCS has updated its Duals Plan Letter and this new provider bulletin also reflects these changes.

In order to ensure that beneficiary transitions into Cal MediConnect are smooth and do not result in disruptions in care, the Cal MediConnect continuity of care policy provides beneficiaries in Cal MediConnect plans with the right to continue seeing non-participating physicians for a limited period of time.

New Advocacy Tools from Justice in Aging

March 25, 2016

Fact Sheet Detailing Two Important Beneficiary Protections—Deeming and Aid Paid Pending

Low income Californians, including beneficiaries dually eligible for Medicare and Medi-Cal, can often temporarily lose Medi-Cal eligibility or move between different eligibility levels. This can often result in disruptions in coverage and care. Under the CCI, a dually eligible beneficiary in a Cal MediConnect health plan who loses full Medi-Cal eligibility can remain in their Cal MediConnect plan for a period of time before being disenrolled—a process known as “deeming.” Deeming periods provide beneficiaries time to resolve eligibility issues. In addition, if a beneficiary is disenrolled from the CCI or Cal MediConnect due to a loss of or change in Medi-Cal eligibility and files an appeal, they have the right to continue receiving services for the duration of the appeals process, provided they make this request—also known as “aid-paid pending”—within 10 days of being notified about the change in eligibility or coverage. More information on deeming and aid-paid pending can be found in a new fact sheet, including how each can minimize disruption in care for dual eligible beneficiaries in CCI counties.

Balance Billing Toolkit for Advocates

When doctors, hospitals, or other providers charge beneficiaries with both Medi-Cal and Medicare for services—it is called balance billing. Balance billing is illegal under federal law. Recently, Justice in Aging released a toolkit for advocates that walks through the basics of balance billing and the federal protections for beneficiaries. It provides examples of how the problems manifest, how to fix them when they arise, and contains letters advocates can use when helping low income clients facing balance billing. The toolkit also includes a webinar that explains balance billing protections and how to work with providers to prevent erroneous billing. Access the toolkit and other balance billing-related materials here.