http://www.lahealthaction.org/index.php/library/index en vcalderon@lahealthaction.org Copyright 2012 2012-05-16T22:04:34-08:00 http://lahealthaction.org/index.php/library/full_entry/3831/ Memorandum to the Board of Supervisors providing information regarding the Governor's FY 2012-13 proposed State Budget and potential impacts on L.A. County including details on promoting coordinated care and enhancing the quality of home-based and community services for dual eligibles, Healthy Families shift to Medi-Cal, and other pertinent budgetary information related to the Department of Health Services, Mental Health and Public Social Services. State Budget, Health Insurance and Coverage Programs, Health Care Reform and Expansion, Health Care Financing, Costs of Health Care, Medi-Cal Redesign 2012-01-10T19:39:59-08:00 http://lahealthaction.org/index.php/library/full_entry/3847/ Report discussing issues which need to be addressed before ACA implementation and Medi-Cal transformation in 2014. Topics covered include financing the system, simplifying eligibility and enrollment, and improving reimbursement, outcomes and provider participation. There is concern that without making these improvements, participation, subscriber health outcomes and provider satisfaction are likely to be low. Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Health Care Reform and Expansion, Medi-Cal Redesign 2012-01-04T00:46:12-08:00 http://lahealthaction.org/index.php/library/full_entry/3145/ Memorandum from the L.A. County DHS to the Board of Supervisors reporting updated information on the mandatory conversion of Seniors and Persons with Disabilities (SPDs) from fee-for-service Medi-Cal into managed care under the California §1115 Waiver. Memorandum contains a recommendation that the Board of Supervisors delegate authority to the Director of Health Services, or his designee to negotiate and execute Medi-Cal managed care provider agreements with L.A. Care Health Plan, effective March 1, 2011 through September 30, 2014, upon review and approval by County Counsel and the CEO, and with notice from the Board. Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Outreach, Enrollment, Retention and Utilization, Section 1115 Medicaid Waiver, Medi-Cal Redesign 2011-03-01T18:23:38-08:00 http://lahealthaction.org/index.php/library/full_entry/3140/ Report of the Medi-Cal simplification policy alternatives developed lead by ITUP-led Program Simplification Workgroup presenting recommendations in categories such as eligibility rules and administrative simplifications, determining eligibility and program access. Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Reform and Expansion, Medi-Cal Redesign 2011-01-24T22:06:06-08:00 http://lahealthaction.org/index.php/library/full_entry/2718/ Report commissioned by the California HealthCare Foundation (CHCF) surveying physicians in the California to determine participation rates in Medi-Cal. This report presents findings and implications of non-participation on the low-income population. Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Health Care Delivery Systems, Health Professionals, Health Status and Issues, Vulnerable Populations and Health Disparities, Medi-Cal Redesign 2010-07-01T21:53:33-08:00 http://lahealthaction.org/index.php/library/full_entry/2660/ Report providing recommendations on maximizing California's opportunity to radically simplify coverage and allow Med‐Cal to become the cornerstone of a more streamlined, system‐wide approach to covering low income citizens and legal permanent residents. California can also develop a more modern Medi‐Cal system by: 1) Dropping Medi‐Cal’s complex and unnecessary aid codes, income disregards and exemptions; 2) Modernizing and streamlining Medi‐Cal’s eligibility determination and enrollment systems; 3) Ensure seamless transitions of eligibility between Medi‐Cal, the Exchange and employment‐based coverage; and 4) Implement Medi‐Cal “wrap around” coverage for working families with limited coverage through employers. State Budget, Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Reform and Expansion, Health Care Financing, Costs of Health Care, Medi-Cal Redesign 2010-06-06T19:29:10-08:00 http://lahealthaction.org/index.php/library/full_entry/2735/ Memorandum from Gary Passmore of the Congress of California Seniors (CCS) to Director David Maxwell-Jolly of the Department of Health Care Services stating the Congress of California Senior's comments and concerns regarding State's 1115 Waiver implementation plan. State Budget, Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Health Care Reform and Expansion, Section 1115 Medicaid Waiver, Understanding the Waiver, Advocacy, Other Hospital Financing Waiver Documents, Medi-Cal Redesign 2010-05-26T02:15:52-08:00 http://lahealthaction.org/index.php/library/full_entry/2733/ Memorandum from LHPC to Director David Maxwell-Holly and Chief Director Toby stating the LHPC's comments and concerns regarding the proposed Section 1115 Medicaid Waiver Implementation Plan. Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Health Care Reform and Expansion, Health Care Financing, Costs of Health Care, Section 1115 Medicaid Waiver, Advocacy, Medi-Cal Redesign 2010-05-20T01:49:42-08:00 http://lahealthaction.org/index.php/library/full_entry/2277/ This briefing paper examines the significant proposed changes in the state's Medi-Cal program put forward by the Department of Health Care Services. The concept paper proposes improved management and coordination of care and strengthening the state's safety net. It focuses on the following four groups within Medi-Cal who are the most seriously ill and who do not have a specific method to organize or coordinate their care within Medi-Cal: • Seniors and persons with disabilities • Dual eligibles (Those eligible and enrolled in both Medi-Cal and Medicare) • California Children's Services (CCS) • Those requiring specialty mental health care Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Financing, Costs of Health Care, Health Status and Issues, Maternal and Child Health, Vulnerable Populations and Health Disparities, Section 1115 Medicaid Waiver, Other Hospital Financing Waiver Documents, Medi-Cal Redesign 2009-11-18T22:23:43-08:00 http://lahealthaction.org/index.php/library/full_entry/2218/ Medi-Cal and Healthy Families, as well as local children's health initiatives, are lifelines for children who have no other access to affordable health coverage. In fact, without Medi-Cal and Healthy Families, nearly four and a half million additional California children would be uninsured.The story of children's health coverage, however, is not merely a story about numbers. It is a story of kids being able to see the doctor when they have the flu, sprain an ankle, or suffer from asthma, diabetes or other chronic illnesses. It is also the story of parents who can rest easier because their children are covered and a childhood illness or playground mishap will not mean bankruptcy.The children and families in this portfolio shared their experiences in the hope that, one day, all California children will have health coverage that meets their needs at a cost their parents can afford. Health Insurance and Coverage Programs, Health Care Reform and Expansion, Health Care Financing, Costs of Health Care, Health Status and Issues, Maternal and Child Health, Vulnerable Populations and Health Disparities, Medi-Cal Redesign, Children's Health and Coverage 2009-10-26T20:08:29-08:00 http://lahealthaction.org/index.php/library/full_entry/2195/ This memorandum to Senator Max Baucus (Chairman of the Senate Finance Committee) is a preliminary analysis of the Chairman’s mark for the America’s Healthy Future Act of 2009, incorporating the amendments that have been adopted to date by the Committee on Finance. Some key components of the bill include: establishing a mandate for most legal residents of the United States to obtain health insurance; set up insurance “exchanges” through which certain individuals and families could receive federal subsidies to substantially reduce the cost of purchasing that coverage; significantly expand eligibility for Medicaid; substantially reduce the growth of Medicare’s payment rates for most services (relative to the growth rates projected under current law); impose an excise tax on insurance plans with relatively high premiums; and make various other changes to the Medicaid and Medicare programs and the federal tax code. The estimate includes a projected net cost of $518 billion over 10 years for the proposed expansions in insurance coverage. That net cost itself reflects a gross total of $829 billion in credits and subsidies provided through the exchanges, increased net outlays for Medicaid and the Children’s Health Insurance Program (CHIP), and tax credits for small employers; those costs are partly offset by $201 billion in revenues from the excise tax on high-premium insurance plans and $110 billion in net savings from other sources. The net cost of the coverage expansions would be more than offset by the combination of other spending changes that CBO estimates would save $404 billion over the 10 years and other provisions that JCT and CBO estimate would increase federal revenues by $196 billion over the same period. Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Reform and Expansion, Health Care Delivery Systems, Hospitals, Emergency Services and Trauma Care, Ambulatory Care, Health Professionals, Health Care Financing, Costs of Health Care, Health Status and Issues, Maternal and Child Health, Chronic Conditions, Health Behaviors, Vulnerable Populations and Health Disparities, Medi-Cal Redesign, Children's Health and Coverage 2009-10-08T22:35:50-08:00 http://lahealthaction.org/index.php/library/full_entry/2136/ This memorandum provides a summary of the Los Angeles Healthcare Options Task Force report whose four categories of recommendations include: Quality Care Delivery, Finance, Information Technology and Governance & Management. Attachment II provides a full summary of DHS status and recommendations for each of these areas, but full implementation will require additional funding and/or redirection of existing resources. While not recommending the formalized Planning Commission entity recommended by the task force, DHS does support developing a structure to support increased collaboration and coordination between public and private entities. Health Care Delivery Systems, Hospitals, Emergency Services and Trauma Care, Ambulatory Care, Health Professionals, Health Care Financing, Costs of Health Care, Health Status and Issues, Vulnerable Populations and Health Disparities, Governance, Alternative Governance Models, Martin Luther King, Jr.-Harbor Hospital, L.A. County Documents, Medi-Cal Redesign 2009-07-06T21:17:06-08:00 http://lahealthaction.org/index.php/library/full_entry/2103/ This bill seeks to make quality, affordable health care available to all Americans, reduce costs, improve health care quality, enhance disease prevention and strengthen the health care workforce. The short title of this act is: "Affordable Health Choices Act" Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Reform and Expansion, Health Care Delivery Systems, Hospitals, Emergency Services and Trauma Care, Ambulatory Care, Health Professionals, Health Care Financing, Costs of Health Care, Health Status and Issues, Maternal and Child Health, Chronic Conditions, Health Behaviors, Vulnerable Populations and Health Disparities, Medi-Cal Redesign, Nursing Workforce Shortage, Children's Health and Coverage 2009-06-09T22:25:15-08:00 http://lahealthaction.org/index.php/library/full_entry/2046/ This joint statement signed by 17 diverse health care stakeholders -- including groups representing consumers, providers, insurers, and business -- sough to find and define consensus on as many issues as possible. This statement outlines the priorities and important considerations that must be made to make sure that comprehensive healthcare reform occurs. Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Health Care Reform and Expansion, Health Care Financing, Costs of Health Care, Health Status and Issues, Vulnerable Populations and Health Disparities, Medi-Cal Redesign, Children's Health and Coverage 2009-03-31T21:57:00-08:00 http://lahealthaction.org/index.php/library/full_entry/2003/ This report recommends an integrated set of policies to extend coverage to all by: establishing a national insurance exchange that offers a choice of private plans and a new public plan; requiring everyone to have coverage, with income-related premiums to make coverage affordable; and instituting insurance market reforms that focus competition on outcomes and value. On this foundation, payment policies would change the way we pay for care to enhance the value of primary care and move from fee-for-service to more "bundled" methods of paying that encourage coordinated care and hold providers accountable for improving health outcomes and prudent use of resources. Investment policies would accelerate the spread and use of health information technology and establish a center for comparative effectiveness to enhance knowledge and appropriate use of evidence-based care. Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Health Care Reform and Expansion, Health Care Delivery Systems, Hospitals, Emergency Services and Trauma Care, Ambulatory Care, Health Care Financing, Costs of Health Care, Health Status and Issues, Chronic Conditions, Health Behaviors, Vulnerable Populations and Health Disparities, Medi-Cal Redesign, Children's Health and Coverage 2009-02-19T18:05:19-08:00 http://lahealthaction.org/index.php/library/full_entry/2002/ This report recommends an integrated set of policies to extend coverage to all by: establishing a national insurance exchange that offers a choice of private plans and a new public plan; requiring everyone to have coverage, with income-related premiums to make coverage affordable; and instituting insurance market reforms that focus competition on outcomes and value. On this foundation, payment policies would change the way we pay for care to enhance the value of primary care and move from fee-for-service to more "bundled" methods of paying that encourage coordinated care and hold providers accountable for improving health outcomes and prudent use of resources. Investment policies would accelerate the spread and use of health information technology and establish a center for comparative effectiveness to enhance knowledge and appropriate use of evidence-based care. Health Insurance and Coverage Programs, Employment-based Health Insurance, Public Health Insurance Coverage Programs, Health Care Reform and Expansion, Health Care Delivery Systems, Hospitals, Emergency Services and Trauma Care, Ambulatory Care, Health Care Financing, Costs of Health Care, Health Status and Issues, Chronic Conditions, Health Behaviors, Vulnerable Populations and Health Disparities, Medi-Cal Redesign, Children's Health and Coverage 2009-02-19T17:51:33-08:00 http://lahealthaction.org/index.php/library/full_entry/1839/ Letter outlining federal health policy issues impacting the Los Angeles health safety net that LA Health Collaborative Leadership Team members are encouraging a new administration to address upon taking office. The priorities include: repeal of the restrictive rules issued by the Centers for Medicare and Medicaid Services (CMS), federal flexibility in negotiating the next waiver, additional funding for workforce development and federal investment in prevention and chronic disease management. Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Reform and Expansion, Health Care Delivery Systems, Health Professionals, Health Care Financing, Costs of Health Care, Health Status and Issues, Vulnerable Populations and Health Disparities, Medicaid Citizenship Documentation Requirement, Medi-Cal Redesign 2008-09-20T00:00:37-08:00 http://lahealthaction.org/index.php/library/full_entry/1808/ This report found that only 26% of the 8.5 million eligible for Denti-Cal receive treatment every year. The researchers surveyed Federally Qualified Health Centers (FQHCs) to better understand effective methods of expanding dental care to low-income Californians. Some recommendations include: peer networking programs, sharing of "best practices," clarifying billing rules, greater capital and start-up funding, and workforce development. Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Reform and Expansion, Health Care Delivery Systems, Health Professionals, Health Care Financing, Costs of Health Care, Health Status and Issues, Vulnerable Populations and Health Disparities, Medi-Cal Redesign 2008-08-22T18:25:24-08:00 http://lahealthaction.org/index.php/library/full_entry/1676/ This memorandum summarizes the actions taken by the Senate and Assembly Budget Committees regarding the Governor's proposed budget cuts. It focuses specifically on the fiscal impact on LA County and how the proposed cuts to CalWorks, In-Home Supportive Services, Safety Net Care Pool, South LA Preservation Fund, and the elimination of the Cash Assistance Program for Immigrants would affect the County. State Budget, Health Insurance and Coverage Programs, Public Health Insurance Coverage Programs, Health Care Financing, Costs of Health Care, Medi-Cal Redesign 2008-06-11T16:42:26-08:00 http://lahealthaction.org/index.php/library/full_entry/1641/ An overview of the effects of the State Health Budget Cuts on LA County including: cuts to Health Care Providers, cuts to the County Health system, elimination of important Medi-Cal benefits, cuts to Community Clinics, and cuts to programs serving the Elderly and Disabled. State Budget, Health Insurance and Coverage Programs, Outreach, Enrollment, Retention and Utilization, Health Care Reform and Expansion, Health Care Financing, Costs of Health Care, Health Status and Issues, Vulnerable Populations and Health Disparities, Medicaid Citizenship Documentation Requirement, Medi-Cal Redesign, Children's Health and Coverage 2008-05-23T19:55:36-08:00