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The Healthy Families Program Transition into Medi-Cal

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. Budget Decision.

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The Healthy Families Program Transition into Medi-Cal

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  1. 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

  2. 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.

  3. 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

  4. 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)

  5. County-by-County Numbers on the Transition Number of children who will transition per phase for Imperial, Riverside, and San Bernardino counties

  6. Pre-requisites for an Effective, Responsible Transition • Implementation timeline must be flexible • Implementation plan must be submitted and reviewed • Performance and monitoring standards must be created

  7. Pre-requisites for an Effective, Responsible Transition • Provider network adequacy report must be submitted • Federal approvals and guidance must be confirmed • Outreach and communication must be coordinated and comprehensive

  8. Concerns Readiness Federal approval Lack of an implementation plan Network adequacy/access

  9. 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)

  10. Next Steps Continue to monitor transition implementation Ensure that pre-requisites for an effective, responsible transition are met

  11. 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

  12. Key Websites on the Transition MRMIB http://www.mrmib.ca.gov/MRMIB/HFPTransition.html DHCS http://www.dhcs.ca.gov/services/Pages/HealthyFamiliesTransition.aspx

  13. For More Information TCP’s Website: www.childrenspartnership.org Contact me: Christine Sebastian Health Program Associate The Children’s Partnership 310-260-1220 csebastian@childrenspartnership.org

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