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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
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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.
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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
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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)
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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
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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
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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
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Concerns
Readiness
Federal approval
Lack of an implementation plan
Network adequacy/access
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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)
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Next Steps
Continue to monitor transition implementation
Ensure that pre-requisites for an effective, responsible transition are met
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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
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Key Websites on the Transition
MRMIB http://www.mrmib.ca.gov/MRMIB/
HFPTransition.html
DHCS http://www.dhcs.ca.gov/services/Pages/
HealthyFamiliesTransition.aspx
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For More Information
TCP’s Website: www.childrenspartnership.org
Contact me: Christine Sebastian
Health Program AssociateThe Children’s [email protected]