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,
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.
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
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)
County-by-County Numbers on the Transition Number of children who will transition per phase for Imperial, Riverside, and San Bernardino counties CountyPhase 1Phase 2Phase 3Phase 4 Imperial0004,373 Riverside37,41424,19413,5350 San Bernardino 29,74221,6039,9390
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
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
Concerns Readiness Federal approval Lack of an implementation plan Network adequacy/access
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)
Next Steps Continue to monitor transition implementation Ensure that pre-requisites for an effective, responsible transition are met
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
Key Websites on the Transition MRMIB tion.html tion.html DHCS lthyFamiliesTransition.aspx lthyFamiliesTransition.aspx
For More Information TCP’s Website: Contact me: Christine Sebastian Health Program Associate The Children’s Partnership