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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
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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 CountyPhase 1Phase 2Phase 3Phase 4 Imperial0004,373 Riverside37,41424,19413,5350 San Bernardino 29,74221,6039,9390
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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 Provider network adequacy report must be submitted Federal approvals and guidance must be confirmed 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/HFPTransi tion.html http://www.mrmib.ca.gov/MRMIB/HFPTransi tion.html DHCS http://www.dhcs.ca.gov/services/Pages/Hea lthyFamiliesTransition.aspx http://www.dhcs.ca.gov/services/Pages/Hea lthyFamiliesTransition.aspx
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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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