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CalOptima Commits $100 Million for Homeless Health Programs

New initiatives have been created to address the complex needs of members who are homeless

Orange, California (April 5, 2019)

The CalOptima Board of Directors appropriated another $74.8 million in funding yesterday for response, coordination and other new initiatives benefitting Medi-Cal members who are homeless. These initiatives involve medically necessary covered services and enhance CalOptima’s recent commitment of $25.2 million, including $11.4 million for mental health services, $11 million for recuperative care services, which is intended to improve outcomes for homeless members being discharged from the hospital and $2.8 million for clinical field and response teams.

“CalOptima is urgently addressing the homeless crisis and is committed to enhancing our current health care delivery system to meet the unique needs of our homeless members,” said Paul Yost, M.D., CalOptima Chairman of the Board. “We will continue to collaborate with the county, health networks, homeless advocacy groups and the community to ensure that CalOptima members receive the care they need.”

The new financial commitment will fund initiatives to be developed to address the rising trends in homelessness and provide health care services for at-risk and homeless CalOptima members. They will supplement the latest programs that have been designed to deliver quality care tailored to their needs. In March, the CalOptima Board of Directors approved the launch of a clinical field team pilot program in partnership with community health centers. Starting this month, the program will place mobile teams of doctors and medical assistants in the community to provide urgent care services.

Also authorized by the Board last month, and supporting this new health care delivery approach, will be a specialized department, the CalOptima Homeless Response Team. This group of eight staff will focus on care coordination, health care navigation services and supportive resources.

“Our coordinated services will include urgent care, wound care, vaccinations, screenings and prescription medications as well as referrals and appointment scheduling,” said Dr. Nikan Khatibi, CalOptima Vice Chairman of the Board. Our specialized teams will have regular hours at shelters, be on-call and able to coordinate referrals for behavioral health, substance abuse, recuperative care and social services.”

Currently, CalOptima is enhancing the system of care for members who are homeless in the following ways:

  • Clinical Field Team Pilot Program: CalOptima will partner with Federally Qualified Health Centers (FQHCs) to bring urgent care services to homeless individuals in the community. The clinical field teams, which could include a physician, medical assistant and social worker, will be available during extended hours. FQHCs will be able to serve CalOptima members as well as non-members. Services for non-members will be covered by federal funding available to FQHCs for the uninsured. Further, the CalOptima Board authorized up to $1.6 million for startup costs for the pilot and $500,000 for services through the end of June 2019.
  • CalOptima Homeless Response Team: This internal team of CalOptima staff will be the single point of contact designated to serve members who are homeless by supporting the clinical field teams, providing navigation services and more. The multidisciplinary group will include personal care coordinators and clinical case managers.
  • Recuperative Care Services: CalOptima has committed $11 million for recuperative care services as part of Orange County Health Care Agency’s Whole-Person Care Pilot program. Recuperative care facilities provide a clean, safe place for a homeless member discharged from the hospital to stay for up to 90 days when medically indicated. The Medical Respite Program is available for CalOptima homeless members who need more than the 90 days of recuperative care allowed under the Whole-Person Care Pilot to complete their treatment.
  • Regional Mental Health and Wellness Campus: The Orange County Board of Supervisors and other partners recently announced plans to create an integrated mental health campus providing a seamless continuum of services from preventive care to crisis stabilization, with CalOptima providing funding for enhanced Medi-Cal services for CalOptima members. The first-of-its-kind facility will start construction this spring and is expected to serve a significant number of homeless individuals based on their high incidence of mental illness.
  • Homeless Coordination at Hospitals: CalOptima has committed $10 million dollars to help hospitals meet requirements for homeless-specific discharge planning and care coordination effective July 1, 2019. The funding will be distributed based on the volume of services provided to members.

“CalOptima was created to serve the most vulnerable members of our community and with these new programs we continue to honor that commitment and our mission. We have a long history of working with our community partners and look forward to maintaining these strong relationships and identifying new opportunities to optimize our health care delivery system for our members,” said CEO Michael Schrader.

About CalOptima

A county organized health system, CalOptima provides publicly funded health care coverage for low-income children, adults, seniors and people with disabilities in Orange County, California. CalOptima’s mission is to provide members with access to quality health care services delivered in a cost-effective and compassionate manner. In total, CalOptima serves nearly 770,000 members with a network of more than 8,000 primary care doctors and specialists, as well as 23 hospitals.

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