5 Things California: The Future of CalAIM, Barger Talks About Mental Health and Community-Centered Care – State of Reform

We have a very intelligent group of minds here at State of Reform. I am honored to have the chance to work with and mentor some of these people. Eli Kirshbaum is one of those who put together much of today’s newsletter. Another is Emily Boerger, who is our editor.

They help lead a team of seven journalists who track healthcare, reform, and policy in states like California.

In the future, I will be more behind on these bulletins. After a decade of writing and editing them, it’s time to hand the keys over to other intelligent voices. I will write a column again from time to time. But you can be sure your inbox is in good hands with people like Eli, Emily, Patrick, Nicole, Aaron, Ethan, and Soraya.

Thanks, as always, for reading our articles!

With the help of Eli Kirshbaum

1. Sup. Barger talks about pandemic response and mental health

During the morning lecture at the 2021 Los Angeles Reform State Health Policy Conference, LA County Supper. Catherine barger described the county’s cooperation with the state as “phenomenal” during the pandemic, despite communication problems early on. “When the governor made an announcement, we would have half an hour to focus on what the state was imposing. Communication was lacking at the beginning, but towards the end we got better, ”she said.

The supervisor also spoke about the county and state’s work to support the mental health of Los Angeles residents, noting that the LA County Department of Mental Health 24/7 hotline has experienced a 50% increase in calls during the pandemic. She explained how the county has partnered with Headspace to provide free mental health resources to all residents and said she hopes the county is “very successful” Mental assessment team will continue to expand. You can watch Barger’s full opening speech here.

2. Lawmakers Solve Difficulties in Getting Bills to the Legislature

At the State of Reform Conference, Senator Monique Limón and Asm. Adrin Nazarian spoke about the obstacles that lawmakers face in the policy-making process. The two agreed that being persistent is essential. Limón, whose multiple Alzheimer’s bills failed in previous sessions, finally managed to move forward this year’s attempt by the two chambers. “You don’t give up, you just keep going and keep going,” she said.

Nazarian – including invoice banning health plans from imposing deductibles on insulin prescriptions was killed during the Senate Appropriations Committee this session – said the tax consideration is important but can hamper policy-making and often becomes too political. When bills are successful, they often differ significantly from their original form, Limón said. “They start out as a single idea, and – almost a hundred percent of the time – that idea evolves through amendments,” she said.

3. CalAIM’s vision of power acronyms

DHCS CalAIM The initiative is expected to be implemented on January 1, 2022, bringing with it a variety of new transformational agendas including Community Supports (formerly In-Lieu of Services) and Enhanced Care Management (ECM). At our conference in Los Angeles, a panel of healthcare leaders discussed what rolling out these programs will look like and how it will change California’s healthcare delivery system.

“The implementation required an unprecedented level of energy, cross-sector collaboration, regular and close communication and even deeper levels of partnership among all stakeholders,” said Martha Santana-Chin, Medi-Cal Director of Health Net. Beau Hennemann, director of special programs at Anthem, explained how DHCS projects like LTSS and the Nursing home program have helped pave the way for a large-scale transformation of the delivery system like CalAIM.

4. Experts discuss post-COVID healthcare payment reform

Carole Cusack, Director of Pay Client Engagement and Strategy at 3M, explained at last month’s conference how COVID-19 exposed an inadequate funding structure in healthcare in the United States. She said the country had over-invested in its capacity to deal with “low-value visits” and under-invested in crisis management – as evidenced by the lack of space, personnel and emergency equipment during the crisis. pandemic – and primary care.

On the same panel, Adam bard, Senior Director of Healthcare Transformation Implementation at Blue Shield of California, explained his organization’s Pay for Value payment model strategy and how it rewards value rather than volume. “We know the suppliers are exhausted. We know that current modeling almost requires unsustainable productivity to get your money back [the amount that] providers deserve to be reimbursed. So we shift that to value, focusing on other metrics such as quality results, ”he said. See the full panel conversation here.

5. Health leaders suggest ways to include community in health care

Sonya Young-Aadam, CEO of the California Black Women’s Health Project, said “culture” and “racism” should be seen as social determinants of health at last month’s conference. She said the state must recognize these two social determinants and intentionally invest in health initiatives developed by the black community, such as Mentally mobilized sisters, Anti-violence companies, and Sistahs aging gracefully and gracefully (SAGE).

Anuradha Rao, MD, another panel speaker and pediatrician at FQHC Omni Family Health, discussed her facility’s unique SDOH-driven model of care, explaining how she screens each patient’s family to identify any outside factors that may affect their overall health. They then use an online platform, Unite Us, to connect patients with needed community resources, including affordable housing, food and transportation. This community-driven practice has proven to be successful, as 81% of service connections offered to its patients through Unite Us between April and June 2021 were accepted.


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