Coordinated Care Initiative Cal MediConnect

SAN DIEGO COUNTY REGIONAL COALITION CCI SURVEY RESULTS

In January 2014, the County of San Diego’s Long Term Care Integration Project (LTCIP) was awarded a two-year grant from The SCAN Foundation to serve as the Regional Coalition for San Diego County. As the Regional Coalition, the LTCIP is charged with supporting Long Term Services and Supports (LTSS) policy development and advancement, and supporting the implementation of the Coordinated Care Initiative (CCI) in San Diego County.

To gauge the understanding of CCI among LTCIP stakeholders, the LTCIP developed and conducted a survey through the CCI Advisory Committee. The ultimate goal of the survey was to use the results to inform CCI outreach/education efforts and development of outreach materials.  This project was supported by the grant from The SCAN Foundation - advancing a coordinated and easily navigated system of high-quality services for older adults that preserve dignity and independence. For more information, visit www.TheSCANFoundation.org.

The survey was comprised of 15 questions that were specifically phrased to not only gain a sense of LTCIP stakeholder understanding of the CCI but also to utilize the survey as a means to educate stakeholders about CCI.  The survey was administered electronically through survey monkey and was sent by the Chair of the CCI Advisory Committee to a total of 606 LTCIP stakeholders.  The LTCIP received 105 responses, which equates to a 17% response rate. Please click to view the San Diego County Regional Coalition CCI Survey Results.

COORDINATED CARE INITIATIVE (CCI) 9/25/14

On September 10, 2014, the Department of Health Care Services released an All Plan Letter (APL) 14-0010 related to Care Coordination Requirements for Managed Long-Term Services and Supports. This APL clarifies care coordination requirements for Managed Long-Term Services and Supports for Medi-Cal managed care health plans participating in CCI. On September 15, 2014, DHCS hosted a stakeholder webinar focused on continuity of care. For more recent DHCS activities related to CCI, please visit the Cal Duals website: http://www.calduals.org.

COORDINATED CARE INITIATIVE (CCI) 7/20/14

The DSNP Policy Proposal has been passed.  The ALL PLAN LETTER 14-007 dated June 26, 2014 provides guidance relating to requirements that Dual-Eligible Special Needs Plans (D-SNPs) have with the State under the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), as amended by the Affordable Care Act of 2010.  This guidance covers MIPPA-compliant contracts to D-SNPs and Fully Integrated Dual Eligible Special Needs Plans (FIDE-SNPs) for 2015 and for the duration of the Duals Demonstration project, Cal MediConnect.  To read the policy click here.

Cal MediConnect Ombudsman Program

Cal MediConnect participants can ask questions and resolve problems regarding their health care through the Cal MediConnect Ombudsman Program.  Housed within the Department of Managed Health Care (DMHC) and initiated with help from the Department of Health Care Services (DHCS), the Ombudsman service will be performed by an independent, third party firm, the Legal Aid Society of San Diego.  The Legal Aid Society of San Diego, and a number of experienced subcontractors throughout the demonstration counties, will be available to provide ombudsman services to Cal MediConnect beneficiaries allowing for more objective analysis and observation.

The Cal MediConnect ombudsman program is designed to:

  • assist enrollees filing appeals and complaints where needed
  • investigate, negotiate and resolve enrollee problems/complains with Cal MediConnect plans
  • refer enrollees to relevant entities and programs as needed

The ombudsman offers independent, local, person-centered, and linguistically and culturally competent assistance with Cal MediConnect issues.  For help with navigating Cal MediConnect please call (855) 501-3077 (TTY 1-855-874-7914). Hours of Operation: Monday through Friday, 9 a.m. to 5 p.m. and you can visit their website at www.healthconsumer.org.

The Coordinated Care Initiative Advisory Committee

The Coordinated Care Initiative Advisory Committee was established by the managed care health plans participating in the Coordinated Care Initiative in May 2012. The purpose of this committee is to provide recommendations to the managed care health plans about program operations, benefits, access to services, adequacy of grievance processes, and consumer protections. The Advisory Committee provides input to the health plans in the development, implementation and continued operation of the demonstration in San Diego County.  To view meeting agendas and approved minutes please click on the links listed below.

For the most current information about the Coordinated Care Initiative and Cal MediConnect, please go to the Cal Duals website: www.CalDuals.org.  Also, please visit our CCI/Cal MediConnect Virtual Resource Toolkit below which houses a wealth of information about CCI and Cal MediConnect including San Diego County's CCI Advisory Committee meeting agendas and minutes as well as specific information about CCI in San Diego County. 

CCI/Cal MediConnect Virtual Resource ToolKit Description

The resources included in this ToolKit are meant to provide information about California’s Coordinated Care Initiative (CCI).  PLEASE NOTE the ToolKit contains some important historical documents.  Therefore, we have ensured that all materials indicate the date, whether on the document itself or noted next to the link, in which it was published.  

 

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