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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.

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Presentation on theme: "Overview and Children’s Advocates’ Response The Healthy Families Program Transition into Medi-Cal Christine Sebastian Health Program Associate The Children’s."— Presentation transcript:

1 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

2 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.

3 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

4 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)

5 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

6 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

7 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

8 Concerns Readiness Federal approval Lack of an implementation plan Network adequacy/access

9 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)

10 Next Steps Continue to monitor transition implementation Ensure that pre-requisites for an effective, responsible transition are met

11 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

12 Key Websites on the Transition MRMIB tion.html tion.html DHCS lthyFamiliesTransition.aspx lthyFamiliesTransition.aspx

13 For More Information TCP’s Website: Contact me: Christine Sebastian Health Program Associate The Children’s Partnership


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