Sonoma County Considers Shifting Medi-Cal Recipients to HMO Plans, Launching Healthy Kids Program

The Sonoma County Board of Supervisors on Tuesday voted to create a task force of hospital, community clinic and physician group representatives to determine whether the county can shift 47,000 low-income Medi-Cal beneficiaries into a managed care plan, the Santa Rosa Press Democrat reports. Under the proposal, Sonoma County would join a regional managed-care system already established in Solano, Napa and Yolo counties.

County Public Health Officer Mary Maddux-Gonzalez said county officials are trying to resolve "the most critical issue of funding" by negotiating physician reimbursement rates for an HMO-style plan with the state. A similar proposal in Marin County last year was rejected because officials could not obtain adequate reimbursement rates, and Maddux-Gonzalez said Sonoma County could face a similar problem.

County health officials in February will begin meeting monthly with the task force and hope to decide by October whether the program could be implemented in 2007 (Rose, Santa Rosa Press Democrat, 11/30).

Sonoma County plans to launch a Healthy Kids program to enroll about 8,000 uninsured children in health care services for about $11 million over five years, the Press Democrat reports. The Department of Health Services on Tuesday outlined the program to county supervisors.

County officials estimate that about 5,300 children in the county are uninsured because their parents are unaware of eligibility or are confused by the enrollment process for health insurance programs. An additional 1,500 children are ineligible for government-funded programs because their parents are not legal residents of the United States, and about 1,200 children are ineligible for public health assistance because their parents' incomes exceed eligibility limits, officials estimate.

The Healthy Kids program will contract with Kaiser Permanente, Sutter Health and Santa Rosa Memorial hospitals to provide services for uninsured children. The hospitals have provided more than $500,000 in program funding, and the county is working to raise about $1.3 million from private companies.

Separately, the Kaiser Permanente Child Health Plan has pledged about $5.2 million in services for uninsured children (Rose, Santa Rosa Press Democrat, 11/29).