Federal Approval of Duals Plan May Come Soon

At a budget subcommittee hearing yesterday, Department of Health Care Services Director Toby Douglas said he hopes to get federal approval for the Coordinated Care Initiative within weeks.

The CCI, also known as the duals demonstration project, is a plan to move half a million Californians with dual eligibility in both Medicare and Medicaid into Medi-Cal managed care programs. The plan calls for consolidating  disparate health care services and funding streams  to improve and integrate  care for seniors and persons with disabilities, while saving the state money  as well.

“We hope it’s imminent,” Douglas said at yesterday’s Budget Subcommittee on Health and Human Services, when he was asked for an approval timeline by Assembly member Mariko Yamada (D-Davis).

“We are talking with our federal partners, and trying to resolve a few issues,” Douglas said. “We hope we can resolve them in the next couple of weeks. That is our goal.”

The duals project involves 530,000 people in eight counties: Alameda, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo and Santa Clara.

Douglas also assured subcommittee members that the rapid timeline of implementation — phasing in over about a year — will be slowed if the plan is not ready for any reason.

“There will be numerous measurements for monitoring [progress and readiness].” Douglas said. “We’re not moving forward till our [health] plans are ready, and monitoring is in place. And we are committed to providing transparency in the process.”

Assembly member and committee chair Holly Mitchell (D-Los Angeles) said she was glad to hear that.

“There is a fear in the community about the scope of this transition,” Mitchell said. “So if it looks like there will be changes, you reach out and let us know. We want to make sure this transition goes through without harming Californians.”

One of those metrics for readiness is the development of a series of measurements known as a “process indicators dashboard,” which will help state health officials monitor how the transition is going.

“It’s an important indicator for how fast we move,” said Vanessa Cajina, legislative advocate for the Western Center on Law and Poverty. “If you don’t have a dashboard, you don’t know if you need to apply brake pressure.”

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Capitol Desk Medi-Cal Medicare