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Letter from Congress Focuses on Healthy Families Transition

California’s effort to move approximately 860,000 children from the Healthy Families program has drawn national attention.

Twenty-two members of the House of Representatives, including House Speaker Nancy Pelosi (D-San Francisco), last week sent a letter to state health officials, urging caution in the Healthy Families transition to Medi-Cal managed care.

The transition is slated to begin Jan. 1 when almost half the Health Families kids — about 415,000 — make the switch. The state still needs CMS approval for the plan.

“We hope that federal agencies will pay some attention to Congress and will look a little harder at how the oversight process is happening and what the state is actually doing,” said Judy Darnell, director of public policy for the United Ways of California.

Darnell said state health care officials have listened to stakeholder concerns, but that responsiveness to those concerns has been lacking.

“What we’re trying to do is make sure the transition is successful, and we want to ensure children have continuity of care and timely access to care,” Darnell said. “[Health officials] have been willing to engage with stakeholders, and that’s been great, but it feels like it’s fallen on deaf ears so far.”

A coalition of children’s health organizations, including United Way, sent a letter to state officials at the start of November urging the state to exercise caution in the transition.

“This transition should not to go forward unless they’re ready,” Darnell said. “The whole goal [of the state] seems to be to stay on track … we just have to get started. And our question is, ‘Why do we have to get started on this so quickly?’ “

Norman Williams, deputy director of public affairs for the Department of Health Care Services, said in a written statement that the department takes the letter from Congressional leaders seriously.

“DHCS values this input from our elected leaders. We appreciate their recommendation that the transition be conducted in a manner that protects the health of these children while ensuring continuity of care,” Williams wrote. “DHCS planned and is undertaking a cautious approach to the transition of the 860,000 children from the Healthy Families program into Medi-Cal.”

Williams said the approach to the transition is gradual and measured.

“We will use a four-phase approach in which no children will be transitioned until Jan. 1, 2013, or later. The transition will happen gradually over the course of a year, during which we will closely monitor the process and make adjustments when necessary. More than 90 percent of health providers under contract with Healthy Families also contract with Medi-Cal. And, we continue to work closely with advocates and other stakeholders to ensure we are responsive to the important needs of this population,” Williams wrote.

Federal health officials may want to amend the transition plan, Darnell said, because the public perception in California about Medi-Cal managed care is important to the overall health care reform effort.

“One thing I think they’re worried about is the future consequences for implementation of the Affordable Care Act,” Darnell said. “If all of a sudden people don’t understand, and they see it’s going badly, they may have a bad taste in their mouths for Medicaid. One of the things about [the members of Congress who signed last week’s letter] is that all of them have been highly supportive of ACA implementation, and they may feel that’s at stake.”

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