For more information phone 858-495-5853 or send us an email.
- ANNOUNCEMENTS -
Next LTCIP Quarterly Stakeholder Meeting - Friday 6/13/14
IMPORTANT UPDATE | COORDINATED CARE INITIATIVE (CCI) 4/2014
The Department of Health Care Services has created a Cal MediConnect Enrollment dashboard that will be updated every month. The Dashboard presents Cal MediConnect Enrollment data on a county by county basis covering multiple aspects of the enrollment process such as the number of current enrollees, number of opt-outs, projected enrollment numbers, notice mailing schedule and the State's Health Care Options call center statistics. April's Cal MediConnect Dashboard can be found here. For future Cal MediConnect Enrollment Dashboard reports please look in the CCI/Cal MediConnect ToolKit.
On March 25th, 2014, the Department of Health Care Service (DHCS) announced a change to its Coordinated Care Initiative (CCI) enrollment timeline and strategy in order to continue to move forward to provide high quality, coordinated care to beneficiaries eligible for Medicare and Medi-Cal. DHCS has adjusted the enrollment dates for subpopulations in order to increase consumer clarity, prevent the need for multiple transitions in a single year, ensure sufficient time for noticing of fee-for-service (FFS) populations, and ensuring plan readiness. To review the new enrollment timeline for San Diego County please 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 will offer 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.
Update on CCI Beneficiary Notification 3/2014
Below are the numbers of notices that have gone out to San Diego County CCI beneficiaries who are slated for the April/May Enrollment. (Source: CDA)
- 10,700 Cal MediConnect
- 8,700 MLTSS
CCI Population Estimate for San Diego County (2/2014)
New population estimates were published in a Background Paper for the Senate Budget & Senate Health Oversight Hearing on Coordinated Care Initiative. To read the full report click here.
- San Diego County Dual Eligible Population - 55,798
- San Diego County Eligible Medi-Cal-Only Enrollees into Medi-Cal Managed Care - 64,000
- Total CCI Population in San Diego County - 119,798
Beneficiary Notification Process
Those who need to select a new plan, will receive three different notices, sent 90, 60 and 30 days ahead of their enrollment date. This is the same for beneficiaries eligible for Cal MediConnect and beneficiaries in Medi-Cal fee-for-service who need to choose a managed care plan for their long-term services and supports (MLTSS). Those beneficiaries who are NOT eligible for Cal MediConnect and who are already enrolled in a Medi-Cal managed care plan will now receive one 30 day notice, instead of a 45 day notice, prior to the change in their benefit package. For the latest status of the CCI Enrollment Notices please click here.
- 90, 60 and 30 day notices
- The 60 day notice, an enrollee will receive a Guidebook and choice form
MLTSS beneficiaries NOT in a Medi-Cal Managed Care Plan:
- 90, 60 and 30 day notices
MLTSS beneficiaries currently in a Medi-Cal Managed Care Plan:
- 30 days prior to the change in benefit package
Please note: All notices from the State will be in BLUE envelopes (example)
LTCIP Awarded 2-Year Grant from The SCAN Foundation
LTCIP, under the leadership of AIS, has been awarded a two-year grant from The SCAN Foundation to serve as the Regional Coalition for San Diego County carrying on the great work accomplished over the past two years by the San Diego Senior Alliance. United by a common vision of high-quality client-driven care, LTCIP will represent the county on the California Collaborative for Long Term Services and Supports whose goal is to transform the state’s system of long-term services and supports (LTSS). Additionally, as the Regional Coalition the LTCIP is charged with supporting outreach and education efforts related to CCI. With additional funding through the grant, key LTCIP stakeholders will work with a consultant to design a LTSS Brokerage Model that can be replicated by Aging & Disability Resource Connections (ADRCs) throughout the state and country.
To learn more about the California Collaborative for Long Term Services and Supports' Regional Coalitions please click here.
LAN Event Materials
Learning and Action Network | November 19, 2013 | Achieving Person Centered Care in San Diego and Imperial Counties
Want to learn more about the Long Term Care Integration Project?
For more information about LTCIP please contact Brenda Schmitthenner, the Manager of the LTCIP, at (858)495-5853 or at firstname.lastname@example.org.