County-Based Medi-Cal Administrative Activities (MAA)
Mimi Hall, Interim Health Services Agency (HSA) Director for the County of Santa Cruz, presented on Medi-Cal Administrative Activities (MAA). MAA is a federal program authorized by centers for Medicaid and Medicare. To participate at the California state level, the state Department of Health Care Services (DHCS) contracts with local health jurisdictions, such as the HSA.
Unfortunately, because the MAA program is optional for states and counties, available federal dollars are not always maximized. To optimize participation in this program, the HSA has taken on the role as the local governmental agency (LGA) to provide oversight of planning and implementation. In this case, the HSA’s responsibilities go beyond acting as an ‘accountant’, and more towards providing training, networking, and opportunities to develop a comprehensive strategy to grow base funds.
In order for an organization to participate, there are two important concepts, which many Santa Cruz nonprofits satisfy. First is the concept of Federal Financial Participation (FFP), which is the federal government’s portion of matching the efforts and expenditures of the HSA towards Medi-Cal covered services. The second concept is on Certified Public Expenditures (CPEs) which are nonfederal, local, or state funds that the federal government will match. CPEs are the funds that were used for actual costs of providing eligible services and/or activities. The MAA program allows for those FFP costs to be reimbursed between 50% and 75%. Types of activities that are claimable for reimbursement include Medi-Cal outreach, coordination and monitoring of Medi-Cal covered services, Medi-Cal program planning and policy development, and Medi-Cal contract administration.
For questions or more information, contact HSA Interim Director, Mimi Hall at email@example.com or LGA Coordinator, Nikki Yates at firstname.lastname@example.org.
Cruz to Health: Santa Cruz County Whole Person Care Pilot
Emily Chung, Whole Person Care (WPC) Program Director at HSA, Behavioral Health, presented an update on the WPC – Cruz to Health (WPC – C2H) Pilot Program which began in July, 2017. This program receives pilot dollars from the Department of Health Care Services (DHCS) as part of the MediCal 2020 waiver. The goals of WPC include integrating systems for better coordination, analyzing data infrastructure to provide services, and improving clinical and health outcomes for clients.
The WPC-C2H Pilot Program targets adult Medi-Cal beneficiaries of HSA clinics with risk factors including, but not limited to, mental health and/or substance use diagnosis, homeless or at risk for mental health and/or substance use diagnosis, homeless or at risk for homelessness, four or more psychiatric hospitalizations in a 12-month period, and prescriptions of five or more medications for chronic health conditions.
The Pilot Program’s Care Coordination Strategy includes working closely with key partners such as HIP to facilitate discussions on systems transformations, the Santa Cruz Health Information Organization (SCHIO) to Identify community’s data sharing needs, and IT integration to analyze data infrastructure and optimize resources. This level of multidisciplinary coordination has many benefits for clients such as increased communication resulting in shared care plans, integrated illness management and recovery (I-IMR), and TeleFriend devices to help clients manage their chronic psychiatric and medical conditions. Currently, there are 318 individuals enrolled in WPC-C2H. Statistics about conditions that clients typically have are shown in Figure 1. Because WPC-C2H enrollment is currently at capacity, next steps for this program include starting a new referral waitlist in which individuals will be reviewed for eligibility on a first-come, first-serve basis.
Figure 1: WPC – C2H: Enrollment Statistics. The numbers for people experiencing homelessness or who have a criminal justice history are low and undercounted indicating a data gap, which is being addressed to accurately report the WPC population.
For questions and more information about this program or the Data Sharing Convening, contact Emily Chung, Program Director at email@example.com.
WPC main email: firstname.lastname@example.org
New HIPC Leadership Introductions & Updates
Trina White, Chief Administrative Officer (CAO) and Stephanie Conner-Kent, Chief Nurse Executive (CNE) introduced themselves as the new leaders of Sutter Maternity & Surgery Center (SMSC).
In 2018, the SMSC team fulfilled several noteworthy accomplishments such as achieving Centers for Medicare & Medicaid Services (CMS) five star, gold standard rating for clinical quality as well as receiving the prestigious Leapfrog Top Hospital award. SMSC recently received the Center of Excellence in Robotic Surgery (COERS) award to recognize the center’s vibrant minimally invasive program for surgery, as well as the Center of Excellence in Minimally Invasive Gynecologic Surgery (COEMIG) award. SMSC was also awarded with The Joint Commission (TJC) Perinatal Certification and the baby friendly re-certification which recognized the Center’s efforts to lower C-section rates, support physiologic birth, and raise standards of care to increase healthier outcomes for mothers and newborns. Lastly, SMSC was recognized as a leader in LGBQT health equality.
This year, SMSC began the Sutter Safe Care Initiative. The initiative aims to foster a culture of safety and improvement through extensive team engagement and staff training, beginning in September. SMSC’s priorities continue to focus on community partnerships, and safety and clinical quality.