Seniors and people with disabilities who are eligible for MediCal and Medicare can now integrate their services into one plan in 12 California counties.
Additionally, the recent expansion of MediCal and the elimination of limits on assets such as bank accounts, property and a second car help more people qualify for MediCal coverage.
During the video conference: “How MediCal helps seniors and people with disabilities. Californians thrive in their communities,” organized by Ethnic Media ServicesDepartment of Health Care Services (DHCS) leaders, and community health care providers shared how these MediCal programs are helping older and disabled Californians live healthier lives at home.
Dana Durham, chief of the Department of Health Care Services’ Managed Care Monitoring and Quality Division, said they work to ensure members have access to comprehensive preventive services that meet their needs before they get sick.
“This is interconnected with what we call social drivers of health, to understand where people are, where they are born, where they live, where they learn, play and worship because all of these things drive their health, quality of life and other things that we consider risk factors.”
She noted that there are a variety of services and programs available to help people such as enhanced care management and community supports.
“Together, these benefits and services provide coordinated access to more culturally competent care, better integration of physical and behavioral health, and increased transparency.”
MediCal and Medicare
Anastasia Dodson, deputy director of the Department of Health Care Services’ Office of Medicare Innovation and Integration, noted that MediCal is California’s Medicaid program that provides comprehensive care for low-income Californians.
He said that in California there are about 6.6 million people who have Medicare, and 1.6 million have both Medicare and MediCal.
“Those on both programs often suffer from complex health conditions involving physical, behavioral and social needs.”
She said some people with Medicare may not know that they can also enroll in MediCal if they have limited income.
“MediCal works with Medicare to cover most of your co-pays and prescription drug costs, and there are other benefits in MediCal that aren’t available in regular Medicare, such as long-term care, dental support, and more.”
He said that people enrolled in both programs will probably not pay for any type of care.
“We encourage anyone who has Medicare to also apply for MediCal and then, if the person meets the income limit for medical expenses, they can get both.”.
He said that in order to navigate the benefits of both programs, they help them combine their benefits into one plan in 12 counties, Fresno Kings, Los Angeles, Madera, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Mateo, Santa Clara and Tulare.
New services
Jenna LaPlante, Senior Director of Care Management Programs at Institute on Agingsaid they have been able to transfer some of the disabled adults they serve who live in nursing homes to the new MediCal services.
“We now serve clients in nine counties across the state through care coordination, enhanced management and community supports.”
He said the counties currently served are San Francisco, San Mateo, Santa Clara, Santa Cruz, Monterey, Merced, Alameda, Riverside and San Bernardino.
“We are in discussions with several other health plans across the state to look at expanding our services. This has allowed us to serve more people than we have ever served before and we are very excited about that.”
Many options
Carrie Madden from Aging and Disability Resource Connection of Central and South LAstated that their main services are information and references, and they provide them quickly.
“As we take notes of the cases and issues people are calling us about, we can send them to the providers of the services they are looking for; and once we have provided them with the information about the services they are requesting, we will call back in a few days to make sure they actually made the connection.”
He explained that many times the person who calls already has an idea of the service and program he or she wants.
But he said once you start talking to them, giving them options and discovering their capabilities, they find that there may be programs that are a better fit for them.
She mentioned that when they receive calls from homeless people, they discover that they need much more than just finding a place to live.
“Many of them have no income and no food. Sometimes they need a wheelchair. What we do is refer them to all of those services; and then we follow up to make sure that each individual service has been provided.”
And finally, she said that they have the transition service, which is when they help people leave nursing homes and treatment centers, and provide them with the services they need to continue living in the community where they came from.
Housing support
Keith Miller, CEO of Communities Actively Living Independently and Freely (CALIF), one of 20 independent living centers in California that work with older adults and people with disabilities, said they recently signed a contract to provide community-based housing support services, and case management and support for people who come into emergency rooms.
She said a program was created to help people with disabilities and seniors connect with agencies once they are discharged from the hospital and provide ongoing support for college programs that use MediCal dollars to pay for direct services.
“We also provide support to people in areas experiencing disasters. We work closely with the Department of Rehabilitation, the state, county and city along with several other community partners. The only criteria to receive services under MediCal is that you are a person with a disability and can benefit from our services.”
Far from institutionalization
Lilly Sanchez, a CALIF case manager, said they offer a variety of services from helping a person obtain housing or maintain their housing to helping them obtain their benefits.
“These are essential services that a person requires or needs, especially when they are in a vulnerable state. We also help keep people away from being institutionalized in a nursing home, since we work specifically with disabled people and seniors in that category.”