TITLE
Recommendation to authorize City Manager, or designee, to execute an agreement, and all necessary documents and any subsequent amendments, including amendments to the amount of the award, with LA Care Health Plan and Health Net to accept and expend grant funding in the amount of $810,808 for capacity building support to develop Enhanced Care Management and Community Supports under California Advancing and Innovating Medi-Cal’s (CalAIM) Incentive Payment Program for a one-year period estimated to begin in October 2022, with the option to extend the agreement for an additional one-year period, at the discretion of the City Manager; and
Increase appropriation in the Health Fund Group in the Health and Human Services Department by $810,808, offset by grant revenue. (Citywide)
DISCUSSION
CalAIM is a new initiative by the California Department of Health Care Services (DHCS) to improve the quality of life and health outcomes of Medi-Cal members by implementing a broad delivery system, program, and payment reform across the Medi-Cal program. The initiative seeks to: establish a population-health management framework to address social determinants of health and improve health equity statewide; focus on an Enhanced Care Management (ECM) approach; and, fund Community Supports (CS) which will serve as cost-effective alternatives to covered services in the Medi-Cal managed care delivery system.
CalAIM is comprised of interdisciplinary approaches to care that address the clinical and non-clinical needs of high-cost and/or high-need populations (populations of focus) in Medi-Cal through a systematic coordination of services and comprehensive, community-based care management. Populations of focus are defined as high-utilizers of emergency services, people experiencing homelessness, and adults with serious mental illness or substance use disorder who are impacted by complex social factors. CalAIM is unique as it has an enhanced focus on and the incorporation of serv...
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