Healthcare Access: Medi-Cal Redetermination Project

Health Care Access

Expand existing project, program, or initiative

The need is critical to raise awareness of steps Medi-Cal beneficiaries need to take, and when they need to take them, to maintain their health plan coverage. Medi-Cal enrollments and re-enrollments are already a central focus at WWLA for low-income, predominantly Latino and numerously immigrant residents in its Los Angeles service area. WWLA is committed to, through the efforts of its expert Certified Enrollment Counselors/Health Plan Navigators, ensuring 100% of Medi-Cal members are informed - and appropriately re-enrolled. Most WWLA clients, and potential clients, are considered a hard-to-reach population. Often, due to unique cultural individualities, they lack knowledge of healthy living programs, lack access to healthcare services, and are at risk of slipping through the healthcare safety net because of limited resources to access these services. WWLA provides families with culturally relevant and effective messages concerning Medi-Cal coverage policy to retain their benefits.

WWLA's Healthcare Access program will increase the awareness and understanding that COVID-19-era continuous coverage for Medi-Cal enrollees is ending and everyone must re-enroll on an annual basis so their coverage will not lapse. WWLA will conduct increased access-to-healthcare presentations, and staff will provide initial Medi-Cal-enrollment assistance and Medi-Cal continuation recertification/re-enrollment, helping both groups on an ongoing basis to navigate their health plans. Focus will be on Medi-Cal plan retention, for which the annual requirement is returning following COVID-19-era automatic continuous coverage. WWLA Certified Enrollment Counselors will facilitate health and wellness seminars and culturally sensitive presentations in Spanish. To maintain an active list of program partners, WWLA staff will conduct outreach to businesses, community organizations, and schools serving low-income populations, with subject matter including preventive health education, enrollment (and retention) into Medi-Cal and other affordable health insurance programs, i.e., Medicare and My Health LA, nutrition information, and physical activity. To assess the program, staff will document and create reports regarding a) the number of one-on-one outreach engagements; b) the number of new enrollments and renewals into Medi-Cal and other coverage plans; and c) client demographics and their health plan choices.

Low-income residents of WWLA's catchment area in south and central Los Angeles, which includes an estimated 70% Latino and 40% immigrant residents, will through this program have the awareness to enroll and re-enroll into Medi-Cal, an effective health plan for which they are eligible. According to the 2000 U.S. Census, for two large communities within WWLA's service area, Boyle Heights residents are 94.0% Latino and 52.4% foreign-born, while Pico Rivera residents are 85.4% Latino and 64.6% foreign-born. WWLA expects during the 12-month grant period, to provide healthcare plan enrollment and retention assistance to over 3,000 clients applying for or retaining healthcare. We expect at least 750 newly enrolled Medi-Cal recipients and a minimum of 2,250 re-enrollments. WWLA expects to have 90%-100% of already enrolled participants retain that coverage for the next 12 months.

As stated, Medi-Cal enrollments and re-enrollments are already a central focus at WWLA. For the 12-month period ending February 28, 2023, WWLA provided 220 preventive health presentations for 106 different partners to 2,326 participating residents. Enrollment assistance that included Medi-Cal at community clinics, online, and at our offices, was provided to 1,731 new applicants and renewal/retention assistance to 1,084 existing Medi-Cal members. Regarding evidence, WWLA utilizes an Airtable database and reporting evaluation methods to assess and revise programs to best meet the needs of specific audiences. WWLA's Board and key staff monitor, review, and discuss programs' metrics, identifying activities requiring improvement and laying out plans of action for improvement. WWLA maintains a database of contacts, activities, and attendance logs and records them into the Community Health Outreach Initiative (CHOI) database, managed by the L.A. County Dept of Public Health.

Not applicable