CPCA PARTNERS WITH THE DEPARTMENT OF HEALTH CARE SERVICES ON THE MEDI-CAL HEALTH NAVIGATOR PROJECT
The California Primary Care Association (CPCA) advocated and successfully secured a one-time state and federal $20 million investment for Medi-Cal health navigation services. This opportunity resulted in funding to community health centers (CHCs) and consortia for Medi-Cal outreach, enrollment, renewal, utilization, and troubleshooting efforts across California. These activities will support California’s Medi-Cal redetermination and expansion goals through 2025.
The Department of Health Care Services (DHCS) is the designated recipient of the funding and contracted with CPCA to administer these funds as a Third-Party Administrator (TPA). CPCA launched a two-part application process in September 2023 to award $17.75 million to subcontractors for work between December 1, 2023 and June 30, 2025. CPCA received strong interest from CHCs and consortia across the state; 190 health centers and 11 consortia applied and requested a total of $58 million. CPCA leveraged DHCS’s scoring matrix and a review panel to review and score all applications. Based on the scoring outcomes and funding methodology, CPCA recommended potential awardees to DHCS for their review. Organizations advancing on to part two of the application are currently submitting their narrative, work plan, and budget plan.
CPCA anticipates subcontracting with 24 organizations, which include 114 CHCs, and 10 consortia in over 40 counties across the state. Notably, some of these counties have not received any SB 154 funding to date or are underfunded based on percentage of Medi-Cal patients compared to SB 154 navigation funding. What’s more, the majority of organizations supported through this funding have not received any SB 154 funding previously, which demonstrates the wide impact of this program and investment.
DHCS will provide final approval of all subcontractors, work plans, and budget plans, and subcontracting will commence in December 2023. Once implemented, this funding will support community health centers and consortia to provide Medi-Cal Health Navigator services and activities pursuant to AB 102, as prescribed by Senate Bill 154 (Chapter 38, Statutes of 2022) with a focus on one or more of the twelve target populations:
Persons with mental health disorder needs;
Persons with substance use disorder needs;
Persons with disabilities;
Aged persons;
Persons who are homeless;
Young people of color;
Immigrants and families with mixed immigration status;
Persons with limited English Proficiency;
Low-wage workers and their families;
Uninsured children and youth formerly enrolled in Medi-Cal;
Persons who are in county jail, in state prison, on state parole, on county probation or under post-release community supervision; and
Populations affected by the Medi-Cal eligibility expansions.
Click here to view more information about the CPCA Medi-Cal Health Navigators Project. Email HealthNavigators@cpca.org with questions.