New CalAIM-focused position at CalOptima will prioritize culturally appropriate provision of Community support – State of Reform

With the aim of improving the delivery of CalAIM services to the beneficiaries, CalOptima, the public entity overseeing Medi-Cal in Orange County, has recently created a new post entitled “Executive Director of Medi-Cal / CalAIM. ” According to CalOptima representatives, the position is the first of its kind to be rolled out of a health plan in the state.

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The position was given to Kelly Bruno-Nelson, who previously served as president and CEO of the National Health Foundation (NHF), a Los Angeles-based nonprofit organization that works to improve the health of underserved communities. Bruno-Nelson says this new leadership position will help advance CalOptima’s role in meeting the objectives of the nationwide CalAIM initiative, in particular with regard to Community support to address the recipients’ social health determinants.

With CalOptima is one of the few state health plans to offer all 14 of CalAIM’s Community Supportssays Bruno-Nelson that the creation of a team in CalOptima dedicated solely to monitoring the rollout of CalAIM will help ensure that CalOptima complies with Department of Health Care Services (DHCS) regulations and guidelines, as well as constantly evolving to better meet the needs of members.

“[CalOptima] is a health plan that recognizes that the social determinants of health, which are 80% of our ability to be healthy, really should be at the center, ”said Bruno-Nelson. “Health plans have really put direct health care at the center of everything, and the philosophical shift has been very difficult to make, and I think CalOptima, by creating this position, is really setting the bar for what it looks like.”

She said her position will be focused on applying research and developing best practices to extend the basic guidelines and services outlined by DHCS and to make the implementation of CalAIM as smooth as possible. For example, Community Support Liaisons will be designated for the sole purpose of assisting CalOptima’s Community Support providers.

“[We will be] looks at each of these 14 Community grants and says: ‘What are the minimum requirements? What are the parameters? What do our members need and how can we expand these services? ‘”Said Bruno-Nelson.

“It’s literally engaging [Community Supports providers] in these discussions, and then try to develop services within each of the parameters that better reflect the needs of our members … It’s just taking a program that could be implemented in a meat and potato way, and really just try to expand our thinking, and the best way to do that is to engage the community-based organizations that provide the services. “

She underlined her enthusiasm for extending beyond the services outlined by DHCS, to better tailor services to CalOptima members and to anchor the delivery of each of the Community’s support in the dignity of the members.

“E.g, [with medically tailored meals], should the medically tailored meals be delivered in the traditional way? Should they be a Meals-On-Wheels service? Can it be a food pharmacy? There are many different ways to offer meals that are culturally more appropriate and ultimately more dignified.

It is the dignity behind the services, it is not just going the easy way, but going the dignified way that makes our members feel more human and just feel fair. ”

Bruno-Nelson added that she hopes to collaborate and share ideas with other health plans as CalOptima’s work in this area continues.

“I hope we can be a role model, I hope we can provide assistance. I do not think CalOptima is going to do all this work and then keep all these good ideas close to us … The more people, who learns what we do and we can work with, the better. “

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