Medi-Cal Capacity Grant Program


Priority Focus Areas and Goals

Click on a Focus Area below for more information.


1. Provider Capacity

The Alliance has experienced significant growth since the implementation of the Affordable Care Act (ACA), with over 120,000 new members between January 1, 2014 and January 1, 2016. This dramatic increase in new members, many of whom have complex medical and behavioral health conditions requiring frequent and intensive care, has put new demands on provider capacity and strained providers’ ability to deliver timely access to health care services. Additional provider capacity is needed to serve the growing Medi-Cal population in our service area.


Funding Goals for Provider Capacity


Within this priority focus area, the Alliance will award grants to:

1.

Increase member access to timely health care services.

2. Increase the number and array of health care providers (e.g. specific provider types, geographic locations, language, and culture) in our service area.
3. Support the delivery of comprehensive, coordinated, patient-centered care.
4. Engage members to manage their own health to reduce preventable illness.

Funding interests include:

 •  Expansion, construction, acquisition and/or renovation of clinic sites to increase organizational capacity to provide care to Medi-Cal members.
 •  Infrastructure enhancements, such as health information technology and equipment that enhance access and supports integrated and coordinated care delivery.
 •  Technical assistance and practice coaching to improve clinic operations, increase access to care, and improve member experience and quality of care.
 •  Provider recruitment to increase the number and availability of health care providers in the Alliance service area.

2. Behavioral Health and Substance Use Disorder Services

Behavioral health conditions and substance use disorders are among the most significant health problems facing our members. Behavioral health conditions and substance use seriously impact physical health and are associated with costly and debilitating chronic conditions, including diabetes, heart disease, and cancer. Access to behavioral health services and substance use disorder treatment is limited in the Alliance service area, partly due to a shortage of specialized providers and lack of integration with primary care services. Individuals with both physical and behavioral health conditions receive services from fragmented systems of care that often lack coordination. Addressing behavioral health and substance use challenges is central to promoting healthy individuals, families and communities.


Funding Goals for Behavioral Health and Substance Use Disorder Services


Within this priority focus area, the Alliance will award grants to:

1.

Increase the availability of behavioral health and substance use disorder services.

2. Increase integration of behavioral health and substance use disorder services and primary health care.
3. Increase coordination of care and services across systems.

Funding interests include:

 •  Expansion, construction, acquisition and/or renovation of facilities to increase organizational capacity to provide behavioral health services and substance use disorder treatment to Medi-Cal members.
 •  Infrastructure enhancements, such as health information technology and equipment that increase access and support coordinated and integrated care delivery.
 •  Technical assistance and training to increase organizational capacity to provide behavioral health and substance use disorder treatment services, support efforts to integrate services, and improve member experience and quality of care.

3. High Utilizer Support Resources

The term “high utilizer” describes individuals who have complex physical, psychological, and social needs and often lack the ability and support to use the health care system effectively. As a result of their complex needs and a fragmented health care system, high utilizers often have frequent and avoidable emergency room visits, hospitalizations, and readmissions. Multiple chronic conditions and behavioral health and/or substance use disorders are major drivers of costly high utilization of medical services. Medically fragile Medi-Cal members need intensive medical care and non-medical resources, such as housing assistance and other support services, to achieve better health outcomes.


Funding Goals for High Utilizer Support Resources


Within this priority focus area, the Alliance will award grants to:

1.

Improve care coordination for our most complex and medically fragile members.

2. Improve health outcomes of members with high risk chronic conditions.
3. Strengthen linkages to community-based resources to reduce barriers to care.

Funding interests include:

 •  Expansion, construction, acquisition and/or renovation of temporary or permanent supportive housing or other placement options which facilitate access to care for the Alliance’s most complex and medically fragile Medi-Cal members.
 •  Infrastructure enhancements, such as health information technology and equipment that support coordinated and integrated care delivery, such as data sharing systems.
 •  Technical assistance and training to increase organizational capacity to expand or improve services for the Alliance’s most complex and medically fragile Medi-Cal members.










 


















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