Medi-Cal: enhanced care management and community supports.
If enacted, SB 324 would significantly alter the mechanisms by which Medi-Cal managed care plans deliver services to targeted populations. The bill mandates that plans respect member preferences when selecting service providers and emphasizes the integration of community-based organizations into the care process. The legislation calls for a shift from mere provision of healthcare to a comprehensive approach that encompasses social determinants of health, ultimately benefiting the communities served by these plans.
Senate Bill 324, introduced by Senator Menjivar, aims to enhance the existing Medi-Cal program by updating and improving the delivery of enhanced care management (ECM) and community supports for eligible beneficiaries. This bill requires Medi-Cal managed care plans to contract with community providers whenever these providers are available and can meet the required standards. These enhancements intend to ensure a more holistic, person-centered approach to healthcare for individuals enrolled in Medi-Cal managed care plans, particularly those who are high utilizers of healthcare services or experiencing homelessness.
The sentiment surrounding SB 324 is largely positive, with strong support from healthcare advocates and local community organizations who view the bill as a necessary step in addressing the non-clinical needs of Medi-Cal beneficiaries. However, there may be concerns regarding the increased workload for managed care plans in contracting and managing these community partnerships, ensuring all providers adhere to quality standards.
Some points of contention include the operational implications for Medi-Cal managed care plans, which may need to adjust their business models to effectively engage community providers. Additionally, the requirement for broader reporting and the periodic review of community support utilization data may be seen as regulatory burdens by industry stakeholders. The changes could lead to challenges in ensuring consistent service delivery across diverse geographic areas and populations.