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Provider Digest | Issue 2

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A peek at what’s ahead: Alliance Strategic Plan Executive Summary

Thank you for working with us to provide accessible, quality health care guided by local innovation! As we look ahead, we are excited to implement our 2022-26 Strategic Plan, and we can’t do this important work without you.

To read highlights and get a brief overview of the areas of focus, check out our Executive Summary. Over the next five years, the Alliance will build on its history of improvement and innovation, relying on member voices to inform and guide our actions.

Read the complete version of the Strategic Plan

Enhanced Care Management and Community Supports available in Merced, Monterey and Santa Cruz counties

As of July 1, 2022, Enhanced Care Management (ECM) services are now available in Merced County. ECM was launched in Monterey and Santa Cruz counties in January 2022.

Additionally, two new Community Supports (CS)—Recuperative Care and Short-Term Post Hospitalization Housing—have also been rolled out in all three counties.

California Advancing and Innovating Medi-Cal (CalAIM) is an initiative by the Department of Health Care Services (DHCS) to improve the quality of life and health outcomes of Medi-Cal members by implementing a broad delivery system, program and payment reform across the Medi-Cal program. CalAIM establishes the framework to address social determinants of health and improve health equity statewide.

A key feature of CalAIM is the introduction of Enhanced Care Management (ECM) in the Medi-Cal managed care delivery system, and a new menu of Community Supports, or in lieu of services (ILOS), which can serve as cost-effective alternatives to covered Medi-Cal services.

ECM providers deliver:

  • Comprehensive care management.
  • Care coordination.
  • Health promotion.
  • Comprehensive transitional care.
  • Individual and family support services.
  • Referrals to community social supports.

Los apoyos comunitarios incluyen lo siguiente:

  • Servicios de Navegación de Transición de Vivienda.
  • Depósitos de Vivienda.
  • Servicios de Obtención de Vivienda y de Mantenimiento.
  • Comidas Médicamente Personalizadas.
  • Cuidados de Recuperación.
  • Short-term Post Hospitalization Housing.
  • Sobering Centers (Monterey County).

For training, policies, toolkits and member referral forms, visit our ECM/CS page for providers.

COVID-19 vaccine updates

Health care professionals have a central role in discussing vaccination against COVID-19 with their patients. Please share the following updates with your patients.

COVID-19 vaccines for younger children and infants

CDC has expanded COVID-19 vaccine eligibility to infants and younger children. It is now recommended that everyone 6 months and older get vaccinated.

To learn more, visit the CDC page detailing COVID-19 vaccine recommendations for children and teens.

CDC also offers information that may be helpful for talking to parents about their children’s COVID-19 vaccinations, including answers to frequently asked questions

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/vaccine-safety-children-teens.html

Booster updates

In May of 2022, the Centers for Disease Control and Prevention (CDC) updated COVID-19 vaccine booster dose guidelines.

There is evidence that the COVID-19 vaccine booster can further enhance or restore protection that might have decreased after a primary series vaccination. Data show that people with booster doses were 21 times less likely to die from COVID-19  and 7 times less likely to be hospitalized when compared to those who were unvaccinated.

Everyone ages 5 years and older should get 1 booster at least four months after completing their COVID-19 vaccine primary series Adults ages 50 years and older and people ages 12 years and older who are moderately or severely immunocompromised should receive a second booster dose at least four months after the first booster dose.

For more information regarding clinical considerations, please visit the sitio web de los CDC.