Medi-Cal Capacity Grant Program (MCGP)

Funding Need for Provider Capacity

• The Alliance service area needs additional providers to ensure our Medi-Cal population has access to timely health care services.
• Organizations that serve the Medi-Cal population need increased capacity and infrastructure to increase access and expand services for members.
• Providers that serve the Medi-Cal population need support in changing their clinic operations to improve quality, efficiency and patient experience through the adoption of the Patient Centered Medical Home.

Funding Goals for Provider Capacity

1. Increase member access to timely health care services.
2. Increase the number and array of health care providers (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 in order to reduce preventable illness.

Funding Interests for Provider Capacity

• 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 support 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.

Funding Need for Behavioral Health and Substance Use Disorder Services

• Behavioral health conditions and substance use seriously impact physical health and are associated with costly and debilitating chronic conditions.
• 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.
• 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

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 for Behavioral Health and Substance Use Disorder Services

• 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.

Funding Need for High Utilizer Support Resources

• “High utilizer” members are individuals who have complex physical, psychological and social needs and often lack the ability and support to use the health care system effectively.
• High utilizers often have frequent and avoidable emergency room visits, hospitalizations and readmissions.
• 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

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 for High Utilizer Support Resources

• Expansion, construction, acquisition and/or renovation of temporary or permanent supportive housing or other placement options that 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.

Funding Need for Healthy Eating and Active Living (HEAL)

• Access to healthy food and opportunities for physical activity in the Alliance service area is essential to preventing illness and promoting overall well-being for Medi-Cal members.
• Supporting chronic disease management and recovery from illness through nutrition.

Funding Goals for Healthy Eating and Active Living (HEAL)

1. Increase member access to fresh, affordable, healthy food.
2. Increase member access to physical activity opportunities.
3. Engage members to manage their own health to reduce preventable illness.
4. Strengthen linkages between the health care delivery system, schools and community-based organizations to support HEAL.

Funding Interests for Healthy Eating and Active Living (HEAL)

Projects that increase Medi-Cal member access to nutritious foods and opportunities for physical activity in health care, school and community settings, such as:

• Partnerships between health care and community organizations to tackle food insecurity through innovative projects.
• Programs that provide home meal delivery to complex-case patients, post-hospital discharge, to reduce hospital readmissions and emergency department utilization.