Medi-Cal Capacity Grant Program (MCGP)
The Alliance makes investments to health care and community organizations in Merced, Monterey and Santa Cruz counties through the Medi-Cal Capacity Grant Program to realize the Alliance’s vision of heathy people, healthy communities.
These investments focus on:
- Increasing the availability, quality and access of health care and supportive resources for Medi-Cal members.
- Addressing social drivers that influence health and wellness in our communities.
Since 2015, the Alliance has awarded 588 grants totaling over $129.8 million to 141 organizations in the Alliance’s service area to strengthen the local health care delivery system.
Focus Areas and Goals
The MCGP provides grants to local organizations through investments in three focus areas:
- Access to Care.
- Healthy Beginnings.
- Healthy Communities.
The goals and priorities under each focus area guide strategy development for new MCGP funding opportunities.
The Alliance will focus on strengthening and expanding the provider workforce to address provider shortages and increase the number of providers who reflect the diversity of the Alliance’s membership. The Alliance will also make investments to improve coordination across the health care system and address infrastructure and capacity gaps to ensure that Medi-Cal members are able to access high-quality care when, where and how they need it.
Funding Need for Access to Care
- Health care workforce shortages in the Alliance service area impact Medi-Cal members’ access to timely health care services.
- New provider types are being integrated in the Medi-Cal health care continuum to deliver a range of new non-medical services to address social drivers of health.
- The existing health care workforce is challenged to reflect the racial, ethnic, cultural and linguistic diversity of Alliance members.
- Organizations that serve the Medi-Cal population need expanded capacity and infrastructure to increase access to services.
Funding Goals for Access to Care
- A robust health care workforce that can deliver coordinated, person-centered care and the full array of Medi-Cal services.
- Improved patient-provider communication and trusted relationships, resulting from an expanded network of Medi-Cal providers who are linguistically and culturally responsive.
- Medi-Cal members are able to access high-quality care when, where and how they need it.
Funding Priorities for Access to Care
- Address workforce shortages, infrastructure and capacity gaps.
- Increase the racial, ethnic, cultural and linguistic diversity of the provider network to better reflect the Alliance’s membership.
- Improve the coordination, integration and capacity of the behavioral health system, including coordination between the physical health system and behavioral health system.
By investing in early childhood development, the Alliance will positively impact the health and well-being of its youngest members and their families in the short and long term, as well as ensure they have the resources and support needed to thrive.
Funding Need for Healthy Beginnings
- The first five years of life are critical to health and brain development.
- Historical and persistent trauma (including systemic racism) and adverse childhood experiences can negatively impact physical, mental, emotional and behavioral health.
- Barriers to preventative services affect maternal, infant and child health.
- Investing in early childhood development has proven benefits for children, families and society.
Funding Goals for Healthy Beginnings
- Families with a new child receive timely prenatal and post-natal care to ensure optimal physical and mental health for mothers and to promote healthy birth outcomes.
- Children are healthy and thriving by age 5.
- Children (prenatal through age 5) and their parents/caregivers have access to preventative health care services and community resources to support their families’ health and well-being.
- Parents and caregivers have the knowledge, resources and support they need to provide safe, nurturing environments for their children.
Funding Priorities for Healthy Beginnings
- Increase access and use of preventative health services, early identification and intervention services, behavioral health interventions and early childhood development interventions.
- Provide parents with social support and education about child development and parenting.
- Assist families in navigating the health care system and connecting to health and community resources that support child development and family well-being.
- Promote strategies for systems change that allow families to fulfill aspirations for children’s long-term health and economic opportunities.
By investing in the non-medical factors that impact health, such as food and housing, the Alliance can ensure that Medi-Cal members have access to what is needed to live their healthiest lives at every stage of life. Creating communities where healthy options are easy and available to all can reduce health disparities, support healthy and active lifestyles and reduce risk of chronic disease.
Funding Need for Healthy Communities
- Social, economic and environmental factors shape individual health and well-being. These factors influence risk for chronic conditions such as diabetes, asthma and cardiovascular disease.
- Lack of access to healthy food, safe and stable housing, quality schools and safe places to exercise and play create barriers to health.
- Geographic communities experience differences in environmental factors and distribution of resources, which contribute to disparities in health risks and quality-of-life outcomes.
- Medi-Cal members experience barriers such as: limited English proficiency, transportation, childcare, and health literacy; food insecurity; overcrowded housing; insecure employment; and low wages. These barriers impede their ability to access services and manage their health.
Funding Goals for Healthy Communities
- Medi-Cal members have access in their communities to what is needed to live their healthiest lives, support healthy options and reduce risk of chronic disease, including access to:
- Fresh, affordable, healthy food.
- Safe places to play and be active.
- Permanent supportive housing for Medi-Cal members experiencing homelessness.
- Medi-Cal members have the knowledge and resources to effectively manage their health.
- Medi-Cal members are empowered to advocate for policy and systems changes that promote good health for themselves and their communities.
Funding Priorities for Healthy Communities
- Focus on individuals, families and communities experiencing disparities in health.
- Invest in drivers of individual and community health and well-being, such as nutritious food, supportive housing and safe places to be active.
- Engage trusted community-based organizations to promote available health care services and resources to reduce disparities.
- Support community/youth leadership development and civic engagement efforts that transform infrastructure and promote wellness and health equity for individuals and the community.
The following principles guide MCGP grantmaking.
- Equity in impact.
- The MCGP will ensure grantmaking is tailored to local needs and prioritizes resources and attention to communities and populations that experience inequities.
- The MCGP will engage the community to understand the diversity of health-related needs and opportunities to advance the Alliance’s vision of Healthy People. Healthy Communities.
- The MCGP will create opportunities for members to play a central role in crafting solutions through grantmaking to improve health and well-being for themselves, their families and their communities.
- Trusting relationships with partners.
- The MCGP is committed to building trusting, collaborative relationships with community partners based on mutual respect, collaborative learning and aligned priorities.
- Transparent, accessible and responsive grantmaking.
- The MCGP seeks to minimize administrative burden on grantees and ensure the level of effort is commensurate with the grantee organization’s scale and administrative ability.
- The MCGP ensures accountability for grant funds and transparency about funding decisions and requirements.
- The scale and impact of MCGP investments on the Medi-Cal system, infrastructure and members is measured and communicated.
- Grantmaking informed by Medi-Cal delivery system expertise and experience.
- Grantmaking is responsive to funding gaps and infrastructure needs to meet the challenges of Medi-Cal transformation.
- Investments support systems change and innovations in the safety net health care delivery system to address root causes that impact health.
- Grantmaking is developed in close coordination with Alliance staff, Board and community stakeholders.
- Holistic view of health.
- Grantmaking promotes a holistic view of health that includes supporting Medi-Cal members in achieving and maintaining optimum physical, mental and social well-being.
- Investments to address disease prevention and disease management are made upstream from the medical model to address root causes and prevention.
The MCGP is a part of the Alliance’s financial plan, which creates prudent health plan reserves and enables the use of surplus funds to expand access and improve Alliance member benefits. The Alliance allocates funding to the MCGP from its earned net income after meeting regulatory and Board designated reserve requirements and ensuring adequate funding for augmented provider reimbursements and successful implementation of Medi-Cal program requirements. The MCGP’s financial strategy is founded on the following elements:
- Funding Allocations. MCGP funding is allocated by county and funding opportunity. Funding allocations also consider equity in impact of programs, not just equity in allocation.
- Annual Spending Plan. The MCGP develops and adheres to an annual spending plan to ensure transparency to potential grantees about the level of funding to be made available in the community for activities within the focus areas.
- Member Benefit. The MCGP makes strategic use of Alliance reserves to strengthen the delivery system to meet Medi-Cal member needs.
- Local Innovation. The MCGP ensures strategic use of reserves to enable local innovation rather than supplanting state resources for ongoing program administration. Covered Service benefit expansions, provider payment augmentation and other services managed by the health plan are addressed via the health plan’s operating budget, not through the MCGP.
- Funding Decisions Free from Conflicts of Interest. The MCGP relies on an administrative decision-making structure that avoids conflicts of interest in the approval of programs and specific grants.
These key criteria are used to evaluate funding requests and will be used to guide planning for future MCGP investments:
- Medi-Cal Purpose: All grants must benefit Medi-Cal beneficiaries.
- Sustainability: The Alliance makes investments with the goal of creating lasting change in the Medi-Cal delivery system or in member and community health that is sustainable past the grant funding period. Grants are generally one-time investments to build capacity or ensure adequate local infrastructure to meet Alliance member needs.
- Service Area: Grantees must maintain ongoing operations, including staffing and programs, in the Alliance service area.
- Alignment with Vision, Mission and Priorities: The Alliance invests in organizations and efforts that advance the Alliance’s vision, mission and strategic priorities.
- Focus Areas: Funding awards must be associated with at least one of the MCGP focus areas and support the identified goals for that focus area.
- Supplanting: MCGP funding should not be used to supplant or duplicate other funding in order to focus investments on areas where limited funding is available or where other funding sources can be leveraged to have a greater impact.