In July 2017, the Employment and Human Services Department (EHSD) entered an Interdepartmental Services Agreement with Health Services to partner in the staffing of the Whole Person Care CommunityConnect Pilot Program.
Whole Person Care CommunityConnect (CMCT) serves 14,400 Medi-Cal recipients who are at high risk of utilizing high acuity medical services across multiple delivery systems of the Contra Costa County Health System. The program integrates physical health, behavioral health, and social services in a patient-centered manner to improve the health and well-being of this vulnerable population. These clients often overuse the emergency room department, inpatient hospitalization and psychiatric emergency resources due to a myriad of social barriers, including housing insecurity, poverty related challenges, mental health and substance related disorders, and social isolation. EHSD has embedded two (2) eligibility workers (Social Service Program Assistants) to serve the clients of CMCT. A primary function of the SSPAs is to assist CMCT clients in maintaining eligibility to Medi-Cal and gain access to additional benefits for which they may be eligible.
Each month, between 800-1,000 CMCT clients’ Medi-Cal lapses, meaning their coverage has terminated. This can occur for a variety of reasons (no longer need coverage, moved out of county, etc.), but a significant reason is that the client missed their re-determination period due to the social barriers they face on a daily basis. The SSPAs work collaboratively with the CMCT Case Managers to assist in restoring Medi-Cal for clients during a 90-day cure period to ensure continuity in health care and continued eligibility to CMCT. Another role the SSPAs play is assisting in processing applications for CalFresh and Cash Aid. Many clients are unaware of their eligibility for additional public services. As they become aware through the support of their Case Managers, the dedicated SSPAs are able to conduct the intake process with the client, ensuring their benefits are processed in a timely manner.
Due to the high volume of clients, an additional SSPA will assist in the above mentioned roles. More clients will be restored to Medi-Cal, more client benefits will be granted benefits in a timely manner, and more clients will remain eligible to CMCT.
If this action is not approved, EHSD will not be able to ensure the timely and necessary granting of benefits necessary to ensure continued eligibility to CMCT, thus placing Health Services at risk of losing clients for the Whole Person Care pilot.