January 25, 2023

In This Issue

CalOptima Health News


CalOptima Health Behavioral Health Integration Launches Innovative Programs 


CalOptima Health Expands CalAIM Community Supports


CalOptima Health Launches Enhanced Care Management Academy for CBOs


Applications for $36.5 Million Funding for CBOs Addressing Homelessness Ends January 31


CalOptima Health Welcomes New Medical Directors


CalOptima Health Offers Eligible Members Health Rewards for Cervical Cancer Screenings


Community Partner Highlight: Latino Health Access


Orange County Board of Supervisors Appoints 2023 Officers


Medi-Cal Redetermination Will Resume in April


Access and Share Emergency Resources from the California Health and Human Services Agency (CalHHS)




Vertical portrait of a cheerful family with red Tet symbolic isolated on white

PACE Director Interviewed on Coordinating Care for Elderly Parents


Dietitian Shares Weight Loss Tips


NAMI OC President Discusses Peer Support Program in Partnership with CalOptima Health


U.S. COVID-19 Public Health Emergency Extended Through April


2023 Health Care Forecast Conference

CalOptima Health News


CalOptima Health Unveils Innovative Behavioral Health Programs

CalOptima Health’s Behavioral Health Integration team begins 2023 with a focus on innovative programs for members with mental health needs. CalOptima Health formed a partnership with National Alliance for Mental Illness (NAMI) Orange County to launch a peer support program for Medi-Cal members recently discharged from a psychiatric inpatient hospital stay or emergency room visit. As part of the $5 million grant program, NAMI Orange County will pair trained peer mentors with CalOptima Health members to provide social support and assistance with navigating mental health resources. 


In another key partnership, CalOptima Health is working with all 29 Orange County school districts to address the growing mental health crisis among children and teens. Through a statewide initiative called the Student Behavioral Health Incentive Program (SBHIP), up to $25 million in incentives will be available


for school districts that make behavioral health system improvements and open

Portrait of young African-American therapist leading support group for children with teenage girl speaking

Up to $25 million in incentives will be available for school districts that make behavioral health system improvements and open the door for Medi-Cal reimbursement of services delivered at schools.


the door for Medi-Cal reimbursement of services delivered at schools. The incentive dollars will fund significant new resources, such as more counselors, wellness programs, telehealth services and crisis screenings. 


CalOptima Health Expands CalAIM Community Supports

CalOptima Health is proud to announce that all 14 CalAIM Community Supports are now available to eligible members. Please review the member-facing flyers to learn more about the comprehensive services that are part of Medi-Cal. These services are meant to improve members’ quality of life and health outcomes by meeting people where they are in life, addressing social drivers of health, and breaking down barriers by fulfilling housing, food and other supportive needs. 


These flyers were developed with CalOptima Health members in mind. Please share them to alert members about the services for which they may be eligible. 

Enhanced Care Management Academy Will Train CBOs

The Enhanced Care Management (ECM) benefit is a cornerstone of California Advancing and Innovating Medi-Cal (CalAIM) to coordinate care across both physical and behavioral health systems. CalOptima Health is expanding the network of community-based organizations (CBO) providing ECM services by launching the “ECM Academy.” The goal is to train Federally Qualified Health Centers (FQHCs) and CBOs to provide ECM benefits, resulting in more CalOptima Health members receiving culturally relevant care tailored to their unique needs in a community setting. The first cohort of the ECM Academy began on January 20 and will conclude at the end of June. More than 20 FQHCs and CBOs are already enrolled, collectively representing the diversity of our members and county. 


The second cohort of the ECM academy will launch in July. CBOs interested in participating can email CalOptima Health Director of CalAIM Mia Arias at mia.arias@caloptima.org to learn more.

Grant Applications for $36.5 Million in Funding for CBOs Addressing Homelessness End January 31

CalOptima Health is participating in the Department of Health Care Services' (DHCS) Housing and Homelessness Incentive Program (HHIP) and is offering a $36.5 million Notice of Funding Opportunity (NOFO) for CBOs to support the delivery and coordination of health and housing services for Medi-Cal members who are experiencing homelessness or are at-risk of homelessness. The online portal to submit applications will close end of day Tuesday, January 31. The funding areas include the following three priority areas:

  1. Infrastructure to coordinate and meet member housing needs
  2. Partnerships and capacity to support referrals for services
  3. Delivery of services and member engagement.


There is also a dedicated pool of funding for organizations with small operational budgets (less than $5 million) serving equity populations. For questions and to learn more about the application process, contact CalOptima Health Program Manager Jasmine Awadallah at jasmine.awadallah@caloptima.org or 657-900-1459. 

CalOptima Health Welcomes New Medical Directors

Said Elshihabi, M.D.

Dr. Elshihabi will lead the development of CalOptima Health’s value-based neurosurgery and spine program. He is a board-certified neurosurgeon with expertise in managing spinal disorders, brain tumors and cranial trauma and performing interventional spine procedures. Dr. Elshihabi has more than 15 years of active private practice experience and five years of utilization and quality management experience in neurosurgery and spine surgery. He received his medical degree from the University of Texas Health Science Center at San Antonio and completed his neurosurgery residency at the University of Arkansas for Medical Sciences. 

Tanu Pandey, M.D., MPH, FACP

Dr. Pandey’s focus at CalOptima Health will include transgender health, appeals and grievances, and quality. She is double board certified in internal and preventive medicine and has a master’s degree in public health. She was in clinical practice for more than 20 years before becoming a full-time physician executive. She has 15 years of utilization management experience, and her areas of expertise are transgender health, clinical documentation and durable medical equipment. Dr. Pandey also worked in academic medicine as core faculty at Cook County Hospital and Rush University in Chicago, and at the Geffen School of Medicine at UCLA.

Eligible Members Can Receive Health Rewards for Cervical Cancer Screenings

Get Informed. 

Cervical cancer is cancer of the cervix. The cervix is the lower structure of the uterus or womb, where a baby grows when a woman is pregnant. The Pap test, also known as a Pap smear, screens for cervical cancer and can help find cervical cancer early. A Pap test is quick and simple. Some women may feel minor discomfort that goes away after the test is over. 


Get Screened.

At 21 years of age and older, women should talk with their doctor about routine Pap tests and how often they should be done.


Get Vaccinated.

Most people don’t realize that the human papillomavirus (HPV) is the main cause of cervical cancer. HPV is a very common sexually transmitted infection. Most people get it, but it often goes away on its own. However, if HPV doesn’t go away, it can cause cancer. 

There is a vaccine to prevent HPV. The HPV vaccine protects individuals against the infection and cancers. The schedule for getting vaccinated depends on age and health status. Ask a doctor if the HPV vaccine is right for you. You can get the HPV vaccine at no cost.


CalOptima Health Medi-Cal member ages 21 to 64 may be eligible for a gift card after completing a cervical cancer screening. Visit www.caloptima.org/healthrewards to learn more. 

Community Partner Highlight:

Latino Health Access

Latino Health Access (LHA) has been a pioneer in the Promotor de Salud/Community Health Worker (CHW) model in the U.S. Promotores are community members trained in health education, systems navigation, and advocacy. They use a peer approach and popular education to engage with hard-to-reach populations on sensitive topics such as mental health, childhood sexual abuse and immigration. Promotores also provide support and coaching to participants navigating different systems (i.e., medical, education, immigration, legal) and cultivate their leadership to take personal or community action to support decisions affecting their health and wellness.

LHA provides family-centered services, including COVID-19 resources, Diabetes classes, youth groups, tenant counseling, support groups, and weekly food distribution. In addition, LHA houses the Downtown Family Resource Center. 


To learn more about LHA’s services and current projects, please visit their website www.latinohealthaccess.org.

Orange County Board of Supervisors Appoints 2023 Officers

On January 10, the Orange County Board of Supervisors (OC BOS) appointed Supervisor Don Wagner to serve as Chairman and Supervisor Andrew Do to serve as Vice Chairman for the 2023 calendar year. The OC BOS has also re-appointed two Supervisors to serve on the CalOptima Health Board of Directors: Supervisor Andrew Do, Supervisor Doug Chaffee and appointed Supervisor Vicente Sarmiento as alternate.

Medi-Cal Redetermination Will Resume in April

Starting April 1, DHCS is returning to regular Medi-Cal eligibility and enrollment operations. During the declared COVID-19 Public Health Emergency (PHE), Medi-Cal members retained coverage regardless of any changes in circumstances. However, as part of the Consolidated Appropriations Act of 2023 signed by President Biden, the continuous coverage requirements will end after March 31, regardless of whether the PHE has ended. Counties will then have to determine if members are still eligible for Medi-Cal. CalOptima Health members will receive a mailed letter from the County of Orange Social Services Agency (SSA) asking to confirm their contact information as an initial step in this verification effort. If a member has changed addresses or other contact information during the PHE, they should notify the SSA by calling 855-541-5411 or visiting ssa.ocgov.com

Access and Share Emergency Resources from CalHHS

The California Health and Human Services Agency (CalHHS) has released Emergency Resource Guides in English and Spanish, offering resources for personal emergency plans, mental health services, social services, health care services and more. Access and share the guides with those in your community who could benefit from them. Visit chhs.ca.gov to learn more.

In The News:

PACE Director Interviewed on Coordinating Care for Elderly Parents

Monica Macias, Director of CalOptima Health’s Program of All-Inclusive Care for the Elderly (PACE), was featured as an expert source in a December 19 U.S. News article on coordinating with siblings to care for elderly parents. “Coordinating care for aging parents takes a village — one person cannot do it alone,” said Macias. She encourages adult family members to communicate with each other and “ensure that you’re having conversations with your aging parents regarding their wishes and reminding yourself that these are their wishes.” 

In The News:

CalOptima Health Dietitian Shares Weight Loss Tips

Sara Bagheri, M.S., R.D., a health coach and registered dietitian at CalOptima Health, shared advice on achieving better weight loss in a U.S. News article published on January 5. Noting the various resources available to dieters, from online guides and educational benefits to support options through wellness benefits at work, Bagheri underscored that consulting a dietitian can also be helpful: “Dietitians are usually capable of investigating the underlying cause of excess weight, and they can advise their clients to connect with therapists.”

NAMI OC President Discusses Peer Support Program in Partnership with CalOptima Health

In an interview with KROQ 106.7 on December 25, National Alliance for Mental Illness (NAMI) Orange County President Steve Pitman discussed the organization’s partnership with CalOptima Health on a five-year mental health peer support program for Medi-Cal members, funded by a $5 million grant from CalOptima Health. “We are going to pair people who are just getting out of psychiatric units with someone who has been down that road… so they have someone they can talk to about how they’re feeling, where they might go to get more services,” Pitman explained. “It’s very effective at reducing recidivism rates.”

U.S. COVID-19 Public Health Emergency Extended Into April

On January 11, U.S. Secretary of Health and Human Services (HHS) Xavier Becerra renewed the federal COVID-19 Public Health Emergency (PHE) for an additional 90 days through April 11. While it is not known if the PHE will be renewed again or allowed to expire at that time, HHS officials are expected to make an announcement by February 10, in keeping with their previous commitment to provide a 60-day notice before terminating the PHE. 

2023 Health Care Forecast Conference

Join UCI’s Paul Merage School of Business, Center for Health Care Management and Policy for the 32nd annual Health Care Forecast Conference, hosted in-person at the Beckman Center, Irvine, CA, on Thursday, February 23. Attendees have the option of attending in-person or virtually. Presentations will discuss how sectors of the health care system are working to address health equity and social determinants of care, how providers and organizations are managing the shift to value-based care, and how innovation is enabling improved operating efficiency, patient access, care quality and health equity. Register to secure your seat. 

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