Thirty years ago this month, a dedicated group of community members, health care providers, business leaders and elected officials came together to address a growing crisis: the lack of access to health care services for Orange County’s Medi-Cal eligible recipients. The solution was the creation of CalOptima Health, established by the Orange County Board of Supervisors as a county organized health system. Since then, we’ve grown from serving 180,000 members to more than 900,000 — a remarkable journey made possible by the commitment and compassion of so many.

At last week’s Board meeting, Senator Tom Umberg, Assemblywoman Sharon Quirk-Silva, Chairman of the Orange County Board of Supervisors Doug Chaffee and Supervisor Vicente Sarmiento presented resolutions honoring our 30 years of service. The State Senate and Assembly resolutions were signed by all members of the Orange County delegation, representing universal support for CalOptima Health. At the meeting, we also recognized our nine extraordinary staff members who have been with us since the very beginning:

•    Olga Garcia, Program Specialist, Customer Service

•    Ravina Hui, Director, Operations Management

•    Ladan Khamseh, Executive Director, Operations 

•    Carol Matthews, Project Manager, Quality Analytics

•    Maria Medina, Buyer Sr., Procurement & Vendor Management

•    Elizabeth Ramos-Lopez, Supervisor, Grievance and Appeals Resolution Services

•    Linda Rodriquez, Accounting Clerk Sr., Accounting

•    Thu Tran, Analyst Int., IT Applications Management

•    Cydney Weber, Social Worker, Case Management

Finally, on October 18, we are inviting our members to our headquarters for a members-only health and resource fair in recognition of our 30th anniversary.

CalOptima Health's OneCare advertising campaign, set to launch in October, builds on the success of last year’s “Built Around You” campaign by using focus group feedback to refine and refresh the creative elements. This year, we are introducing a dedicated caregiver campaign, emphasizing the crucial role caregivers play in health care decisions for their loved ones. The campaign will employ various advertising modalities, including print, outdoor, television, programmatic display, streaming audio, social media, and paid search.

CalOptima Health hosted a luncheon to celebrate the successful completion of our Student Behavioral Health Incentive Program (SBHIP) initiative. This collaborative effort brought together key stakeholders, including the Orange County Department of Education; the Orange County Health Care Agency; CHOC, a part of Rady Children’s Health; Hazel Health; Western Youth Services; and several others. The overarching goal of SBHIP was to expand access to mental health services for K–12 students in all 28 public school districts in Orange County. Through this initiative, CalOptima Health was awarded the full incentive allocation of $25.5 million from the California Department of Health Care Services (DHCS). These funds were instrumental in planning and implementing sustainable, school-based behavioral health interventions. Congratulations to Carmen Katsarov, LPCC, CCM, Executive Director of Behavioral Health Integration at CalOptima Health, and her dedicated team for their leadership and commitment over the past three years. Their efforts laid a strong foundation for the continued support of youth mental health in our community. The SBHIP Final Report provides a comprehensive overview of the program’s impact. A link will be shared in an upcoming Community Update.

On September 10, CalOptima Health's Chief Operating Officer, Yunkyung Kim, spoke at the Westminster City Council Meeting and thanked the city council for their partnership and support of our successful Back-to-School Health and Resource Fair in August.

CalOptima Health continues to prepare for the launch of a Covered California line of business, effective January 1, 2027. Following the Board’s approval on June 5, staff submitted an initial filing on June 16 to the California Department of Managed Health Care (DMHC) to expand the scope of CalOptima Health’s current Knox-Keene Act license, which is required to offer a commercial insurance product. Since then, we have interfaced with DMHC on two rounds of comments and are working on exhibits for our second filing in late October. With the conclusion of the Deloitte Consulting LLP operational gap analysis, staff have initiated several new workstreams to discuss and implement solutions in order to achieve operational readiness during the next year. On September 15, Covered California issued the draft 2027 Qualified Health Plan application. Our teams are currently reviewing and developing strategies to respond in April 2026. Lastly, CalOptima Health continues to negotiate provider contracts and execute amendments with several existing vendors to include Covered California in their scopes of service.

There are currently 171 PACE organizations across the United States, 28 in California and three in Orange County. As the first PACE program to open in Orange County, CalOptima Health PACE is proud to be celebrating our 12-year anniversary this month. We are currently serving more than 525 participants, and in a recent survey, participants rated CalOptima Health PACE as one of the top five PACE organizations. Our current advertising campaign distinguishes CalOptima Health PACE as the premier PACE program in Orange County. The tagline is “Senior Care to Keep You Active and Living at Home” and emphasizes that CalOptima Health PACE is a leader in complete care for Orange County seniors. It increases awareness of our PACE program through advertising that includes print, outdoor, radio, television, digital display, social media, programmatic video (YouTube), search engine marketing and direct mail. Using a unique, personal approach, the campaign features photography of our actual PACE participants enjoying the benefits of the program. 

This workshop explores how pharmacotherapy has transformed the treatment of substance use disorders, moving beyond abstinence-only approaches toward evidence-based medical care. Participants will learn about the mechanisms, indications and clinical applications of medications. Attendees will leave with a deeper understanding of how pharmacologic interventions can expand treatment access.

When: Wednesday, October 8

Time: Noon–1:30 p.m.

Location: Zoom Webinar

• 1.5 CE Credits offered
• Registration is required. To RSVP, click here. For questions, contact continuingeducation@caloptima.org
• Please see flyer for more information.

Give Us Hope Orange County invites you to the Hope Health Fair, for a day of health services and resources. The Hope Health Fair brings together community members and organizations to help remove barriers to health services, resources and improve access to care.

When: Saturday, October 18

Time: 9:30 a.m.–Noon

Location: Vietnamese Catholic Church Center, 1538 Century Blvd., Santa Ana,

For more information and registration, please call 714-265-1181. See flyer for event details.

Join UCI Mind, Alzheimer's Association and Alzheimer's Orange Country for the 36th Annual Southern California Alzheimer's Disease Research Conference. Discover groundbreaking insights at the conference and delve into the critical intersection of genetics and environment in Alzheimer's disease risk.

When: Thursday, October 24

Time: 8 a.m.–3 p.m.

Where: Irvine Marriott, 18000 Von Karman Ave., Irvine

Registration is required, click here to register. For more information, visit the website

UC Irvine's annual Women's Health Summit brings together health care and social service professionals, researchers, educators, government, nonprofits and advocates. The conference is dedicated to women's health, well-being and features information about the state of women's health in Orange County, disparities and systems gaps.

When: Friday, November 14

Time: 8:30 a.m.–2 p.m.

Where: Beckman Center of the National Academies of Sciences & Engineering, 100 Academy Way, Irvine

To register, click here.

The Orange County March of Dimes is hosting a community expo, where you can hear from experts, meet community partners and connect to resources. Learn about the state of maternal and infant health and the crucial role that March of Dimes plays in supporting millions of families each year.

When: Saturday, November 15

Time: 8 a.m.–Noon

Where: Newport Beach Civic Center, 100 Civic Center Dr., Newport Beach

To register, click here. See flyer for more details.

The Annual Enrollment Period (AEP) for CalOptima Health OneCare (HMO D-SNP), a Medicare Medi-Cal Plan, will open October 15 and will run through December 7. To be eligible for OneCare a member must be:

• Age 21 and older
• Living in Orange County
• Enrolled in Medicare Parts A and B
• Receiving Medi-Cal benefits

Starting in 2026, the OneCare Flex Plus plan will be consolidated into the OneCare Complete plan due to changes in the federal Medicare program. All existing OneCare Flex Plus members will be transitioned into OneCare Complete.

• CalOptima Health OneCare Complete — Our original plan offers $0 copays on medical and hospital services and generic prescription drugs. It includes many extras, such as a fitness benefit, comprehensive dental, more vision care, a flex card for over-the-counter (OTC) items and for those who qualify, food and produce.

As an Exclusively Aligned Enrollment D-SNP, OneCare can accept enrollment from members every month due to the Special Enrollment Period (SEP) for dual-eligibles.

Individuals who are covered by both Medi-Cal and Medicare could qualify for CalOptima Health OneCare (HMO D-SNP), a Medicare Medi-Cal Plan. Learn more about this special plan at our upcoming in-person presentations: 

CalOptima Health | 505 City Parkway West, Orange

• Wednesday, October 8, 10 a.m.

Superior Grocers | 1710 S. Main St., Santa Ana

• Thursday, October 9, 2 p.m.
• Tuesday, October 14, 10 a.m.
• Thursday, October 16, 2 p.m.
• Tuesday, October 21, 10 a.m.
• Thursday, October 23, 2 p.m.
• Tuesday, October 28, 10 a.m.
• Thursday, October 30, 2 p.m.

Presentations are only offered in English, and light snacks will be served. To learn more, view event flyers in English, Spanish and Vietnamese.  

CalOptima Health OneCare (HMO D-SNP), a Medicare Medi-Cal Plan, now offers members a flex card (OneCare &more card) to purchase over-the-counter items (and in some cases, groceries) in-store and online. Additionally, the health rewards members have been able to earn in the form of a physical gift card in previous years are now added to the flex card instead. Members can earn rewards by completing certain health care tests or screenings and submitting an online form on this page.

To use the flex card, a member must first activate the card by texting ACTIVATE to 53746, calling 1-855-263-6673 (TTY 711), or visiting andmorehealth.com/onecare. Many members have not yet activated their cards and are missing out on the benefits. If members need help, please encourage them to call OneCare Customer Service at 1-877-412-2734 (TTY 711).