The Latest News from CalOptima |
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CalOptima Seeks to Launch Covered California Plan |
To better support continuity of care for current members and provide an additional coverage option for Orange County residents, CalOptima is working, for the first time, toward offering a health plan option through Covered California, the state’s health insurance marketplace where residents can find affordable, quality coverage and potentially qualify for financial help to reduce their monthly premiums.
CalOptima’s Board of Directors formally requested that the Orange County Board of Supervisors consider changing a county ordinance enacted in 2012, before California’s health insurance marketplace began. A hearing is currently set for August 23 to amend the ordinance to allow for development of this new plan option. Once approved, CalOptima’s Covered California plan would start in January 2024.
“Currently, CalOptima is the single largest health insurer in Orange County, providing Medi-Cal coverage for one in four residents. Yet our members often experience changes in employment or in family circumstances that make them ineligible for Medi-Cal,” said Michael Hunn, CalOptima Chief Executive Officer. “By offering a Covered California plan as a bridge from Medi-Cal, CalOptima can provide the continuity of care that is essential to member health — members can choose to stay with the CalOptima network of contracted providers even as their circumstances change.”
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Orange County Moves to “HIGH” Transmission Rate on CDC’s COVID-19 Data Tracker |
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Due to recent increases in COVID-19 case counts,
Orange County was moved to “High” community
transmission status as of July 14, according to the Centers for Disease Control and Prevention (CDC) COVID-19 Community Level Data Tracker. As of July 15, the seven-day average COVID-19 case rate in Orange County increased to 33.1 per 100,000 people, and the average number of daily COVID-19 cases is 1,068. The positivity rate increased to 17.4 %, with hospitalizations at 277, and the number of ICU admissions increased to 35. The OC Health Care Agency (HCA) reports COVID-19 cases and hospitalization data using the state’s database reflecting laboratory-reported PCR tests. With widespread use of at-home rapid antigen testing, which go unreported, the true number of COVID-19 cases across the country are being undercounted. To read the OC Health Care Agency’s press release, click here. |
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Back-To-School Vaccination Events |
CalOptima is working with community partners to host mobile back-to-school vaccination events for students and their families. Routine vaccines will be administered at no cost to both CalOptima members and the community in attendance. View a complete list of events here. |
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Anaheim Union High School District
Open to the public
July 29, 2022
9 a.m.– 6 p.m.
501 N. Crescent Way, Anaheim
Vaccines: Routine and
COVID-19
Click here for event flier. |
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Northgate Gonzalez Market
Open to the public
July 30, 2022
9 a.m.–Noon
770 S. Harbor Blvd., Santa Ana
Vaccines: Routine and
COVID-19
Click here for event flier. |
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Latino Health Access
Open to the public
August 6, 2022
10 a.m.– 2 p.m.
450 W. 4th St.,
Santa Ana
Vaccines: Routine and
COVID-19
Click here for event flier. |
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Please check the CDC child and adolescent schedule of immunizations for routine vaccines here. |
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CalFresh Educational Materials |
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CalOptima is prioritizing access to nutritious food for our members and the community at large by promoting the CalFresh program, a state and federally funded program. A family of four can receive up to $835 per month, and an individual can receive up to $250 per month, to purchase healthy and nutritious food via a debit-like card.
Please help us spread the word about food insecurity with our members and the community by sharing CalFresh flyers when engaging with individuals and families you serve and displaying CalFresh posters at your site(s).
CalFresh flyers are available to share in seven threshold languages (English, Spanish, Vietnamese, Korean, Mandarin, Arabic and Farsi), CalFresh Posters (English, Spanish and Vietnamese) and Frequently Asked Questions (FAQs) in English, which can be accessed here. Please feel free to share the electronic copies of CalFresh materials. To request hard copies, please email jennifer.funez@caloptima.org and indicate the document(s) you are requesting, quantity and language(s).
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CalOptima COVID-19 Vaccine Clinics for Kids and the Community |
Protect your children and neighbors going back to school and before the winter COVID-19 season. CalOptima invites community members 5 years and older to get their vaccine or booster on the following dates: |
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CalOptima will be on-site to check CalOptima Medi-Cal eligibility, give $25 Member Health Rewards to eligible members and host a resource table. View the event flyer here. Register at 1-714-834-2000 or www.othena.com.
Medi-Cal and CalFresh enrollment will be available on-site.
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CalOptima Welcomes Chief Compliance Officer and Executive Director of Network Operations |
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John Tanner, Chief Compliance Officer |
John Tanner has spent his entire career in health care compliance and health plan operations and brings a wealth of knowledge and experience spanning more than 30 years. Prior to joining CalOptima, John was Director, Regulatory Compliance for SCAN Health Plan and Vice President, Compliance Operations for Molina Healthcare. He most recently served as Chief Compliance Officer for Beacon Healthcare Systems. |
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Michael Gomez, Executive Director of Network Operations |
Michael Gomez is responsible for the development, expansion and support of CalOptima’s provider delivery system for all lines of business and programs. He brings more than 34 years of experience in executive leadership roles in hospitals and hospital systems, medical groups, and health plans. Prior to joining CalOptima, he was a business development consultant with several large hospitals and health systems, including Martin Luther King Jr.
Community Hospital and Fountain Valley Medical Development Corp.
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Local College Students Receive Scholarships Donated by CalOptima Employees |
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CalOptima employees personally donated a total of $9,000 to fund scholarships for members who are planning to enter careers in health care or social services. Six winners were chosen in this year’s competitive annual scholarship contest. The top two recipients each received $2,500 scholarships (see below), with four runners up receiving $1,000 each. Winners were chosen based on their essays describing how they have benefited from CalOptima’s health care services, how their current studies will help them in their future career and why they are a good candidate to receive this scholarship. |
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Marina Esquivel Cisneros
Hometown: San Juan Capistrano
Saddleback College
Major: Nursing
Activities/Accolades:
- Work at Mission Hospital as a COPE Health Scholar
- Member of Phi Theta Kappa Honors Society
- Spanish Intern/Volunteer with Breakthrough San Juan Capistrano
- Saddleback College Dean’s List
Excerpt from Marina’s application: “So many of my peers feel that attending college is an unattainable dream because we have so few role models in our low-income, immigrant community. I am committed to going to college to be an example to others in my generation that they can achieve their goals. Receiving CalOptima’s scholarship would demonstrate to myself and others that I have the potential to pursue my dreams of giving back to my community as a nurse.”
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Vianey Gutierrez
Hometown: San Clemente
California State University, Fullerton
Major: Nursing
Activities/Accolades:
- Past President of San Clemente High School’s Interact Club
- High School Tutor
- San Clemente Rotary Afterschool Club
- AYSO Volunteer
Excerpt from Vianey’s application: “Coming from an immigrant family, I was never encouraged to go to college, simply because my family couldn’t afford it. But ever since I can remember, I have always been interested in working in the medical field. I have worked through many struggles in my life to be where I am today. I know that with CalOptima’s scholarship, I will be able to realize my dream of going to college and achieving my goal of working in the medical field as a nurse.”
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Community Partner Highlight: CalFresh Healthy Living |
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CalFresh Healthy Living (SNAP-Ed) supports healthy, active and nourished lifestyles by teaching Californians about good nutrition and how to stretch their food dollars while also building partnerships in communities to make the healthy choice, the easy choice. The Health Care Agency Nutrition Services Program is charged with making this happen. They believe that small changes can lead to healthy victories, and their target audience is low-income Orange County residents that are CalFresh (SNAP) recipients or CalFresh eligible. The program works on a continuous basis with schools, early childcare centers, health clinics, medical providers, family resource centers, WIC clinics, food pantries and distribution sites, residents, and neighborhoods to implement activities to make these changes. |
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Through virtual classes, community presentations, health fairs/events, store tours and more, CalFresh Healthy Living actively engages participants by giving them resources such as handouts, web links and even recipe cards. The program use several curricula and messaging tools to educate the community on heathy nutrition and even offers bilingual staff to assist.
Working with early childcare centers as well as parks and recreation groups in cities and neighborhoods, CalFresh Healthy Living helps identify opportunities to give children a safe place to play. For example, the program shares simple and affordable physical activity ideas, such as stencil playgrounds, which are a favorite option among the children and communities served. For additional information visit http://ssa.ocgov.com. |
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InfoSeries on Family Homelessness |
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HHIP Virtual Listening Session |
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A virtual InfoSeries on a Local and National Snapshot on Family Homelessness will take place on Tuesday, August 23, from 9–10:30 a.m. The event is designed to provide a local and national overview of family homelessness, where attendees can learn about local-level efforts to address family homelessness and receive an update on CalAIM, new Community Supports and how members can access these services. Click here to register for the event. |
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The California Department of Health Care Services established the Housing and Homelessness Incentive Program (HHIP) that will enable CalOptima to earn incentive funds for addressing homelessness and housing insecurity as social drivers of health and health disparities.
Join CalOptima for a virtual HHIP Listening Session on Thursday, August 11 from 1–2:30 p.m. to provide real time feedback about community needs, challenges, and barriers surrounding homelessness to help shape future homelessness investments. Click here to register for the event. |
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National Health Center Week |
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New Parents Resource Fair |
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The Coalition of Orange County is hosting a Spanish language webinar on “Accessing Your Benefits” for community members on Tuesday, August 9, from 5–6:30 p.m. The event will give community members the opportunity to learn about their Medi-Cal benefits. Click here for the event flyer. |
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Join Westminster Family Resource Center on August 2, from 11 a.m.–1 p.m., for their New Parents Resource Fair. The event is a special resource fair aimed to support families with children 0–3 years of age. It is a great opportunity to help families connect with resources and community support from the start. Click here for the event flyer. |
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988 Suicide & Crisis Lifeline |
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In July 2022, our country entered a new era of more equitable and accessible crisis services, marked by the adoption of 988 as the easy-to-remember three-digit dialing, texting and chat code for anyone experiencing a suicidal or mental health-related crisis. The 988 Suicide & Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) offers 24/7 call, text and chat access to trained crisis counselors, who can help people experiencing a suicidal, substance use and/or mental health crisis, or any other kind of emotional distress. People can also dial 988 if they are worried about a loved one who may need crisis support. To learn more about the lifeline, click here. |
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COVID-19 Public Health Emergency Renewed |
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On July 15, U.S. Secretary of Health & Human Services, Xavier Becerra renewed the COVID-19 public health emergency (PHE) for an additional 90 days through October 13, 2022. It is still not yet known if the PHE will be allowed to expire at that time or if it will be renewed once again. However, administration officials previously committed to providing states with a 60-day notice before terminating the PHE, so states will be informed by September 13 if it is being extended again. |
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How to Contact CalOptima During the COVID-19 Pandemic |
CalOptima Customer Service remains ready to respond to member needs. Members can call Customer Service from the safety of their home, 24 hours a day, 7 days a week. We have staff who speak their language. |
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CalOptima, A Public Agency www.caloptima.org
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