The Latest News from CalOptima |
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CalOptima Launches California Advancing and Innovating Medi-Cal (CalAIM) |
CalOptima will be able to serve Orange County’s under-resourced residents even better now following the statewide implementation of the California Advancing and Innovating Medi-Cal (CalAIM) initiative on January 1, 2022.
CalAIM is a five-year initiative from the California Department of Health Care Services (DHCS) that moves Medi-Cal into a more standardized and simplified system focused on helping enrollees live healthier lives. It takes a whole-person care approach that addresses social determinants of health — the non-medical factors that impact health outcomes — by extending supports and services beyond hospitals and health care settings directly into the community. “CalAIM will ensure all CalOptima members receive the care they need, when they need it, no matter what language they speak or what ZIP code they live in,” said Supervisor Andrew Do, Chair of the CalOptima Board of Directors and Chairman of the Orange County Board of Supervisors. “CalAIM’s robust whole-person care approach will give our members with the most complex needs quality care that prioritizes prevention.”
Two key components of CalAIM’s whole-person approach include:
- Enhanced Care Management (ECM) — comprehensive care coordination and management for members with complex needs who are facing difficult life and health circumstances
- Community Supports — services offered to meet enrollees’ needs for health and health-related services that address social determinants of health
“Through CalAIM, we will be able to provide greater access to care in collaboration with our clinical providers and community stakeholders,” said Michael Hunn, CalOptima Interim Chief Executive Officer. “The initiative will help address many of the complex challenges facing our most vulnerable residents, including the unsheltered, and the growing aging population who will benefit from better coordination of care.”
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The event is designed to provide an overview of CalAIM, information about Enhanced Care Management, Community Supports and referral sources, and an opportunity for community feedback.
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As of January 1, 2022, the Medi-Cal pharmacy benefit transitioned from CalOptima to Medi-Cal Fee-For-Service under a program called Medi-Cal Rx. CalOptima members with questions can call the Medi-Cal RX Customer Service Line at 1-800-977-2273, 24 hours a day, 7 days a week. |
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When filling a prescription, CalOptima members will need to present a Benefit Identification Card (BIC), provided by the County of Orange Social Services Agency (OCSSA). To support Medi-Cal Rx, members can request a CalOptima replacement ID card from CalOptima and/or BIC Card from the OCSSA.
Click here for information on how to request a CalOptima replacement ID card. Click here for information on how to request a replacement BIC card. Members can also visit the CalOptima Pharmacy information page here. |
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CalOptima Board Approves $45 Million in Provider Funding, and Additional Resources for Orange County’s Vulnerable |
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During a special session on December 20, CalOptima’s Board of Directors acted on several items that reinforce the agency’s commitment to serving Orange County’s vulnerable population of low-income residents.
The Board actions include:
- Approving up to $45 million in provider incentives to assist with coordinating care across a range of services
- Extending pilot programs that support those experiencing homelessness, such as Clinical Field Teams and shelter-based health services
- Continuing CalOptima’s Member Health Rewards program through 2022 to encourage vaccination against COVID-19
To read more about the funding and resources, click here. To read the full press release, click here. |
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CalOptima COVID-19 Vaccine Clinic for Kids and the Community |
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Children ages 5–11, accompanied by a parent/guardian, and unvaccinated community members of all ages, are invited to attend the upcoming CalOptima clinics on January 15 and 22.
- Saturday, January 15, 9 a.m.–3 p.m. Orange County Social Services Agency Central Regional Office, 2020 W. Walnut St., Santa Ana
- Saturday, January 22, 9 a.m.–3 p.m. Orange County Social Services Agency Central Regional Office, 2020 W. Walnut St., Santa Ana
CalOptima will be on-site to check CalOptima Medi-Cal eligibility, give $25 Member Health Rewards to eligible members who receive a vaccine and host a resource table. Vaccine event flyers are available in English, Spanish and Vietnamese. |
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Register at 1-714-834-2000 or www.othena.com. CalOptima Medi-Cal members can arrange transportation by calling 1-888-587-8088. |
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CalOptima Department Highlight: Cultural and Linguistics |
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As a health care organization in the diverse community of Orange County, CalOptima strongly believes in the importance of providing culturally and linguistically appropriate services for our members. To ensure effective communication regarding treatment, diagnosis, medical history, and health -education, CalOptima developed the Cultural and Linguistic Services program, which integrates culturally and linguistically appropriate services at all levels of the organization. |
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CalOptima’s Cultural and Linguistic Services (C&L) provides no cost interpreter and translation services to CalOptima members. Interpreter services are provided for members at key points of contact, such as medical appointments. Telephonic, face-to-face and video interpreting services are available for CalOptima members at no-cost and in any language.
Member-facing Medi-Cal materials are translated by CalOptima staff in the following threshold languages: Arabic, Chinese, Farsi, Korean, Spanish and Vietnamese as well as in alternative formats, which include Braille, large font or audio.
To read more about C&L click here. |
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Community Partner Highlight: Dayle McIntosh Center |
The Dayle McIntosh Center (DMC) offers free services for people with disabilities to live independently in their own homes and communities. Because DMC staff are people with disabilities, they understand the challenges of living with a disability and want to empower each individual’s independent living journey.
DMC staff can offer support with learning daily living skills, acquiring assistive technology, finding a caregiver, exploring accessible housing options, meeting peers with disabilities, and more. DMC's newest program is Dignity at Home, which provides no-cost home modifications and mobility aids to low-income households. Some of the items and services offered include home safety assessments, ramps, grab bars, stair lifts, wheelchairs, scooters and others needed to reduce the risk of falling. DMC also offers the Aging with Vision Loss Program which provides skill training and daily living aids to older adults ages 55 and above who are adapting to vision loss. These services are provided in the home by Independent Living Skills instructors, many of whom also live with vision loss. Using the right tools and techniques, older adults with vision loss can continue living full and independent lives.
DMC serves people with all disabilities — no medical records required. Call 714-621-3300 or visit www.daylemc.org to connect with DMC's services. |
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The Importance of Vision Screenings |
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This season has been an exciting time for students, as many return to in-person learning. While families rush to get everything checked off their Back-to-School to-do lists, it’s possible that one important item may have been missed — an eye examination. Making sure a child can see clearly and effortlessly is a critical component in setting a child up for success in the classroom.
Click here for the full article provided by Ketchum University, which discusses the importance of vision screenings. |
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Toolkit Provides Resources for Annual Wellness Visits |
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Due to the ongoing COVID-19 pandemic, some members may have been unwilling or unable to visit their health care provider, missing needed care or preventive screenings such as the Annual Wellness Visit, which is specifically designed to support the health care needs of older adults. During the Medicare covered Annual Wellness Visit, members and providers can create or update a personal prevention plan designed to prevent or detect illness, based on an individual member’s health and risk factors.
To learn more about the Annual Wellness Visit, click here. |
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January Is Cervical Cancer Awareness Month |
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.
At 21 years of age and older, women should talk with their doctor about routine Pap tests and how often they should be done.
Click here to read the remainder of the cervical cancer article. |
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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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