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Outreach and Enrollment Workgroup

Back to Medi-Cal Eligibility

As part of California’s efforts to implement the federal Patient Protection and Affordable Care Act (ACA), the Legislature and the Governor, authorized by Assembly Bill (AB) 82, have approved a proposal to accept private foundation funds with a 1:1 federal match.

AB 82, Section 70 (Medi-Cal In-Person Enrollment Assistance Payments)

The Department of Health Care Services (DHCS) has accepted contributions by the California Endowment (TCE) in the amount of fourteen million dollars ($14,000,000) and will seek an equal amount in federal matching funds for purposes of implementing the following:

Certified Enrollment Counselors (CECs) and Certified Insurance Agents (CIAs) will be eligible to receive an enrollment assistance payment of fifty-eight dollars ($58) for each approved Medi-Cal application if the Medi-Cal applicant(s) is newly eligible (pursuant to ACA) or was not enrolled in Medi-Cal  for 12 months or more (prior to the application date). Payments will be issued by Covered California.

UPDATE: Payments for in-person application assistance that resulted in Medi-Cal enrollments will start by the beginning of July 2014. The first round of payments will be made for those applications that resulted in at least one newly eligible 19-64 year old on the application. The California Department of Health Care Services and Covered California continue to refine the payment process and will begin issuing payments as soon as possible for the remaining applications that received in-person enrollment assistance, including applications with children under 19 years old.

AB 82, Section 71 (Medi-Cal Outreach and Enrollment Grant Funding)

DHCS has accepted contributions by TCE in the amount of twelve and a half million dollars ($12,500,000) and will seek an equal amount in federal matching funds for purposes of implementing the following:

DHCS will allocate Medi-Cal outreach and enrollment (O&E) funding to counties to supplement, but not supplant, Medi-Cal O&E efforts associated with the implementation of ACA. DHCS will develop selection criteria for the  allocation of funds to counties for Medi-Cal O&E. Medi-Cal O&E funding allocations will be apportioned geographically according to the estimated number of persons who are eligible but not enrolled into Medi-Cal and who will be newly Medi-Cal eligible as of January 1, 2014. Consideration for Medi-Cal O&E funding will only be given to those Medi-Cal O&E efforts that place special emphasis on one or more of the following populations:

1. Persons with mental health disorder needs
2. Persons with substance use disorder needs
3. Persons who are homeless
4. Young men of color
5. Persons who are in county jail, state, prison, on state parole, on county probation, or under post release community supervision
6. Families of mixed-immigration status
7. Persons with limited English proficiency

Awardees of Medi-Cal O&E funding will not receive Medi-Cal in-person enrollment assistance payments, and vice versa. Awardees will also be required to submit progress reports and program outcomes to DHCS. Unless otherwise extended by state law, this grant funding opportunity is scheduled to end on June 30, 2016. DHCS encourages that county agencies/departments partner with CBOs, school districts, county departments/agencies, or city/cities in their targeted outreach and enrollment efforts associated with this grant funding opportunity.

Inquiries regarding the Outreach and Enrollment Workgroup efforts may be directed to: OEworkgroup@dhcs.ca.gov.

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