ບົດບັນທຶກກອງປະຊຸມສະພາສຽງ ແລະ ວິໄສທັດຂອງ Medi-Cal
ວັນທີ: ກັນຍາ 30, 2026
ເວລາ: 17:30 – 19:30
Type of Meeting: Virtual (Closed to the Public)
Members Present: Abigail Coursolle; Marty Omoto; Uchey Dijeh, MD; Azalia Ryckman; Lupe Wilson; Sydney Turner; Ann Marie Torres-Delgadillo; Tiffany Huyenh-Cho; Jenny McLelland; Marlen Torres; Rebecca Sullivan
Members Not Present: Mike Odeh, Kate Ross, Avita Singh, Elissa Feld, Christian Espinoza
DHCS Staff and Partners: Michelle Baass, Director; Tyler Sadwith, State Medicaid Director and Chief Deputy Director for Health Care Programs; Krissi Khokhobashvili, Deputy Director, Office of Communications; Chris Esguerra, MD, MBA, Chief Quality and Medical Officer and Deputy Director, Quality and Population Health Management; Shaun Garcia, Chief, Quality and Health Equity; Eduardo Lozano, Stakeholder and Community Engagement Analyst; Maria Romero-Mora, Stakeholder and Community Engagement Analyst; Kiran Poonia, Stakeholder and Community Engagement Analyst; Isabel Flores, Stakeholder and Community Engagement Analyst; Evelyne Kane, Associate Director of Community Engagement and Capacity Building, Camden Coalition; Alexis Taylor, Founder and CEO, Taylor and Payne Consulting
ຂໍ້ມູນເພີ່ມເຕີມ: ກະລຸນາອ້າງອີງເຖິງ ການນຳສະເໜີ PowerPoint ທີ່ໃຊ້ໃນລະຫວ່າງກອງປະຊຸມສຳລັບສະພາບການ ແລະ ລາຍລະອຽດເພີ່ມເຕີມ.
Agenda:
| ເວລາ | ເນື້ອໃນ |
|---|---|
| 5:30 – 6:00 | ຍິນດີຕ້ອນຮັບ ແລະ ເປີດງານ |
| 6:00 – 6:25 | ເຮັດໃຫ້ Medi-Cal ດີຂຶ້ນ: ຊ່ວຍໃຫ້ຜູ້ຄົນໄດ້ຮັບການດູແລທີ່ເຂົາເຈົ້າຕ້ອງການ, ເມື່ອເຂົາເຈົ້າຕ້ອງການມັນ |
| 6:25 – 7:10 | ການສົນທະນາໃນຫ້ອງແຍກກຸ່ມ |
| 7:10 – 7:25 | ບົດລາຍງານ ແລະ ຄຳເຫັນຂອງສະມາຊິກ |
| 7:25 – 7:30 | ຄຳກ່າວປິດ |
ຍິນດີຕ້ອນຮັບ ແລະ ການແນະນຳ
ປະເພດການກະທຳ: ຂໍ້ມູນ
Presenters: Kiran Poonia and Michelle Baass
ລາຍການເປີດ:
- ສະມາຊິກສະພາ Voices and Vision ໄດ້ຮັບການຕ້ອນຮັບ, ແລະ ຄວາມຍຸຕິທຳທາງດ້ານພາສາ ແລະ ມາດຕະຖານຂອງຊຸມຊົນໄດ້ຖືກທົບທວນຄືນເພື່ອເຕືອນຜູ້ເຂົ້າຮ່ວມກ່ຽວກັບການມີສ່ວນຮ່ວມ ແລະ ການປະຕິບັດການມີສ່ວນຮ່ວມ.
- ຜູ້ເຂົ້າຮ່ວມໄດ້ຖືກຮ້ອງຂໍໃຫ້ເປີດເຜີຍຂໍ້ຂັດແຍ່ງທາງຜົນປະໂຫຍດໃດໆ; ບໍ່ມີໃຜຖືກລະບຸຕົວຕົນ.
- DHCS welcomed two new members to the Voices and Vision Council. Council members and DHCS staff were invited to introduce themselves.
- Director Michelle Baass described the meeting’s focus on making Medi-Cal better and helping members receive the care they need, when they need it. She framed the discussion within DHCS’ Medical Value Strategy and acknowledged the broader context of federal changes and state budget challenges.
Unsatisfactory Immigration Status to Fee-for-Service Transition Recommendations
- DHCS shared an update on the recommendations concerning the transition of Medi-Cal members with unsatisfactory immigration status from managed care to fee-for-service.
- DHCS reviewed the feedback received on the draft recommendations, and the recommendations were ready to move forward for a vote.
- Members would receive an email with a Microsoft Forms link and instructions for confidential online voting.
- DHCS would follow up directly with members who submitted feedback to provide responses and additional context.
- Members were invited to contact DHCS with questions during the voting period.
ເຮັດໃຫ້ Medi-Cal ດີຂຶ້ນ: ຊ່ວຍໃຫ້ຜູ້ຄົນໄດ້ຮັບການດູແລທີ່ເຂົາເຈົ້າຕ້ອງການ, ເມື່ອເຂົາເຈົ້າຕ້ອງການມັນ
ປະເພດການກະທຳ: ຂໍ້ມູນ
Presenter: Chris Esguerra
ລາຍລະອຽດການນຳສະເໜີ:
- DHCS presented the Medical Value Strategy, an approach to improving Medi-Cal by helping members receive the right care, at the right time, and at the right cost. The presentation focused on aligning programs, policies, and investments to improve health outcomes, member experience, and overall value in the health care system
- ຈຸດສຳຄັນລວມມີ:
- The strategy is intended to align programs and policies toward a shared goal and identify policies, practices, or behaviors that may work against one another or may not add value.
- Improving member health and connecting them with effective, culturally relevant care can lead to better outcomes and help prevent the need for higher levels of care.
- The strategy focuses on spending Medi-Cal funds in ways that help members become healthier and feel better.
- Provider payment should be connected to how effectively providers help members stay healthy and achieve meaningful outcomes, rather than only on the number of tests, appointments, or other services delivered.
- Important elements of value include timely access to care, care coordination, data sharing, prevention, individual and community health outcomes, efficient use of Medi-Cal funds, and high-quality care.
- Foundational supports include investments in primary care, care coordination, community health workers, and technical assistance that helps different parts of the health care system work together.
- Clear and aligned expectations are needed across managed care plans, county behavioral health plans, providers, and other parts of the health care delivery system.
- Value-based approaches should be scalable statewide rather than limited to individual providers, cities, or counties.
- Current areas of work include skilled nursing facilities, primary care, maternal and maternity care, mental and behavioral health services, hospitals, access, outcomes, care coordination, and data sharing.
- Payment can be used to support effective care delivery, health and wellness, member experience, quality, access, care coordination, health equity, population health, and the management of overall costs.
- DHCS plans to collaborate with the health care community to better understand what people value when considering their physical and mental health.
Clarifying Questions
- ສະມາຊິກໄດ້ມີໂອກາດຖາມຄຳຖາມທີ່ຊັດເຈນກ່ຽວກັບການນຳສະເໜີ.
- Question: How does the Medical Value Strategy align with ongoing budget and payment system changes, and what is the timeline for implementation?
- Response: DHCS explained that the Medical Value Strategy brings together existing work already underway across DHCS. Examples included quality and accountability initiatives, primary care investment and payment transformation efforts, skilled nursing facility value-based work, hospital-focused initiatives, and maternal health programs. DHCS also noted that the strategy provides a shared framework for aligning these efforts around helping members receive the right care, at the right time, and at the right cost.
Recap of September 16 Medi-Cal Member Advisory Committee (MMAC) Meeting
- A member who serves on both the MMAC and Voices and Vision Council provided a recap of the September 16 MMAC meeting, where members discussed the same topic
- Members of the MMAC discussed the value strategy as a plan to help members receive the right care at the right time, in the right place, and at the right cost.
- Members were glad the discussion focused on improving Medi-Cal rather than cutting it and appreciated the focus on whether care helps people rather than only counting services.
- Members identified accountability as a recurring theme and wanted to know what DHCS would do and wanted funding to include follow through.
- Members discussed the importance of people being guided to the appropriate place for help rather than being turned away.
- Members asked that people working with members, including front desk staff, be trained to be respectful and understanding.
- Members asked how providers would be affected by the changes, how providers would be held responsible for results, and whether Medi-Cal would pay providers enough to retain them, particularly in areas with provider shortages.
- Members identified providers who care, complete care, culturally and linguistically respectful care, prevention, information, privacy, accurate provider lists, more providers to choose from, and support for maintaining independence as important aspects of value.
- Members identified delays in equipment repairs or replacements and the need for a dependable backup plan during a mental health crisis as concerns.
- Members said they would invest in referrals and provider lists, staff training, and complete care, and spend less on providers who do not listen to members and online tools that repeat work.
- Members wanted more responsibility for finding and arranging care to shift from members to health plans and providers.
- Members also wanted clear information about existing benefits and culturally and linguistically appropriate care to become the norm.
ການສົນທະນາໃນຫ້ອງແຍກກຸ່ມ
ປະເພດການກະທຳ: ການສົນທະນາ
Facilitators: Evelyne Kane and Alexis Taylor
ຄຳຕິຊົມຂອງສະມາຊິກ:
Members participated in two breakout rooms to discuss guiding questions related to the Medical Value Strategy. Each room moved through the questions at its own pace, so not all questions were discussed in both rooms. The feedback below reflects themes, ideas, and perspectives shared across both breakout rooms.
What is your overall reaction to the Medi-Cal Value Strategy presentation?
- Several Voices and Vision council members expressed that the presentation was strong and that progress is moving in the right direction.
- One Voices and Vision Council member said that a critical issue was how DHCS would measure whether the value strategy is actually improving care and emphasized the importance of meaningful outcome measurement.
- One Voices and Vision Council member said the presentation gave her hope, but raised concerns that significant needs in the community are not captured on the Medi-Cal application, which only asks about income and other eligibility factors.
- Voices and Vision Council members said the strategy sounded very good, but felt like it was a very large undertaking. They expressed hope that DHCS will follow through on what was presented to achieve the desired outcome.
- DHCS staff responded that health care delivery has historically not done well in measuring health outcomes and that DHCS is focused on establishing positive outcomes and understanding both clinical effectiveness and member experiences.
- DHCS staff said that measuring whether a specialist can be found is important, but DHCS also wants to know whether the specialist was effective and how the member experience was in receiving care.
- One Voices and Vision Council member questioned whether the value strategy would also apply to the fee-for-service delivery system because care coordination is more challenging in that system.
Based on MMAC feedback, what should DHCS include in the Medi-Cal Value Strategy to improve person-centered and culturally responsive care?
- Multiple Voices and Vision Council members shared the desire for more care navigation assistance. Noting that helping members navigate the process effectively would add value, particularly in the context of the upcoming transition of members with unsatisfactory immigration status from managed care to fee‑for‑service.
- Voices and Vision Council members shared highlighted the importance of person-centered and culturally responsive care.
- Multiple Voices and Vision Council members suggested simplifying required paperwork, such as for the recertification process.
- Voices and Vision Council members suggested prioritizing staff training to prevent billing and reimbursement issues, making the process smoother for everyone, including members.
- One Voices and Vision Council member said Medi-Cal should reaffirm a commitment to care that keeps people safe and healthy at home and helps people who are living in nursing homes transition to care at home, citing the Lanterman Act that gives Californians with developmental disabilities an affirmative right to receive care at home and noting that there is not an equivalent right in California law for people with other disabilities.
- One Voices and Vision Council member identified access to medical supplies and equipment, including repairs, as an area of frustration that could be addressed through the value strategy.
- DHCS staff identified an opportunity to explore technology to help members understand benefits and navigate processes.
- One Voices and Vision Council said technology needs to be accessible to people who may not have a home computer and asked whether solutions could be used on a phone and wanted to understand the proposed technology solution more concretely.
- One Voices and Vision Council member praised the Medi-Cal application website, noting that it works well on a phone and allows people to upload documents, while another member noted that while the app is useful for submitting documents, but falls short in supporting the necessary communication with eligibility workers that occurs after document submission, noting that these processes can take significant time and can contribute to people losing coverage and experiencing gaps in care.
- Voices and Vision members suggested that additional investment is needed to support member needs, deepen understanding of community priorities across both DHCS and staff, and expand care coordination.
- Voices and Vision members suggested clearer, easier‑to‑understand role titles across service providers who can provide navigation support (e.g. community health workers, care coordinators, care navigators, etc.) would also help reduce confusion and improve navigation access.
- Voices and Vision members suggested simplifying technology for members as many people have difficulty navigating digital tools and automated phone systems. Making these systems more user‑friendly can help ensure members receive timely support without frustration.
- Voices and Vision members discussed the need for the value strategy to address community health center needs.
- One Voices and Vision Council member suggested keeping the initial implementation simple so funding can reach providers quickly.
How can DHCS measure whether the Medi-Cal Value Strategy is actually improving care for Medi-Cal members?
- Members discussed the importance of defining what success would look like in member day-to-day experiences.
- One Voices and Vision Council member suggested starting small and testing strategies before scaling them statewide, using the results to inform implementation.
- One Voices and Vision Council member described a positive experience his son had receiving care across transportation, hospitals, surgery, and a nursing home, contrasting this experience with a family member’s health care experiences. They wondered how positive experiences could be identified, reinforced, and replicated for other people.
- One Voices and Vision Council member said a critical measure of value is how members and patients interact with providers, and that reducing administrative burden could give providers more capacity to work with members. They noted that DHCS also needs to balance administrative processes required for data collection and measuring success.
- One Voices and Vision Council member identified both member satisfaction across the entire experience (from the application processing through care) as an important measure of success, and also identified provider satisfaction as important metrics.
- One Voices and Vision Council member suggested considering both access to navigation and successful navigation (connecting to desired/necessary services) as success metrics.
- One Voices and Vision Council member said technology could potentially help members identify specialty providers and providers that align with their language and religious beliefs.
- One Voices and Vision Council member said success looks like care at home and people leaving the hospital as soon as their needs are met.
- Voices and Vision Council members suggested establishing standardized metrics, such as Consumer Assessment of Healthcare Providers and Systems (CAHPS), and developing additional validated measures can help assess outcomes more accurately and reduce reliance on guesswork or ad‑hoc methods.
If you had $100 to invest in improving member experience, where would that money go first? And if you needed to take $100 out of something, what would you redesign because it’s not providing enough value?
- One Voices and Vision Council member identified community health workers, housing, and transportation as areas for investment.
- One Voices and Vision Council member identified coverage of premiums or other out-of-pocket costs as an area for investment.
- One Voices and Vision Council member identified excessive prior authorization procedures as an area where resources could potentially be reduced.
- One Voices and Vision Council member identified paperwork and assistance for individuals and families responding to health care notices and paperwork as an area where resources could be invested.
- Members discussed investing in care coordination, including community health workers and other staff working directly with members.
- Members discussed investing in care at home and in the community, reducing paperwork, and shifting care away from institutional settings.
ບົດລາຍງານ ແລະ ຄຳເຫັນຂອງສະມາຊິກ
ປະເພດການກະທຳ: ການສົນທະນາ
Presenters: Abigail Coursolle and Sydney Turner
- Breakout room reporters shared summaries of the discussions that took place in their respective groups and highlighted key themes, questions, and ideas raised by members.
- Following the report-outs, members were invited to share additional comments or reflections with the full group. No additional comments were raised.
ຄຳກ່າວປິດ
ປະເພດການກະທຳ: ຂໍ້ມູນ
ຜູ້ນຳສະເໜີ: Kiran Poonia ແລະ Michelle Baass
ລາຍການທີ່ໄດ້ປຶກສາຫາລື:
- DHCS will compile the themes, questions, and ideas from the meeting into a minutes document and post it on the DHCS website.
- The voting email and instructions for the unsatisfactory immigration status to fee-for-service transition recommendations was sent the following day.
- Members were invited to email DHCS with questions during the voting process.
- The next Voices and Vision Council meeting will be held on Wednesday, December 9, 2026, and will be closed to the public.
- The next MMAC meeting will be held on November 18, 2026.
- Director Baass thanked members for their participation, feedback, and partnership and encouraged members to continue visiting the Medi-Cal Changes webpage for more information about what members need to know and the latest changes to the Medi-Cal program.
ການເລື່ອນກອງປະຊຸມ
ຊື່ຂອງຜູ້ທີ່ເລື່ອນກອງປະຊຸມ: Michelle Baass
ເວລາເລື່ອນອອກໄປ: 19:30 ໂມງ PDT