The State of California has formally submitted to the Centers for Medicare and Medicaid Services (CMS) the revised Demonstration Proposal for California’s Coordinated Care Initiative: State Demonstration to Integrate Care for Dual Eligible Individuals. This proposal is being published for a second 30-day public comment period at the CMS website.  

The Demonstration Proposal describes how California will structure, implement and monitor an integrated delivery system and payment model for dual eligible (Medicare and Medi-Cal) beneficiaries. The goals of the demonstration are to improve health outcomes, promote a more efficient health care system and allow more beneficiaries to stay in their homes and communities for as long as possible. 

The Demonstration Proposal offers a vision for coordinated care models in California that provide seamless access to the full continuum of medical, social, long-term and behavioral supports and services that dual eligible beneficiaries need to maintain good health and a high quality of life. The proposal reflects rounds of input provided by a wide array of consumers and stakeholders during numerous conversations and public meetings over the past year. 

Duals Demonstration Transition Plan

• Draft Transition Plan
• Transition Plan Comment Template

Proposal Submitted to CMS

• Cover Letter from DHCS, DSS and CDA to CMS (May 31, 2012)
• Memo Summarizing Key Changes (May 31, 2012)
• Demonstration Proposal (May 31, 2012)
• Demonstration Proposal — Large Format (14 pt font)
• Demonstration Proposal with red-lined edits
• Letters of Support

Written Comments

The following three documents contain 271 pages of comments. The list posted below includes all the organizations that submitted comments according to their placement in the following three PDFs.

• List of Organizations that submitted commentsComments (65 pages submitted as Excel worksheets) 
• Comments  (A – C)
• Comments (D – Z)

Draft Proposal

• Draft Proposal For Public Comment (April 4, 2012)
• Large Format (14 pt font) Proposal for Public Comment (April 4, 2012)

Background Materials

• Demonstration Fact Sheet
• Press Release (April 4, 2012)

Initial four county fact sheets

• Los Angeles
• Orange
• San Diego
• San Mateo

Announcement letters to health plans

View each plan’s application to participate in the demonstration here.

• Care 1st 
• Community Health Group 
• Molina
• Health Net
• L.A. Care
• CalOptima
• Health Plan of San Mateo
• Alameda Alliance for Health
• Anthem Blue Cross
• Contra Costa Health Plan
• Inland Empire Health Plan
• Santa Clara Family Health Plan

*All documents are in PDF format unless otherwise noted.