Passage of the Coordinated Care Initiative (CCI) in July 2012 marks an important step toward transforming California’s Medi-Cal (Medicaid) care delivery system to better serve the state’s low-income seniors and persons with disabilities. Building upon many years of stakeholder discussions, the CCI begins the process of integrating delivery of medical, behavioral, and long-term care services and also provides a road map to integrate Medicare and Medi-Cal for people in both programs, called “dual eligible” beneficiaries.

Understandably, implementation of the CCI and its expansion of mandatory Medi-Cal managed care enrollment to the dually eligible population is of concern to new – and existing – California PACE programs as this population is the primary enrollment base of the PACE program.  DHCS is committed to maintaining a productive partnership with PACE and has taken steps to ensure PACE remains both a strong and viable program.  DHCS has incorporated PACE into its California managed care systems as an enrollment option through the following mechanisms: 

PACE representation in beneficiary enrollment notices/forms/materials and outreach

The DHCS included language in Senate Bill 1008 (Chapter 33, Statutes of 2012) exempting current PACE enrollees from enrollment into the Duals Demonstration.  Further, in CCI counties where PACE programs exist, Medi-Cal beneficiaries will be choosing among the Medi-Cal plans and PACE.  In launching CCI, PACE Organization information will be on all beneficiary notification and health plan choice forms in zip codes where PACE is offered.  Beneficiaries who express interest in PACE will have a 60 day window for the PACE Organization to determine their PACE eligibility and choice prior to assignment to a Medi-Cal plan.

Outreach efforts to beneficiaries and providers about the CCI, benefit coverage, and enrollment choices will include information on PACE Organizations.  DHCS’ enrollment call center staff will be trained to assist beneficiaries to make an appropriate choice among managed care plans and PACE Organizations.  This will apply not only to initial implementation of CCI but on an ongoing basis as newly eligible beneficiaries are identified. 

Implementation of the CCI is not intended to eliminate PACE but rather expand upon the model of care that PACE has been committed to preserve over the last 30 years.  DHCS recognizes the value and success of PACE and looks forward to maintaining a working relationship with the PACE organizations while meeting our commitments and core values, fulfilling our mission of protecting the health of all Californians.