New CalAIM-Focused Position at CalOptima Will Prioritize Providing Culturally Appropriate Community Supports – State of Reform

In an effort to improve the delivery of CalAIM services to beneficiaries, CalOptima, the public entity overseeing Medi-Cal in Orange County, recently created a new position titled “Executive Director of Medi-Cal/CalAIM”. According to CalOptima representatives, the post is the first of its kind to be rolled out by a health plan in the state.

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The job went to Kelly Bruno-Nelson, who was previously president and CEO of the National Health Foundation (NHF), a Los Angeles-based nonprofit that works to improve the health of underserved communities. Bruno-Nelson says this new leadership position will help strengthen CalOptima’s role in achieving the goals of the statewide CalAIM initiative, particularly with respect to the Community supports to address the social determinants of beneficiary health.

With CalOptima being one of the few health plans in the state to offer CalAIM’s 14 community supportsBruno-Nelson says creating a team within CalOptima dedicated solely to overseeing the CalAIM rollout will help ensure CalOptima is compliant with Department of Health Services (DHCS) rules and guidelines, as well as help move forward constantly to improve to meet the needs of members.

“[CalOptima] is a health plan recognizing that the social determinants of health, which account for 80% of our ability to be healthy, really should be front and center,” said Bruno-Nelson. “The health plans have really put direct health care at the center of everything, and that philosophical shift has been very difficult to make, and I think CalOptima, by creating this position, is really setting the bar on what that looks like. .”

She said her position will focus on applying research and developing best practices to develop the core guidelines and services defined by DHCS, and to make CalAIM’s implementation as smooth as possible. Community Support Liaisons, for example, will be appointed for the sole purpose of assisting CalOptima Community Support Providers.

“[We will be] looking at each of these 14 community supports and saying, “What are the minimums? What are the parameters? What do our members need and how can we expand these services? said Bruno-Nelson.

“It’s literally engaging the [Community Supports providers] in those discussions and then trying to develop services in each of those settings that more reflect the needs of our members… It’s just a matter of taking a program that could be implemented in a meat and potatoes way, and really trying to broaden our thinking, and the best way to do that is to involve the community organizations that provide the services. »

She highlighted her enthusiasm to expand beyond the services outlined by the DHCS to better tailor services to CalOptima members and to root the provision of each of the community supports in member dignity.

“For instance, [with medically tailored meals], should these medically appropriate meals be provided in the traditional way? Does it have to be a meals-on-wheels service? Could it be a food pharmacy? There are many ways to provide more culturally appropriate and ultimately more dignified meals.

It’s the dignity behind the services, it’s not just about taking the easy route, it’s about taking the dignified route that makes our members feel more humane and just feel fair.

Bruno-Nelson added that she hopes to collaborate and share ideas with other health plans as CalOptima’s work in this space continues.

“Hopefully we can be a role model, hopefully we can help. I don’t think CalOptima is going to do all this work and then keep all these great ideas close to us… The more people who learn what we do and who we can partner with, the better.

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