Vulnerable Medi-Cal patients set to get support from $13.4 million pilot program

More than $13.4 million is set to flow into Monterey County over the next five years as part of a federally funded pilot program to help the most vulnerable and medically fragile Medi-Cal patients get the care they need to get well, the County of Monterey Health Department announced Tuesday.

The Whole Person Care Pilot Program will use case managers to make sure that patients don’t get lost in the public healthcare maze, getting sicker along the way and costing the county more money in the long run.

“The current system of health care is fragmented and frequently difficult for an individual to navigate,” said Elsa Jimenez, Director of the Monterey County Health Department, in a statement. “By coordinating physical and mental health services along with social services the individual can receive appropriate and supportive care.”

Monterey County is one of 18 counties approved to participate in the pilot by the California Department of Health Care Services. The county health department is the lead agency managing the program, in partnership with other public agencies and nonprofits, including the Department of Social Services, the Sheriff’s office, Natividad Medical Center, Salinas Valley Memorial Healthcare System, and homeless organizations.

The goal is to work together to coordinate services for at-risk patients who are “high-utilizers” of the county’s health services, decreasing their need for future services.

“Often the challenges posed by mental health and homelessness complicate treatment of chronically ill individuals” said Jimenez. “That is why the collaboration between healthcare providers, county services and nonprofit organizations is essential to providing the wrap around services the individuals need.”

Agencies receiving the funds are required to match up to the $13.4 million through committing staffing and other resources to the program, according to health department spokesperson Karen Smith.

Built into the program are payments and incentives for achieving positive health outcomes and reducing hospital and mental health readmissions.

Another goal of the program: create a permanent infrastructure to continue the program past the June 30, 2021 pilot end date.