Strategic Plan for California’s Healthy Families Program (HFP) Transition to Medi-Cal Finalized

[Updated] California’s Health and Human Services Agency (CHHS) has published their plan for handling the upcoming transition of over 800,000 children from the Healthy Families Program to Medi-Cal. Plan details include a timetable for each phase of the transition, service coverage and continuity of care plans, and transition numbers by phase and county (a reference tool of interest for school districts participating in the MAA program that are likely to see an increase in their Medi-Cal percentages as a result of the transition).

 

Transition Timeline

The Healthy Families Program (HFP) transition will be phased in starting no earlier than January 2013, and families will start to receive notices about the transition beginning in late October 2012. As outlined in CHHS’ Strategic Plan for California’s Healthy Families Program (HFP) Transition to Medi-Cal, current Healthy Families enrollees will be transitioned to Medi-Cal in four distinct phases:

Phase 1:  No sooner than January 1, 2013, children enrolled in a HFP health plan that is also a Medi-Cal managed care health plan in their county of residence shall be enrolled in the same plan.  According to an October 31, 2012 letter from DHCS to all California County Welfare Divisions, all enrollment in the Health Families Program will stop as soon as Phase 1 is implemented. This phase includes approximately 409,000 children.

Phase 2:  No sooner than April 1, 2013, children enrolled in a HFP health plan that is also a subcontractor of a Medi-Cal managed health care plan, in their county of residence, to the extent possible, shall be enrolled into a Medi-Cal managed care health plan that includes the child’s current plan.  This phase includes approximately 259,000 children.

Phase 3:  No sooner than August 1, 2013, children enrolled in a HFP health plan that is not a Medi-Cal managed care health plan and does not contract or subcontract with a Medi-Cal managed care health plan shall be enrolled in a Medi-Cal managed care health plan in that county.  Enrollment shall include consideration of the child’s primary care providers pursuant to the requirements of statute.  This phase includes approximately 151,000 children.

Phase 4:  No sooner than September 1, 2013, children residing in a county that is not currently a Medi-Cal managed care county shall be transitioned into Medi-Cal managed care health plans, provided the successful completion of efforts to expand Medi-Cal managed care statewide by the State.  Pursuant to AB 1467, Chapter 23, Statutes of 2012, DHCS is in the process of expanding Medi-Cal managed care into the 28 counties that do not currently have managed care.  The department intends to complete this expansion prior to September 1, 2013.  This phase includes approximately 42,000 children.

County-Specific Transition Numbers

As previously reported, school districts participating in the Medi-Cal Administrative Activities (MAA) program are likely to see an increase in their Medi-Cal percentages as a result of the transition. DHCS has published a reference table that allows you to track — by county — the number of Healthy Families Program enrollees transitioning to Medi-Cal during each phase.

Read More

See how many children are projected to transition to Medi-Cal in your county…

Read “What Families Should Know About Changes to Healthy Families” published by California Coverage & Health Initiatives…

Read the complete Healthy Families Program transition plan…

Visit DHCS’ dedicated landing page for the Healthy Families Program transition…