■ Official: As Healthy Families ends, ‘goal is to minimize impacts’ to low-income kids

By Donna Beth Weilenman
Staff Reporter

With the impending end to Healthy Families, California’s children’s health insurance program, Partnership HealthPlan of California is preparing to shift beneficiaries to the state Medi-Cal program this spring.

It’s one part of a multi-phase change that will add Kaiser Permanente clients, such as those in Vallejo, in April, and those receiving medical care under commercial plans in August.

The change came when Gov. Jerry Brown obtained federal approval to move 860,000 lower-income children from Healthy Families, California’s health insurance program for children, to Medi-Cal.

About 2,000 clients will be affected by the shift, said Dave McCallum, marketing and community relations manager for Partnership HealthPlan.

“Our total Solano County Healthy Families membership is 956, our total Benicia Healthy Families membership is 10, and our total Vallejo Healthy Families membership is 125,” he said.

Partnership HealthPlan, based in Fairfield, is a commission that manages health care for Medi-Cal recipients.

Some objected to Brown’s move, including state Senate President Pro Tem Darrell Steinberg, who said too many children would lose access to medical providers.

Brown said the change was needed as California readies itself for changes in health care laws that start next year.

The governor also said the change would be more efficient and ultimately would save money, though critics of the change have challenged that assertion, too.

After Brown received federal permission to make the change, Norman Williams, a spokesman for the California Department of Health Care Services, said 200,000 children in eight of the state’s larger counties would be the first involved in the transition.

He said the change would be completed this year.

The move hit a snag late last year when the Department of Health Care Services mis-mailed 2,643 Medi-Cal benefits identification cards meant for families with children who would be switched away from Healthy Families.

Williams said at the time the cards that were sent to the wrong families affected about 1.5 percent of those who would be changing to Medi-Cal. He blamed a computer error for the mistake.

Meanwhile, Partnership HealthPlan of California (PHC) is working to make the transition a smooth one for the affected children, said Jack Horn, the agency’s chief executive officer.

“We’re here to help,” Horn said. “PHC is dedicated to making this state-mandated switch as seamless as we can.”

He said more staff has been hired and providers have been contracted, and technological changes have been made to accommodate the change.

“We have a Care Coordination team that will help our members with any health issues they have during the transition and beyond,” Horn said.

McCallum said the areas in which clients will see the most change are in dental and mental heath plans. “There are likely to be a different network of providers,” he said.

Dental services soon will be provided by California Denti-Cal and Solano County Health and Health and Social Services, which includes the county’s mental health system.

Otherwise, particularly in addressing medical needs, he said, “there are very few changes,” though he said some of those “small changes” could be significant to clients should care providers change.

In terms of costs to clients, he said, “everything else is similar.”

For most clients, particularly those earning up to about 138 percent of the poverty level, there is no cost or co-pay, depending on the level of service, he said.

“Most will experience no change,” McCallum said.

Some above the poverty level may be paying from $13 to $39 a month for their children’s insurance, he said. Eventually, those making up to 400 times the poverty level may have access Medi-Cal care, he said.

The expanded eligibility is expected to increase participants in the new plan, he said.

“We anticipate an increase in the number of members in Partnership HealthPlan, maybe by a third.”

The more participants, the less it costs per person to provide the services, he explained.

McCallum said he expects no decrease in doctor participation. PHC medical providers have agreed to participate in Medi-Cal, he said.

No change is expected as Kaiser patients, including those in Vallejo, change to Medi-Cal; that provider also has agreed to participate, McCallum said.

The only question remaining is how many of the commercial plan partners will participate in the August transition, he said. “We’re working on those contracts,” he said. “We’ll see a small difference. It’s hard to really know.”

PHC started as a coalition from County Medical Society, Kaiser Permanente, NorthBay Healthcare systems, Sutter Solano Medical Center, Solano County Department of Health and Social Services, the Agricultural Workers Health Center of Dixon, Vacaville Community Clinic, Planned Parenthood, the Council of Cities and the Solano County Office of Education.

The initial alliance, formed in 1988 to help the medically uninsured and those receiving inadequate service, was called the Solano Coalition for Better Health.

The current organization was founded in 1993 in Solano County, and expanded into Napa County in 1998. From then until 2011, it added Yolo, Sonoma, Marin and Mendocino counties. It now serves more than 150,000 members.

Williams said PHC is working to keep the change from disrupting medical services to children.

“The department has thoughtfully planned this transition to maximize the continuity of care and maintain adequate health care provider networks for these children,” he said.

“Our goal is to minimize impacts to children.”