Care1st CCI Advisory Committee Meeting
Thursday, August 7, 2014
11:30-1:30 p.m.
Care1st Corporate Offices - Monterey Park, California
Care1st CCI Advisory Committee Meeting
Thursday, August 7, 2014, 11:30 AM – 1:30 PM
Advisory Committee Member
Care1st Staff
Present:
 Debra Cherry, Alzheimer’s Association
 Louis Frick, Access to Independence
 Janet Heinritz-Canterbury, Personal Assistance Services
Council (PASC)
 Lorie Van Tilburg, Southern Caregiver Resource Center
 Norma Jean Vescovo, Independent Living Center of
Southern California
 June Simmons, Partners in Care Foundation
 Laura Trejo, City of Los Angeles Department of Aging
Present:
 Sahaar Azariah, Esq., Legal & Regulatory Department
 Susan Bell, Director of CCI - LA
 Kelly Chang, CCI Project Management Specialist
 Steven Chang, Director of Social Services
 Linda Fleischman, Health Education Director
 Araceli Garcia, LTSS Provider Relations Liaison - LA
 Beverly Gibbs, VP of Medical Health - LA
 Richard Golfin, Director of CMC Compliance
 Greg Greenwood, Behavioral Health Director
 Esmeralda Guzman, Provider Relations Manager
 Tracie Howell, VP of Medi-Cal Operations
 Rebecca Huff, LTSS Project Management Specialist
 Roni Kaminski, Director of CCI - SD
 Pamela Mokler, VP of LTSS
 Eddy Moreno, Director of Outreach & Education
 Catrina Rodriguez, Behavioral Health Manager
 Jamie Ueoka, VP of Program Development
 Josie Wong, VP of Medical Health Services - SD
Absent:
 Lynn Daucher, former CA State Legislator and Director, CA
Department of Aging
 Jon Pynoos, UPS Professor of Gerontology, Policy &
Planning, Andrus Gerontology Center, University of Southern
California
 Lorenza Sanchez, Los Angeles County, Community &
Senior Services
AGENDA
ITEM
I. Call to Order
PRESENTATION/DISCUSSION
Pamela Mokler, Committee Chair, called the meeting to order. Meeting
commenced at 11:30 p.m.
II. Introduction
Pam welcomed Care1st CCI Advisory Committee Members and Care1st Staff
to the first quarterly meeting and opened with introductions.
III.
Presentations
& Discussions
Pam presented an overview of the purpose of CCI Advisory Committee and a
brief summary of its functions, giving reference to the CCI Advisory
Committee Policy and Procedure (a copy was provided to all).
Recommendations made by the Committee will either go to the Public Policy
Committee and/or to the board, if applicable.
Pam continued with a brief description of Care1st’s history and background,
and a summary of current efforts in California to coordinate care and the
Coordinated Care Initiative (CCI): Cal MediConnect & Managed Long Term
Services and Supports (MLTSS).
Jamie Ueoka , VP of Program Development, presented the following:
 Care1st’s involvement and relationship with CMS and the State, and
described the breakdown of delegated responsibilities between Care1st
and its IPA partners. She also referenced the extensive training that is
done with the IPAs and medical groups, and the lessons Care1st has
learned from our experience managing the SPDs.
 Health Risk Assessment (HRA) Process and Member Services’ outreach
to newly enrolled members through Care1st Welcome Calls
 Covered benefits and services for CCI: Cal MediConnect & MLTSS.
Following this was a discussion of the HRA process and the challenges
COMMITTEE ACTION/RECOMMENDATIONS
AGENDA
ITEM
PRESENTATION/DISCUSSION
associated with enrollment discrepancies and correcting/reporting inaccurate
contact information.
COMMITTEE ACTION/RECOMMENDATIONS
Discussion:
What has been the biggest challenge with the HRA’s? (Louis Frick)
Are the HRA’s periodically updated or is it approved for the duration of the
pilot? (Debra Cherry)
Does the Plan have control over the annual wellness visit? How can we
capture information on people with cognitive impairment? (Debra Cherry)
What is the feedback from the Welcome Calls and what are the differences
between passively enrolled members and voluntary? Discussion re: confusion
over forms and how to opt out and provider denial issues and confusion over
responsible party for claims/payment. (Janet Canterbury)
A discussions ensued on possible outreach solutions.
Catrina Rodriguez, Behavioral Health Manager, presented an overview of
care coordination and services/covered benefits between the Plan and the
Counties (Los Angeles and San Diego), and between medical and behavioral
Health providers.

Susan Bell, CCI Clinical Director in Los Angeles County, gave an
overview of case management, care coordination and Continuity of Care.
Key Items Discussed:
 Los Angeles vs. San Diego model
 Delegated responsibilities with IPAs and Medical Groups
 Process on how to handle Continuity of Care requests
Recommendations:
Include reports in future meetings on number of calls to
Member Services re: CMC, types of calls, percent of opt outs,
etc.
Janet Heinritz-Canterbury suggested doing a town hall/robocall on these billing issues to help clarify and address some of
the confusion and concerns.
Laura Trejo recommended that Catrina Rodriguez,
Behavioral Health Manager, connect with Sarah Gelberd, MD,
LA Department of Mental Health, Countywide Older Adult
Services. She will follow up with contact information.
AGENDA
ITEM
PRESENTATION/DISCUSSION
How does information get transferred to the new doctor for cases of Continuity
of Care? (Norma Vescovo)


Reporting requirements
Case Management responsibilities – delegated and internal
Steven Chang, Director of Social Services, gave an overview of the LTSS
benefits.
Key Items Discussed:
IHSS – eligibility criteria and a case study example
MSSP – eligibility criteria and a case study example
CBAS – eligibility criteria & Care1st’s experience with the program
Do plans still need to obtain a face to face eligibility determination/evaluation
by a nurse for CBAS? (June Simmons)
LTC & SNF – eligibility criteria
Difference between institutional vs. custodial care. LTSS Care Coordination
with delegated groups
Pamela Mokler followed up with a discussion of typical LTSS services
needed to stay in the community and a description of Care Plan Options
(CPOs).
Key Items Discussed:
COMMITTEE ACTION/RECOMMENDATIONS
AGENDA
ITEM
PRESENTATION/DISCUSSION
Potential interventions and/or solutions with regards to IHSS recipients
COMMITTEE ACTION/RECOMMENDATIONS
Recommendations:
City of Los Angeles developed a pilot program with Critical Signal
Technologies (CST) that was able to defer approximately 2,000 nonemergency medical response calls
Janet Heinritz-Canterbury offered the Public Authority’s
assistance with member outreach and discussions regarding
consumer direction. Eddy Trejo, Community Outreach
Director, said that he will follow up with Janet.
Plan flexibility to assist members through Care Plan Options
The next meeting will be in December
We need to make it easier to transition safely from the
hospital to home than it is to transition from the hospital to a
SNF. easier and safer transitions with expedited processes
Meetings will be held simultaneously in both Los Angeles and San Diego
counties; members in LA will come to the Corporate offices in Monterey Park
and members in San Diego will go to Care1st’s San Diego office.
Norma Jean Vescovo offered the Independent Living
Center’s help with the Community Care Transition program
funded by the Department of Rehabilitation.
Next Steps:
Debra Cherry suggested that perhaps the Plan can step in
and help those individuals who are cognitively infirmed, and
do not have any family assistance that is readily available.
IV. Meeting
Concluded
Meeting was concluded at l:40 PM.
Pam made a request for recommendations for consumers and
caregivers to serve on the Committee, as well as topics for
discussion at future meetings.