California tries new approach to social ills – Orange County Register

While dealing with the stubborn COVID-19 pandemic, California is also facing a host of equally resilient social ills, including chronic illness, homelessness, poverty, drug abuse, and more. drugs and alcohol, mental illness and street crime.

State and local governments have created programs to improve the impact of these diseases, but they often operate in silos, each targeting a specific condition with no overt coordination. with others, although the people they serve often have problems.

For example, a homeless person not only lacks housing, but is also poor and likely to have medical problems and mental illnesses, alcohol and/or drug addiction related to the criminal justice system. .

Furthermore, formal approaches are largely passive, giving aggrieved people the opportunity to improve many of their things, but, except in rare cases, do not require their cooperation.

The state budget 2022-23 that Governor Gavin Newsom proposed last week signals that the state will begin to approach chronic social issues differently, integrating services with the goal of “whole care care.” represent people”, intervene more strongly and, in some cases, take charge of those whose lives are out of control.

At the heart of this new approach is called “California Advance and Innovations Medi-Cal” or CalAIM for short, which Newsom celebrates as “a once-in-a-generation opportunity to completely transform the system.” Medi-Cal) in California” when he signed the authorization. Medi-Cal, California’s health care system for the poor, has more than 14 million people enrolled, more than a third of the state’s residents.

CalAIM is described in the budget as “a framework that encompasses broad distribution, program and payment system reform across the entire Medi-Cal program (that) that recognizes the opportunity to transform the approach whole person care integrating health care and other social health determinants, at the statewide level with a clear focus on improving health and reducing health disparities and inequalities health, including improving and expanding behavioral health care. ”

“Previous research has shown that the highest-cost (Medi-Cal) enrollees are often being treated for multiple chronic conditions (such as diabetes or heart failure) and often suffer from health disorders. mental health or substance use,” said Legislature budget adviser Gabe Petek in an analysis of CalAIM. “Costs for this population are often attributed to frequent hospital admissions and high costs of prescription drugs. In some cases, social factors such as homelessness play a role in this high utilization of these registrants. “

With Medi-Cal serving a large portion of the state’s population, CalAIM could have a large social impact – especially since it envisions a much broader role. For example, insurance companies and other Medi-Cal providers will assign personal care managers to their clients, not only to monitor their medical care, but also to improve improve other aspects of their lives, such as housing and income support.