Whole Child Model Stephanie Sonnenshine, CEO ITUP February 6, 2019 - PowerPoint PPT Presentation

Improving Medi-Cal for Patients with Complex Needs Whole Child Model Stephanie Sonnenshine, CEO ITUP February 6, 2019 Santa Cruz | Monterey | Merced Counties

IMPROVING CARE FOR MEDI-CAL PATIENTS WITH COMPLEX NEEDS Goals of the WCM include: Whole Child Model ➢ Improve coordination and integration of services Integration of services ➢ Maintain access to and quality of specialty care for children eligible for ➢ Active participation by parents and families the CCS and Medi-Cal ➢ Improved coordination of care programs, to provide ➢ Care in the most appropriate settings comprehensive ➢ Maintain existing patient-provider relationships treatment and a focus on whole child.

IMPROVING CARE FOR MEDI-CAL PATIENTS WITH COMPLEX NEEDS Whole Medi- CCS Child Cal Model • • • Specialized services Comprehensive coverage Comprehensive • Complex conditions Low income adults, coverage • • Up to age 21 families and persons with Children with CCS and • County disabilities Medi-Cal eligibility • • administered Medi-Cal plans Medi-Cal plan administered administers

IMPROVING CARE FOR MEDI-CAL PATIENTS WITH COMPLEX NEEDS Meet Gideon . He is 3 years old and has epilepsy. He requires a wheelchair and needs a feeding pump to eat. He attends 3 hours of school each day, and either goes to swim therapy, physical and occupational therapy, equine therapy, or speech therapy. His mom spends a lot of time talking to social workers and doctors. * Fictionalized member

IMPROVING CARE FOR MEDI-CAL PATIENTS WITH COMPLEX NEEDS PATIENT CENTERED Family Medi-Cal CCS Providers Managed ➢ Listen to the patient Care Plan ➢ Agree on shared goals PCPs County ➢ Form partnerships Child ➢ Listen to experts ➢ Commit to continuous Medi-Cal DHCS Providers improvement Family/Child Legislature Advocates

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