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Health Equity Forum: News from the Executive Director – January 2015

Medi-Cal Waiver Provides Great Opportunity to Promote Health Equity

This year is off to an exciting start with a new two-year legislative session, the release of the Governor’s 2015-16 budget proposal, and new opportunities for advancing health and equity for California’s communities of color. One critical and pressing opportunity facing the state is the renewal of California’s 1115 waiver. The waiver gives states like California additional flexibility to design and improve their Medicaid program (Medi-Cal in California) and Children’s Health Insurance Program (CHIP). With the waiver, states can expand eligibility, provide additional services not typically covered, and use innovative service delivery systems that improve care, increase efficiency, and reduce costs, otherwise referred to as the “Triple Aim.” 

What’s missing from these conversations is a focus on a fourth aim, promoting health equity. California’s Medi-Cal program now provides coverage to over 12 million low-income Californians, the majority from communities of color. The success of California’s 1115 waiver proposal depends on the degree to which the needs of Medi-Cal’s diverse enrollees are considered. Through our participation in the 1115 waiver renewal process, CPEHN is working to bring awareness to the historic inequities in health outcomes that our communities experience, and the need for innovative policy proposals to help reform traditional health care coverage into systems that can provide meaningful access to services for our communities.

The Department of Health Care Services has established a stakeholder process for consumers, plans, providers, and others to provide input into the 1115 waiver application. Five workgroups -- safety net, MCO/provider incentives, workforce, housing, and Delivery System Reform Incentive Program (DSRIP) 2.0 -- have been meeting since October 2014. CPEHN will be weighing in with recommendations on the integration of behavioral health and substance use disorder treatment, ensuring a culturally competent workforce, and encouraging the state to identify social determinants of health in which to invest for prevention efforts. If you have comments or would like to join us in these conversations we would love to hear from you. Please email me at

CPEHN also will continue supporting efforts to expand health care coverage to the remaining uninsured and advocating for the integration of health into the state’s planning documents. We will also be sponsoring two bills that seek to improve access to critical information for California’s Limited English Proficient communities. We hope you will join us as we continue promote policies that improve health and foster equity for communities of color in California.