DHCS: California Health Care Roadmap Will Make Medi-Cal More Accessible, Member-Driven

Although California reached its lowest uninsured rate in state history in 2022, many Californians still do not have access to timely, quality and affordable health care.

This disparity disproportionally affects Black Californians and other people from underserved groups, particularly low income individuals.

Public Health authorities say this racial gap contributes to higher rates of illness and premature death.

"African American Californians are among the most likely groups to report that they always make their health a priority. However, African American Californians experience disparities in care and outcomes despite having higher health insurance coverage rates (93%) than the state average," according to data included in a California Department of Health Care Services (DHCS) report.

"For example, the life expectancy at birth for African American Californians is five years shorter than the state average and the lowest life expectancy of all racial and ethnic groups," the report continues.

Dr. Pamela Riley, chief health equity officer and assistant deputy director of Quality and Population Health Management at DHCS, said the disparities should not exist.

"Who you are and where you live should not determine whether you live or how well you live," said Riley.

"Everyone, regardless of race, ethnicity, where you live, age, gender, language, sexuality, income, citizenship, has a right to compassionate and comprehensive care that meets their physical and behavioral health needs," said Riley, who was speaking at a virtual press conference hosted by Ethnic Media Services (EMS) organized to inform the public about Medi-Cal's efforts to better meet the health needs of more Californians.

Over the last decade, DHCS has taken several steps to eliminate this problem including expanding Medi-Cal access to all low-income Californians, re gardless of immigration status; eliminating the "asset test" requirement so only income is considered when determining MediCal eligibility; expanding language access so members can receive interpretation services; and creating new community supports that provide culturally responsive and more customized care, including housing aid, nutritious meals, and substance abuse treatment.

Riley said to create meaningful change and foster genuine trust with Medi-Cal members, DHCS must work directly with members and trusted messengers particularly in Black and Indigenous communities of color who have not been historically underserved by the healthcare system.

DCHS' multi-year initiative contains 3 phases. The first, which concluded recently, consisted of a member feedback listening tour that began in November of 2023. It consisted of 11 virtual and in person listening sessions with members across the state that were facilitated by MediCal community partners in a variety of health care fields. These tours were focused in areas of the state most impacted by health disparities including rural areas and communities with a high concentration of minorities.

Overviews of all the sessions are documented on the DHCS website.

The second and current phase of the health equity initiative is a code sign phase working directly with members and community-based organizations to ensure that voices are heard and considered in identifying solutions that impact care that people need. DHCS is identifying partners to help implement the information gathered during the statewide tour.

The final phase is the Health and Equity Roadmap. This report, which is scheduled to be released next year, will outline steps to reach mutual goals compiled in the first two phases to achieve a more equitable healthcare system in the state.