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Reorienting the Safety Net for the Remaining Uninsured: California's County Indigent Health Programs

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Health Access California presents their March 2015 report: "Reorienting the Safety-Net for the Remaining Uninsured: Findings From a Follow-Up Survey of County Indigent Health Programs," which shows wide variation among county programs for low-income uninsured residents, and marked trends after the Affordable Care Act.

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Reorienting the Safety Net for the Remaining Uninsured: California's County Indigent Health Programs

  1. 1. WelcomeWelcome
  2. 2. Get Involved!Get Involved!  VisitVisit health4allca.orghealth4allca.org  Follow the conversation at #Health4All.Follow the conversation at #Health4All.
  3. 3. County Indigent Care ProgramsCounty Indigent Care Programs After the Affordable Care ActAfter the Affordable Care Act April 2015April 2015 Anthony Wright, Executive DirectorAnthony Wright, Executive Director Sawait Hezchias-Seyoum, Policy AdvocateSawait Hezchias-Seyoum, Policy Advocate Reorienting the Safety Net forReorienting the Safety Net for the Remaining Uninsuredthe Remaining Uninsured www.health-access.org www.facebook.com/healthaccess www.twitter.com/healthaccess
  4. 4. CALIFORNIA IMPLEMENTS Millions with new consumer protections; financial assistance 4+ million Californians with new coverage CALIFORNIA IMPROVES EARLY: * Low-Income Health Programs * Children with pre-existing conditions * Maternity coverage BETTER: * Exchange that negotiates & standardizes * Medi-Cal express lane enrollment options * Continuing CA’s inclusion of legal immigrants including DACA students
  5. 5. Who Needs More Help?Who Needs More Help? ACA has millions ofACA has millions of “winners,” who have new coverage, new“winners,” who have new coverage, new access, and/or new financial help to afford coverage. Everyoneaccess, and/or new financial help to afford coverage. Everyone wins with a health system more humane, more rational, morewins with a health system more humane, more rational, more transparent, with new consumer protections and incentivestransparent, with new consumer protections and incentives aligned for improved quality & reduced cost.aligned for improved quality & reduced cost. Issues remain:Issues remain: •Medi-Cal year-round, but can be frozen out of Covered CAMedi-Cal year-round, but can be frozen out of Covered CA •No mandate if coverage is more than 8%No mandate if coverage is more than 8% AndAnd on affordability, some folks will need more helpon affordability, some folks will need more help :: •Uninsured undocumented immigrantsUninsured undocumented immigrants •Those inThose in “family glitch”: family members for workers with“family glitch”: family members for workers with employer based coverage affordable for just themselvesemployer based coverage affordable for just themselves •Some over 400% federal poverty level (typically older, in high-Some over 400% federal poverty level (typically older, in high- cost areas) who doncost areas) who don’t have affordability guarantee.’t have affordability guarantee. •Those in Exchange who find monthly premiums/cost sharing stillThose in Exchange who find monthly premiums/cost sharing still a burden, and may/may not decline coverage.a burden, and may/may not decline coverage.
  6. 6. California May Have 3 MillionCalifornia May Have 3 Million Remaining UninsuredRemaining Uninsured
  7. 7. Our Current Safety-NetOur Current Safety-Net  Uninsured live sicker, die younger, oneUninsured live sicker, die younger, one emergency from the financial ruin.emergency from the financial ruin.  Emergency Rooms: But only to stabilizeEmergency Rooms: But only to stabilize emergencies; Bill and debt afterwardsemergencies; Bill and debt afterwards – 2006 Fair Hospital Pricing Law2006 Fair Hospital Pricing Law www.hospitalbillhelp.orgwww.hospitalbillhelp.org  Private providers: clinics, hospital charity carePrivate providers: clinics, hospital charity care  Counties.Counties. – Counties have aCounties have a “17000” obligation to provide basic care“17000” obligation to provide basic care – CaliforniaCalifornia’s 58 counties continue to vary widely on’s 58 counties continue to vary widely on their service to the uninsuredtheir service to the uninsured – How they provide care; What care they provide;How they provide care; What care they provide; and to who, especially based on income &and to who, especially based on income & immigration status.immigration status.
  8. 8. 3 Flavors of Counties3 Flavors of Counties PUBLICPUBLIC HOSPITALHOSPITAL •AlamedaAlameda •Contra CostaContra Costa •KernKern •Los AngelesLos Angeles •MontereyMonterey •RiversideRiverside •San BernardinoSan Bernardino •San FranciscoSan Francisco •San JoaquinSan Joaquin •San MateoSan Mateo •Santa ClaraSanta Clara •VenturaVentura ““ARTICLE 13”ARTICLE 13” FresnoFresno MercedMerced OrangeOrange PlacerPlacer SacramentoSacramento San DiegoSan Diego San Luis ObispoSan Luis Obispo Santa BarbaraSanta Barbara Santa CruzSanta Cruz StanislausStanislaus TulareTulare Yolo*Yolo* Others are part of CMSPOthers are part of CMSP (County Medical Services Program)(County Medical Services Program) 99
  9. 9. 1010
  10. 10. Source of Major Apprehension:Source of Major Apprehension: Some County Health $ ReallocatedSome County Health $ Reallocated Counties had 2 options for determining the redirected amount. Each county must inform DHCS of tentative decision by 11/1/13 Must adopt a resolution by 1/22/14 60% of 1991 Health Realignment Funds + 60% of Maintenance of Effort Maintenance of Effort is capped at 14.6% of the total value of each county’s 10-11 allocation. County Savings Determination Process (Formula) Lesser of: (Revenues-Costs) x .80 (.70 in 13/14) Or County Indigent Care Health Realignment Amount (=Health Realignment Amount x Health Realignment Indigent Care Percentage) With the Medi-CalWith the Medi-Cal expansion, AB85expansion, AB85 reallocated up toreallocated up to $900 million of $1.4 billion$900 million of $1.4 billion in funds for countiesin funds for counties for public health andfor public health and indigent careindigent care Article 13 CountiesArticle 13 Counties 1111
  11. 11. KEY FINDINGS: EligibilityKEY FINDINGS: Eligibility  Our survey found that some countiesOur survey found that some counties adjusted benefits but largely notadjusted benefits but largely not eligibility.eligibility.  A lot of apprehension about AB85, countyA lot of apprehension about AB85, county realignmentrealignment  Many Other Counties inMany Other Counties in “Wait and See” Mode“Wait and See” Mode – CMSP: Eliminated optometry, mental health,CMSP: Eliminated optometry, mental health, substance abuse; reduced dental; shortenedsubstance abuse; reduced dental; shortened certification to 3 months.certification to 3 months.  Nothing in Funding Formula Requires Cuts inNothing in Funding Formula Requires Cuts in Eligibility—Allows Full Reimbursement ofEligibility—Allows Full Reimbursement of Services for What Counties Provided BeforeServices for What Counties Provided Before – Need to Spend the $ to Get ReimbursedNeed to Spend the $ to Get Reimbursed – Limits Are On Use of State $ For Going FurtherLimits Are On Use of State $ For Going Further
  12. 12. FRESNOFRESNO Amparo CidAmparo Cid  Director of SRCP and AttorneyDirector of SRCP and Attorney  California Rural Legal AssistanceCalifornia Rural Legal Assistance Foundation (CRLAF)Foundation (CRLAF)  Lawsuit to get out from legal injunction to care for theLawsuit to get out from legal injunction to care for the undocumentedundocumented  Preliminary vote to eliminate MISPPreliminary vote to eliminate MISP  Effort to change safety-net program from hospital contractEffort to change safety-net program from hospital contract  Board of Supervisor vote on April 7, 2015 to continueBoard of Supervisor vote on April 7, 2015 to continue revamped program: $5 million for specialty carerevamped program: $5 million for specialty care
  13. 13. Self-Reporting: Care Beyond the ER for Undocumented Adults Alameda Fresno Kern Los Angeles Riverside San Francisco San Mateo Santa Clara Santa Cruz Ventura Prior to 2009: Contra Costa Sacramento Yolo
  14. 14. KEY FINDINGS: EnrollmentKEY FINDINGS: Enrollment  2014 implementation of the Affordable Care Act led to2014 implementation of the Affordable Care Act led to dramatic reductions in the number of Californiansdramatic reductions in the number of Californians on county indigent care programson county indigent care programs —as counties—as counties successfully enrolled people in Medi-Cal and Coveredsuccessfully enrolled people in Medi-Cal and Covered CaliforniaCalifornia –Low Income Health ProgramsLow Income Health Programs –Horizontal integration, Express lane enrollment, presumptiveHorizontal integration, Express lane enrollment, presumptive eligibility, etc.eligibility, etc.  Counties with broad eligibility requirements areCounties with broad eligibility requirements are seeing strong continued needseeing strong continued need for their safety-netfor their safety-net programs—with tens of thousands enrolled.programs—with tens of thousands enrolled.  Counties with restrictive eligibility requirements—Counties with restrictive eligibility requirements— especially those that exclude the undocumented—especially those that exclude the undocumented— are finding few if anyone leftare finding few if anyone left in their indigent carein their indigent care programs.programs. –Not because need isnNot because need isn’t there, but because programs are not’t there, but because programs are not oriented to the remaining uninsured.oriented to the remaining uninsured.
  15. 15. Steps ForwardSteps Forward ACA Provides Significant Savings toACA Provides Significant Savings to State/CountiesState/Counties With Many Covered, Time to:With Many Covered, Time to: – Re-Orient Safety-Net, Do It BetterRe-Orient Safety-Net, Do It Better – The Lessons of LIHP: Primary/Preventative MedicalThe Lessons of LIHP: Primary/Preventative Medical Home, rather than episodic/emergency careHome, rather than episodic/emergency care – Extending Eligibility to the Remaining UninsuredExtending Eligibility to the Remaining Uninsured ““Now We Can Say Yes”Now We Can Say Yes” – Los Angeles, Alameda, San Francisco, SantaLos Angeles, Alameda, San Francisco, Santa Clara, San Mateo, Etc.Clara, San Mateo, Etc. Bridges to a Statewide SolutionBridges to a Statewide Solution
  16. 16. LOS ANGELESLOS ANGELES Sonya VasquezSonya Vasquez  Policy DirectorPolicy Director  Community Health Councils, Inc.Community Health Councils, Inc. 323.295.9372323.295.9372 sonya@chc-inc.orgsonya@chc-inc.org
  17. 17.  Primary Care ProgramPrimary Care Program for low-income uninsured people in Losfor low-income uninsured people in Los Angeles County. (MHLA is not insurance)Angeles County. (MHLA is not insurance)  FundedFunded by LAC Board of Supervisors ($61 million each year)by LAC Board of Supervisors ($61 million each year)  ServicesServices occur at contracted community clinics (primary care) &occur at contracted community clinics (primary care) & county facilities (specialty, urgent and emergency care)county facilities (specialty, urgent and emergency care)  PaymentsPayments for clinics as of April 1for clinics as of April 1stst are $36 Per Member Per Monthare $36 Per Member Per Month  QualificationsQualifications: Not eligible for Covered CA, Medi-Cal, , Employer: Not eligible for Covered CA, Medi-Cal, , Employer coverage, etc; Uninsured, LA County resident, Age 6+ (as of now),coverage, etc; Uninsured, LA County resident, Age 6+ (as of now), Income below 138% Federal Poverty LevelIncome below 138% Federal Poverty Level  Program openedProgram opened October 1October 1stst and stays open until total enrollmentand stays open until total enrollment is met (estimated 146,000)is met (estimated 146,000)  EnrollmentEnrollment as of February 28as of February 28thth was 93,253 (94% Latino) – 64% ofwas 93,253 (94% Latino) – 64% of target in 5 monthstarget in 5 months My Health LA (MHLA)My Health LA (MHLA) http://dhs.lacounty.gov/MHLA
  18. 18.  Coalition formed Fall 2013 to strengthen the LACoalition formed Fall 2013 to strengthen the LA county health safety-net infrastructure in order tocounty health safety-net infrastructure in order to improve the quality of health care and increaseimprove the quality of health care and increase access for the remaining uninsured.access for the remaining uninsured.  Almost 30 organizations representing LA CountyAlmost 30 organizations representing LA County residents includes advocacy groups (health &residents includes advocacy groups (health & immigration), labor, clinics, faith based andimmigration), labor, clinics, faith based and community based organizations.community based organizations.  Submitted recommendations, met with the county,Submitted recommendations, met with the county, held press events, participated in stakeholderheld press events, participated in stakeholder meetings, and convened consumer forums.meetings, and convened consumer forums.
  19. 19. LA: Current ConcernsLA: Current Concerns Capacity & FundingCapacity & Funding  No formal outreach yet enrollment increasing 12,000-14,000 a monthNo formal outreach yet enrollment increasing 12,000-14,000 a month  Benefits not comprehensive & only offered at community clinicsBenefits not comprehensive & only offered at community clinics  Healthy Kids (0-5) program closingHealthy Kids (0-5) program closing CONSUMER FOCUSED MARKETING AND OUTREACHCONSUMER FOCUSED MARKETING AND OUTREACH  No formal outreach/education & limited consumer engagementNo formal outreach/education & limited consumer engagement  Confusion about services, who is served and the impact on immigrationConfusion about services, who is served and the impact on immigration  Information only in English and SpanishInformation only in English and Spanish Enrollment OptionsEnrollment Options  Only clinics can enroll & only at certain sites (although this is beingOnly clinics can enroll & only at certain sites (although this is being reviewed)reviewed) Prioritizing Data Collection and ReportingPrioritizing Data Collection and Reporting  Only demographic data available (although this is expected to change)Only demographic data available (although this is expected to change) Coordination of CareCoordination of Care  Concerns about enrollees moving between community and countyConcerns about enrollees moving between community and county clinicsclinics
  20. 20. SACRAMENTOSACRAMENTO Nenick VuNenick Vu  LeaderLeader  Sacramento Area Congregations TogetherSacramento Area Congregations Together (ACT)(ACT)  Eliminated services to the undocumented in 2009; reducedEliminated services to the undocumented in 2009; reduced county clinic capacitycounty clinic capacity  New Board of Supervisors makeupNew Board of Supervisors makeup  Options presented in Board Workshop in MarchOptions presented in Board Workshop in March
  21. 21. CONTRA COSTACONTRA COSTA Alvaro Fuentes,Alvaro Fuentes, Executive Director,Executive Director, Community Clinic ConsortiumCommunity Clinic Consortium of Contra Costa and Solano Countyof Contra Costa and Solano County  County eliminated services to adult undocumented in 2009County eliminated services to adult undocumented in 2009  Access to Care Stakeholders CollaborativeAccess to Care Stakeholders Collaborative  Contra Costa CARES – proposed coverage programContra Costa CARES – proposed coverage program
  22. 22. Making #Health4All History *ThisMaking #Health4All History *This Year*Year* 2626  Secure and Expand our County Safety-Net Programs:Secure and Expand our County Safety-Net Programs: Counties are the last resort of coverage. Some counties areCounties are the last resort of coverage. Some counties are enhancing their safety-net for the remaining uninsured, withenhancing their safety-net for the remaining uninsured, with programs like My Health LA. We need to encourage moreprograms like My Health LA. We need to encourage more counties to care for the undocumented.counties to care for the undocumented.  Continuing CaliforniaContinuing California ’s Coverage of “Deferred Action”’s Coverage of “Deferred Action” Immigrants:Immigrants: The President’s executive action had the impactThe President’s executive action had the impact of expanding the category of immigrants covered by state-of expanding the category of immigrants covered by state- funded Medi-Cal.funded Medi-Cal. We need to defend and secure thisWe need to defend and secure this major victory. Also:major victory. Also:  Making Progress to a Statewide Solution forMaking Progress to a Statewide Solution for #Health4All:#Health4All: An effort now in its third year, we can takeAn effort now in its third year, we can take another step to Health4All, expanding Medi-Cal to moreanother step to Health4All, expanding Medi-Cal to more immigrants, and setting up the structure for a mirrorimmigrants, and setting up the structure for a mirror marketplace so everyone can seek coverage.marketplace so everyone can seek coverage.
  23. 23. New County OpeningsNew County Openings Other CountiesOther Counties: Not Just Sacramento, Contra Costa: Not Just Sacramento, Contra Costa CMSP Strategic Planning ProcessCMSP Strategic Planning Process DAPA/PresidentDAPA/President ’s Executive Order’s Executive Order – With federal papers/work authorization, likely qualifiesWith federal papers/work authorization, likely qualifies – Forces conversation at the county level about eligibilityForces conversation at the county level about eligibility – Reduces the county cost as state covers part of this populationReduces the county cost as state covers part of this population ““Medi-Cal 2020” WaiverMedi-Cal 2020” Waiver – ““Public Safety Net System Transformation & ImprovementPublic Safety Net System Transformation & Improvement Program.”Program.”  Allow Use of DSH/Safety Net Care Pool $ for Primary,Allow Use of DSH/Safety Net Care Pool $ for Primary, Coordinated, Upstream Care.Coordinated, Upstream Care.  Would Be a Major Incentive for Public Hospital CountiesWould Be a Major Incentive for Public Hospital Counties – Delivery System Reform Throughout Health SystemDelivery System Reform Throughout Health System – Integration with Other County Services & Potential SavingsIntegration with Other County Services & Potential Savings
  24. 24. Bradley ClevelandBradley Cleveland  Planning and Health Policy ConsultantPlanning and Health Policy Consultant  San Mateo County Union Community AllianceSan Mateo County Union Community Alliance  Former Campaign Manager, Yes on AAFormer Campaign Manager, Yes on AA  Alameda Health SystemAlameda Health System (Highland Hospital, etc)(Highland Hospital, etc)  HealthPACHealthPAC  Reauthorizes 1/2 cent sales tax through 2034,Reauthorizes 1/2 cent sales tax through 2034, raises over $100 million per yearraises over $100 million per year  Campaign messages focused on critical traumaCampaign messages focused on critical trauma and emergency services, and county safety netand emergency services, and county safety net  New reportNew report “Winning Revenues for the Remaining Uninsured”“Winning Revenues for the Remaining Uninsured” ALAMEDAALAMEDA
  25. 25.                                                                                                                                  RICH PEDRONCELLI, ASSOCIATED PRESS The chairman of the California Legislative Latino Caucus plans to propose a new law that would expand access to health insurance for all Californians, including those living in the country illegally. State Sen. Ricardo Lara, D-Bell Gardens, is working with a broad coalition of organizations to map out the details of a bill that would cover undocumented immigrants, who are excluded from insurance coverage under the national Affordable Care Act, or ACA. “Immigration status shouldn’t bar individuals from health coverage, especially since their taxes contribute to the growth of our economy,” Lara said in a news release. NEWS State senator wants health care for all immigrants By ROXANA KOPETMAN / ORANGE COUNTY REGISTER Published: Jan. 10, 2014 Updated: 6:04 p.m. COUNTY EFFORTS A BRIDGE TOCOUNTY EFFORTS A BRIDGE TO A STATEWIDE SOLUTIONA STATEWIDE SOLUTION
  26. 26. Continuing CaliforniaContinuing California ’s’s Commitment to CoveringCommitment to Covering ImmigrantsImmigrants  Progress made on California-specific efforts to cover:Progress made on California-specific efforts to cover: –legal immigrants, including recent immigrants here lesslegal immigrants, including recent immigrants here less than 5 years;than 5 years; –People Residing Under the Color of Law (PRUCOL); nowPeople Residing Under the Color of Law (PRUCOL); now including DACA Dream Act students; to include thoseincluding DACA Dream Act students; to include those covered under DAPA when the Presidentcovered under DAPA when the President’s executive’s executive order is upheld.order is upheld. Legislative proposal mirrors ACA: SB4(Lara)Legislative proposal mirrors ACA: SB4(Lara) Similar to last yearSimilar to last year ’s SB1005(Lara):’s SB1005(Lara): State-only Medi-Cal for those not legally present, similar toState-only Medi-Cal for those not legally present, similar to other non-federally covered populationsother non-federally covered populations –Building off emergency Medi-CalBuilding off emergency Medi-Cal  Allowing undocumented immigrants to buy (unsubsidized, with their own money) coverage through Covered California. If federal waiver denied, set up “mirror marketplace.”
  27. 27. Financing #Health4AllFinancing #Health4All LOS ANGELES TIMES:LOS ANGELES TIMES: ““Study sees modest costs inStudy sees modest costs in healthcare for immigrants herehealthcare for immigrants here illegally”illegally” By Patrick McGreevy * May 21, 2014By Patrick McGreevy * May 21, 2014 Increased health of poor Californians could reduce costsIncreased health of poor Californians could reduce costs down the road, study saysdown the road, study says Extending healthcare to people in the country illegally would cost the state a modestExtending healthcare to people in the country illegally would cost the state a modest amount more but would significantly improve health while potentially saving money foramount more but would significantly improve health while potentially saving money for taxpayers down the road, according to a study released Wednesday.taxpayers down the road, according to a study released Wednesday. The study by the UCLA Center for Health Policy Research estimates that the net increase inThe study by the UCLA Center for Health Policy Research estimates that the net increase in state spending would be equivalent to 2% of state Medi-Cal spending, or between $353state spending would be equivalent to 2% of state Medi-Cal spending, or between $353 million and $369 million next year, while the net increase in spending would be up to $436million and $369 million next year, while the net increase in spending would be up to $436 million in 2019. Enrollment in Medi-Cal would increase by up to 730,000 people next yearmillion in 2019. Enrollment in Medi-Cal would increase by up to 730,000 people next year and up to 790,000 in four years.and up to 790,000 in four years.
  28. 28. Financing #Health4AllFinancing #Health4All  These Californians already in our health system today,These Californians already in our health system today, getting care in the most expensive, least efficient way.getting care in the most expensive, least efficient way.  More effectiively use existing dollars & revenue streams:More effectiively use existing dollars & revenue streams: – Maintaining funds for restricted scope Medi-Cal for emergencyMaintaining funds for restricted scope Medi-Cal for emergency carecare – Savings from existing programs that serve this populationSavings from existing programs that serve this population – Natural recoupment from county realignment formulaNatural recoupment from county realignment formula – Leverage existing MCO and hospital provider feeLeverage existing MCO and hospital provider fee – More effectively use existing state-only Medi-CalMore effectively use existing state-only Medi-Cal – Opportunities under the Medi-Cal waiverOpportunities under the Medi-Cal waiver  President ObamaPresident Obama’s executive action and deferred action’s executive action and deferred action  Decisions to deal with the remaining costs:Decisions to deal with the remaining costs: – Additional revenues face a 2/3 voteAdditional revenues face a 2/3 vote – Making this a budget priorityMaking this a budget priority , against other priorities, against other priorities – Phasing in/starting with a down payment with aPhasing in/starting with a down payment with a proposalproposal
  29. 29. #Health4All 3333
  30. 30. Core MessagesCore Messages 3434  Investing in California:Investing in California: Undocumented Californians are anUndocumented Californians are an economic engine for the state. An overwhelming percentage workeconomic engine for the state. An overwhelming percentage work and pay taxes. They are an economic asset. Investing in them isand pay taxes. They are an economic asset. Investing in them is investing in our state.investing in our state.  Prevention Makes Economic Sense:Prevention Makes Economic Sense: Emergency roomEmergency room treatment is an expensive substitute for preventive care. It makestreatment is an expensive substitute for preventive care. It makes economic sense to invest in preventive services that minimize theeconomic sense to invest in preventive services that minimize the risk of chronic disease and more chronic treatment later on.risk of chronic disease and more chronic treatment later on.  Increasing Access to Affordable Care is the ResponsibleIncreasing Access to Affordable Care is the Responsible Thing to do:Thing to do: Everyone—regardless of ability to pay or legal statusEveryone—regardless of ability to pay or legal status —should have access to affordable health care. After Obamacare,—should have access to affordable health care. After Obamacare, the remaining uninsured, including the undocumented, should havethe remaining uninsured, including the undocumented, should have access to affordable care, including a comprehensive set ofaccess to affordable care, including a comprehensive set of preventive services and a health home.preventive services and a health home.
  31. 31. Organizing and Communications:Organizing and Communications: We Need Action & Stories!We Need Action & Stories! 3535
  32. 32. OpportunitiesOpportunities This YearThis Year Focused Attention:Focused Attention: Now-JuneNow-June  CountiesCounties – SupervisorsSupervisors – AdministratorAdministrator – Health DepartmentsHealth Departments  StateState – GovernorGovernor – State Legislative LeadersState Legislative Leaders – Legislative ProcessLegislative Process – Budget ProcessBudget Process Obstacles: Money, Messaging, Priorities,Obstacles: Money, Messaging, Priorities,
  33. 33. For more informationFor more information Website: http://www.health-access.orgWebsite: http://www.health-access.org Blog: http://blog.health-access.orgBlog: http://blog.health-access.org Facebook: www.facebook.com/healthaccessFacebook: www.facebook.com/healthaccess Twitter: www.twitter.com/healthaccessTwitter: www.twitter.com/healthaccess Health Access CaliforniaHealth Access California Capitol Office: 1127 11Capitol Office: 1127 11thth Street, Suite 234,Street, Suite 234, SacramentoSacramento , CA 95814, CA 95814 916-497-0923916-497-0923 Northern California Office:Northern California Office: 414 13414 13thth Street, Suite 450,Street, Suite 450, OaklandOakland, CA 95612, CA 95612 510-873-8787510-873-8787 Southern California Office: 121 West Lexington Drive, Suite 246, Glendale, CA 91203
  34. 34. Question and AnswerQuestion and Answer  Note: Remember to type your questionsNote: Remember to type your questions into the chat box.into the chat box.
  35. 35. Contact InformationContact Information  Anthony WrightAnthony Wright , Executive Director, Health Access California, Executive Director, Health Access California awright@health-access.org  Bradley ClevelandBradley Cleveland , Planning and Health Policy Consultant, San, Planning and Health Policy Consultant, San Mateo County Union Community Alliance bfcleveland@gmail.comMateo County Union Community Alliance bfcleveland@gmail.com  Alvaro FuentesAlvaro Fuentes, Executive Director of the Community Clinic, Executive Director of the Community Clinic Consortium of Contra Costa afuentes@clinicconsortium.orgConsortium of Contra Costa afuentes@clinicconsortium.org  Nenick VuNenick Vu, Sacramento Area Congregations Together, Sacramento Area Congregations Together nenickvu@gmail.comnenickvu@gmail.com  Amparo CidAmparo Cid, Director of Sustainable Rural Communities Project, Director of Sustainable Rural Communities Project amparocid@crlaf.orgamparocid@crlaf.org  Sonya VasquezSonya Vasquez, Policy Director of Community Health Councils, Policy Director of Community Health Councils SVasquez@chc-inc.orgSVasquez@chc-inc.org  Josue ChavarinJosue Chavarin, Program Associate, The California Endowment, Program Associate, The California Endowment jchavarin@calendow.orgjchavarin@calendow.org
  36. 36.  THANK YOU!THANK YOU!

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