Orange County Supervisor tells CalOptima how to spend $60 million for homeless health care

Orange County Supervisor Andrew Do offered a spending plan Wednesday for CalOptima, the county’s health insurance for the poor, saying the agency needs to do more to improve its outreach to homeless people — a group that he noted is dying at an alarming rate.

Do, a CalOptima board member, also called for a special June 14 meeting of the agency’s directors to consider his proposal that the agency “immediately” spend $60 million of a $100 million package approved by CalOptima in April.

CalOptima oversees health services for 750,000 indigent Medi-Cal program members in Orange County.

Do, during a news conference Wednesday, accused CalOptima administrators of allowing health services for people living on the streets and in shelters to get tied up in red tape, repeating a critique he’s offered several times in the past year.

And in a letter to CalOptima Chief Executive Officer Michael Schrader, dated May 29, Do wrote that nearly three quarters of the 210 homeless people who died last year in Orange County “were enrolled in CalOptima services, but were not provided adequate services.”

“We have a humanitarian crisis in Orange County,” Do said Wednesday, also pointing out that the First District he represents is home to half the county’s CalOptima members, whose health care is paid for by federally-funded Medicaid dollars.

Schrader didn’t directly address Do’s request for a meeting, saying Wednesday that CalOptima has an ad hoc committee that meets regularly with advocates and community leaders, and that “all CalOptima board members have opportunity to discuss and vote on the recommendations” of that committee. Schrader also noted that board members and others can “propose alternative actions and timetables.”

Do said that because so many homeless people enrolled in CalOptima face unique challenges, such as a lack of  transportation, CalOptima needs to improve its outreach to those clients. He suggested the agency could meet people wherever they might be — in community parks, shelters or even the street.

Do said only 47 homeless people had been served so far by mobile health teams that CalOptima began rolling out a few weeks ago, but that 36 of those people were previous CalOptima clients.

Do labeled his spending plan the Homeless CARE Proposal — an acronym for how he envisions dividing up the $60 million that CalOptima has set aside for unspecified services. His ideas include:

• $10 million for clinic health services in all homeless shelters.
• $10 million to for an authorized mobile health team to respond to all homeless providers (not just Health Care Agency workers).
• $20 million for residential support services and housing navigation
• $20 million to extend recuperative care for homeless individuals with chronic physical health issues.

Schrader acknowledged that a majority of the 210 homeless people who died in 2018 in Orange County were Medi-Cal members, saying “CalOptima and the County have a shared responsibility for coordinating services and working collaboratively.”

Schrader also said improving health services to homeless people is a “top priority” for CalOptima, and listed $40 million the agency approved for “high impact programs.” These include:

• $11.4 million for the Be Well Regional Mental Health & Wellness Campus
• $11 million for expanded access to recuperative care
• $7.6 million for the county’s first-ever clinical field teams and care coordinators
• $10 million for hospitals to better coordinate discharge planning for homeless individuals

But Do wants health services to be delivered more quickly so that homeless people don’t die from lack of care.

“The responsibility for CalOptima to act becomes greater and more urgent,” Do said, while flanked by the director of the county’s Health Care Agency, the operators of the Courtyard emergency homeless shelter in downtown Santa Ana, and Father Dennis Kriz, a Catholic priest who has tracked and written about the county’s homeless death toll.

Kriz, who said 25 homeless people died in the first two months of this year — roughly the same pace as last year —  said he’s worried about how people living outside will fare this summer, when heat and dehydration become health threats.

Kriz, the parish priest at St. Philip Benizi Catholic Church in Fullerton, called for an end to conditions that he believes have led to last year’s high homeless death toll.

“There is no reason for this to go on.”