Duals Demonstration Program Delayed to September 2013

The implementation of the Coordinated Care Initiative (CCI) has been delayed to September 2013, according to Governor Jerry Brown’s proposed budget for fiscal year 2013-14 released last Friday. This is good news as many advocates and providers have been voicing their concerns about the readiness of such a major transition.

Still pending federal approval, the Coordinated Care Initiative (CCI) aims to integrate the delivery of Medi-Cal beneficiaries’ medical, behavioral, mental and long-term care services by providing all services through managed health care. The initiative includes the “Duals Demonstration” which would give beneficiaries with both Medicare and Medi-Cal (referred to as “dual eligibles”) the opportunity to receive their benefits from the two programs through one plan. While it would be mandatory to receive their Medi-Cal benefits through a managed care plan, dual eligibles would have the option of whether to receive their Medicare benefits through the same plan. This initiative aims to improve the current “fragmented” system of health care where beneficiaries receive services from two programs with limited coordination.

Two areas of the Governor’s proposed budget relate to CCI, the timeline for the initiative and the enrollment process.

The Timeline: The proposed budget calls for implementing both parts of the CCI, the duals demonstration and the Long Term Supports and Services program transition to managed care, in September 2013 versus June 2013. With this 3-month delay, beneficiaries affected by this transition will receive a notice about the change no earlier than June 2013.

The Enrollment Process: The CCI has 8 participating counties: Alameda, Los Angeles, San Bernardino, San Diego, San Mateo, Santa Clara, Orange and Riverside. According to the Governor’s budget announcement:

  • In Los Angeles County, enrollment will phase in over 18 months.
  • In San Mateo, enrollment will occur all at once in September 2013.
  • For all other counties, enrollment will phase-in over 12 months.

We, as well as many advocates across the state, are closely watching the CCI’s developments and its implementation timeline as this initiative will affect 526,902 beneficiaries statewide. Many of these to-be-affected beneficiaries are our state’s most vulnerable beneficiaries, and any lapse in care during this transition/implementation process could be detrimental, if not catastrophic to the health of some people.

For more information on the CCI, see the CalDuals.org website. You can sign up for their updates and also give feedback on the initiative by visiting their Contact Us page.

For a quick summary of the CCI, see the Fact Sheet: Coordinated Care Initiative Executive Summary (pdf). (Note: for the most recent figures, see the New Duals Data posted in November 2012.)


Karen Joy Fletcher

Our blogger Karen Joy Fletcher is CHA’s Communications Director. With a Masters in Public Health from UC Berkeley, she is the online “public face” of the organization, provides technical expertise, writing and research on Medicare and other health care issues. She is responsible for digital content creation, management of CHA’s editorial calendar, and managing all aspects of CHA’s social media presence. She loves being a “communicator” and enjoys networking and collaborating with the passionate people and agencies in the health advocacy field. See her current articles.