L.A.’s Whole Person Care Pilot – Enrollment has begun!

by L.A. Care Health Plan & Health Net

To care for people with complex needs, it is critical to coordinate and integrate the full spectrum of care—medical, behavioral, socioeconomic and beyond. For the sickest and most vulnerable Medi-Cal patients, California’s Whole Person Care (WPC) pilot will do just that. It will do it by increasing links and services outside of the traditional health system into the larger community.

The pilot, which is called WPC-LA in Los Angeles County, focuses on a broad range of social determinants of health, such as: income, nutrition, housing/homelessness, environmental factors, incarceration history, and individual behaviors. These are all factors that can affect whether someone ends up in the hospital or is able to thrive in their community, and in many cases be part of a productive workforce.

Los Angeles County’s Department of Health Services (LADHS), the lead agency for WPC-LA, has been working closely with Health Net and L.A. Care Health Plan, the primary service providers of Medi-Cal in the county, and with community-based providers, hospitals, and clinics to develop the vision and structure of the pilot in Los Angeles County. LADHS has developed an ambitious set of 15 programs targeting six high-risk populations – those who have repeated incidents of avoidable emergency room use or hospital admissions which are among the costliest. They are Homeless High-risk, Justice-Involved High-risk, Mental Health High-risk, Substance Use Disorder High-risk, Medically High-risk, and Perinatal High-risk.

The WPC-LA pilot relies on Community Health Workers (CHWs) who build trusting relationships with their clients to help them access services and put their lives back together. One such worker is Angel Horvitz. She began working with WPC-LA in March 2017, interacting with participants who primarily need housing and substance use treatment. Angel recalls a participant she met through a social worker at a hospital who was struggling with substance use disorder.  While in the hospital, Angel spent time building a relationship with the patient. Upon discharge, Angel helped enroll the patient in outpatient substance use services, mental health counseling, and connected the individual with benefits through the Department of Public Social Services. This helped the participant establish a source of income, reach sobriety, and process their trauma.

Health Net and L.A Care are actively collaborating to ensure that we are supporting our providers and our members. Since launching the pilot in the middle of last year, we have partnered closely with DHS to negotiate a data-use and sharing agreement. It was critical that the system protect patient privacy while allowing health plans and providers to better coordinate care.

Ultimately, the mission of WPC-LA is to improve health outcomes and reduce utilization of high-cost services among the Medi-Cal beneficiaries in L.A. County. Nearly four million people in the county are covered by Medi-Cal. A report commissioned by the state estimates nearly 138,000 people will be served by WPC-LA programs over the course of the five-year pilot. L.A. Care and Health Net are committed to this collaborative effort that will ensure the WPC-LA pilot reaches its goal of providing comprehensive coordinated care that will benefit our members.