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Agency overview | |
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Formed | April 1, 1997 [1] |
Type | Local public authority |
Jurisdiction | Los Angeles County [1] |
Headquarters | 1200 W. 7th Street Los Angeles, CA 90017 |
Annual budget | US$8.77B (2015) [2] |
Agency executives |
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Website | lacare |
The Local Initiative Health Authority for Los Angeles County (L.A. Care) is a public agency that provides health insurance to Los Angeles County residents, particularly those who are low-income or uninsured, through four health coverage programs including Medi-Cal.
L.A. Care Health Plan (Local Initiative Health Authority for Los Angeles County) was created in 1997 by the State of California to provide health care services for Medi-Cal managed care beneficiaries, uninsured children and other vulnerable populations in Los Angeles County. [3]
In 1993, the State Department of Health Services produced a report entitled “Expanding Medi-Cal Managed Care: Reforming the Health System – Protecting Vulnerable Populations” which served as a blueprint for expansion of Medi-Cal managed care. It designated L.A. County as one of the areas for the “Two-Plan Model” where a locally organized Medi-Cal managed care plan (local initiative health plan) would be formed to compete directly for Medi-Cal managed care enrollments with a “commercial plan.” After a competitive selection process, Health Net of California was chosen by the State as the “commercial plan,” L.A. Care Health Plan was formed as the Local Initiative Health Authority of Los Angeles County, and the Two-Plan Model began to operate in L.A. County. [1]
During its 1997 launch, L.A. Care contracted with seven established health plans, referred to as plan partners: Blue Cross of California (now Anthem), Community Health Plan (CHP), Kaiser Permanente, Care 1st, UHP, Tower Health Plan and Maxicare. By 2006, L.A. Care had established its own direct line of business in Medi-Cal. [3] [4]
In 2008, L.A. Care launched the Medicare Advantage Special Needs Plan (SNP) for those dually-eligible for both Medi-Cal and Medicare. Starting in 2015, dually-eligible members were given the option to join the L.A. Care Cal MediConnect plan, offering members a coordinated care model within a single health plan and will help to foster better health outcomes and improved quality of life for dual-eligibles. [5]
L.A. Care is governed by a 13-member stakeholder Board of Governors representing consumers, community clinics, physicians, hospitals, federally-qualified health centers, children's health care providers, and the Los Angeles County Department of Health Services. Two of the seats are held by consumers who are elected by L.A. Care enrollees. L.A. Care is among the few public health plans to have consumer members on its governing board with full voting privileges. [6]
Fifteen consumer advisory committees from across Los Angeles County advise the board of governors. [7]
L.A. Care launched its Community Health Investment Fund in 2001. Since then, it has awarded more than $132 million in grants and support for the health care safety net, to improve community and public health and expand health insurance coverage among underserved populations. [8] Grant initiatives include the Tranquada Awards, [9] [10] which provide infrastructure support for safety net clinics, the Oral Health Initiative, [11] which expands access to dental care for low-income Angelenos, and the Health Information Technology Initiative, [12] which helps clinics purchase and implement technologies such as disease registries and electronic health records.
In 2017, L.A. Care announced a $20 million commitment to address homelessness in Los Angeles County. The five-year commitment is with Brilliant Corners, a nonprofit that works with the county's Housing for Health program. [13]
Jointly operated by Blue Shield of California Promise Health Plan and L.A. Care Health Plan, community resource centers offer member support services, enrolment in local and state assistance programs and other community services. Centers are currently located in Pomona, Lynwood, East Los Angeles and Palmdale. The centers, to total 14, are part of a five-year, $146 million initiative launched by the two health plans in 2019 to expand community health access across Los Angeles County. [14]
L.A. Care Health Plan previously operated Family Resource Centers. [15] They were located in East L.A., Lynwood, Inglewood, Boyle Heights, Pacoima and Palmdale, CA, providing free health education, fitness and nutrition classes to all community members. [16] [17] [18]
In April 2010, L.A. Care was awarded a federal grant to establish a Health Information Technology Regional Extension Center (REC), called HITEC-LA, to help doctors in L.A. County adopt and use Electronic Health Records (EHRs). [19] HITEC-LA is the sole REC in L.A. County, under the terms of the grant. The grant was awarded by the U.S. Department of Health and Human Services through the Health Information Technology for Economic and Clinical Health Act (HITECH Act), of the American Recovery and Reinvestment Act of 2009. [20] [21]
In July 2018, L.A. Care launched Elevating the Safety Net, a long-term initiative to recruit primary care physicians to the Los Angeles County safety net. The L.A. Care Board of Governors committed $31 million for the initiative, which has three programs: medical school scholarships, medical school loan repayments and a recruitment program to help clinics and practices with physician salary subsidies, sign-on bonuses and relocation costs. [22]
In 2021, L.A. Care provided $3.2 million to Charles Drew University of Medicine and Science, White Memorial Medical Center Charitable Foundation, AltaMed Health ServicesCorporation, and the David Geffen School of Medicine at UCLA in support of 25 residency positions. [23]
In March 2022 LA Care was fined $55 million by the California Department of Managed Health Care and the California Department of Health Care Services for "deep-rooted, systemic failures that threaten the health and safety of its members." [24] In March 2023, the Los Angeles Times reported that, according to hospitals in the region, the problems persisted and had reached a "crisis point." [25] LA Care agreed to pay $1.3 million to settle patient privacy violations in September 2023. [26]
Los Angeles General Medical Center is a 600-bed public teaching hospital located at 2051 Marengo Street in the Boyle Heights neighborhood of Los Angeles, California, and one of the largest academic medical centers in the United States. The hospital facility is owned by Los Angeles County and operated by the Los Angeles County Department of Health Services. Doctors are faculty of the Keck School of Medicine of USC, who oversee more than 1,000 medical residents being trained by the faculty. Additionally, the United States Navy sends doctors, nurses and corpsmen to train at the hospital, working alongside staff in the trauma center.
In November 2004, voters in the U.S. state of California passed Proposition 63, the Mental Health Services Act (MHSA), which has been designed to expand and transform California's county mental health service systems. The MHSA is funded by imposing an additional one percent tax on individual, but not corporate, taxable income in excess of one million dollars. In becoming law in January 2005, the MHSA represents the latest in a Californian legislative movement, begun in the 1990s, to provide better coordinated and more comprehensive care to those with serious mental illness, particularly in underserved populations. Its claim of successes thus far, such as with the development of innovative and integrated Full Service Partnerships (FSPs), are not without detractors who highlight many problems but especially a lack of oversight, large amount of unspent funds, poor transparency, lack of engagement in some communities, and a lack of adherence to required reporting as challenges MHSA implementation must overcome to fulfill the law's widely touted potential.
AIDS Healthcare Foundation (AHF) is a Los Angeles-based 501(c)(3) nonprofit organization that provides HIV/AIDS prevention, treatment, and advocacy services. As of 2024, AHF operates about 400 clinics, 69 outpatient healthcare centers, 62 pharmacies, and 22 Out of the Closet thrift stores across 15 U.S. states, Washington, D.C., Puerto Rico, and 46 countries, with over 5,000 employees, and provides care to more than two million patients. The organization's aim is to end the AIDS epidemic by ensuring access to quality healthcare, including HIV and STD testing, prescription of medications like Pre-exposure Prophylaxis (PrEP), and referrals to specialty pharmacies. AHF is the largest provider of PrEP in the United States, though its founder Michael Weinstein has received criticism for his past opposition to the drug.
Health Services Los Angeles County, officially the Los Angeles County Department of Health Services, operates the public hospitals and clinics in Los Angeles County and is the United States' second largest municipal health system, after NYC Health + Hospitals.
The California Medical Assistance Program is the California implementation of the federal Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal poverty level. Benefits include ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder treatment, dental (Denti-Cal), vision, and long-term care and support. Medi-Cal was created in 1965 by the California Medical Assistance Program a few months after the national legislation was passed. Approximately 15.28 million people were enrolled in Medi-Cal as of September 2022, or about 40% of California's population; in most counties, more than half of eligible residents were enrolled as of 2020.
University Muslim Medical Association, Inc. (UMMA) Community Clinic is the first Muslim American founded community-based health organization in the United States. Located in South Los Angeles, UMMA has a culturally and religiously diverse staff serving an equally diverse community.
SCAN Health Plan (SCAN) is a not-for-profit, Medicare Advantage based in Long Beach, California. Founded in 1977, SCAN provides healthcare coverage to Medicare beneficiaries in California, Arizona, Texas and Nevada, serving more than 285,000 members. It is one of the largest not-for-profit Medicare Advantage plans in the country. SCAN Health Plan is part of SCAN Group.
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This article summarizes healthcare in California.
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