The mission of the CMSP Governing Board is to partner with participating CMSP counties in meeting their indigent health care responsibilities by delivering cost-effective, high quality health care services through the CMSP benefit program and to develop pilot projects and alternative products that support improved delivery of health care services in participating counties to CMSP members and populations potentially eligible for CMSP and other public programs. The Governing Board’s ability to fulfill its mission is dependent on maintaining the fiscal soundness of the CMSP benefit program and the overall CMSP budget.
The Governing Board shall maintain the fiscal soundness of the overall CMSP budget by giving first priority to the CMSP benefit program and second priority to pilot projects and alternative products.
Timely and useful data will be effectively used to inform CMSP benefit program policy development and development of pilot projects and alternative products for improved delivery of health care services.
The Governing Board will maintain a spirit of openness and collaboration in its decision-making processes and strive to keep county officials and health care stakeholders across the range of participating counties actively engaged with the Governing Board to continuously identify and develop cost-effective strategies to strengthen the CMSP benefit program and improve local delivery of health care services in participating counties.
CMSP Benefit Program
CMSP members will receive medically necessary services in a manner that promotes delivery of the right care at the right time by the right health care provider.
CMSP will seek the provision of culturally and linguistically competent services by participating health care providers.
Care management and coordination, including case management services where appropriate, will assist CMSP members in managing their personal health conditions and related circumstances.
Procedures and systems will be implemented to assure that CMSP members who are eligible for Medi-Cal, Covered California, and other public or private programs are appropriately linked with these programs in order to promote CMSP as a secondary payer after other available programs.
Development of Pilot Projects and Alternative Products
Among other approaches, the Governing Board may establish pilot projects and alternative products that emphasize improvement in health care delivery in participating counties for CMSP members and populations potentially eligible for CMSP or other public programs.
Timely and useful data and other information on health system needs in participating counties, CMSP and potentially CMSP low-income and uninsured populations, and evidence-based strategies for health system improvement will be effectively utilized to inform the development of pilot projects and alternative products.
Priorities for Pilot Projects
Priorities for Pilot Projects and Alternative Products
Developing and strengthening the healthcare workforce serving CMSP and other publicly funded populations in CMSP counties, with an emphasis on primary care and high-need specialty care provider recruitment and retention models and approaches.
Promoting expanded transportation options for CMSP and other publicly funded populations in CMSP counties to enable better access to needed health care services.
Developing models and approaches for regional service delivery for CMSP and other publicly funded populations to maximize efficiencies in the delivery of health care and behavioral health care services in CMSP counties.
Promoting integrated health and human service delivery approaches in CMSP counties for high-need, multi-system utilizers of CMSP and other publicly funded health care, behavioral health, and social services systems and community-based service providers.
Promoting wellness, health improvement and expanded access to health and behavioral health care services in CMSP counties for CMSP eligible persons and populations left out of or unable to access publicly funded coverage, including CMSP, Medi-Cal and Covered California.
Developing models and approaches to address the social determinants of health that affect the underlying conditions of populations served by CMSP and other publicly funded health and human service programs.