Eligibility & Enrollment

Eligibility & Enrollment Director, Njeri McGee-Tyner and Project Coordinator, Eliana Apostolou, during the Member Services meeting, August 2012.

The Alameda Health Consortium coordinates eligibility and enrollment efforts with community health centers to ensure that patients successfully enroll in Medi-Cal, HealthPAC (Health Program of Alameda County), and other public health coverage programs for which they are eligible. The Alameda Health Consortium’s Eligibility and Enrollment Department provides community health centers with training, resources, and technical support.

Studies of the Medi-Cal process have shown that its complexity is a primary barrier to enrollment.  To increase the chances of community health center patients’ successful Medi-Cal application approval, and to encourage more people to apply for health coverage, the Alameda Health Consortium’s Eligibility and Enrollment Department manages a program called On-Site Medi-Cal Eligibility (OSME).

The goal of the OSME is to facilitate the enrollment of entire families in Medi-Cal and to retain their benefits. The program is a joint effort between the Alameda Health Consortium and the Alameda County Social Services Agency. The OSME Program has four major components:

  • Alameda County Medi-Cal eligibility workers who are out-stationed at community health centers
  • Community health center staff who assist patients
  • Medi-Cal eligibility trainings
  • Ongoing monitoring and coordination

Health center staff during the Member Services meeting, August 2012.

People who apply for Medi-Cal through community health centers receive extensive assistance from health center staff who understand community needs and who help explain how to complete forms, collect required documentation, and preparation for County eligibility interviews. Additionally, health center staff assist with annual renewals for Medi-Cal beneficiaries so that they do not lose their health coverage. The Alameda Health Consortium works with more than 80 eligibility and enrollment staff across the community health centers, by coordinating efforts, tracking changes in Medi-Cal and HealthPAC, and providing training and technical assistance to health center staff.

 

Inquiries about Eligibility and Enrollment may be directed to: Njeri McGee-Tyner at ntyner@alamedahealthconsortium.org or Kristen Clopton at kclopton@alamedahealthconsortium.org