L.A. Care Health Plan

The Local Initiative Health Authority of Los Angeles County, doing business as L.A. Care Health Plan, is an independent, local public agency based in Los Angeles, California, that began operations as a licensed health plan in 1997. The organization provides health insurance for low-income individuals in Los Angeles County through four health coverage programs including Medi-Cal.

Company Description
L.A. Care Health Plan (Local Initiative Health Authority of Los Angeles County) was created 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.

History and structure
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.

During its 1997 launch, L.A. Care contracted with seven established health plans, referred to as plan partners: Blue Cross of California (now Anthem Blue Cross), 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. L.A. Care currently has three plan partners. They are Anthem Blue Cross, Kaiser Permanente, and Care 1st.

Starting in 1998, L.A. Care became involved in the Healthy Families program, California's version of the Children's Health Insurance Plan (CHIP), and then in 2003 launched L.A. Care's Healthy Kids program for children ages 0–5, funded in partnership with First 5 LA and the Children's Health Initiative of Greater Los Angeles. Healthy Kids was established as an insurance program for families who do not qualify for Medi-Cal or Healthy Families due to either income or immigration status. It was expanded to children ages 6–18 in 2004. L.A. Care announced that the Healthy Kids programs would end at the end of 2016 as a result of SB 75 – a California law implemented in May 2016 – which expanded full-scope Medi-Cal benefits to all low-income children regardless of immigration status.

In 2008, L.A. Care launched the Medicare Advantage Special Needs Plan (SNP) for those dually-eligible for both Medi-Cal and Medicare. L.A. Care closed the Medicare SNP on December 31, 2014, as it chose to participate in the Cal MediConnect dual-eligible pilot. In January 2015, L.A. Care began accepting passive enrollment into the Cal MediConnect program. Cal MediConnect offers 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.

On October 1 2013, L.A. Care Health Plan launched L.A. Care Covered, a new health plan accredited by the NCQA and selected by Covered California to administer health insurance to Los Angeles County residents.

Governance
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, Los Angeles County and its 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.

Fifteen consumer advisory committees from across Los Angeles County advise the board of governors.

Community grantmaking
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. Grant initiatives include the Tranquada Awards, which provide infrastructure support for safety net clinics, the Oral Health Initiative, which expands access to dental care for low-income Angelenos, and the Health Information Technology Initiative, which helps clinics purchase and implement technologies such as disease registries and electronic health records.

Family Resource Centers
L.A. Care Health Plan has five Family Resource Centers. They are located in Lynwood, Inglewood, Boyle Heights, Pacoima and Palmdale, CA. A sixth Family Resource Center will open in East Los Angeles in early 2019. These centers provide free health education, fitness and nutrition classes to all community members.

Promotion of Health Information Technology
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). 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.