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Who we are and what we do
CenCal Health (formerly
The Santa Barbara Regional Health Authority) administers several
publicly-funded health care programs for low income residents of
Santa Barbara and San Luis Obispo counties; the primary one
being the Medi-Cal program. (California’s version of Medicaid)
CenCal Health is a public entity that is governed by a 13 member
Board of Directors appointed by the Santa Barbara and San Luis
Obispo county boards of supervisors. Our Board of Directors is
composed of local government representatives, physicians,
hospital representatives, member representatives, other health
care provider representatives, and business representatives.
Although a public entity, it must operate like a business,
managing funds as efficiently as possible in carrying out its
mission.
Since beginning operations
in 1983, CenCal Health has, among other things, created access
to high quality health care for its members through contracts
with local providers (physicians, clinics, hospitals,
pharmacies, etc.); and coordinates care for its members through
a primary care provider case management system, aided by
numerous plan programs and activities. This case management
system has resulted in not only a high quality of care delivered
to its membership, but also significant monetary savings by
working with health care providers to deliver health care in a
coordinated way and as efficiently as possible. The program that
began here is now acknowledged to be the oldest Medicaid managed
care program of its kind in the country. Medi-Cal has since
become a demonstration program for other counties and states,
and has served as a model for Medicaid reform.
Programs we offer
Medi-Cal is CenCal
Health’s largest program, currently serving approximately
100,000 residents in our service area of Santa Barbara and San
Luis Obispo counties. Other programs we administer include the
Healthy Families and Healthy Kids programs (serving low income
children); the Access for Infants and Mothers Program (AIM)(serving
low income expectant mothers and their newborn children); and,
the In Home Supportive Services (IHSS) health care program
(providing health care coverage to those that work to assist
people in their homes).
Eligibility for all
programs is determined by income status. Medi-Cal members are
automatically inscribed into our program from the State of CA,
while Healthy Families, Healthy Kids, as well as AIM and IHSS
members must apply and qualify based on specific income
levels.
Once members are in our
system, they are able to choose (or have assigned) a Primary
Care Physician (PCP), which will serve as their “medical home”.
We have a dedicated bi-cultural and bi-lingual Member Services
Department that is able to assist with member questions,
appointment scheduling, arranging non-emergency transportation
if required, and a host of other issues. We truly care about
the well-being of our members, many of them medically fragile,
and we live and work in the community that we serve.
On the other side of the
coin is our valued and compassionate physician network that
individually contract with CenCal Health to see our members.
They are supported by our dedicated Provider Services as well as
our Claims Department that visit the physician offices, assist
with submission of claims, hold workshops to train doctor’s
office staff, produce a monthly Provider bulletin, as well as
many other duties.
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