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2021 REPORT TO THE COMMUNITY

Resilience

Orange County is forever changed by the lives lost due to the COVID-19 pandemic, and our health system is permanently altered, too. CalOptima’s report reflects on the past year as a way to honor the incredible work of our providers on behalf of CalOptima members. Our health care community found the resilience needed to carry us through, warmed by strong relationships, inspired by purposeful innovation and supported by continued accountability. We are Better. Together.

CEO Reflects on the Pandemic Year

Chief Executive Officer Richard Sanchez expresses thanks to those who made a difference in the lives of CalOptima members. By maintaining strong, collaborative relationships, he says we can use the lessons of COVID-19 to create a brighter future and better health system in Orange County.

Strong Relationships

CalOptima did not let COVID-19’s mandate of physical distancing lead to diminished relationships. We strengthened ties with members, providers and the community in a time when compassion, respect and responsiveness were more important than ever. While nearly 80% of CalOptima employees are now working from home, they carry our mission with them and continue to serve even larger numbers of members.

Membership Growth

COVID-19 caused widespread economic challenges and the suspension of Medi-Cal renewal. As a result, more individuals became or stayed eligible for CalOptima’s health care coverage, and membership grew rapidly. View this unprecedented one-year trajectory, from February 1, 2020, to January 31, 2021.


Customer Service Team Connects With Members

Customer Service Supervisor Shannon Jefferson-Malone shares the experience of CalOptima’s frontline staff during the pandemic. She says the team worked to build members’ trust and confidence by providing essential information.

Telehealth Takes Off During COVID-19

A year ago, the COVID-19 pandemic shifted doctor-patient relationships, as in-person office visits were rethought. Thousands of CalOptima providers embraced offering telehealth services to not only reduce the risk of infection but to maintain continuity of care. The transition to virtual care happened nearly overnight, but it wasn’t without concerns.

“Addressing the fear of the unknown with our staff and the families we serve was essential for making a successful transition to telehealth,” says Junie Lazo-Pearson, Ph.D., BCBA-D, Chief Clinical Officer at Huntington Beach-based Advanced Behavioral Health, which provides behavioral health care and applied behavior analysis services for pediatric CalOptima members. “Talking with the families and maintaining open communication was central to managing the hurdle.”

For her practice, Dr. Lazo-Pearson says that a benefit of telemedicine is increased parent engagement. Delivering techniques for parents via virtual sessions helps them become more active participants in their child’s health. Telehealth also helped her staff grow, as they collaborate on weekly Zoom meetings to share information and exchange ideas about identifying and delivering the best options for the children in their care.

Dr. Lazo-Pearson also represents CalOptima providers as the chair of the Provider Advisory Committee, and so she understands that the dramatic shift to telemedicine that challenged many providers initially has likely changed their practices permanently. In her office, she is planning for a future that combines in-home treatment along with telehealth services because of the efficiencies in reaching a larger number of members and their families more often.

Provider Communications

Providers are CalOptima’s essential partners in fighting the pandemic, and open lines of communication are essential. In 2020, CalOptima shared more than 300 COVID-19-related updates on regulatory and operational issues with our health networks.

Mental Health

The pandemic’s toll on mental health is heavy with higher rates of anxiety, depression and suicide in the past year. Responding to more than 150 calls a day, CalOptima connected members to providers who could help and is prepared for the anticipated long-term impact on mental health.

Community Connections

Accurate information and ample resources — that’s what our community needed amid the pandemic. CalOptima responded with a COVID-19-specific weekly electronic newsletter, CalOptima Announcements, full of valuable articles sent to more than 2,700 recipients.

Employee Safety

In the early weeks of the pandemic, CalOptima acted immediately to protect employees’ health, arranging for more than 700 to telework safely from their homes. Employees surveyed appreciate the temporary flexibility and feel as productive as ever.

Purposeful Innovation

Driven by an unwavering commitment to Orange County’s vulnerable residents, CalOptima tapped into our ability to innovate amid change. The team brought creativity and flexibility when envisioning revised programming. Many programs focused on improving quality care for members turned out so well they may outlast the virus.

Telehealth Growth

To limit the spread of COVID-19 and maintain access to care, providers pivoted to telehealth, embracing the new technology faster than ever expected. Some industry reports say that the telehealth trend leaped forward 10 years in mere months. This chart shows just how quickly all of CalOptima’s networks and PACE responded with virtual care services, from before the pandemic in Q4 2019 to Q4 2020.


PACE Featured on Local News

When COVID-19 hit, CalOptima’s Program of All-Inclusive Care for the Elderly (PACE) turned on a dime to develop its PACE Without Walls model, which delivers essential services in participants’ homes rather than the typical PACE center group setting. Now a year old, the innovative program continues to provide quality care in this fashion, garnering local and national attention, including this segment on KABC7.

PACE Drive-Thru Events Cruise to Success

The pandemic made drive-thrus popular again — and not for movie watching. CalOptima’s Program of All-Inclusive Care for the Elderly (PACE) joined the trend by hosting drive-thru events this past year to administer immunizations and celebrate the program’s seventh anniversary.

Given the need to maintain PACE participants’ protection against the flu, PACE organized a two-week-long drive-thru immunization event in September to deliver flu vaccines and pneumococcal, shingles and Tdap vaccines. PACE made it festive with a Hawaiian theme of Surf on Thru, Prevent the Flu. PACE Manager of Clinic Operations Christine Sisil, RN, said that more than 300 vaccines were administered efficiently as participants in cars and vans rolled through the parking lot and rolled up their sleeves for their shots.

In a separate event, the parking lot turned party scene on October 1 to recognize PACE’s seventh anniversary. The celebration offered a safe, socially distanced way to engage participants who missed being together at the center. A dozen stations were set up under tents to deliver medical supply care packages as well as a full dose of fun. Seated in the passenger seat of the car, a participant could play a few games from the window and enjoy a bit of entertainment as an Elvis impersonator crooned to passersby.

Nursing Home Training

Nursing homes have been devastated by the pandemic. CalOptima partnered with UCI infectious disease experts to launch a comprehensive staff training program covering everything from COVID-19 prevention to vaccine safety. Used by more than 50 facilities, the program is saving lives and reducing illness.

Homeless Health

CalOptima members experiencing homelessness are particularly at risk for COVID-19, so we quickly modified our Homeless Health Initiative to speed services to this group, introducing a telehealth option for our Clinical Field Teams and COVID-19 testing at shelters.

Vaccine Incentives

With so much at stake in ending the pandemic, CalOptima launched our largest ever Health Rewards program to offer $25 Target or Subway gift cards to members for each dose of vaccine they receive, up to $50 per member. CalOptima’s Board approved $36.1 million for these incentive programs for eligible members.

Health Equity

The need to vaccinate CalOptima members who live in the hardest-hit communities is critical. So in February 2021, CalOptima and Orange County Health Care Agency partnered on the COVID-19 Vaccine Equity Pilot Program. As of April 1, we have directly allocated more than 56,000 doses to those who need them most.

Continued Accountability

COVID-19 tested CalOptima’s longstanding values of accountability and transparency as a public agency and proved them unshakable. We remain committed to our continued responsibility for spending funds wisely, protecting the safety and security of our partners and employees, and upholding quality goals. Our resilience in this pandemic comes from knowing what matters and staying focused on those ideals.

$38 Million Added Funding

Financial support for CalOptima’s tireless provider partners continues to be a priority during the pandemic. While remaining accountable for spending public dollars wisely, the Board has approved more than $38 million in additional funding in rate increases or new programs to help address COVID-19 challenges.

Note: 75% of members are served by CalOptima’s 12 delegated health networks; 25% of members are served by fee-for-service providers in CalOptima Community Network or CalOptima Direct. Fee-for-service providers include physicians, hospitals, community health centers and long-term care facilities.


Awareness Campaign Educates Orange County

Catching eyes across Orange County, the CalOptima COVID-19 Awareness Campaign was launched to educate the community about infection prevention, vaccine safety and more. From May 2020 to present, the ads are making a difference and extending CalOptima’s role as a public agency.

Facilities Team Puts Employees’ Health First

To protect employees’ health during this unprecedented time, CalOptima’s Facilities team has stepped up to ensure that all work areas are safe by implementing vigorous cleaning schedules and strict office protocols.

Like many other businesses, CalOptima requires temperature checks, face masks and physical distancing. While nearly 80% of CalOptima’s workforce has been teleworking since March 2020, the Facilities team continues to work diligently to mitigate the spread of COVID-19 for those who continue to work on site. With 10 floors of workspace and nearly 20 breakrooms, Facilities sanitizes each area three times a day by wiping all door handles, copy machines, fax machines, printers, light switches, refrigerators, sinks and microwaves. If employees touch it, the team cleans it.

In addition to increased cleaning on each floor, Facilities installed signage throughout the building to enforce one-way hallways and physical distancing. They also disassembled and reassembled cubicles for employees to sit safely apart. This work to reconfigure our space continues as CalOptima prepares for an eventual return to the building for selected employees in the post-pandemic era.

With gloves on and sanitizing spray in hand, the Facilities team is truly dedicated to keeping our employees healthy and well while at work. Thank you!

Virtual Meetings

Open, public meetings are essential to CalOptima governance and operations, so in the early days of the pandemic, we moved Board and advisory committee meetings online. Hundreds of stakeholders join us virtually each month.

Temporary Telework

When Orange County enacted its stay-at-home order in March 2020, CalOptima worked quickly to shift more than 700 employees to temporary telework. We spent more than $1 million on telework devices and personal protective equipment to safeguard the health of our team.

Compliance and Quality

COVID-19 presents compliance and regulatory challenges, but letting quality care slip isn’t an option. CalOptima is following a myriad of new reporting requirements from the state while also keeping a watchful eye on our providers, holding them accountable for performance but showing appropriate flexibility during this time.

Strategic Plan

CalOptima is adjusting our 2020–2022 Strategic Plan to align with pandemic realities in health equity, social determinants of health, behavioral health and service delivery models. To invite collaboration, staff engaged our advisory committees for feedback in Spring 2021.

Dynamic Leadership

Navigating the uncharted territory of a pandemic wasn’t easy, but the Board of Directors and Executive Team found their way by relying on CalOptima’s true north: members. Oversight and decision-making based on what’s best for members ensures success and helps fulfill the CalOptima mission. CalOptima leaders would like to thank employees, providers, community partners and others for their commitment on the journey.

Board of Directors

  • Supervisor Andrew Do, Chairman
    Chairman, Orange County Board of Supervisors and Supervisor, First District
  • Isabel Becerra, Vice Chair
    Chief Executive Officer, Coalition of Orange County Community Health Centers
  • Doug Chaffee
    Orange County Board of Supervisors, Supervisor, Fourth District
  • Clayton Chau, M.D., Ph.D.
    Orange County Health Officer and Director of Orange County Health Care Agency
  • Clayton M. Corwin
    President, StoneCreek Company
  • Mary Giammona, M.D., MPH
    Pediatrician and Physician Executive
  • Victor Jordan
    Chief Operating Officer and Health Network Executive, Providence Southern California
  • J. Scott Schoeffel
    Attorney
  • Nancy Shivers, MSN, RN, CCM
    Member Representative
  • Trieu Tran, M.D.
    Orthopedic Surgeon
  • Lisa Bartlett, Alternate
    Orange County Board of Supervisors, Supervisor, Fifth District

Executive Team

  • Richard Sanchez, REHS, MPH
    Chief Executive Officer
  • Gary Crockett
    Chief Counsel
  • Emily Fonda, M.D.
    Chief Medical Officer
  • Nancy Huang
    Chief Financial Officer
  • Ladan Khamseh
    Chief Operating Officer
  • Diana Hoffman
    Deputy Chief Counsel
  • Belinda Abeyta
    Executive Director, Operations
  • Brigette Hoey
    Executive Director, Human Resources
  • Tracy Hitzeman, RN
    Executive Director, Clinical Operations
  • Silver Ho
    Executive Director, Compliance
  • Marie Jeannis, RN
    Interim Executive Director, Quality & Population Health Management
  • Michelle Laughlin
    Executive Director, Network Operations
  • Rachel Selleck
    Executive Director, Public Affairs