Expanding Medicaid Compatible Work Opportunities

What is the problem that needs to be addressed? Please describe how it is related to mental health.
Previously, project submissions for Mental Health Care Choice and Health Care Plan Choice Tool were struck down as not valid choices for OC MHSA INN. Based upon anecdotal experience, Cal-Optima and Orange County Health Care Agency Behavioral Health Services (OC HCA BHS) provide better continuity of care among health care providers and better quality of care than private health insurance. Thus, remaining on Cal Optima and OC HCA BHS should be a choice that exists in the future. Currently, forcing Able-Bodied Adults Without Dependents (ABAWAD) into work requirements to keep Medicaid benefits is working its way through the Federal Centers for Medicare and Medicaid Services (CMS) as a new policy. Thus, offering a widespread opportunity for Cal-Optima compatible work should be a public policy goal ready to go before the work requirements come to Orange County.

Why is this a concern for Orange County? What can Orange County and other counties learn from this project?
Orange County has worked very hard to make Cal-Optima a Medicaid program that works in the local community and OC HCA BHS a mental health system that works in the local community. Preserving these assets/institutions should be a priority for public policy. Regardless of what happens to public policy at the Federal level, maintaining the public choice of Cal-Optima and OC HCA BHS should be preserved.

What is currently being done to resolve this problem in our county and throughout the United States? If applicable: Is it working; why or why not?
See Mental Health Care Choice and Health Care Plan Choice Tool for previously declined choices to solve this problem.

What is new or different about this project idea? Please describe how this differs from what is already being done (Question 6). Please list any research that was done on this topic.
Expanding Medicaid compatible work opportunities has yet to be tried in Orange County. Employers are not interested in offering employment below the poverty line, but in order to keep quality healthcare for people with mental illness, offering employment below the poverty line should be a priority for employers as a possible stepping stone in recovery.

What is the project idea? Please describe how this project will operate.
Use public policy to promote employment compatible with SSI/SSDI/Medicare/Medicaid benefits for people experiencing mental illness. Low hourly wage jobs do exist, but they are rigid with a schedule and subject to boom-bust cycles that can waste the time and resources of a person living below the poverty line. Creating jobs with a monthly stipend at the monthly equivalent of the Federal Poverty Line – the “white collar” equivalent of low hourly wage jobs – creates flexibility for the person experiencing mental illness. Flexibility is required to keep compliance with Cal-Optima and OC HCA BHS benefits. This is the consequence of tying quality healthcare and health benefits to a specific income.

Additional Information:
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November 5, 2019

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