2010-2020 BHC Dashboard

Building Healthy Communities: A Decade in Review

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GOAL 2

Health Happens with Prevention

Californians have ready access to a health system that prioritizes prevention and coverage for all.

BHC partners supported a successful Affordable Care Act through outreach and enrollment efforts…

2.3M+ new enrollees in 2015 alone.

NEW MEDI-CAL ENROLLEES IN 2015
BHC SITE BHC COUNTY
South LA, Boyle Heights, Long Beach Los Angeles

951,974

City Heights San Diego

295,620

South Kern Kern

280,169

Eastern Coachella Valley Riverside

275,521

South Sacramento Sacramento

159,825

East Oakland Alameda

133,044

Central/Southeast/Soutwest Fresno Fresno

114,331

Richmond Contra Costa

85,967

East Salinas (Alisal) Monterey

47,504

Southwest Merced & East Merced County Merced

37,915

Central Santa Ana Orange

13,6191

Del Norte & Tribal Lands Del Norte

2,9682

1: Children in 2016-2017
2: Bringing total number to over 10,500 or 40% of county population.
Source: BHC Policy Inventory Tool, 2020.

…which led to a greater decline in the uninsured rate

among adults and children...

BHC Communities Comparison Communities
Uninsured Adults (Adjusted for Community Characteristics)
Uninsured Children/Teens (Adjusted for Community Characteristics)
Source: “Assessing Changes in Community Health over the First Five Years of BHC,” California Health Interview Survey, UCLA, 2016.

…and helped make CA a national model of success

A Decade of Medi-Cal

Enrollment in California’s Medicaid program for low-income people grew 78% between early 2010 and late 2019. Most of the increase was due to the state’s expansion of the program under the federal Affordable Care Act in 2014, accounting for about 3.7 million new enrollees, totaling to around 13 million Californians (1/3 of the state).
Enrollment data from the State Department of Health Care Services in considered preliminary for a year after the reporting period ends. The 2019 data, which is within that time frame, may change slightly.
Credit: Harriet Blair Rowan/California Healthline
Source: California Department of Managed Health Care + Created with Datawrapper

California Endowment Commited $225 Million to Help Implement Affordable Care Act in 2013

Source: “Medi-Cal’s Very Big Decade,” Kaiser Health News; 2020. “California Endowment Commits $225 Million to implement Affordable Care Act, Philanthropy News Digest, 2013.

Partners helped improve children’s health access bringing the uninsured rate to a historic-low

Kids’ uninsured rate in CA decreased 12 percentage points between 2000 and 2019.

Statewide Context for Outreach & Enrollment

97% of all children now have access to coverage & care

Note: The policy changes identified here reflect accomplishments championed by BHC participants during the initiative, but not necessarily with TCE funds. All TCE grants to BHC participants were made in compliance with the requirements of federal tax law.
Source: California Children’s Report Card, Children Now, 2016.

Sites advanced coverage of undocumented populations at the local level

BHC Site/Counties Efforts between 2010 - 2015 Efforts between 2016 - 2020
Los Angeles Created My Health LA program and commits $61 million year per year to provide a no-cost health care program for uninsured residents regardless of residence status; program supported ~150k people. Passed Enhance My Health LA Motion which integrated mild to moderate mental health services at the primary care level, and expanded access to mental health services.
Richmond Supported “Contra Costa Cares” program ($1M) to provide primary care access for 3k individuals to be enrolled in the program. Extended “Contra Costa Cares” and expanded program to 4.4k with commitment of $750k to be matched by partnering hospitals.
Salinas Supervisors allocated $500k toward funding of a pilot program offering primary care services to 58.8k undocumented residents, however, did not cover laboratory and prescription services. Supervisors allocated $2.3M for expansion of existing piilot healthcare project, called Esperanza Care; included expanded laboratory and prescription coverage for an additional 2.5k people.
Sacramento Supervisors voted unanimously for a budget which included funding for a Healthy Partners Program for up to 3k undocumented residents, but places an age restriction of 64. Supervisors voted to raise the cap of the Healthy Partners Program which provided health care to undocumented residents from 3k to 4k, and eliminated age restriction.
Coachella Medically Indigent Services Program (MISP) program was preserved in Riverside County, after proposed legislation threatened elimination. -
BHC Communities for Undocumented Coverage Source: BHC Policy Inventory Tool, 2020.

BHC partners contributed to expanding coverage for all undocumented under age 26 (#Health4All)

  • The number of county programs serving medically indigent adults regardless of immigration status jumped from 11 to 47 (of 58 in total) between October 2017 and July 2018
  • Standard of care continues to vary accross counties.
  • In 2019, California became first state to offer health benefits to undocumented immigrants (under age 25); will cover ~100k young adults.
  • Public charge & federal legislation aimed to disinvest from ACA remain a threat: It is estimated that 274k children have dropped Medi-Cal between 2017-19 due to new anti-immigrant policies at the federal level.

Ultimate goal is to provide health access and coverage to all Californians, regardless of immigration status or age.

Statewide Context for Undocumented Coverage Source: “California’s Patchwork of Care,” Sacramento Bee; 2019; “California is 1st State To Offer Health Benefits to Adult Undocumented Immigrants,” NPR, 2019.

Public partnership pilots come to fruition ensuring the sustainability of these efforts

Source: “Commissioners Hail New Era for Health Workforce,” California Future Health Workforce Commission, 2019; “California’s Health Homes Program Approved to Begin in July,” California Hospital Association, 2018; “Ensuring Access and Affordable Health Care for All Californians: A Synthesis Update,” Engage R+D, 2019.

Partners contributed to building prevention capacity and infrastructure of local communities’ health systems

The California Accountable Communities for Health Initiative (CACHI)

  • Established itself as a public/private partnership between state government and private funders.
  • Utilized a new model called Accountable Communities for Health (ACH) which brings together clinical providers with public health departments, schools, social service agencies, nonprofit organizations, business groups, public safety agencies and others, in a collective effort to make a community healthier.
  • Centered community member voice in how their local health care, public health, and social service organizations addresses key health priorities, such as substance use, heart disease and community violence.
  • Joined over 100 communities across the country implementing the ACH model.

Fund leveraged by CACHI

  • TCE’s investment leveraged nearly two-fold from other private funders, totaling $19M from seven funders.
  • Local communities leveraged their CACHI grants into ~$2M of further investment.
CACHI COMMUNITIES
CATALYST
  • Imperial County
  • Merced County
  • San Diego County
  • San Joaquin County
  • Santa Clara County
  • Sonoma County
ACCELERATOR
  • Fresno County
  • Humboldt County
  • Lake County
  • Los Angeles County
    • Boyle Heights
    • Long Beach
    • San Gabriel Valley
  • Riverside County
  • Sacramento County

Receives administrative support from Community Partners, a Los Angeles-based nonprofit intermediary organization and fiscal sponsor that helps foster, launch and grow creative solutions to community challenges.

** Receives administrative support from the Public Health Institute, a nonprofit dedicated to promoting health, wellbeing, and quality of life for people throughout California, across the nation, and around the world.

Source: CACHI One-Page Overview, 2019.

More About Health Happens with Prevention

Statewide Context Timeline

Click here for a digital timeline that highlights the statewide context, contributions, and policy changes informed and supported by our Building Healthy Communities partners that are connected to the 2010-2020 BHC Dashboard Summary.

Jump to the Timeline

BHC Communities Interactive Map

Click here for a digital map that highlights many local achievements championed by our 14 Building Healthy Community sites that are connected to the 2010-2020 BHC Dashboard Summary.

Jump to the Map

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