Whole Person Care-Los Angeles: Medicaid Waiver 1115, January 1, 2016-December 31, 2021, Impact Report by the Los Angeles County Department of Health Services

Whole Person Care-Los Angeles (WPC-LA), administered by the Los Angeles County Department of Health Services (LAC-DHS) and funded for six years until 2021 by the Medicaid Waiver 1115, was an unprecedented opportunity to improve care for the sickest and most marginalized Los Angeles County Medi-Cal recipients. The program served individuals who were homeless, justice-involved, had substance use disorder, serious mental illness, complex health issues, or barriers to a healthy pregnancy.

As detailed in this report, by connecting participants to primary care, housing, and social services, many WPC-LA programs improved continuity of care and reduced costly acute care utilization, including medical and psychiatric hospitalizations and emergency department visits. The program ended in December 2021, although many enrollees are getting the same services through a new State program called CalAIM that started in January 2022.

UCLA CTSI Community Engagement and Research Program was the evaluation partner, which entailed conducting the evaluation plan, statistical analysis, and writing the report.

Los Angeles County Department of Health Services, Medical-Legal Community Partnership Report: Meeting Legal Needs to Advance Health Equity in the Safety-Net: Before and During the COVID-19 Pandemic, March 2022

A report about Los Angeles County’s novel Medical-Legal Community Partnership (MLCP) provides no-cost civil legal help to low-income patients in a safety net healthcare setting. The program launched in 2018 at the LA County Department of Health Services, the second-largest county health system in the US. The report describes and provides data on how the program helped address patients’ social needs and details lessons learned from MLCP implementation (including during the pandemic). As one key example, patients’ legal issues changed during the pandemic, and the MLCP lawyers also shifted how they delivered legal services.

Los Angeles County Reentry Programs Improve Access to Primary Care for Justice-Involved Adults

Participation in the Los Angeles County Reentry Programs within Whole Person Care-Los Angeles (WPC-LA) is associated with reduced utilization of costly acute care services and increased utilization of primary care. The reentry services provided to justice-involved individuals reentering the community after incarceration offer both pre-release and post-release services. These services link vulnerable individuals to health and social services to reduce recidivism and improve health outcomes. Since launching the program, participants have increased primary care use by 13%.

Whole Person Care-Los Angeles Residential and Bridging Care Program Decreased Acute Care Use and Increased Primary Care Use for Patients with Serious Mental Illness

The Whole Person Care-Los Angeles (WPC-LA) Residential and Bridging Care (RBC) Program provides discharge planning and linkage to community-based resources to patients with serious mental illness (SMI). High-acuity behavioral health facilities promote the flow of patients to their next level of care to facilitate care continuity and patient stabilization. Patients in the RBC program have seen a 15% reduction in psychiatric inpatient admissions, a 14% reduction in medical inpatient admissions, and a 9% increase in primary care use.

Los Angeles County Homeless Care Support Services (HCSS) and Tenancy Support Services (TSS) Reduce Acute Medical Care Use and Increase Primary Care Use

The Whole Person Care-Los Angeles permanent supportive housing program, in conjunction with Homeless Care Support Services (HCSS) and Tenancy Support Services (TSS), places high acuity homeless patients into sustainable, long-term housing. Since the Whole Person Care program began supporting permanent supportive housing in 2017, there has been an 11% decrease in inpatient hospitalizations, 7% decrease in ER visits, and 8% increase in primary care usage.

Whole Person Care-Los Angeles Increases Primary Care for Adults with a Substance Use Disorder

Through the Los Angeles County Department of Health Services (LAC-DHS), Whole Person Care-Los Angeles (WPC) operates the Substance Use Disorder Engagement, Navigation, and Support (SUD-ENS) program. The SUD-ENS program helps patients with an active substance use disorder navigate substance use resources and social services. Since the SUD-ENS program began in 2017, there has been a seven percent increase in primary care use, six percent reduction in medical inpatient admissions, and four percent reduction in emergency department visits.

Whole Person Care-Los Angeles (WPC-LA) Administers the Kin Through Peer (KTP) Program        

The KTP program connects patients with serious mental illness to long-term social support from a peer community health worker who serves as a surrogate "kin." Since the KTP program began, there has been a 17% percent reduction in psychiatric inpatient admissions, an 11% reduction in medical inpatient admissions, and a 16% reduction in emergency department visits.

Transitions of Care Program Reduces Emergency Department and Inpatient Admissions for Medically High-Risk Individuals in Los Angeles County 

As part of the Transitions of Care Program within Los Angeles County Department of Health Services Whole Person Care Program, CHWs engage patients in the hospital-to-home transition and link them to primary care, behavioral health, and social services through a 30-day intensive care management system which has led to a reduction in high-cost emergency department visits and inpatient admissions, and an increase primary care visits.