SB 1004 Implementation Resources: Helping Medi-Cal Plans Provide Access to Palliative Care

SB 1004 is the California law that requires Medi-Cal managed care plans to provide access to palliative care. As part of CHCF’s ongoing efforts to help health plans and providers prepare for implementation, CHCF is offering a yearlong series of technical assistance activities, which started in June 2017. We will add resources to this page over time, so check back frequently for the most up-to-date information.

What Is SB 1004?

SB 1004 (Hernandez, Chapter 574, Statutes of 2014) requires the California Department of Health Care Services (DHCS) to “establish standards and provide technical assistance for Medi-Cal managed care plans to ensure delivery of palliative care services.” DHCS, in partnership with CHCF and other organizations, has held a series of events to support SB 1004 implementation and to educate interested parties about palliative care and strategies for developing and delivering services. Materials from those sessions, policy documents, and links to resources are available through DHCS.

SB 1004 implementation began January 1, 2018.

Technical Assistance Series

To help health plans and providers develop and sustain successful palliative care services, CHCF’s technical assistance series will focus on five topics:

1. Estimate Volume and Baseline Costs: Learn how to estimate the number of members eligible for palliative care — an important step in implementation planning. Understand how eligible members are currently using health care resources, data that will be used in estimating and (eventually) assessing program impact and in targeting outreach and education efforts.

2. Estimate Care Delivery Costs: Anticipate the costs of delivering care, based on your clinical model, environment, and other variables. These data will help providers build sustainable palliative care programs.

3. Assess Capacity and Launch Services: Assess your readiness to deliver SB 1004 palliative care and prepare to launch, by determining the capacity of local providers to deliver palliative care services, developing strategies to fill identified gaps, and developing plans for patient referral and provider education.

4. Gauge and Promote Success: Understand approaches to tracking and assessing quality measures, patient and family outcomes, and fiscal and utilization outcomes. Use these measures of success to improve and ensure the long-term sustainability of your program.

5. Address Common Implementation Challenges: Join other health plans, delegated medical groups, and palliative care providers to discuss challenges in early implementation, and share lessons learned and best practices from the first six months of SB 1004 care delivery.

These technical assistance activities are designed for representatives from Medi-Cal managed care plans, health systems with delegated fiscal and operational responsibility for implementing SB 1004, and provider groups that may offer palliative care clinical services.

Watch a recording of a webinar that provided an overview of this technical assistance series. Presentation slides are also available under Document Downloads below.