Guiding Principles
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A Board Room Table. General Principles

  1. The Governing Board shall maintain the fiscal soundness of the overall CMSP Budget by giving first priority to the CMSP benefit program and second priority to pilot projects and alternative products.

  2. Timely and useful data will be effectively used to inform CMSP benefit program policy development and development of pilot projects and alternative products for improved delivery of health care services.

  3. The Governing Board will maintain a spirit of openness and collaboration in its decision making processes and strive to keep county officials and health care stakeholders across the range of participating counties actively engaged with the Governing Board to continuously identify and develop cost-effective strategies to strengthen the CMSP benefit program and improve local delivery of health care services in participating counties.

Principles for the CMSP Benefit Program
  1. CMSP members will receive medically necessary services in a manner that promotes delivery of the right care at the right time by the right health care provider.

  2. CMSP will seek the provision of culturally and linguistically competent services by participating health care providers.

  3. Care management and coordination, including case management services where appropriate, will assist CMSP members in managing their personal health conditions and related circumstances.


  4. Procedures and systems will be implemented to assure that CMSP members who are eligible for Medi-Cal, Covered California, and other public or private programs are appropriately linked with these programs in order to promote CMSP as a secondary payer after other available programs.
Principles for Development of Pilot Projects and Alternative Products
  1. Among other approaches, the Governing Board may establish pilot projects and alternative products that emphasize improvement in health care delivery in participating counties for CMSP members and populations potentially eligible for CMSP or other public programs

  2. Timely and useful data and other information on health system needs in participating counties, CMSP and potentially CMSP low-income and uninsured populations, and evidence-based strategies for health system improvement will be effectively utilized to inform the development of pilot projects and alternative products.

 

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