The Authorization to Share Confidential Medi-Cal Information (ASCMI) pilot was a four-week program initiated by the California Department of Health Care Services (DHCS) that designated three lead Health/Community Information Exchanges (HIEs/CIEs) to trial the use of a universal consent form and a consent management service for their local Medi-Cal programs. 2-1-1 San Diego administered the pilot in San Diego County, Manifest MedEx led in San Joaquin County, and Serving Communities Health Information Organization (SCHIO) supported Santa Cruz County with implementation. 

On September 22, 2023, Connecting for Better Health partnered with Stewards of Change Institute and the California Health Care Foundation to produce the first of four webinars in the Advancing Consent Management in California series. The series began with insights into the ASCMI pilot and discussion around improving the consent process.

Lead HIE/CIEs from each of the ASCMI pilots shared an overview of their experiences, lessons learned, and how ASCMI can inform broader CalAIM goals. Program partners also joined to share their perspectives as providers close to the consent management process. 

Leslie Goodyear-Moya, senior advisor of strategic initiatives at Manifest MedEx, reported that “people did want to sign this. It is not just administrators that see the inefficiencies [of the current consent process].” 

Echoing this sentiment, Camey Christenson, chief business development officer at 2-1-1 San Diego, said that this pilot clearly showed that “people seeking assistance are willing and eager to share their information, even their most sensitive information.” Christenson also divulged that 2-1-1 San Diego volunteered for this pilot because they are interested in advancing behavioral health data exchange, which requires additional privacy protections. 

Terrance Massey, administrative deputy director of San Joaquin County Behavioral Health Services, agreed and added that they were excited to join this project with Manifest MedEx specifically to share substance use disorder (SUD) information under 42 CFR Part 2, as they have been trying to break down the wall between mental health and SUD data to treat the large proportion of their patient population with co-occurring disorders. 

Representing an addiction treatment center in Santa Cruz County, Stephanie Macwhorter, the chief operating officer at Janus of Santa Cruz, also noted a high prevalence of co-occurring disorders in their patient population so comprehensive information exchange is particularly important for them. Macwhorter reported that the ASCMI pilot opened the doors to new relationships within the county, which has improved the flow of information. 

Daniel Chavez, executive director of SCHIO, shared that both Santa Cruz County and the local Medi-Cal managed care plan believe that the universal consent form and consent management service should be rolled out more broadly, which emerged as a recurring theme across all three county pilots. 

The main takeaways from the first webinar in the Advancing Consent Management in California series include:

• Medi-Cal managed care plans are at the center of CalAIM and need to actively participate in advocating for and implementing a streamlined consent management process to support comprehensive data exchange in their communities.
• All parties involved enthusiastically await a universal consent form to streamline care.
• Strong leadership from DHCS is critical to advance consent management and comprehensive data exchange in California. 

View the webinar recording here, and register here for the next webinar in the four-part series focusing on legal considerations for consent-to-share.