Title
Adopt a Resolution to:
a. Receive an update from the County Departments of Health, Social Services, and Natividad on proposed outreach, education, marketing, and application assistance plan to mitigate impacts from State and Federal policy changes on Medi-Cal;
b. Amend the Health Department’s Health Administration Bureau’s Fiscal Year (FY) 2025-26 Adopted Budget (001-4000-8600-HEA014) to increase appropriations by $250,000 financed by a reduction in the contingencies appropriation (001-1050-CAO020-8034) to provide funding for Medi-Cal Outreach and Education to residents (4/5ths vote required); and
c. Authorize and direct the Auditor-Controller and County Administrative Office to incorporate the changes in the FY 2025-26 Health Administration Bureau’s Adopted Budget (001-4000-8600-HEA014) (4/5ths vote required).
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors adopt a resolution to:
a. Receive an update from the County Departments of Health, Social Services, and Natividad on proposed outreach, education, marketing, and application assistance plan to mitigate impacts from State and Federal policy changes on Medi-Cal;
b. Amend the Health Department’s Health Administration Bureau’s Fiscal Year (FY) 2025-26 Adopted Budget (001-4000-8600-HEA014) to increase appropriations by $250,000, financed by a reduction in the contingencies appropriation (001-1050-CAO020-8034) to provide funding for Medi-Cal Outreach and Education to residents (4/5ths vote required); and
c. Authorize and direct the Auditor-Controller and County Administrative Office to incorporate the changes in the FY 2025-26 Health Administration Bureau’s Adopted Budget (001-4000-8600-HEA014) (4/5ths vote required).
SUMMARY/DISCUSSION:
On September 30, 2025, the Board of Supervisors received an update on recent State and Federal policy changes to Medi-Cal that impact Monterey County residents. Following this update, the Board provided preliminary direction and authorized up to $250,000 to develop and implement an outreach and media strategy to help residents apply for Medi-Cal through December 31, 2025, before enrollment cap takes effect for Unsatisfactory Immigration Status enrollment on January 1, 2026.
County staff will work with local community-based organizations and marketing experts to develop strategies, budget, and timeline for implementation of activities. The Health Department will serve as the lead for the County of Monterey and execute County standard agreements with eligible organizations.
The proposed approach focuses on three main areas of work: training, outreach and engagement, and media strategies. Following is a summary of activities/deliverables and proposed budget amount per area of work.
Areas of Work
Training of Community Health Workers and CBO Staff
• Identify local Community Based Organizations (CBOs) with existing Community Health Worker (CHW) programs OR have an active BenefitsCal account with DSS to assess interest in conducting coordinated direct outreach and support across Monterey County.
• Train identified CHWs and partner staff on State and Federal Policy changes on the Medi-cal program and how to complete the Medi-cal application. Additionally, provide a refresher on available healthcare and other services and resources.
Community Outreach and Education
• Contract CBOs with existing Community Health Worker (CHW) programs OR have an active BenefitsCal account with DSS to provide outreach, education, and application assistance support for residents, prioritizing application assistance for residents with “Unsatisfactory Immigration Status”.
• Contracted CBO will also help residents navigate additional resources to ensure access to care and services.
Media Strategy
• In partnership with the County’s Public Information Office, the Department of Social Services, the County Health Department, and Natividad,, develop key bilingual messages to clarify State and Federal Policy changes and actions residents need to take to seek application assistance support.
• Launch a broad campaign using outlets, which may include traditional media, social media, and direct methods (e.g., text messaging).
• Strengthen messaging as needed to increase the visibility of outreach and education efforts.
Budget & Deliverables
Training: $5,000 - $10,000 for training staff, partners, and CHWs on upcoming changes to Medi-Cal and application assistance, as well as providing a refresher on available healthcare services and other community resources. .
Community Outreach and Engagement: $190,000 - $195,000 to conduct outreach and education, provide application assistance, and link residents to legal aid and other resources, as appropriate. Deliverables will include tracking reach at outreach events and one-on-one resident encounters. Specific deliverables to be refined during contracting process.
Media Strategy: $50,000 - $60,000 to develop of creative content, implement media campaign, including placements, and deployment of social media marketing.
The proposed strategies balance immediate outreach and education needs with longer-term capacity building, ensuring residents are supported through enrollment process and ongoing access to services. Unspent funds at year-end will be carried forward and may be used through the end of the fiscal year (June, 2026) to continue supporting residents, particularly as new policy changes-such as work requirements and renewal processes-take effect in 2027.
Funding for this project will be supplied from the reserve for contingencies (001-1050-8034-CAO020), which requires appropriation of the funds to the Health Administration Bureau’s FY 2025-26 Adopted Budget. The Department requires an increase in appropriations for these costs, as they are not included in the current Adopted Budget. Due to the timing of this item, and direction from the Board to bring it back within two weeks, this item is being presented to the Board of Supervisors.
This work supports the Monterey County Health Department’s 2025-2028 Strategic Plan, Goal 1: Build Community Power and Partners’ Capacity to Increase Equity and Improve Health, particularly Objectives 1.2 (energize cross-sector partners to advance equitable policy and systems changes) and 1.3 (improve the Department’s information dissemination to diverse communities and sectors by building trusted partners’ capacity to reach priority populations and enhancing the Department’s ability to deliver clear, accessible information). Together, these actions advance health equity, strengthen community power, and prepare residents for upcoming Medi-Cal policy changes in 2026 and 2027.
Additionally, this work supports Goal 2: Provide Exceptional Person-Centered Care through Accessible, Community-Focused Health Services, specifically Objective 2.2 (increase accessibility of medical, dental, mental health, and substance use services, especially for underserved communities) by helping ensure that Monterey County residents- particularly those who have historically faced barriers to care-can more easily access the health services they need, thereby supporting equitable, person-centered care.
It also supports the following of the ten essential public health services, specifically, 4. Mobilize community partnerships and action to identify and solve health problems; 5. Develop policies and plans that support individual and community health efforts.
OTHER AGENCY INVOLVEMENT:
Natividad and the Department of Social Services are involved in the development and implementation of proposed draft plan. County staff will work collaboratively to identify community based organizations and other agencies to support implementation of strategies.
FINANCING:
The impact to the General Fund in Fiscal Year 2025-26 will be $250,000, which will be financed by a reduction in the contingencies appropriation (001-1050-CAO020-8034)., and a corresponding increase in appropriations in the Health Department Administration Bureau’s FY 2025-26 Adopted Budget (001-4000-8600-HEA014) to provide the budget capacity for these services.
BOARD OF SUPERVISORS STRATEGIC PLAN GOALS:
__X_ Well-Being and Quality of Life
____ Sustainable Infrastructure for the Present and Future
__X_ Safe and Resilient Communities
__X_ Diverse and Thriving Economy
____ Administrative
Prepared by: Karla Tinajero, Finance Manager II, 755-4963
Reviewed by: Miriam Mendoza, Finance Manager III,755 4622
Approved by: Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Attachments:
Board Report
Resolution