Title
a. Receive an update from the County Departments of Health, Social Services, and Natividad on the County’s outreach, education, marketing, and Medi-Cal application assistance efforts to mitigate impacts from State and Federal policy changes on Medi-Cal; and
b. Provide direction to staff on future strategies to be implemented, as appropriate.
Report
RECOMMENDATION:
It is recommended that the County of Monterey Board of Supervisors:
a. Receive an update from the County Departments of Health, Social Services, and Natividad on the County’s outreach, education, marketing, and Medi-Cal application assistance efforts to mitigate impacts from State and Federal policy changes on Medi-Cal; and
b. Provide direction to staff on future strategies to be implemented, as appropriate.
SUMMARY
On September 30, 2025, the Board of Supervisors received an update from County staff 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, with a focus on supporting residents with Unsatisfactory Immigration Status enrollment before December 31, 2025. These funds supported a coordinated effort led by the Health Department in partnership with our Department of Social Services, Natividad Hospital, various community-based organizations, and media partners to inform residents about upcoming changes to Medi-Cal and support them in accessing care. The goal was to focus on Monterey County residents-particularly those facing barriers to accessing health care services-to help them enroll in Medi-Cal before major changes take place to the Medi-Cal program.
DISCUSSION:
On October 14, 2025, the Board of Supervisors received a second presentation outlining the
proposed areas of work and budget for the $250,000 allocation. At that time, the Board formally
authorized the funding for the Health Department, which has served as the lead for the County of Monterey and executed County standard agreements with eligible organizations. Following this
approval, the Health Department entered into a formal MOU with the Department of Social Services to engage a local media firm, TMD, to support implementation of the media strategy. In addition, Natividad provided in-kind support by contributing input on marketing materials, allowing Medi-Cal outreach messaging to be placed on billboards already under contract with Natividad, and supporting the dissemination of outreach materials through its outreach staff.
Additionally, a formal County agreement was executed with the Community Foundation for Monterey County, which has regranted funds to eight local Community Based Organizations (CBOs) to support community outreach and education, as well as the training of local Community Health Workers (CHWs) and other organizational staff involved in this effort.
As previously proposed, the County’s approach focused on three main areas of work: training, outreach and engagement, and media strategies. The following provides a summary of activities and a budget allocation for each area of work.
Areas of Work
• Training: Trained Community Health Workers and other staff on recent State and Federal Medi-Cal policy changes and on how to complete the Medi-Cal application.
• Community Outreach and Education: Providing outreach and education to support
residents with Medi-Cal application assistance, with a priority focus on residents with
“Unsatisfactory Immigration Status.”
• Media Strategy: Developing and disseminating key bilingual messages to clarify State and Federal policy changes and promote resources to access application assistance support efforts.
Final Budget/Expenditures
• Training: $12,342
• Community Outreach and Engagement/Administration Fee: $164,500 (will fully expend budgeted amount of $177,658)
• Media Strategy: $60,000
Our efforts were implemented across the three main areas: training, outreach and engagement, and media strategies. These activities balanced immediate outreach and education needs with longer-term capacity building to ensure residents were supported throughout the Medi-Cal enrollment process and could maintain ongoing access to care.
Although the bulk of our effort was implemented in the last few months of the calendar year, we saw a significant impact. Most notably, we saw Medi-Cal applications increase by 13% in November and 20% in December compared to the same months the prior year. We also saw Customer Service visits increase by 3% in November and then almost 19% in December compared to the prior year. The most significant change was in Medi-Cal applications, where we saw the downward trend in application submissions reverse and begin to trend upward, suggesting our outreach efforts were having an effect on residents either delaying or who were not going to apply for Medi-Cal.
Additionally, funded partners have reported continuing to support residents with ongoing application assistance, as many were able to initially apply for Medi-Cal through BenefitsCal, but now need support with collecting and uploading documentation to ensure they comply with all DSS documentation requirements for the final state application, which is still pending for many individuals.
There is $13,158 in unspent funds that have been carried forward into calendar year 2026 which will be used to continue supporting this effort, particularly as additional policy changes-such as work requirements and renewal processes-take effect. However, without additional investment, the partnering CBOs will not have the resources to continue to support residents with applications for Medi-Cal, CalFresh, and other benefits. Ongoing efforts are limited to mainly the following efforts performed by County staff. Natividad will continue with their outreach efforts and supporting uninsured patients entering their facility with the application process. Health Department, through their CORE team comprised of four permanent and two temporary CHW staff and a Chronic Disease Prevention Specialist, will continue to support individual residents with application processes. Department of Social Services’ MC-CHOICE program will also continue to support individual residents and community partners with application assistance as well. However, while these efforts are critical, reach will be limited due to resource constraints. Leveraging the partnerships we’ve begun through this effort will be the most effective way to reach a larger proportion of our community- especially those most vulnerable to disproportionate health disparities and barrier to care.
This work continues to support 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 were involved in the development and implementation of the plan and selection of community-based organizations and other agencies to support the implementation of strategies.
FINANCING:
The impact to the General Fund in Fiscal Year 2025-26 is $250,000, which was financed by a reduction in the contingencies appropriation (001-1050-CAO020-8034), and a corresponding increase in appropriations in the Health Department’s 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:
This project advances Strategic Goal A: Well-Being and Quality of Life by increasing access to affordable health coverage and healthcare services for Monterey County residents, particularly those in communities disproportionately impacted by health disparities.
Mark a check next to the related Board of Supervisors Strategic Plan Goals:
_X_ Well-Being and Quality of Life (Implement a meaningful community engagement program to raise awareness and connect more individuals to services.)
____ Sustainable Infrastructure for the Present and Future
____ Safe and Resilient Communities
____ Diverse and Thriving Economy
____ Administrative
Prepared by: Vicente Lara, Public Health Program Manager II, 755-4390
Reviewed by: Miriam Mendoza, Assistant Director of Health Services, 755-4622
Approved by: Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Dr. Chad Harris, CEO, Natividad, 783-2551
Roderick Franks, Director of Social Services, 755-4435
Attachments:
Board Report
Presentation