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Orange County’s health insurance plan for the elderly, poor and needy – called CalOptima – is quickly adapting services to a more remote model, in response to the spreading novel coronavirus, including allowing for three-month prescription refills and increased home services for its elderly members.
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Officials at the agency say they are looking to keep its elderly members at home as much as possible during Gov. Gavin Newsom’s stay home order.
“We have 399 members in that now and the average age is 74. They are a very high risk population. They are all nursing home eligible, but living in the community,” said CalOptima’s Medical Director, Miles Masatsugu about the people in all-inclusive elderly care program.
The agency has closed off its senior clinic in Garden Grove and screened everyone there to make sure the virus didn’t spread to the center, which normally hosts meals, recreation, therapy and other medical services for seniors.
“We closed the center off for any visitors, but that very quickly changed as a lot of the members no longer wanted to come to the center and there’s some pretty high-risk members who we moved the care from the clinic to their homes,” Masatugu said.
By Monday afternoon, there were 125 people in the County who tested positive for the virus, according to the Orange County Health Care Agency website.
“Most of the members now are going to receive their care from home. We are going to do that telephonically or do house visits,” Masatugu said. “We are still leaving the center open so our transportation can transport people back and forth.”
CalOptima’s purple vans deliver food, prescriptions and other supplies to seniors who aren’t living in a nursing home.
And the agency is keeping its medical teams on the street to service homeless people, who are among the most vulnerable to get the virus since they aren’t currently able to be isolated in the large, county-run shelters.
CalOptima’s Chief Medical Officer Dr. David Ramirez said the teams were notified they’re exempt from the county and Newsom’s stay home order.
“We made clear that they can continue to provide care. And we’ve always directed them to do what’s clinically appropriate in the many situations that they encounter,” Ramirez said. “We’re committed to paying for all testing, treatment and [future] vaccines related to COVID-19.”
The agency has also made changes to allow for digital doctor’s office visits, known as telehealth.
“One of the biggest things that has happened recently is that the use of telehealth has been expanded and encouraged. So providers and patients can now use the telephone as a means to have remote, virtual visits,” Ramirez said.
Ramirez said the health insurance agency has also moved most of its services to digital platforms to limit face-to-face interaction, including making sure its members are getting connected to the right services and new member sign-ups.
“We’re still supporting our members just as much, but we’re trying to make it telephonic and electronic instead of in-person to prevent the spread [of the virus] and protect our members and providers and our staff,” Ramirez said.
Dr. Paul Yost, CalOptima board chairman and himself a medical doctor, said the best thing people can do right now is keeping the recommended six feet away from other people, known as social distancing.
“The main thing for right now is social distancing and trying to prevent the spread as much as possible so we don’t see a huge spike that will stress our healthcare delivery system more than it will be,” Yost said. “If you do feel ill, don’t go to the ER, don’t go to the doctor’s office, but call them first. So you’re not going to expose everybody in the waiting room.”
Like state and federal public health officials, Yost said the virus spreads like the flu, through sneezing and coughing, which is why officials recommend the six-foot distance from people.
Yost noted the death rate from the novel coronavirus is significantly higher than the flu.
“It is more serious than the flu,” Yost said. “I don’t want to panic people either, because panic is never helpful. I think it’s good for people to take a deep breath, listen to the CDC.”