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This paper has been developed as technical assistance to the State of California.  As such, it presents a range of options on different paths that could be taken by the state in a waiver request to the federal government.  The paper makes no recommendations.  Rather, this paper was developed with the understanding that it will be used as the beginning of a process with stakeholders to discuss waiver options.  As part of this public process, the concepts presented here were previously presented by the consulting team at a three-hour public event sponsored by the California Senate Office of Research in early June 2009.  While the paper is an initial step in waiver development, it is worth noting that the language can still be highly technical and is designed for audiences with background in health care policy and financing.

About Harbage Consulting

Harbage Consulting is an independent health policy consultancy.  Peter Harbage, President of Harbage Consulting, has more than a decade of experience working to improve health policy at the federal, state and local level.  Working almost exclusively with government agencies and non-profit foundations, Harbage Consulting has published extensively on health reform concepts, the public financing of health care, Medicaid and California-specific health policy issues.  Hilary Haycock has held senior communications positions dealing extensively with health care issues. She is currently a graduate student studying health policy at Georgetown University and holds an undergraduate degree with high honors from the University of California at Berkeley.

About Health Management Associates

Health Management Associates is an independent national research and consulting firm specializing in complex health care program and policy issues. Founded in 1985, in Lansing, Michigan, Health Management Associates provides leadership, experience, and technical expertise to local, state, and federal governmental agencies, regional and national foundations, investors, multi-state health system organizations and single site health care providers, as well as employers and other purchasers in the public and private sectors.  Theresa Sachs is a nationally known expert on design and financing of Medicaid and CHIP waiver programs with more than 20 years experience in health care.  Jim Frizzera worked at CMS (formerly HCFA) for the last twenty years and is considered a national expert on Medicaid reimbursement and state financing.   Stan Rosenstein has 31 years experience with government heath care programs, with the emphasis on Medicaid and was the long time California Medicaid Director with over 13 years as the Medicaid Director or Deputy Medicaid Director and over 21 years as an executive appointee with the State of California. 

About the Blue Shield of California Foundation

Blue Shield of California Foundation is committed to making health care effective, safe, and accessible for all Californians, and to ending domestic violence.  The Foundation blends community-based philanthropy with strategic innovation to move our state forward. As one of California’s largest health philanthropies, the Foundation serves as a catalyst for change, promoting new solutions and bringing together a diverse array of stakeholders.

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