Medi-Cal Managed Care Office of the Ombudsman helps solve problems from a neutral standpoint to ensure that members receive all medically necessary covered services for which plans are contractually responsible.

The Office of Legislative and Governmental Affairs facilitates, coordinates and advocates for the development and enactment of legislation in the interest of public health. As a key player in carrying out the mission of the Department of Health Care Services to preserve and improve the health status of all Californians, the office assists in the development and refinement of the state's health care laws.

The Medi-Cal Managed Care Division (MMCD) provides high-quality, accessible and cost-effective health care through managed care delivery systems. Medi-Cal pays medical expenses for people with low incomes, including people who are aged, disabled or have high medical costs. If certain requirements of the program are met, Medi-Cal will help pay for doctor visits, hospital stays, prescription drugs, rehabilitation and other medical services.

The Office of Public Affairs (OPA) is responsible for overall communications and outreach activities designed to engage the general public, as well as a wide variety of health care, community, business, academic, legislative and other groups, including the media, intergovernmental organizations, and public advocacy groups in the department’s agenda. OPA develops and executes public affairs strategies to support the goals and objectives of the department and serves as the central channel for information to the department’s various stakeholders, the public and the media.

The mission of the Department of Health Care Services (DHCS) is to preserve and improve the health status of all Californians. DHCS works closely with health care professionals, county governments and health plans to provide a health care safety net for Californians with low incomes and people with disabilities. DHCS finances and administers a number of individual health care service delivery programs, including the California Medical Assistance Program (Medi-Cal), the California Children’s Services program, the Child Health and Disability Prevention program and the Genetically Handicapped Persons Program.

The California Health and Human Services Agency (CHHS) oversees 12 departments and one board that provide: health care, social and mental health services; alcohol and drug treatment services; income assistance; and public health services to Californians from all walks of life. More than 33,000 people work for departments in CHHS at state headquarters in Sacramento, in regional offices throughout the state. and in residential facilities serving individuals with mental illness or developmental disabilities. CHHS receives more than $25 billion from the state’s General Fund, second only to education. The agency’s total budget - including federal funds and special funds - is approximately $83 billion. Major programs include: no-cost and low-cost health care coverage for low-income Californians (Medi-Cal); income support for the aged, blind or disabled (SSI/SSP); income support for CalWORKs recipients; and low-cost public health insurance (Healthy Families) for children from working families.

The California Department of Aging (CDA) administers programs that serve older adults, adults with disabilities, family caregivers, and residents in long-term care facilities throughout the state. The department administers funds allocated under the federal Older Americans Act, the Older Californians Act and through the Medi-Cal program. The department contracts with the network of Area Agencies on Aging, which directly manages a wide array of federal- and state-funded services that: help older adults find employment; help older and disabled individuals live as independently as possible in the community; promote healthy aging and community involvement; and help family members in their vital caregiving role. CDA also contracts directly with agencies that operate the Multipurpose Senior Services Program through the Medi-Cal home-and community-based waiver for the elderly, and certifies Adult Day Health Care centers for the Medi-Cal program. The department's mission is to promote the independence and well-being of older adults, adults with disabilities, and families.

The California Commission on Aging (CCoA) was established in 1973 by the Burton Act. It was confirmed in the original Older Californians Act of 1980 and reconfirmed in the Mello-Granlund Older Californians Act of 1996. It is composed of 25 commissioners: 19 appointed by the governor, three appointed by the speaker of the state Assembly, and three by the Senate Rules Committee. All commissioners volunteer for three-year terms and the majority shall be 60 years or older. The commission serves as "the principal advocate in the state on behalf of older individuals, including, but not limited to, advisory participation in the consideration of all legislation and regulations made by state and federal departments and agencies relating to programs and services that affect older individuals." As such, it is the principal advisory body to the governor, state legislature, and state, federal and local departments and agencies on issues affecting older individuals in order to ensure a quality of life for older Californians, so they may live with dignity in their chosen environment. The CCoA also provides administrative support to Triple-A Council of California (TACC). CCoA priorities include: enhancing advocacy efforts through legislation and policy analysis; identifying opportunities to disseminate information on a variety of aging issues; fulfilling advisory responsibilities via a statewide plan, policy and program as well as regulation reviews; forging strong partnerships; and promoting discussion on the state's baby boomer planning efforts and our growing diversity.

California established the Olmstead Advisory Committee to ensure the involvement of people with disabilities and other system stakeholders in making recommendations on actions to improve California's long-term care system. The committee represents consumers, family members, providers and advocates. Members of the committee serve on a volunteer basis without compensation. The committee is responsible for providing input to the California Health and Human Services Agency on its efforts to implement the California Olmstead Plan, recommending actions to improve California's long-term care system and creating opportunities to fund expanded or new activities to support individuals with disabilities in their community.

AARP, formerly the American Association of Retired Persons, is a nonprofit, nonpartisan organization with a membership that advocates for people ages 50 and older. Since 1958, AARP has lobbied for senior issues, including the passage of Medicare in 1965. AARP offers support from staffed offices in all 50 states, Washington, D.C., Puerto Rico and the U.S. Virgin Islands.

California Health Advocates is a nonprofit organization dedicated to Medicare advocacy and education for Californians. The group provides unbiased information about Medicare benefits and long-term care for people who live in California. Founded in 1997, California Health Advocates is the leading Medicare advocacy and education nonprofit in California. It receives financial support from a broad range of private and public organizations.

Health Services Advisory Group Inc. (HSAG) has functioned for more than 30 years as a team of professionals working to provide health care quality improvement and quality review. Its mission is to provide quality expertise to those who deliver care and helpful information to those who receive health care services. Since its inception in 1979 as a Medicare peer review organization, HSAG has grown to serve more than 20 percent of the Medicare population nationwide as a quality improvement organization (QIO). QIOs are private, mostly not-for-profit organizations, staffed by doctors and other health care professionals, who are trained to review medical care, to help beneficiaries with complaints about the quality of care and to implement improvements in the quality of care available throughout the spectrum of care. QIOs are required under Sections 1152-1154 of the Social Security Act. HSAG has also become involved with Medicaid programs in more than a dozen states, where they work to assure the quality, access, timeliness and appropriateness of care for approximately 45 percent of the nation’s Medicaid recipients.

The Area Agency on Aging Council of California, also known as the Triple-A Council of California (TACC), represents the 33 Area Agencies on Aging advisory councils. Funding for TACC is provided through California state tax return check-off as well as through the California Foundation on Aging.

Long-term care ombudsmen are advocates for residents of nursing homes and assisted living facilities. They resolve complaints and educate seniors and long-term care providers about their rights and good care practices. They also provide information to the public on nursing homes and other long-term care facilities and services, residents' rights and legislative and policy issues. In 1978, an amendment to the federal Older Americans Act required every state to have an ombudsman program that addresses complaints and advocates for improvements in the long-term care system. The ombudsman program is administered by the Administration on Aging (AoA).

The Health Insurance Counseling & Advocacy Program (HICAP), called the State Health Insurance Assistance Program (SHIP) in most other states, is a national program that offers counseling and assistance to people with Medicare and their families. Coordinators provide counseling on Medicare benefits, Medicare Prescription Drug Plans (Part D), Social Security, Medicaid and veterans' benefits. SHIP, formerly the Information, Counseling and Assistance (ICA) grants program, was created under section 4360 of the Omnibus Budget Reconciliation Act of 1990. This act authorized the Centers for Medicare & Medicaid Services (CMS) to make grants to states for health advisory services programs for people with Medicare.

The Senior Medicare Patrol (SMP) program helps Medicare and Medicaid beneficiaries avoid, detect and prevent health care fraud. The goal is to protect older people and to preserve the integrity of the Medicare and Medicaid programs. The federal program was created in 1996 by the Health Insurance Portability and Accountability Act (HIPAA) and amended in 2006 by Titles II and IV of the Older Americans Act.

The Area Agencies on Aging (AAA) were established under the Older Americans Act (OAA) Comprehensive Services Amendments in 1973 to respond to the needs of Americans 60 and older in every local community. The amendments added a new Title V, which authorized grants to local community agencies in every state. The AAAs provide a range of options that allow older adults to choose the home- and community-based services and living arrangements that suit them best.

Carrie Owen Plietz became CEO of Sutter Medical Center Sacramento in September 2011. Plietz had been named chief operating officer earlier in the year as part of the planned transition. Previously, she was the chief administrative officer at the California Pacific Medical Center. She earned a master’s degree in health administration at the Virginia Commonwealth University School of Medicine.

Thomas McAfee, leader of the UC San Diego (UCSD) Medical Group, is interim CEO of UCSD Health System and president of the UCSD Ambulatory Surgery Center. At UCSD Health System, he helped create a clinical culture that is focused on referral-based practice and patient-centered care. Before joining the university, he served as chief medical officer and vice president of quality improvement for Brown & Toland Medical Group in San Francisco, vice president at UC-Stanford Health Care and associate chief medical officer at the University of California in San Francisco. McAfee was recruited in 2002 as UCSD Health Sciences’ first physician-in-chief.

Tom Gammiere is the CEO and senior vice president of Scripps Mercy Hospital. In his leadership role, he is responsible for the day-to-day operations of the 517-bed Scripps Mercy Hospital San Diego campus in Hillcrest and the 183-bed Scripps Mercy Hospital Chula Vista, which caters to San Diego’s South Bay. Beginning his career at Scripps in 1987 as the assistant administrator, Gammiere worked his way up to administrator by 1992. He is the former chairman of the board of directors for the Health Care Association of San Diego and Imperial Counties. Prior to Scripps, he was an assistant administrator of support services at St. Benedict’s Hospital in Ogden, Utah.

Los Angeles native Amir Dan Rubin became president and CEO of Stanford Hospital & Clinics in January 2011. From 2005 to 2011, he acted as chief operating officer at the UCLA Health System in Los Angeles, Calif. His tasks at the 832-bed UCLA Health System, with a budget of $1.6 billion and over 8,000 employees, included overseeing the operations of the Ronald Reagan UCLA Medical Center, Mattel Children’s Hospital at UCLA, the Resnick Neuropsychiatric Hospital at UCLA, Santa Monica-UCLA Medical Center and Orthopedic Hospital and many outpatient centers across the west side of Los Angeles. Rubin received his MBA from the University of Michigan.

James H. Hickman, longtime Bay Area resident, was named president and CEO of the Alta Bates Summit Foundation and vice president of philanthropy for Sutter Health’s East Bay Region. Hickman came to Summit from Hickman Strategies, the company he founded to supply business strategy, communications and resource development services to social organizations and nonprofits. Hickman also worked as vice president of external affairs at the Institute of OneWorld Health, a nonprofit pharmaceutical company that focused on developing drugs for neglected diseases in developing countries.

Warren Browner is CEO of California Pacific Medical Center and an adjunct professor of epidemiology and biostatistics at the University of California, San Francisco, where he received his medical degree. Presently, Browner is researching human longevity and frailty, pinpointing genetic markers for longevity, and slowing the aging process. He is also investigating the connection between osteoporosis and other diseases, including atherosclerosis and breast cancer.

Calvin Knight joined John Muir Health as president and CEO, coming from Swedish Health Services in Seattle, where he was president and chief operating officer. At Swedish Health Services, Knight was responsible for overseeing the operations at five medical campuses and multiple ambulatory care sites. He played a large part in building the strategy behind a multispecialty physician organization, as well as developing service lines for orthopedics, cancer, cardiovascular, neurosciences, women and infants, and pediatrics. Knight earned master’s degrees in health administration and business administration from the University of Iowa, and holds a bachelor’s degree from Western Washington University.

In 2004, Ruthita J. Fike became the CEO and administrator at the 950-bed Loma Linda University Medical Center, and executive vice president for hospital affairs at Loma Linda University Adventist Health Sciences Center. Previously, Fike was executive vice president of operations and support services for Centura Health, Colorado’s largest health care system.

Dev GnanaDev, the first doctor in California to win the John P. McGovern Compleat Physician Award, is a trauma surgeon and medical director at Arrowhead Regional Medical Center. He served as president of the California Medical Association in 2008-2009. In 2007, he won the American Medical Association Foundation’s Pride in Profession award. GnanaDev has spent his entire medical career in public hospitals.

Lloyd H. Dean has served as the president, CEO and director of Dignity Health (formerly Catholic Healthcare West), since 2000. This system includes Mercy General Hospital and Mercy San Juan Medical Center. He joined Cytori Therapeutics as a director in November 2010 and was appointed chairman of the board of directors in April 2011. Prior to this, he was the executive vice president and chief operating officer of Advocate Health Care and was in a management-level position at Upjohn Company. Currently, Dean is involved in many other organizations, including California Health Association of USA, Mercy Housing Inc., Wells Fargo & Company and the Bay Area Council.

Carl J. Etter is chief executive and senior vice president of Scripps Memorial Hospital Encinitas, a138-bed facility. Prior to Scripps, Etter was assistant vice president for Community Health Systems, a Tennessee-based multistate hospital system, where he oversaw the CEOs of 20 facilities across seven states. Before joining Community Health Systems, Etter was CEO at the 180-bed acute-care Riley Memorial Hospital, a Mississippi-based institution. He was also the CEO/administrator at the 111-bed Woman’s Hospital. Etter earned a master’s degree in hospital administration from Yale University School of Medicine.

Mitch R. Creem, with 25 years of management experience, became CEO for USC University Hospital and USC Norris Cancer Hospital in April 2009. Prior to joining USC, Creem was the associate vice chancellor and chief financial officer for UCLA Medical Sciences, a gathering of institutions that includes the Geffen School of Medicine at UCLA, UCLA Faculty Practice and the UCLA Hospital System. He has substantial experience with: business valuations; organizational, financial and governance structures; strategies for clinical and operational consolidation; bankruptcies and reorganizations; and health care startups.

Gary Fybel, who has more than 30 years of experience in health care, joined the 422-bed Scripps Memorial Hospital La Jolla as CEO in August 2000. Before that, Fybel acted as interim president and CEO of Saint Joseph Health System, Humboldt County, and as administrator and chief operating officer of the Mission Hospital Regional Medical Center. Fybel earned an MBA from California State University, Long Beach. Fybel has worked at Placientia-Linda Community Hospital and at Anaheim General Hospital, where he was CEO.

Thomas M. Priselac, an expert on policy issues related to the delivery and financing of health care, has been serving as president and CEO of Cedars-Sinai Health System since January 1994, and has been associated with the organization since 1979. Prior to joining Cedars-Sinai, Priselac was an executive at the Montefiore Hospital in Pittsburgh. He is also a chairman of the American Hospital Association Board of Trustees.

In January 2011, Linda Smith, a native of San Jose, was made CEO of Santa Clara Valley Medical Center (VMC), San Jose’s only level-one trauma center. Smith started her career in the medical world at VMC when she was 17 years old, as a respiratory therapist. Today she oversees 5,600 employees at the 574-bed acute care hospital.

Karolee M. Sowle joined the Desert Regional Medical Center in 1997 and worked her way up to the position of president and CEO by 2008, serving as chief nursing officer and chief operating officer along the way. Prior to joining the hospital, Sowle was chief nursing officer at St. Nicholas Hospital in Sheboygan, Wis., and chief nursing officer at the Department of Veterans Affairs Medical Center in Tomah, Wis.

David T. Feinberg is an expert in attention deficit/hyperactivity disorder, autism, pediatric bipolar disorder, pediatric depression and adolescent substance abuse. He became president of UCLA Health System in July 2011 and has been CEO and associate vice chancellor since 2007. UCLA hospitals treat more than 80,000 patients each year and are consistently ranked among the top in the nation by “U.S. News and World Report.” Feinberg previously served as medical director of the Resnick Neuropsychiatric Hospital and head of the NPH Faculty Practice Group. He is a clinic professor of psychiatry on the faculty of the David Geffen School of Medicine at UCLA.

Ann Madden Rice, an expert in the management of health care institutions, is CEO of the 631-bed University of California Davis Medical Center. With an annual budget of $1 billion and with medical clinics in 10 California communities, the center employs 6,500 people. Previously, Rice served as chief financial officer and chief operating officer of the Mary Greeley Medical Center in Ames, Iowa, and as vice president of fiscal services for the Central Vermont Medical Center in Barre, Vt. Rice earned a bachelor’s degree in accounting and logistics from Iowa State University in 1979 and a master’s degree in accounting from the University of Iowa in 1983.