ORANGE, Calif. — For Michael Hunn, the trail from priesthood to well being care was seamless.

Hunn, a native of St. Louis, endorsed hospitalized sufferers as a Catholic priest within the Nineteen Eighties earlier than leaving the clergy and shifting to well being care administration. Over the subsequent three many years, he was CEO of 9 completely different hospitals — in California, Texas, and Missouri — amongst different senior govt positions. Throughout his uncommon trajectory, there’s been a widespread thread: a need to assist folks.

“It was at all times in me to need to try this,” stated Hunn, 66, who stays a religious Catholic. He requested the church to launch him from clerical duties when he determined to pursue a lay life and the chance to marry.

In March, Hunn was formally named CEO of CalOptima, the publicly run medical health insurance plan for Orange County’s Medi-Cal enrollees. Medi-Cal is California’s model of Medicaid, the federal-state program that gives well being protection to folks with low incomes.

Hunn stepped in late final 12 months as CalOptima’s interim CEO after the earlier chief govt, Richard Sanchez, retired. Board members praised Hunn’s management and stated his many years of well being care expertise made him the best individual to information the company via large adjustments coming to Medi-Cal.

CalOptima, one of many state’s largest Medi-Cal plans, serves 882,000 members — over a quarter of Orange County’s inhabitants. Many enrollees need assistance with housing and employment, along with medical and psychological well being care. CalOptima, like all different Medi-Cal plans, has dedicated to collaborating in a new initiative, California Advancing and​ Innovating Medi-Cal, or CalAIM. The $6 billion experiment is meant to supply weak enrollees with nontraditional companies — akin to housing and meals help, cleansing, and residential modifications — that may enhance their well being.

Hunn, who studied well being care ethics as a seminary pupil and incessantly consulted on end-of-life choices whereas making hospital rounds as a priest, stated he’s utilizing CalAIM to supply CalOptima members with housing help and recuperative care, which supplies sufferers — a few of them homeless — a respite after they’re discharged from the hospital. Extra companies might be added later.

In the meantime, the state is searching for greater oversight of all Medi-Cal health plans, which may put stress on Hunn. The California Division of Well being Care Companies, which runs Medi-Cal, is working up new well being plan contracts that may improve laws and set up stricter reporting necessities beginning in 2024. And CalOptima may face competitors for the primary time if the state permits Kaiser Permanente to leap into the fray as planned.

There are occasions when Hunn’s duties at CalOptima battle together with his spiritual creed. Medi-Cal pays for reproductive care, such as abortions, that’s banned by Catholic well being doctrine. And it covers doctor visits and lethal drugs for terminally sick sufferers who select to end their lives, an act the Vatican has referred to as “intrinsically evil.”

KHN reporter Bernard J. Wolfson sat down with Hunn in his workplace on the ninth ground of CalOptima’s headquarters to speak about his transformation from priest to well being care govt and the adjustments in Medi-Cal. The interview has been edited for size and readability.

Q: Did you ever contemplate a extra hands-on function in well being care — turning into a physician, for instance?

Earlier than I went into the theologate, I did decide up an utility for Saint Louis College medical college. I severely thought perhaps I ought to pursue drugs, as a result of I cherished it a lot having labored within the hospitals. I prayed about it. I talked to my mom, primarily, about it. She stated, “Observe your coronary heart. Do what you assume is best for you, however I feel the church is looking you.”

Q: How do you reconcile your Catholic religion with operating a company that pays for reproductive and end-of-life care?

I’m not a ethical arbiter for an additional’s determination, so I set that apart and depart what I imagine at residence. On the skilled aspect, I’ll fulfill the duty and obligation as required.

Q: The Kaiser Permanente cope with the state, if permitted, would take patients and revenue away from CalOptima. And since KP can primarily choose the Medi-Cal members it desires, it may depart you with a bigger proportion of high-cost sufferers. What worries you most concerning the deal?

It could have been preferable if the dialogue about a direct contract had had extra alternative for enter and dialogue versus a form of shock announcement. We don’t need a two-tier well being system created. Tier one can be, “In case you come to Kaiser, we’re going to pick who we need to have in our community.” Tier two is all people else.

If it does proceed, we are going to do every thing in our energy to ensure it’s seamless for the member.

Q: What do you consider the state’s new Medi-Cal prescription drug program underneath Magellan Well being?

These main statewide initiatives at all times begin off with bumps. There have been IT bumps and on the Magellan aspect some staffing bumps. I feel one of many keys was the decision wait occasions, and there was some work that wanted to be carried out with the formulary.

However the quantity of calls about it from our members is steadily dropping. We nonetheless subject about 30 calls a day, which is approach down. On the top, it was properly over 100 a day. It’s smoothing out.

Q: There’s a large push in California for higher fairness in well being care, and Medi-Cal plans are being required to rent chief fairness officers. Do you could have one?

We’re simply now ending a job description, and we are going to publish that place and begin on the lookout for candidates. We are able to really heat-map the place there are disparities and what we suspect to be meals insufficiency, unemployment, lack of entry to recent vegetables and fruit. It’s unbelievable the info that’s on the market. I need the fairness officer to have the ability to have a look at that and say strategically, “We’ve acquired a gap proper right here. What are we doing right here, as a result of we’re lacking it?”

Q: Let’s discuss CalAIM. Which of its 14 nontraditional services is CalOptima offering at this level?

We now have began doing housing deposits for CalOptima members who’re eligible. We’re additionally starting to work on collaborative housing navigation, the place we are going to navigate our members to group assist companies that get folks positioned into housing.

One other large piece in CalAIM that we’re additionally engaged on is recuperative care.

Q: Are you able to clarify what that’s?

Recuperative care is fairly fundamental. It’s for people who most occasions are coming from a hospital. They’re typically homeless or unhoused, and so they actually want a place to recuperate. They aren’t fairly prepared to return to a shelter and positively not again to the streets.

Whereas they’re there, employees will work to get them attached for housing navigation, job placement, behavioral and psychological well being companies. They’ve a medical facility on-site to allow them to see a physician; they’ve dentistry to cope with tooth.

Q: You appear sharply targeted on aiding Orange County’s homeless inhabitants.

Anyone who’s homeless in Orange County goes to have eligibility for CalOptima as a result of they don’t have assets.

I went out on the homeless depend within the metropolis of Fountain Valley, and I met nose to nose with our homeless of their automobiles, of their vans, within the filth, within the parks, underneath the bridges, of their tents, behind buildings, behind dumpsters. And each particular person — that’s our member.

This story was produced by KHN, which publishes California Healthline, an editorially unbiased service of the California Health Care Foundation.

Bernard J. Wolfson: [email protected], @bjwolfson