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HEROIC Project

Office of the Patient Advocate
HMO Enrollee Regional Outreach
and Information Centers (HEROIC Projects)
MHAC, MHA Los Angeles, and MHA San Diego

Overview and Purpose
The Office of the Patient Advocate (OPA), an independent office established in 2000 is charged with informing and educating consumers about their rights and responsibilities as Health Plan enrollees. OPA is required to annually publish an internet-based HMO Report Card on the quality of HMO services, develop consumer education materials and programs, assist HMO/PPO enrollees, advise the Department of Managed Health Care regarding consumer issues, and collaborate with government and community-based patient advocacy organizations.

In 2002, OPA created the HMO Enrollee Regional Outreach and Information Centers (HEROIC) program to provide a local focus to OPA's education and awareness outreach efforts. The purpose of this local consumer outreach is to help enrollees make the best use of their HMOs; to provide them with the information and resources they need to navigate the health system; and to help them deal with problems when they occur.

Mental Health Association in California (MHAC) received one of three HEROIC contracts awarded in 2008 to provide consumer assistance and advocacy on a statewide level on behalf of health plan enrollees, in our case, who need assistance with mental health services.

MHAC also worked collaboratively with MHA Los Angeles, MHA San Diego, MHA San Francisco, and MHA Sacramento to apply for local HEROIC contracts.  Our joint proposals with MHA Los Angeles and MHA San Diego were also awarded contracts to address similar goals described in the statewide project, at the local community level.

Office of the Patient Advocate

  • For answers to frequently asked questions and to obtain a copy of, "How to Use Your Health Plan" resource guide and the "What You Should Know About Mental or Behavioral Health Care" information card.
  • Or call to order free materials in many languages.

    • 1-866-466-8900
    • 1-866-499-0858 (TTY)

Department of Managed Health

  • For general information on how the state of California oversees HMO/PPO's and for special health plan surveys and department reports.

HELP Center

  • Call to get more information on how to access your health plan benefits or to file a complaint about your HMO/PPO to the California Health Plan Help Center.

    • 1-888-466-2219
    • 1-877-688-9891 (TTY)

Participating Organizations
Mental Health Association in California
Mental Health America Los Angeles
Mental Health America San Diego
Racial and Ethnic Mental Health Disparities Coalition (REMHDCO)
California Youth Empowerment Network (CAYEN)
Pupil Services Coalition

HEROIC Awardee Organizations
Bay Area Legal- Alameda
Bay Area Legal- Contra Costa
California Health Advocates (statewide)
California Health Collaborative (statewide)
Center for Health Care Rights
Central Coast Centers for Independent Living
Disability Resources Agency for Independent Living
Disability Rights Legal Center
Fresno Healthy Kids
Greater Bakersfield Legal Assistance
Health Rights Hotline- LSNC
Independent Living Resource Center-San Francisco
Inland Behavioral Health Services
Legal Aid Society of San Diego-CCHEA
Legal Aid Society of San Mateo

Office of the Patient Advocate

  • For answers to frequently asked questions and to obtain a copy of, "How to Use Your Health Plan" resource guide and the "What You Should Know About Mental or Behavioral Health Care" information card.
  • Or call to order free materials in many languages.

    • 1-866-466-8900
    • 1-866-499-0858 (TTY)

Department of Managed Health

  • For general information on how the state of California oversees HMO/PPO's and for special health plan surveys and department reports.

HELP Center

  • Call to get more information on how to access your health plan benefits or to file a complaint about your HMO/PPO to the California Health Plan Help Center.

    • 1-888-466-2219
    • 1-877-688-9891 (TTY)

MHAC HEROIC Statewide Project
The overall purpose of the statewide project is to apply the Mental Health Association in California's (MHAC) leadership and network connections with the newly created Racial and Ethnic Mental Health Disparities Coalition (REMHDCO) to develop culturally appropriate materials and provide educational outreach about Health Plan rights (and services) to support racial and ethnic minorities in accessing mental health services through an HMO/PPO health care plan.

In addressing racial and ethnic minorities through culturally competent services, there are two general needs identified by the Mental Health Association in California ("MHAC") for this project.  First is enforcing the current mental health parity law, which our local chapters strongly advise us is still unfamiliar territory to many mental health HMO/PPO enrollees, particularly those for whom English is not a first language.  Second is providing racial and ethnic minority, HMO/PPO-enrollees information about why, when, and how to seek mental health care, including how to pursue an effective complaint if enrollees are wrongfully denied care. 

MHAC will conduct the following activities under this project:

  • Survey to Assess the Health Care Needs of Racial/Ethnic minority HMO/PPO enrollees
    Develop a survey with key statewide and local partners that will assess the needs and level of concerns and frustration of racial/ethnic communities with HMO/PPO services.

  • OPA Behavioral Health Information Insert Card
    Convene workgroups from racial/ethnic communities to develop recommendations to the OPA on how make their "What You Should Know About Mental or Behavioral Health Care" information card culturally appropriate for:
      • African Americans
      • Asian and Pacific Islanders
      • Latinos
      • Native Americans
      • Transition Age Youth (ages 16-25)
  • HMO Mental Health Guide
    Work with local and statewide mental health leaders to develop a culturally sensitive HMO Mental Health Guide, modeled after OPA's current HMO Guide but incorporate much of MHAC's already existing "Reaching for the Light" publication; a culturally appropriate Spanish version will also be developed.

  • Outreach Events
    MHAC will work with local partners, including MHA LA and MHA SD, to participate in education, training, and conference events for racial/ethnic communities statewide on the following topics:
      • How to use your mental health benefits under your HMO/PPO
      • State and Federal Mental Health Parity

Contact: Arnulfo Medina, Program Director
                916-557-1167

MHA-LA and MHA-SD Local HEROIC Projects
The purpose and goals for each of the local MHA projects are similar to that of MHAC's statewide project. Accordingly, each joint project has two major objectives: 1) to increase access to mental health benefits through education and outreach to HMO/PPO enrollees about their health plan rights and choices (such as pursuing a complaint or getting a referral to another doctor, psychiatrist, or psychologist); and 2) to encourage HMO/PPO enrollees—empowered by knowing and understanding their health plan rights—to access their HMO/PPO mental health benefits in a preventive manner (rather than solely in or after a crisis situation). Each local project will utilize slightly different methods to achieve their goals.

MHA-LA and MHA-SD will look to host workshops and be involved in community health fairs, walk-a-thons, workplace employee assistance programs, and even non-traditional gatherings such as block parties and cultural-specific events to provide information to the community on how to access their HMO/PPO benefits and Mental Health Parity.

The local projects require 50 events/activities or 7,000 contacts per year.

MHA LA Contact: Julia Scalise, Project Manager, 562-284-1232
MHA SD Contact: Peggy Beers, Project Manager, 619-543-0412 ext. 110