If you didn’t know it, you might think it was a party.

There’s music, food, a live talk show complete with host, guests and video clips – even a “Who Wants to be a Millionaire?” type game show with prizes. People ask questions, they engage each other, they laugh.

But looks aren’t always what they seem.

The purpose of events like this are for seniors to learn about California’s Coordinated Care Initiative, an Affordable Care Act program that attempts to coordinate the delivery of Medicare and Medi-Cal health benefits into a single system for those eligible for both with the goal of improving the integration of all forms of care.

Advocates for African American Elders (AAAE) at the USC Edward R. Roybal Institute on Aging has so far held three events like these to get the word out about the Coordinated Care Initiative, and especially its Cal MediConnect program whose job is to streamline delivery of care, mostly because dual-eligible seniors will either be passively enrolled in a participating health plan or have to opt out by January 1, 2015. To ensure continuity of care with their preferred health care providers, seniors will need to make a decision one way or another.

With around 1.1 million people dually eligible for both Medicare and Medi-Cal coverage in California, the Coordinated Care Initiative’s goal is to improve care coordination for these low-income seniors and individuals with disabilities. The program is initially being implemented in eight California counties, including Los Angeles, before it expands to other parts of the state. There are an estimated 370,000 dual-eligible people who live in Los Angeles.

“Many African-American seniors in Los Angeles have limited access to quality health care and health information,” said Karen Lincoln, an associate professor at the USC School of Social Work and a senior scientist at the USC Roybal Institute who founded and chairs AAAE. “In light of high rates of chronic health conditions, associated disability and limited long-term care options for African-American seniors, we wanted to do our part to increase access to health care information by holding these educational events in underserved communities.”

Reaching out

The California Wellness Foundation funded a study led by Lincoln that surveyed more than 550 African Americans age 50 or older in South Los Angeles and the South Bay, such as West Adams, Watts, Compton, Carson and Long Beach, California, and found nearly 82 percent indicated they had never heard of the new initiative. Since Los Angeles County has the greatest number of older adults of any California county and the seventh largest African-American population of all U.S. metropolitan areas, Lincoln found this statistic troubling.

“This finding was very disturbing since the Coordinated Care Initiative had been implemented two years prior, and many of the seniors in our study were dual-eligible,” she said. “Since the CCI is a complicated but important initiative for African-American seniors to know about, I was interested in any method that would allow us to present fairly complex information in a way that seniors could understand.”

So the AAAE team thought of a way to make it easier for seniors to comprehend and retain this complex information. Bryan Gaines, AAAE’s co-chair and project assistant, suggested the talk and game show format, something he had successfully used before to engage African-American seniors.

“The format is very effective because information about the CCI is presented in a simple, entertaining and culturally sensitive way,” Lincoln said. “It allows seniors to be involved and engaged in the conversation, rather than simply being receptacles for information that is difficult to understand and thus act upon.”

The events became so popular – 98 percent of seniors who have participated reported learning something new and useful – that the five Coordinated Care Initiative health plans are now participants, and some are even sponsors, of the project.

Auleria Eakins, an AAAE member and manager of community outreach and education for LA Care Health Plan, one of the participating Cal MediConnect health plans, said that meeting people in-person and on their level is especially important for seniors because that’s how they best respond to new information.

“For some seniors, just getting a piece of paper in the mail may not signal a call to action. Even calling over the phone may not work for seniors,” Eakins sad. “But at this last event, seniors took notes and asked questions. They like that human appeal that LA Care, other health plans and AAAE are able to provide. This program format appeals to all types of learners where they are, and that resonates best with the population we’re trying to reach.”

Eakins said she is proud of the work AAAE and LA Care have done in continuing to build trust within this community.

“People won’t talk to you unless they trust you,” she said. “Sponsoring this event shows that we have a genuine interest in this community.”

Making it relevant

AAAE’s mission is to engage African-American elders in enhancing their quality of life through advocacy, education and increasing access to community resources. When the group was founded in 2012 by Lincoln, one of its priorities was to explore whether outreach and education efforts about the Coordinated Care Initiative were effective and to see what it could do to improve those efforts.

“Materials and presentations are often neither culturally relevant nor congruent,” Lincoln said. “They do not typically include images of African Americans nor do they present the information in a way that many African Americans can clearly understand. We bring a lot of information and resources to the community through one event, rather than seniors having to navigate a complicated health care system to get this information on their own.”

Denny Chan, an attorney with the National Senior Citizens Law Center, also participated in a recent event to help explain how the Coordinated Care Initiative works. He spoke alongside Lincoln and showed seniors what the initiative’s packet looked like, what was in it and why it was important to fill out the paperwork.

"It struck me as not only a great collaboration among different groups but also – perhaps more importantly – exactly the kind of outreach that works,” he said. “It was thoughtful and sensitive to how dual eligibles tend to receive information, and it was done in a culturally appropriate manner.”

In the end, all Lincoln and her AAAE collaborators want is for seniors to get the information they need to make informed decisions that will affect their quality of life.

“We hope that low-income seniors and persons with disabilities will have increased access to quality, coordinated health care that meets their needs, improves or maintains their health, and increases their ability to remain in their communities and avoid institutionalization for as long as possible,” Lincoln said.