Report 2018-122 Recommendation 10 Responses
Report 2018-122: Department of Health Care Services: It Has Not Ensured That Medi-Cal Beneficiaries in Some Rural Counties Have Reasonable Access to Care (Release Date: August 2019)
Recommendation #10 To: Health Care Services, Department of
To ensure that all counties are aware of the managed care model options available to them and of the steps necessary to implement those models, DHCS should provide by December 2019 information to all counties that clearly defines each managed care model and the steps and legal requirements needed to establish each model.
6-Month Agency Response
DHCS has created and posted to the DHCS website a document outlining the necessary information that explains the steps and legal requirements to establish each plan model type. DHCS has shared the link to the document with the County Health Executives Association of California and California State Association of Counties to distribute to its members. The document was also mailed out to the Managed Care Advisory Group and other groups as identified by DHCS. The link on the website to where the document can be found is https://www.dhcs.ca.gov/services/Documents/MMCD/MMCDModelFactSheet.pdf.
- Completion Date: December 2019
- Response Date: January 2020
California State Auditor's Assessment of 6-Month Status: Partially Implemented
Although DHCS' fact sheet defines the managed care models and presents required steps and legal references, the information it provides is at a very high level and does not describe specific details that would direct counties on how to establish each model. We look forward to hearing more from DHCS on its efforts to issue more specific guidance for that purpose.
- Auditee did not address all aspects of the recommendation
60-Day Agency Response
DHCS is working internally to create the necessary information for posting to the DHCS website that explains the steps and legal requirements to establish each plan model type. In addition, DHCS has recently updated the DHCS website and has made improvements that allows the public easy access to information regarding information about health plans. Two improvements to the website include easily accessible links entitled "Medi-Cal Managed Care", as well as a direct link entitled "Finding your County Office". DHCS also continues to be committed to meet with counties when requested to discuss issues about managed care and answer questions regarding the models. Finally, DHCS will issue an information update letter to the County Health Executives Association of California and/or the CA State Association of Counties notifying them of changes to the DHCS website which may be of assistance to counties.
- Estimated Completion Date: December 2019
- Response Date: October 2019
California State Auditor's Assessment of 60-Day Status: Partially Implemented
We look forward to reviewing DHCS' six-month response to evaluate the information DHCS is creating that will address the steps and requirements for establishing each plan model type.
Agency responses received are posted verbatim.