2023-115 Audit Scope and Objectives
Departments of Health Care Services and Managed Health Care—Access to Behavioral Health Services for Children
The audit by the California State Auditor will provide independently developed and verified information related to the timely access to behavioral health services for children in Medi-Cal and California Children's Services (CCS) programs administered by the departments of Health Care Services (DHCS) and Managed Health Care (DMHC). The audit's scope will include, but not be limited to, the following activities:
- Review and evaluate the laws, rules, and regulations significant to the audit objectives.
- Determine what statewide data is available related to children enrolled in Medi-Cal or CCS who sought behavioral health care. If statewide data is unavailable, inspect health records for a selection of children enrolled in Medi-Cal or CCS who sought behavioral health care services.
- For children enrolled in Medi-Cal or CCS, determine the following using statewide data or for a selection of children:
- The average number of days between the date the behavioral health service was requested to the date of the appointment.
- Relevant trends in timely access to behavioral health services based on ethnicity, geographic region, or medical condition.
- For a selection of children enrolled in Medi-Cal or CCS who did not receive timely access to behavioral health services, to the extent possible, determine the reasons for delays in obtaining behavioral health services and the impacts of those delays on their care.
- To the extent possible, determine how many behavioral health providers in California accept Medi-Cal. In addition, determine how many behavioral health providers provided services to Medi-Cal patients in the last year.
- Determine what steps DHCS and DMHC can take to improve timely access to behavioral health care.
- To the extent possible, analyze emergency department visits for children needing behavioral health services, for the most recent five year period, to determine the following:
- Relevant trends for these visits.
- The share of these visits paid by state programs versus private insurance.
- Review and assess any other issues that are significant to the audit.
California State Auditor's Office