Report 2022-502
September 13, 2022

Follow-Up: Children in Medi-Cal
The Department of Health Care Services Is Still Not Doing Enough to Ensure That Children in Medi‑Cal Receive Preventive Health Services

September 13, 2022

The Governor of California
President pro Tempore of the Senate
Speaker of the Assembly
State Capitol
Sacramento, California 95814

Dear Governor and Legislative Leaders:

Approximately half of California's children receive medical care through the California Medical Assistance Program (Medi‑Cal). Nearly all of these 5.5 million children receive care through managed health care plans (health plans) to which California pays a monthly premium for each enrolled child. However, in analyzing data for nearly the past decade, we determined that less than 50 percent of the children in Medi‑Cal have received the required preventive services that would help ensure that they live healthier, more productive lives.

In March 2019, my office issued report 2018-111 regarding the Department of Health Care Services' (DHCS) oversight of the delivery of preventive services to children in Medi‑Cal. This follow‑up report presents an update on DHCS's efforts to implement that report's recommendations. We found that DHCS made some progress implementing that audit's recommendations, but it has yet to fully implement eight of the 14 recommendations we made, and many of DHCS's efforts to improve its oversight of health plans' provision of children's preventive services were placed on hold during the COVID-19 pandemic. We believe that the ongoing threat of COVID-19 and other communicable diseases provides more reason, not less, for DHCS to reinstitute and improve its oversight of health plans' provision of required preventive health care services to children.

Respectfully submitted,

Acting California State Auditor

DHCS Department of Health Care Services
external reviewer External Quality Review Organization
Bright Futures American Academy of Pediatrics' Bright Futures recommended schedule of care
HCAI Department of Health Care Access and Information