Report 2014-130 Recommendation 12 Responses
Report 2014-130: California Department of Health Care Services: It Should Improve Its Administration and Oversight of School‑Based Medi-Cal Programs (Release Date: August 2015)
Recommendation #12 To: Health Care Services, Department of
To streamline the organizational structure of its administrative activities program and to improve the program's cost-effectiveness, Heath Care Services should implement a single statewide quarterly random moment time survey and draft revisions to regulations as appropriate and to applicable documents, including the manual, oversight strategies and plans, and policy and procedure letters.
Annual Follow-Up Agency Response From October 2021
DHCS submitted the SMAA Manual to CMS for approval on 9/29/2020 and CMS has not responded with guidance or an approval. Additionally, DHCS submitted the RMTS Manual to CMS 10/13/2020 and CMS has not responded with guidance or an approval.
- Estimated Completion Date: 07/31/2022
California State Auditor's Assessment of Annual Follow-Up Status: Pending
Annual Follow-Up Agency Response From November 2020
A revised SMAA Manual was approved by CMS in 2019; however, additional revisions were made and approved by CMS in April 2020 to include guidance regarding RMTS statistically invalid quarters. Furthermore, the SMAA 2020 Administrative Manual and the California School-Based RMTS Manual, incorporating the LEA Billing Option Program, are being revised and will be sent to CMS for approval.
- Estimated Completion Date: July 2021
California State Auditor's Assessment of Annual Follow-Up Status: Pending
Annual Follow-Up Agency Response From October 2019
SMAA regulation development will begin now that back casting is completed. DHCS submitted a revised SMAA Manual to CMS for approval in November 2017, with additional revisions submitted in June 2019, and approval of the manual is pending approval of SPA 15-021. The revision incorporates provisions of SPA 15-021 to incorporate the LEA BOP into the SMAA RMTS. The revision also includes oversight strategies and plans, and all current policy and procedure letters.
- Estimated Completion Date: August 2020
California State Auditor's Assessment of Annual Follow-Up Status: Pending
Annual Follow-Up Agency Response From August 2019
SMAA regulation development will begin now that back casting is completed. DHCS submitted a revised SMAA Manual to CMS for approval in November 2017 and approval is pending approval of SPA 15-021. The revision incorporates provisions of SPA 15-021 to incorporate the LEA BOP into the SMAA RMTS. The revision also includes oversight strategies and plans, and all current policy and procedure letters.
- Estimated Completion Date: August 2020
California State Auditor's Assessment of Annual Follow-Up Status: Pending
Annual Follow-Up Agency Response From November 2018
SMAA regulation development will begin once backcasting is completed by June 2019. DHCS submitted a revised SMAA Manual to CMS for approval in November 2017. The revision incorporates provisions of SPA 15-021 to incorporate the LEA BOP into the SMAA RMTS. The revision also includes
oversight strategies and plans, and all current policy and procedure letters.
- Estimated Completion Date: August 2020
California State Auditor's Assessment of Annual Follow-Up Status: Pending
Annual Follow-Up Agency Response From September 2017
Legislation that was proposed in 2016 would have significantly amended SMAA's Welfare and Institutions (W&I) Code and current pending legislation may also significantly amend SMAA's W&I Code; therefore, SMAA has delayed the development of regulations. In addition, the SMAA Manual was approved by CMS on October 31, 2016, and includes revisions to programmatic oversight methodologies, policies and procedure documents, and enhanced reporting requirements and accountability measures. DHCS continues to draft revisions to the proposed SMAA regulations to support programmatic authority. DHCS anticipates submission of regulations by January 2018.
- Estimated Completion Date: 01/31/2018
California State Auditor's Assessment of Annual Follow-Up Status: Pending
1-Year Agency Response
DHCS submitted the SMAA manual to CMS on August 15, 2016. Once the manual is approved by CMS, DHCS will incorporate specific items into regulations. DHCS anticipates submission of regulations by June 30, 2017.
- Estimated Completion Date: June 2017
- Response Date: September 2016
California State Auditor's Assessment of 1-Year Status: Pending
6-Month Agency Response
DHCS staff continues to review Policy and Procedure Letters, CMS guidance letters, RMTS manual language, Welfare and Institutions Code, and oversight requirements to determine which elements should be included as regulations. DHCS is currently revising the School Based Medi-Cal Administrative Activities Manual, which is the claiming guide for the SMAA program.
- Estimated Completion Date: June 2017
- Response Date: March 2016
California State Auditor's Assessment of 6-Month Status: Pending
60-Day Agency Response
DHCS staff have attended regulation training and are compiling and reviewing all issued Policy and Procedure Letters, CMS guidance letters, RMTS manual language, Welfare and Institutions Code, and oversight requirements to determine which elements should be included as regulations.
Estimated submission date is June 30, 2017.
- Estimated Completion Date: June 2017
- Response Date: October 2015
California State Auditor's Assessment of 60-Day Status: Pending
All Recommendations in 2014-130
Agency responses received are posted verbatim.