Report 2018-111 Recommendation 19 Responses

Report 2018-111: Department of Health Care Services: Millions of Children in Medi-Cal Are Not Receiving Preventive Health Services (Release Date: March 2019)

Recommendation #19 To: Health Care Services, Department of

To maximize the benefits of the studies it commissions from its EQRO, DHCS should ensure that by September 2019 the EQRO's annual reports include an assessment of the actions plans have taken to address the EQRO's prior-year recommendations.

Annual Follow-Up Agency Response From November 2020

DHCS will continue to require the EQRO to include in the annual Technical Report, an evaluation of each MCP's follow-up actions in response to the prior years' recommendations. The most recent report, published in July 2020, includes the evaluation. See each MCP's "Recommendations" section within the Plan Specific Evaluation Reports, in Volume 2 of the Technical Report found here: https://www.dhcs.ca.gov/Documents/CA2018-19-EQR-Technical-Report-Vol2.pdf

California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented

As we recommended, the EQRO report now includes an assessment of MCP's follow-up actions.

1-Year Agency Response

DHCS has instructed the EQRO to evaluate each MCPs actions in response to the prior two years' worth of EQRO recommendations in the annual technical reports. MCPs have been notified that they will be required to report to the EQRO their actions in response to the recommendations as described. The evaluations are being incorporated into the annual technical report which will be available in April 2020.

California State Auditor's Assessment of 1-Year Status: Partially Implemented

DHCS' current contract requires the EQRO to include an assessment of the degree to which each plan has addressed effectively the quality improvement recommendations made by the EQRO during the prior reporting periods' review.

6-Month Agency Response

DHCS has instructed the EQRO to evaluate each MCPs actions in response to the prior two years' worth of EQRO recommendations in the annual technical reports. MCPs have been notified that they will be required to report to the EQRO their actions in response to the recommendations as described. Although instructions have been given to, and are being implemented by, the EQRO before September 2019, the report including the evaluations will not be available until April 2020.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

DHCS is working with the EQRO to clearly incorporate an assessment of actions taken by MCPs to the prior year's recommendations. The assessment will occur for the 2019 recommendations and be incorporated into the technical report that is submitted to CMS in April of 2020.

California State Auditor's Assessment of 60-Day Status: Pending

We look forward to reviewing changes to DHCS' agreement with its EQRO and seeing changes in the technical report in DHCS' 6-month or 1-year response.

All Recommendations in 2018-111

Agency responses received are posted verbatim.