Report 2023-103 Recommendation 5 Responses

Report 2023-103: The Comprehensive Perinatal Services Program: The Lack of Usage Data Prevents the State From Knowing How Often Medi‑Cal Members Receive Perinatal Care (Release Date: February 2024)

Recommendation #5 To: Health Care Services, Department of

To ensure that the State informs all Medi-Cal members of the perinatal program and the enhanced services available to them, Health Care Services should, by June 2024, update its Medi-Cal template and guidance to managed care plans to require that all member handbooks describe the enhanced perinatal program benefits. At a minimum, this language should include information on pregnancy-related health education, nutrition counseling, and assessments and referrals for basic health needs and mental health care.

6-Month Agency Response

Within the past six months, DHCS and CDPH completed a comprehensive inventory of all member and provider-facing CPSP materials and used the list to guide decision-making in terms of identifying opportunities for both streamlining and enhancement. DHCS and CDPH have identified certain CPSP materials needing refinements. For DHCS, the updates include creating a brand-new maternal health care webpage with a dedicated CPSP subpage with resources for both Medi-Cal members and providers, updates to the "My Medi-Cal" member document (known as PUB 68) to specifically include CPSP material, updates to various sections of the Medi-Cal Provider Manual, and updates to the 2024 MCP Evidence of Coverage (EOC).

Additionally, DHCS would flag a shift in the timing for the release of the "Birthing Care Pathways" public report, which includes CPSP modernization work and is now expected in Quarter 3 of 2024. The report includes input based on engagement with external stakeholders.

The 2024 MCP EOC errata, which includes the perinatal program benefits, has been completed and released to all Medi-Cal MCPs. All MCPs are required to have the 2024 EOC errata containing information on pregnancy-related health education, nutrition counseling, assessments, and referrals for basic health needs and mental health care in production by July 1, 2024.

Beyond the 2024 MCP EOC updates, DHCS expects the new material health/CPSP webpages to be live in Fall 2024, along with the various MCP Manual updates. Lastly, the "My Medi-Cal" (PUB 68) updates are to be completed by March 31, 2025.

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

60-Day Agency Response

DHCS and CDPH have conducted a preliminary inventory of member and provider-facing CPSP materials and intend to use the list to guide decision-making in terms of identifying opportunities for both streamlining and enhancement. DHCS and CDPH recognize certain CPSP materials may benefit from refinements, which will be discussed by DHCS and CDPH at monthly meetings. Additionally, due to the timing of the release of the "Birthing Care Pathways" public report in Summer 2024, as well as the need to engage with external stakeholders, DHCS will continue to provide updates on this front and strive to identify and make any necessary updates to applicable member-facing materials by June 2024.

The 2024 MCP Evidence of Coverage (EOC) is currently being revised via an errata to include the perinatal program benefits identified in Recommendation 3. The updated EOC language that includes updates regarding information on pregnancy-related health education, nutrition counseling, assessments, and referrals for basic health needs and mental health care is undergoing final internal reviews and will be implemented prior to June 2024.

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

All Recommendations in 2023-103

Agency responses received are posted verbatim.