Report 2023-115 Recommendation 9 Responses

Report 2023-115: Department of Health Care Services and Department of Managed Health Care: Children Enrolled in Medi-Cal Face Challenges in Accessing Behavioral Health Care (Release Date: November 2023)

Recommendation #9 To: Health Care Services, Department of

To improve its ability to use timely access surveys as a tool to improve access to behavioral health services, by November 2024, DHCS should develop a compliance threshold for the percentage of appointments in each Medi-Cal managed care plan meeting timely access standards. For example, DHCS might consider how many calls a member should have to make before obtaining a timely appointment and calculate a threshold accordingly.

1-Year Agency Response

DHCS completed discussions with the Department of Managed Health Care to develop consistent compliance thresholds. Compliance thresholds will have been set and DHCS will have informed the Medi-Cal Managed Care Plans (MCPs) of the policy by November 30, 2024.

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

We will review the compliance thresholds when DHCS finalizes and publishes them in its forthcoming All-Plan Letter. DHCS separately communicated that it anticipates publishing the all-plan letter in January 2025.

6-Month Agency Response

No change from the previous update: DHCS has initiated conversations with the Department of Managed Health Care to develop consistent compliance thresholds. Once established, DHCS will set compliance thresholds and inform the MCPs of the policy by November 2024.

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

60-Day Agency Response

DHCS has initiated conversations with the Department of Managed Health Care to develop consistent compliance thresholds. Once established, DHCS will set compliance thresholds and inform the MCPs of the policy by November 2024.

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

All Recommendations in 2023-115

Agency responses received are posted verbatim.