To improve beneficiary utilization rates and provider participation under the program's fee-for-service delivery system, Health Care Services should immediately take the following actions: direct Delta Dental to submit annually a plan that describes how it will remedy the dental access problems in the State's underserved areas and in California's border communities.
Delta Dental has submitted their provider and beneficiary outreach and education plans (outreach plans) to DHCS and they are still under review. The outreach plans specifically outline how dental access issues will be addressed in underserved areas within California and the border communities. DHCS will conduct ongoing monitoring of the outreach plans to ensure beneficiary needs are addressed and that all contract provisions are satisfied. Delta Dental's annual submission of outreach plans has been made a condition of precedent to payment.
Health Care Services provided copies of the provider and beneficiary outreach and education plans. These plans include information such as goals, objectives, processes, tasks, deadlines, and responsible parties. Health Care Services stated that workgroups will be convened in September 2015 and that revisions to the plans will be based on workgroup input. Plan approval by Health Care Services will then follow. It also stated that Delta Dental will be directed to implement the plans immediately after finalization.
DHCS has received an initial draft from Delta Dental of an outreach plan that describes how it will address the dental access problems in underserved areas within California and the border communities. The DHCS is in the process of evaluating the initial draft of the plan to ensure beneficiary needs are addressed and all contract provisions are satisfied. DHCS expects to comply with the established implementation date of July 1, 2015.
Agency responses received are posted verbatim.