Report 2018-111 Recommendation 7 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 #7 To: Health Care Services, Department of

To ensure that children in Medi-Cal have access to all of the preventive services for which they are eligible, DHCS should modify by May 2019 its contracts to make it clear to plans and providers that they are required to provide services according to Bright Futures.

Annual Follow-Up Agency Response From October 2021

DHCS submitted contract updates to CMS on December 30, 2020. DHCS is working on obtaining signatures from MCPs to submit to CMS. The revised language focused on the importance of providing preventive care services according to Bright Futures schedules. Language was added to specifically include the periodicity timeline/schedule established by AAP Bright Futures. Additional contract language was added to clarify requirements for medically necessary services.

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


Annual Follow-Up Agency Response From November 2020

As previously reported, DHCS has drafted contract language which addresses EPSDT. DHCS agrees to provide confirmation to CSA in the next update to confirm the Managed Care Plan (MCP) contract has been submitted to CMS with updates to address EPSDT. The target date for submission is December 2020.

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

We are continuing to assess this recommendation as partially implemented, given the steps taken by DHCS as reported in its six-month response. We will review the updated contract language when DHCS has finalized it.


1-Year Agency Response

DHCS has drafted contract language which addresses EPSDT. This language will be submitted to CMS by the end of 2020.

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

We are continuing to assess this recommendation as partially implemented, given the steps taken by DHCS as reported in its six-month response. We will review the updated contract language when DHCS has finalized it.


6-Month Agency Response

DHCS released an updated EPSDT APL with enhanced language regarding Bright Futures for MCP, stakeholder, and advocate feedback. DHCS has reviewed all stakeholder feedback and made appropriate changes to the APL. The APL was published in August 2019 and has been posted under the following link: https://www.dhcs.ca.gov/formsandpubs/Pages/AllPlanLetters.aspx

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

Although DHCS has released its All-Plan Letter (APL), it has not updated the contracts to eliminate the unclear language in the contracts that we discuss on page 29 of our report. DHCS informed us that it intends to update the contracts in November 2019.


60-Day Agency Response

DHCS released an updated EPSDT APL with enhanced language regarding Bright Futures for MCP, stakeholder, and advocate feedback. DHCS is currently incorporating feedback and anticipates publishing the APL no later than June 1, 2019.

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

We look forward to reviewing the updated all-plan letter with DHCS' 6-month response.


All Recommendations in 2018-111

Agency responses received are posted verbatim.