Report 2023-115 Recommendation 18 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 #18 To: Managed Health Care, Department of

To identify and address timely access issues that affect children, by November 2024, Managed Health Care should update its survey methodology to assess compliance with timely access standards specifically for behavioral health care providers serving children.

60-Day Agency Response

To be responsive to the CSA's recommendations, the DMHC will need additional staffing and statistical funding to develop and test changes to the methodology, and annually evaluate and report the results in the Timely Access Report. As indicated in response to recommendation 3, the DMHC's methodology is codified into regulation. Any change to the methodology requires regulatory amendment. The DMHC's current exemption from the Administrative Procedures Act (APA) only allows the DMHC to make changes until December 31, 2025. Typically, development and testing of significant changes to the statistical methodology require several years to complete. After the initial implementation, the DMHC and its statistical vendor evaluate the data reported under the updated methodology and make additional refinements to ensure that the resulting data is valid and reliable. Where significant changes are made, such as those recommended by the CSA, refinements may be required over several reporting cycles. As of this date, any changes would be included in the next methodology for measurement year 2025, and the resulting data would be reported to the DMHC on May 1, 2026. Given, given the expiration of the APA exemption in H&S section 1367.03, sub. (f)(3) on December 31, 2025, the DMHC will need an extension of the APA exemption to implement and refine these changes in future regulatory amendments to the survey methodology.

California State Auditor's Assessment of 60-Day Status: Will Not Implement

Managed Health Care's response indicates it will not implement this recommendation.

All Recommendations in 2023-115

Agency responses received are posted verbatim.