What’s happening: The California State Auditor recently investigated children’s access to Medi-Cal-covered behavioral health services.
What else to know: The auditor concluded that many Medi-Cal health plans were out of compliance with state requirements for timely care and that the Department of Health Care Services (DHCS) is not adequately disciplining health plans.
The auditor found:
- Children must wait 13 days (despite the state’s standard of 10 days) for a standard outpatient appointment.
- 43% of children needing urgent appointments with a psychiatrist wait longer than the state’s 96-hour wait time standard.
- DHCS cannot demonstrate that using corrective action plans has meaningfully improved children’s access to care. DHCS has not used its authority to impose financial sanctions on the health plans.
The auditor noted that the high number of children’s emergency department visits for mental health concerns demonstrates the need for Medi-Cal managed care plans to improve children’s access to upstream behavioral health services.