Report 2014-130 Recommendation 13 Responses

Report 2014-130: California Department of Health Care Services: It Should Improve Its Administration and Oversight of School‑Based Medi-Cal Programs (Release Date: August 2015)

Recommendation #13 To: Health Care Services, Department of

To the extent that local educational consortia and local governmental agencies are no longer involved in the administrative activities program, Health Care Services should develop and issue a standard contract for claiming units to sign to participate in the program.

Annual Follow-Up Agency Response From August 2019

DHCS has a standard contract process for all contracts within the department. DHCS will continue to use the current contract agreements with all LEC/LGAs that contract with the LEAs. DHCS will not implement.

California State Auditor's Assessment of Annual Follow-Up Status: Will Not Implement

Annual Follow-Up Agency Response From November 2018

DHCS has a standard contract process for all contracts within the Department. DHCS will continue to use the current contract agreements with all LEC/LGAs that contract with the LEAs

California State Auditor's Assessment of Annual Follow-Up Status: Will Not Implement

Annual Follow-Up Agency Response From September 2017

DHCS has a standard contract process for all contracts within the Department. DHCS will continue to use the current contract agreements with all LEC/LGAs that contract with the LEAs

California State Auditor's Assessment of Annual Follow-Up Status: Will Not Implement

1-Year Agency Response

DHCS will maintain its current contract agreements with the LEC/LGAs who contract with the LEAs.

California State Auditor's Assessment of 1-Year Status: Will Not Implement

As we state on page 44 of our report, implementing a single statewide quarterly time survey would render local educational consortia and local governmental agencies unnecessary for the administrative activities program. Health Care Services would therefore need to contract directly with claiming units. As we point out on page 34 of our report, having a standardized contract, like the one Health Care Services uses for the billing option program, would help ensure that contracts with claiming units are appropriate and consistent with applicable federal and state requirements.

6-Month Agency Response

DHCS currently has contracts with LECs and LGAs, but not with LEAs. LECs and LGAs have contract agreements with LEAs who voluntarily participate in the SMAA program. The SMAA program currently has the authority to only allow LEAs to participate in the program if they have contract agreements with either their regional LEC or LGA. LEAs do not currently have an option of contracting directly with DHCS to participate in the SMAA program.

California State Auditor's Assessment of 6-Month Status: Will Not Implement

Although Health Care Services states that it will not implement this recommendation, its additional statements indicate otherwise. Health Care Services acknowledges that it uses standard contracts for all local educational consortia and local governmental agencies with which it contracts. Further, in its 60-day response, Health Care Services stated that contracting directly with local educational agencies is dependent upon elimination of local educational consortia and local governmental agencies and the time frame needed to transition duties to claiming units. These statements are in line with our recommendation.

60-Day Agency Response

DHCS disagrees with the recommendation.

DHCS currently has standard contracts with the LEC/LGAs. Should DHCS determine the necessity of eliminating the LEC/LGAs from the SMAA program, DHCS will continue to use standard contracts for all claiming units contracting with DHCS. Contracting directly with the LEAs would be dependent upon elimination of LEC/LGAs and the timeframe needed to transition duties to the claiming units.

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

Although Health Care Services states that it will not implement this recommendation, its additional statements indicate otherwise. Health Care Services acknowledges that it uses standard contracts for all local educational consortia and local governmental agencies with which it contracts. Further, Health Care Services states that contracting directly with local educational agencies is dependent upon elimination of local educational consortia and local governmental agencies and the time frame needed to transition duties to claiming units. These statements are in line with our recommendation.

All Recommendations in 2014-130

Agency responses received are posted verbatim.