California Department of Health Care Services

California Department of Health Care Services
Agency overview
Jurisdiction California
Annual budget US$ 91 billion (2015-16)[1]
Agency executive
  • Jennifer Kent, Director
Parent agency California Health and Human Services Agency
Website www.dhcs.ca.gov

The California Department of Health Care Services (DHCS) is a department within the California Health and Human Services Agency that finances and administers a number of individual health care service delivery programs, including Medi-Cal, which provides health care services to low-income people. It was formerly known as the California Department of Health Services, which was reorganized into the DHCS and the California Department of Public Health.[2]

Operations

A building occupied by the California Department of Health Care Services.

A December 2014 audit of the DHCS's Medi-Cal dental care program (Denti-Cal) by the California State Auditor reported that:

  • "Information shortcomings and ineffective actions" by DHCS are putting child beneficiaries at higher risk of dental disease.
  • Only 43.9 percent of children enrolled in Denti-Cal had seen a dentist the previous year – the 12th worst among states that submitted data.
  • Reimbursement rates for the 10 most common dental procedures were 35 percent of the national average – and haven’t risen since the 2000-2001 budget year.
  • Eleven California counties had no Denti-Cal providers or no providers willing to accept new child patients covered by Denti-Cal: Del Norte, Tehama, Yuba, Sierra, Nevada, Amador, Calaveras, Alpine, Mariposa, Mono and Inyo counties.
  • California might not have enough Denti-Cal-participating dentists to handle millions of new Denti-Cal beneficiaries as a result of the Affordable Care Act.
  • DHCS had not adequately overseen its Denti-Cal administrative contractor, which had not "performed contract-required outreach for improving dental access in underserved areas."[1]
    • With 13 million children and adults enrolled, Denti-Cal is the largest state-sponsored dental insurance program
    • Private contractor that administers Denti-Cal is Delta Dental. In 2016, the State of California awarded Delta Dental a new contract to provide administrative services for the Denti-Cal program, continuing the 42-year relationship[3]

Controversies

  • Medi-Cal Dental paid to the doctors only 30% of what commercial insurers paid for the same procedures per October 2017 report; even though DHCS must annually review reimbursement levels for Medi-Cal dental services to ensure “reasonable access” for Medi-Cal beneficiaries pursuant to Welfare & Institutions Code §14079 [4]
  • In San Francisco, 61,440 children were enrolled in Denti-Cal as of 2016 [4], but only one pediatric dentist was accepting new patients as of Mar 2018 [5]; similarly, there were only 15 dentists that accepted new clients for 173,000+ adult patients

References

  1. 1 2 Little Hoover Commission (April 2016), Report #230: Fixing Denti-Cal
  2. ↑ www.dhs.ca.gov Archived December 29, 2012, at the Wayback Machine.
  3. ↑ "Delta Dental 2016 Annual Report" (PDF).
  4. 1 2 "DHCS Medi-Cal Dental Services Rate Review by the Department of Health Care Services October 2017" (PDF).
  5. ↑ Denti-Cal provider referral list - San Francisco Mar 2018. "denti-cal.ca.gov" (PDF).
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