Report 2013-125 Recommendation 13 Responses

Report 2013-125: California Department of Health Care Services: Weaknesses in Its Medi-Cal Dental Program Limit Children's Access to Dental Care (Release Date: December 2014)

Recommendation #13 To: Health Care Services, Department of

To improve beneficiary utilization rates and provider participation under the program's fee-for-service delivery system, Health Care Services should immediately take the following actions: increase Delta Dental's access to beneficiary address information and require it to contact beneficiaries residing in underserved areas directly to make them aware of the program's benefits.

6-Month Agency Response

On June 9, 2015, Department of Health Care Services (DHCS) provided Delta Dental with address information for beneficiaries in underserved areas (defined in California Dental Medicaid Management Information System contract 04-35745 as areas with a utilization rate of 41.17% or less). This information will enable Delta to perform direct outreach by phone or mail to beneficiaries in underserved areas. In addition, to more fully support Delta Dental's outreach efforts to beneficiaries throughout the state, DHCS will begin providing address information for all Medi-Cal beneficiaries on a monthly basis no later than September 30, 2015.

  • Completion Date: June 2015
  • Response Date: July 2015

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

Health Care Services provided documentation showing it passed information to Delta Dental in June 2015. Furthermore, the 2015 Dental Outreach and Education Plan provided by Health Care Services identifies beneficiary outreach activities, including separate outreach efforts to newly enrolled beneficiaries and to existing beneficiaries.

60-Day Agency Response

DHCS is working with Delta Dental to provide them with beneficiary address information so that Delta Dental can contact beneficiaries who reside in underserved areas directly for the purposes of informing beneficiaries about their dental benefits. The DHCS is currently testing this approach with Delta Dental by administering an outreach campaign by mail and automatic follow-up telephone calls to guardians of beneficiaries' ages zero through three years of age to determine its effectiveness as a strategy to inform beneficiaries of their dental benefits. DHCS will need to secure additional funding through the administration in order to implement this recommendation by July 1, 2015.

  • Estimated Completion Date: July 2015
  • Response Date: February 2015

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

All Recommendations in 2013-125

Agency responses received are posted verbatim.