Report 2014-130 Recommendation 12 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 #12 To: Health Care Services, Department of

To streamline the organizational structure of its administrative activities program and to improve the program's cost-effectiveness, Heath Care Services should implement a single statewide quarterly random moment time survey and draft revisions to regulations as appropriate and to applicable documents, including the manual, oversight strategies and plans, and policy and procedure letters.

Annual Follow-Up Agency Response From September 2017

Legislation that was proposed in 2016 would have significantly amended SMAA's Welfare and Institutions (W&I) Code and current pending legislation may also significantly amend SMAA's W&I Code; therefore, SMAA has delayed the development of regulations. In addition, the SMAA Manual was approved by CMS on October 31, 2016, and includes revisions to programmatic oversight methodologies, policies and procedure documents, and enhanced reporting requirements and accountability measures. DHCS continues to draft revisions to the proposed SMAA regulations to support programmatic authority. DHCS anticipates submission of regulations by January 2018.

  • Estimated Completion Date: 01/31/2018

California State Auditor's Assessment of Annual Follow-Up Status: Pending


1-Year Agency Response

DHCS submitted the SMAA manual to CMS on August 15, 2016. Once the manual is approved by CMS, DHCS will incorporate specific items into regulations. DHCS anticipates submission of regulations by June 30, 2017.

  • Estimated Completion Date: June 2017
  • Response Date: September 2016

California State Auditor's Assessment of 1-Year Status: Pending


6-Month Agency Response

DHCS staff continues to review Policy and Procedure Letters, CMS guidance letters, RMTS manual language, Welfare and Institutions Code, and oversight requirements to determine which elements should be included as regulations. DHCS is currently revising the School Based Medi-Cal Administrative Activities Manual, which is the claiming guide for the SMAA program.

  • Estimated Completion Date: June 2017
  • Response Date: March 2016

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


60-Day Agency Response

DHCS staff have attended regulation training and are compiling and reviewing all issued Policy and Procedure Letters, CMS guidance letters, RMTS manual language, Welfare and Institutions Code, and oversight requirements to determine which elements should be included as regulations.

Estimated submission date is June 30, 2017.

  • Estimated Completion Date: June 2017
  • Response Date: October 2015

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


All Recommendations in 2014-130

Agency responses received are posted verbatim.


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