Report 2014-134 Recommendation 7 Responses

Report 2014-134: California Department of Health Care Services: Improved Monitoring of Medi-Cal Managed Care Health Plans Is Necessary to Better Ensure Access to Care (Release Date: June 2015)

Recommendation #7 To: Health Care Services, Department of

To ensure that it can handle adequately the volume of calls from Medi-Cal beneficiaries, Health Care Services should implement an effective plan to upgrade or replace its telephone system and database to make certain that its ombudsman office can handle the volume of calls and maintain complete data to make informed management decisions.

1-Year Agency Response

No update from the 6 month update. However, providing CSA requested documentation.

6-month Update: The new Ombudsman phone system was successfully implemented on September 30, 2015. The new phone system has expanded incoming call capacity with call back features, in addition to a more robust phone tree referral mechanism. In January 2016, the Office of the Ombudsman will release public data related to the implementation of the new phone system. Seven positions are currently filled with the remaining two in the final stages of recruitment.

  • Completion Date: September 2015
  • Response Date: June 2016

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

Although Health Care Services provided documentation to support that it has implemented a new telephone system, it did not provide adequate documentation to demonstrate that the new system can handle the volume of calls and maintain complete data to make informed management decisions.

  • Auditee did not substantiate its claim of full implementation

6-Month Agency Response

The new Ombudsman phone system was successfully implemented on September 30, 2015. The new phone system has expanded incoming call capacity with call back features, in addition to a more robust phone tree referral mechanism. In January 2016, the Office of the Ombudsman will release public data related to the implementation of the new phone system. Seven positions are currently filled with the remaining two in the final stages of recruitment

  • Completion Date: September 2015
  • Response Date: January 2016

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

Although Health Care Services indicates it has successfully implemented its new telephone system, it has not yet provided documentation to substantiate the successful implementation. We followed up with Health Care Services to obtain the public data it refers to in its response, and Health Care Services stated that the release of public data related to the implementation of the new phone system has been postponed and a new release date has not been determined.

  • Auditee did not substantiate its claim of full implementation

60-Day Agency Response

The new Ombudsman phone system is currently in development and expected to be operational in September 2015. DHCS has received approval for 9 Limited Term positions from the legislature beginning July 1, 2015.

  • Estimated Completion Date: September 2015
  • Response Date: August 2015

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


All Recommendations in 2014-134

Agency responses received are posted verbatim.


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