Millions of Children in Medi-Cal Not Receiving Preventive Health Services, JLAC & Assembly Health Hold Oversight Hearing

Tuesday, April 30, 2019

Assemblymember Rudy Salas and Assemblymember Jim Wood hear testimony during joint oversight hearing

SACRAMENTO – Today, Assemblymember Rudy Salas (D-Bakersfield), chair of the Joint Legislative Audit Committee, and Assemblymember Jim Wood (D-Santa Rosa), chair of the Assembly Health Committee, held a joint oversight hearing to look into the alarming findings of the State Auditor’s audit report released in March regarding the Department of Health Care Services’ oversight of the delivery of preventive services to children in Medi-Cal.

Among the findings of the report, it was revealed that an average of 2.4 million children in Medi-Cal per year did not receive all required preventive services and that California’s utilization rate for preventive services has remained below 50 percent and ranked 40th for all states.

“Access to health care providers and preventive services for children in Medi-Cal is severely lacking, especially in rural and other medically underserved communities,” said Assemblymember Salas. “This is unacceptable. Our state prides itself on expanding access to quality, affordable health care, but we are not making the necessary investments or providing adequate oversight and accountability. This audit report has detailed and shown how this issue is affecting children, and now we must follow through on solutions to ensure access to preventive health care for our most vulnerable populations in the most medically underserved areas.”  

At the hearing, members of the Joint Legislative Audit Committee and Assembly Health Committee heard testimony from the State Auditor Elaine Howle on the findings of the audit, along with Jennifer Kent, Director of the Department of Health Care Services, and additional stakeholders including Mike Odeh, Director of Health Policy for Children Now, and Casey Nagel MD, policy advisor for the American Academy of Pediatrics, California.

Assemblymember Salas has continued to work on increasing access to healthcare services during his tenure in the Assembly, including this year requesting that an additional $50 million be included in the 2019-20 state budget to help grow and increase diversity among the healthcare workforce in the most underserved areas of the state. Among the recommendations of the audit to increase access to preventive services for children in Medi-Cal, the State Auditor noted that, “To increase access to preventive health services for children, DHCS should propose to the Legislature funding increases to recruit more providers in the areas where they are needed most.” For more highlights from the audit, see below:

Audit Highlights:

  • An annual average of 2.4 million children enrolled in Medi-Cal do not receive all required preventive services.
  • Many of the State's children do not have adequate access to Medi-Cal providers who can deliver the required pediatric preventive services.
  • Limited provider access is due, in part, to low Medi-Cal reimbursement rates.
  • States with higher utilization rates offer financial incentive programs that California could implement, but it would likely require additional funding.
  • DHCS delegates responsibilities to ensure access and use of children's preventive services to managed care plans, but it does not provide effective guidance and oversight.
    •  It does not provide adequate information to plans, providers, and beneficiaries about the services it expects children to receive.
    •  It does not ensure that plans regularly identify and address underutilization of children's preventive services.
    •  It has not followed up on plans' efforts to mitigate cultural disparities in the usage of preventive services.


Assemblymember Salas represents part of the City of Bakersfield, the cities of Arvin, Hanford, Corcoran, Delano, Lemoore, McFarland, Shafter, Wasco, and the communities of Armona, Avenal, Buttonwillow, Home Garden, Kettleman City, Lamont, Lost Hills, Stratford and Weedpatch.