Senate Budget & Fiscal Review Sub. No. 3 Hears Update on CCS WCM Implementation
On Thursday, the Senate Budget & Fiscal Review Subcommittee No. 3 on Health and Human Services held a hearing that included an informational update on the California Children’s Services (CCS) Whole Child Model (WCM) implementation. Recall, SB 586 (Chapter 625, Statutes of 2016) established the WCM in designated County Organized Health System (COHS) jurisdictions through which CCS case management and service authorization responsibilities were transitioned from counties to the Medi-Cal managed care plans.
Thursday’s hearing featured Department of Health Care Services (DHCS) Director Jennifer Kent to provide an update on implementation activities. Director Kent discussed the phased-in implementation process, as well as the delayed Phase Three implementation in Orange County due to network adequacy concerns. Orange County will be the final county set to transition to the WCM on July 1, 2019. Director Kent discussed various implementation challenges, including case management activities, transportation benefits, and eligibility determinations.
The hearing also featured panelists from the Health Plan of San Mateo, the California Children’s Hospital Association, Family Voices of California, and the Children’s Specialty Care Coalition. Panelists discussed their respective experiences in implementing the WCM in specified jurisdictions throughout the state, as well as successes and challenges with the transition of these services to a managed care model.
Much of the informational item during the hearing focused on the WCM evaluation plan. Stakeholders have expressed concerns about DHCS’s scope of work, methodology, and metrics for the evaluation and its consistency with the intent of SB 586. Director Kent indicated during the hearing that an evaluation date previously published by DHCS was erroneous; the WCM implementation evaluation will occur three years after the full implementation of WCM, which is consistent with statute. Director Kent further reiterated her department’s commitment to soliciting feedback and input from stakeholders and ensuring the evaluation meets all elements delineated in statute.
Subcommittee Chair Senator Richard Pan inquired about care coordination efforts and changes in service provided by counties versus health plans, and evaluation strategies, and data sources to be used in the evaluation process.