California Healthline Daily Edition

Summaries of health policy coverage from major news organizations

California Palliative Care Program Faces Slow Implementation

A California law (SB 1004) to expand Medi-Cal beneficiaries' access to palliative care services has been slow to roll out, prompting concerns from patient advocates, HealthyCal reports.

Medi-Cal is California's Medicaid program (Guzik, HealthyCal, 7/6).


Gov. Jerry Brown (D) signed SB 1004, by state Sen. Ed Hernandez (D-West Covina), last fall. The law requires the California Department of Health Care Services to establish standards and provide technical assistance to managed care plans to ensure delivery of palliative care services to Medi-Cal beneficiaries (Stephens, California Healthline, 5/4).

In California, palliative care services vary across different Medi-Cal plans, according to recent DHCS survey. For example, some plans included education programs to help providers have end-of-life discussions with patients, but others did not offer such services. The survey included responses from just seven of the 22 managed care plans contracted with DHCS.

Details of Rollout

In June, state officials met to discuss progress toward implementing the Medi-Cal palliative care requirements under SB 1004.

DHCS spokesperson Anthony Cava said the department is working out ideas for the program and how to measure its effectiveness. DHCS also is working with the California HealthCare Foundation to develop the program. CHCF publishes California Healthline.

Cava said, "We will work with stakeholders on the final design for the initial guidance, hopefully to be released this fall."

Some palliative care advocates have said that the process of implementing the law has moved too slowly.

However, Coalition for Compassionate Care of California CEO Judy Thomas said that it is necessary to take time to ensure the program is thoroughly developed.

Thomas said that "some providers are kind of frustrated and feel like things could move faster ... but we'd rather have something that's thoughtful and makes practical sense than have something that's rushed or sets up goals that can't be met."

Next Steps

Helen McNeal, executive director of the California State University Institute for Palliative Care, said implementation of a Medi-Cal palliative care program still will face barriers after its guidelines have been developed.

McNeal said, "Educating the workforce needed is one of the challenges that I think everyone agrees is an issue," noting that the state does not yet "have the trained workforce that [it] need[s] in order to deliver great palliative care to everyone who needs it" (HealthyCal, 7/6).

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