DHS Files Emergency Proposals for Medi-Cal; Advocates Criticize Plans

The Department of Health Services last week filed emergency regulations that would allow the state to increase its efforts to recoup the cost of nursing home services from families of deceased Medi-Cal beneficiaries, the Sacramento Bee reports.

As permitted under federal law, the state collects money from the estates of deceased Medi-Cal beneficiaries who received state-funded care when they were older than age 55. Courts have said that California's collection policies are inconsistent.

Through an emergency proposal, Gov. Arnold Schwarzenegger's (R) administration wants to expand the types of property collected by the state. In addition, the proposal would charge families 7% interest on the amount they owe to the state if they are unable to pay the entire bill at once.

In 2004, the state recovered $53.9 million from the estates of Medi-Cal beneficiaries. With expanded collection efforts this year, the state expects to recoup $63.5 million. Projected collections for future years were unavailable.

According to documents filed March 14 and written by administration officials in August, declaring an emergency would allow DHS to institute the policy more quickly.

The Office of Administrative Law must approve or reject the administration's request by Friday to enact the emergency regulations immediately. If the regulations were approved, they could go into effect without a public hearing and would be valid for 120 days. The state must gather public comment to enact permanent regulations, but it can file for extensions of the emergency policies.

Advocates have criticized the emergency proposal, saying the governor is trying to enact policies without first hearing the concerns of citizens.

"This administration as a whole doesn't seem to like public comment or getting the public involved so, instead of releasing regulations on a normal basis and allowing public comment, they file everything on an emergency basis," Pat McGinnis, director of California Advocates for Nursing Home Reform, said.

But Ken August, a spokesman for DHS, said, "Current regulations are ambiguous, and they allow for loopholes," adding, "Federal law requires us to protect the integrity of the program. ... We have a responsibility to those enrolled in Medi-Cal and to the public in general to stop abuse whenever we can."

This is the third time in recent months that the administration's use of emergency regulations has "stirred protests," the Bee reports (Benson, Sacramento Bee, 3/22).