Recommendation To Consolidate Medi-Cal Application Process Raises Questions

The Oakland Tribune on Monday examined a recommendation by the California Performance Review that calls for allowing the state rather than counties to determine Medi-Cal beneficiaries' eligibility and manage the application process (Marcucci, Oakland Tribune, 8/9). The 2,500-page report, released last week by Gov. Arnold Schwarzenegger (R), proposes eliminating or consolidating more than 100 boards and commissions and modifying state business practices in an effort to save $32 billion over five years.

The report aims to save almost $5 billion over five years by making changes to the Health and Human Services Agency. Among the proposals is a move to eliminate 17,000 county employees and hire private contractors to determine Medi-Cal beneficiaries' eligibility and administer many of the applications online (California Healthline, 8/5). The recommendation calls for a single Internet-based application for Medi-Cal and the welfare and food stamp programs, similar to the current Healthy Families application, according to the Tribune.

Some advocates for low-income families "question whether a private company could do a better job, and how accountable they would be to the public," the Tribune reports.

Ed Barnes of the East Bay Community Law Center said, "You have a portion of the resources for the program devoted to profit, rather than performance. A portion of what you need to run the program disappears."

Alameda County Supervisor Gail Steele noted that the change would reduce counties' financial obligations, but she added, "It's always harder to find help in the state system."

Supporters of the proposal are pleased that issues are being considered, but they are waiting for more details, according to the Tribune. Some have questioned how people "on the wrong side of the digital divide" would access the application and how the responsibilities of the county welfare offices would be delegated to help people find work and leave the programs, the Tribune reports.

HHSA spokesperson Nicole Kasabian Evans said the department is reviewing the proposals (Oakland Tribune, 8/9).