Report: Counties Play ‘Crucial Role’ in California Health Care Reform

California's 58 counties play a "crucial role" in driving health care reform in the state, according to a report by the California HealthCare Foundation, State of Reform reports.

CHCF publishes California Healthline.

Details of Report

The report is a follow-up to research from 2011 that assessed how state and federal policies had been implemented in California counties (Lee, State of Reform, 10/22).

The new report reviewed:

• County health services and programs related to medical care, behavioral health and public health;
• Health responsibilities among counties and how they meet such responsibilities; and
• State and federal policies affecting county programs (CHCF report, October 2015).

Findings

The report found that counties have been key financial drivers in Affordable Care Act implementation, noting that they provide the non-federal Medicaid matching funds for programs related to:

• Mental health; and
• Substance use disorders.

However, the report found that there is room for improvement in terms of counties' roles in health care and overall public health (State of Reform, 10/22).

Specifically, the report noted, "Despite the passage of landmark federal health care reform ... county roles and responsibilities for health and health care remain as they have for decades."

The report noted that counties roles still are evolving (CHCF report, October 2015).

Meanwhile, the report found that counties will need to develop new funding strategies as certain policies sunset or new ones are implemented.

In particular, the report noted that counties will be greatly affected by the ending of the California Children's Services program under Medi-Cal, the state's Medicaid program (State of Reform, 10/22). Gov. Jerry Brown (D) earlier this month signed a bill (AB 187) to continue CCS as a carve-out benefit until January 2017 (Gorn, California Healthline, 10/13).

According to the report, other policies that likely will affect health care systems among counties in the state include:

• Reconciliation of costs for indigent care savings scheduled to happen in 2016; and
• Reductions in federal disproportionate share hospital payments in 2018 (State of Reform, 10/22).