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Hours on hold, limited appointments: Why California babies aren't going to the doctor

Jenny Gold, Los Angeles Times on

Published in Health & Fitness

Three years later, the auditor released a follow-up report, saying that the department had failed to fully implement eight of the 14 recommendations, including making sure directories of available providers are accurate and requiring health plans to address barriers to care.

The 2022 report found access had grown even worse, a decline largely attributed to the pandemic. Just 42% of children in Medi-Cal received their recommended preventive care. An average of 2.9 million children were missing out on care each year.

For the youngest children the results were particularly troubling: 60% of 1-year-olds and 73% of 2-year-olds in Medi‑Cal did not receive the required number of preventive services.

Although federal law requires that families have access to primary care within 10 miles or 30 minutes of their home, the health department had issued more than 10,000 exceptions. In Monterey County, for example, a healthcare plan requires families to travel up to 58 miles to see a pediatrician.

The department has since implemented all but one of the recommendations it agreed to, and is in the process of overhauling the Medi-Cal program, the response said. This includes beginning to levy higher fines against Medi-Cal plans that do not provide recommended well-child visits, vaccinations and lead screenings to enough children.

A spokesperson for the State Auditor's office said the department has not proved that they have implemented three of the recommendations.

 

This month, the department announced assessments and fines for 2022. While DHCS reported some progress on access to well-child visits, the plans continued to struggle overall, and the quality of children's healthcare lagged behind measures for other types of care, including behavioral health and chronic disease management.

Only one plan met all of the minimum standards on children's health: Community Health Group Partnership Plan in San Diego. Eighteen out of 25 plans were fined $25,000-$890,000 for poor performance, including for children's health.

Long waits, long drives

Parents and advocates say getting care for children remains a daily challenge. About 11 million Californians live in a primary care shortage area, where a pediatrician can be difficult to find.

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