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Riverside County: Medi-Cal's worst

Partner: 
Press-Enterprise
Summary: 

No county in California has a worse record than Riverside County for processing Medi-Cal applications. In a recent audit, the county failed to meet deadlines for processing new applications 30.8 percent of the time, or three times the maximum allowed by federal and state law. Riverside is the only California county that has failed to meet Medi-Cal enrollment deadlines every year since the current monitoring system began in 2004. The county has been swamped with a state-high 30 percent increase in beneficiaries for Medi-Cal, the government's health program for the poor and disabled. Its struggle to handle the influx does not bode well for the state’s ability to handle a wave of new Medi-Cal applicants that will come via health reform in 2014.

Results
Riverside County: Worst Medi-Cal record in state
John Gonzales and Lora Hines | November 1, 2010
Pregnant and diagnosed with thyroid cancer, Karina Hernandez went to a Riverside County social services office late last summer desperate for medical care. Then she waited. Despite placing dozens of phone calls to speed up her case, the 27-year-old Lake Elsinore area resident would not get approval for her Medi-Cal application for two months -- or two weeks past the 45-day federal deadline for processing applications. "You do everything they ask you to do, and still it's not enough," said Hernandez, who added a handwritten letter to her lobbying effort as the deadline passed. "Sometimes, literally, I think they wish I would get sick enough and die."
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Results
No penalties for failed Medi-Cal performance
John Gonzales and Lora Hines | November 1, 2010
  What is the penalty for failing to meet federal requirements for timely processing of Medi-Cal applications? Apparently, there is no penalty. Riverside County has fallen shy of federal benchmarks every auditing year since 2004. Yet while county officials have had to file brief plans for corrective action, the problem has gotten worse. When state audits were first submitted, in 2004, they included a provision that a county failing to meet standards could have 2 percent of its Medi-Cal funding withheld as a fine.
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Results
Seeking ways to improve Medi-Cal application process
John Gonzales and Lora Hines | November 1, 2010
If Riverside County is to make progress in enrolling Medi-Cal applicants in a timely way, it might consider the role played by Marie Padrone. Since 1997, Padrone has helped people with their Medi-Cal applications -- not at one of the county's 13 social service offices -- but at one of three county health clinics. Padrone said her clients rarely encounter Medi-Cal enrollment problems because she helps them complete forms and makes follow-up calls to ensure they bring in their documents. "Ninety-nine percent of them are ready to go when they leave this office," said Padrone.
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Results
Editorial: Medi-Cal Mess
The Press-Enterprise | November 8, 2010
Riverside County's deficient handling of health care for the poor is unacceptable. County supervisors should be asking tough questions about why the county cannot meet federal standards for handling Medi-Cal claims promptly, and demanding solutions that will improve the county's performance.
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