A state healthcare department is defending itself after criticism arose over a $2.3 million monthly sanction of the Kern County Behavioral Health and Recovery Services Department.
The California Department of Health Care Services announced April 8 that it was imposing the multi-million-dollar sanction against Kern County over staffing levels of mental healthcare workers.
The state department said Kern County had fallen short of federal and state requirements that regulate the amount of healthcare workers that must be employed by counties to provide adequate coverage.
The requirements first became effective in July 2018 and the state’s actions were the first time it attempted to bring California’s counties into compliance with the new laws that govern mental health services under MediCal.
Initially, the state said Kern County Behavioral Health was short 205 mental healthcare providers, arriving at the figure through a calculation based on the number of MediCal beneficiaries within the county.
The number was later revised to 29 after consultation with Kern County officials.
Nine other counties received sanctions, according to the state, including Fresno, Kings and San Bernardino counties.
The Department of Health Care Services characterized the sanctions as a necessary step to ensuring adequate mental health care throughout the state.
Behavioral Health Director Bill Walker criticized the Department of Health Care Services for mismanaging the sanctions in part by not giving counties enough time to respond to the plan.
He said he believed a plan he submitted to the state in October of 2018 showed the county met the requirements, and received no communication from the state until last week that the plan was not sufficient.
He told The Californian that he could have already hired enough employees to satisfy state regulations if the Department of Health Care Services had told him the corrective plan had fallen short.
However, representatives for the Department of Health Care Services pushed back against the notion that they had not given counties enough time to come up with corrective plans.
The state first notified the noncompliant counties in September that they would be issued sanctions if they did not come up with corrective plans.
But before that, the Department of Health Care Services provided a timeline to The Californian, showing presentations to county behavioral health directors as far back as 2016 detailing the new requirements.
On top of that, the department said Kern County was given enough time to avoid a sanction.
“Kern County has had several months to remedy the identified deficiencies and still has until June, 8, 2019 to submit evidence of correction before DHCS withholds any funding,” the department said in a statement to The Californian. “DHCS takes its oversight role seriously and believes it is of paramount importance that MediCal beneficiaries have access to medically necessary specialty mental health services, which requires an adequate network of mental health providers.”
The department also said that it had responded to numerous emails from Kern County addressing technical questions.
The sanctions, which will be enforced by the Department of Health Care Services withholding funds from counties, will not take effect until June 8.
Walker has said the county plans to hire 56 new employees before the deadline, which would bring Kern Behavioral Health into compliance.
Even if the county fails to hire the additional staff, Walker said the department could weather a few months of the sanctions without a big impact.
The state will release the funds to the county once it determines the county has come into compliance with regulations.