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DHCS Fact Sheet

• Medi-Cal currently serves about 12.8 million Californians.
• More than one-third of Californians receive health care services financed or organized by DHCS, making the department the largest health care purchaser in the state.
• DHCS invests more than $95 billion in public funds to provide low-income Californians with access to affordable, high-quality health care, including medical, dental, mental health, substance use disorder services, and long-term services and supports.
• DHCS programs emphasize prevention-oriented health care that promotes health and well-being. This serves those with the greatest health care needs through the effective use of public resources. DHCS focuses on improving the health of all Californians by enhancing quality and the patient care experience, while appropriately reducing the per capita costs of health care programs.
• More than 80% (10.1 million) of Medi-Cal members in all 58 counties receive their health care through 22 managed care health plans. DHCS is committed to ensuring that members have patient-centered, coordinated care and are aware of their choices.

Budget

• The 2015-16 budget contains more than $95 billion in total public funds for the support of DHCS services and programs, including $18 billion General Fund. DHCS has more than 3,700 employees. For fiscal year 2015-16, Medi-Cal will receive approximately $61.7 billion in federal funds.

Medi-Cal

• Created in 1966, Medi-Cal is California's Medicaid health care program that covers a variety of medical services for children and adults with limited income and resources.
• Medi-Cal is supported by federal and state funds and accepts applicants regardless of sex, race, religion, color, national origin, sexual orientation, marital status, age, disability or veteran status.

Medi-Cal Eligibility

• The Affordable Care Act (ACA) authorized states to expand Medicaid, effective January 1, 2014, to many low-income individuals under age 65 who were ineligible
for coverage by establishing a new income eligibility limit of 138 percent of the federal poverty level. More than 4.2 million of the state’s current Medi-Cal members have enrolled in the program since California implemented the ACA in January 2014.
• Children are eligible for Medi-Cal as long as their family income does not exceed 250 percent of the federal poverty level.

Mental Health and Substance Use Disorder Services

• As of July 1, 2013, mental health and substance use disorder services came fully under DHCS’ purview from, respectively, the former Departments of Mental Health and Alcohol and Drug Programs.
• DHCS develops, implements, and oversees policies and procedures related to the Specialty Mental Health Consolidation Program and non-waiver Medi-Cal mental health services. DHCS also assesses and develops effective and efficient delivery systems that improve mental health care options and reduce mental and physical health care costs.
• DHCS establishes and implements policies and procedures for the effective operation of the Drug Medi-Cal Treatment Program and assesses and develops effective and efficient delivery systems that improve substance use treatment services and outcomes and help to reduce health care costs.

Provider Participation

• Hospitals, doctors, pharmacists, dentists and other health care providers participate in the Medi-Cal program to provide medically necessary services to members.
• For fee-for-service (FFS) Medi-Cal September 2014 data show that there are 84,628 enrolled primary care physicians, 44,538 of whom have a specialty. This is a FFS number only and doesn’t represent the total number of physicians who provide Medi-Cal services through contracts with Medi-Cal managed care health plans.
• DHCS’ federally approved access monitoring plan assists when issues arise regarding provider access to services. Members are also provided with access to care/providers in managed care health plans.

 

Published by DHCS’ Office of Public Affairs – January 2016

Last modified on: 1/14/2016 12:15 PM