Draft Budget Proposes Significant Delay In Medi-Cal Palliative Care Services

Originally posted on January 12, 2017

JANUARY 11, 2017 (Sacramento, CA)—The California Department of Health Care Services (DHCS) shared a 2017-18 budget document yesterday showing that Gov. Jerry Brown is proposing to delay the implementation of a program that would expand access to palliative care services for Medi-Cal Managed Health Care Plan enrollees. DHCS had previously indicated April 2016 as the implementation date in a draft “All Plan Letter” the department was using to collect public comment. The new implementation date is set for “no sooner than July 1, 2018,” according to the draft budget.

Signed by Gov. Brown in 2014, Senate Bill 1004 (Hernandez) requires DHCS to establish standards and provide technical assistance for Medi-Cal Managed Health Care Plans (MCPs) to ensure delivery of palliative care services to beneficiaries. Integrating palliative care practices, such as coordinated pain and symptom management, improves outcomes and quality of life for patients with serious illnesses such as cancer, congestive heart failure, or liver disease. The Medi-Cal program serves over 13 million people, and of those, over 10 million are in a MCP.

“SB 1004 is a cost-neutral bill—it was not designed to give additional money to health plans or pay providers,” said Judy Thomas, CEO of the Coalition for Compassionate Care of California. “Delaying the implementation of this bill not only creates confusion among California’s health plans, it continues to deny the most vulnerable people in our state access to quality, palliative care when they are seriously ill or nearing the end of life.”

For the last two years, Coalition for Compassionate Care of California (CCCC) and other leaders in the California palliative care community have been working with DHCS to help shape the new standards.

In September 2016, DHCS issued a SB 1004 Medi-Cal Policy paper outlining levels of palliative care services and health conditions that would qualify beneficiaries for coverage under the category of “SB 1004 Palliative Care.” DHCS also acknowledged the need for additional palliative care options for children.

CCCC is in communications with DHCS and will be learning more about what this means for Medi-Cal MCP enrollees, and health plans and clinicians providing care for people on Medi-Cal.

SB 1004 legislation was inspired by the Nick Snow Children’s Hospice and Palliative Care Act (AB 1745), legislation that led to the Partners For Children (PFC) Pediatric Palliative Care Benefit under Medi-Cal. AB 1745 was championed by the Children’s Hospice & Palliative Care Coalition and CCCC.

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The Coalition for Compassionate Care of California (CCCC) is an interdisciplinary partnership of thought-leaders from healthcare systems and organizations, government agencies, consumer organizations, and individuals working together to promote high-quality, compassionate palliative and end-of-life care for all Californians. Since 1998, CCCC has been working to transform healthcare so that medical care is aligned with individual patient preferences—that people get the care they need and no less, and the care they want and no more. Through advocacy, education, and resource development, CCCC is working to ensure that organizations and communities have the information, knowledge and tools to increase access to advance care planning and palliative care.