Children face long waits for behavioral healthcare through California Medicaid, audit finds

Many children face long wait times for behavioral health appointments, a California state audit found. 

The audit, published Nov. 28, found children with Medi-Cal coverage often had to wait longer for urgent psychiatry appointments than state standards allow. Over 40% of urgent psychiatry appointments had wait times longer than 96 hours, and for those wait times that exceeded the limit, patients had to wait an average of 13 days for urgent visits. 

Medi-Cal, the largest Medicaid program in the country, serves 5.7 million people under 21, according to the audit. 

The state's healthcare services department also approved unrealistic standards for network adequacy, according to the audit, sometimes requiring children to travel up to two hours to receive care. 

The healthcare services department also had weaknesses in its surveys of Medicaid managed care provider networks and access adequacy, including failing to measure how many plans met 48-hour wait time standards for urgent appointments. 

The California state auditor recommended the healthcare services department improve its survey methodologies to monitor 48-hour standards and develop a new methodology to calculate provider-to-member ratios requirements for outpatient behavioral health providers. 

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