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California

Medi-Cal official to leave healthcare post in January

Health coverage
Healthcare coverage applicants in Los Angeles, 2012. The director of California’s Department of Health Care Services, Toby Douglas, said Friday that he would leave his post in January. Around 11 million Californians are enrolled in Medi-Cal, the state’s healthcare program for the poor.
(Michael Robinson Chavez / Los Angeles Times)

The official who led California’s giant public healthcare services department through a tumultuous implementation of Obamacare reforms -- including a months-long period during which hundreds of thousands of Medicaid applications have languished, waiting to be processed -- will depart his position in January, state officials have announced.

Toby Douglas directed the state’s $91-billion Department of Health Care Services for four years, a period of “unprecedented change and growth as California embraced the Affordable Care Act,” said state Health and Human Services Secretary Diana S. Dooley in a letter to colleagues Friday.

During Douglas’ tenure, Dooley wrote, the state’s healthcare program for the poor, known as Medi-Cal, began transforming into a managed care system and added 3.5 million new beneficiaries, growing to nearly 11 million members in all -- an expansion that has been heralded by healthcare advocates.

“That’s staggering,” said Anthony Wright, executive director of the advocacy group Health Access. “It’s more than a quarter of the state.”

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At the same time, advocates and officials have roundly criticized Douglas and his agency for problems that emerged during the healthcare expansion, including a months-long backlog in processing Medi-Cal applications because of troubles getting state and county computer systems to communicate.

In May, bottlenecked applications reached 900,000; by July, after the federal government and advocacy groups wrote letters to Douglas demanding plans to solve the problem, the number had been whittled down to 600,000.

This week, according to the health services department, 350,000 applications remained in limbo. Some waiting applicants, worried about costs, have delayed seeking medical care, advocates say. 

Critics, including state Assemblyman Richard Pan (D-Sacramento), have also targeted the agency for a lack of accountability and transparency, and have challenged the low reimbursement rates Medi-Cal offers participating doctors. On Friday, however, Pan praised Douglas’s work, saying that the enormity of implementing healthcare reforms and persistent budget challenges had contributed to “difficult times” for the department.

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“He worked hard in a challenging environment,” Pan said.

In an interview with The Times on Friday, Douglas said that he had left his job voluntarily and that he was proud of his track record expanding and improving Medi-Cal.

“Now we have healthcare plans that are accountable,” he said of the shift to managed care. “People aren’t just getting a Medi-Cal card, they’re getting a healthcare system.”

Douglas said he had not yet secured his next job, but that he planned to continue working in healthcare in California.

The search for a new director would begin shortly, Dooley said.

For more on healthcare, follow me on Twitter: @LATerynbrown


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