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Medi-Cal phone lines are overwhelmed

Posted 8 years 288 days ago ago by   

Sacramento Bee -- Thousands of calls to California’s Medi-Cal complaint lines don’t get through, and thousands more that manage to ring the call center go unanswered, according to a new state audit.

For the year that ended in January 2015, the phone system to the Medi-Cal Ombudsman Office rejected up to 45,000 calls in a month, State Auditor Elaine Howle said in her report to lawmakers.

Of the calls that did get through, only one-third and one-half were handled by ombudsman staff each month.

“(B)etween February 2014 and January 2015, an average of 12,500 additional calls went unanswered,” the audit states. A department official blamed the unrelenting backlog and unanswered calls on inadequate staffing and “hardware limitations” that cause the call database to crash “frequently, resulting in loss of data.”

The Medi-Cal telephone miscues conjure up memories of the Employment Development Department’s overwhelmed call center lines in 2009 during the height of the Great Recession. A few years later, a rocky computer-system overhaul boosted call volumes to the CalPERS’ member help lines, where on-hold times ran up to two hours until an automated call-back system was launched.

Jennifer Kent, the director of Department of Health Care Services, which oversees Medi-Cal and related programs, said in a written response to the audit that a new telephone system has been purchased for the ombudsman’s office. It should be in place by September of this year, she wrote.

As for telephone staffing, Kent’s stated, the department “currently has a pending request with the Legislature to secure additional positions in 2015-16.”