Comings and Goings, and Best Wishes

Big news today, as Toby Douglas, the director of the Department of Health Care Services, announced he would be leaving that post by the end of the year. For the last four years in that position, he ran Medi-Cal, which provides health care and coverage for a staggering 11 million Californians–more than a quarter of the state.

It was a surprise for many of us–we were with Toby all yesterday at an all-day Medi-Cal Stakeholders Advisory Committee, and he hid this news like a good poker player. The meeting provided updates on what will be his legacy at the Department: the shift of seniors and people with disabilities into coordinated and managed care, the budget cuts during the recession and the partial restoration of key benefits, the absorption of programs like Healthy Families, and most notably, the expansion of coverage and the other eligibility and enrollment changes under the Affordable Care Act. He talked about the need for the Department and Medi-Cal to grow and evolve, to meet a new mission and mandate.

The meeting, which we will post the notes from shortly, also delved deeply into two areas that he will start the work but leave unfinished for his successor: the work to ensure access to patients in Medi-Cal, with more rigorous reviews of network adequacy and timely access, and the discussion around a new 1115 waiver and negotiations with the federal government–the plan for Medi-Cal for the next five years, and the implementation of additional delivery system reform.

It’s hard to overstate the importance of Medi-Cal in general, of Toby’s job, and as part of the Affordable Care Act. Covered California may have been the bright shiny object, but Medi-Cal covered more people and could be seen as having greater successes (nearly 2 million enrollees, the Low-Income Health Programs and express lane enrollment) and failures (the still-pending 350,000 backlog of applications).

We are glad Toby is staying through the end of the year, to provide a good transition, and appreciate his work, and wish him well in whatever his new career offers.


Also this week, our former colleague Beth Abbott started as the new head of the Office of the Patient Advocate. We are excited about her tenure, and were happy to see these pictures of her getting sworn in by Health and Human Services Secretary Diana Dooley. We look forward to seeing who Secretary Dooley gets to swear in for the DHCS job in the beginning of 2015.