EL DORADO COUNTY, Calif. – The El Dorado County Grand Jury has submitted its report on the County’s Health and Human Services Agency (HHSA). They discovered
staffing issues with Medi-Cal Eligibility Specialists that led to challenges for clients, including delays in service and the inability to move to other health plans. The Medi-Cal program is administered by HHSA.

The Grand Jury highlighted four key issues:

  • The Continuous Enrollment clause (2020-2023) in a state-mandated policy during Covid-19 overwhelmed staff with enrollment updates after the policy ended.
  • Salary inequities compared to neighboring counties.
  • Lack of metrics for staffing and productivity.
  • A 6-month training program with a low completion rate.

The Grand Jury recommends that the County urgently needs to evaluate and increase HHSA Eligibility Specialists’ pay and benefits to compete with similar county agencies which regularly hire staff away. We also recommend that the County develop and deploy metrics and tools for evaluating staff, productivity, and turnover rates.

The Grand Jury investigates complaints, and they had received a complaint which stated that clients could not disenroll from the program and that repeated inquiries to the County were unanswered. The complaint warranted a deeper investigation into the County’s ability to process Medi-Cal clients effectively. HHSA has three Medi-Cal support locations in South Lake Tahoe, Placerville, and Shingle Springs. There
are many Medi-Cal support locations in neighboring counties, including six locations in Sacramento County, that attract experienced employees from our West Slope locations.

El Dorado County has an average Eligibility Specialist-I pay of $43,822.29 and $49,843.24 for Eligibility Specialist-II. In comparison, Placer County pays their Eligibility Specialist-I an average of $46.978.20 and $61,808.26 Eligibility Specialist-II. Calavaras County doesn’t have a ESI, but pays its ESII $55.962.37.

The Grand Jury found the current staffing of the HHSA Medi-Cal division is inadequate, unable to keep up with the workload from post-Covid disenrollment requests, and many employees are leaving because of the lower pay; The Medi-Cal eligibility specialist is a challenging position and difficult to identify and hire
candidates. Onboarded employees require six months of training, with roughly 50 percent of those completing the process. HHSA doesn’t track the exact numbers; HHSA does not currently have a system for tracking Medi-Cal eligibility specialist staff productivity; The HR system does not track turnover rates, which should include documentation for reason for leaving, and which would provide greater insight to staff shortages and how to improve hiring and retention rates; Several counties have implemented the use of lower cost call centers to address basic
inquiries for greater efficiency and referring enrollment steps to eligibility specialists. Currently El Dorado County relies on eligibility specialists to manage all tasks associated with inquiries to the department and calls from clients to their case workers, increasing their workload.

The report now goes to the El Dorado County Board of Supervisors (BOS).

The Grand Jury suggests the BOS:

  • Direct Human Resources to conduct a compensation study for the Eligibility Specialist classification and ensure that total compensation is competitive with neighboring counties by August 30, 2025.
  • Direct HHSA to implement a process, such as utilizing a software system, to track and evaluate eligibility specialist staff performance and productivity by end of 2025.
  • Direct Human Resources to investigate software systems that can track employee turnover and reasons for resignations/terminations by end of 2025. This information should be employed to determine future efforts to address staffing issues and shared periodically with the Board of Supervisors.
  • Direct HHSA to develop a plan by end of 2025 to review the costs and benefits of a call center approach to complement eligibility specialty staff.

To look at the full Grand Jury report on HHSA, visit HERE.