California’s Eight Health Entities: What’s the Difference?

California has eight health-related entities: Health and Human Services Agency, Department of Managed Health Care, Department of Health Care Services, Department of Public Health, Office of Health Information Integrity, California Health Facilities Financing Authority, Office of Statewide Health Planning and Development, and California Health Benefit Exchange. What’s the difference?

Health and Human Services Agency

Government Code Title 2, Division 3, Part 2.5, Chapter 1, Section 12806 provides that the California Health and Human Services Agency succeeds to and is vested with all of the duties, powers, responsibilities, and jurisdiction vested in the prior Health and Welfare Agency.

Department of Managed Health Care

Health and Safety Code Division 2, Chapter 2.2, Article 1, Section 1341 specifies that there is in state government, in the California Health and Human Services Agency, a Department of Managed Health Care that is charged with executing the laws of California related to health care service plans and their business. The chief officer of the DMC is the Director, who is appointed by the Governor and holds office at the Governor’s pleasure.

Pursuant to Section 1342.6, it is the intent of the Legislature to ensure that the citizens of this state receive high-quality health care coverage in the most efficient and cost-effective manner possible. In furtherance of this intent, the Legislature finds and declares that it is in the public interest to promote various types of contracts between public or private payers of health care coverage, and institutional or professional providers of health care services.

Department of Health Care Services

Health and Safety Code Division 101, Part 1, in Sections 100100 to 100922 provides for the California Department of Health Services. Chapter 1 concerns the organization of the DHCS. Section 100100 states that there is in the state government, in the California Health and Human Services Agency, a State Department of Health Care Services.

Pursuant to Section 100105, the DHCS is under the control of an executive officer known as the Director of Health Care Services, who is appointed by the Governor and confirmed by the State Senate. The director can appoint two chief deputies. Per Section 100115, there is a Division of Rural Health.

Department of Public Health

Health and Safety Code Division 112, Part 1, Chapter 1 specifies the organization of the State Department of Public Health in Sections 131000 to 131020. Section 131000 specifies that there is in the California Health and Human Service Agency a State Department of Public Health.

Office of Health Information Integrity

Health and Safety Code Division 109 created the Office of Health Information Integrity in Section 130200. Section 130220 specifies that there is established within the California Health and Human Services Agency the Office of Health Information Integrity to ensure the enforcement of state law mandating the confidentiality of medical information. In addition, the Office is administered by a director who is appointed by the Secretary of California Health and Human Services.

California Health Facilities Financing Authority

Government Code Title 2, Division 3, Part 7.2 establishes the Health Facilities Financing Authority Act. Section 15430 is the citation to the Act. Section 15431 provides that the California Health Facilities Authority is continued in state government as the California Health Facilities Financing Authority, which constitutes a “public instrumentality” and the exercise of its powers are deemed to be performing an essential public function.

Section 15438.6 created the Cedillo-Alarcon Community Clinic Investment Act of 2000. As part of this Act, the Legislature made certain findings and declarations. Among others, the states the Authority may award grants to any eligible clinic for purposes of financing capital outlay projects. The maximum grant amount is $250,000.

Office of Statewide Health Planning and Development

Health and Safety Code Division 107, Part 1 establishes the Office of Statewide Health Planning and Development in Section 127000 to 127050. Chapter 1 contains general provisions and Section 127000 provides that there is in the state government, in the Health and Human Services Agency, an Office of Statewide Health Planning and Development.

Pursuant to Section 127005, OSHPD is under the control of an executive officer known as the Director of Statewide Health Planning and Development, who is appointed by the Governor and confirmed by the State Senate. OSHPD succeeded to the duties, powers, and jurisdiction of the State Department of Health relating to health planning and research development, as well as the Facilities Construction Unit.

California Health Benefit Exchange

Government Code Title 22 provides for the California Health Benefit Exchange in Sections 100500 to 100522. Section 100500 specifies that there is in state government the California Health Benefit Exchange, which is an independent public entity not affiliated with any other agency or department and it known as Covered California.

Covered California is governed by an executive board consisting of five members who are residents of California. Of the members of the board, two are appointed by the Governor, one is appointed by the Senate Committee Rules, and one is appointed by the Speaker of the Assembly. The Secretary of the California Health and Human Services Agency serves as a voting, ex officio member of the board.

These board members are appointed for a term of four years and these appointees must have demonstrated and acknowledged expertise in at least two areas, such as health care coverage, benefits and plan administration, administering a health care delivery system, marketing insurance products, IT systems, etc.

Among other responsibilities, the board is responsible for using the funds awarded by the United States Secretary of Health and Human Services for planning and establishing the Exchange.