Overview

• Expenditure Proposal and Trends
• Caseload Trends
• Spending by Major Program
• Major Budget Changes

Crosscutting Issues

• Healthy Families Program
• New Program to Expand Health Coverage for Children
• Federal Legislation Provides New Funding
• California's Healthy Families Program Enacted
• The Budget Request
• Governor's Budget Proposes Net Spending Total of $197 million in 1998-99
• Analysis and Recommendations
• $1.4 Billion of Federal Funds Will Roll Forward
• Federal Approval of Continuing Eligibility in Doubt
• Requiring Children in the CCS Program to Enroll in The Healthy Families Program Would Result in Savings
• Including Regional Center Services As a Healthy Families Benefit Should Be Explored

Departmental Issues

• Department of Aging (4170)
• Proposed Expansion Would Not Allocate Funds According to Need
• Budget Does Not Reflect Savings From an Increase in Federal Funds
• Department of Alcohol And Drug Programs (4200)
• Budget Does Not Reflect Increase In Federal Medi-Cal Sharing Ratio
• Department of Health Services State Operations (4260)
• Armed and Over Budget
• Filling Positions Would Generate Savings
• Phantom Positions Undermine Legislative Oversight
• California Medical Assistance Program (Medi-Cal)
• Medi-Cal Benefits And Eligibility
• What Benefits Does Medi-Cal Provide?
• How Medi-Cal Works
• Who Is Eligible for Medi-Cal?
• Medi-Cal Expenditures
• 1997-98 Budget Savings
• Budget Year
• Medi-Cal Spending and Caseload Trends
• Spending Trends
• Caseload Declines Change Case "Mix"
• The Medi-Cal Estimate
• Medi-Cal Estimate Includes Adjustments for Shift to Managed Care
• Savings From Uncertainty Adjustments Appear Arbitrary
• County Administration Estimate-- Caseload Growth Funding Unnecessary
• Expanding Medi-Cal Coverage For Poor Working Families
• Are Transitional Medi-Cal Participation Rates Too Low?
• Additional Year of Transitional Medi-Cal in Doubt
• Plan Needed for Implementing Medi-Cal Eligibility Under Section 1931(b)
• Augmentation for 1931(b) Eligibility Determinations Not Justified
• Long-Term Care
• Department Plans New Payment Approach for Nursing Homes
• Public Health
• Proposition 99
• Family Education Proposal--Redirecting Funds to Existing Program Would Increase Chances of Success
• Childhood Lead Poisoning Prevention Program
• Administration Renews Request to Implement Federal Abstinence Education Program
• Funding Alternatives Available for Emerging Infectious Diseases and Food Safety Programs
• Newborn Hearing Screening Proposal Has Merit, But Cost Estimate Needs Justification
• California's Litigation Against the Tobacco Companies
• Department of Developmental Services (4300)
• Community Services Program
• Proposal to Augment Regional Center Case Management Staff Is Incomplete
• Proposed Position "Upgrades" and Salaries Are Excessive
• Care Facility Training Program Is Overbudgeted
• Federal Waiver for Habilitation Services Could Result in State Savings
• Legislature Needs More Information On Supported Living Augmentation
• Technical Issue--Case Management For Community Placements Overbudgeted
• Placement Decisions for DC Residents Should Be Reviewed
• Continue Funding for Camarillo Maintenance
• New Nursing Staff Should Be Budgeted at First Salary Step

• Department of Mental Health (4440)
• Inflation Increase Overbudgeted
• Employment Development Department (5100)
• Federal Welfare-to-Work Block Grant Program
• Background
• Governor's Proposal
• Legislature Has Options
• Department of Rehabilitation (5160)
• Governor's Proposal Does Not Fund Statutory Rate Increase
• Caseload Projections Do Not Reflect Trends
• Legislative Oversight: Delay in Submission Of Supported Employment Cost Study
• Federal Waiver for Habilitation Services Could Result in State Savings
• Department of Social Services CalWORKs Program (5180)
• Current-Year Update of CalWORKs/TANF Program
• Major Changes in 1997-98
• Recent Federal Action on Welfare Reform
• 1998-99 Budget Issues
• Budget Proposes to Continue Past Grant Reduction and Eliminate Cost-of-Living Adjustment
• Defer Expenditure of State Match For Welfare-to-Work Program Until 1999-00
• Impact of Budget Reductions in CalWORKs
• Budget for CalWORKs Administration Does Not Reflect Savings From Projected Caseload Decline
• CalWORKs Employment Services Are Overbudgeted
• Establish a TANF Reserve

• Foster Care
• Budget Underestimates Proportion Of Cases Eligible for Federal Funds
• Child Support Enforcement
• Child Support Incentive Payment Systems
• The Current State Incentive System
• Mirroring the Proposed Federal System
• Evaluation of the Proposed Federal System
• An Alternative Incentive System
• Evaluation of the Legislative Analyst's Office Alternative Incentive System
• Impact of the Proposals on County Incentive Payments
• Legislative Analyst's Suggested "Performance Enhancement Process"
• Conclusion
• Budgeting Issues
• Budget Overestimates Child Support Incentive Payments
• Budget Overestimates Effect of Arrearage Distribution Changes
• Food Stamps Program
• California Food Assistance Program
• Supplemental Security Income/State Supplementary Program
• Caseload Growth Is Overestimated
• Budget Proposes to Eliminate State Cost-of-Living Adjustment

• In-Home Supportive Services
• State Plan Amendment Would Result in General Fund Savings
• Federal Funds Not Budgeted
• County Administration of Welfare Programs
• Food Stamps Budget Does Not Reflect Savings From Projected Caseload Decline
• Automation Projects
• Special Programs
• Licensed Maternity Home Care Program Overbudgeted
• Adoptions
• Budget Underestimates Proportion of AAP Cases Eligible for Federal Funds
• State May Earn Federal Adoptions Incentive Payments
• Community Care Licensing Division
• Use Special Fund Balances to Increase Technical Assistance and Achieve General Fund Savings