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May 8, 2013 - Presented to Senate Budget and Fiscal Review Subcommittee No. 3 on Health and Human Services
May 6, 2013 - Historically, the state has spent tens of millions of dollars annually from the General Fund for the California Department of Corrections and Rehabilitation (CDCR) to provide mental health treatment services to mentally ill parolees. Our analysis indicates that federal Medicaid reimbursements could be attained for some of the costs of these existing services. Moreover, the amount of federal reimbursements could increase significantly under the federal Patient Protection and Affordable Care Act (ACA) if the Legislature chooses to expand Medi-Cal to provide health coverage to most low-income individuals, as authorized by ACA. In order to maximize the federal reimbursements that will be available for parolee mental health treatment, especially if the state expands Medi-Cal eligibility, we recommend that CDCR (1) provide increased Medi-Cal application assistance for mentally ill parolees to ensure that all eligible parolees are enrolled, (2) develop a process—in collaboration with the Department of Health Care Services (DHCS)—to claim federal reimbursement for the costs of assisting inmates with benefits applications, and (3) develop a process—in collaboration with DHCS—to claim federal reimbursement for parolee mental health treatment services provided to parolees. If the state took these steps, we estimate it could achieve net General Fund savings of about $6 million in 2013-14 and $28 million annually upon full implementation in 2014-15 (assuming the state implements the Medi-Cal expansion).
April 17, 2013 - Presented to Assembly Budget Subcommittee No. 5 on Public Safety
April 3, 2013 - Presented to: Assembly Budget Subcommittee No. 5 on Public Safety
March 14, 2013 - Presented to: Senate Budget Subcommittee No. 5 on Corrections, Public Safety and the Judiciary Hon. Loni Hancock, Chair
February 15, 2013 - The Governor’s 2013-14 budget for criminal justice programs is relatively flat. It contains few major proposals for the judiciary or corrections compared with recent years when the state budget included significant budget cuts to programs, as well as major policy changes. In total, the Governor's budget provides $13.2 billion for criminal justice programs in 2013-14. This is an increase of about 2 percent over estimated current-year expenditures. In this report, we review the Governor’s 2013-14 budget proposals for criminal justice programs, including the judicial branch, California Department of Corrections and Rehabilitation, Board of State and Community Corrections, and the Department of Justice. We identify concerns with several of the proposals and make recommendations for legislative consideration. In some cases, we identify proposals that we think should be rejected or modified, resulting in several million dollars of General Fund savings. We also identify several issues that we think would benefit from additional legislative oversight. These include (1) how trial courts will implement budget reductions in coming years, particularly in the absence of reserves beginning in 2014-15, (2) the new staffing methodology being implemented by the federal court-appointed Receiver currently managing the state’s inmate medical system, and (3) efforts by the Board of State and Community Corrections to meet its statutory mission to assist local agencies improve criminal justice outcomes through technical assistance and data collection.
February 5, 2013 - Since 1997, federal policy has made it possible to draw down federal Medicaid reimbursement for off-site inpatient health care services for eligible state prison inmates. Most recently, the Patient Protection and Affordable Care Act and the associated Low-Income Health Program (LIHP) created as part of the state's "Bridge to Reform Waiver" have expanded the number of inmates eligible for the state's Medicaid program (known as Medi-Cal) and have increased the total amount of reimbursements the state can receive. Our research finds that while the state has recently developed a process for obtaining federal funds for such services, the state has been unable to maximize the available federal funding. In particular, the federal court-appointed Receiver overseeing prison medical care has been unable to secure memoranda of understanding (MOUs) with certain counties to enroll inmates in their LIHPs. In addition, the Department of Health Care Services (DHCS) has been unable to process certain claims for federal reimbursement because of technical and quality control problems. In order to ensure that the state maximizes the available federal funding, we recommend that the Legislature (1) hold budget hearings to identify and resolve any remaining obstacles preventing the Receiver from securing MOUs with counties to enroll inmates in their LIHPs, and (2) require DHCS to report on its efforts to address problems that are preventing certain claims for federal reimbursement from being successfully processed.
January 17, 2013 - In recent years, the state has passed various laws altering the state's criminal justice system. Most notably, in 2011, the state shifted--or "realigned"--responsibility to house and supervise tens of thousands of adult felons from the state to local governments. Major policy changes such as the 2011 realignment, as well as others, are likely to raise numerous questions from policymakers, practitioners, and the public regarding those policies' impacts on public safety and costs. Consequently, we are releasing an updated version of our 2007 report California's Criminal Justice System: A Primer. This report includes key statistics on crime rates, adult and juvenile arrests, prosecutions in the criminal courts, and state and local corrections in California. Where possible, this information is provided through 2011, providing readers with a picture of the state's criminal justice system prior to the full implementation of the 2011 realignment, against which they can evaluate how the system changed following realignment (such as in terms of crime rates, court caseloads, and correctional populations). This report also includes in-depth discussions of some of the most important criminal justice issues likely to face policymakers in coming years.
November 8, 2012 - In recent years, the state has entered into public-private partnerships (P3) to finance, design, construct, operate, and maintain two state infrastructure projects in order to achieve benefits that they might not have obtained under a more traditional procurement approach. In this report, we find that the P3 practices of these recent projects are not necessarily aligned with the P3 best practices identified in research. Based on our findings, we identify several opportunities for the state to further maximize its benefits when deciding to procure a state infrastructure project as a P3. Specifically, we recommend that the Legislature (1) specify P3 project selection criteria in statute, (2) require a comparative analysis of a range of procurement options in order to better determine which procurement option would most effectively benefit the state, (3) require the existing Public Infrastructure Advisory Commission (PIAC) to approve state P3 projects, and (4) modify the structure and responsibilities of PIAC to better provide state expertise on P3s.
May 16, 2012 - In April 2012, the California Department of Corrections and Rehabilitation (CDCR) released a report (referred to as the “blueprint”) on the administration’s plan to reorganize various aspects of CDCR operations, facilities, and budgets in response to the effects of the 2011 realignment of adult offenders, as well as to meet various federal court requirements (such as reducing the inmate population to meet specified population cap targets). In this brief we (1) summarize and assess the major aspects of the blueprint and (2) present alternative approaches that are available to the Legislature. In our view, much of the administration’s blueprint merits legislative consideration. However, the General Fund costs of the planned approach—in particular, an estimated $78 million in annual debt service—is a significant tradeoff. We find that the state could meet its facility requirements (including those for medical and mental health treatment) and specified population cap targets at much lower ongoing General Fund costs than proposed by the administration, potentially saving the state as much as a billion dollars over the next seven years.
April 19, 2012 - In 2006, after finding that California had failed to provide a constitutional level of medical care to its inmates, a federal court appointed a Receiver to take over the direct management and operation of the state's inmate medical care program from the California Department of Corrections and Rehabilitation (CDCR). Since that time, the current and prior Receiver have taken a variety of actions to revamp CDCR's medical program. In this report, we (1) provide a status report on the Receiver’s actions, (2) describe how these actions have impacted inmate medical care spending and outcomes, (3) discuss the experiences of other states that have faced problems similar to California’s in delivering inmate medical care, and (4) provide recommendations for delivering a constitutional level of inmate medical care in the most cost-effective manner as possible in the long run. These recommendations include establishing an independent oversight board, taking steps to address current operational efficiencies to bring state expenditures to a more sustainable level, and establishing a pilot project to contract for medical care services.
April 13, 2012 - Over the last four years, the judicial branch has experienced various one–time and ongoing budget reductions as the state has faced large budget shortfalls. The Governor's 2012–13 budget continues the ongoing reduction to the branch, provides the Judicial Council with full authority to implement the reduction among branch entities, and proposes increasing civil fees to generate $50 million in new revenues to help the branch address their reduction. To the extent the Legislature approves the Governor's proposal, ongoing solutions should be identified and implemented in 2012–13, particularly since recent transfers and loans from branch special funds have greatly reduced the fund balances available as a potential budget solution. Specifically, we recommend the Legislature reject the Governor's proposed budget bill language authorizing the Judicial Council to allocate the reductions, adopt specific actions to achieve ongoing savings in the judicial branch, and require that the judicial branch submit a report on potential operational efficiencies.
March 22, 2012 - Presented to: Senate Budget Subcommittee No. 5 on Corrections, Public Safety and the Judiciary Hon. Loni Hancock, Chair
March 14, 2012 - Presented to: Assembly Budget Subcommittee No. 4 on State Administration Hon. Joan Buchanan, Chair Assembly Budget Subcommittee No. 5 on Public Safety Hon. Gilbert Cedillo, Chair
February 23, 2012 - In 2011, the state enacted several bills to realign to county governments the responsibility for certain felon offenders who previously had been eligible for state prison and parole. These changes will significantly reduce the inmate and parole populations managed by CDCR. This report identifies the impacts of the realignment of adult offenders on CDCR's operations and facility needs, discusses whether realignment will enable the state to meet the prison population limit required by the federal court, as well as whether the change in the makeup of CDCR's inmate population following realignment will affect its housing, mental health, and medical facility needs. The report provides recommendations on how to better match CDCR facilities and programs with the remaining inmate population following the realignment.