Staff
Mark Newton
(916) 319-8323
Deputy Legislative Analyst: Health, Developmental Services, and Technology
Jason Constantouros
(916) 319-8322
Medi-Cal/Managed Care/Family Health/Health Care Affordability and Workforce Development
Brian Metzker
(916) 319-8354
Privacy, Security, and Technology
Ryan Miller
(916) 319-8356
Medi-Cal/Behavioral Health/Covered California/CalHHS Agency Issues
Angela Short
(916) 319-8309
Child Welfare, Child Support, Community Services and Development, Community Care Licensing, CalSTRS
Karina Hendren
(916) 319-8352
Medi-Cal/Long-Term Care/Developmental Services
Will Owens
(916) 319-8341
Public Health/Behavioral Health/State Hospitals
Sonia Schrager Russo
(916) 319-8361
CalWORKs/CalFresh
Juwan Trotter
(916) 319-8358
In-Home Supportive Services/Aging Programs
Ginni Bella Navarre
(916) 319-8342
Deputy Legislative Analyst: Human Services and Governance


Publications

Health and Human Services

To browse all LAO publications, visit our Publications page.



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The 2018-19 Budget: Evaluating FI$Cal

March 2, 2018 - In this analysis, we describe the Financial Information System for California (FI$Cal) Project and the major changes to the project based on the newly released Special Project Report (SPR). We also describe the Governor’s 2018-19 budget proposal to fund activities associated with the new SPR at the State Controller’s Office. Finally, we make associated findings and recommendations.


Report

The 2018-19 Budget: The Administration’s Proposition 55 Estimates

March 1, 2018 - Proposition 55 (2016) aimed to increase funding for Medi-Cal under a formula administered by the Department of Finance. In 2018-19, the first year of implementation of this calculation, the administration’s interpretations and estimates result in no additional funds to Medi-Cal. Two key choices lead to this result. First, the administration’s decision to subtract $3.5 billion from available revenues to account for its proposed optional reserve deposit significantly reduces the calculation’s starting point, eliminating a surplus that would have directed funds to Medi-Cal. Second, the administration’s workload budget approach is based on a broad definition of currently authorized services, which also has the effect of reducing the amount of potential funds for Medi-Cal under the measure. Different decisions about these two features of the measure could result in more or less funding for Medi-Cal by hundreds of millions—or even billions—of dollars in the future.


Report

The 2018-19 Budget: Analysis of the Health and Human Services Budget

February 16, 2018 - In this report we provide a broad overview of the Governor's health and human services budget, highlighting major year-over-year changes. We then provide a more in-depth analysis of select programmatic areas.


Handout

Overview of Select Safety Net Programs: SSI/SSP, CalFresh, and CalWORKs

February 14, 2018 - Presented to: Senate Budget and Fiscal Review Committee


Handout

Financing Considerations for Potential State Healthcare Policy Changes

February 5, 2018 - Assembly Select Committee on Health Care Delivery Systems and Universal Coverage.

2/5/18: Correction to Figure 3.


Report

Sequestering Savings From the Closure of Developmental Centers

January 31, 2018 - In this report, we (1) provide brief background information about Developmental Center (DC) closures and the Department of Developmental Services budget, (2) discuss potential savings in terms of net operational savings and increased revenues from the sale or repurposing (specifically leasing) of DC properties, and (3) address other practical implications and trade‑offs of the proposal.


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Recent Congressional Action on the Children’s Health Insurance Program (CHIP)

January 23, 2018 - Recent Congressional action appropriates funding for the Children’s Health Insurance Program (CHIP) through federal fiscal year 2022-23. The federal cost share authorized by Congress for the program is higher than what was assumed in the Governor’s budget. These actions reduce estimated General Fund Medi-Cal costs by about $300 million in 2017-18 and about $600 million in 2018-19. As a result, we anticipate the May Revision will reflect $900 million in lower General Fund expenditures, and an equal amount of resources available for any purpose.

Updated 2/9/18: On Friday, February 9, 2018, Congress appropriated additional funding for CHIP through FFY 2026-27 at states' traditional cost share which, in California, is 35 percent. No changes were made to the previous reauthorization of CHIP funding through FFY 2022-23, discussed in this post.

Updated 2/9/18: Figure 1 updated to include Governor's funding assumptions through 2021‑22.


Report

The Potential Effects of Ending the SSI Cash-Out

January 8, 2018 - The Supplemental Report of the 2017-18 Budget Act directed our office to report on the programmatic and fiscal implications of ending a long-standing state policy that provides Supplemental Security Income/State Supplementary Payment (SSI/SSP) recipients an extra $10 payment in lieu of their being eligible to receive federal food benefits through California’s CalFresh program. This is known as the SSI cash-out (or the CalFresh cash-out). In this report, we (1) describe how ending the SSI cash-out would affect households differently, (2) discuss the estimated statewide net effect of ending the SSI cash-out on federal food benefits drawn down by the state and how any variation in the underlying assumptions can create significantly different estimates, (3) provide examples of how ending the SSI cash-out would affect the poverty status of certain households, and (4) as directed by the Supplemental Report, discuss potential options the Legislature could consider to hold households negatively affected by the elimination of the SSI cash-out harmless and present additional issues that merit legislative consideration.


Report

Evaluation of the Statewide Project Management Office

December 7, 2017 - In this report, we provide background regarding the objectives and operations of the Project Management Office (PMO), detail our findings in evaluating the PMO, introduce two significant recent developments and their impacts on the PMO, and make associated recommendations on how the Legislature should proceed to better align the office with the original legislative intent.


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Fiscal Outlook: Developmental Services

November 15, 2017 - This web post provides information about the fiscal outlook for the Department of Developmental Services from 2017-18 through 2021-22. It also considers the fiscal impact of the closure of state-run Developmental Centers, which will occur over the outlook period.

This is part of a collection of material for The 2018-19 Budget: California’s Fiscal Outlook. See a complete list of this year's fiscal outlook material on our fiscal outlook budget page.


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Fiscal Outlook: Medi-Cal

November 15, 2017 - This online post discusses the major factors that we project will impact General Fund spending in Medi-Cal from 2017-18 to 2021-22.

This is part of a collection of material for The 2018-19 Budget: California’s Fiscal Outlook. See a complete list of this year's fiscal outlook material on our fiscal outlook budget page.


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Fiscal Outlook: In-Home Supportive Services (IHSS)

November 15, 2017 - In this fiscal outlook post, we discuss our near- and long-term costs projections for the In-Home Supportive Services (IHSS) Program and significant cost drivers and savings.

This is part of a collection of material for The 2018-19 Budget: California’s Fiscal Outlook. See a complete list of this year's fiscal outlook material on our fiscal outlook budget page.


Handout

State Efforts to Address Youth Homelessness

October 10, 2017 - Presented to: Senate Human Services Committee and Assembly Human Services Committee.


Report

Measuring CalWORKs Performance

September 6, 2017 - Currently, performance measurement in the California Work Opportunity and Responsibility to Kids (CalWORKs) program is relatively limited and largely focuses on processes involved with the program's operation—particular emphasis is given to a federal performance measure known as the "work participation rate" (WPR)—rather than on the program's end results, or outcomes. As part of the 2017-18 budget package, the Legislature adopted a new framework for performance measurement in CalWORKs that will be known as the CalWORKs Outcomes and Accountability Review (Cal-OAR). In this report, we outline the rationales for measuring program performance and outline why, ideally, performance measurement should focus on outcomes. We then raise several issues to be considered as the Cal-OAR system is further developed and implemented in the coming years.


Handout

Health and Human Services Agenda Item 4260-101-3305—Proposition 56 Medi-Cal Spending

June 7, 2017 - Presented to Budget Conference Committee