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March 1, 2012 - Presented to Senate Budget and Fiscal Review Committee, Hon. Mark Leno, Chair
February 29, 2012 - Presented to Assembly Budget Subcommittee No. 1 on Health and Human Services, Hon. Holly J. Mitchell, Chair
February 22, 2012 - The Governor proposes to reduce funding for the CalWORKs program and state-subsidized child care programs. Under his budget plan, these programs would be reduced a total of $1.4 billion or about 20 percent in 2012-13 compared to what current law otherwise would require. These savings would be achieved by imposing stricter limits on which families are eligible to receive which types of services, as well as lowering state payments for CalWORKs recipients and child care providers. Additionally, the Governor’s proposal would make major changes to the way the state administers both welfare-to-work and child care services. In this report, we describe and analyze the Governor’s proposals related to the CalWORKs program and then turn to a similar discussion of the proposed changes to child care programs. We conclude by providing the Legislature with illustrative packages of ways to achieve savings in these two areas using different approaches than the Governor's.
February 21, 2012 - Presented to: Joint Oversight Hearing of the Assembly and Senate Health Committees and Assembly and Senate Budget Subcommittees on Health and Human Services Hons. Bill Monning and Ed Hernandez, Chairs, Assembly and Senate Health Committees Hons. Holly Mitchell and Mark DeSaulnier, Chairs, Assembly and Senate Budget Subcommittees on Health and Human Services
February 21, 2012 - Presented to: Joint Oversight Hearing of the Assembly and Senate Health Committees and Assembly and Senate Budget Subcommittees on Health and Human Services
February 17, 2012 - As part of the 2012-13 budget, the Governor proposes to reduce the negotiated rates paid to Healthy Families Program (HFP) managed care plans and shift the children enrolled in HFP to Medi-Cal over a nine-month period. In this report, we provide background information on HFP and Medi-Cal and how they will be affected by implementation of federal health care reform. We discuss the potential merits of the Governor’s proposal, but raise several implementation issues and concerns. Specifically, the savings in the budget year may be less than the administration’s estimates, and the proposal will disrupt healthcare services for some HFP enrollees and may impact access to providers. Finally, we make recommendations that encourage the consideration of alternatives to the Governor’s plan.
February 17, 2012 - California’s system for providing health and social services to low-income seniors and persons with disabilities (SPDs) receiving Medicare and/or Medi-Cal is not coordinated. This lack of care coordination may lead to SPDs being unnecessarily hospitalized or placed in skilled nursing facilities rather than remaining in their own homes—resulting in poor outcomes for recipients and higher costs for the federal and state governments. As part of the 2012-13 budget, the Governor attempts to address this issue by proposing to integrate health and social services into managed care for most SPDs. In this report, we provide background information on the Medi-Cal and Medicare Programs and describe recent federal and state legislation to address fragmented care delivery. We discuss the potential merits of the Governor’s proposal, but raise several implementation issues and concerns. Finally, we make recommendations that encourage care coordination for SPDs by first completing and evaluating a currently authorized integrated care demonstration project in four counties rather than expanding the demonstration statewide as proposed by the Governor— an action that we think is premature. We also encourage the consideration of other ways to test the integration of benefits for SPDs.
February 13, 2012 - Currently, three automation systems make up California’s Statewide Automated Welfare System (SAWS). These systems support some of the state’s major health and human services programs by providing eligibility determination, case maintenance, and reporting functions at the county level. Chapter 13, Statutes of 2011 (ABX1 16, Blumenfield) directs the administration to reduce this number to two by migrating, or moving, counties on an existing system to Los Angeles County’s new system. In this report, we identify several issues for the Legislature to consider as the administration pursues legislative goals for SAWS consolidation. We offer alternative procurement approaches for the migration that would encourage greater vendor competition. Finally, we make several recommendations to enhance legislative oversight and clarify legislative priorities for SAWS consolidation.
January 3, 2012 - Over the past several years, the state has experienced waitlists in county jails to transfer those deemed incompetent to stand trial (IST) to state hospitals for treatment. In response to the waitlist, which averages between 200 and 300 individuals a month, the Department of Mental Health began a pilot program in San Bernardino County to treat ISTs in county jail instead of at a state hospital. This report finds that the pilot program has greater flexibility to hold down costs and has been able to restore ISTs to competency in a shorter amount of time than state hospitals. We find that if the pilot program is expanded, it has the potential to significantly reduce the waitlist, as well as reduce costs to the public sector.
September 29, 2011 - An Overview of Federal Funding in California
June 28, 2011 - Assembly Committee on Human Services and Assembly Select Committee on Foster Care Hon. Jim Beall, Chair
May 10, 2011 - Presented to: Senate Committee on Human Services Hon. Carol Liu, Chair
February 2, 2011 - Senate Budget and Fiscal Review Subcommittee No. 5 On Corrections, Public Safety and the Judiciary Hon. Loni Hancock, Chair
February 2, 2011 - The Governor proposes $1.5 billion in budget solutions for CalWORKs. In this handout we summarize the Governor’s proposals, assess their impacts, and present alternative approaches to achieving General Fund savings in CalWORKs. Presented to: Assembly Budget Subcommittee No. 1 On Health and Human Services Hon. Holly Mitchell, Chair
February 1, 2011 - Total expenditures for the regional center system that provides services for persons with developmental disabilities more than doubled between 1999-00 and 2009-10, leading to a series of actions by the Legislature to slow down the growth in the program. In this report, we describe and assess proposals in the Governor’s 2011-12 budget plan to achieve further cost containment in programs administered by the Department of Developmental Services, including community services. We recommend approval of the Governor’s budget proposals to (1) extend the 4.25 percent provider payment reduction and the commensurate reduction to regional center (RC) operations, and (2) obtain additional federal funds for services provided through the developmental centers and the RCs. We also recommend the Legislature either expand the existing Family Cost Participation Program or implement means testing to determine who is eligible to receive these state services.These changes, we would acknowledge, represent a significant departure from the policies originally adopted in the Lanterman Act but would help ensure the long-term sustainability of the program for those consumers with the greatest financial need for its services.