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February 21, 2007 - The budget plan implements Chapter 241, Statutes of 2006 (SB 162, Ortiz) that creates a new Department of Public Health (DPH) and Department of Health Care Services (DHCS) from the existing Department of Health Services. We recommend the Legislature require the administration provide additional information to ensure cost neutrality as required under Chapter 241.
February 21, 2007 - We estimate a shift of veterans from Medi-Cal to the federal Veterans Administration (V.A.) health system could save the state up to $250 million annually, while providing those veterans with quality health care services. We recommend that California join 42 other states participating in a federal data matching process that would facilitate achieving these goals.
February 21, 2007 - We review the proposal for a net reduction of $25 million for Proposition 36 programs, discuss why this reduction might eventually result in increased prison costs, and recommend redirecting funds in order to support Proposition 36 programs at their current level.
February 21, 2007 - Although the quality assurance (QA) initiative for In Home Supportive Services (IHSS) has improved the accuracy and standardization of service hour authorizations by social workers, there are limited controls assuring that recipients receive their service hours in accordance with their case plan. We review the department’s implementation of the QA initiative, and provide recommendations to enhance program integrity and increase the likelihood that recipients receive services in accordance with their case plans.
February 21, 2007 - In order to increase work participation to avoid federal penalties, the Governor proposes new time limits and sanctions on children whose parents cannot or will not comply with CalWORKs work participation requirements. However, under the budget’s own assumptions, California will meet federal participation requirements by FFY 2008. Thus, these policy changes are not needed to avoid federal penalties, and we recommend their rejection. We offer an alternative to the Governor’s full-family sanction proposal.
February 21, 2007 - California has made significant changes in the CalWORKs program in order to increase work participation among recipients. Estimates by the administration of the participation increases associated with recent policy changes, in conjunction with the caseload reduction credit, suggest that California would likely be in compliance with federal work participation requirements in federal fiscal year 2008.
February 21, 2007 - In 2005 the Department of Finance (DOF) began an information technology (IT) project to replace the state’s budget system. After interviewing departments’ financial staff, DOF has concluded the project needs to be expanded because most state department automated financial systems are old and do not support modern financial reporting requirements. The Governor’s budget proposes a $1.3 billion IT project over the next decade to develop a statewide financial system that would be used by all departments. Our analysis discusses the primary components of this project proposal, key issues the Legislature should consider in evaluating the project, and recommends additional oversight tools if the Legislature decides the project should go forward.
February 21, 2007 - The administration proposes a number of changes to the state’s information technology (IT) governance structure. Our analysis finds that (1) the planning and policy development roles are appropriately placed with the Chief Information Officer (CIO), (2) moving IT project oversight to CIO would eliminate objectivity, and (3) a separate security office may create an unnecessary layer of review. We recommend the Legislature adopt an alternative structure that addresses these concerns.
February 21, 2007 - Index of Information Technology Issues in the Analysis of the 2007-08 Budget Bill
February 15, 2007 - Presented to the Senate Health Committee, Hon. Sheila Kuehl, Chair
February 12, 2007 - Persistent increases in health care spending and deficiencies in health care quality are attributable in part to the continued reliance by many health care providers on archaic, paper-based methods of storing and communicating health information. Health information technology (HIT) offers the potential to improve health care delivery and quality, but adoption of these tools by health care providers has been slow. Our review assesses the potential for HIT tools such as electronic health records (EHRs) and regional health information organizations (RHIOs) to meet these challenges, and provides an overview of HIT development efforts in government and the private sector. We conclude that the state should take steps to promote widespread adoption of HIT, and we outline several strategies to achieve that goal.
January 4, 2007 - Although the state licenses about 58,000 child care facilities serving up to 1.2 million children, there is little information readily available to parents about the safety and quality of this care. This report describes options to improve the availability of such information. We recommend that the availability of existing information be improved and that ratings be established based on a provider’s safety history.