Health and Human Services Publications

Report

The Potential Effects of Ending the SSI Cash-Out

• Format:
• PDF
• HTML

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

• Format:
• PDF
• HTML

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.

Post

Fiscal Outlook: Developmental Services

• Format:
• HTML

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.

Post

Fiscal Outlook: Medi-Cal

• Format:
• HTML

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.

Post

Fiscal Outlook: In-Home Supportive Services (IHSS)

• Format:
• HTML

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.

Hearing Handout

State Efforts to Address Youth Homelessness

• Format:
• PDF

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

Report

Measuring CalWORKs Performance

• Format:
• PDF
• HTML

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.

Hearing Handout

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

• Format:
• PDF

June 7, 2017 - Presented to Budget Conference Committee

Hearing Handout

Item 4140-101-0001—OSHPD—Funding for Health Care Workforce Development Item 6440-001-0001—UC—Graduate Medical Education and Base Allocation

• Format:
• PDF

June 2, 2017 - Presented to Budget Conference Committee

Post

The 2017-18 Budget: Overview of the Governor's May Revision Medi-Cal Budget Proposal

• Format:
• HTML

May 17, 2017 - In this Budget and Policy Post, we provide an overview of several of the key factors driving the changes in estimated and proposed Medi-Cal spending in 2016-17 and 2017-18; our evaluation of the Governor’s updated caseload estimates; and an update on several key proposals from the January budget, some of which have been modified at May Revision. During continuing budget deliberations, we recommend that the Legislature ask for clarity from the Department of Health Care Services on how the Major Risk Medical Insurance Program will be funded in the future under the Governor’s proposal if Health Care Services Plans and Penalties Fund revenues are insufficient to cover the costs of the program. We also recommend that the Legislature, should it approve the Governor’s plan to cancel the planned transition of Newly Qualified Immigrants from Medi-Cal to Covered California, consider trailer bill language that repeals existing state statutory language that calls for the transition. Finally, we recommended a downward technical adjustment of $62 million General Fund to the 2017-18 May Medi-Cal Estimate.

Post

The 2017-18 Budget: The Governor's May Revision In-Home Supportive Services Cost-Sharing Proposal

• Format:
• HTML

May 16, 2017 - Rather than return to the original 1991 realignment cost-sharing ratios for In-Home Supportive Services (IHSS) as initiated by the Governor in January (described in our report: The Coordinated Care Initiative: A Critical Juncture), the administration proposes establishing a new Maintenance of Effort (MOE) for counties’ share of IHSS cost. The new MOE would include both services and administration using 2017-18 costs. The new MOE would significantly increase costs to counties in 2017-18 relative to 2016-17. While the MOE shifts significant costs to counties, the proposal provides state General Fund support and additional realignment revenue to partially offset this increase. In this analysis, we lay out the various components of this complex proposal. We also raise key questions for Legislative consideration and provide our recommendation for how to move forward.

Hearing Handout

Major Issues Facing the Unemployment Insurance Program

• Format:
• PDF

May 10, 2017 - Presented to: Senate Labor and Industrial Relations Committee

Hearing Handout

AHCA: Medicaid as a Per Capita Capped Allotment and the CBO’s Analysis

• Format:
• PDF

March 22, 2017 - Presented to: Assembly Budget Subcommittee No. 1 on Health and Human Services and Assembly Health Committee

Hearing Handout

What the Patient Protection and Affordable Care Act (ACA) Means for California

• Format:
• PDF

March 22, 2017 - Presented to Assembly Budget Subcommittee No. 1 On Health and Human Services and Assembly Health Committee

Report

The 2017-18 Budget: Analysis of the Medi-Cal Budget

• Format:
• PDF
• HTML

March 9, 2017 - In California, the federal‑state Medicaid program is administered by the Department of Health Care Services (DHCS) as the California Medical Assistance Program (Medi‑Cal). Medi‑Cal is by far the largest state‑administered health services program in terms of annual caseload and expenditures. In this report, we provide an analysis of the administration’s caseload projections, including a discussion of the projected increases in ACA optional expansion caseload. We also provide an assessment of several aforementioned major factors affecting projected changes in Medi‑Cal spending in 2017‑18 and other policy changes proposed by the administration. These include the Governor’s proposed uses of Proposition 56 revenues, the proposal to shift additional New Qualified Immigrants (NQIs) to Covered California in 2017‑18, assumptions around federal CHIP funding, and the proposed abolition and transfer of the Major Risk Medical Insurance Fund (MRMIF).