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Health and Human Services Publications

To browse all LAO publications, visit our Publications page.


 


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.

Post

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.

Post

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.

Post

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.

Post

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

Handout

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

June 2, 2017 - Presented to Budget Conference Committee

Post

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

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.

Health and Human Services 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