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February 12, 2015 - This report analyzes the Governor's 2015-16 state health program budget proposals. In the report, we review trends in the major health programs since 2007-08 (the last budget developed before the most recent recession), analyze the Governor's proposed restructuring of the managed care organization (MCO) tax, and describe the uncertainty regarding continued federal funding for the Children's Health Insurance Program (CHIP). The report also includes an analysis of the Department of State Hospitals budget and an analysis of the Governor's proposals to improve quality and increase staffing for the Licensing and Certification (L&C) Program administered by the Department of Public Health.
February 12, 2015 - This report analyzes the Governor's 2015-16 human services budget proposals. First, we review major trends in human services programs since 2007-08 (the last state budget developed before the major recession) and find that total spending is up by 11 percent (in inflation-adjusted terms), with major changes in how programs are funded. Our report also analyzes the budgetary impacts and issues for the Legislature to consider given the uncertain legal status of new federal labor regulations affecting In-Home Supportive Services (IHSS) and the Department of Developmental Services. The report includes an analysis of the future of the state's developmental centers (DCs) and an analysis of the Governor's budget proposal to further reform the Community Care Licensing (CCL) program that oversees the licensing of child care, children's residential, and adult and senior care facilities. Finally, the report analyzes the Governor's budget proposal to implement 2 of 19 recommendations of a working group established by the Legislature to recommend reforms to the foster care system.
Proposed SSI/SSP figures corrected 3/11/15
January 22, 2015 - In 2012, the Legislature authorized the development and pilot implementation of a universal assessment tool (UAT) to streamline eligibility and level-of-need determinations for three home- and community-based services (HCBS) programs that provide care to seniors and people with disabilities. Our analysis finds that the benefits of a UAT likely outweigh the costs associated with its development. To ensure the UAT achieves the benefits of creating a more effective and efficient approach to HCBS assessment, we recommend: (1) legislation specifying intent to eventually use the UAT on a statewide basis, (2) development of an automated UAT customized to fit within California’s programmatic and policy environment, (3) piloting of county welfare departments and managed care plans as administrators of the UAT, and (4) a formal evaluation of the UAT pilot.
October 30, 2014 - The integration of eligibility and enrollment processes of health and human services (HHS) programs has long been an important issue for the state. In this report, we focus on the integration of three key HHS programs: the California Medical Assistance Program (Medi-Cal), CalFresh, and the California Work Opportunity and Responsibility to Kids (CalWORKs) program. We also raise several issues for legislative consideration, including (1) determining the appropriate balance between local control and standardized statewide processes, (2) considering whether automation systems currently under development could be leveraged to strengthen integration, and (3) considering whether additional programs should be integrated.
October 9, 2014 - Presented to: Senate Committee on Human Services
September 29, 2014 - Presented to: Assembly Health Committee; Assembly Judiciary Committee; Assembly Business, Professions and Consumer Protection Committee; Senate Health Committee Senate Judiciary Committee; Senate Business, Professions and Economic Development Committee
June 2, 2014 - Presented to: Budget Conference Committee
June 2, 2014 - Presented to: Budget Conference Committee
June 2, 2014 - Presented to: Budget Conference Committee
June 2, 2014 - Presented to: Budget Conference Committee
June 2, 2014 - Presented to: Budget Conference Committee
April 10, 2014 - Presented to: Senate Budget and Fiscal Review Subcommittee No. 1 on Education and Senate Budget and Fiscal Review Subcommittee No. 3 on Health and Human Services
April 10, 2014 - Presented to Senate Budget and Fiscal Review Subcommittee No. 4 on State Administration and General Government
March 26, 2014 - In January 2014, the FI$Cal Project submitted, and the Department of Technology approved, special project report (SPR) 5, which updates the project plans. The SPR 5 includes changes in the project's scope, implementation schedule, and future staffing levels. In this report, we find that SPR 5 reduces overall project risk and make recommendations concerning (1) the project's annual reporting requirement to the Legislature and (2) recruitment and retention issues. Ultimately, we believe that the benefits of proceeding with FI$Cal development outweigh the inherent risks that remain, and therefore recommend approval of the Governor’s budget proposal that reflects a reasonable funding plan to implement the updated project plan (SPR 5).
March 19, 2014 - In this report, we review the administration’s 2014-15 budget proposal to continue legal activities related to the suspended 21st Century Project (TFC). We find that the Governor’s 2014-15 budget proposes funding for outside legal counsel at roughly one-half of the State Controller's Office's (SCO) estimate of projected costs, and therefore recommend that the Legislature budget the full estimate instead. In addition, we find that an independent assessment of the TFC Project is a necessary precursor to addressing the state’s unmet need for an updated human resources management and payroll system. As the Governor's proposal lacks such an assessment, we recommend the Legislature appropriate additional resources to SCO for such an assessment. We provide details on what such an assessment should include.