Health and Human Services Publications

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Governor’s May Revision Update: Health Insurance Affordability Proposals

May 15, 2019 - With the May Revision (and prior to the May Revision with the release of proposed implementing legislation), the administration has provided additional details on its January proposal to impose a state individual mandate and use penalty revenues from the mandate to fund health insurance subsidies. In this post, we summarize key updates to the Governor’s proposals and raise some issues for the Legislature’s consideration.

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The 2019-20 May Revision: Governor's May Revision Medi-Cal Budget

May 14, 2019 - The Governor’s May Revision includes Medi-Cal spending of $19.7 billion from the General Fund ($93.4 billion total funds) in 2018-19 and $23 billion from the General Fund ($102.2 billion total funds) in 2019-20. As will be described in this post, about half of the reduction in estimated spending in 2018-19 reflects a shift of costs in Medi-Cal to a different budget item, rather than a true reduction in estimated program costs. After accounting for this shift, the May Revision is about $350 million below January estimates across 2018-19 and 2019-20.

Hearing Handout

Options and Considerations for Implementing the DDS Rate Study

May 9, 2019 - Senate Budget Subcommittee No. 3 on Health and Human Services

Report

The 2019-20 Budget: Assessing the Governor’s Primary Care Physician Residency Proposals

May 9, 2019 - To obtain a license to practice medicine, California law requires all medical school graduates to complete three years of postgraduate training. Most physician‑trainees fulfill this requirement by completing a residency program. The state currently funds two initiatives to support residency programs for primary care physicians. The first initiative is named after its legislative authors, Song‑Brown, and is administered by the Office of Statewide Health Planning and Development (OSHPD). The second initiative is authorized by Proposition 56 and is administered by the University of California (UC). The Governor proposes making certain limited‑term funding for these initiatives ongoing. In this brief, we provide background on residency programs, describe the Governor’s two associated budget proposals, assess those proposals, and make associated recommendations.

Report

The 2019-20 Budget: Analysis of the Governor’s Mental Health Workforce Proposal

May 9, 2019 - The Governor proposes a $50 million one‑time General Fund augmentation for existing mental health workforce programs that are administered by the Office of Statewide Health Planning and Development (OSHPD). This brief (1) provides background on the state’s mental health workforce, (2) gives an overview of existing programs and funding aimed at improving the state’s mental health workforce, (3) summarizes and assesses the Governor’s proposal, and (4) provides options for legislative consideration.

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Letter to Honorable Reyes on Service Provider Rates in the Department of Developmental Services System

May 2, 2019 - Letter to the Honorable Eloise Gómez Reyes on actions that could be taken by the Legislature in the 2019-20 budget based on a contracted study of service provider rates in the Department of Developmental Services (DDS) system.

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The 2019-20 Budget: Reorganization of the Division of Juvenile Justice

April 10, 2019 - This report provides an overview of California’s juvenile justice system including DJJ and highlights several key questions raised by the Governor’s proposal for the Legislature to consider as the administration provides more detailed information on the proposal in the coming months.

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The 2019-20 Budget: Analysis of the Carve Out of Medi-Cal Pharmacy Services From Managed Care

April 5, 2019 - This report analyzes one of the two initiatives included in the Governor's executive order: to transition the pharmacy services benefit in Medi‑Cal, the state’s largest low‑income health care program, from managed care to entirely a fee‑for‑service (FFS) benefit directly paid for and administered by the state.

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The 2019-20 Budget: Analysis of Proposed Increase in State Funding for Local Child Support Agencies

March 26, 2019 - In this report, we provide background on the current child support program. We then describe and assess the Governor’s 2019 20 proposal to create a new budgeting methodology that would increase funding for certain LCSAs by nearly $60 million General Fund. We recommend that the Legislature withhold action on the funding proposal until the administration submits the statutorily required report identifying potential state and local operational efficiencies.

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The 2019-20 Budget: Undoing California’s Outstanding Budgetary Deferrals

March 26, 2019 - When facing budget problems in the past, the state has “deferred” payments from one fiscal year into the next, providing significant one-time budgetary savings. While the state has already addressed many of its outstanding deferrals, there are still three major categories of deferrals remaining. These are related to: (1) state employee payroll, (2) pension payments, and (3) Medi-Cal payments. The Governor proposes using $1.7 billion to undo the payroll and pension deferrals. We find this would improve the state’s fiscal position and moderately improve the state’s budgetary practices, however, this approach has shortcomings relative to alternatives. This post recommends an alternative approach to the Governor’s proposal.

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Housing and Homelessness Funding Impacting Children

March 25, 2019 - These materials were prepared for an informational hearing about housing challenges and their impact on the well-being of children by the Senate Select Committee on the Social Determinants of Children’s Well-Being.

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The 2019-20 Budget: The Governor's Proposal for a New Office of Digital Innovation

March 22, 2019 - In this post, we describe the Governor’s 2019-20 budget proposal to create a new office within California’s Government Operations Agency—the Office of Digital Innovation. We then provide issues for legislative consideration, including key questions about the office’s implementation and legislative oversight of its activities.

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Older Youth Access to Foster Care

March 22, 2019 - The Supplemental Report of the 2018-19 Budget Act directed our office to submit a report to the Legislature reviewing data on the reporting of child abuse or neglect incidents among children who are aged 14 to 17 compared to younger children. In this report, we (1) describe how the state’s Child Welfare Services (CWS) system processes child abuse and neglect reports, (2) discuss observed similarities and differences in reporting outcomes between older and younger youth based on available data, (3) specify limitations in our ability to come to definitive conclusions regarding the treatment of reports for older youth compared to younger youth in the CWS system based on available data, and (4) provide recommendations for the collection of additional data to better understand the potential reasons for differences in outcomes between older and younger youth accessing foster care and determine whether policy interventions are appropriate.

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The 2019-20 Budget: Aligning the State’s IT Project Approval Process With the Annual Budget Process

March 14, 2019 - In this post, we describe how the California Department of Technology’s (CDT) information technology (IT) project approval process—known as the Project Approval Lifecycle (PAL)—does not always align with the state’s annual budget process. We identify seven funding requests in the Governor’s 2019-20 proposed budget for IT project proposals that are currently in various stages of the PAL process. We then describe how these requests for project funding prior to the completion of the PAL planning process may inhibit the Legislature from fully realizing the anticipated benefits of the PAL process, discuss how some project-specific factors can cause misalignment of the budget cycle and PAL, and provide issues for legislative consideration.

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The 2019-20 Budget: Assessing the Governor's 1991 Realignment Proposals

March 8, 2019 - This report evaluates the changes the Governor proposes and assesses whether the changes better position 1991 realignment to achieve its intended benefits and meet the principles of a successful state-county fiscal partnership we identified in our October report.

Health and Human Services Staff

Mark Newton
(916) 319-8323
Deputy Legislative Analyst: Health, Developmental Services and IT
 
Ryan Anderson
(916) 319-8308
CalWORKs/CalFresh
 
Jackie Barocio
(916) 319-8333
In-Home Supportive Services/Aging Programs/Child Support/Veterans Affairs
 
Ben Johnson
(916) 319-8336
Medi-Cal/Hospital Finance/Managed Care
 
Brian Metzker
(916) 319-8354
Privacy, Security, and Technology
 
Sonja Petek
(916) 319-8340
Public Health/Developmental Services
 
Luke Koushmaro
(916) 319-8355
Medi-Cal/Long-Term Care/Family Health/Covered California
 
Angela Short
(916) 319-8309
Teachers' Retirement Policy/ Child Welfare/ Community Care Licensing
 
Corey Hashida
(916) 319-8315
Medi-Cal/Behavioral Health/State Hospitals/Health Planning and Development
 
Ginni Bella Navarre
(916) 319-8342
Deputy Legislative Analyst: Human Services and Governance