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Health and Human Services Publications

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Letter

Letter to Assembly Member Perea on the Potential Transfer of the Drinking Water Program (DWP)

June 18, 2013 - Letter to the Honorable Henry T. Perea, Assembly Member, regarding the advantages and disadvantages of transferring the Drinking Water Program (DWP) from the Department of Public Health (DPH) to a newly created stand-alone entity under the California Environmental Protection Agency (Cal-EPA), as compared to transferring it to the State Water Resources Control Board (SWRCB).

Handout

The Safe Drinking Water State Revolving Fund and Drinking Water Program Governance

May 15, 2013 - Presented to Senate Environmental Quality Committee

Letter

Letter to Honorable Bill Monning on Estimated Costs Related to Certain ACA Provisions

May 1, 2013 - Letter to Honorable Bill Monning, Chair, Senate Subcommittee No. 3 on Health and Human Services, regarding the estimated costs related to provisions of the federal Patient Protection and Affordable Care Act (ACA) that will likely result in additional Medi-Cal enrollment from persons who are currently eligible for the program, but not enrolled.

Handout

Evaluating the Potential Transfer of Drinking Water Activities From DPH to SWRCB (Assembly Budget Subcomittee No. 1)

April 15, 2013 - Presented to: Assembly Budget Subcomittee No. 1 on Health and Human Services

Letter

Letter to the Honorable Bill Emmerson Regarding Bridge Plan

March 18, 2013 - Letter to the Honorable Bill Emmerson Regarding Bridge Plan.

Handout

Evaluating the Potential Transfer of Drinking Water Activities From DPH to SWRCB (Assembly Environmental Safety and Toxic Materials Committee)

March 18, 2013 - Presented to Assembly Environmental Safety and Toxic Materials Committee

Letter

Letter to the Honorable Luis Alejo regarding SDWSRF

March 13, 2013 - Letter to the Honorable Luis Alejo, Chair, Assembly Environmental Safety and Toxic Materials Committee, evaluating the administration and peformance of the Safe Drinking Water State Revolving Fund (SDWSRF).

Report

The 2013-14 Budget: Analysis of the Health and Human Services Budget

February 27, 2013 - The Governor's budget proposes $28.3 billion in expenditures from the General Fund for health and human services programs in 2013-14. This reflects a 3.4 percent increase for health programs and a 7.9 percent increase for human services programs over 2012-13 estimated expenditures. For the most part, the year-over-year budget changes reflect caseload changes, technical budget adjustments, and the implementation of previously enacted policy changes, as opposed to new policy proposals. In the report, we find that the budget does not reflect the fiscal impact of the proposed Medi-Cal expansion, nor does it reflect potential costs and savings related to various other provisions of federal health care reform. We find that the Governor's Medi-Cal budget proposal assumes General Fund savings that are subject to significant uncertainty. We also provide a status update on the transition of the Healthy Families Program enrollees to Medi-Cal, finding that the transition is generally proceeding as planned, with some delays. We discuss problems in the operation of the state's Developmental Centers (DCs) by the Department of Developmental Services, and recommend that oversight of the DCs be strengthened by the creation of an independent Office of the Inspector General. We discuss the recent major program changes to the California Work Opportunity and Responsibility to Kids (CalWORKs) that are reflected in the budget, and recommend that the Legislature augment CalWORKs employment services funding--a Governor's budget proposal--to a level of funding it deems appropriate in light of its priorities for the program. We raise various fiscal and policy concerns about the Governor's budget assumption that a 20 percent across-the-board reduction in In-Home Supportive Services service hours will be implemented beginning on November 1, 2013. In light of these concerns, we recommend that the Legislature repeal the 20 percent reduction and instead continue a 3.6 percent across-the-board reduction that would otherwise sunset at the end of the 2012-13 fiscal year.

Report

The 2013-14 Budget: Coordinated Care Initiative Update

February 27, 2013 - In 2012, the Legislature authorized the Coordinated Care Initiative (CCI) as an eight-county pilot to demonstrate the integration of Medi-Cal and Medicare benefits for "dual eligibles"--beneficiaries eligible for both benefits. The CCI will also integrate long-term services and supports (LTSS) under Medi-Cal managed care in the eight counties for dual eligibles and seniors and persons with disabilities covered only by Medi-Cal. The Governor's budget delays the start date of CCI implementation to September 1, 2013, resulting in lower 2013-14 savings than initially anticipated. Joint federal-state decisions regarding key financing and operational aspects of CCI are pending, creating uncertainty regarding the timely and successful implementation of CCI. We recommend that the Legislature clarify the legal status of CCI to go forward and consider authorizing CCI to test greater integration of In-Home Supportive Services--a particular LTSS--under managed care.

Report

The 2013-14 Budget: Examining the State and County Roles in the Medi-Cal Expansion

February 19, 2013 - Under the Patient Protection and Affordable Care Act, also known as federal health care reform, the state has the option to expand its Medicaid program (known as Medi-Cal) to cover over one million low-income adults who are currently ineligible. Currently counties have the fiscal and programmatic responsibility for the care of the low-income adult population that would be covered by the expansion. The Governor has proposed to adopt the optional expansion, but has outlined two distinct approaches to implementing the expansion—a state-based approach and a county-based approach—and has not indicated a preference for either approach. Under both approaches, the Governor indicates that the expansion will require a reassessment of the state-local fiscal relationship. We find that the expansion would have significant policy benefits, including improved health outcomes for the newly eligible Medi-Cal population. We estimate that fiscal savings to the state as a whole are likely to outweigh the cost of the expansion for at least a decade, although these estimates are subject to significant uncertainty. Despite the significant uncertainty about long-term costs and savings, on balance, we believe the policy merits of the expansion and fiscal benefits to the state as a whole likely will outweigh the costs and potential fiscal risks. We therefore recommend the state adopt the expansion. We also find that the state is in a better position to effectively deliver health services to the newly eligible population. Therefore, we recommend the Legislature adopt a state-based expansion, shifting the fiscal and programmatic responsibility of providing physical health care to the expansion population from counties to the state. Given this shift of responsibility, we further recommend the Legislature redirect a portion of funding currently allocated to counties under 1991 realignment for indigent health care.

Handout

Overview of Children's Dental Services in Medi-Cal and the Healthy Families Program

November 9, 2012 - Presented to Assembly Budget Subcommittee No. 1 on Health and Human Services, Hon. Holly J. Mitchell, Chair

Handout

Funding and Oversight of State Developmental Centers

October 23, 2012 - Senate Budget and Fiscal Review Subcommittee No. 3 on Health and Human Services, Hon. Mark DeSaulnier, Chair and Senate Human Services Committee, Hon. Carol Liu, Chair

Handout

Proposition 29: Imposes Additional Tax on Cigarettes for Cancer Research

May 1, 2012 - Presented to: Assembly Health Committee, Hon. William W. Monning, Chair and Assembly Revenue and Taxation Committee, Hon. Henry T. Perea, Chair

Handout

Overview of Health Care Districts

April 11, 2012 - Presented to Assembly Accountability and Administrative Review Committee, Hon. Roger Dickinson, Chair

Handout

Recent History of Adult Day Health Care and Transition of Seniors and Persons With Disabilities Into Managed Care

March 7, 2012 - Presented to Joint Oversight Hearing on Long-Term Care Integration and Medi-Cal Managed Care, Assembly Budget Subcommittee No. 1 on Health and Human Services and Assembly Committee on Aging and Long-Term Care

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