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February 1, 2011 - Total expenditures for the regional center system that provides services for persons with developmental disabilities more than doubled between 1999-00 and 2009-10, leading to a series of actions by the Legislature to slow down the growth in the program. In this report, we describe and assess proposals in the Governor’s 2011-12 budget plan to achieve further cost containment in programs administered by the Department of Developmental Services, including community services. We recommend approval of the Governor’s budget proposals to (1) extend the 4.25 percent provider payment reduction and the commensurate reduction to regional center (RC) operations, and (2) obtain additional federal funds for services provided through the developmental centers and the RCs. We also recommend the Legislature either expand the existing Family Cost Participation Program or implement means testing to determine who is eligible to receive these state services.These changes, we would acknowledge, represent a significant departure from the policies originally adopted in the Lanterman Act but would help ensure the long-term sustainability of the program for those consumers with the greatest financial need for its services.
January 26, 2011 - Presented to Assembly Budget Subcommittee No. 1 on Health and Human Services and Assembly Budget Subcommittee No. 2 on Education
January 26, 2011 - Presented to Assembly Budget Subcommittee No. 1 on Health and Human Services
June 18, 2010 - Presented to The Conference Committee on the Budget
June 14, 2010 - Presented to The Conference Committee on the Budget
June 14, 2010 - Recently, there has been significant legislative and public interest in the state’s Every Woman Counts (EWC) program for breast cancer early detection. We provide background on the EWC program and other state breast cancer programs and describe the recent history of the program, including caseload and funding trends and recent program changes. We also recommend the Legislature adopt a modified version of the Governor’s May Revision cost containment proposals, consider redirecting existing funding for research to direct clinical services, and improve transparency and oversight by requiring the administration to prepare a formal budget estimate for the EWC program.
June 8, 2010 - Presented to The Conference Committee on the Budget
June 3, 2010 - Conference Compromise for Item 4260-001-0001 of the 2010 Budget Conference Committee (page 3).
May 13, 2010 - The Patient Protection and Affordable Care Act (PPACA), often referred to as federal health care reform, is far-reaching legislation that will change how millions of Californians access health care coverage. We provide an overview of the new law and describe its implications for state health programs in the near term and the long term. We also recommend the Legislature think broadly about implementing PPACA and identify key issues to address including: (1) future costs for health programs, (2) whether structural changes to health programs are warranted, (3) whether PPACA should prompt a reevaluation of the state-local relationship, (4) new strategies that could bolster health care quality and outcomes, and (5) how future workforce and health infrastructure needs should be addressed.
May 3, 2010 - Through Chapter 7, Statutes of 2009, the Legislature has directed the Department of Health Care Services and the Department of Social Services to implement a statewide eligibility and enrollment determination process for the California Work Opportunity and Responsibility to Kids (CalWORKs), Food Stamp, and Medi-Cal programs. The new statewide process is intended to achieve two primary outcomes: (1) providing better service to people applying for these programs and (2) lowering administrative costs through better use of technology. We identify possible improvements and cost-savings in the eligibility and enrollment process. We also recommend a general approach that the Legislature may wish to consider when making difficult decisions about how to proceed with Chapter 7.
April 27, 2010 - Presented to Assembly Budget Subcommittee No. 1 on Health and Human Services
March 26, 2010 -
Health and social services (H&SS) expenditures account for about 29 percent of General Fund spending in California. As part of his plan to bring revenues and expenditures into balance, the Governor’s budget proposes major reductions and program eliminations in the area of H&SS. In this report we describe spending and program requirements as well as key considerations for evaluating budget solutions. We also identify strategies for achieving savings in a restricted environment.
This report and the companion piece The 2010-11 Budget: Health and Social Services Budget Primer provide a framework for policymakers as they make very difficult budget decisions in health and social services.
March 26, 2010 - Addresses the 2010-11 Budget through a Special Session brief, a summary of Health findings and recommendations, and the companion reports Health and Social Services Budget Primer and Health and Social Services—A Restricted Environment.
March 26, 2010 -
In 2009-10, expenditures for health and social services programs in California are estimated to be about $25 billion or 29 percent of statewide General Fund spending. Spending on health and social services programs accounts for 36 percent of total spending when special funds, federal funds, and the General Fund are included. This primer provides an understanding of the overall health and social services expenditures, the workings of major health and social services programs, spending trends in major programs, and the major funding sources for health and social services programs.
This primer and the companion piece The 2010-11 Budget: Health and Social Services—A Restricted Environment provide a framework for policymakers as they make very difficult budget decisions in health and social services.
March 24, 2010 - Presented to: Assembly Budget Subcommittee No. 1 On Health and Human Services Hon. Dave Jones, Chair