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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
February 20, 2014 - The report analyzes the Governor's 2014-15 health budget proposals. In it, we (1) provide an analysis of the impact the implementation of the Patient Protection and Affordable Care Act (ACA)--known as federal health care reform--is having on the Medi-Cal program; (2) analyze the Governor's budget proposal to exempt certain, but not all, classes of Medi-Cal providers and services from retroactive recoupments of payment reductions; and (3) assess the fiscal outlook for the California Health Benefit Exchange, also known as Covered California.
August 6, 2013 - Since 2009, the state has used a computer data matching process known as the Public Assistance Reporting Information System (PARIS) to identify certain military veterans who receive Medi-Cal services and may be able to voluntarily shift to health care services provided by the U.S. Department of Veterans Affairs (USDVA). We find that the fiscal and policy benefits from the state's current implementation of PARIS Veterans activities are limited, due to resource constraints and a problematic approach to outreach. We recommend that the Legislature provide additional resources to conduct a new pilot that tests a modified approach to PARIS Veterans outreach. We also find that the state has not pursued a major source of savings related to the PARIS Veterans match: counting a type of USDVA monetary benefit known as aid and attendance toward the costs of the In-Home Supportive Services program. We recommend that the Legislature require the administration to report on the rationale for current policies that prevent the state from realizing these savings.
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).
May 15, 2013 - Presented to Senate Environmental Quality Committee
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.
April 15, 2013 - Presented to: Assembly Budget Subcomittee No. 1 on Health and Human Services
March 18, 2013 - Letter to the Honorable Bill Emmerson Regarding Bridge Plan.
March 18, 2013 - Presented to Assembly Environmental Safety and Toxic Materials Committee
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).
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.
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.