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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.
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
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