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Health and Human Services Publications

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Handout

LAO Assessment of the Governor's Care Coordination Initiative

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

Report

The 2012-13 Budget: Oversight and Accountability at State Hospitals

March 1, 2012 - The Governor’s budget plan proposes to eliminate DMH and create a new Department of State Hospitals (DSH), shifting the remaining community mental health programs to various departments. This new structure would allow the administration to better focus on the fiscal and programmatic issues unique to state hospitals. In 2008-09, the Office of State Audits and Evaluations (OSAE) conducted an audit which outlined the problems state hospitals experienced, concluding that staffing did not adequately reflect hospital workload, funding was not sufficient for annual operating expenditures, and that state hospitals were not efficiently using their staff. Similarly in a 2011 self-audit, DMH found that many of the same problems from the 2008 audit remained. We concur with both audit teams’ assessments. In this brief report, therefore, we recommend an audit be conducted that looks at a number of issues, including state hospital budgeting practices, the fiscal controls being put in place, and the level of vacancies and their impact on the state budget and on hospital performance. We recommend this added oversight with respect to state hospitals should take place regardless of the Legislature’s decision on the creation of a new DSH.

Report

The 2012-13 Budget: Developmental Services Budget Update

March 1, 2012 - Over the three-year period from 2009-10 to 2011-12, the Department of Developmental Services’ (DDS) General Fund spending has remained relatively flat. This has been the case in spite of rapidly growing caseloads and other cost pressures. In this brief, we discuss the measures adopted by the Legislature over these three years to reduce General Fund costs in both Developmental Centers (DCs) and Regional Centers (RCs).

Handout

Analysis of the Governor's CalWORKs Proposal

March 1, 2012 - Presented to Senate Budget and Fiscal Review Committee, Hon. Mark Leno, Chair

Handout

Recent History of the CalWORKs Program

February 29, 2012 - Presented to Assembly Budget Subcommittee No. 1 on Health and Human Services, Hon. Holly J. Mitchell, Chair

Handout

Governor's Proposed Alcohol and Drug Program Shift

February 21, 2012 - Presented to: Joint Oversight Hearing of the Assembly and Senate Health Committees and Assembly and Senate Budget Subcommittees on Health and Human Services Hons. Bill Monning and Ed Hernandez, Chairs, Assembly and Senate Health Committees Hons. Holly Mitchell and Mark DeSaulnier, Chairs, Assembly and Senate Budget Subcommittees on Health and Human Services

Handout

Governor's Proposed Community Mental Health Program Shift

February 21, 2012 - Presented to: Joint Oversight Hearing of the Assembly and Senate Health Committees and Assembly and Senate Budget Subcommittees on Health and Human Services

Report

The 2012–13 Budget: Analysis of the Governor's Healthy Families Program Proposal

February 17, 2012 - As part of the 2012-13 budget, the Governor proposes to reduce the negotiated rates paid to Healthy Families Program (HFP) managed care plans and shift the children enrolled in HFP to Medi-Cal over a nine-month period. In this report, we provide background information on HFP and Medi-Cal and how they will be affected by implementation of federal health care reform. We discuss the potential merits of the Governor’s proposal, but raise several implementation issues and concerns. Specifically, the savings in the budget year may be less than the administration’s estimates, and the proposal will disrupt healthcare services for some HFP enrollees and may impact access to providers. Finally, we make recommendations that encourage the consideration of alternatives to the Governor’s plan.

Report

The 2012-13 Budget: Integrating Care for Seniors and Persons With Disabilities

February 17, 2012 - California’s system for providing health and social services to low-income seniors and persons with disabilities (SPDs) receiving Medicare and/or Medi-Cal is not coordinated. This lack of care coordination may lead to SPDs being unnecessarily hospitalized or placed in skilled nursing facilities rather than remaining in their own homes—resulting in poor outcomes for recipients and higher costs for the federal and state governments. As part of the 2012-13 budget, the Governor attempts to address this issue by proposing to integrate health and social services into managed care for most SPDs. In this report, we provide background information on the Medi-Cal and Medicare Programs and describe recent federal and state legislation to address fragmented care delivery. We discuss the potential merits of the Governor’s proposal, but raise several implementation issues and concerns. Finally, we make recommendations that encourage care coordination for SPDs by first completing and evaluating a currently authorized integrated care demonstration project in four counties rather than expanding the demonstration statewide as proposed by the Governor— an action that we think is premature. We also encourage the consideration of other ways to test the integration of benefits for SPDs.

Report

An Alternative Approach: Treating the Incompetent to Stand Trial

January 3, 2012 - Over the past several years, the state has experienced waitlists in county jails to transfer those deemed incompetent to stand trial (IST) to state hospitals for treatment. In response to the waitlist, which averages between 200 and 300 individuals a month, the Department of Mental Health began a pilot program in San Bernardino County to treat ISTs in county jail instead of at a state hospital. This report finds that the pilot program has greater flexibility to hold down costs and has been able to restore ISTs to competency in a shorter amount of time than state hospitals. We find that if the pilot program is expanded, it has the potential to significantly reduce the waitlist, as well as reduce costs to the public sector.

Handout

An Overview of Federal Funding in California

September 29, 2011 - An Overview of Federal Funding in California

Report

The 2011-12 Budget: Options to Achieve Savings in the Regional Center System

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.

Handout

AB 3632 Mental Health Services

January 26, 2011 - Presented to Assembly Budget Subcommittee No. 1 on Health and Human Services and Assembly Budget Subcommittee No. 2 on Education

Handout

Alcohol and Drug Program Realignment

January 26, 2011 - Presented to Assembly Budget Subcommittee No. 1 on Health and Human Services

Handout

DHCS CA-MMIS

June 18, 2010 - Presented to The Conference Committee on the Budget

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