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February 18, 2004 - The Governor's budget plan proposes to establish limits on enrollments ("caps") for certain specified health and social services programs. We recommend that the Legislature consider the Governor's enrollment cap proposal on a case-by-case basis, weighing the potential fiscal benefits of capping each identified health and social services program against the complexities and issues relating to the creation of caseload caps. Based upon such an analysis, we recommend that nine be rejected, propose one be approved with some modifications, and make no recommendation regarding one cap proposal.
February 18, 2004 - During the past four years, the Legislature has approved significant increases in resources to combat fraud in the Medi-Cal Program. While these actions have resulted in increased savings and allowed the state to avoid some additional program costs, fraud remains a major concern in the Medi-Cal program. In this analysis, we explain the structure of the Department of Health Services' (DHS) antifraud program and how it compares to national models of fraud control in fee-for-service Medicare and Medicaid. We identify areas in which the DHS could be more effective in combating Medi-Cal fraud and offer recommendations as to how DHS could better manage and structure its antifraud efforts. We also review the Governor's 2004-05 budget proposals for expansion of antifraud efforts and recommend changes. Reduce Item 4260-001-0001 by $2,354,000.
February 18, 2004 - We describe the current Medi-Cal health care delivery system and evaluate its strengths and weaknesses in regard to addressing the health care needs of the aged and disabled. We identify additional aged and disabled persons that would benefit from receiving care from managed care plans. We recommend the enactment of legislation directing the Department of Health Services (DHS) to gradually shift an estimated 330,000 aged or disabled persons from the fee-for-service system to the Medi-Cal managed care system. We further recommend strengthening the existing Medi-Cal managed care system to address problems that limit the ability of DHS to ensure access to services and quality of care.
February 11, 2004 - California's program for substance abuse treatment services to Medi-Cal beneficiaries, known as Drug Medi-Cal, provides a patchwork of services with an inconsistent level of support for different modes of treatment and for different treatment populations. In this report, we recommend an approach for addressing these concerns which would provide greater authority and resources for community-based services, contain the fast-growing costs of methadone treatment, and integrate a new and potentially more cost-effective mode of treatment into Drug Medi-Cal that does not require a net increase in state General Fund resources.
March 6, 2003 - Hearing handout presented to the Senate Health and Human Services Committee and Budget and Fiscal Review Subcommittee No. 3
February 19, 2003 - Developmental centers (DC) population has declined significantly over the last forty years. We examine the DC system's population trends and cost-effectiveness, and provide the Legislature with options and recommendations related to future DC operations.
February 19, 2003 - Poor management of treatment for persons with chronic diseases, such as asthma, diabetes, and heart disease, is driving up the state's costs for Medi-Cal. The implementation of a disease management program could eventually reduce state expenditures by as much as hundreds of millions of dollars annually.
February 19, 2003 - The state's programs to provide services for some of its most medically fragile children is missing opportunities to control increasing costs and preserve General Fund resources that could help address the state's fiscal problems. Potential General Fund savings would be at least $43 million.
November 6, 2002 - The Public Employees Retirement System (PERS) is taking a number of steps to help control the sharply rising cost of the state health insurance program for employees and retirees. We recommend that the legislature provide ongoing oversight of this program and highlight two Legislative options for limiting costs: developing lower-cost HMO options and changing the way state contributions are determined.
August 8, 2002 - We discuss the reasons for the recent withdrawals of health coverage by health maintenance organizations (HMOs) from rural areas and recommend a number of steps that we believe will create a more attractive health care marketplace for HMOs. In those rural areas where these steps are not enough to attract HMOs, we identify ways communities can develop their own health care systems.
February 20, 2002 - The administration's proposal to "securitize" the state's future revenues from settlement of litigation with tobacco companies is a feasible and reasonable step for the Legislature to consider However, we recommend that the Legislature consider this transaction only if presented a more detailed analysis demonstrating that the net financial outcome would be beneficial to the state.
February 20, 2002 - We recommend the Legislature set aside funding for the AB 3632 program mandate--"Services to Handicapped Students"--pending development of a new program of county mental health services for special education pupils.
February 20, 2002 - The state is at risk of losing $750 million in unspent federal State Children's Health Insurance Program funds over the next two years in the absence of congressional action. We suggest the Legislature work with the congressional delegation regarding the availability of these funds. We also present examples of options to minimize this potential loss of federal funds.