April 1, 1986 - This report is divided into six chapters. In Chapter I, we describe the implementation of the Dental Disease Prevention program. In Chapter II, we summarize the methodology of the University of California San Francisco study. Chapter III reports the results and shortcomings of the study. In Chapter IV, we discuss the impact of the program on state expenditures for medical and dental care. Chapter V describes the options for improving the program's cost-effectiveness, and Chapter VI presents our conclusions and recommendations.
November 9, 2021 - Examines Medi-Cal enrollment of Department of Developmental Services (DDS) consumers and the fiscal effect that additional Medi-Cal enrollment would have on the DDS budget and on state costs overall.
Correction 11/19/21: Corrected average annual per person fee-for-service cost in Medi-Cal.
April 19, 2021 - The Supplemental Report of the 2020-21 Budget Act requires our office to evaluate options for enhancing federal financial participation through Medi-Cal for consumers served by the Department of Developmental Services. This post provides an interim update of our initial findings and preliminary assessment. A final report will be delivered to the Legislature in the late summer.
February 16, 2018 - In this report we provide a broad overview of the Governor's health and human services budget, highlighting major year-over-year changes. We then provide a more in-depth analysis of select programmatic areas.
February 24, 2017 - In this report, we discuss the Governor’s budget proposals for Department of Developmental Services (DDS), providing our assessment of the budget package for DDS and analyzing one of the proposed trailer bills, which we find raises a number of issues. Also in this report, we describe the general nature of shifts in both policy and practice in the field of developmental services, detailing the relevant state and federal policies and their implications for the future developmental services program in the state, and discussing issues for the Legislature to consider as DDS implements these changes.
March 4, 2016 - The Governor’s 2016-17 budget proposes $3.8 billion from the General Fund for Department of Developmental Services (DDS) programs—a 7.5 percent increase over 2015-16 estimated expenditures. This report focuses on the Governor's major policy-driven spending augmentations in the community services program. This report also summarizes legislation enacted as part of the recent special session that provides significant additional funding to the community services program and considers the Governor’s January proposals in this context.
February 12, 2015 - This report analyzes the Governor's 2015-16 human services budget proposals. First, we review major trends in human services programs since 2007-08 (the last state budget developed before the major recession) and find that total spending is up by 11 percent (in inflation-adjusted terms), with major changes in how programs are funded. Our report also analyzes the budgetary impacts and issues for the Legislature to consider given the uncertain legal status of new federal labor regulations affecting In-Home Supportive Services (IHSS) and the Department of Developmental Services. The report includes an analysis of the future of the state's developmental centers (DCs) and an analysis of the Governor's budget proposal to further reform the Community Care Licensing (CCL) program that oversees the licensing of child care, children's residential, and adult and senior care facilities. Finally, the report analyzes the Governor's budget proposal to implement 2 of 19 recommendations of a working group established by the Legislature to recommend reforms to the foster care system.
Proposed SSI/SSP figures corrected 3/11/15
February 7, 2020 - The following report assesses the Governor’s proposed 2020‑21 budget for the Department of Developmental Services (DDS), which currently serves about 350,000 individuals with qualifying developmental disabilities in California. We first provide an overview of the budget proposal, including caseload projections and changes in year‑over‑year spending. We then consider four key new policy proposals. First, and most significantly, we consider the Governor’s proposal for a performance‑incentive program, which appears to represent a new direction for the DDS system. Second, we assess the Governor’s proposal to provide supplemental rate increases in additional service categories in 2020‑21. Third, we review a proposal to reduce the caseloads of service coordinators who work with children ages 3, 4, and 5. Finally, we examine the Governor’s proposed additions to DDS’ crisis and safety net services.
July 2, 2015 - Presented to Senate Committee on Public Health and Developmental Services Second Extraordinary Session
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 21, 1990 - One of the Legislature's challenges over the next decade is to promote adequate access to nursing facility beds for the state's population. Our review suggests that it is possible that there will be a disparity between the need for nursing facility services and the growth of bed supply over the next decade. Furthermore, the current Medi-Cal reimbursement system may be (1) contributing to low supply growth, (2) causing access problems to nursing facility beds for Medi-Cal clients, and (3) providing incentives that encourage expansion of facilities that are more costly to operate.