The IHSS program consists of two components: the Personal Care Services Program (PCSP) and the Residual IHSS program. Services provided in the PCSP are federally reimbursable under the Medicaid Program. The PCSP limits eligibility to categorically eligible Medi-Cal recipients (California Work Opportunity and Responsibility to Kids and SSI/SSP recipients) who satisfy a "disabling condition" requirement. Personal care services include activities such as: (1) assisting with the administration of medications; and (2) providing needed assistance with basic personal hygiene, eating, grooming, and toileting. The following cases are excluded from the PCSP and therefore receive services through the Residual IHSS program: cases with domestic services only, protective supervision tasks, spousal providers, parent providers of minor children, "income eligibles" (generally, recipients with income above a specified threshold), "advance pay" recipients (eligible for payments prior to the provision of services), and recipients covered by third party insurance.
Background. In order to be eligible for services under the IHSS program, a person must be living in his or her own home and be either "status eligible" or "income eligible." An individual is considered to be status eligible if he or she is receiving SSI/SSP. An individual is considered to be income eligible if he or she:
Federal Funds Could Be Obtained for Income Eligibles. Income eligibles currently are excluded from the PCSP component of the IHSS program. These cases are funded in the Residual IHSS program, at a ratio of 65 percent General Fund and 35 percent county funds.
The income eligibles population falls into two categories: (1) those who are not eligible for the PCSP because of federal Medicaid regulations (for example, because they are receiving services from a spouse or paying for services using the advance pay option), and (2) those who may be eligible for the PCSP at the option of the state under Medicaid regulations but are excluded by the provisions of the State Medicaid Plan. Our analysis indicates that the second category could be made eligible for federal funding simply by amending our State Medicaid Plan to allow this group to be eligible for the PCSP. This would result in federal reimbursement for services at the Medicaid sharing ratio of approximately 51 percent.
We estimate that including income eligibles in the PCSP would result in additional federal Medicaid funds of $81.9 million in 1998-99, with a net savings of $35.1 million to the General Fund and $18.9 million in county funds. (Our estimate accounts for the possibility that some additional people, who are not currently receiving services through IHSS but rather are paying for personal care services "out of pocket,"will become eligible for the PCSP.) Accordingly, we recommend that the Legislature adopt budget bill language directing the Department of Health Services to submit the necessary State Medicaid Plan amendment to the federal Department of Health and Human Services to allow IHSS income eligibles to be included in the PCSP.
This could be accomplished by adoption of the following budget bill language in Item 4260-001-0001:
"The Department of Health Services shall, by September 30, 1998, submit to the Secretary of Health and Human Services an amendment to the State Medicaid Plan so as to allow income eligibles in the In-Home Supportive Services (IHSS) program, who are not otherwise excluded under Title XIX of the Social Security Act, to be eligible for services under the IHSS Personal Care Services Program."
Federal Title XX Social Services Block Grant funds are allocated to the states and can be used for a variety of purposes in social services programs, with no state maintenance-of-effort requirement. The budget projection of the Title XX funds that will be available for expenditure in 1998-99 is based on an assumption which underestimates the amount actually allocated to California in federal fiscal year 1998. In recognition of this, the department revised its estimate of available Title XX funds after the budget was introduced, indicating that the state will receive an additional $12.7 million of these funds in the budget year. We agree with the department's new projection.
These additional federal funds can be used to offset state General Fund expenditures. Consequently, we recommend that the additional funds be budgeted for the IHSS program, in lieu of General Fund support, for a state savings of $12.7 million. This is consistent with how Title XX funds currently allocated to the department are budgeted, and will not result in a reduction in the level of services provided under the program.
Pursuant to the reorganization of the budget, Item 5180-141 does not include the county costs for administering the California Work Opportunity and Responsibility to Kids (CalWORKs) program, because these costs are reflected in the CalWORKs program appropriation in Item 5180-101 (see our analysis of CalWORKs).
The budget proposes an appropriation of $269.7 million from the General Fund for county administration of welfare programs (excluding CalWORKs) in 1998-99. This represents a decrease of $38.4 million, or 12 percent, from estimated current-year expenditures. This reduction is primarily due to (1) substantially reduced costs for the Statewide Automated Child Support System as the state temporarily suspends its child support automation effort and (2) the shifting of certain child support court commissioner costs to the Judicial Council. (The budget, however, separately includes a $20 million "set-aside" for child support automation.)
decline. (Reduce Item 5180-141-0001 by $7,766,000, reduce Item 5180-141-0890 by $10,545,000, and reduce Item 5180-101-0890 by $2,614,000.)
Typically, the methodology used to budget for county administration of the Food Stamps program is based on the amount counties actually spent in the past year, adjusted for projected changes in caseload and inflation in the budget year. This amount is also adjusted for policy changes, if any. The budget proposal for county administration, however, does not reflect the 7.9 percent caseload reduction that the budget projects for the Food Stamps program in 1998-99. Making this adjustment would result in General Fund savings of $7.8 million. Accordingly, we recommend that the budget for county administration be reduced to be consistent with the caseload projections.
In addition, our recommendation would result in a $2.6 million reduction for the county share of expenditures, but for technical reasons this would translate into a reduction of federal TANF funds. (This is due to the interaction between our recommendation and an existing statutory provision.) Because these funds are part of a block grant, they would be retained by the state and could be used for other CalWORKs activities.
The LMHC program provides residential care and maternity-related services to unmarried pregnant women under the age of 18. The budget proposes General Fund expenditures of $2 million for support of the program in 1998-99. Figure 35 (see page 156) shows the amount of funds budgeted and spent by maternity homes since 1994-95. As the figure indicates, expenditures have fallen short of the amount appropriated for the program in the last three years. Based on our discussions with the department, we estimate that the program will revert $1.6 million to the General Fund in the current year.
The department advises that the expenditure levels accurately reflect the need for LMHC program services. We note that many unmarried pregnant women under the age of 18 are placed in foster care group homes instead of licensed maternity homes because they require additional nonmaternity related services that LMHC facilities are not licensed to provide. Given the demonstrated level of demand for LMHC program services, we recommend a General Fund reduction of $1.6 million to more accurately reflect the program's anticipated spending level.
There are two components of the Adoptions Program: (1) the Relinquishment (or Agency) Adoptions Program, which provides services to facilitate the adoption of children in foster care; and (2) the Independent Adoptions Program, which provides adoption services to birth parents and adoptive parents when both agree on placement.
In addition to the Adoptions Program, the Adoptions Assistance Program (AAP) provides grants to parents who adopt "difficult to place" children. State law defines these children as those who, without assistance, would likely be unadoptable because of their age, racial or ethnic background, handicap, or because they are a member of a sibling group that should remain intact.
The AAP provides grants to parents who adopt "difficult to place" children. For those cases meeting federal eligibility criteria, the federal government will fund 51.23 percent of costs (51.55 percent beginning October 1998). For nonfederally eligible cases, the state covers 75 percent of costs and counties fund 25 percent.
The budget estimates the proportion of AAP cases that are federally eligible using caseload data from June 1996 through April 1997. Beginning in May 1997, Los Angeles County corrected an error in its eligibility determination procedures that had resulted in many AAP cases that met the federal criteria being counted as not federally eligible. The county redetermined federal eligibility for all of its AAP cases, and a much larger proportion of cases have been determined to be federally eligible. Figure 36 shows that the changes reported by the county have substantially increased the statewide proportion of AAP cases that are receiving federal funding, with the percentage of federally eligible cases increasing from 72 percent in April 1997 to 83 percent in September 1997.
The budget estimate of the proportion of AAP cases that are eligible for federal funding--71 percent statewide--does not reflect the corrected eligibility determination procedures in Los Angeles County. Based on recent data, we project that 82 percent of AAP cases will be federally eligible in 1998-99. Combining this projection with the rate of total caseload growth assumed in the budget, we estimate that federal expenditures for the AAP are understated by $8.8 million, and combined state and county expenditures are therefore overstated by the same amount. Accordingly, we recommend that the budget be adjusted to reflect our estimates, resulting in a General Fund savings of $6.6 million and a county funds savings of $2.2 million.
The federal Adoptions and Safe Families Act of 1997 (PL 105-89) authorizes the Secretary of Health and Human Services to make incentive payments to states that increase the number of adoptions of children in foster care in federal fiscal years (FFY) 1998-02. The incentive payment would be $4,000 per child, plus an additional $2,000 for each special needs adoption, with a maximum allocation to all states of $20 million in each fiscal year. The incentive payments may be used to augment services that are provided under the foster care, child welfare services, and adoptions programs, or to supplant General Fund money that is currently spent on these programs and is not used to match federal funds.
If the authorized level of federal adoptions incentive funds is appropriated for FFY 99 (October 1998 through September 1999), and if counties meet their state Adoptions Initiative performance agreement targets in 1997-98 and 1998-99, we estimate that the state could earn as much as $15 million in incentive payments in FFY 99. As noted above, the maximum incentive payment allocation to all states is capped at $20 million. Therefore, unless other states perform poorly, California would probably earn less than the full $15 million.
The Legislature could express its preferences on this issue by adopting budget bill language--either to augment programs or reduce General Fund expenditures--in anticipation of the potential receipt of these funds.
The budget proposes expenditures of $85.2 million ($36 million General Fund) for the CCLD in 1998-99. This represents a 45 percent increase in General Fund expenditures from the current year, largely due to a projected increase in licensing program workload and a proposal to provide early childhood development training to child care providers.
Background. Under current law, the DSS collects annual fees which fund some of the costs of licensing community care facilities. Current law also provides that for each year, fee revenues exceeding $6 million (after deducting administrative costs) shall be deposited in the Technical Assistance Fund, and shall be available for appropriation to establish and maintain CCLD staff to provide technical assistance to licensees.
Technical Assistance. The Technical Support Program (TSP) within the CCLD includes eight program analysts who provide technical assistance to residential care providers licensed by the division. The TSP provides both group training sessions for care providers and in-depth consultations with individual providers who are having difficulty in complying with licensing standards. The TSP is supported by $450,000 from the Technical Assistance Fund and $360,000 from the General Fund in the current year.
The Child Care Advocate Program (CCAP) within the CCLD includes 13 program analysts who provide technical assistance to child care providers licensed by the division. The CCAP is supported by $360,000 from the Technical Assistance Fund, $386,000 from the Child Health and Safety Fund, and $280,000 from the General Fund in the current year.
Large Balance in Technical Assistance Fund. The budget projects that the Technical Assistance Fund year-end balance will increase from $784,000 in 1996-97 to $1.3 million in the current year and $1.7 million in the budget year. The budget estimates annual revenues of $1.3 million and expenditures of $868,000 in 1998-99. If annual revenues and expenditures continue at these levels, the fund balance will increase by approximately $400,000 annually.
Additional Technical Assistance Could Result in Savings. The department reports that, although the TSP is effective in increasing compliance with licensing standards, providers who desire an in-depth consultation often must wait several months before staff are available to provide assistance.
To the extent that technical assistance enables providers to comply with licensing regulations, expenditures on such assistance could result in future General Fund savings by decreasing the workload in other areas of the licensing program. Based on our discussions with the department, we believe that using Technical Assistance Fund resources for additional TSP positions would reduce the backlog for in-depth consultations, and would increase the number of providers who are in compliance with licensing regulations. Accordingly, we recommend increasing Technical Assistance Fund expenditures by $386,000 in 1998-99 to augment the TSP by five new positions. With these additional staff, the department would then have one program analyst in each of the division's 13 district offices.
Excess Fund Balances Could Be Used to Achieve General Fund Savings.Expanding the TSP by five positions would align Technical Assistance Fund revenues and expenditures at a level of about $1.3 million. However, the fund would continue to have a year-end balance of about $1.4 million, or 110 percent of expenditures, which is well in excess of a prudent reserve.
These funds could be used to provide additional technical assistance; however, this would create an ongoing expenditure which, at some point, would exhaust the reserves unless revenues increase. Furthermore, adoption of our recommendation would, by staffing all of the district offices, bring the resources for technical assistance to a level which we believe are sufficient to meet the program's needs. Thus, we believe it would be reasonable to use the reserves to replace one-time General Fund monies proposed in the budget for community care licensing activities. Specifically, we recommend appropriating $1.2 million from the Technical Assistance Fund, with a corresponding reduction in the General Fund, to support the following one-time expenditures proposed in the budget:
Adoption of our recommendation would leave a projected year-end fund balance of about $100,000 in the Technical Assistance Fund, which would amount to about 8 percent of ongoing expenditures from the fund. We note that because the authorizing legislation requires that Technical Assistance Fund monies be expended to fund the creation and maintenance of new Technical Assistance positions, our recommendation would require trailer bill legislation to supersede this provision in 1998-99.
Health and Social Services
|Healthy Families Program|
|1. $1.4 Billion of Federal Funds Will Roll Forward Into 1999-00.Under the budget plan, about $1.4 billion of California's federal allocation through June 1999 will remain unspent and roll forward. It is likely that most, if not all, of these funds will remain unspent.||C-19|
|2. Federal Approval of Continuing Eligibility in Doubt.Withhold recommendation on $9.2 million from the General Fund requested in the Department of Health Services' (DHS) Medi-Cal budget to provide one-month continuing eligibility for children, pending resolution of federal objections to this proposal.||C-19|
|3. Requiring Children in the California Children's Services (CCS) Program to Enroll in the Healthy Families Program, If Eligible, Would Result in State and Local Savings. Reduce Item 4260-111-0001 by $9,118,000, Increase Item 4280-101-0001 by $2,972,000.Recommend enactment of legislation to require qualifying participants in the CCS Program to enroll in the Healthy Families Program in order to provide more comprehensive health care services to CCS children and to reduce net General Fund and county costs by $6.2 million each in 1998-99 compared with the Governor's budget.||C-20|
|4. Including Regional Center Services As a Healthy Families Benefit Should Be Explored. Recommend that DHS, the Department of Developmental Services and the Managed Risk Medical Insurance Board report at budget hearings on the feasibility of including regional center services as a Healthy Families benefit, including an estimate of any potential state savings.||C-22|
|Department of Aging|
|5. Proposed Expansion Would Not Allocate Funds According to Need. Withhold recommendation on $12.2 million ($9.1 million General Fund) requested to expand several California Department of Aging programs because the program expansion is not based on the need for services.||C-23|
|6. Budget Does Not Reflect Savings From an Increase in Federal Funds. Reduce Item 4170-101-0001 by $125,000 and Increase Item 4170-101-0890 by $125,000.Recommend a General Fund reduction of $125,000 in the amount proposed for the Multipurpose Senior Services Program to reflect additional federal funds due to an increase in the federal share of costs of this program.||C-29|
|Department of Alcohol and Drug Programs|
|7. Budget Does Not Account for Increased Federal Medicaid Sharing Ratio. Reduce Item 4200-101-0001 by $280,000 and Item 4200-102-0001 by $37,000.Recommend budget adjustment, for a $317,000 General Fund savings.||C-30|
|Department of Health Services--State Operations|
|8. Armed and Over Budget. Reduce Item 4260-001-0001 by $193,000. Recommend reduction in the amount requested for the California Zero Fraud Tolerance Initiative because (1) large travel allotments are unnecessary, (2) additional border inspectors should be budgeted at the entry-level position classification, and (3) armed officers are not required to conduct eligibility verifications in hospitals or computer database checks of aliens.||C-32|
|9. Filling Positions Would Generate Savings. Increase Item 4260-001-0001 by $1,090,000 and Reduce Item 4260-101-0001 by $4,761,000. Recommend General Fund augmentation of $1.1 million to fill 39.3 vacant positions in order to increase recoveries from third parties and reduce General Fund Medi-Cal costs by $4.8 million, for a net savings of $3.7 million.||C-34|
|10. Phantom Positions Undermine Legislative Oversight. Recommend that the department present a revised staffing plan to the budget subcommittees that identifies and proposes to eliminate approximately 500 vacant positions that the budget does not propose to fund in 1998-99.||C-34|
|California Medical Assistance Program (Medi-Cal)|
|11. Medi-Cal Estimate Includes Adjustments for Shift to Managed Care. The Medi-Cal estimate has been reduced by $14.9 million in 1997-98 and $93.9 million in 1998-99 (about half General Fund) in order to correct for distortions caused by the shift to managed care. We find that these adjustments are appropriate in nature and do not seem unreasonable in size. We will review the specific methodology of these adjustment as part of our overall review of the Medi-Cal estimate for the May Revision.||C-49|
|12. Savings from Uncertainty Adjustments Appear Arbitrary. The Medi-Cal budget estimate includes General Fund savings of $109.6 million in 1997-98 and $133 million in 1998-99 as a result of adjustments that reduce expenditures 2 percent below the department's mid-range estimate. These adjustments appear arbitrary at this time, and we recommend excluding these savings for budget planning purposes, pending a more complete analysis of the Medi-Cal estimate and the most recent available caseload and expenditure information for the May Revision.||C-50|
|13. Caseload Growth Funding for County Administration is Unnecessary. Reduce Item 4260-101-0001 by $16,700,000. Recommend total General Fund reduction of $26.1 million (including current-year savings of $9.4 million) because these amounts have been budgeted for caseload growth which the department's Medi-Cal estimate indicates will not occur.||C-51|
|14. Are Transitional Medi-Cal Participation Rates Too Low? Recommend that the department report during budget hearings on (1) the reasons for the apparent low participation rate in Medi-Cal transitional coverage, (2) the number of eligible families that do not participate and lack other health coverage, and (3) progress in implementing recent legislation to improve administration of the transitional program and outreach and education efforts.||C-54|
|15. Additional Year of Transitional Medi-Cal in Doubt.Withhold recommendation on $2.6 million ($1.3 million General Fund) proposed to fund extended Medi-Cal transitional benefits, pending the outcome of discussions between the Department of Health Services (DHS) and the Health Care Financing Administration to obtain a federal waiver necessary to implement the additional coverage.||C-56|
|16. Plan Needed for Implementing Medi-Cal Eligibility Under Section 1931(b). Recommend that DHS develop, prior to budget hearings, a proposal for implementing Section 1931(b) Medi-Cal eligibility and coordinating 1931(b) eligibility with the current medically needy and transitional Medi-Cal eligibility categories. We present some issues for the Legislature to consider in evaluating this proposal.||C-59|
|17. Augmentation for Section 1931(b) Eligibility Determinations Not Justified. Reduce Item 4260-101-0001 by $15,630,400. Recommend total General Fund reduction of $23.4 million (including current-year savings of $7.8 million) for additional county eligibility determinations because the new workload will substitute for existing workload.||C-62|
|18. Department Plans New Payment Approach for Nursing Homes. We recommend that DHS report at budget hearings on its plans for revising payments to long-term-care facilities.||C-63|
|19. Proposition 99--New Positions Not Justified by Workload.Recommend deletion of three of the eight new positions requested, and redirection of the $286,000 savings into the Proposition 99 media campaign.||C-65|
|20. Redirecting Funds Proposed for New Program Into Proven Existing Program Likely to Be More Cost Effective. Recommend redirecting proposed $2.6 million General Fund augmentation to establish a new early childhood family education program into the existing Adolescent Family Life Program.||C-68|
|21. Positions Not Needed in Childhood Lead Poisoning Prevention Program. Reduce Item 4260-001-0080 by $786,000. Recommend deleting nine new positions proposed in the budget and two existing positions because the workload can be addressed by related budget proposals.||C-70|
|22. Administration Renews Request to Implement Federal Abstinence Education Program. We comment on the proposal and related research.||C-71|
|23. Funding Alternatives Available for Emerging Infectious Diseases and Food Safety Programs. Reduce Item 4260-001-0001 by $1,006,000 and Increase Item 4260-001-0177 by $828,000. Recommend deleting 13 new positions proposed for the Emerging Infectious Diseases program and instead permitting the department to fill 12 position vacancies by reducing the salary savings requirement, for a net General Fund savings of $178,000. Further recommend funding the proposed Food Safety program with industry fees instead of $828,000 from the General Fund.||C-74|
|24. Newborn Hearing Screening Proposal Has Merit, But Cost Estimate Needs Justification. We withhold recommendation, pending submission of additional justification by the department.||C-76|
|Department of Developmental Services|
|25. Reporting Changes Would Improve Legislative Oversight of Case Management Funding. Recommend that funds appropriated for case management be scheduled separately in the Budget Bill. Further recommend adoption of supplemental report language requiring the department to report on the implementation of its plan to augment case management.||C-80|
|26. Proposed Position Upgrades Are Excessive. Reduce Item 4300-101-0001 by $4,511,000, Item 4260-101-0001 by $1,686,000, and Item 4260-101-0890 by $1,789,000. Recommend reduction of $3.3 million from the General Fund to align proposed regional center position upgrades more closely with actual duties and salaries. Further recommend that new case management positions be budgeted at the first salary step of the relevant state classification, for a General Fund savings of $2.9 million.||C-83|
|27. Care Facility Training Program is Overbudgeted. Reduce Item 4300-101-0001 by $1,569,000, Item 4260-101- 0001 by $2,412,000, and Item 4260-101-0890 by $2,558,000. Recommend budget reduction to reflect the department's planned phase-in of training and associated pay increases for community care facility employees, for a General Fund savings of $4 million in 1998-99.||C-87|
|28. Federal Waiver for Habilitation Services Could Result in State Savings. Recommend that DDS, in cooperation with the Department of Rehabilitation (DR), include services provided under the Department of Rehabilitation's Habitation Services program in the state's application for a new Home and Community Based Services federal waiver. This could result in a significant increase in federal funds and commensurate savings to the state.||C-89|
|29. Legislature Needs More Information on Supported Living Augmentation. Withhold recommendation on $2 million proposed for the expansion of supported living services in 1998-99 because the department (1) has not yet allocated $1 million appropriated for expansion in the current year and (2) is in the process of surveying regional centers to determine the level of demand for these services.||C-90|
|30. Technical Issue--Case Management for Community Placements Overbudgeted. Reduce Item 4300-101-0001 by $276,000, Item 4260-101-0001 by $99,000, and Item 4260-101-0890 by $106,000. Recommend adjusting the budget to correct for a technical error, which would result in a General Fund savings of $375,000.||C-91|
|31. Developmental Center Placements Should Be Judicially Reviewed. Recommend enactment of legislation requiring the DDS to institute a process for conducting judicial reviews to determine the appropriateness of developmental center placement for current residents who have never had such reviews.||C-92|
|32. Continue Funding for Camarillo Maintenance. Increase Item 4300-003-0001 by $3,799,000. Recommend $3.8 million General Fund augmentation to continue maintenance of the state hospital and developmental center because California State University's proposal to assume control of the site is premature.||C-97|
|33. Proposed Developmental Center Positions Should Be Budgeted at First Salary Step. Reduce Item 4300-003-0001 by $97,000, Item 4260- 101-0001 by $722,000, and Item 4260-101-0890 by $767,000.Recommend that most of the new nursing positions be budgeted at the first salary step, to be consistent with standard budgeting procedures, for a General Fund savings of $819,000 in 1998-99.||C-97|
|Department of Mental Health|
|34. Inflation Adjustment Is Overbudgeted. Reduce Item 4440-103-0001 by $2,096,000. Recommend a technical adjustment to reflect an updated forecast of the 1998-99 medical Consumer Price Index.||C-99|
|Employment Development Department|
|35. Federal Welfare-to-Work Block Grant Program. California will receive up to $363 million in federal Welfare-to-Work block grant funds to serve specified hard-to-employ Temporary Assistance for Needy Families recipients, if the state provides the necessary one-third match. The Governor proposes to spend $95 million from the General Fund for the state match and further proposes a plan for the entire federal allotment. We review the proposal and identify options available to the Legislature.||C-101|
|Department of Rehabilitation|
|36. Governor Proposes to Suspend Statutory Rate Increase for the Work Activity Program. Suspension of the rate increase would result in a General Fund cost avoidance of $9.6 million.||C-107|
|37. Caseload Projections Do Not Reflect Recent Trends. Reduce Item 5160-101-0001 by $5,448,000, Increase Item 5160-001-0001 by $644,000, and Increase Item 5160-001-0890 by $2,381,000.Recommend a net reduction of $4.8 million from the General Fund to reflect recent trends in the Work Activity Program and Supported Employment Program.||C-108|
|38. Department Should Report on Supported Employment Cost Study. Recommend department advise Legislature on the status and findings of the statutorily required study.||C-110|
|Department of Social Services--
|39. Recent Federal Changes in Welfare Reform Have Significant Implications for California. We review the key features of the Balanced Budget Act and the recently issued proposed federal regulations.||C-114|
|40. Governor Proposes to Continue Past Grant Reduction and Eliminate Statutory Cost of Living Adjustments. These changes result in a General Fund cost avoidance of $248 million. We review the Governor's proposals and comment on them.||C-116|
|41. Defer Expenditure of State Match for Welfare-to-Work Program Until 1999-00. Reduce Item 5180-101-0001 by $95,000,000.Recommend deferring the proposed General Fund expenditure of $95 million in state matching funds for the federal Welfare-to-Work block grant by one year because the state may be able to identify the required match from within the base budget for the CalWORKs program in 1999-00, at no additional cost to the General Fund.||C-118|
|42. Impact of Budget Reductions in CalWORKs. Because of the federal maintenance-of-effort requirement, any budget reductions in the CalWORKs program identified by the Legislature would result in a savings of federal funds. Such savings could be (1) redirected to other priorities in CalWORKs, (2) placed into a reserve for future years, and/or (3) transferred to the Social Services Block Grant (Title XX), where the funds could be used to offset General Fund spending in other departments.||C-120|
|43. Budget Does Not Reflect Savings From Projected Caseload Decline. Reduce Item 5180-101-0890 by $40,011,000. Recommend that proposed expenditures for county administration of the CalWORKs program be reduced by $40 million in federal funds to reflect the budget's projected caseload decline.||C-121|
|44. CalWORKs Employment Services Are Overbudgeted. Reduce Item 5180-101-0890 by $209,174,000. Recommend that the budget for CalWORKs employment services be reduced by $209 million because the budget exceeds the estimated amount needed to fully fund the program.||C-122|
|45. Establish a Temporary Assistance for Needy Families Reserve. Recommend that the Legislature place at least 50 percent of our identified savings in the CalWORKs program into a reserve for expenditure in future years.||C-126|
|Aid to Families with Dependent Children--
|46. Budget Underestimates Proportion of Cases Eligible for Federal Funds. Increase Item 5180-101-0890 by $19,690,000 and Reduce Item 5180-101-0001 by $7,894,000. Recommend reducing the General Fund amount budgeted for the Aid to Families with Dependent Children-Foster Care program by $4.3 million in 1997-98 and $7.9 million in 1998-99 because the budget underestimates the number of cases that are eligible for federal funding.||C-129|
|Child Support Enforcement|
|47. Adoption of New Incentive Payment System Could Improve Child Support Enforcement Program.Recommend legislation be enacted to establish a child support incentive payment system in which county incentive payments are a function of county administrative effort and cost-effectiveness. Further recommend legislation to establish a specified administrative review procedure for low-performing counties.||C-132|
|48. Child Support Incentive Payments Are Overstated.Reduce Item 5180-101-0001 by $26,307,000. Recommend reducing the General Fund amount proposed for child support incentive payments by $20.3 million in 1997-98 and $26.3 million in 1998-99 because the budget overestimates state incentive payments to counties for non-CalWORKs child support collections.||C-143|
|49. Budget Underestimates Arrearages Available to Offset CalWORKs Grant Costs. Reduce Item 5180-101-0001 by $26,416,000 and Reduce Item 5180-101-0890 by $32,270,000.Recommend reducing proposed General Fund expenditures to more accurately reflect amount of arrearages available to offset CalWORKs grant costs.||C-143|
|Supplemental Security Income/
State Supplementary Program
|50. Supplemental Security Income/State Supplementary Program (SSI/SSP) Caseload Growth Is Overestimated. Reduce Item 5180-111-0001 by $63,980,000. Recommend reducing the General Fund amount proposed for SSI/SSP grants by $49 million in 1997-98 and $64 million in 1998-99 because caseload growth is overestimated.||C-147|
|51. Budget Proposes to Eliminate State Cost-of-Living Adjustment. By proposing to delete the requirement to restore the statutory state cost-of-living adjustment, the budget would achieve a cost avoidance of $39 million in 1998-99.||C-148|
|In-Home Supportive Services|
|52. State Plan Amendment Would Increase Eligibility for the Personal Care Services Program (PCSP). Increase Item 5180-111-0890 by $81,902,000 and Reduce Item 5180-111-0001 by $35,136,000. Recommend adoption of budget bill language to direct the Department of Health Services to submit a State Medicaid plan amendment to allow In-Home Supportive Services "income eligibles" to be included in the PCSP, which would result in $81.9 million in additional federal funds and a General Fund savings of $35.1 million.||C-150|
|53. Federal Funds Not Budgeted. Increase Item 5180-111-0890 by $12,662,000 and Reduce Item 5180-111-0001 by $12,662,000.Recommend that federal funds budgeted for the IHSS program be increased by $12.7 million, and General Fund support be reduced by the same amount, to reflect federal Social Services Block Grant funds that the state will receive and which are not reflected in the budget.||C-152|
|County Administration of Welfare Programs|
|54. Budget Does Not Reflect Savings From Projected Caseload Decline. Reduce Item 5180-141-0001 by $7,766,000, Reduce Item 5180-141-0890 by $10,545,000, and Reduce Item 5180-101-0890 by $2,614,000.Recommend proposed expenditures for county administration of the Food Stamps program be reduced by $7.8 million from the General Fund to reflect the budget's projected caseload decline.||C-153|
|55. Licensed Maternity Home Care Program Overbudgeted. Reduce Item 5180-151-0001 by $1,595,000. Recommend a General Fund reduction of $1.6 million to reflect the actual expenditure trend.||C-155|
|56. Budget Underestimates Proportion of Adoptions Assistance Program (AAP) Cases Eligible for Federal Funds. Increase Item 5180-101-0890 by $8,848,000 and Reduce Item 5180-101-0001 by $6,636,000. Recommend reducing the General Fund amount budgeted for the AAP by $6.6 million in 1998-99 because the budget underestimates the number of cases that are eligible for federal funding.||C-157|
|57. State May Earn Federal Adoptions Incentive Payments. California could receive up to $15 million in federal adoptions incentive payments, beginning October 1998, depending primarily on how much is appropriated for the new program in federal fiscal year 1999.||C-159|
|Community Care Licensing Division|
|58. Use Special Fund Balance to Increase Technical Assistance and Achieve General Fund Savings. Reduce Item 5180-001-0001 by $1,200,000, and Increase Item 5180-001-0270 by $1,586,000. Recommend augmenting the budget by $386,000 from the Technical Assistance Fund to establish five new positions for technical assistance in the Community Care Licensing Division. Further recommend appropriating $1,200,000 from the Technical Assistance Fund, with a corresponding reduction from the General Fund, to support certain one-time expenditures in 1998-99.||C-160|