LAO 2005-06 Budget Analysis: General Government

Analysis of the 2005-06 Budget Bill

Legislative Analyst's Office
February 2005

Health Services—State Operations

The Department of Health Services (DHS) administers a broad range of programs for primary care and family health, public health, environmental health, and county health services. It also administers the Medi-Cal Program, which provides health care services to welfare recipients and other qualified low-income persons (primarily families with children and the aged, blind, or disabled). The DHS operates certification and licensing programs for certain types of medical providers, including nursing homes and hospitals.

The Governor's budget for DHS state operations proposes $264 million from the General Fund ($987 million from all fund sources) for 2005-06. The proposed budget would provide an increase of about $3.6 million in General Fund resources, or about 1.4 percent, compared with the revised current-year level of expenditures for DHS state operations. These resources would be used to support almost 5,700 staff and offset other program expenses.

Information Technology Projects Violate State Rules

We withhold recommendations on several proposals to modify or develop information technology systems pending receipt and review of Feasibility Study Reports to support the requests.

The budget proposes $13.8 million (all funds) and nine positions for a number of new or modified information technology (IT) systems for DHS. Figure 1 describes the requests and their proposed costs and positions. In "Part V" of The 2005-06 Budget: Perspectives and Issues, we provide specific recommendations on the proposed IT system for the California Rx program. We discuss the remaining proposals below.

Figure 1

Department of Health Services
Information Technology Proposals

(Dollars in Thousands)




Medi-Cal eligibility information—
Modify existing IT systems.


Medi-Cal beneficiary cost sharing—
Develop new payment and reconciliation IT system.


Dental providers—
Modify existing IT system.



Estate recovery and personal injury cases—
Develop new case management system.



Medi-Cal managed care—
Modify existing IT system.



California Rx program—
Develop new IT system.



County caseload trends—
Create reports.


Hospital financing—
Modify existing IT system.





Feasibility Study Reports (FSRs) Needed to Justify IT Proposals. Current state policy requires departments to prepare FSRs for any IT proposal that is included in the budget. The FSR must include (1) a description of the program problems that the department is attempting to solve, (2) the costs to develop and maintain the new or modified system, and (3) implementation schedules describing the tasks and timeframes to complete the IT proposal. In addition, according to state policy, IT projects that are included in the budget must be submitted to the Legislature and receive approval from the Department of Finance (DOF). At the time this analysis was prepared, the department had not provided FSRs or detailed information to support any of the proposals. In addition, it is not clear why DOF approved these requests even though FSRs have not been prepared.

Withhold Recommendations on IT Proposals. Since FSRs have not been provided for these proposals, it is not clear what specific business problems the department is attempting to address, how much the new or modified systems would cost to maintain and operate, and how long it will take to implement or change the systems. For these reasons, we withhold recommendations on the proposals pending the receipt and review of FSRs to support the requests.

Return to Health and Social Services Table of Contents, 2005-06 Budget Analysis