Major Issues

Overview

• Expenditure Proposal and Trends
• Caseload Trends
• Spending by Major Program
• Major Budget Changes

Crosscutting Issues

• Federal Medicaid Match
• Technical Issue: Budget Proposal to Increase Federal Medicaid Match Understates General Fund Savings

Departmental Issues

• Health and Human Services Agency (0530)
• Thinking about Health Care Expansion
• Secretary to Develop Plan for Health Care Reforms
• A Framework for Considering Health Coverage Expansions
• Options for Expanded Coverage
• Department of Health Services (Medi-Cal) (4260)
• Medi-Cal Benefits And Eligibility
• What Benefits Does Medi-Cal Provide?
• How Medi-Cal Works
• Who Is Eligible for Medi-Cal?
• More Than Half of Medi-Cal Spending Is for the Elderly And Disabled
• Medi-Cal Expenditures
• Spending Up Sharply in the Current Year
• $507 Million General Fund Deficiency in 1998-99
• Budget Year
• Medi-Cal Spending and Caseload Trends
• Growth in Cost Per Eligible Is Driving Spending
• Has Managed Care Slowed Spending Growth?
• Budget Depends on Risky Federal Assumptions
• Implementation of California's Section 1931(b) Program Begins
• Delay in Implementing Section 1931(b) Eligibility is Costly
• Lagging Redeterminations Could Increase Costs Further
• Budget Overestimates CalWORKs-Related Medi-Cal Caseload
• The DHS Expands Section 1931(b) Eligibility Above CalWORKs Income Limits
• Benefits, Rates, and Costs
• Smoking Cessation Drugs Overbudgeted
• Department Should Report on Potential New Rate Setting Approaches
• Hospital Construction Program--Spending Estimates and Future Projections Needed
• Bringing the Medi-Cal Estimate Up to Date
• Medi-Cal Estimating Methodology Needs Revision
• Public Health
• Proposition 99
• Certain Health Programs Hit Hard
• Other Public Health Programs
• Budget Proposes Elimination of General Fund Support For County Medical Services Program
• Budget Underestimates Federal Funds for ADAP
• Budget Proposes One-Year Extension for Community Challenge Grant Program
• Cancer Research Fund Balance Should Be Transferred to General Fund
• Budget Does Not Maximize Federal Funds For Drinking Water Program
• Managed Risk Medical Insurance Board (4280)
• Healthy Families Program
• New Policies Adopted to Increase Enrollment
• Monthly Enrollments Falling Behind Budget Projections for Current Year
• Budget Proposes to Apply Income Deductions For Determining Eligibility
• Department of Developmental Services (4300)
• Community Services Program
• Self-Determination Holds Promise, Needs Further Evaluation
• Program Development Fund Surplus Can Offset General Fund
• Developmental Centers Program
• Budget Does Not Reflect Full Savings From Napa Program Closure
• Budget-Year Projections of Federal Funding May Be Overly Optimistic
• Department of Mental Health (4440)
• Overbudgeting for SVP Evaluations
• Medi-Cal Expenditures Out of State's Control
• Decrease Mentally Disordered Offender Evaluation Payment Rates
• State Hospital Budget Underestimates MDO Commitments
• State Hospital Budget Methodology Needs Revision
• Employment Development Department (5100)
• Workforce Investment Act
• Department of Social Services CalWORKs Program (5180)
• Current-Year Update of the CalWORKs Program
• 1999-00 Budget Issues
• Impact of Maintenance-of-Effort Requirement
• Budget Underestimates Cost of Providing the Statutory COLA
• The CalWORKs Grant Levels
• Count Spending on Programs for Women Offenders And Parolees Toward MOE Requirement
• Budget Underestimates Savings From Maximum Family Grant Policy
• Budget for Services and Child Care Should Reflect Impact of Nonparticipation
• Incentive Payments Should Be Related to Improved County Performance
• Options for Using Identified Savings
• Budget Proposes to Use County Carry-Over Balances as a Funding Source
• Transfer Extra Child Care Funds to Child Care Reserve
• Penalty for Failure to Meet Federal Work Participation Rate
• Withhold Recommendation on Savings Attributable to Diversion
• Withhold Recommendation on Budget for CalWORKs Community Service
• Options for Budgeting Community Service Employment
• Rethinking the Budget for CalWORKs Services and Administration
• Foster Care
• Are Foster Family Agencies "Too Successful"?
• Food Stamps Program
• California Food Assistance Program
• Supplemental Security Income/State Supplementary Program
• Budget Underestimates Cost of Providing Statutory COLA
• The SSI/SSP Grant Levels
• Cash Assistance Program for Aged, Blind, and Disabled Legal Immigrants
• Alternatives for the Regional 4.9 Percent Grant Reduction
• County Administration of Welfare Programs
• Automation Projects
• Budget Proposes No State Share Of Federal Penalty on Automation
• Budget Assumes Other Counties Will Absorb Los Angeles County "Share" of Federal Penalty
• Child Welfare Services
• Child Welfare Caseload Forecast Should Be Revised
• Independent Living Program Is Overbudgeted
• Adoptions
• State Reporting Problems Could Jeopardize Receipt of Federal Adoptions Incentive Payments
• No Clear Rationale for Proposal to Eliminate New Program