Presented to Senate Budget Subcommittee No. 3 on Health and Human Services

Presented to Assembly Budget Subcommittee No. 1 on Health and Human Services, Hon. Holly J. Mitchell, Chair

Presented to Assembly Budget Subcommittee No. 4 on State Administration

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.

Presented to Assembly Budget Subcommittee No. 1 on Health and Human Services, Hon. Holly J. Mitchell, Chair

Presented to: Senate Budget and Fiscal Review Subcommittee No. 5 on Corrections, Public Safety and the Judiciary, Hon. Loni Hancock, Chair.

Presented to: Assembly Budget Subcommittee No. 1 on Health and Human Services Hon. Holly J. Mitchell, Chair

The FI$Cal project recently completed a procurement and selected the vendor who will build FI$Cal, the state's single, fully integrated financial information system. Project staff has submitted several documents to the Legislature, including a special project report that updates the project plans, a report to the legislature that includes information on the procurement, and a budget request for $89 million ($54 million General Fund) and 86 new positions in order to begin the first year of system development. This report (24 pages): (1) provides an extensive background on the project; (2) describes the innovative procurement process that state staff conducted to secure vendor services to build the FI$Cal system, including information on the procurement results; (3) reviews the FI$Cal project plans as explained in project documents; and (4) analyzes features of the project’s proposed plans and offers recommendations to the Legislature as it considers the budget request and the future of the system. Based upon our analysis of the proposed plans and review of project status, we believe that the benefits of proceeding with FI$Cal development at this time outweigh the costs of the project. In addition to the inherent benefits derived from having a modern, fully integrated financial information system for the state, proceeding with FI$Cal would also avoid substantial costs associated with replacing various individual financial management systems over the next several years. However, we recognize the tight budget times requiring the Legislature to make difficult decisions regarding programmatic reductions. Therefore, should the Legislature wish to proceed with the project, we offer alternative funding options that reduce the state’s reliance on General Fund monies to pay for the project in the short term. These options include the state's GS $Mart loan program, vendor financing, and advanced payments from the special funds for the first few years of system development. Additionally, we point out ways the project’s change management and staffing plans to implement FI$Cal statewide could be improved to reduce risk and maximize project benefits.

Presented to Senate Human Services Committee, Hon. Carol Liu, Chair

The In-Home Supportive Services (IHSS) program—administered at the state level by the Department of Social Services (DSS)—provides in-home care for persons who cannot safely remain in their own homes without such assistance. Since 2009-10, the IHSS program has experienced significant budget-related changes intended to achieve General Fund savings. As part of the 2012-13 budget, the Governor proposes significant changes to the IHSS program. First, the Governor proposes to transition IHSS from a fee-for-service benefit to a managed care benefit. In addition, the Governor proposes to eliminate domestic and related care services for most IHSS recipients who live with another person. We find that this reduction presents significant legal and implementation challenges, and we therefore offer the Legislature two savings alternatives for its consideration. The first alternative is to consider extending a 3.6 percent across-the-board reduction in service hours that is set to expire at the end of the current year. The second alternative is to consider reenacting a reduction in state participation in provider wages to a level, determined by a study, that does not impact recipient access to services.

Presented to: Senate Budget and Fiscal Review Subcommittee No. 4 on State Administration and General Government, Hon. Gloria Negrete McLeod, Chair

The Governor proposes to reduce funding for the CalWORKs program and state-subsidized child care programs. Under his budget plan, these programs would be reduced a total of $1.4 billion or about 20 percent in 2012-13 compared to what current law otherwise would require. These savings would be achieved by imposing stricter limits on which families are eligible to receive which types of services, as well as lowering state payments for CalWORKs recipients and child care providers. Additionally, the Governor’s proposal would make major changes to the way the state administers both welfare-to-work and child care services. In this report, we describe and analyze the Governor’s proposals related to the CalWORKs program and then turn to a similar discussion of the proposed changes to child care programs. We conclude by providing the Legislature with illustrative packages of ways to achieve savings in these two areas using different approaches than the Governor's.

Currently, three automation systems make up California’s Statewide Automated Welfare System (SAWS). These systems support some of the state’s major health and human services programs by providing eligibility determination, case maintenance, and reporting functions at the county level. Chapter 13, Statutes of 2011 (ABX1 16, Blumenfield) directs the administration to reduce this number to two by migrating, or moving, counties on an existing system to Los Angeles County’s new system. In this report, we identify several issues for the Legislature to consider as the administration pursues legislative goals for SAWS consolidation. We offer alternative procurement approaches for the migration that would encourage greater vendor competition. Finally, we make several recommendations to enhance legislative oversight and clarify legislative priorities for SAWS consolidation.

Since 2008, the cost of providing unemployment insurance (UI) benefits in many states has exceeded available resources. As a result, by 2010 the UI funds in 32 states were insolvent, forcing those states to obtain loans from the federal government to continue payment of UI benefits. In this report, we conduct a comparative analysis of the UI programs in all 50 states and Washington D.C. to provide context for the Legislature in considering potential solutions to California's UI insolvency. Our analysis finds that California’s UI program pays comparatively lower weekly benefits, but pays these weekly benefits for a longer duration and to a relatively larger caseload. As a result, California has comparatively higher total program costs. To the extent the Legislature desires, California’s comparatively high cost structure could be mitigated by changing its UI eligibility and benefits duration policies. However, regardless of UI policies, California’s UI program is likely to have a higher UI cost structure than the average U.S. state as a result of its comparatively worse labor market.

Beginning in 2008, the Unemployment Insurance (UI) funds of many states, including California’s, were under stress and soon became insolvent. Many states sought loans from the federal government. As of June 2011, California’s outstanding federal loan totaled over $10 billion. Three federal proposals have recently been introduced to address the insolvency issue. All three would improve the solvency of California’s UI fund and two would likely eliminate California’s UI fund deficit by 2016. Regardless of whether Congress acts, we recommend that the Legislature ensure implementation of a long–term solvency plan by 2014. If federal reforms are enacted, it is likely that no additional action by the Legislature will be necessary. However, if no federal reforms are enacted, it will be critically important for the Legislature to adopt its own long–term solvency plan. We recommend that the Legislature consider an approach which includes both increased employer contributions and decreased benefits for UI claimants.