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Health and Human Services
May Revision Adjustments-Highlights
NEW RATE METHODOLOGY FOR MEDI-CAL MANAGED HEALTH CARE PLANS
After an extensive effort, recommendations have been made by an independent consultant to improve the Department of Health Services' (DHS') rate-setting methodology for Medi-Cal managed health care plans. These plans play a crucial role in providing access to health care for vulnerable Californians, serving approximately 3.2 million Medi-Cal beneficiaries each year. The May Revision includes $214.3 million ($107.1 million General Fund) to provide rate adjustments to the plans as determined by the new rate methodology, which will be implemented at the beginning of each plan's new rate year. This funding will provide a transition period to plans that otherwise would have received rate reductions under the new methodology. This is consistent with the state's prior practice of phasing in rate adjustments. Supporting a stable Medi-Cal managed care network is important to ensure adequate access to care and to support the successful implementation of Health Care Reform.
SALARY INCREASES FOR CLASSIFICATIONS AFFECTED BY THE COLEMAN AND PEREZ COURT CASES
The May Revision includes total funding of $1.6 million ($914,000 General Fund) for the Department of Developmental Services and $7.5 million ($7.4 million General Fund) for the Department of Mental Health to provide salary increases to employees in job classifications affected by these court cases. These increases are necessary to properly protect and serve the clients of these departments by retaining existing staff and enhancing the recruitment of additional mental health and dental professionals. This funding will enable the departments to increase salaries for psychiatrists and senior psychologists by between 66 and 74 percent, and raise salaries for all other impacted mental health classifications by between 10 and 40 percent. This funding also will increase salaries for both departments' dental staff by between 36 and 58 percent.
EARLY AND PERIODIC SCREENING, DIAGNOSIS AND TREATMENT PROGRAM
The Early and Periodic Screening, Diagnosis and Treatment Program (EPSDT) program provides physical and mental health services to full-scope Medi-Cal beneficiaries under the age of 21. The May Revision proposes a decrease of $24.3 million ($12.2 million General Fund and $12.1 million in federal fund reimbursements) due to a lower estimate of EPSDT claims than included in the Governor's Budget. The May Revision includes an increase of $39.9 million ($17.2 million General Fund and $22.7 million in federal fund reimbursements) to pay for the settlement of audits from the 2004-05 fiscal year, consistent with historical practice.
Responding to program and fiscal concerns, including a 2006-07 deficiency request for $243 million to pay prior year obligations owed to counties, the Department of Finance's Office of State Audits and Evaluations (OSAE) recommended the elimination of the cost settlement adjustment, historically used to discount claims estimates. The OSAE found that continuing to use the discount factor could result in under-funding and contribute to future deficiency requests. The May Revision reflects an increase of $61.6 million ($30.8 million General Fund and $30.8 million in federal fund reimbursements) for 2007-08, and will minimize the future accumulation of obligations for each fiscal year going forward.
EMERGENCY FUNDING FOR FOOD BANKS
The May Revision continues the Administration's unprecedented commitment to provide state funding, in response to last winter's freeze disaster, to local food banks and the California Emergency Foodlink, a private organization that stores and delivers food during emergencies. A total of $4.7 million General Fund already has been allocated pursuant to Government Code Section 8690.6, and the May Revision proposes an additional $4.45 million General Fund for food banks and the Foodlink.
Federal aid recently was made available to provide disaster unemployment insurance and commodities for individuals affected by the freeze. The federal commodities began arriving in April 2007. The emergency funding provided by the state has been used for the purchase and distribution of food to affected individuals, and to replenish and increase the state's reserve to prepare for future emergency distributions. In addition, the funding included in the May Revision will enable the food banks to store and distribute food from the more than 1,500 expected truckloads of federal commodities.
COST OF DOING BUSINESS ADJUSTMENTS FOR COUNTIES ADMINISTERING STATE SOCIAL SERVICES PROGRAMS
The May Revision proposes a new methodology for adjusting county administrative costs for human services programs. Chapter 75, Statutes of 2006 (AB 1808) required the Department of Social Services (DSS) to estimate the costs for county administration of human services programs using county-specific cost factors, examine factors contributing to those costs, and include the estimated county administration costs in budget documents beginning with the 2007-08 May Revision. AB 1808 also required the DSS to submit a plan to the Legislature for developing a new method of budgeting child welfare services. The Administration proposes a budgeting methodology that would provide predictable, stable funding for county administration costs in the CalWORKs, Food Stamp, Child Welfare Services, Foster Care, Adoptions, In-Home Supportive Services (IHSS), and Adult Protective Services programs, coupled with reforms designed to improve performance and accountability. Specifically, beginning in 2008-09, an annual adjustment to county administration funding would be provided equivalent to the salary and benefit increases provided to state employees, subject to appropriation. Annual adjustments would be coupled with an increased focus on accountability and incentives for improved services for children, families and low-income aged, blind or disabled Californians. The proposed methodology will build on the CalWORKs Pay-for-Performance program, existing state and county sharing in federal penalties for failure to meet performance measures in the CalWORKs and Food Stamp programs, and on the Child Welfare Services Outcomes and Accountability System. Further, the Administration proposes to establish a county share in federal Child Welfare Services penalties and to establish performance and accountability measures for the IHSS program. These reforms will provide a stable funding base for county administration and services that will grow commensurate with personnel costs, as well as introduce fiscal incentives to meet program goals and ensure the efficient use of state funds.
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CHAPTER HIGHLIGHTS for
Health and Human Services Back to Top
PRINTABLE BUDGET DOCUMENTS Back to Top
Revised Budget Summary - Health and Human Services (pdf * - 42K)
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Provides the entire Health and Human Services Chapter in pdf format.
ADDITIONAL INFORMATION Back to Top
Revised Budget Detail - Health and Human Services
Displays Revised Budget Detail information for Health and Human Services.
Proposed Budget Summary - Health and Human Services (January 2007)
Displays Proposed Budget Summary information for Health and Human Services.
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