Health and Human Services
Major Accomplishments in 2006-07


AFFORDABLE PRESCRIPTION DRUGS
 Two bills chaptered in 2006 to protect the health and well-being of uninsured or underinsured individuals will provide millions of low-income Californians with access to discounted prescription drugs.

Chapter 619, Statutes of 2006 (AB 2911) created the California Discount Prescription Drug Program to deliver prescription drugs at prices up to 40 to 60 percent below retail for generic and brand name drugs to individuals in families with incomes below 300 percent of the federal poverty level (currently, $29,400 for an individual and $60,000 for a family of four), to individuals who have significant unreimbursed medical expenses and incomes that fall below the state median family income (currently, $68,310 for a family of four), or, upon federal approval, to eligible seniors whose drugs are not covered by Medicare. Applicants will use a simple form and enroll at local pharmacies, doctors' offices, clinics, on the Internet or through a call center for a modest $10 annual fee. The Governor's Budget includes $8.8 million and 15.2 positions to implement this program in 2007-08.

Chapter 720, Statutes of 2006 (AB 2877) created the California Rx Prescription Drug web site, which will provide information to Californians about the options available for obtaining prescription drugs at affordable prices. The web site will include information on state programs and pharmaceutical manufacturer patient assistance programs that provide free or low-cost prescriptions to qualifying individuals. The newly created Department of Health Care Services (DHCS) will use redirected staff to implement the web site in summer 2007. The Governor's Budget includes $96,000 and 0.9 position for ongoing web site maintenance.


SB 437 - ENROLLING ELIGIBLE CHILDREN IN HEALTH COVERAGE PROGRAMS
 According to 2005 figures, approximately 447,000 children are eligible for Medi-Cal or the Healthy Families Program (HFP), but are not enrolled. Chapter 328, Statutes of 2006 (SB 437) helps ensure more children have access to health coverage by streamlining enrollment for Medi-Cal and HFP and reducing administrative barriers to ensure children get enrolled and their coverage is not interrupted. SB 437 establishes a pilot program, which can be expanded statewide, that allows parents to self-certify income and assets when enrolling their children in Medi-Cal and during the annual eligibility review process. SB 437 also allows self-certification during the annual eligibility review for HFP. When children apply for Medi-Cal and are found ineligible, but appear eligible for HFP, counties will be able to enroll them in HFP so their health coverage is not delayed. Children enrolling in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) will benefit from expedited enrollment into Medi-Cal or HFP while the state verifies eligibility for either health program.

The Governor's Budget includes $35.9 million ($16.9 million General Fund) and 9.4 positions in 2007-08 for SB 437 implementation activities and enrollment increases in the DHCS, the Department of Public Health (DPH) and the Managed Risk Medical Insurance Board (MRMIB). For the DHCS, Medi-Cal will implement a pilot program for self-certification of income in two counties by July 1, 2007. This pilot is expected to increase Medi-Cal enrollment by 16,472 children in 2007-08. For the DPH, implementation activities include joint efforts among DHCS, DPH and MRMIB to develop the feasibility study reports necessary to begin implementing changes to several automated eligibility systems. This includes an automated enrollment gateway system from local WIC offices using the Integrated Statewide Information System. For the MRMIB, self-certification of income at the annual eligibility review will be implemented by January 1, 2008, and is expected to increase HFP enrollment by 13,237 children in the first six months.


DEPARTMENT OF HEALTH SERVICES RESTRUCTURING
 Effective July 1, 2007, Chapter 241, Statutes of 2006 (SB 162) creates the new DPH and the DHCS from the existing Department of Health Services (DHS). This change will increase accountability, improve the effectiveness of public health programs and health care purchasing activities, enhance state leadership in public health, and increase organizational focus on the departments' respective core missions. The creation of the two new departments is budget neutral.


BIOMONITORING
 The Governor's Budget provides $1.2 million General Fund and 2.8 positions in 2007-08 for the DPH to begin implementation of an environmental contaminant biomonitoring program pursuant to Chapter 599, Statutes of 2006 (SB 1379). This funding will support a contract to develop a sampling design and establish parameters for this program. This proposal is a collaborative effort that also includes $0.2 million General Fund for the California Environmental Protection Agency's Office of Environmental Health Hazard Assessment and $0.1 million General Fund for the Department of Toxic Substances Control.


PROPOSITION 83 (JESSICA'S LAW)
 Jessica's Law, approved by California voters in November 2006, enhances public safety by changing the laws that provide for the commitment, control and supervision of sex offenders. Jessica's Law has the potential to increase sexually violent predator (SVP) commitments to state hospitals from an average of 49 to 440 annually. The population increase of SVPs in state hospitals is reflected in the increased costs at state hospitals.

By expanding the definition of a sexually violent offense, as well as lowering the current two victim criterion to one victim, Jessica's Law significantly increases the number of case referrals to the Department of Mental Health (DMH). The number of cases referred to DMH for screening is expected to increase almost tenfold (from 582 to 5,528 cases annually). The Governor's Budget includes $25.0 million General Fund in 2007-08 to fund additional SVP contractor evaluations and expert court testimonies, $24.1 million General Fund for state hospitals to support 440 new SVP commitments and $449,000 General Fund for Coalinga State Hospital to support the increase in SVP referrals. The budget includes $4.3 million General Fund and 41.8 positions in DMH headquarters to contract, monitor, record and report information for the multiple evaluations and expert court testimonies required.

To immediately begin implementing Jessica's Law, the Governor's Budget reflects a current year augmentation of $15.2 million General Fund for the increased cost of contractor evaluations and expert court testimonies, $12.1 million General Fund for state hospitals to support 271 new SVP commitments, $927,000 General Fund and 21 positions at DMH headquarters to be phased in during the year and $678,000 General Fund and 7.2 positions for Coalinga State Hospital to support the increase in SVP referrals. The California Department of Corrections and Rehabilitation section discusses the impacts of Jessica's Law on that department.


REAL CHOICE LONG-TERM CARE SYSTEMS TRANSFORMATION
 The Governor's Budget provides $900,000 in federal funds for implementation of the Real Choice Systems Transformation Grant, referred to as the California Community CHOICE program, to help build the state's long-term care system infrastructure and increase the capacity of the home- and community-based services system. The HHSA received a five-year, $3 million Real Choice Systems Transformation Grant from the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS). The California Community CHOICE program is consistent with the Administration's commitment to reforming the long-term care system by improving access to home- and community-based services, improving information technology systems and developing a funding system that promotes community living options.


DEVELOPMENTAL DISABILITIES SERVICE PROVIDER RATE INCREASES
 The Budget Act of 2006 includes an increase of $70.1 million ($47.7 million General Fund) for a 3-percent cost-of-living increase to programs serving individuals with developmental disabilities that have been subject to provider rate freezes that have been necessary during the last three years. This adjustment is provided to programs for which the Department of Developmental Services (DDS) sets rates (community care facilities, community-based day programs, habilitation service programs, respite agencies, and vouchered respite) and specified contract-services programs (supported living, transportation, and look-alike day programs). This rate increase has promoted provider stability and helped to maintain a continuity of services to consumers and families within the community.


EMPLOYMENT SUPPORT FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
 The Budget Act of 2006 includes $186.5 million ($112.5 million General Fund) for the DDS and the Department of Rehabilitation to provide employment services for persons with developmental disabilities through the Supported Employment Program (SEP) and the Work Activity Programs (WAP). This funding level reflects a 24-percent rate increase for on-the-job training, a doubling of individual and group job placement fees within the SEP Program, and a 3-percent provider rate increase within the WAP program. In addition, the Budget Act of 2006 includes an increase of $19.1 million ($13.3 million General Fund) to provide additional wage enhancements for direct care providers in WAP and day programs. This increased funding is designed to result in savings in costlier alternative programs, such as day service programs. This new funding is increasing employment opportunities to persons with developmental disabilities and providing services to ensure that consumers remain successful in their jobs. For consumers who are able to work, having a job is a cornerstone to community integration and self-sufficiency.


CHILD WELFARE SERVICES IMPROVEMENTS
 Working together in recent years, the Administration and Legislature have taken action to improve the safety, permanency, and well-being of children. The Governor's Budget maintains the $255 million ($160 million General Fund) investment provided to improve the safety, permanency, and well-being of youth in foster care and continues efforts to reform the Child Welfare Services (CWS) program. Cornerstones of this effort include the Outcome Improvement Project that ties some local funding to improved outcomes and a waiver to use federal funds on preventive services that reduce the need for foster care placements. The Governor's Budget proposes to continue the significant investments made to date, with the expectation that the California Child Welfare Council created by Chapter 384, Statutes of 2006 (AB 2216) will help to maximize these investments through increased coordination of the many agencies and departments that serve children and families involved with CWS.


LICENSING
 The Administration has made significant investments and enacted legislation to better protect Californians and to improve access to necessary services:

  • Enacted Chapter 647, Statutes of 2006 (SB 1301) to increase patient safety, improve oversight, and help mitigate significant health care costs associated with medical errors by requiring reporting of serious medical errors to the DHS and establishing time frames for both the reporting and follow-up investigations. The Governor's Budget provides $7.2 million and 42.7 positions to implement this important legislation.
  • Enacted Chapter 526, Statutes of 2006 (SB 739) to improve quality of care and help reduce costs associated with infections patients acquire while at a health care facility. This bill requires the DHS to develop and implement a health care associated infections surveillance and prevention program, establishes reporting requirements, requires hospitals to develop and implement standards to prevent infections and the spread of influenza, and requires hospitals to plan for pandemic influenza. The Governor's Budget provides $2.0 million and 13.3 positions to more effectively prevent health care-acquired infections.
  • Rebuilt health facility licensing programs and strengthened oversight of health and human services facilities to better protect vulnerable Californians by augmenting licensing programs by more than $4.1 million and 27.1 new staff in 2007-08.
  • Strengthened the state's oversight of health care facilities by enacting Chapter 895, Statutes of 2006 (SB 1312) to require the DHS to monitor nursing home compliance with both state and federal requirements and to support improved patient safety by authorizing financial penalties when a hospital commits a serious health and safety violation.
  • The Budget Act of 2006 included $6.7 million ($6 million General Fund) and 75.8 positions for the Department of Social Services (DSS) to implement a comprehensive licensing reform initiative. The initiative is designed to increase protections for clients in licensed facilities and improve the efficiency and effectiveness of the Community Care Licensing program. This initiative doubled the number of random sample licensing visits annually, formalized training for critical field staff, and implemented a series of administrative proposals to improve the operational efficiency of the licensing program.
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ADDITIONAL INFORMATION Back to Top
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