BILL ANALYSIS �
SENATE GOVERNANCE & FINANCE COMMITTEE
Senator Lois Wolk, Chair
BILL NO: SB 893 HEARING: 5/18/11
AUTHOR: Wolk FISCAL: Yes
VERSION: 5/11/11 TAX LEVY: No
CONSULTANT: Ewing
HEALTH AND HUMAN SERVICES SYSTEM IMPROVEMENT
AND ACCOUNTABILITY ACT OF 2011 (URGENCY)
Creates a review and outcome reporting system for health
and human service programs.
Background and Existing Law
The Health and Human Services Agency administers and
oversees health, social services, public assistance, and
rehabilitation programs that affect nearly all
Californians. Annual funding for health and human service
programs includes $36 billion in state funds, and $38
billion in federal funding.
The Agency provides leadership and direction to the
departments under its jurisdiction, including the:
Department of Aging
Department of Alcohol and Drug Programs
Department of Child Support Services
Department of Community Services and Development
Department of Developmental Services
Emergency Medical Services Authority
Department of Health Care Services
Department of Mental Health
Department of Public Health
Department of Rehabilitation
Department of Social Services
Office of Statewide Health Planning and Development
Managed Risk Medical Insurance Board
The Agency's leadership role includes promoting
coordination and service integration, reducing duplication
and fragmentation, and ensuring the integrity of health and
human service programs.
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The Agency or the departments under its jurisdiction
monitor compliance with state statutes and funding
requirements, review performance, and conduct program
evaluations of health and human service programs, many of
which are administered by local agencies or community-based
organizations. For example, the Legislature established
the California Child and Family Service Review System,
requiring the Agency to form a workgroup to identify
outcome indicators for California's child welfare system
and a process for reviewing the quality of child welfare
programs. The Department of Social Services also must
identify and promote the replication of best practices for
child welfare services (AB 636, Steinberg, 2001).
California's ongoing fiscal crisis has required funding
reductions for nearly all health and human services. In
response, the Governor has called for restructuring public
safety and health and human service programs, including
changes in mental health, substance abuse treatment, child
welfare services, and other programs.
The Governor's realignment proposal draws upon similar,
prior efforts. In 1991, the state adopted major changes in
the organization of specific mental health, social service,
and health programs. Those changes shifted program
responsibilities from the state to the counties,
established new cost-sharing ratios, and provided the
counties with a dedicated funding stream for those
programs. Among other reforms, the Governor's proposal
calls for reducing the state's role in administering and
funding health and related programs while expanding the
state's role in providing technical assistance and
monitoring outcomes.
Proposed Law
Senate Bill 893 directs the Health and Human Services
Agency, by December 1, 2013, in collaboration with
specified entities, to design and establish a system for
periodically reviewing the performance of the health and
human service programs under the jurisdiction of the
Agency.
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The bill requires the Agency to ensure that the design of
the review system recognizes and is coordinated with
existing performance review and accountability systems.
SB 893 requires the Agency to establish mechanisms for the
identification and promotion of best practices in the
delivery of health and human services.
The bill directs the Agency to draft an information sharing
plan to enable the exchange of information and data
necessary to evaluate health and human programs and promote
the adoption of best practices.
SB 893 directs the Agency to provide the Legislature with
periodic reports on its progress, including identifying
statutory, funding, staffing or other barriers to
accomplishing the goals of the bill.
State Revenue Impact
No estimate.
Comments
1. Purpose of the bill . Senate Bill 893 builds upon the
outcomes and accountability system for California's Child
Welfare System under AB 636 (Steinberg, 2001). The AB 636
system allows the public and policymakers to monitor the
Child Welfare System and it provides clear direction to
managers and staff on the overarching goals of that system.
SB 893 expands that successful model to other health and
human service programs. California's fiscal crisis
requires the state to ensure that publicly supported
programs are effective and continuously improving through
the identification and replication of best practices.
Despite progress in some areas, the state does not
currently have a strategy for reviewing the quality of
public programs, monitoring outcomes or providing the
guidance and technical assistance needed to promote the
replication of best practices. SB 893 will equip the
Health and Human Services Agency to pursue the role
envisioned under the Governor's realignment proposal.
2. Before its time ? In his January budget proposal, the
Governor indicated that he would propose a number of
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policy, fiscal, and organizational reforms to support the
implementation of his realignment proposal. It may be
premature to pursue SB 893's reforms without a better
indication from the Governor how he intends to pursue the
monitoring and technical assistance functions included in
his realignment proposal.
3. One review system or many ? The Health and Human
Services Agency oversees hundreds of programs and policies.
SB 893 envisions a collaborative process to design a
review system for most if not all programs under the Agency
by December 1, 2013. The Committee may want to prioritize
the design of a review system for those programs that have
the greatest impact on the health and welfare of
Californians and the state budget.
Support and Opposition (5/12/11)
Support : Unknown.
Opposition : Unknown.