BILL ANALYSIS �
SENATE GOVERNANCE & FINANCE COMMITTEE
Senator Lois Wolk, Chair
BILL NO: SB 893 HEARING: 7/6/11
AUTHOR: Wolk FISCAL: Yes
VERSION: 6/20/11 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 Agency program's includes
$36 billion in state funds and $38 billion in federal
funding.
The Agency provides leadership to 13 state entities,
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, and
Managed Risk Medical Insurance Board.
The Agency's leadership role includes promoting
coordination and service integration, reducing duplication
and fragmentation, and ensuring program integrity. In
turn, the entities that make up the agency administer
programs, monitor compliance with state statutes and
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funding requirements, review performance, and conduct
program evaluations for health and human service programs,
many of which are administered by local agencies or
community-based organizations.
California's ongoing fiscal crisis has required funding
reductions for nearly all health and human services. As
part of his budget proposal, the Governor has called for
shifting program responsibilities among state departments,
expanding the authority of local agencies over the
operations of select public programs, and reducing state
expenditures to balance the budget.
Proposed Law
Senate Bill 893 directs the Health and Human Services
Agency, by December 1, 2013, in collaboration with local
agencies, service recipients and others, to design and
establish a system for periodically reviewing the
performance of mental health, substance abuse treatment,
child welfare services, and adult protective services
programs.
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.
SB 893 - 6/20/11 -- Page 3
Comments
1. Purpose of the bill . SB 893 builds upon the outcomes
and accountability system for California's Child Welfare
System (AB 636, Steinberg, 2001). The AB 636 system allows
the public and policymakers to monitor the Child Welfare
System and provides clear direction to managers and staff
on the system's overarching goals. SB 893 expands and
improves upon that model to ensure that key human service
programs are effective and utilizing best practices.
Despite progress in some areas, state and local officials
currently do not 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 equips the Health
and Human Services Agency to develop and implement that
strategy.
2. An executive branch function ? The Health and Human
Services Agency is already directed to support coordination
and conduct oversight of publicly supported programs. SB
893 provides direction where additional direction may not
be needed. The Health and Human Services Secretary to can
pursue the goals of SB 893 without legislation.
3. Making good on past promises ? The 1991 program
realignment shifted program authority from state government
to the counties and called for state agencies to focus on
oversight and technical assistance. The Mental Health
Services Act establishes specific goals for the delivery of
mental health services and establishes an oversight
commission. The federal government requires the state to
monitor the performance of substance abuse and child
welfare programs. But California does not yet have systems
in place to monitor and communicate information on
performance and outcomes with the public and policymakers.
With limited exceptions, the state has not developed the
capacity to identify best practices and promote their
adoption.
4. What they said . AB 893 responds to comments from local
officials during informational hearings held by the Senate
Governance and Finance Committee in January 2011.
Witnesses testified that barriers on information sharing
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will impede the ability of local agencies to reduce costs
and improve outcomes as proposed in the Governor's January
budget proposal. SB 893 requires the development of an
information sharing plan, but also directs the Agency to
consult with local officials and others on what information
should be shared as part of its role in monitoring
outcomes, supporting service integration and providing
technical assistance.
5. Double referral . SB 893 was double-referred to Senate
Human Services and Senate Governance and Finance. SB 893
passed out of the Human Services Committee on a vote of
4-2.
Support and Opposition (6/30/11)
Support : Unknown.
Opposition : Unknown.