AB 2456, as introduced, Melendez. Health care.
The California Constitution requires the Governor to submit annually to the Legislature a budget itemizing state expenditures and estimating state revenues and requires the Legislature to pass the Budget Bill by midnight on June 15. Under existing law, a state agency for which an appropriation is made is generally required to submit to the Department of Finance for approval a complete and detailed budget setting forth all proposed expenditures and estimated revenues for the ensuing fiscal year.
Under the federal Patient Protection and Affordable Care Act (PPACA), each state is required to, by January 1, 2014, establish an American Health Benefit Exchange that makes available qualified health plans to qualified individuals and small employers. Existing state law establishes the California Health Benefit Exchange (Exchange) within state government, specifies the powers and duties of the board governing the Exchange, and requires the board to facilitate the purchase of qualified health plans through the Exchange by qualified individuals and small employers by January 1, 2014.
The bill would require the Exchange to submit to the department and the Legislative Analyst’s Office a complete and detailed budget utilizing performance-based budgeting, as defined, that sets forth all proposed expenditures and estimated revenues for the ensuing fiscal year. The bill would require the Exchange to, if necessary, develop a process for consulting with contractors or other responsible entities and stakeholders to develop information related to performance standards and program performance. The bill would require the department to include specified performance-based budgeting information for the Exchange in the Governor’s Budget and to post that information on the department’s Internet Web site. The bill would also require the Legislative Analyst’s Office to review the adequacy of performance metrics and progress toward targeted outcomes in preparing its review of the Governor’s Budget as it relates to the Exchange.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
The Legislature finds and declares all of the
2following:
3(a) State government must focus on the outcomes of public
4policy decisions and public programs to ensure opportunities are
5available for all Californians to achieve a high quality of life.
6(b) The Legislature must ensure that policymakers, public
7program administrators, and rank-and-file state workers have access
8to relevant and timely information so that they can make informed
9decisions in the design and delivery of public programs.
10(c) The focus of that information must be on the goals of those
11public programs and the performance of the public agencies in
12administering those programs.
13(d) Goal and performance information should be widely
14available, relevant, and timely for informing budget, policy, and
15oversight decisions.
16(e) In order to identify performance measurements relevant to
17budget, policy, and oversight decisionmaking, public agencies
18must consult with the public, rank-and-file state workers,
19supervisors, and other officials responsible for the delivery of
20public programs.
21(f) Performance measurements, including
information on
22outcomes and other metrics relevant to improving those outcomes,
23should be designed to ensure that limited public resources are well
24spent.
P3 1(g) Establishing goal, performance, and outcome information
2for public programs should be part of a systematic review of the
3effectiveness and efficiency of those programs.
4(h) Goal, performance, and outcome information should be
5made widely available to the public.
6(i) Goal, performance, and outcome information should be used
7in the annual budget and policymaking process to inform fiscal
8and policy decisions and by the Legislature to enhance oversight
9of public programs and to ensure results-based
accountability.
10(j) As a component of legislative oversight, goal, performance,
11and outcome information should be used to identify programs that
12require fundamental reforms to improve outcomes and programs
13subject to elimination because they are ineffective.
Section 13335.1 is added to the Government Code, to
15read:
(a) As used in this article, the following definitions
17shall apply:
18(1) “Exchange” means the California Health Benefit Exchange
19established pursuant to Title 22 (commencing with Section 100500)
20of the Government Code.
21(2) “Performance-based budgeting” means a system of budgeting
22that uses information on performance to inform resource allocation
23decisions, thereby establishing clear accountability.
24(b) The purpose of performance-based budgeting is to inform
25policy, fiscal, and oversight decisions by the Governor and
26Members of the Legislature; to focus managers, supervisors, and
27
rank-and-file workers on achieving desired goals; and to
28communicate to the public the value of public programs, progress
29toward desired results, and the choices available to improve the
30expenditure of public funds.
31(c) The Exchange shall submit to the department and the
32Legislative Analyst’s Office a complete and detailed budget at the
33time and in the form prescribed by the department that sets forth
34all proposed expenditures and estimated revenues for the ensuing
35fiscal year.
36(d) The budget submitted pursuant to subdivision (c) shall use
37performance-based budgeting to make clear to policymakers and
38the public the value and results of existing operations and proposed
39changes.
P4 1(e) The budget submitted pursuant to subdivision (c) using
2performance-based budgeting shall identify and update
all of the
3following:
4(1) The mission and goals of the Exchange.
5(2) The activities and programs focused on achieving those
6goals.
7(3) Performance metrics that reflect desired outcomes for
8existing and proposed activities and a targeted performance level
9for the following year.
10(4) Prior year performance data and an explanation of deviation
11from previous year targets.
12(5) Proposed changes in statute, including the creation of
13incentives or elimination of disincentives that could improve
14outcomes or hold down costs.
15(6) A description of the impacts and consequences to parties
16affected by an activity or program proposed for modification or
17elimination.
18(7) A five-year projection of estimated assessment levels on
19health plans to pay for Exchange expenditures.
20(f) Performance-based budgeting shall be used by the Exchange
21and shall allow the public and policymakers to understand the
22effectiveness and efficiency of the Exchange. The Exchange shall,
23if necessary, develop a process for consulting with contractors or
24other responsible entities, and stakeholders to develop information
25related to performance standards and program performance.
26(g) The department shall include performance-based budgeting
27information for the Exchange in the Governor’s
Budget in both
28printed and electronic formats if prepared, and post the information
29on its Internet Web site where the department routinely posts
30budget information. That information shall include, but not be
31limited to, information on all of the following:
32(1) The mission and goals of the Exchange’s provided spending
33authority in the Governor’s Budget.
34(2) The activities and programs focused on achieving those
35goals.
36(3) Performance metrics that reflect desired outcomes for
37existing and proposed activities and a targeted performance level
38for the following year.
39(4) Prior year performance data and an explanation of deviation
40from previous year targets.
P5 1(5) A description of the impacts and consequences to parties
2affected by an activity or program proposed for modification or
3elimination.
4(h) The Legislative Analyst’s Office shall review the adequacy
5of performance metrics and progress toward targeted outcomes in
6preparing its review of the Governor’s Budget as it relates to the
7Exchange.
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