Introduction
The California health and human services 2022/2023 budget increased from that of 2021/2022. The increase was caused by the expansion of the total state budget by 2%. Most of the health and human service changes in the 2023 budget are those that were not met in 2021/22. This section of the general budget covers in-home supportive services, food assistance programs, care economy for the workforce, and child support programs, among others. The budget allocation was influenced by internal and external factors, including economic, social-cultural, and employee competence. All the stakeholders must be involved in making changes to solve the needs of various programs and departments. For example, employees are encouraged to advance their training to reduce employee competency gap within California public healthcare centers. This paper analyzes external and internal factors affecting the California health and human services budget and recommends solving the needs. Therefore, although the state budget is affected by various external and internal factors, only a few needs resolving.
External and Internal Factors Affecting the Budget
External Factors
Economic
The California governor expanded the Care Economy Workforce development package budget. The report shows that the healthcare and other related workforce have not been adequately considered in terms of economic benefits for years. Therefore, the budget was increased by $ 17 billion to cover three years of the development package (“Analysis of the Care Economy,” 2022). The package is expected to improve employees’ living standards. Additionally, the package could help them access additional training and increase cultural diversity. The governor also promised to target the workforce in underserved regions of the state. The need for expanded funding results from rising economic costs and requirements among the workforce.
The governor’s office decreased the 2022/23 child welfare and program implementation budget. Forster care systems and other eligible families receive federal funding to support care and services for children. Although these needs will be present next year, the governor needed to reduce the system funding. According to the report, more than $ 1 billion was cut from this year’s budget (“Analysis of Child Welfare,” 2022). The reduction is necessary because the 2022 budget contained additional one-time and limited-time funding programs for the system. Therefore, deducting the $ 1 billion will account for the general foster care budget (“Analysis of Child Welfare,” 2022). Another reason for the reduction is declining spending within the foster care system. The state governor, therefore, finds the need to save more money to boost the economy by cutting down the program budget.
Social
The California Governor’s office increased In-Home Supportive Services (IHSS) for the elderly. The allocated budget of $ 18.5 billion is an increase of $ 1.6 billion from the 2022 budget (“In-Home Supportive Services,” 2022). The IHSS program offers domestic and personal care services to low-income earners, specifically the aged, the disabled, and the blind. The program hires county social workers who are paid on an hourly basis. The governor’s report indicates that paid hours and hourly wages increase yearly (“In-Home Supportive Services,” 2022). The primary cause of the increased paid hours and wages is the rising care needs for the covered population. Further information shows that the paid hours grow at a relatively similar rate to the historical levels. The number of IHSS caseloads per hour was not much affected by the presence of COVID-19. Therefore, the increase in the budget is caused by social factors amongst the program beneficiaries that make social workers work for more hours.
The governor’s office registered an expansion of the California Food Assistance Program (CFAP). CFAP provides food and nutritional needs to California immigrants aged 55 and above. The budget ensured an increase of CFAP funds from $28.9 million to $ 40 million (“California Food Assistance Program,” 2022). The office also promised that the program would cover all income-eligible individuals aged 55 and above in the state. Therefore, for individuals over 55 to qualify for the program benefits, they must earn below 200% of the federal poverty level, whether immigrants or not (“California Food Assistance Program,” 2022). The budget also indicates that the funding will likely increase following the increasing poverty gap. The current change in the budget is caused by poverty levels amongst low-income earners in the region. Therefore, California’s immigrants and American citizens need food and nutritional help.
The California budget 2022/23 also allowed full pass-through of past-due CalWORKs recoupment payments to former program families. Under California law, when a parent applies for CalWORKs grants and does not live with their other partners, they should sign for a child support case (“Analysis of Child Support,” 2022). This arrangement helps the government to cut a portion of the child support payments to pay back costs for the CalWORKs aid received by the family. The governor will allow low-income earning families who formerly received the CalWORKs aid to keep the child support payment too. The state government will not collect or cut child support payments but allow needy parents to have it. The arrangement is supposed to enable CalWORKs aid beneficiaries to receive higher funding for their needs. The increasing cost of living contributes highly to the consideration.
Governmental
The California government expanded the funding of Supplemental Security Income / State Supplementary Payment (SSI/SSP) program. The governor added $ 3.1 billion to the yearly budget of the state program (“Supplemental Security Income,” 2022). The increase will only be 8% over the 2021/2022 budget expenditures (“Supplemental Security Income,” 2022). The need for budget expansion is caused by the increase in the full-year cost impact of the 23.95% SSI/SSP grants effected on January 1, 2022 (“Supplemental Security Income,” 2022). In other words, since the national government added more grants to both the federal and state SSI/SSP programs, the California office also needed to expand its expenditures.
Insurance Plans
California governor expanded health insurance coverage and affordability of health care costs budget. The 2023 budget expanded full-scope Medi-Cal coverage to all remaining income-eligible undocumented populations in the state. Previously, Medi-Cal only covered documented income-eligible families. The governor will ensure that the extension of other families’ coverage should begin on January 1, 2024 (“Health Care Access,” 2022). There is also a suggestion of reducing the Medi-Cal premiums to zero cost for individuals not eligible for the insurance coverage. Lastly, the governor proposed creating a healthcare affordability office to control the rising cost of healthcare. The increasing need for health insurance causes these changes as healthcare costs rise.
Global Factors
The governor’s office increased the 2023 Medi-Cal budget to cover Public Health Emergency (PHE) funds. The office needed $ 34.9 billion, which is $ 8 billion more than the 2022 budget (“Public Health Foundational,” 2022). Since the start of COVID-19, the states have received more PHE funds. The governor expected the last year’s emergency funds to be available until June 2022. However, if the fund was not allocated to the next budget, California would not have enough resources to handle any health emergency. Compared to 2020 and 2021, the COVID-19 caseload growth has continually slowed down and is expected to maintain the trend in the next year. The budget experts in the governor’s office predict that the health systems should stay financially ready for global health emergencies. Such opinions were reached following the lesson of unpreparedness witnessed across the country during the COVID-19 crisis.
The California government increased the California Work Opportunity and Responsibility to Kids (CalWORKs) program budget. The program provides jobs and grants to low-income earning families within the state. The 2022/23 budget expanded the funding with $ 291 million, reaching $ 6.9 billion (“Analysis of the Governor’s CalWORKs,” 2022). The funding need is caused by a rising caseload and increasing costs that would be met by one-time funding for COVID-19. Between March and April 2021, the CalWORKs beneficiaries received additional financing from COVID-19 relief funds (“Analysis of the Governor’s CalWORKs,” 2022). Although the CalWORKs caseload is expected to rise, the county administrative funding is proposed to decline. Therefore, with the increasing caseload amongst program beneficiaries, the governor needed to increase the program funding.
Internal Factors
Employee Competence and Care Quality Control
The California 2022/23 also highlighted the need to increase funding for the California Department of Public Health (CDPH) budget. The report shows that the program was stagnant until the COVID-19 pandemic, which highlighted several needs. The health crisis indicated the critical role of public health systems, inadequate information technology, lab capacity, and understaffing. The governor’s budget added $ 300 million to the yearly budget to improve these services (“Public Health Foundational,” 2022). The report shows that the state would focus on six core areas: IT, emergency response, staff recruitment and training, community health, communication, and community partnerships (“Public Health Foundational,” 2022). The funds will improve employee competency by advancing their knowledge and skills in the highlighted areas. The goal of this program will be to increase real-time disease surveillance, enhance strategic planning, and coordinate communication and regional epidemiological activities. Such competency improvements are critical for a higher quality of care delivery in public health.
Recommended Changes to Resolve Needs
The budget highlights a few areas that need solutions to improve California’s health and human services. One of the critical needs requiring an answer is increasing the Public Health Emergency (PHE) budget. The governor added $ 8 billion to the 2022/23 budget (“Public Health Foundational,” 2022). The legislative analysis indicated that the governor might have exaggerated the emergency budget. The state’s reasoning is to prevent or adequately control future global health emergencies such as COVID-19 (“Public Health Foundational,” 2022). However, following the declining pandemic cases and the health system’s alertness, the budget should be reduced. I recommend that the state cut down the emergency funds by half and only include $ 4 billion in the next year’s budget. Although health emergency alertness is critical following the COVID-19 pandemic, the California economy also needs awakening. Therefore, the extra $ 4 billion can be used to cover more low-income families on health insurance.
A high number of low-income families in California are sinking into poverty. That is the main reason for the increased CalWORKs funding. An excellent recommendation is to raise more grants on CalWORKs, thereby allowing more vulnerable families to secure jobs. By increasing funding for the program, low-income families will also receive more aid in the short term. The state should allocate more funds to project development and employ more vulnerable beneficiaries for a long time. The state government should also consider documenting immigrants who cannot access better-paying jobs in the region. They will acquire better-waged employment and improve their living standards by registering them. In general, the state will have raised its economy by reducing poverty.
Another critical suggestion is for the DCPH program funding to create a workforce pipeline, strengthen the statewide lab network, and design a proper IT strategy. Of the allocated budget increment of $ 300 million, only $ 100 million is directly allocated for state healthcare development (“Public Health Foundational,” 2022). The $ 200 million is earmarked for the local health jurisdictions. Consequently, the problems of IT, Lab, and employee network is not adequately solved. The budget’s legislative analysis reveals that more funds are needed to improve the three states’ needs sufficiently. Therefore, more funds should be allocated to the CDPH program for sufficient development.
Conclusion
California’s health and human services budget is more positive and thus needs less resolution. The budget seeks to solve more external than internal issues in the sector. Social and economic issues are highly considered in the report analysis. Although internal factors are limited, it indicates that the industry is doing well from the offices. Therefore, only a few needs in the form of economic, social, and global factors need fixing. Following the suggested solutions, the California government should pay more attention to external factors affecting funding deficiencies in the next year. Increasing social needs and the high cost of living are crucial factors on which to focus. The number of people below the poverty level is rising in the region. Henceforth, the state governor must act toward stabilizing the affected families.
References
Analysis of child support program proposals. (2022). Legislative Analyst’s Office. Web.
Analysis of child welfare proposals and program implementation updates. (2022). Legislative Analyst’s Office. Web.
Analysis of the care economy workforce development package. (2022). Legislative Analyst’s Office. Web.
Analysis of the governor’s CalWORKs proposals. (2022). Legislative Analyst’s Office. Web.
California food assistance program. (2022). Legislative Analyst’s Office. Web.
In-home supportive services. (2022). Legislative Analyst’s Office. Web.
Health care access and affordability. (2022). Legislative Analyst’s Office. Web.
Public health foundational support. (2022). Legislative Analyst’s Office. Web.
Supplemental security income/state supplementary payment (SSI/SSP) program. (2022). Legislative Analyst’s Office. Web.