[{"_1":2,"_112":-5,"_113":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88,100],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6621710,"mediaKeyId","2800414-46ebb8a0680ce5ed4c878339b896cf88","parentId",2800414,"title","DHCS outlines Medi-Cal budget pressures; seeks reappropriation for Medi-Cal Connect and civil-rights staffing","audioSeconds",258,"startMs",6400000,"endMs",6658000,"viewUrl","/Search/View?dp=1&key=2800414-46ebb8a0680ce5ed4c878339b896cf88&start=6400&end=6658","thumbnailUrl","https://assets.pipeline.soar.com/2800414-46ebb8a0680ce5ed4c878339b896cf88/thumbnail_6400000.jpg","articleUrl","/articles/6621710/California/DHCS-outlines-Medi-Cal-budget-pressures-seeks-reappropriation-for-Medi-Cal-Connect-and-civil-rights-staffing","mediaUrl","https://secure.pipeline.soar.com/6621710-08627941445f69ea5319961aad95bfd0/orig.mp4?Expires=1775098072&Signature=DU8FWJdNgVuor4MH~lMzPHIcqf4UiZSXa8YKpDh-O1HO3o9uh1toWEQ863YnKOgsvrZXt5rAKYrzSZXlO83l5pkJRoC2gKvatHZiJm6nX694s0BEq4VtWV1aOBfA1OP1x~Lcnk19M05fCxzvn9p7mxEfhE-g1xEX1ZhNL9JmoG6UbJDwjdCm5KCX9u7SYfit3uH5OLnaBKBijiqY2C8qqBA8jg0YtUD1QjgTkmFOI6lzx1Hhu0UNMUFp~mxntI8sKQfeGJMApLU8pTnoynBHU-kjsTzRroVoy-7pw~J-7W3Zt~SIjMec-I2IZBRV1w-F2R3ijFfq5TLK4nce-jarvw__&Key-Pair-Id=KUT5TJCACFTXG","author","California State Senate","date","2025-03-27T00:00:00Z","article","Department of Health Care Services officials briefed the Senate subcommittee on several budget items tied to Medi‑Cal operations, including an ongoing cash-flow challenge, a request to reappropriate funds for the Medi‑Cal Connect population‑health-management platform, and proposals to add staff for civil-rights compliance and Medi‑Cal administrative activities targeted at justice‑involved populations.

DHCS told the committee that on March 4 the Department of Finance activated a $3.4 billion interim loan to make Medi‑Cal provider payments. DHCS indicated it will request an additional $2.8 billion consistent with the Governor’s budget to cover anticipated shortfalls through the fiscal year.

Medi‑Cal Connect reappropriation: DHCS requested reappropriation of up to $19.7 million in general fund authority to continue implementation contracts for the Medi‑Cal Connect population health management platform. The department said two of five user releases have launched, with a third release scheduled for July, and that reappropriated funds would support the prime vendor, risk‑stratification technical expertise and project support services required to deliver releases 3–5.

Civil‑rights workload: DHCS described a Civil Rights Office workload increase driven by litigation settlement obligations and new reporting requirements tied to managed‑care and county mental health plan complaints. The office reported a dramatic increase in complaint reviews between 2019 and 2022 and requested permanent positions to process increased reporting and oversight responsibilities.

Medi‑Cal administrative activities for justice‑involved individuals: DHCS is also seeking five permanent positions to develop and operate a Medicaid Administrative Activities claiming program related to AB 133, which authorizes limited pre‑release services up to 90 days before release from incarceration. The department emphasized that federal approvals and federal claiming requirements are necessary prerequisites for ongoing claiming and that the request will transition certain one‑time PATH funds into ongoing federal revenue streams where permitted.

Why it matters: The multi‑billion cash flow loan and associated supplemental request underscore short‑term fiscal pressure in the Medi‑Cal program and frame the broader debate over long‑term solvency and service continuity. Reappropriation of IT funds and civil‑rights staffing affect ongoing program modernization and compliance obligations, while the jail‑reentry administrative‑activities program seeks federal match for pre‑release services.

Follow-up: Senators sought additional fiscal detail on the $2.8 billion figure and asked about connections between federal changes, wage mandates and DHCS cash-flow projections. DHCS said the $2.8 billion is reconciled in the Governor’s budget and agreed to provide finer detail to staff. The Department of Finance confirmed the loan activation and said growth adjustments for the long-term realignment baseline are tied to realigned revenues (sales tax and vehicle license fees).

Ending: DHCS will return with more detailed reconciliations and implementation plans. Legislators indicated they expect written cost justification and timeline information before taking final action in the budget process.","mediaType","Video","parentTitle","Senate Budget and Fiscal Review Subcommittee No. 3 on Health and Human Services","oneSentenceSummary","The Department of Health Care Services told the Senate subcommittee it is operating under a temporary $3.4 billion interim loan activated by the Department of Finance in March to support Medi‑Cal provider payments and will seek an additional $2.8 billion to cover projected shortfalls through the fiscal year.","taxTitle","California State Senate, Senate, Legislative, California","taxId",77650,"location","California","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6621724,"State juvenile-justice office proposes new realignment formula; lawmakers press for spending transparency",4116,376000,4492000,"/Search/View?dp=1&key=2800414-46ebb8a0680ce5ed4c878339b896cf88&start=376&end=4492","https://assets.pipeline.soar.com/2800414-46ebb8a0680ce5ed4c878339b896cf88/thumbnail_376000.jpg","/articles/6621724/California/State-juvenile-justice-office-proposes-new-realignment-formula-lawmakers-press-for-spending-transparency","https://secure.pipeline.soar.com/6621724-d58de41f4d81469e15c54a94c7506a41/orig.mp4?Expires=1775098072&Signature=CUvIOuVphKI1T1fMh4cg06K7joC4R22hy2uqSeZwzNDhl-gxVuI7CdQNBl6e917JFBsHzdQwR4yw8PYgD12mpqScK9dd1PPCvaWrJ~kOswp-p1Xt13pbeWizVMGdSlYB258SG9asNO0M4sNG~hoJz3gvzHkg~aTbw6vvx-~zFchUQTfkqmh5rMrWjaO~eRdneIuDtYgVqEm5UWuLbqiDPFK3LsvzIWP792mec1YnpVYlYoalGS1zf3E1JqYtW3uGxUWkdgapHtJubOrI0839iuGu5K7r5kzP956veYEvBhmwdlyQJNNH4jAzz8gVoEqtDgJaNiUFiwGcJ6aDfVT40Q__&Key-Pair-Id=KUT5TJCACFTXG","The Office of Youth and Community Restoration told the Senate Budget Subcommittee No. 3 on Health and Human Services on Wednesday that it plans to revise the Juvenile Justice Realignment Block Grant (JJRBG) formula to shift funding toward “less restrictive programs” and away from a static 2018 Department of Juvenile Justice count.

The change, OYCR Director Catherine Lucero said, replaces the old DJJ-based factor with measures that count youth ages 10–17, youth adjudicated for Penal Code section 707(b) offenses, and youth who move from secure youth treatment facilities (SYTFs) into less restrictive programs (LRPs). \"The new factor... does move the infrastructure towards alternatives to long term incarceration when it is safe for the community and in the best interest of the youth,\" Lucero said.

The proposal is intended to implement the reforms of SB 823 by steering funds toward community-based alternatives and creating incentives for stepping youth down from secure settings. Deputy Director Alani Jackson told the committee OYCR has invested $15 million in grants to 11 counties to help build LRPs and described a broad set of OYCR programs, including educational initiatives, workforce development for justice-impacted youth, and an ombuds division that handled 296 complaints in 2024.

Why it matters: Senators repeatedly warned that changing the allocation formula without more robust accountability would risk sending money to facilities that do not deliver improved outcomes. \"That is a complete failure on our part to give a location that has been asked to shut down automatic funding,\" Sen. María Menjivar said, arguing the current statutory allocation process would continue to send pro rata shares to counties even if a facility had been ordered closed. Several senators urged statutory language requiring reporting of actual expenditures, stronger recoupment or withholding authority, and periodic reevaluation of the formula.

Key details from the hearing:
- OYCR's budget and programs: Lucero and Jackson said OYCR's total proposed budget is roughly $251 million, including state operations and local assistance. The office manages 37 authorized positions and a range of grants and technical assistance programs for counties and community-based organizations.
- Ombuds data: OYCR reported 296 complaints in 2024; 56 had been closed at the time of the presentation. Substantiated findings numbered 21; investigators declined 84 complaints; 84 site visits were conducted and more than 5,000 “youth bill of rights” posters were distributed. Complaint types included alleged abuse or punishment, excessive force, denied visits or calls, medical issues, and conditions of confinement.
- Formula mechanics and data sources: OYCR said the revised formula replaces the fixed 2018 DJJ count with three dynamic factors (youth population 10–17, 707(b) adjudications, and counts of youth diverted from or stepped down out of SYTFs into LRPs). The office told the committee AB 169 reporting will provide routine twice-yearly LRP transfer data; the department also uses DOJ/JCPSS data for adjudication counts.
- Implementation timeline: The administration proposes a multi-year rollout and does not intend to implement the new allocations immediately; the earliest effective implementation discussed would occur in calendar 2027 with a phased ramp-up to avoid a “cliff.”

Concerns expressed by senators and others
- Lack of expenditure tracking: Multiple senators asked how the state can ensure counties actually spend JJRBG allocations on youth services; OYCR acknowledged counties submit annual plans but the state does not currently track actual expenditures or require financial closeouts for JJRBG funds. Lucero said allocations are dispersed by Department of Finance independent of OYCR plan review.
- Incentive alignment for judges and probation: Senators questioned whether the combined “prevention + step-down” component could let judges meet the allocation target while leaving probation with no incentive to pursue step-down placements. Lucero and others said judges rely heavily on probation recommendations and that the formula was designed to count both diversion and step-down activity, but senators requested clearer, separate incentives for distinct actors.
- Distinguishing LRPs: Senators asked why the formula does not differentiate LRPs located on SYTF campuses (Title 15-governed) from truly community-based LRPs. OYCR responded their AB 169 data distinguishes transfers to Title 15 versus community LRPs, and said the formula built in the LRP factor to avoid perverse incentives that would favor placing youth in SYTFs to access alternatives.

Follow-up and next steps: Senators repeatedly pressed for statutory changes that would (a) require counties to report actual expenditures and closeouts, (b) allow the state to withhold or recoup funds from facilities ordered to close, (c) require periodic reevaluation of the allocation formula, and (d) improve data collection on dual-status youth (those involved in both foster care and juvenile justice). OYCR said it will continue stakeholder engagement and that the formula is intended as an iterative proposal.

Ending: OYCR provided written materials and the office said it will supply more detailed county-by-county spend and complaint data on request. Lawmakers left the hearing urging language that links funding changes to accountability measures so allocations cannot continue to flow automatically to facilities the state has asked to close.","The Office of Youth and Community Restoration told the Senate subcommittee it plans to revise the Juvenile Justice Realignment Block Grant formula to steer funding away from a static DJJ-based factor and toward counts of adjudicated youth, the youth population, and youth moved into less restrictive programs — a change officials said is designed to support alternatives to long-term incarceration.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6621715,"Health facilities authority seeks extended deadline for jail-diversion infrastructure grants",175,5720000,5895000,"/Search/View?dp=1&key=2800414-46ebb8a0680ce5ed4c878339b896cf88&start=5720&end=5895","https://assets.pipeline.soar.com/2800414-46ebb8a0680ce5ed4c878339b896cf88/thumbnail_5720000.jpg","/articles/6621715/California/Health-facilities-authority-seeks-extended-deadline-for-jail-diversion-infrastructure-grants","https://secure.pipeline.soar.com/6621715-09e48810222e64cf2e3c3a4fb781d85d/orig.mp4?Expires=1775098072&Signature=oljrGH~5xTC8qlrMxfaYElwfdF2guu3IMPUtZsrE40O4LXAzBzeQIsqNBtnIWxmBqlzS~4jDmyjWJKCu57O-IREbnjIR-XsSU0aQ2UDP0znTTdjFHkBYQoRwMBQc27xNAzqJzQhLM1H3emvF9Yd0XVO1W2ngxMgvkyzwp6qiI9Mj4opePGROErVw7oxzqCuQJu3OCXWUVnDRaUI8aH~uEN62EGeIwODy0x66oeoDGxjhTn1gXyH4hArSQaw9-d6rHvVvNyQq6bWqgmXmONheqb~lQ9dPQxzzA4EKR0YxZx~PJrblWy4jKYcxTElUDvxHF1sDG8ZjeqYr0IJnTUY-nw__&Key-Pair-Id=KUT5TJCACFTXG","The California Health Facilities Financing Authority (CHFA) told the Senate subcommittee it needs more time to finish a set of competitive grants intended to build community-based alternatives to incarceration. CHFA requested reappropriation of remaining Community Services Infrastructure (CSI) program funds and an extension of the project deadline to June 30, 2028.

CHFA said the CSI program was funded once in 2017 with $67.5 million from the General Fund to support county projects that expand mental health and substance-use infrastructure for justice-involved individuals. The authority has awarded funds in four competitive rounds and has disbursed about $42.8 million to date; 10 of 14 projects have finished and four remain active in three counties. CHFA noted that counties have faced permitting delays, NIMBY opposition, construction cost increases, labor shortages and COVID-era disruptions.

Why it matters: Without an extension, counties could forfeit remaining grant funds and the unfinished projects — intended to divert people from jails and prisons into crisis stabilization, residential treatment and other community-based services — would revert money to the general fund. Local county representatives urged the committee to allow more time to complete rehabilitation and construction work.

Other CHFA items discussed: CHFA also described other programs in its portfolio and answered questions about the Distressed Hospital Loan Program. CHFA said it has implemented a two-step loan-modification process for hospitals struggling to make initial payments on six-year distressed-hospital loans: (1) a 12-month extension of the deferment period and (2) a possible year-by-year partial forgiveness of debt service tied to demonstrated operational outcomes. CHFA reported it had received eight applications for the 12-month extension and is processing them.

Follow-up and next steps: CHFA asked the subcommittee to approve the proposed reappropriation so counties can finish construction and fully expend their awards. County representatives, including Santa Clara County, urged the subcommittee to support the extension so local diversion capacity is not lost.

Ending: The subcommittee took testimony without voting; CHFA said it would continue to work with counties and the Department of Finance to process the remaining disbursements and that funds forfeited by nonperforming grantees would revert to the general fund.","The California Health Facilities Financing Authority asked the Senate subcommittee to reappropriate remaining funds and extend the deadline for the Community Services Infrastructure grant program to 2028, citing construction delays and permitting challenges that threaten four unfinished projects.",{"_33":101,"_35":36,"_37":38,"_39":102,"_41":103,"_43":104,"_45":105,"_47":106,"_49":107,"_51":108,"_53":109,"_55":56,"_57":58,"_59":110,"_61":62,"_63":64,"_65":111,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6621720,"Providers, counties and PACE operators oppose new DHCS fee and sanction proposals; committee hears concerns",1563,6830000,8393000,"/Search/View?dp=1&key=2800414-46ebb8a0680ce5ed4c878339b896cf88&start=6830&end=8393","https://assets.pipeline.soar.com/2800414-46ebb8a0680ce5ed4c878339b896cf88/thumbnail_6830000.jpg","/articles/6621720/California/Providers-counties-and-PACE-operators-oppose-new-DHCS-fee-and-sanction-proposals-committee-hears-concerns","https://secure.pipeline.soar.com/6621720-9fd785706c2c5cdb9d7020c72a12ec23/orig.mp4?Expires=1775098072&Signature=TIlh9C8P5nYs7R7gs2XMU2QNp7cPcOGPD-K2gZa1ts9kJZRc40GQAYjz6vbxCyOpNCMatS~mACsqlFD9Rtc7VzjmwaJdPs5qjSglTNsHP7Ly0wQZz6R9BTg0lVEKe0cAvO~ETnbq5W6YcQalPoBC~Ji4oF3EpypM2s1z~YCEFSMekdv55jU6IB9F8dA0go35xhtZZ5Y9Ns35lYMpvSPMlmjMD9mr6xRxhht4vSU2jySe2CPCiHB9KFzkCcI5JrRJSaaTWfshB6azvfPnj37Njeb~bsBk6Au~gaR9-ckL8PoX4R7Q32MSN1NXNI9ppvYsGOd8U~vJMtXoWpjLGNSu3A__&Key-Pair-Id=KUT5TJCACFTXG","The Department of Health Care Services asked the Senate subcommittee for authority to charge PACE organizations a fee — capped at 1 percent of capitation — to fund program oversight and staff positions it says are needed to process applications, perform readiness reviews and maintain ongoing oversight of a growing PACE sector. DHCS proposed 33 permanent positions to handle increased workload from new and expanding PACE organizations and said the fee would be collected into a PACE Oversight Fund and reflected as part of annual capitation rates.

PACE organizations and county partners strongly objected. Val Sheehan, CEO of the California PACE Association, told the subcommittee the proposal \"was not developed at all with stakeholder engagement\" and warned that, because the 1% cap is measured against a modest industry margin, the fee could represent a large share of provider profits. \"Up to 1% of 5% is 20%,\" Sheehan said, illustrating the potential impact on programs that already operate on thin margins.

Multiple PACE operators, including Center for Elders' Independence, OnLok, Central Valley PACE, Scene Health and others, filed oral testimony opposing both the fee BCP and related trailer bill language that would expand DHCS sanction authority over PACE programs. Speakers said sanctions modeled on managed-care enforcement are a poor fit for PACE’s integrated, interdisciplinary model and that the department has not finalized audit or enforcement protocols before proposing new penalties. \"It is irresponsible to increase penalties before addressing their gaps in oversight,\" OnLok's Catherine Kelly said.

Why it matters: PACE (Program of All-Inclusive Care for the Elderly) serves medically complex older adults who otherwise require a nursing-level level of care; programs rely on narrow capitation margins and a mix of Medicare and Medi-Cal funding. Testimony argued that replacing current funding with a fee-based oversight structure risks destabilizing care for frail seniors and could force program cutbacks.

Key points from hearing:
- DHCS request and rationale: DHCS requested 33 positions and $6.3 million in total funds to handle a growth trend (roughly 8–12 new or expanded PACE organizations per year). The department said fees would be structured to cover department workload and would be accounted for in capitation rates.
- Provider objections: CalPace and dozens of individual PACE programs said the proposal lacked stakeholder input, contained inconsistent descriptions of how funds would be used (marketing/readiness vs. audits/legal/admin), and could be applied unevenly. Several operators warned that thin margins make PACE vulnerable to even small new costs.
- Sanctions concerns: PACE operators opposed newly proposed monetary sanctions and potential state-appointed temporary management, which they said CMS intentionally excluded from federal PACE rules because external management undermines PACE’s team-based care model.

Public comments and system stakes: More than a dozen PACE leaders and county representatives spoke during public comment, asking the subcommittee to reject both the fee proposal and the sanctions trailer bill and to require DHCS to continue stakeholder negotiations and publish finalized audit protocols before expanding enforcement powers.

Follow-up: LAO recommended as an option setting a temporary fee before establishing an ongoing fee while DHCS and stakeholders firm up scope and costing. Senators indicated willingness to consider a measured approach but emphasized transparency, an audit guide, and assurances that fees would not be repurposed away from PACE oversight.

Ending: The subcommittee heard clear and consistent objections from PACE providers, counties and advocacy groups; members instructed DHCS to continue discussions with stakeholders and to provide more precise cost and scope information before the Legislature considers permanent fee authority or new sanction mechanisms.","Department of Health Care Services presented a PACE workload and fee proposal that would fund new DHCS positions with a fee on PACE capitation; dozens of PACE organizations and counties testified in opposition, saying the fee is excessive, unclear and could destabilize fragile programs for frail elderly Californians.","actionData","errors"]

Article not found

DHCS outlines Medi-Cal budget pressures; seeks reappropriation for Medi-Cal Connect and civil-rights staffing

State juvenile-justice office proposes new realignment formula; lawmakers press for spending transparency

Health facilities authority seeks extended deadline for jail-diversion infrastructure grants

Providers, counties and PACE operators oppose new DHCS fee and sanction proposals; committee hears concerns