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CDCR seeks CalAIM reimbursements and health‑care changes; LAO flags contract medical shortfall and staffing requests
Summary
CDCR told the subcommittee it has begun implementing CalAIM reimbursement components and seeks statutory changes to broaden pre‑licensure waivers for mental‑health staff; the LAO raised concerns about underfunded contract medical costs and urged reporting on unmet expenses.
CDCR and California Correctional Health Care Services (CCHCS) told the Senate subcommittee they are implementing several elements of CalAIM and seek statutory changes to broaden pre‑licensure waivers for mental‑health professionals.
Duane Reeder, deputy director for California Correctional Health Care Services fiscal office, told the committee that CDCR implemented the pharmacy reimbursement component of CalAIM on Feb. 1 and bundle billing for services in the last 90 days and pre‑release activities on April 1. Reeder said the program is ramping up and may expand to cover durable medical equipment and other release‑related services later in 2025.
CDCR proposed trailer bill language to broaden pre‑licensure employment waivers to include additional mental‑health professional classifications, which Reeder said would help reduce vacancy levels among clinicians by widening the pool of hireable professionals while they complete licensure. Reeder said the department is already hiring licensed marriage and family therapists and licensed clinical counselors to fill vacancies.
The Legislative Analyst's Office highlighted a potential shortfall in contract medical services, noting the May revision includes changes that would add about $36 million in the current year and about $33 million in 2025‑26; LAO said total proposed funding would bring contract medical to roughly $396 million in the current year and $391 million in 2025‑26, while CDCR projects actual contract medical spending could be about $441 million, leaving roughly $45 million unfunded. LAO recommended approving one‑time adjustments but directed the department to report on how it will address remaining unmet costs and to update its budgeting methodology by Jan. 10 of the next year.
The LAO also recommended rejecting a May revision augmentation of $2.8 million ongoing for increased health‑care staffing at two women's prisons, saying the administration had not supplied sufficient justification. Department of Finance officials said the staffing proposal responded to a receiver memo after delegation of the women's prisons from the federal receiver and cited higher per‑provider workloads at one facility.
Why this matters: Contract medical spending and clinical staffing directly affect inmates' access to care and the state's court‑mandated responsibilities in health care. The LAO told the committee that the administration must explain unmet contract medical costs and justify staffing increases before the legislature approves ongoing augmentations.
