In two new Budget and Policy posts released by the Legislative Analyst’s Office, state analysts Brian Metzker and Paul Steenhausen, respectively, examine the California Healthcare Eligibility, Enrollment and Retention System (CalHEERS) dashboard developed by the Department of Health Care Services (DHCS) to prioritize issues around Medi-Cal eligibility functionality; and the “Cradle to Career” Data System. Among the takeaways:
- The state’s “Cradle to Career” Data System, which got underway during the 2019-2020 Fiscal Year with $10 million in one-time, non-Prop. 98 General Fund monies, has spent about $4 million of that, and the multi-agency work group guiding it delivered its first report Dec. 31 as expected. The one-time funds were provided to the Office of Planning and Research (OPR) for initial planning activities, including forming a multi-agency work group tasked with making recommendations on key components of the data system. The work group was to transmit its recommendations to the Legislature through three statutorily-required reports. The Legislature received the first work group report on Dec. 31, 2020; the second is expected Thursday. In his proposed FY 2021-2022 state budget, Gov. Gavin Newsom notified the Legislature of his intent to authorize the remaining FY 2019-20 funds “for specific startup costs,” per the LAO. The governor also proposed $14.5 million in non-Prop. 98 General Fund monies for the project — $11.5 million ongoing and $3 million one-time — for what the LAO calls “various other project costs” this FY including standing up a new “Cradle to Career” office in the California Government Operations Agency (GovOps). The governor’s proposed budget includes another $3.8 million in ongoing Prop. 98 General Fund money for “statewide scaling” of the California College Guidance Initiative, a college planning and advising tool now used by some school districts. Newsom calls for having GovOps manage the system and having an 18-member governing board of mostly data providers like the California Department of Education and “higher education segments” oversee it.
- However, the LAO recommends that the Legislature “specify in statute” like trailer bill language that the administration use the California Department of Technology’s Project Approval Lifecycle (PAL) process — not currently required — to plan the system, and “have independent oversight, verification and validation of the system upon completing the PAL process.” This wouldn’t significantly delay the project, according to the LAO. The LAO also recommends that the administration call for more information to support its budget proposals, including market research “that evaluates available technical solutions for the system and estimates the one-time and ongoing project costs based on system requirements”; as well as a project activity schedule and “workload justifications for the requested GovOps positions.” Absent this detail, the LAO advises the Legislature to wait to approve Newsom’s budget request until the project is through the Alternatives Analysis part of the PAL process — and instead consider approving “some amount” of the 2019-2020 FY funding that’s remaining to hire staff.
- The LAO found that the CalHEERS dashboard — created in response to functionality concerns from the County Welfare Directors Association and the Service Employees International Union — “appears to capture known issues comprehensively.” It also found that “frequent and collaborative engagement” between the administration and stakeholders “has helped to clarify issues to be resolved and associated timelines” on addressing those issues. This followed direction from the Legislature earlier in the current FY that the LAO review the dashboard and its processes. The dashboard and process changes “appear to be working as intended,” Metzker told Techwire via email, noting the administration and stakeholders continue to describe the dashboard “as an iterative document, so our assessment is a single point in time provided pursuant to supplemental report language adopted by the Legislature in 2020-21.”
- This post identifies two opportunities for legislative oversight. The Legislature could, it says, require the administration to create annual reports on new dashboard functionalities in CalHEERS releases and on defects fixed, and how the fixes and new functionalities “address known Medi-Cal eligibility functionality issues in CalHEERS.” Lawmakers could also direct DHCS to create “a less technical version” of the dashboard to show them “in a user-friendly and focused way” how its fixes and functionalities could improve the Medi-Cal eligibility processes.
“Understanding the connection between a defect fix and/or new functionality and Medi-Cal program goals is critical for the Legislature to engage with the administration and stakeholders to improve program efficiency,” Metzker said. “A less technical, more focused dashboard and annual reporting on CalHEERS releases would help the Legislature provide continued oversight on the issues raised by stakeholders.”
