Reports on Health & Human Services

  • A Long-Term Strategy for Long-Term Care
    (Report #205, April 2011)
  • First Year Checkup: Strategies for a Stronger Public Health Department (Report #194, January 2009)
  • Addressing Addiction: Improving & Integrating California's Treatment System
    (Report #190, March 2008)
  • A Smarter Way to Care: Transforming Medi-Cal for the Future
    (Report #187, May 2007)
  • Real Lives, Real Reforms:  Improving Health and Human Services
    (Report #173, May 2004)
  • Recommendations for Emergency Preparedness and Public Health  
    (Report #170a, June 2005)
  • To Protect & Prevent:  Rebuilding California's Public Health System 
    (Report #170, April 2003)
  • For Our Health & Safety: Joining Forces to Defeat Addiction 
    (Report #169, March 2003)
  • Still in Our Hands:  A Review of Efforts to Reform Foster Care in California
     (Report #168, February 2003)
  • Young Hearts & Minds:  Making a Commitment to Children's Mental Health 
    (Report #161, October 2001)
  • Being There:  Making a Commitment to Mental Health 
    (Report #157, November 2000)
  • Now in Our Hands:  Caring For California's Abused and Neglected Children
    (Report #152, August 1999)
  • Caring For Our Children: Our Most Precious Investment
    (Report #148, September 1998) WP 6.1
  • Enforcing Child Support: Parental Duty, Public Priority
    (Report #142, May 1997)
  • Long Term Care: Providing Compassion Without Confusion
    (Report #140, December 1996)

    While the State has taken some preliminary steps towards restructuring the long-term care services it provides to consumers, Californians needing long-term care still face a bewildering maze of choices. This report, which is the culmination of an in-depth 11-month study, contains four findings: the State's current oversight structure is too fragmented to allow effective coordination and integration of long-term care services; many of the State's policies favor expensive institutionalization at the expense of home and community-based services preferred by consumers; despite new federal regulations, consumers continue to take issue with the quality of care in skilled nursing facilities; and regulatory change has not kept pace with the changing demands placed on residential care facilities. The report offers 24 recommendations to address these problems, including consolidating long-term care into a single state agency, increasing resources for programs that delay institutionalization, and strengthening the consumer complaint systems now in place for skilled nursing facilities and residential care facilities.
  • Positioning California for Health Care Reform
    (Report #123, September 1993)

    California is far behind other states in moving to implement health care reforms, and at least one barrier is a reluctance to approach the health care needs of state workers and Medi-Cal recipients in a unified manner. In this policy analysis, the Commission makes three recommendations to create a temporary commission to put forth a single plan for a health system, establish a unit within the Department of Health Services to create clinical guidelines that weed out useless and ineffective health care treatments, and perform educational outreach to help consumers make better use of their health care benefits.
  • Mending Our Broken Children: Restructuring Foster Care in California
    (Report #115, April 1992)

    Despite spending more than $1 billion on welfare services for abused and neglected children, the State has failed to ensure that children taken from their troubled homes are given the necessary nurturing for them to become well-rounded adults and productive citizens. Among the recommendations, the Commission urges legislation that would establish a statewide foster care ombudsman program; make the State Department of Social Services solely responsible for licensing; and establish the Child Development and Education Agency. This report has five findings and 16 recommendations.
  • Unsafe in Their Own Homes: State Programs Fail to Protect Elderly from Indignity, Abuse and Neglect.
    (Report #113, November 1991)

    Elderly citizens sometimes are able to remain in their homes despite disabilities with the assistance of a state program, but the flawed system fails to meet the needs of too many senior citizens. In addition, the Commission found that a vast array of services that are supposed to provide a continuum of care for the elderly are not well-integrated and are difficult to access. This report makes five recommendations in regard to the integration of services offered to the elderly and improvements to the In-Home Supportive Services program.
  • Coordinating the Spending on Drug Prevention Programs
    (Report #112, October 1991)

    Follow-up to the Commission's 1988 study of the multitude of programs directed at drug abuse prevention, intervention, treatment and recovery and the State's funding mechanisms, this report discusses the State's efforts to coordinate these programs. In two findings and four recommendations, the Commission urges the State to continue its coordination efforts in the fight against drug abuse, to move aggressively toward block grant funding, and to establish a system for evaluating the success of its efforts.
  • Skilled Nursing Homes: Care Without Dignity
    (Report #109, April 1991) WP 6.0

    This report focuses on the State's refusal to implement federally mandated reforms, the rights of the elderly to informed consent processes before physical and chemical restraints are used, and the State's flawed enforcement system that has failed to protect the elderly. The Commission makes three findings and seven recommendations urging the Governor and the Legislature to take immediate steps to implement federal nursing home reforms, to guarantee people their rights, and to improve the citation and fine system.
  • The Snail's Pace of Reforming Residential Care and Facilities for the Elderly
    (Report #108, February 1991)

    While some improvements have been made in regulating residential care facilities, problems persist. In particular, the implementation of regulations has lagged far behind the statutory changes. In addition, the State has failed to crack down on unlicensed facilities in an expeditious manner. The Commission believes it is time for the State to shift emphasis from reform to enforcement of existing laws through stronger enforcement efforts and speedier adoption of regulations. This report includes two findings and two recommendations.
  • A Prescription for Medi-Cal
    (Report #106, November 1990)

    Three persistent problems plague this complex program: recipients have difficulty accessing treatment; the quality of medical care given recipients is often poor or inconsistent throughout the state; and provider participation is low. This Commission report contains 28 recommendations based on 12 findings. The recommendations embodied in this report can be generalized in three main points: 1) streamline present processes that affect recipients and providers; 2) expand the use of the State's purchasing power to bargain for more efficient and effective ways of providing medical care; and 3) explore the potential of prioritizing health care services.
  • California's Coordination of AIDS Services
    (Report #104, May 1990)

    While the State has commited substantial resources to dealing with AIDS (more than $128 million in 1989-90), there is no coordinated effort to maximize the effect of those dollars. In addition, the lack of firm leadership, commitment and sense of direction at the State level has meant that the State's steps toward coordination have been tentative, halting and, in general, unsuccessful. This report on AIDS services contains four findings and four recommendations to make the Office of AIDS more effective.
  • Runaway/Homeless Youths: California's Efforts to Recycle Society's Throwaways
    (Report #101, April 1990)

    This report is a follow-up to a review of runaway/homeless programs conducted as part of the Commission's 1987 report on Children's Services. The initial report found that there were few services directed toward runaway/homeless youths, but that pilot projects were just beginning in Los Angeles and San Francisco. Based on the success of the pilot projects in providing medical care, shelter, food and counseling, the Commission proposes the appropriation of funds to support new runaway/homeless youth programs modeled after the successful pilot projects.
  • The Medical Care of California's Nursing Home Residents: Inadequate Care, Inadequate Oversight
    (Report #93, February 1989)

    Unlike the Commission's 1983 and 1987 reports, this report focuses solely on medical care provided to nursing home residents. In essence, the report determined high quality medical care was not the top priority of any state agency or any industry group involved with nursing homes. The Commission proposes that nursing homes be required to set up physician peer review panels, make better efforts to track cases and coordinate records, and make every effort to increase the number of physicians with skills in gerontology and geriatrics. This report includes 18 findings and 18 corresponding recommendations.
  • A Report on Community Residential Care for the Elderly
    (Report #92, January 1989)

    One in every six residential care facilities is unlicensed and the backlogged, time-consuming licensing process encourages operators to begin their businesses with no licenses. The report also notes that an increased fine structure recommended in earlier Commission reports is either not used at all by the State or is enforced so haphazardly that it's deterrent effect is little. This report makes 11 findings and 10 recommendations regarding the elimination of unlicensed facilities, enforcement of existing laws, and the education and training of facility staff.
  • Report on the Coordination of Funding for Drug Programs in the State of California
    (Report #89, June 1988)

    In this letter report, the Commission examines the state's system of handling state and federal drug use prevention funds. This report contains three findings and 10 recommendations. Chief among these, the Commission recommends that the Governor and the Legislature establish a master plan for addressing drug abuse in California. Specifically, this plan should encourage cooperation and coordination by drug program administrators, school districts, law enforcement agencies at the State and local levels and with community-based organizations.
  • Children's Services Delivery System in California
    (Report #84, October 1987)

    California has recognized its responsibilities for the well-being of its children by establishing numerous programs to serve and protect them, but the State's children's services delivery system is beset with critical problems. This multi-faceted report contains 23 findings regarding the children's services delivery system and the problems of serving children in need of child care services, runaway/homeless youth, and abused and neglected children. Among the report's 36 recommendations to improve the overall performance of children's services in California, the Commission recommends the establishment of a Commission on Children and Youth to set overall State priorities for serving children; adopting a uniform children's policy to address the full range of services necessary to appropriately treat children in need; the expansion of child care services in the public and private sectors; and establishing statewide minimum training requirements for child care teachers and caregivers.
  • Review of the State's Medi-Cal Program and the Effects of the Reforms
    (Report #81, May 1987)

    This letter report assesses the numerous changes undertaken to implement the major Medi-Cal reforms that occurred in 1982 and to determine if any further changes and improvements are warranted in the Medi-Cal program. In addition, the report contains the Commission's recommendations regarding the overall funding level of the Medi-Cal program, uncompensated care and access to health care by the medically indigent.
  • New and Continuing Impediments to Improve the Quality of Life and the Quality of Care in California's Nursing Homes
    (Report #80, May 1987)

    Despite reforms, the State is not doing enough to ensure quality care for California's many frail and vulnerable nursing home residents. As a result, residents of these facilities continue to be subjected to indignities and their safety is not assured. This Commission report makes a series of recommendations to improve the quality of life in skilled nursing facilities, including increasing enforcement and penalty collection efforts by the State, allowing state receivership for certain skilled nursing facilities as an intermediate sanction, ensuring that voluntary Medi-Cal decertification does not penalize current residents and increasing consumer information services.
  • Accessibility of the Disabled Population to Substance Abuse Treatment
    (Report #79, May 1987)

    Federal and state mandates require substance abuse programs to be accessible to disabled people. This report examines how effective these mandates are, identifies the size of the disabled abusing population, and determines if there are adequate methods of coordinating information and referrals to ensure the delivery of services. The Commission makes three findings and three recommendations regarding the effectiveness and accessibility of alcohol and drug services for persons with disabilities.
  • Children's Services Delivery System in California Preliminary Report - Phase I
    (Report #78, March 1987)
  • Follow-Up Report on Conditions in Community Residential Care Facilities in California
    (Report #63, February 1985)
  • Community Residential Care in California - Community Care as a Long Term Care Service
    (Report #57, December 1983)
  • The Bureaucracy of Care - Continuining Policy Issues for Nursing Home Services and Regulation
    (Report #55, August 1983)
  • Office of Special Health Care Negotiations
    (Report #51, March 1983)
  • Health Care Delivery System Reform
    (Report #43, May 1980)
  • Medi-Cal Reform
    (Report #41, September 1979)
  • Administration of the Mental Health & Developmental Disabilities Programs
    (Report #39, August 1979)
  • Administration of the Medi-Cal Program - Second Supplementary Report
    (Report #37, February 1979)
  • The Status of Health Planning in California - A Supplementary Report
    (Report #36, February 1979)
  • An Analysis of Community Hospital Medi-Cal Audits
    (Report #34, July 1978)
  • Supplemental Report on Developmental Disabilities Program, Department of Health
    (Report #32, December 1977)
  • Supplemental Report on Medi-Cal Program, Department of Health
    (Report #31, September 1977)
  • Supplemental Report on State Hospitals, Department of Health
    (Report #27, April 1977)
  • Supplemental Report on Licensing & Certification, Department of Health
    (Report #26, March 1977)
  • A Study of the Administration of State Health Programs
    (Report #25, January 1976)