January 22, 2013: The "risks and responsibilities" that must be shared in some fashion between county and state government in social services will be the focus of significant negotiations in the next few months, as the changes required under the federal Affordable Care Act go into effect. People who qualify for the public health program under the ACA "will either be [served by] an expanded state program or be under the purview of county government," as Pauline Bartolone reported for Sacramento's CapRadio Monday. Speaking with Bartolone, California Health and Human Services Secretary Diana Dooley, at left, characterized the ACA changes as fundamentally changing "the relatinship between the state and counties for the long term."
On the radio, Farrah McDaid Ting, senior legislative analyst for the California State Association of Counties, says both options present challenges: "The challenge would be securing adequate reimbursement in an adequate time, and also complying with all the requirements and mandates of federal law." The counties are already providing health care to some of the newly eligible, but making all 58 counties responsible under the new federal health law would be a different story.
... County welfare departments administer CalWORKs Stage One child care while the Department of Education administers Stages Two and Three. The three-stage structure was created to ensure recipients of aid are able to participate in work activities, and continue to participate as they transition off cash aid. Additionally, the Department of Education admnisters all other subsidized child care programs to support low-income families so they may remain gainfully employed. The current subsidized child care system is fragmented by design. The various programs operate under different rules and administrative structures that suggest potential efficiencies can be gained through a closer examinationi of the current system. DSS will convene a stakeholder group to assess the current child care structure and opportunities for streamlining and other impovements.