California's system for caring for its aged and disabled population is deeply fragmented and too reliant on emergency room visits, according to the state's official watchdog.
The report by the Little Hoover Commission comes as California--and other states such as Florida--are planning moves of their most vulnerable populations into managed care plans.
The report noted that $7 billion worth of services for 1 million of the state's low-income aged and disabled citizens are provided by seven different departments, none of which are coordinated via a central database.
This makes it virtually impossible to properly coordinate or determine how much each service actually costs, or to prevent overlapping or duplicate services. The result is that many members of this population wind up getting treatment in nursing homes and ERs, even though the purpose of these programs is to provide care in an individual's home.
Moreover, rigid bureaucracies are discouraging hospitals, nursing homes and non-profit organizations from proposing new ideas that might cut costs.
The report recommended that Gov. Jerry Brown and the state Legislature consolidate all services into a single agency and appoint a "czar" to oversee them.