The California Health and Human Services Agency (CHHS) is the largest agency in California’s executive branch. It oversees 13 departments that provide a range of health care services, social services, mental health services, alcohol and drug services, income assistance and public health services. Major programs include low- and no-cost health care coverage for more than 6 million Californians through Medi-Cal, income support for more than 1 million aged, blind and disabled residents through SSI/SSP and income support for more than 1 million through CalWORKS. Programs providing food stamps, child welfare services, in-home supportive services, foster care, vocational rehabilitation and much more are administered by departments within the agency.
Health and Human Services Agency Budget Facts (LA Health Action) (pdf)
One of Governor Edmund G. Brown Sr.’s overarching goals upon taking office in 1959 was centralizing the executive branch and to that end he proposed establishing eight super agencies to oversee groups of departments. Among them was the Health and Welfare Agency. The agency was created by AB 1593 in 1961 and it included the departments of Social Welfare, Mental Hygiene and Public Health.
At the onset, all the agencies created were, by statute, relatively weak. They had minimal staffs and limited power to supervise the powerful departments they encompassed, review and approve budgets, coordinate activities and evaluate performance. But they were created to give the governor more direct control of the departments (and the interests they often represented), and over time the power of the Health and Welfare Agency, like its brethren, grew immensely.
The independent Little Hoover Commission was also created in 1961 to analyze government operations and help plan future executive branch reorganizations. In 1966, voters gave the governor more power to restructure the executive, subject to legislative veto, and reorganization became an ongoing political preoccupation. The makeup of the Health and Welfare Agency fluctuated over the years; at one point the Youth Authority and the Department of Corrections came under its purview, and it was renamed the Human Relations Agency.
The Human Relations Agency included nine major departments—Mental Health, Public Health, Rehabilitation, Medi-Cal, Social Welfare, Employment, Industrial Relations, Corrections and the Youth Authority—in addition to numerous boards and commissions.
Governor Jerry Brown’s 1979 reorganization plan created a separate Youth and Adult Correctional Agency. By that time the Health and Welfare Agency had its old name back.
As agency power grew, opposition to them increased. A 1982 review by the state Assembly found “serious deficiencies” in the agency structure that “fragmented responsibility and created a rigid system which stifles creativity, eliminates competitive ideas, increases administrative costs, delays the implementation of programs, and discourages the employment of competent leaders.” The review recommended that the agencies be taken apart and their duties be returned to the departments. Lawmakers passed legislation to accomplish that but Governor Brown vetoed it.
The Health and Welfare Agency was renamed the Health and Human Services Agency in January 1999.
California’s Executive Agencies, 1959-2003 (by Charlene Wear Simmons, California Research Bureau) (pdf)
Pitts Issues Preliminary Review of 1961 State Legislative Session (by
The Human Relations Agency: Perspectives and Programs Concerning Health, Welfare and Corrections (An interview with Spencer Williams, Regional Oral History Project)
Supporting Reagan: From Banks to Prisons (An interview with James M. Hall, Regional Oral History Project)
The Health and Human Services Agency, through the various entities it oversees, is responsible for administering various state and federal programs for social services, public health services, mental health services, public assistance and rehabilitation. It is the lead agency for Medi-Cal services, and oversees welfare and low-cost public health insurance for children in working families.
The agency oversees and coordinates the activities of 13 departments and two offices; the Office of Statewide Health Planning and Development and the Managed Risk Medical Insurance Board are considered departments despite their names.
Departments
Department of Aging
CDA provides services for older adults, adults with disabilities, family caregivers and residents in long-term care facilities. It contracts with the network of Area Agencies on Aging, which directly manages a wide array of federal and state-funded services. It oversees implementation of the Older Californians Act, which was passed by the state Legislature to comply with federal legislation mandating the availability of certain community services to senior citizens.
Department of Alcohol and Drug Programs
ADP administers prevention, treatment and recovery services for alcohol and drug abuse and problem gambling. It is responsible for interagency coordination with California’s 58 county alcohol and drug program administrators, which it uses to broker these services.
Department of Child Support Services
DCSS administers California’s child support program by overseeing 52 locally-operated offices. The primary purpose of the program is to collect support payments from absent parents for custodial parents and their children. Local child support offices provide services that include locating absent parents; establishing paternity; obtaining, enforcing, and modifying child support orders; and collecting and distributing payments.
Department of Community Services and Development
CSD serves low-income families by partnering with private nonprofit agencies and public local community service providers to administer an energy assistance program, a weatherization assistance program and a lead-based-paint hazard program. CSD also administers the state’s federal funding share for the Community Services Block Grant.
Department of Developmental Services
DDS provides support to individuals with developmental disabilities such as mental retardation, cerebral palsy, epilepsy and autism. The department provides care to 216,000 children and adults with developmental disabilities and 29,000 infants at risk of developmental delay or disability. It fosters service through 21 privately run non-profit regional centers it oversees, and state-run developmental centers (formerly known as state hospitals) and community facilities.
Emergency Medical Services Authority
EMSA oversees approximately 18,000 paramedics and prepares for medical emergency disasters. It licenses and disciplines paramedics, coordinates disaster response, sets education and training standards for emergency medical service providers and develops guidelines for local emergency medical service systems.
Department of Health Care Services
DHCS is the major provider of the health care safety net in California for low-income people and persons with the disabilities. Most of its budget is spent on Medi-Cal, the state incarnation of the federal Medicaid program. The department is the conduit for $42 billion worth of state and federal health care services to 7.7 million low-income state residents. Although the department gets well over half its budget from the federal government, 70% of what California spends from its own General Fund on health care passes through the department. One out of every 10 General Fund dollars eventually ends up at DHCS. Although the department is the lead agency handling Medi-Cal, about one-fifth of Medi-Cal expenditures are made through the Department of Developmental Services, Department of Mental Health, Department of Social Services and the Department of Alcohol and Drug Programs.
Managed Risk Medical Insurance Board
MRMIB is the health insurer of last resort for children of low-income families and pregnant women who don’t qualify for Medi-Cal. It also provides insurance for people with pre-existing conditions who are otherwise denied coverage. Its children’s health insurance program serves 850,000 kids and is the largest in the nation. Many of the department’s functions will be taken over in 2014 by the state’s fledgling Health Benefits Exchange (authorized by the federal Patient Protection and Affordable Care Act).
Department of Mental Health
DMH operates five state mental health hospitals and three acute care centers inside Department of Corrections’ facilities. It administers federal funds targeted for mental health programs and services with a budget of more than $4.5 billion. And the department functions as an information resource, coordinating, evaluating and monitoring efforts of county and local agencies as well as independent organizations. Its responsibilities include implementation of Proposition 63, the Mental Health Services Act of 2004, which provides state tax dollars for specific county mental health programs and services.
Department of Public Health
CDPH is a new department, carved out of the Department of Health Services in 2006 with a specific mandate to protect Californians from disease and respond to public health emergencies. Some of its programs are crafted to support the activities of local health agencies in controlling environmental hazards, preventing and controlling disease and providing health services to populations with special needs. Its creation was spurred by the terrorist attacks of September 11, 2001.
Department of Rehabilitation
DOR runs the largest vocational rehabilitation program in the country and is funded primarily by the federal government. It finds employment for the more than 150,000 disabled Californians, helps them live independently and promotes equality with non-disabled people in the communities where they live and work. The department not only assists disabled state residents, its own work staff is comprised of about 15% disabled individuals, including its current director.
Department of Social Services
CDSS is a state-supervised, county-administered system that provides oversight of programs that affect nearly 3 million of California’s most vulnerable residents—foster children and youth, children and families receiving aid through the California Work Opportunities and Responsibility to Kids (CalWORKs), adults and elderly in licensed community care facilities and aged, blind and disabled recipients requiring in-home supportive services or Supplemental Security Income/State Supplementary Payment (SSI-SSP) assistance.
Office of Statewide Health Planning and Development
OSHPD is the building department for hospitals and skilled-nursing facilities in the state. It is in charge of hospital building safety, including extensive earthquake disaster preparation. The department also functions as a loan company, providing loan insurance for non-profit healthcare facilities.
Offices
Office of Health Information Integrity
CalOHII is the enforcer of state laws that require health care providers to implement appropriate safeguards to protect the privacy of patients’ medical information. The office manages and tracks reported privacy violations and associated investigations. California is in the process of establishing an electronic health information exchange and CalOHII is developing pilot projects to test the feasibility of implementation and standardization across the health care field.
Office of Systems Integration
OSI, established in 2005, is in charge of procuring, managing and delivering complex technology systems for the Health and Human Services Agency. The office coordinates collaboration between technology project developers, manages contracts, and oversees design, development and implementation of IT systems.
Other Initiatives
The Child Welfare Council is an advisory body responsible for improving collaboration between agencies and courts that serve children in the child welfare system. The council is co-chaired by the Health and Human Services secretary and a designee of the state Supreme Court chief justice. The eHealth Initiative is a group of organizations working to facilitate adoption of health information technology. Its initiatives include involvement with electronic health records, telemedicine, health IT, electronic health information, and privacy and security. The Olmstead Advisory Committee represents consumers, family members, providers and advocates in planning for the long term care of people with disabilities. It advises the Health and Human Services Agency on implementation of the Olmstead Plan. The Obesity Prevention Program works toward the goal of increasing physical activity, improving nutrition and preventing obesity. It is funded by the U.S. Centers for Disease Control and Prevention and operated by the state Department of Public Health. The Alzheimer’s Disease and Related Disorders Advisory Committee was established in 1988 to advise and assist the Legislature and the executive branch on the needs of the Alzheimer’s population.
Nearly half of the Health and Human Services Agency’s $88.5 billion budget in 2011-12 came from federal funds and some departments, like Health Care Services, are overwhelmingly funded by federal dollars. The agency has, by far, the largest budget in California government.
Under normal conditions, tracking the flow of money through the agency’s 13 departments is a daunting task, but in recent years it has been complicated by national health care reform, the federal government’s deficit reduction activities and California’s own debt crisis.
The Department of Health Care Services, which handles most of the state’s Medi-Cal expenditures, spends about 52% of the agency’s budget. The Department of Social Services spends 22.3% (mostly on welfare programs), and the departments of Mental Health and Developmental Services each spend about 5.2%.
As is often pointed out, the state budget is actually a local budget, in that 70% of the funds go directly to local communities, health care providers and individuals. Nearly 30 cents of every state budget dollar spent goes to Health and Human Services. (Education gets 50 cents.) But in recent years, fewer of the state’s dollars are going to agency. In 1980-81, one-third of state expenditures were for health and human services. By 2009-10 that had dropped to 29%.
Enacted Budget Summary 2011-12
3-Year Budget (pdf)
Governor Signs 2011-12 Spending Plan (California Budget Project) (pdf)
Where Do California’s Tax Dollars Go? (California Budget Project) (pdf)
Huge Budget Cuts
State health and welfare expenditures make up roughly one-third of the $30 billion California General Fund budget. So when lawmakers aimed to close a $25.4 billion budget gap in 2011, the Health and Human Services Agency was squarely in the cross-hairs. They cut $4.5 billion and the pain was widespread.
“These cuts will come back to bite us,” warned Anthony Wright, executive director of Health Access California. “Many patients will have worse health outcome as a result—which will be more costly in the short and long term. . . . We've gone well past smart and strategic cuts to ones that are just plain stupid.”
More than half the agency’s funding comes from the federal government, but losing 18% of its state General Fund money will ripple through its 13 departments.
Medi-Cal, used by 7.5 million Californians, took a $1.5 billion hit. CalWORKs, the state's welfare program which affects more than 300,000 children will have to do with $567.2 million less.
The cutting may not be done. If revenues fall short during the fiscal year, the agency will suffer additional reductions.
While some of the Medi-Cal cuts are the subject of court fights and might not materialize, the state has already suffered losses of federal stimulus dollars that ran out in June 2011 and face other fallout from budget battles in Washington.
A Fraying Safety Net (by Alexandra Zavis, Los Angeles Times)
Budget Cuts to Hit Health Care for Poor Californians (by Stephanie Sara Chong, The Bay Citizen)
California Won't be the Same Under New Budget (by Wyatt Buchanan, San Francisco Chronicle)
California's Budget Cuts: Where They Hurt The Most (by Matt Sledge, Huffington Post)
California’s State Budget: The Enacted Budget (by Margaret Weston and Jed Kolko, Public Policy Institute of California)
Medi-Cal Cuts Sought as Stimulus Funds Run Out (by Victoria Colliver, San Francisco Chronicle)
Medi-Cal Reimbursement Cuts
Faced with budget crunches in 2008 and 2009, California slashed its Medi-Cal provider payments up to 10%. The result were lawsuits filed against the state by Medi-Cal recipients, providers and advocates to roll back some cuts and block others from taking place. The federal government sets floors for how low states can go in establishing rates, but states have latitude in deciding what their individual rates are.
California tends to be more generous than most states, and have established a Medi-Cal system based on its historic budget decisions. Those suing maintained that although the rates weren’t below the federal standards, the end result would endanger the existing Medi-Cal program and violate state law.
Three separate lawsuits were eventually consolidated into one and the U.S. Ninth Circuit Court of Appeals upheld the complainants’ request for an injunction against the state. California appealed to the U.S. Supreme Court were initial oral arguments in October 2011 indicated that the justices were more interested in whether the complaining parties had standing to bring suit than the merits of their arguments against rate cuts.
The Obama administration and California officials argued that the rate hikes were solely a matter to be decided between the state and federal governments and that private parties shouldn’t be allowed to sue them over the results. Those who sided with the providers argued that private lawsuits served a valuable function and were never meant to be blocked by the law.
US Supreme Court Hears Major California Medi-Cal Provider Rate Reduction Cases (California Disability Community Action Network)
Calif. Medicaid Cuts Open Supreme Court Term (by Emily P. Walker, MedPage)
For Justices’ First Day Back, a Knotty Case Involving Medicaid Cutbacks (by Adam Liptak, New York Times)
Brief of Former HHS Officials as Amici Curiae in Support of Respondents (Pleading before the U.S. Supreme Court) (pdf)
Too Big to Not Fail
The history of California government includes a storyline about the ebb and flow of centralization. Early 20th century progressive movements sought to establish a plethora of boards, commissions and departments to execute the policies of the governor and the Legislature.
In 1959, the Brown administration sought to consolidate its authority by creating “super” agencies that would oversee clusters of departments while reporting directly to the governor. The forerunner of the Health and Human Services Agency was one of the eight super agencies created and over time continued to add new appendages.
By 2004, it was a large and complex bureaucracy that according to the independent Little Hoover Commission was growing dysfunctional. “The relationship between the state departments and local agencies that provide most of the actual services is defined by distrust and suspicion,” the commission opined in a report that said the agency had been unable to coordinate state activities among its 13 departments. “One county representative described the relationship as ‘spy vs. spy.’ ”
It noted “heart breaking failures” as a result, including children being abused in while in foster care or state facilities, and said an array of indicators showed California not faring well compared to other states. It criticized the explosion of pilot projects, “rule upon rule, program upon program, year upon year.” Departments perform duplicative services, like licensing, that increase administrative costs and frustrate local authorities in their dealings with the state.
The report said the system has been hard-wired over decades of political compromises that may have been necessary at one time, but haven’t been reviewed in the intervening years. It concluded that “California cannot sustain its existing health and human services.”
Despite its dire assessment, the report stopped short of calling for the agency’s breakup.
Real Lives, Real Reforms: Improving Health and Human Services (Little Hoover Commission) (pdf)
Obamacare
The Health and Human Services Agency will be in the eye of the storm as the 2014 deadline approaches for implementation of the Patient Protection and Affordable Care Act (ACA), know (derisively) in some quarters as Obamacare. The act is a large piece of legislation that will require significant changes by the states in how they administer health care.
Almost every department in the agency will be affected as the legislation is phased in year by year. That is assuming that the law isn’t declared unconstitutional.
Court challenges to the ACA abound. Twenty-six states are among those who have sued over the legislation signed by President Barack Obama in March 2010 and the matter is headed for consideration, and possible resolution, by the Supreme Court. The country has divided along ideological and political lines over the issue as it competes with the economy and war and peace for attention.
Implementation of the Affordable Care Act in California: A Window of Opportunity for State Policy Makers (Health and Human Services Agency)
Obama Health Care Law Headed to Supreme Court (by David Jackson, USA Today)
On the Left: It’s the Healthy Thing to Do
The Affordable Care Act was not the first choice for health care reform among many on the left. A single-payer system that would essentially extend the Medicare system to everyone in the country received a lot of support from progressives. It would eliminate the role of insurance companies and other middlemen, effectively reducing administrative costs by an estimated 30%. The focus would be on treatment, not costs or eligibility.
But single-payer was deemed politically untenable and President Obama, although slow to embrace the individual mandate requirement of participation, eventually proposed reform that would guarantee health care for the poor and those with pre-existing conditions while spreading the costs among everyone. His proposal introduced the government as a player by establishing a public plan as competition in the marketplace, but retained the basic structure of a system that included insurance companies, HMOs and other gatekeepers.
The oft-debated individual mandate that requires people to either have health insurance or pay a penalty is a lynchpin of the system that keeps prices low by spreading the costs across the largest population possible. It’s a classic principle of insurance.
The plan was similar to a health care proposal enacted in Massachusetts under a Republican governor, and later presidential candidate, Mitt Romney. It also closely approximated previous Republican proposals, including a 1993 bill sponsored by GOP Senator John Chafee in 1993.
The policy origins of that bill could be found in a proposal from the conservative Heritage Foundation in 1989: “[N]either the federal government nor any state requires all households to protect themselves from the potentially catastrophic costs of a serious accident or illness. Under the Heritage plan, there would be such a requirement.” Three years later, the foundation made a similar pitch: “Step #2: Require all households to purchase at least a basic package of insurance, unless they are covered by Medicaid, Medicare, or other government health programs. All Heads of households would be required by law to obtain at least a basic health plan specified by Congress.”
Obama emphasized that health care reform wasn’t just a humanitarian gesture. It was a rational attempt to rein in costs that have soared far ahead of the cost of living. He regarded health care reform as a deficit reduction measure and analysis by the Congressional Budget Office (CBO) supported that assessment. The CBO estimated that the ACA would cut the deficit by $1.3 trillion over 20 years and provide coverage to 95% of the population.
The CBO also projected a slight loss of jobs in the economy, but attributed much of that to the retirement of workers who were only remaining on the job to collect employer-provided health insurance. A highly-publicized study by the National Federation of Independent Businesses that projected a 1.6 million job loss was based on a study done before the ACA was actually passed and included wildly inaccurate assumptions about its provisions.
The virtues of the legislation are manifest and will become immediately evident. Millions of poor people will receive decent health care. People denied coverage because of pre-existing conditions will be now be covered. Young people up to the age of 26 can stay on their parents’ insurance policies. The nation’s health care bill will be reduced.
Other advantages may not be as readily apparent or immediate, but could prove just as important. Lower costs for small businesses, lower drug prices, better medical information technology and more effective preventive services. And maybe a recognition that government intervention in the long-term might be a reasonable counterbalance to Darwinian competition in the health care marketplace.
It’s humane. It’s fiscally responsible. It’s a no-brainer and long overdue.
Single-Payer Health Care versus Individual Mandates: A Dilemma for Democrats (by Gene Rothman, LA Progressive)
The Health Care Law a “Job killer”? The Evidence Falls Short (Politifact)
Comparing Health Reform Bills: Democrats and Republicans 2009, Republicans 1993 (by Maggie Mertens, Kaiser Health News)
CBO: Health-Care Reform Bill Cuts Deficit by $1.3 Trillion Over 20 years, Covers 95% (by Ezra Klein, Washington Post)
Republican Origins of Democratic Health Care Provision (ProCon.org)
On the Right: Repeal the Act
Don’t fix it if it isn’t broken. Many people, especially those with insurance policies provided by their employers, feel that the United States has the best health care system in the world and shouldn’t tamper with it.
They don’t want the government to get between them and their doctors and they don’t want politicians and bureaucrats telling them how to live. This sentiment engendered heated warnings of government “death panels” that would sentence granny to death to save a few dollars. The fear is that a wider dissemination of health care benefits will force rationing of limited resources.
The individual mandate is regarded on the right as coercive, unconstitutional government intrusion into people’s private lives. If the government can force you to buy insurance, the argument goes, what else can they compel you to buy? Or not buy? Or do? Or not do?
Opponents of the ACA strongly question estimates about the act’s fiscal impact. Despite Congressional Budget Office assertions, common sense would seem to dictate that giving subsidized health care to large numbers of people will either reduce the standard of individual care or force a rise in taxes to pay for it. There is no shortage of doctors warning that patients will get far less attention under Obamacare.
In an era of huge budget deficits and questions about the affordability of existing entitlements like Social Security and Medicare, is this really the time to take on more social obligations? Those on the right fear that the health care initiative will not only drain financial resources, it will be a job killer. They cite an estimate from the National Federation of Independent Businesses that says 1.6 million jobs could be lost between 2009 and 2014.
And how wise is it to make these dramatic changes in the country’s social fabric without a strong national consensus?
Instead of ramming through partisan legislation in a contentious manner, a better approach might have been a bipartisan effort to fine-tune the health care marketplace. There is no shortage of good ideas to improve health care. When the GOP-dominated House of Representatives voted in January 2011 to repeal the ACA (the bid failed in the Senate), it offered a list of reforms that it considered more effective: medical liability reform, expanded health savings accounts, purchase of health insurance across state lines, ensured coverage of pre-existing conditions, incentives to states to insure the uninsured and prohibition of “taxpayer funding for abortions.”
20 Ways ObamaCare Will Take Away Our Freedoms (by David Hogberg, Investors Daily)
7 Sickening Questions About Obamacare (by Jon Kraushar, Fox News)
Bad Medicine (Cato Institute)
How ObamaCare Will Affect Your Doctor (by Scott Gottlieb, Wall Street Journal)
House Republicans Offer Alternative Healthcare Proposal (by Janet Hook, Los Angeles Times)
Obamacare: A Budget-Busting, Job-Killing Health Care Law (GOP House of Representatives leadership) (pdf)
The Affordable Care Act is a game-changer. It introduces myriad changes in how health care will be delivered to Californians, not the least of which is the California Health Benefit Exchange.
The exchange, scheduled to begin functioning in 2014, will ultimately subsidize up to 45% of individuals purchasing private insurance and cover 2.3 million uninsured people. State legislation to begin construction of the exchange was passed in 2010 and a five-member board, including Health and Human Services Secretary Diana Dooley, has been appointed to help negotiate health coverage for individuals and businesses with fewer than 100 employees. Former agency Secretary Kim Belshé is also on the panel.
The state will experience a long, and in some cases, uncertain transitional period as it absorbs new clients into the health care system and moves existing clients to new programs. The number of uninsured Californians is expected to drop from 7 million in 2011 to less than half that amount in 2016 while Med-Cal enrollment grows 10%. As part of the transition, the Health and Human Services Agency approved the “Bridge to Reform” waiver that moves roughly $8 billion in federal Medicaid matching funds to the counties for expanded coverage.
Regulations and Guidance (Healthcare.gov)
California’s Health Benefit Exchange Legislation (Insure the Uninsured Project) (pdf)
Schwarzenegger Names Susan Kennedy to Top Healthcare Post (by Anthony York, Los Angeles Times)
Key Facts on California’s “Bridge to Reform” Medicaid Demonstration Waiver (Kaiser Family Foundation) (pdf)
S. Kimberly Belshé, 2003-2010
Grantland Johnson, 1999-2003
Sandra R. Smoley, 1993-1999
Russell S. Gould, 1991-1993
Clifford L. Allenby, 1987-1990
James Stockdale, 1985-1987 (interim)
David B. Swoap, 1983-1985. The Deukmejian appointee was instrumental in establishing a workfare program designed to get welfare mothers off the welfare rolls and into jobs. He worked to dismantle the state’s family planning program, attempted to eliminate sex education in schools and was a passionate anti-choice advocate on abortion.
Douglas X. Patiño, 1982
Mario J. Obledo, 1975-1982. Obledo, appointed by Governor Jerry Brown, was the first Latino official to head a California state agency and a key member of the Latino civil rights movement. He later ran unsuccessfully for governor. Obledo co-founded the Hispanic National Bar Association and served as national president of the League of United Latin American Citizens. President Clinton gave him the Presidential Medal of Freedom Award in 1998.
James E. Jenkins, 1974-1975
Dr. Earl W. Brian, 1972-1973. Dr. Brian was a decorated combat surgeon who served during the Vietnam War. Governor Ronald Reagan appointed him agency secretary shortly after his return from Asia, but he left his post after two years to challenge Alan Cranston for a Senate seat. He lost in the primaries. Brian, a close associate of Reagan Attorney General Ed Meese, became a businessman and was a controversial figure in the ‘80s and ‘90s with alleged ties to the intelligence community. He sued former U.S. Attorney General Elliot Richardson for libel in 1991 over an op-ed piece Richardson wrote for the New York Times. That article tied Brian to the theft of “Inslaw, Inc.” software from the Justice Department and the alleged “October Surprise” attempt to convince Iranians not to release its American hostages until the Reagan-Carter election of 1980 was over. Brian lost the suit. In 1996, Brian was convicted on 10 counts of fraud and sentenced to four years and nine months in prison for activities as chairman of two companies: United Press International and Financial News Network.
James M. Hall, 1971-1972
Lucian Vandegrift, 1968- 1970
Spencer Williams, 1967-1968
Winslow Christian, 1963-1964
- Table of Contents
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Health and Human Services Agency
The California Health and Human Services Agency (CHHS) is the largest agency in California’s executive branch. It oversees 13 departments that provide a range of health care services, social services, mental health services, alcohol and drug services, income assistance and public health services. Major programs include low- and no-cost health care coverage for more than 6 million Californians through Medi-Cal, income support for more than 1 million aged, blind and disabled residents through SSI/SSP and income support for more than 1 million through CalWORKS. Programs providing food stamps, child welfare services, in-home supportive services, foster care, vocational rehabilitation and much more are administered by departments within the agency.
Health and Human Services Agency Budget Facts (LA Health Action) (pdf)
One of Governor Edmund G. Brown Sr.’s overarching goals upon taking office in 1959 was centralizing the executive branch and to that end he proposed establishing eight super agencies to oversee groups of departments. Among them was the Health and Welfare Agency. The agency was created by AB 1593 in 1961 and it included the departments of Social Welfare, Mental Hygiene and Public Health.
At the onset, all the agencies created were, by statute, relatively weak. They had minimal staffs and limited power to supervise the powerful departments they encompassed, review and approve budgets, coordinate activities and evaluate performance. But they were created to give the governor more direct control of the departments (and the interests they often represented), and over time the power of the Health and Welfare Agency, like its brethren, grew immensely.
The independent Little Hoover Commission was also created in 1961 to analyze government operations and help plan future executive branch reorganizations. In 1966, voters gave the governor more power to restructure the executive, subject to legislative veto, and reorganization became an ongoing political preoccupation. The makeup of the Health and Welfare Agency fluctuated over the years; at one point the Youth Authority and the Department of Corrections came under its purview, and it was renamed the Human Relations Agency.
The Human Relations Agency included nine major departments—Mental Health, Public Health, Rehabilitation, Medi-Cal, Social Welfare, Employment, Industrial Relations, Corrections and the Youth Authority—in addition to numerous boards and commissions.
Governor Jerry Brown’s 1979 reorganization plan created a separate Youth and Adult Correctional Agency. By that time the Health and Welfare Agency had its old name back.
As agency power grew, opposition to them increased. A 1982 review by the state Assembly found “serious deficiencies” in the agency structure that “fragmented responsibility and created a rigid system which stifles creativity, eliminates competitive ideas, increases administrative costs, delays the implementation of programs, and discourages the employment of competent leaders.” The review recommended that the agencies be taken apart and their duties be returned to the departments. Lawmakers passed legislation to accomplish that but Governor Brown vetoed it.
The Health and Welfare Agency was renamed the Health and Human Services Agency in January 1999.
California’s Executive Agencies, 1959-2003 (by Charlene Wear Simmons, California Research Bureau) (pdf)
Pitts Issues Preliminary Review of 1961 State Legislative Session (by
The Human Relations Agency: Perspectives and Programs Concerning Health, Welfare and Corrections (An interview with Spencer Williams, Regional Oral History Project)
Supporting Reagan: From Banks to Prisons (An interview with James M. Hall, Regional Oral History Project)
The Health and Human Services Agency, through the various entities it oversees, is responsible for administering various state and federal programs for social services, public health services, mental health services, public assistance and rehabilitation. It is the lead agency for Medi-Cal services, and oversees welfare and low-cost public health insurance for children in working families.
The agency oversees and coordinates the activities of 13 departments and two offices; the Office of Statewide Health Planning and Development and the Managed Risk Medical Insurance Board are considered departments despite their names.
Departments
Department of Aging
CDA provides services for older adults, adults with disabilities, family caregivers and residents in long-term care facilities. It contracts with the network of Area Agencies on Aging, which directly manages a wide array of federal and state-funded services. It oversees implementation of the Older Californians Act, which was passed by the state Legislature to comply with federal legislation mandating the availability of certain community services to senior citizens.
Department of Alcohol and Drug Programs
ADP administers prevention, treatment and recovery services for alcohol and drug abuse and problem gambling. It is responsible for interagency coordination with California’s 58 county alcohol and drug program administrators, which it uses to broker these services.
Department of Child Support Services
DCSS administers California’s child support program by overseeing 52 locally-operated offices. The primary purpose of the program is to collect support payments from absent parents for custodial parents and their children. Local child support offices provide services that include locating absent parents; establishing paternity; obtaining, enforcing, and modifying child support orders; and collecting and distributing payments.
Department of Community Services and Development
CSD serves low-income families by partnering with private nonprofit agencies and public local community service providers to administer an energy assistance program, a weatherization assistance program and a lead-based-paint hazard program. CSD also administers the state’s federal funding share for the Community Services Block Grant.
Department of Developmental Services
DDS provides support to individuals with developmental disabilities such as mental retardation, cerebral palsy, epilepsy and autism. The department provides care to 216,000 children and adults with developmental disabilities and 29,000 infants at risk of developmental delay or disability. It fosters service through 21 privately run non-profit regional centers it oversees, and state-run developmental centers (formerly known as state hospitals) and community facilities.
Emergency Medical Services Authority
EMSA oversees approximately 18,000 paramedics and prepares for medical emergency disasters. It licenses and disciplines paramedics, coordinates disaster response, sets education and training standards for emergency medical service providers and develops guidelines for local emergency medical service systems.
Department of Health Care Services
DHCS is the major provider of the health care safety net in California for low-income people and persons with the disabilities. Most of its budget is spent on Medi-Cal, the state incarnation of the federal Medicaid program. The department is the conduit for $42 billion worth of state and federal health care services to 7.7 million low-income state residents. Although the department gets well over half its budget from the federal government, 70% of what California spends from its own General Fund on health care passes through the department. One out of every 10 General Fund dollars eventually ends up at DHCS. Although the department is the lead agency handling Medi-Cal, about one-fifth of Medi-Cal expenditures are made through the Department of Developmental Services, Department of Mental Health, Department of Social Services and the Department of Alcohol and Drug Programs.
Managed Risk Medical Insurance Board
MRMIB is the health insurer of last resort for children of low-income families and pregnant women who don’t qualify for Medi-Cal. It also provides insurance for people with pre-existing conditions who are otherwise denied coverage. Its children’s health insurance program serves 850,000 kids and is the largest in the nation. Many of the department’s functions will be taken over in 2014 by the state’s fledgling Health Benefits Exchange (authorized by the federal Patient Protection and Affordable Care Act).
Department of Mental Health
DMH operates five state mental health hospitals and three acute care centers inside Department of Corrections’ facilities. It administers federal funds targeted for mental health programs and services with a budget of more than $4.5 billion. And the department functions as an information resource, coordinating, evaluating and monitoring efforts of county and local agencies as well as independent organizations. Its responsibilities include implementation of Proposition 63, the Mental Health Services Act of 2004, which provides state tax dollars for specific county mental health programs and services.
Department of Public Health
CDPH is a new department, carved out of the Department of Health Services in 2006 with a specific mandate to protect Californians from disease and respond to public health emergencies. Some of its programs are crafted to support the activities of local health agencies in controlling environmental hazards, preventing and controlling disease and providing health services to populations with special needs. Its creation was spurred by the terrorist attacks of September 11, 2001.
Department of Rehabilitation
DOR runs the largest vocational rehabilitation program in the country and is funded primarily by the federal government. It finds employment for the more than 150,000 disabled Californians, helps them live independently and promotes equality with non-disabled people in the communities where they live and work. The department not only assists disabled state residents, its own work staff is comprised of about 15% disabled individuals, including its current director.
Department of Social Services
CDSS is a state-supervised, county-administered system that provides oversight of programs that affect nearly 3 million of California’s most vulnerable residents—foster children and youth, children and families receiving aid through the California Work Opportunities and Responsibility to Kids (CalWORKs), adults and elderly in licensed community care facilities and aged, blind and disabled recipients requiring in-home supportive services or Supplemental Security Income/State Supplementary Payment (SSI-SSP) assistance.
Office of Statewide Health Planning and Development
OSHPD is the building department for hospitals and skilled-nursing facilities in the state. It is in charge of hospital building safety, including extensive earthquake disaster preparation. The department also functions as a loan company, providing loan insurance for non-profit healthcare facilities.
Offices
Office of Health Information Integrity
CalOHII is the enforcer of state laws that require health care providers to implement appropriate safeguards to protect the privacy of patients’ medical information. The office manages and tracks reported privacy violations and associated investigations. California is in the process of establishing an electronic health information exchange and CalOHII is developing pilot projects to test the feasibility of implementation and standardization across the health care field.
Office of Systems Integration
OSI, established in 2005, is in charge of procuring, managing and delivering complex technology systems for the Health and Human Services Agency. The office coordinates collaboration between technology project developers, manages contracts, and oversees design, development and implementation of IT systems.
Other Initiatives
The Child Welfare Council is an advisory body responsible for improving collaboration between agencies and courts that serve children in the child welfare system. The council is co-chaired by the Health and Human Services secretary and a designee of the state Supreme Court chief justice. The eHealth Initiative is a group of organizations working to facilitate adoption of health information technology. Its initiatives include involvement with electronic health records, telemedicine, health IT, electronic health information, and privacy and security. The Olmstead Advisory Committee represents consumers, family members, providers and advocates in planning for the long term care of people with disabilities. It advises the Health and Human Services Agency on implementation of the Olmstead Plan. The Obesity Prevention Program works toward the goal of increasing physical activity, improving nutrition and preventing obesity. It is funded by the U.S. Centers for Disease Control and Prevention and operated by the state Department of Public Health. The Alzheimer’s Disease and Related Disorders Advisory Committee was established in 1988 to advise and assist the Legislature and the executive branch on the needs of the Alzheimer’s population.
Nearly half of the Health and Human Services Agency’s $88.5 billion budget in 2011-12 came from federal funds and some departments, like Health Care Services, are overwhelmingly funded by federal dollars. The agency has, by far, the largest budget in California government.
Under normal conditions, tracking the flow of money through the agency’s 13 departments is a daunting task, but in recent years it has been complicated by national health care reform, the federal government’s deficit reduction activities and California’s own debt crisis.
The Department of Health Care Services, which handles most of the state’s Medi-Cal expenditures, spends about 52% of the agency’s budget. The Department of Social Services spends 22.3% (mostly on welfare programs), and the departments of Mental Health and Developmental Services each spend about 5.2%.
As is often pointed out, the state budget is actually a local budget, in that 70% of the funds go directly to local communities, health care providers and individuals. Nearly 30 cents of every state budget dollar spent goes to Health and Human Services. (Education gets 50 cents.) But in recent years, fewer of the state’s dollars are going to agency. In 1980-81, one-third of state expenditures were for health and human services. By 2009-10 that had dropped to 29%.
Enacted Budget Summary 2011-12
3-Year Budget (pdf)
Governor Signs 2011-12 Spending Plan (California Budget Project) (pdf)
Where Do California’s Tax Dollars Go? (California Budget Project) (pdf)
Huge Budget Cuts
State health and welfare expenditures make up roughly one-third of the $30 billion California General Fund budget. So when lawmakers aimed to close a $25.4 billion budget gap in 2011, the Health and Human Services Agency was squarely in the cross-hairs. They cut $4.5 billion and the pain was widespread.
“These cuts will come back to bite us,” warned Anthony Wright, executive director of Health Access California. “Many patients will have worse health outcome as a result—which will be more costly in the short and long term. . . . We've gone well past smart and strategic cuts to ones that are just plain stupid.”
More than half the agency’s funding comes from the federal government, but losing 18% of its state General Fund money will ripple through its 13 departments.
Medi-Cal, used by 7.5 million Californians, took a $1.5 billion hit. CalWORKs, the state's welfare program which affects more than 300,000 children will have to do with $567.2 million less.
The cutting may not be done. If revenues fall short during the fiscal year, the agency will suffer additional reductions.
While some of the Medi-Cal cuts are the subject of court fights and might not materialize, the state has already suffered losses of federal stimulus dollars that ran out in June 2011 and face other fallout from budget battles in Washington.
A Fraying Safety Net (by Alexandra Zavis, Los Angeles Times)
Budget Cuts to Hit Health Care for Poor Californians (by Stephanie Sara Chong, The Bay Citizen)
California Won't be the Same Under New Budget (by Wyatt Buchanan, San Francisco Chronicle)
California's Budget Cuts: Where They Hurt The Most (by Matt Sledge, Huffington Post)
California’s State Budget: The Enacted Budget (by Margaret Weston and Jed Kolko, Public Policy Institute of California)
Medi-Cal Cuts Sought as Stimulus Funds Run Out (by Victoria Colliver, San Francisco Chronicle)
Medi-Cal Reimbursement Cuts
Faced with budget crunches in 2008 and 2009, California slashed its Medi-Cal provider payments up to 10%. The result were lawsuits filed against the state by Medi-Cal recipients, providers and advocates to roll back some cuts and block others from taking place. The federal government sets floors for how low states can go in establishing rates, but states have latitude in deciding what their individual rates are.
California tends to be more generous than most states, and have established a Medi-Cal system based on its historic budget decisions. Those suing maintained that although the rates weren’t below the federal standards, the end result would endanger the existing Medi-Cal program and violate state law.
Three separate lawsuits were eventually consolidated into one and the U.S. Ninth Circuit Court of Appeals upheld the complainants’ request for an injunction against the state. California appealed to the U.S. Supreme Court were initial oral arguments in October 2011 indicated that the justices were more interested in whether the complaining parties had standing to bring suit than the merits of their arguments against rate cuts.
The Obama administration and California officials argued that the rate hikes were solely a matter to be decided between the state and federal governments and that private parties shouldn’t be allowed to sue them over the results. Those who sided with the providers argued that private lawsuits served a valuable function and were never meant to be blocked by the law.
US Supreme Court Hears Major California Medi-Cal Provider Rate Reduction Cases (California Disability Community Action Network)
Calif. Medicaid Cuts Open Supreme Court Term (by Emily P. Walker, MedPage)
For Justices’ First Day Back, a Knotty Case Involving Medicaid Cutbacks (by Adam Liptak, New York Times)
Brief of Former HHS Officials as Amici Curiae in Support of Respondents (Pleading before the U.S. Supreme Court) (pdf)
Too Big to Not Fail
The history of California government includes a storyline about the ebb and flow of centralization. Early 20th century progressive movements sought to establish a plethora of boards, commissions and departments to execute the policies of the governor and the Legislature.
In 1959, the Brown administration sought to consolidate its authority by creating “super” agencies that would oversee clusters of departments while reporting directly to the governor. The forerunner of the Health and Human Services Agency was one of the eight super agencies created and over time continued to add new appendages.
By 2004, it was a large and complex bureaucracy that according to the independent Little Hoover Commission was growing dysfunctional. “The relationship between the state departments and local agencies that provide most of the actual services is defined by distrust and suspicion,” the commission opined in a report that said the agency had been unable to coordinate state activities among its 13 departments. “One county representative described the relationship as ‘spy vs. spy.’ ”
It noted “heart breaking failures” as a result, including children being abused in while in foster care or state facilities, and said an array of indicators showed California not faring well compared to other states. It criticized the explosion of pilot projects, “rule upon rule, program upon program, year upon year.” Departments perform duplicative services, like licensing, that increase administrative costs and frustrate local authorities in their dealings with the state.
The report said the system has been hard-wired over decades of political compromises that may have been necessary at one time, but haven’t been reviewed in the intervening years. It concluded that “California cannot sustain its existing health and human services.”
Despite its dire assessment, the report stopped short of calling for the agency’s breakup.
Real Lives, Real Reforms: Improving Health and Human Services (Little Hoover Commission) (pdf)
Obamacare
The Health and Human Services Agency will be in the eye of the storm as the 2014 deadline approaches for implementation of the Patient Protection and Affordable Care Act (ACA), know (derisively) in some quarters as Obamacare. The act is a large piece of legislation that will require significant changes by the states in how they administer health care.
Almost every department in the agency will be affected as the legislation is phased in year by year. That is assuming that the law isn’t declared unconstitutional.
Court challenges to the ACA abound. Twenty-six states are among those who have sued over the legislation signed by President Barack Obama in March 2010 and the matter is headed for consideration, and possible resolution, by the Supreme Court. The country has divided along ideological and political lines over the issue as it competes with the economy and war and peace for attention.
Implementation of the Affordable Care Act in California: A Window of Opportunity for State Policy Makers (Health and Human Services Agency)
Obama Health Care Law Headed to Supreme Court (by David Jackson, USA Today)
On the Left: It’s the Healthy Thing to Do
The Affordable Care Act was not the first choice for health care reform among many on the left. A single-payer system that would essentially extend the Medicare system to everyone in the country received a lot of support from progressives. It would eliminate the role of insurance companies and other middlemen, effectively reducing administrative costs by an estimated 30%. The focus would be on treatment, not costs or eligibility.
But single-payer was deemed politically untenable and President Obama, although slow to embrace the individual mandate requirement of participation, eventually proposed reform that would guarantee health care for the poor and those with pre-existing conditions while spreading the costs among everyone. His proposal introduced the government as a player by establishing a public plan as competition in the marketplace, but retained the basic structure of a system that included insurance companies, HMOs and other gatekeepers.
The oft-debated individual mandate that requires people to either have health insurance or pay a penalty is a lynchpin of the system that keeps prices low by spreading the costs across the largest population possible. It’s a classic principle of insurance.
The plan was similar to a health care proposal enacted in Massachusetts under a Republican governor, and later presidential candidate, Mitt Romney. It also closely approximated previous Republican proposals, including a 1993 bill sponsored by GOP Senator John Chafee in 1993.
The policy origins of that bill could be found in a proposal from the conservative Heritage Foundation in 1989: “[N]either the federal government nor any state requires all households to protect themselves from the potentially catastrophic costs of a serious accident or illness. Under the Heritage plan, there would be such a requirement.” Three years later, the foundation made a similar pitch: “Step #2: Require all households to purchase at least a basic package of insurance, unless they are covered by Medicaid, Medicare, or other government health programs. All Heads of households would be required by law to obtain at least a basic health plan specified by Congress.”
Obama emphasized that health care reform wasn’t just a humanitarian gesture. It was a rational attempt to rein in costs that have soared far ahead of the cost of living. He regarded health care reform as a deficit reduction measure and analysis by the Congressional Budget Office (CBO) supported that assessment. The CBO estimated that the ACA would cut the deficit by $1.3 trillion over 20 years and provide coverage to 95% of the population.
The CBO also projected a slight loss of jobs in the economy, but attributed much of that to the retirement of workers who were only remaining on the job to collect employer-provided health insurance. A highly-publicized study by the National Federation of Independent Businesses that projected a 1.6 million job loss was based on a study done before the ACA was actually passed and included wildly inaccurate assumptions about its provisions.
The virtues of the legislation are manifest and will become immediately evident. Millions of poor people will receive decent health care. People denied coverage because of pre-existing conditions will be now be covered. Young people up to the age of 26 can stay on their parents’ insurance policies. The nation’s health care bill will be reduced.
Other advantages may not be as readily apparent or immediate, but could prove just as important. Lower costs for small businesses, lower drug prices, better medical information technology and more effective preventive services. And maybe a recognition that government intervention in the long-term might be a reasonable counterbalance to Darwinian competition in the health care marketplace.
It’s humane. It’s fiscally responsible. It’s a no-brainer and long overdue.
Single-Payer Health Care versus Individual Mandates: A Dilemma for Democrats (by Gene Rothman, LA Progressive)
The Health Care Law a “Job killer”? The Evidence Falls Short (Politifact)
Comparing Health Reform Bills: Democrats and Republicans 2009, Republicans 1993 (by Maggie Mertens, Kaiser Health News)
CBO: Health-Care Reform Bill Cuts Deficit by $1.3 Trillion Over 20 years, Covers 95% (by Ezra Klein, Washington Post)
Republican Origins of Democratic Health Care Provision (ProCon.org)
On the Right: Repeal the Act
Don’t fix it if it isn’t broken. Many people, especially those with insurance policies provided by their employers, feel that the United States has the best health care system in the world and shouldn’t tamper with it.
They don’t want the government to get between them and their doctors and they don’t want politicians and bureaucrats telling them how to live. This sentiment engendered heated warnings of government “death panels” that would sentence granny to death to save a few dollars. The fear is that a wider dissemination of health care benefits will force rationing of limited resources.
The individual mandate is regarded on the right as coercive, unconstitutional government intrusion into people’s private lives. If the government can force you to buy insurance, the argument goes, what else can they compel you to buy? Or not buy? Or do? Or not do?
Opponents of the ACA strongly question estimates about the act’s fiscal impact. Despite Congressional Budget Office assertions, common sense would seem to dictate that giving subsidized health care to large numbers of people will either reduce the standard of individual care or force a rise in taxes to pay for it. There is no shortage of doctors warning that patients will get far less attention under Obamacare.
In an era of huge budget deficits and questions about the affordability of existing entitlements like Social Security and Medicare, is this really the time to take on more social obligations? Those on the right fear that the health care initiative will not only drain financial resources, it will be a job killer. They cite an estimate from the National Federation of Independent Businesses that says 1.6 million jobs could be lost between 2009 and 2014.
And how wise is it to make these dramatic changes in the country’s social fabric without a strong national consensus?
Instead of ramming through partisan legislation in a contentious manner, a better approach might have been a bipartisan effort to fine-tune the health care marketplace. There is no shortage of good ideas to improve health care. When the GOP-dominated House of Representatives voted in January 2011 to repeal the ACA (the bid failed in the Senate), it offered a list of reforms that it considered more effective: medical liability reform, expanded health savings accounts, purchase of health insurance across state lines, ensured coverage of pre-existing conditions, incentives to states to insure the uninsured and prohibition of “taxpayer funding for abortions.”
20 Ways ObamaCare Will Take Away Our Freedoms (by David Hogberg, Investors Daily)
7 Sickening Questions About Obamacare (by Jon Kraushar, Fox News)
Bad Medicine (Cato Institute)
How ObamaCare Will Affect Your Doctor (by Scott Gottlieb, Wall Street Journal)
House Republicans Offer Alternative Healthcare Proposal (by Janet Hook, Los Angeles Times)
Obamacare: A Budget-Busting, Job-Killing Health Care Law (GOP House of Representatives leadership) (pdf)
The Affordable Care Act is a game-changer. It introduces myriad changes in how health care will be delivered to Californians, not the least of which is the California Health Benefit Exchange.
The exchange, scheduled to begin functioning in 2014, will ultimately subsidize up to 45% of individuals purchasing private insurance and cover 2.3 million uninsured people. State legislation to begin construction of the exchange was passed in 2010 and a five-member board, including Health and Human Services Secretary Diana Dooley, has been appointed to help negotiate health coverage for individuals and businesses with fewer than 100 employees. Former agency Secretary Kim Belshé is also on the panel.
The state will experience a long, and in some cases, uncertain transitional period as it absorbs new clients into the health care system and moves existing clients to new programs. The number of uninsured Californians is expected to drop from 7 million in 2011 to less than half that amount in 2016 while Med-Cal enrollment grows 10%. As part of the transition, the Health and Human Services Agency approved the “Bridge to Reform” waiver that moves roughly $8 billion in federal Medicaid matching funds to the counties for expanded coverage.
Regulations and Guidance (Healthcare.gov)
California’s Health Benefit Exchange Legislation (Insure the Uninsured Project) (pdf)
Schwarzenegger Names Susan Kennedy to Top Healthcare Post (by Anthony York, Los Angeles Times)
Key Facts on California’s “Bridge to Reform” Medicaid Demonstration Waiver (Kaiser Family Foundation) (pdf)
S. Kimberly Belshé, 2003-2010
Grantland Johnson, 1999-2003
Sandra R. Smoley, 1993-1999
Russell S. Gould, 1991-1993
Clifford L. Allenby, 1987-1990
James Stockdale, 1985-1987 (interim)
David B. Swoap, 1983-1985. The Deukmejian appointee was instrumental in establishing a workfare program designed to get welfare mothers off the welfare rolls and into jobs. He worked to dismantle the state’s family planning program, attempted to eliminate sex education in schools and was a passionate anti-choice advocate on abortion.
Douglas X. Patiño, 1982
Mario J. Obledo, 1975-1982. Obledo, appointed by Governor Jerry Brown, was the first Latino official to head a California state agency and a key member of the Latino civil rights movement. He later ran unsuccessfully for governor. Obledo co-founded the Hispanic National Bar Association and served as national president of the League of United Latin American Citizens. President Clinton gave him the Presidential Medal of Freedom Award in 1998.
James E. Jenkins, 1974-1975
Dr. Earl W. Brian, 1972-1973. Dr. Brian was a decorated combat surgeon who served during the Vietnam War. Governor Ronald Reagan appointed him agency secretary shortly after his return from Asia, but he left his post after two years to challenge Alan Cranston for a Senate seat. He lost in the primaries. Brian, a close associate of Reagan Attorney General Ed Meese, became a businessman and was a controversial figure in the ‘80s and ‘90s with alleged ties to the intelligence community. He sued former U.S. Attorney General Elliot Richardson for libel in 1991 over an op-ed piece Richardson wrote for the New York Times. That article tied Brian to the theft of “Inslaw, Inc.” software from the Justice Department and the alleged “October Surprise” attempt to convince Iranians not to release its American hostages until the Reagan-Carter election of 1980 was over. Brian lost the suit. In 1996, Brian was convicted on 10 counts of fraud and sentenced to four years and nine months in prison for activities as chairman of two companies: United Press International and Financial News Network.
James M. Hall, 1971-1972
Lucian Vandegrift, 1968- 1970
Spencer Williams, 1967-1968
Winslow Christian, 1963-1964