Jerry Brown is expected to release his budget proposal today, and it won’t be pretty.

Some of those cuts are likely to hit health care programs in California. To be ready, Diana Dooley, the new secretary of Health and Human Services, recently appointed several familiar names to her team:

• David Maxwell-Jolly, previously director of the state’s Department of Health Care Services, was named the undersecretary for the entire HHS agency.
• Toby Douglas, formerly chief deputy director of DHCS, now becomes director of that department.
• Terri Delgadillo was re-appointed as director of the state’s Department of Developmental Services.

Cuts to health care programs are not new to any of the appointees, as the state has had to scale back program funding year after year.

Maxwell-Jolly and Douglas were instrumental in designing and negotiating the recently approved federal Medicaid waiver. That $10 billion of federal money spread out over the next 5 years will go a long way toward maintaining a health care safety net in California.

But health care advocates and experts are worried about deep cuts in health care services — including the specter of lowering Medi-Cal rates to providers, requiring co-payments from Medi-Cal subscribers, shifting the burden of services to the counties without adequately funding that shift, and many other human services budget cuts.

Previous cost-cutting proposals from Schwarzenegger have included eliminating CalWORKs and Adult Day Health Care, and health care and budget experts are divided on whether or not we’ll see those kind of budget cutbacks proposed today.

But Brown did warn that the cuts will be more drastic than most people expect. “I think when they see the budget they’ll have even more concerns than they do today,” Brown said last week.