October 15, 2018 - California has shifted programmatic and funding responsibility between the state and counties for various programs over the last 40 years. Historically, these shifts—or realignments—aimed to benefit both the state and counties by providing greater local flexibility over services, allowing counties opportunities to innovate and improve program outcomes, and encouraging cost savings by requiring counties to share in program costs. To achieve these benefits, we believe there are certain principles any realignment needs to follow. This report evaluates the extent to which one of California’s more notable realignments undertaken in 1991 achieves the intended benefits and meets these principles.
February 22, 2019 - In this report, we evaluate the Governor's major human services budget proposals for programs administered by the Department of Social Services, including the California Work Opportunities and Responsibility to Kids (CalWORKs), the Supplemental Security Income/State Supplementary Payment (SSI/SSP), the In-Home Supportive Services (IHSS), and foster care.
February 24, 2020 - This brief provides information, analysis, and key issues to consider in evaluating the Governor’s 2020-21 budget proposals for the major programs in Department of Social Services.
May 16, 2017 - Rather than return to the original 1991 realignment cost-sharing ratios for In-Home Supportive Services (IHSS) as initiated by the Governor in January (described in our report: The Coordinated Care Initiative: A Critical Juncture), the administration proposes establishing a new Maintenance of Effort (MOE) for counties’ share of IHSS cost. The new MOE would include both services and administration using 2017-18 costs. The new MOE would significantly increase costs to counties in 2017-18 relative to 2016-17. While the MOE shifts significant costs to counties, the proposal provides state General Fund support and additional realignment revenue to partially offset this increase. In this analysis, we lay out the various components of this complex proposal. We also raise key questions for Legislative consideration and provide our recommendation for how to move forward.
February 27, 2017 - In this report we provide (1) background on the health care and Long‑Term Services and Supports (LTSS) issues that the Coordinated Care Initiative (CCI) was intended to address, (2) an update on the CCI’s results and challenges to date, (3) an assessment of the Governor’s elimination of the CCI and budget proposal to extend certain CCI components, and (4) options for the Legislature on how to move forward. As ending the In‑Home Supportive Services (IHSS) has major, and rather complex, implications for 1991 realignment, we include a technical appendix at the end of this report that provides an in‑depth analysis of these implications.
October 18, 2017 - Each year, our office publishes the California Spending Plan to summarize the annual state budget. This publication discusses the 2017‑18 Budget Act and other major budget actions approved in 2017. In general, it reflects budgetary actions that the Legislature has taken through September 2017. In some cases, as noted, we discuss budget actions approved by the Legislature after June 15, 2017. In late July, for example, the Legislature passed and the Governor approved, an extension of authority for the Air Resources Board to implement the state’s cap‑and‑trade program from 2020 to 2030.
May 29, 2019 - In this web post, we describe the update to the Governor’s 1991 realignment proposal introduced in January. Additionally, we assess whether the changes included in the Governor’s May Revision align with our realignment principles and address the issues we raised for Legislative consideration in January.
February 6, 2001 - Realignment, enacted in 1991, transferred various mental health, health, and social services programs from the state to county control. It also altered program cost-sharing ratios, and provided counties with dedicated tax revenues to pay for these changes. Although realignment has been largely successful, we recommend implementation of several changes including a simplified allocation structure for new revenues that relies on a single formula.
October 5, 2020 - Each year, our office publishes the California Spending Plan to summarize the annual state budget. This publication provides an overview of the 2020‑21 Budget Act, provides a short history of the notable events in the budget process, and then highlights major features of the budget approved by the Legislature and signed by the Governor. All figures in this publication reflect the administration’s estimates of actions taken through June 30, 2020, but we have updated the narrative to reflect actions taken later in the legislative session. In addition to this publication, we have released a series of issue‑specific posts providing more detail on various programmatic aspects of the budget.
April 21, 2021 - This report: (1) describes how appropriations limits work for the state, school districts, and local governments in California; (2) explains why the limit is a constraint for state government; and (3) concludes with a variety of short- and long-term policy options—both of which we think the Legislature will need to take—in response to the issue.
February 16, 2018 - In this report we provide a broad overview of the Governor's health and human services budget, highlighting major year-over-year changes. We then provide a more in-depth analysis of select programmatic areas.
August 19, 2011 - As part of the 2011-12 budget plan, the Legislature enacted a major shift—or “realignment”—of state program responsibilities and revenues to local governments. In total, the realignment plan provides $6.3 billion to local governments to fund various criminal justice, mental health, and social services programs in 2011-12, and ongoing funds for these programs annually thereafter. We recommend the Legislature address a few pressing implementation issues before this legislative session ends. We also identify a series of more extensive issues that we recommend the Legislature address in early 2012, such as developing local funding formulas with an eye towards the long term, promoting local accountability, and simplifying the plan’s extensive network of accounts and subaccounts.
February 19, 2013 - Under the Patient Protection and Affordable Care Act, also known as federal health care reform, the state has the option to expand its Medicaid program (known as Medi-Cal) to cover over one million low-income adults who are currently ineligible. Currently counties have the fiscal and programmatic responsibility for the care of the low-income adult population that would be covered by the expansion. The Governor has proposed to adopt the optional expansion, but has outlined two distinct approaches to implementing the expansion—a state-based approach and a county-based approach—and has not indicated a preference for either approach. Under both approaches, the Governor indicates that the expansion will require a reassessment of the state-local fiscal relationship. We find that the expansion would have significant policy benefits, including improved health outcomes for the newly eligible Medi-Cal population. We estimate that fiscal savings to the state as a whole are likely to outweigh the cost of the expansion for at least a decade, although these estimates are subject to significant uncertainty. Despite the significant uncertainty about long-term costs and savings, on balance, we believe the policy merits of the expansion and fiscal benefits to the state as a whole likely will outweigh the costs and potential fiscal risks. We therefore recommend the state adopt the expansion. We also find that the state is in a better position to effectively deliver health services to the newly eligible population. Therefore, we recommend the Legislature adopt a state-based expansion, shifting the fiscal and programmatic responsibility of providing physical health care to the expansion population from counties to the state. Given this shift of responsibility, we further recommend the Legislature redirect a portion of funding currently allocated to counties under 1991 realignment for indigent health care.
February 1, 1992 - The outlook for the 1992-93 budget is dominated by the continued poor performance of the state and national economies. Even if recovery from the recession is now underway, as anticipated by the 1992-93 Governor’s Budget, state revenues will not be sufficient to both pay off the accumulated budget deficits and fund state services at current levels. Further delays in the timing of the state’s recovery will compound the problem faced by the Legislature in crafting a budget for 1992-93. The Governor’s Budget realistically addresses only a portion of the state’s budget problem. Although it would make some significant reductions in major state programs, it relies upon optimistic assumptions as to the availability of federal and other funds to bring the budget into balance, and does not offer an adequate reserve fund to protect the budget against unanticipated changes.