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February 10, 2005 -
Our analysis indicates that the Governor's California Rx plan for drug discounts for the uninsured provides a reasonable starting point for the development of such a program. However, we propose, among other changes, that in the event that drug makers fail to make good on their promises for significant price concessions, an automatic trigger would phase-out the proposed voluntary approach to obtaining rebates from drug manufacturers, and be replaced by an alternative strategy likely to result in greater discounts on more drugs for consumers.
A related report—Lowering the State's Costs For Prescription Drugs—which addresses the state's purchasing of drugs for its own programs, will be released shortly.
February 9, 2005 - Presented to a joint hearing of the Senate Budget and Fiscal Review Subcommittees No. 1 and No. 3 on February 9, 2005.
April 29, 2004 - Presented to Budget Subcommittee No.1 on April 28, 2004.
March 24, 2004 - Presented to Assembly Budget Committee on March 24, 2004
March 4, 2004 - Today, the Medi-Cal Program offers a paradox: aged and disabled beneficiaries who would benefit the most from the improved health care that can come from receiving coordinated care have largely been excluded from Medi-Cal managed care. To improve health care for this group and reduce Medi-Cal expenditures, we recommend shifting an estimated 330,000 aged or disabled persons from the fee-for-service system to Medi-Cal managed care.
February 24, 2004 - Index of Information Technology Issues in the Analysis of the Budget Bill, 2004-05
February 18, 2004 - In March 2003, the Department of Finance began a statewide assessment of 117 state information technology (IT) projects. The results of the assessment indicate that departments are having problems (1) developing their IT projects and (2) adhering to state policies. Our analysis examines the assessment results, identifies some possible deficiencies in the state's IT processes, and makes recommendations on how the Legislature can address the deficiencies.
February 18, 2004 - The Governor proposes sweeping reductions to the IHSS program in the form of eligibility restrictions, provider wage reductions, and limitations on services. The details of each aspect of the proposal are discussed below. In a subsequent discussion, we comment on the Governor's proposal and present alternatives for legislative consideration.
February 18, 2004 - In order to improve the program's cost effectiveness, we recommend enactment of legislation that (1) sets grant levels at an amount that recognizes the adoptive parents' financial responsibility for their adoptive children, (2) better ties benefit levels to the needs of adoptive children, and (3) narrows the definition of "special needs" so as to focus the program's financial assistance on those children who are likely to benefit the most from such aid. These changes will save approximately $2 million General Fund in 2004-05, growing to approximately $12 million in 2005-06.
February 18, 2004 - As of February 2004, Congress had not completed action on federal welfare reauthorization. We describe the major features of the currently pending House and Senate versions of welfare reform and update our fiscal estimates of these measures.
February 18, 2004 - The Governor's budget proposes a number of changes to the CalWORKs program, including stricter work requirements and greater sanctions. These program reforms would result in $167 million in grant savings, partially offset by $134 million in child care costs and $2.5 million in automation costs in 2004-05. We discuss welfare reform in California, summarize the Governor's reform proposals, present a framework for considering the proposals, and offer comments and recommendations.
February 18, 2004 - The cost to the state of operating regional centers (RCs) for persons with developmental disabilities has continued to escalate at a rapid pace, with General Fund spending more than doubling in the past five fiscal years despite efforts to obtain more federal funds to offset state support. We analyze recent caseload and program spending trends to determine what is driving this growth, review the major initiatives to date to address the situation, consider the Governor's proposal to address these issues, and offer additional approaches for containing RC program costs.
February 18, 2004 - The Governor's budget proposal to cap Healthy Families Program enrollment, while feasible and effective in addressing the state's fiscal problems, raises a number of issues. We recommend against this approach because other alternatives are available to the Legislature to hold down the cost of the Healthy Families Program.
February 18, 2004 - The Governor's budget plan assumes that the Health Plan of San Mateo (HPSM), which provides services to roughly 50,000 Medi-Cal beneficiaries, will not be in operation in 2004-05. The HPSM is one of the County Organized Health System (COHS)—a form of managed care—that contracts with Medi-Cal in eight counties. At least two of these plans reportedly face financial problems and others may in the future. The failure of HPSM or other COHS plans could prove costly to the state. Accordingly, we recommend that the Legislature initially reject the administration proposal to budget for the phase-out of HPSM and direct the Department of Health Services to explore alternatives that would permit it to remain in operation. The Legislature should also consider several options to address the COHS plan's financial problems in order to avoid an increase in General Fund costs and the other serious consequences of their loss for Medi-Cal beneficiaries.