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March 7, 2018 - Presented to Assembly Budget Subcommittee No. 1 on Health and Human Services
March 2, 2018 - In this analysis, we describe the Financial Information System for California (FI$Cal) Project and the major changes to the project based on the newly released Special Project Report (SPR). We also describe the Governor’s 2018-19 budget proposal to fund activities associated with the new SPR at the State Controller’s Office. Finally, we make associated findings and recommendations.
March 1, 2018 - Proposition 55 (2016) aimed to increase funding for Medi-Cal under a formula administered by the Department of Finance. In 2018-19, the first year of implementation of this calculation, the administration’s interpretations and estimates result in no additional funds to Medi-Cal. Two key choices lead to this result. First, the administration’s decision to subtract $3.5 billion from available revenues to account for its proposed optional reserve deposit significantly reduces the calculation’s starting point, eliminating a surplus that would have directed funds to Medi-Cal. Second, the administration’s workload budget approach is based on a broad definition of currently authorized services, which also has the effect of reducing the amount of potential funds for Medi-Cal under the measure. Different decisions about these two features of the measure could result in more or less funding for Medi-Cal by hundreds of millions—or even billions—of dollars in the future.
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.
February 14, 2018 - Presented to: Senate Budget and Fiscal Review Committee
February 5, 2018 - Assembly Select Committee on Health Care Delivery Systems and Universal Coverage.
2/5/18: Correction to Figure 3.
January 31, 2018 - In this report, we (1) provide brief background information about Developmental Center (DC) closures and the Department of Developmental Services budget, (2) discuss potential savings in terms of net operational savings and increased revenues from the sale or repurposing (specifically leasing) of DC properties, and (3) address other practical implications and trade‑offs of the proposal.
January 23, 2018 - Recent Congressional action appropriates funding for the Children’s Health Insurance Program (CHIP) through federal fiscal year 2022-23. The federal cost share authorized by Congress for the program is higher than what was assumed in the Governor’s budget. These actions reduce estimated General Fund Medi-Cal costs by about $300 million in 2017-18 and about $600 million in 2018-19. As a result, we anticipate the May Revision will reflect $900 million in lower General Fund expenditures, and an equal amount of resources available for any purpose.
Updated 2/9/18: On Friday, February 9, 2018, Congress appropriated additional funding for CHIP through FFY 2026-27 at states' traditional cost share which, in California, is 35 percent. No changes were made to the previous reauthorization of CHIP funding through FFY 2022-23, discussed in this post.
Updated 2/9/18: Figure 1 updated to include Governor's funding assumptions through 2021‑22.
January 8, 2018 - The Supplemental Report of the 2017-18 Budget Act directed our office to report on the programmatic and fiscal implications of ending a long-standing state policy that provides Supplemental Security Income/State Supplementary Payment (SSI/SSP) recipients an extra $10 payment in lieu of their being eligible to receive federal food benefits through California’s CalFresh program. This is known as the SSI cash-out (or the CalFresh cash-out). In this report, we (1) describe how ending the SSI cash-out would affect households differently, (2) discuss the estimated statewide net effect of ending the SSI cash-out on federal food benefits drawn down by the state and how any variation in the underlying assumptions can create significantly different estimates, (3) provide examples of how ending the SSI cash-out would affect the poverty status of certain households, and (4) as directed by the Supplemental Report, discuss potential options the Legislature could consider to hold households negatively affected by the elimination of the SSI cash-out harmless and present additional issues that merit legislative consideration.
December 7, 2017 - In this report, we provide background regarding the objectives and operations of the Project Management Office (PMO), detail our findings in evaluating the PMO, introduce two significant recent developments and their impacts on the PMO, and make associated recommendations on how the Legislature should proceed to better align the office with the original legislative intent.
November 15, 2017 - This web post provides information about the fiscal outlook for the Department of Developmental Services from 2017-18 through 2021-22. It also considers the fiscal impact of the closure of state-run Developmental Centers, which will occur over the outlook period.
This is part of a collection of material for The 2018-19 Budget: California’s Fiscal Outlook. See a complete list of this year's fiscal outlook material on our fiscal outlook budget page.
November 15, 2017 - This online post discusses the major factors that we project will impact General Fund spending in Medi-Cal from 2017-18 to 2021-22.
This is part of a collection of material for The 2018-19 Budget: California’s Fiscal Outlook. See a complete list of this year's fiscal outlook material on our fiscal outlook budget page.
November 15, 2017 - In this fiscal outlook post, we discuss our near- and long-term costs projections for the In-Home Supportive Services (IHSS) Program and significant cost drivers and savings.
This is part of a collection of material for The 2018-19 Budget: California’s Fiscal Outlook. See a complete list of this year's fiscal outlook material on our fiscal outlook budget page.
October 10, 2017 - Presented to: Senate Human Services Committee and Assembly Human Services Committee.
September 6, 2017 - Currently, performance measurement in the California Work Opportunity and Responsibility to Kids (CalWORKs) program is relatively limited and largely focuses on processes involved with the program's operation—particular emphasis is given to a federal performance measure known as the "work participation rate" (WPR)—rather than on the program's end results, or outcomes. As part of the 2017-18 budget package, the Legislature adopted a new framework for performance measurement in CalWORKs that will be known as the CalWORKs Outcomes and Accountability Review (Cal-OAR). In this report, we outline the rationales for measuring program performance and outline why, ideally, performance measurement should focus on outcomes. We then raise several issues to be considered as the Cal-OAR system is further developed and implemented in the coming years.