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March 22, 2017 - Presented to Assembly Budget Subcommittee No. 1 On Health and Human Services and Assembly Health Committee
March 9, 2017 - In California, the federal‑state Medicaid program is administered by the Department of Health Care Services (DHCS) as the California Medical Assistance Program (Medi‑Cal). Medi‑Cal is by far the largest state‑administered health services program in terms of annual caseload and expenditures. In this report, we provide an analysis of the administration’s caseload projections, including a discussion of the projected increases in ACA optional expansion caseload. We also provide an assessment of several aforementioned major factors affecting projected changes in Medi‑Cal spending in 2017‑18 and other policy changes proposed by the administration. These include the Governor’s proposed uses of Proposition 56 revenues, the proposal to shift additional New Qualified Immigrants (NQIs) to Covered California in 2017‑18, assumptions around federal CHIP funding, and the proposed abolition and transfer of the Major Risk Medical Insurance Fund (MRMIF).
March 1, 2017 - Assembly Budget Subcommittee No. 1 on Health and Human Services
February 28, 2017 - The Governor's budget proposes $14 million total funds across various departments to strengthen information security. In this analysis, we discuss our findings and recommendations regarding the state's approach towards strengthening information security.
February 28, 2017 -
In this set of budget posts, we provide an overview of the Governor's 2017-18 budget for human services programs. We also describe the budget proposal in detail for the In-Home Supportive Services, Supplemental Security Income/State Supplementary Payment, and CalWORKs programs.
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.
February 24, 2017 - In this report, we discuss the Governor’s budget proposals for Department of Developmental Services (DDS), providing our assessment of the budget package for DDS and analyzing one of the proposed trailer bills, which we find raises a number of issues. Also in this report, we describe the general nature of shifts in both policy and practice in the field of developmental services, detailing the relevant state and federal policies and their implications for the future developmental services program in the state, and discussing issues for the Legislature to consider as DDS implements these changes.
February 22, 2017 - Assembly Budget Subcommittee No. 1 on Health and Human Services
February 22, 2017 - Proposition 56 was approved by voters in November 2016 to increase taxes on cigarettes and other tobacco products. Questions have been raised as to whether the Governor’s proposals for allocating Proposition 56 revenues meet the initiative’s requirement to supplement—and not supplant—existing spending in several areas. To examine these questions, we begin by reviewing the provisions of Proposition 56 and the Governor’s budget proposals. We then discuss whether the Governor’s proposals for Medi‑Cal could be viewed as supplanting General Fund resources and identify the relevant case law. We conclude by describing some trade‑offs for the Legislature to consider in allocating the Proposition 56 revenues.
February 17, 2017 - Summarizes the major impacts that the ACA has had in California, explores what the ACA’s repeal could mean for the state, and assesses a collection of policy alternatives to the ACA that the new federal administration and Congress are currently considering.
Correction 3/6/17: Removed reference to Alpine County as having only one participating insurer.
February 17, 2017 - In recent years, the California Department of Technology has begun implementing a new IT project approval process—known as the Project Approval Lifecycle (PAL)—with the goal of helping to bolster project planning and reducing the likelihood of project challenges or failure. Although the PAL process has the potential to improve the quality of IT project implementation in theory, we raise a number of issues for the Legislature to consider as it exercises oversight of this new process. First, the merits of providing funding for IT project planning proposals should be determined on a case-by-case basis, and we note a few issues the Legislature may want to consider when determining whether to support a request for IT project planning funds. Additionally, we identify these funding requests for PAL-related planning activities as an early opportunity for the Legislature to weigh in on the potential project. Finally, we find that the Legislature could increase its oversight of the PAL process by (1) building in additional oversight methods when approving budget requests and (2) considering an evaluation of the actual benefits of the new project approval process.
February 9, 2017 - Presented to Senate Budget and Fiscal Review Committee
November 28, 2016 - This report presents the results of our projections to inform the Legislature and stakeholders about levels of disability and the potential need for long–term supports and services (LTSS) among California’s seniors over the next several decades. These projections provide a useful starting point in understanding how California’s changing population demographics will impact the LTSS delivery system. The results presented in this report can also be built upon with further analysis focused on utilization and financing of LTSS over the long term.
A companion video and infographic highlight key findings from the report.
November 1, 2016 - Presented to Senate Human Services Committee
June 14, 2016 - Presented to: Assembly Health Committee Assembly Revenue and Taxation Committee Senate Health Committee