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February 24, 2005 - The state lacks a unified strategic approach to homeland security. The Office of Homeland Security and the Department of Health Services have not sufficiently coordinated their efforts. We make a number of recommendations to address these problems, including the development of a strategic plan and annual expenditure report.
February 23, 2005 - Presented to Senate Budget and Fiscal Review Subcommittee No. 3
February 17, 2005 - State agencies purchase about $4.2 billion annually in prescription and nonprescription drugs as part of their responsibilities to deliver health care services to their program recipients. Our review—which focused on 10 percent of these purchases—found several deficiencies in the state's procurement of drugs which lead to it paying higher costs than necessary. We make a number of recommendations to correct these procurement and administrative deficiencies which would, if implemented, generate savings totaling tens of millions of dollars annually.
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.