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May 9, 2019 - Senate Budget Subcommittee No. 3 on Health and Human Services
May 9, 2019 - To obtain a license to practice medicine, California law requires all medical school graduates to complete three years of postgraduate training. Most physician‑trainees fulfill this requirement by completing a residency program. The state currently funds two initiatives to support residency programs for primary care physicians. The first initiative is named after its legislative authors, Song‑Brown, and is administered by the Office of Statewide Health Planning and Development (OSHPD). The second initiative is authorized by Proposition 56 and is administered by the University of California (UC). The Governor proposes making certain limited‑term funding for these initiatives ongoing. In this brief, we provide background on residency programs, describe the Governor’s two associated budget proposals, assess those proposals, and make associated recommendations.
May 9, 2019 - The Governor proposes a $50 million one‑time General Fund augmentation for existing mental health workforce programs that are administered by the Office of Statewide Health Planning and Development (OSHPD). This brief (1) provides background on the state’s mental health workforce, (2) gives an overview of existing programs and funding aimed at improving the state’s mental health workforce, (3) summarizes and assesses the Governor’s proposal, and (4) provides options for legislative consideration.
May 2, 2019 - Letter to the Honorable Eloise Gómez Reyes on actions that could be taken by the Legislature in the 2019-20 budget based on a contracted study of service provider rates in the Department of Developmental Services (DDS) system.
April 10, 2019 - This report provides an overview of California’s juvenile justice system including DJJ and highlights several key questions raised by the Governor’s proposal for the Legislature to consider as the administration provides more detailed information on the proposal in the coming months.
April 5, 2019 - This report analyzes one of the two initiatives included in the Governor's executive order: to transition the pharmacy services benefit in Medi‑Cal, the state’s largest low‑income health care program, from managed care to entirely a fee‑for‑service (FFS) benefit directly paid for and administered by the state.
March 26, 2019 - In this report, we provide background on the current child support program. We then describe and assess the Governor’s 2019 20 proposal to create a new budgeting methodology that would increase funding for certain LCSAs by nearly $60 million General Fund. We recommend that the Legislature withhold action on the funding proposal until the administration submits the statutorily required report identifying potential state and local operational efficiencies.
March 26, 2019 - When facing budget problems in the past, the state has “deferred” payments from one fiscal year into the next, providing significant one-time budgetary savings. While the state has already addressed many of its outstanding deferrals, there are still three major categories of deferrals remaining. These are related to: (1) state employee payroll, (2) pension payments, and (3) Medi-Cal payments. The Governor proposes using $1.7 billion to undo the payroll and pension deferrals. We find this would improve the state’s fiscal position and moderately improve the state’s budgetary practices, however, this approach has shortcomings relative to alternatives. This post recommends an alternative approach to the Governor’s proposal.
March 25, 2019 - These materials were prepared for an informational hearing about housing challenges and their impact on the well-being of children by the Senate Select Committee on the Social Determinants of Children’s Well-Being.
March 22, 2019 - In this post, we describe the Governor’s 2019-20 budget proposal to create a new office within California’s Government Operations Agency—the Office of Digital Innovation. We then provide issues for legislative consideration, including key questions about the office’s implementation and legislative oversight of its activities.
March 22, 2019 - The Supplemental Report of the 2018-19 Budget Act directed our office to submit a report to the Legislature reviewing data on the reporting of child abuse or neglect incidents among children who are aged 14 to 17 compared to younger children. In this report, we (1) describe how the state’s Child Welfare Services (CWS) system processes child abuse and neglect reports, (2) discuss observed similarities and differences in reporting outcomes between older and younger youth based on available data, (3) specify limitations in our ability to come to definitive conclusions regarding the treatment of reports for older youth compared to younger youth in the CWS system based on available data, and (4) provide recommendations for the collection of additional data to better understand the potential reasons for differences in outcomes between older and younger youth accessing foster care and determine whether policy interventions are appropriate.
March 14, 2019 - In this post, we describe how the California Department of Technology’s (CDT) information technology (IT) project approval process—known as the Project Approval Lifecycle (PAL)—does not always align with the state’s annual budget process. We identify seven funding requests in the Governor’s 2019-20 proposed budget for IT project proposals that are currently in various stages of the PAL process. We then describe how these requests for project funding prior to the completion of the PAL planning process may inhibit the Legislature from fully realizing the anticipated benefits of the PAL process, discuss how some project-specific factors can cause misalignment of the budget cycle and PAL, and provide issues for legislative consideration.
March 8, 2019 - This report evaluates the changes the Governor proposes and assesses whether the changes better position 1991 realignment to achieve its intended benefits and meet the principles of a successful state-county fiscal partnership we identified in our October report.
March 7, 2019 - California's current paid family leave program, implemented in 2004, provides up to six weeks of partial wage replacement to workers who take time off to bond with a new child or care for an ill family member. In the 2019-20 Governor's Budget, the Governor included a conceptual proposal to expand paid family leave and make the program more flexible. In this handout, we describe the major features of the state's current paid family leave program and compare it to programs in other states and countries. We then outline potential options to expand paid family leave. Finally, we provide a preliminary assessment of the potential effects of such expansions.
February 28, 2019 - In this report, we evaluate three Governor's budget proposals related to early intervention services for infants and toddlers with special needs. These include: (1) $60 million ongoing (split between Proposition 56 tobacco tax revenues and federal Medicaid funding) to provide supplemental payments to physicians who screen children covered by Medi-Cal for developmental delays, (2) four new positions (at a cost of $446,000 General Fund) to increase state oversight of Regional Center early intervention services, and (3) possible forthcoming trailer bill language to improve transitions for children aging out of early intervention services and into preschool special education. We recommend rejecting the proposed supplemental payments and approving the other two proposals and further recommend the Legislature consider broader reforms to address longstanding weaknesses in the state's early intervention system.
Update (3/4/19): Figure 3 totals adjusted.