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August 21, 2019 - Assembly Committee on Accountability and Administrative Review and Assembly Committee on Health
June 3, 2019 - Presented to: Budget Conference Committee
June 3, 2019 - Presented to: Budget Conference Committee
June 3, 2019 - Presented to: Budget Conference Committee
May 29, 2019 - In this web post, we describe the update to the Governor’s 1991 realignment proposal introduced in January. Additionally, we assess whether the changes included in the Governor’s May Revision align with our realignment principles and address the issues we raised for Legislative consideration in January.
May 16, 2019 - In January, the Governor proposed a $50 million one-time General Fund augmentation for existing mental health workforce programs that are administered by OSHPD. In the May Revision, the Governor proposes an additional $100 million in MHSA funding for mental health workforce. This post (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 proposals, and (4) provides options for legislative consideration.
May 15, 2019 - With the May Revision (and prior to the May Revision with the release of proposed implementing legislation), the administration has provided additional details on its January proposal to impose a state individual mandate and use penalty revenues from the mandate to fund health insurance subsidies. In this post, we summarize key updates to the Governor’s proposals and raise some issues for the Legislature’s consideration.
May 14, 2019 - The Governor’s May Revision includes Medi-Cal spending of $19.7 billion from the General Fund ($93.4 billion total funds) in 2018-19 and $23 billion from the General Fund ($102.2 billion total funds) in 2019-20. As will be described in this post, about half of the reduction in estimated spending in 2018-19 reflects a shift of costs in Medi-Cal to a different budget item, rather than a true reduction in estimated program costs. After accounting for this shift, the May Revision is about $350 million below January estimates across 2018-19 and 2019-20.
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.
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 - 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.
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.
February 26, 2019 - Presented to: Assembly Committee on Health and Senate Committee on Health