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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.
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.
June 14, 2016 - Presented to: Assembly Health Committee Assembly Revenue and Taxation Committee Senate Health Committee
May 25, 2016 - Presented to: Assembly Health Committee and Senate Health Committee
May 10, 2016 - Presented to: Assembly Health Committee and Senate Health Committee
March 4, 2016 - The Governor’s 2016-17 budget proposes $3.8 billion from the General Fund for Department of Developmental Services (DDS) programs—a 7.5 percent increase over 2015-16 estimated expenditures. This report focuses on the Governor's major policy-driven spending augmentations in the community services program. This report also summarizes legislation enacted as part of the recent special session that provides significant additional funding to the community services program and considers the Governor’s January proposals in this context.
February 18, 2016 - The 2016-17 Budget: Overview of Governor’s Proposals to Implement the Medical Marijuana Regulation and Safety Act
February 11, 2016 - In this report, we provide an analysis of the administration’s caseload projections, as well as a discussion of the impacts of the ACA on the ability to project caseload. We also provide an assessment of several General Fund cost pressures on the horizon in Medi–Cal, including the sunset of the hospital QAF.
December 17, 2015 - Presented to: Conference Committee on SBX2 2 and ABX2 1, Second Extraordinary Session
December 1, 2015 - Conference Committee on SB X2 2 and AB X2 1, Second Extraordinary Session
October 13, 2015 - Earlier this year, California submitted a proposal to renew its Section 1115 waiver, which is due to expire at the end of October. The state is currently negotiating with the federal government over the terms and conditions of this waiver renewal. In this post, we examine key issues and concerns related to the availability of federal funding for California’s proposal. The post provides a primer on how Section 1115 waivers are generally financed, an overview of California’s proposal, and a discussion of the challenges the proposal faces within that financing structure.