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May 24, 2021 - In this post, we provide our preliminary comments on the Governor’s 2021-22 May Revision behavioral health proposals. We first provide an overview of the Children and Youth Behavioral Health Initiative proposal. We then provide some overarching comments on both (1) the initiative overall and (2) specific proposals within the initiative. We then provide an overview of the May Revision updates to the Behavioral Health Continuum Infrastructure proposal, our comments on the adjustments made to this proposal, and remaining outstanding questions we have on this proposal.
May 24, 2021 - The revised 2021-22 Department of Developmental Services budget at May Revision includes $6.6 billion General Fund ($10.7 billion total funds), a 1.6 percent increase in General Fund spending from the budget proposed in January. This increase is driven in large part by a number of new policy proposals totaling approximately $80 million General Fund. In this post, we provide comments on one of the key policy proposals.
May 21, 2021 - In this post, we provide our preliminary comments on the Governor’s 2021‑22 May Revision proposal for Medi‑Cal. We first provide an overview of the proposal, noting the major changes made relative to the Governor’s January budget, as well as changes made to estimated 2020‑21 spending relative to the January estimates. We then describe, and provide our comments on, the Governor’s proposal to augment the January proposal for the California Advancing and Innovating Medi‑Cal (CalAIM) package. We follow with descriptions of, and comments on, the Governor’s modified telehealth policy proposal, the proposal to extend full‑scope Medi‑Cal coverage to older undocumented immigrants, and the proposal to use American Rescue Plan Act funding to provide financial relief for designated public hospitals.
May 17, 2021 - On May 14, 2021, Governor Newsom presented a revised state budget proposal to the Legislature. (This annual proposed revised budget is called the “May Revision.”) In this post, we provide a summary of the Governor’s revised budget, focusing on the overall condition and structure of the state General Fund—the budget’s main operating account. In the coming days, we will analyze the plan in more detail and provide additional comments in hearing testimony and online.
May 13, 2021 - This budget series post provides an overview of the Governor’s January budget proposal for an ongoing, post-pandemic Medi-Cal telehealth policy; an assessment of the Governor’s proposal; and issues for legislative consideration.
May 7, 2021 - This post describes how coronavirus disease 2019 has affected access to health care in California through the earliest months of 2021. Contrary to expectations in light of the high level of pandemic-induced job losses, we find that health care coverage has either remained steady or potentially increased during the pandemic. We explore reasons why health care coverage trends have defied expectations. However, health care employment and utilization both declined significantly, particularly in the early months of the pandemic. Although access to care is trending toward pre-pandemic levels, continued monitoring of these trends is warranted. We provide several policy options that the Legislature could consider for sustaining and improving access to care, such as funding or making policy changes to address a deficit in children’s preventive services that has arisen among Medi-Cal-enrolled children during the pandemic.
May 6, 2021 - On March 11, 2021, the President signed into law the American Rescue Plan Act of 2021 (ARP Act)—a $1.9 trillion coronavirus disease 2019 relief package. This post highlights the health-related provisions of the ARP Act that provide significant funding directly to state/local health care and public health agencies, rural hospitals, home- and community-based services programs, subsidized individual market health coverage programs, and public behavioral health services. Where possible, based on currently available information, we provide an estimate of the funding allocations to California governments and other entities in the state. While this post reflects our best understanding of the high-level content and implications of this legislation as of late April, we will update the post as new information and clarifications become available.
May 5, 2021 - This budget and policy post responds to legislative requests for our office to estimate the costs of expanding comprehensive Medi-Cal coverage to all otherwise eligible Californians regardless of their immigration status. We estimate that nearly one million undocumented immigrants would gain full coverage under this expansion. Assuming a January 1, 2022 implementation, we estimate that the additional cost of expansion would be $790 million General Fund ($870 million total funds) in 2021-22. On an ongoing basis, we estimate the additional cost of the expansion would be $2.1 billion General Fund (nearly $2.4 billion total funds). Both our caseload and cost estimates are subject to significant uncertainty and rest on a number of key assumptions. Moreover, our ongoing estimates would be expected to change over time with medical inflation and changes in caseload and utilization.
April 19, 2021 - The Supplemental Report of the 2020-21 Budget Act requires our office to evaluate options for enhancing federal financial participation through Medi-Cal for consumers served by the Department of Developmental Services. This post provides an interim update of our initial findings and preliminary assessment. A final report will be delivered to the Legislature in the late summer.
March 25, 2021 - Supplemental report language adopted by the Legislature in 2020-21 directed our office to provide an assessment of a new dashboard developed by the administration for Medi-Cal eligibility functionality issues in the California Healthcare Eligibility, Enrollment, and Retention System—an information technology system. This post provides our assessment of the dashboard and associated process changes, and identifies opportunities for legislative oversight going forward.
March 15, 2021 - The California Advancing and Innovating Medi-Cal (CalAIM) proposal is a far-reaching set of reforms to expand, transform, and streamline Medi-Cal service delivery and financing. This post—the fourth in a series assessing different aspects of the Governor’s proposal—analyzes CalAIM proposals targeted at seniors and persons with disabilities, including new benefits and structural changes to how long-term services and supports (LTSS) are administered. (LTSS include, among other supports and services, institutional care in nursing homes and home- and community-based services such as home care and personal care services.)
March 12, 2021 - The California Advancing and Innovating Medi-Cal (CalAIM) proposal is a set of reforms to expand, transform, and streamline Medi-Cal service delivery and financing. This post—the third in a series assessing different aspects of the Governor’s proposal—analyzes CalAIM’s potential to reduce health disparities, and therefore promote health equity.
February 19, 2021 - This post analyzes the Governor’s proposal in the Department of State Hospitals to provide $233.2 million General Fund in 2021-22 and $136.4 million General Fund in 2022-23 and ongoing to establish a demonstration project—that would be optional for counties to participate in—in which responsibility for treating individuals found incompetent to stand trial and facing a felony charge would be realigned to participating counties.
February 17, 2021 - This post analyzes the Governor’s proposal in the Department of Health Care Services to provide $750 million General Fund—on a one-time basis—in competitive grants to counties to acquire or renovate facilities for community behavioral health services.
February 17, 2021 - This post analyzes the Governor’s proposal in the Department of Health Care Services to provide $200 million General Fund ($400 million total funds) one time to provide incentive payments to Medi-Cal managed care plans to increase the number of students receiving behavioral health services.