Staff
Mark Newton
(916) 319-8323
Deputy Legislative Analyst: Health, Developmental Services, and Technology
Jason Constantouros
(916) 319-8322
Medi-Cal/Managed Care/Family Health/Health Care Affordability and Workforce Development
Brian Metzker
(916) 319-8354
Privacy, Security, and Technology
Ryan Miller
(916) 319-8356
Medi-Cal/Behavioral Health/Covered California/CalHHS Agency Issues
Angela Short
(916) 319-8309
Child Welfare, Child Support, Community Services and Development, Community Care Licensing, CalSTRS
Karina Hendren
(916) 319-8352
Medi-Cal/Long-Term Care/Developmental Services
Will Owens
(916) 319-8341
Public Health/Behavioral Health/State Hospitals
Sonia Schrager Russo
(916) 319-8361
CalWORKs/CalFresh
Juwan Trotter
(916) 319-8358
In-Home Supportive Services/Aging Programs
Ginni Bella Navarre
(916) 319-8342
Deputy Legislative Analyst: Human Services and Governance


Publications

Health and Human Services

To browse all LAO publications, visit our Publications page.



Report

The 2022-23 Budget: Analysis of the Medi-Cal Budget

February 9, 2022 - This brief analyzes the Governor’s budget proposal for Medi-Cal. We include an analysis of the administration’s caseload projections, provide options for renewing the managed care organization tax (that the Governor proposes to let expire), and provide our assessment of the discretionary budget proposals to provide equity and practice transformation payments and eliminate certain existing provider payment reductions.


Report

The 2022-23 Budget: Overview of the Governor's Budget

January 13, 2022 - On January 10, 2022, Governor Newsom presented his proposed state budget to the Legislature. In this report, we provide a brief summary of the proposed budget based on our initial review. In the coming weeks, we will analyze the plan in more detail and release several additional budget analyses.

Update (1/21/22): Includes a corrected estimate of Governor’s Budget proposals that are excludable under the State Appropriations Limit (SAL).


Handout

Overview of Funding for the Lanterman-Petris-Short Act

December 15, 2021 - Presented to: Assembly Committee on Judiciary Assembly Committee on Health


Post

The 2022-23 Budget: Medi-Cal Fiscal Outlook

November 17, 2021 - This post describes our fiscal outlook for Medi‑Cal, the major factors that we expect to drive changes in General Fund spending in Medi Cal, and a number of our key underlying assumptions. (Specifically, this post concerns projections of Medi‑Cal local assistance spending within the Department of Health Care Services [DHCS].)


Report

Enhancing Federal Financial Participation for Consumers Served by the Department of Developmental Services

November 9, 2021 - Examines Medi-Cal enrollment of Department of Developmental Services (DDS) consumers and the fiscal effect that additional Medi-Cal enrollment would have on the DDS budget and on state costs overall.

Correction 11/19/21: Corrected average annual per person fee-for-service cost in Medi-Cal.


Post

The 2021-22 Spending Plan: Health

October 22, 2021 - The spending plan provides $33.7 billion General Fund for health programs. This is an increase of $6.7 billion, or 25 percent, compared to the revised 2020‑21 spending level. This year-over-year increase primarily is due to significant growth in projected General Fund spending in Medi-Cal. About two-thirds of the increase in General Fund Medi-Cal spending reflects technical budget adjustments (for example, adjustments due to projected caseload increases), while the remaining one-third reflects a large number of discretionary policy augmentations.


Handout

CDPH’s Licensing and Certification of SNFs

October 5, 2021 - Assembly Committee on Health


Post

The 2021-22 Budget: LAO Preliminary Comments on the Governor’s Major May Revision Behavioral Health Proposals

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.


Post

The 2021-22 Budget: Department of Developmental Services (DDS) May Revision Budget 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.


Post

The 2021-22 Budget: LAO Preliminary Comments on the May Revision Medi-Cal Budget

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.


Post

The 2021-22 Budget: Initial Comments on the Governor’s May Revision

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.


Post

The 2021-22 Budget: Analysis of the Governor’s Medi-Cal Telehealth Proposal

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.


Post

Impact of COVID-19 on Health Care Access

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.


Post

COVID-19: American Rescue Plan’s Major Health-Related Funding Provisions

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.


Post

Estimated Cost of Expanding Full-Scope Medi-Cal Coverage to All Otherwise-Eligible Californians Regardless of Immigration Status

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.