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636 Publications Found
February 23, 2006 - An increasing portion of long-term care spending is for community-based services rather than institutional care. We examine the “cost-drivers” behind the growth in these costs and recommend that administration budget requests for long-term care projects be modified.
February 23, 2006 - A new federal hospital financing waiver is estimated to result in a net increase in Medi-Cal costs of $39 million over its first two years. We recommend that the waiver instead be implemented in a manner that avoids these costs and generates significant state savings.
February 23, 2006 - Future uncertainty about reauthorization of federal funding and the eventual exhaustion of unspent federal funds pose a risk of significant future increases in state costs for the Healthy Families Program (HFP). We present alternatives to hold down increases in overall HFP costs and to obtain additional financial support for the program.
February 23, 2006 - Spending for some specific services and supports for persons with developmental disabilities varies so widely among regional centers (RCs) as to raise concerns about the fiscal controls over these expenditures. We recommend an audit to evaluate the situation.
February 23, 2006 - The Legislature should take steps to deter costly nonemergency visits to emergency rooms (ERs) and to improve access to care and quality of care in community settings. This should be accomplished by establishing effective copayments on the inappropriate use of ERs and by seeking available federal funds to improve access to primary care.
February 23, 2006 - We review the state’s response to problems in the rollout of the new federal Medicare Part D prescription drug benefit and recommend Medi-Cal reductions of almost $335 million over two years to adjust for this rapidly changing situation.
February 23, 2006 - The retirement contribution rates set by CalPERS for the state and many local governments were volatile in the late 1990s and the early part of this decade. Governments had difficulty predicting annual contributions during their budgeting process. In 2005, CalPERS adopted a comprehensive rate stabilization policy. We believe the new policy promises more stability in contribution rates for the state and other public entities.
February 23, 2006 - The budget includes $382million ($203 million General Fund) for compensation increases for: (1) memoranda of understanding with five of the 21 employee bargaining units, (2) supervisors and managers of employees in those five units, (3) judges, (4) prison medical personnel required to receive them by a court order in the Plata v. Schwarzenegger case, and (5) medical personnel in other departments.
February 23, 2006 - The administration proposes to switch the Governor’s Office budget from traditional budgeting to an automatic annual adjustment. The change would cost about $1 million annually. The administration has offered no policy reason why the current process is not working. We therefore recommend that the Legislature reject the proposal to put the Governor’s Office budget on autopilot spending.
February 23, 2006 - The Governor’s budget assumes that proposed authority for the administration to reduce departmental budgets during the year will decrease overall state costs by $258 million. Since 2002-03, enacted budgets have included similar provisions. In reality, however, the full magnitude of these savings is rarely achieved. We recommend that the Legislature delete the proposed authority. The administration should identify any specific proposed savings in departmental budgets during the spring budget process.
February 23, 2006 - The Secretary of State (SOS) has provided few details on the department’s proposed implementation of HAVA. Based on the information received to date, however, we have a number of serious concerns with the agency’s approach. Delays by SOS over the past year in implementing components of the state’s HAVA plan have impaired counties’ ability to acquire and install HAVA-compliant equipment for the upcoming June 2006 primary election. In addition, SOS’s proposal for a statewide voter registration database exposes the General Fund to millions of dollars in costs, despite the state having received over $350 million in HAVA funds. We withhold recommendation on SOS’s HAVA expenditures pending the submittal of detailed justifications.