January 4, 2018 - In 2015‑16, California provided early intervention services to about 41,000 infants and toddlers with special needs. These infants and toddlers either have a disability (such as a visual or hearing impairment) or a significant developmental delay (such as not beginning to speak or walk when expected). California’s early intervention system consists of three programs administered by two types of local agencies—schools and regional centers for persons with developmental disabilities. This report provides the first comprehensive analysis of this system since it was established in 1993. The report has three main sections. We first provide background on California’s early intervention system, then assess this system, and conclude by recommending several ways to improve the system.
February 13, 2019 - In this report, we describe the major changes and proposals in the Governor's proposed $100.7 billion (all funds) Medi-Cal budget. Specifically, we advise the Legislature to seriously consider renewing the managed care organization tax, despite the Governor not proposing to do so; present issues for consideration related to the Governor's proposed expansion of comprehensive Medi-Cal coverage for young adults regardless of immigration status; and provide an initial assessment of the Governor's proposals to use Proposition 56 funding in Medi-Cal to extend and expand provider payment increases. We recommend approval of the Governor's proposals to improve fiscal oversight of the Medi-Cal budget, and also recommend that the Legislature require the administration provide additional information to the Legislature in an effort to improve fiscal oversight and transparency of this very large, complex budget going forward.
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.
February 22, 2019 - This report analyzes the use of Proposition 56 (2016) funding in Medi‑Cal to improve access to quality care. First, we provide background on how Medi‑Cal services are financed within Medi‑Cal’s multiple delivery systems. Then, we review how access and quality are monitored, primarily within Medi‑Cal’s managed care delivery system. We summarize how Proposition 56 funding in Medi‑Cal has been used to date, and the changes proposed under the Governor’s 2019‑20 budget. Next, we assess Medi‑Cal managed care plans’ performance on selected state access and quality standards. Finally, we provide issues for consideration and recommendations on how to use Proposition 56 funding in Medi‑Cal going forward to improve access to quality care.
February 16, 2018 - In this report we provide a broad overview of the Governor's health and human services budget, highlighting major year-over-year changes. We then provide a more in-depth analysis of select programmatic areas.
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.
March 29, 2022 - In this post, we provide an overview of the proposed 2022-23 Department of Developmental Services (DDS) budget and assess the three main new discretionary proposals. We then raise oversight issues for legislative consideration.
September 29, 2023 - The Supplemental Report of the 2023-24 Budget Act contains statements of legislative intent and requests for studies that were adopted by the Legislature during deliberations on the 2023-24 budget package.
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.