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The 2019-20 Budget: Analysis of the Governor’s Mental Health Workforce Proposal


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The 2019-20 May Revision: Analysis of the Governor’s January and May Mental Health Workforce Proposals

May 16, 2019 - In January, the Governor proposed a $50 million one-time General Fund augmentation for existing mental health workforce programs that are administered by OSHPD. In the May Revision, the Governor proposes an additional $100 million in MHSA funding for mental health workforce. This post (1) provides background on the state’s mental health workforce, (2) gives an overview of existing programs and funding aimed at improving the state’s mental health workforce, (3) summarizes and assesses the Governor’s proposals, and (4) provides options for legislative consideration.

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The 2022-23 Budget: Analysis of the Care Economy Workforce Development Package

March 10, 2022 - This post analyzes the Governor’s proposed Care Economy Workforce Development Package. We provide an assessment and recommendations for both the package as a whole and for two specific components of the package.

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The 2019-20 Budget: Assessing the Governor’s Primary Care Physician Residency Proposals

May 9, 2019 - To obtain a license to practice medicine, California law requires all medical school graduates to complete three years of postgraduate training. Most physician‑trainees fulfill this requirement by completing a residency program. The state currently funds two initiatives to support residency programs for primary care physicians. The first initiative is named after its legislative authors, Song‑Brown, and is administered by the Office of Statewide Health Planning and Development (OSHPD). The second initiative is authorized by Proposition 56 and is administered by the University of California (UC). The Governor proposes making certain limited‑term funding for these initiatives ongoing. In this brief, we provide background on residency programs, describe the Governor’s two associated budget proposals, assess those proposals, and make associated recommendations.

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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.

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The 2021-22 Budget: UC Programs in Medical Education

February 26, 2021 - This post analyzes the Governor's proposal to provide a General Fund augmentation to the University of California's Programs in Medical Education. These programs provide medical education focused on health equity and clinical experiences focused on underserved communities.

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[PDF] The 2019-20 Budget: Department of State Hospitals

February 13, 2019 - The Governor’s budget proposes $2 billion for the Department of State Hospitals (DSH) in 2019‑20—an increase of $59 million (3 percent) from the revised 2018‑19 level. In this report, we assess four specific DSH proposals and offer recommendations for legislative consideration.

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The 2021-22 Budget: Educator Workforce Proposals

February 19, 2021 - In this post, we analyze the Governor’s proposals to address teacher shortages, as well as his proposals to provide additional professional development for school staff. For each, we provide background, describe the Governor’s proposals, assess these proposals, and offer associated recommendations.

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The 2024-25 Budget: Department of Health Care Access and Information

February 27, 2024 - This post provides an overview of the Governor’s proposed budget for the Department of Health Care Access and Information, analyzes proposals around health care workforce programs, and provides an implementation update to two recently enacted hospital relief programs.

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The 2018-19 Budget: Criminal Justice Proposals

February 27, 2018 - The Governor’s budget proposes a total of $17.2 billion from various fund sources for judicial and criminal justice programs in 2018‑19. This is an increase of $302 million, or 2 percent, above estimated expenditures for the current year. The budget includes General Fund support for judicial and criminal justice programs of $13.9 billion in 2018‑19, which is an increase of $270 million, or 2 percent, over the current‑year level. In this report, we assess many of the Governor’s budget proposals in the judicial and criminal justice area and recommend various changes. We provide a complete listing of our recommendations at the end of the report.

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The 2020-21 Budget: Analysis of the Department of State Hospitals Budget

February 11, 2020 - The Governor’s budget proposes $2.3 billion for the Department of State Hospitals (DSH) in 2020‑21—an increase of $232 million (11 percent) from the revised 2019‑20 level. In this report, we assess three specific DSH proposals and offer recommendations for legislative consideration.

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Analysis of California’s Physician-Supervision Requirement for Certified Nurse Midwives

March 11, 2020 - In an effort to ensure safety and quality, California state law places occupational licensing restrictions on who may provide childbirth and reproductive-related health care services to women. These restrictions include a requirement that nurse midwives may only practice under the supervision of a licensed physician. At the request of a member of the Legislature, this report analyzes whether this requirement is meeting its intended safety and quality objectives, without significantly increasing cost or decreasing access to health care services. Drawing on national research—that compares health care outcomes in states with and without a similar physician-supervision requirement for nurse midwives—we find that California's requirement is unlikely to improve safety and quality for low-risk pregnancies and births. Moreover, we find that the requirement could limit access to nurse-midwife services, and potentially health care services for women overall, while also raising the cost of care. We recommend that the Legislature consider removing the state’s physician-supervision requirement, while adding other safeguards to ensure safety and quality. Such safeguards could include, for example, requiring nurse midwives to maintain appropriate referral and consultative relationships with physicians and requiring that they maintain medical malpractice insurance.

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[PDF] The Master Plan at 50: Improving State Oversight of Academic Expansions

December 2, 2009 - The state’s public higher education segments periodically create new degree programs and schools, and each segment has internal procedures for reviewing and authorizing them. State law delegates the state’s oversight of proposals to the California Postsecondary Education Commission (CPEC) but their role is only advisory and limited to certain proposals. In 2007 CPEC determined that a new law school proposed for University of California (UC) Irvine was unnecessary and duplicative. The opening of the new law school this fall despite CPEC’s objections calls into question the ability of the state’s approval process to prevent unnecessary or nonpriority programs and schools. In this report, we examine a number of new programs and schools that have been approved in the last few years to determine the efficacy of the state’s approval process. We conclude that there are several structural changes that are needed to improve the approval process including (a) measuring supply and demand in major fields, (b) identifying the extent to which proposals fit with the state's priorities and resources, and (c) increasing oversight from the Legislature.

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[PDF] Evaluation of CSU's Doctor of Nursing Practice Pilot Program

January 5, 2017 - To increase capacity in its nursing programs during the nursing shortage in the late 1990's, the California State University (CSU) cited a need to increase the number of nursing faculty holding a doctoral degree (required for tenured/tenure-track positions) and expressed interest in establishing its own Doctor of Nursing Practice (DNP) program to prepare such faculty. In response, the state enacted Chapter 416 of 2010 which temporarily allows CSU to offer an independent DNP on a pilot basis. Related legislation requires our office to evaluate the pilot program and make a recommendation regarding its extension. For a variety of reasons, we recommend the Legislature allow the CSU DNP pilot to sunset.

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The 2020-21 Budget: Criminal Justice Proposals

February 18, 2020 - The Governor’s 2020‑21 budget includes a total of $19.7 billion from all fund sources for the operation of judicial and criminal justice programs. This is a net increase of $341 million (2 percent) over the revised 2019‑20 level of spending. General Fund spending is proposed to be $16.2 billion in 2020‑21, which represents an increase of $213 million (1 percent) above the revised 2019‑20 level. In this report, we assess many of the Governor’s budget proposals in the judicial and criminal justice area and recommend various changes. Below, we summarize some of our major recommendations. We provide a complete listing of our recommendations at the end of the report.