February 19, 2020 - Assembly Budget Subcommittee No. 1 On Health and Human Services Assembly Budget Subcommittee No. 4 On State Administration
January 13, 2020 - This report presents our office’s initial assessment of the Governor’s budget. We estimate the Governor had a $6 billion surplus to allocate to discretionary purposes in 2020-21. The Governor allocates most of the surplus toward one-time purposes, including maintaining a positive year-end balance in the state’s discretionary reserve. Under the administration’s estimates, total reserves would reach $20.5 billion at the end of 2020-21—this represents a $1.7 billion increase from the 2019-20 enacted level. California continues to enjoy a healthy fiscal situation. Despite its positive near-term picture, the budget’s multiyear outlook is subject to considerable uncertainty. In addition to describing the condition of the budget under the Governor’s proposal, this report discusses tools the Legislature can use to mitigate against these heightened risks.
January 20, 2020: Upon further review, one item included in the original version of Appendix Figure 3 on discretionary on health spending should not have been included (specfically, use of the Medi-Cal drug rebate fund to offset General Fund costs). Removing this item—which reduces General Fund spending—from the list of discretionary choices made in the Governor’s budget increases our calculation of the surplus to $6 billion. The document is updated to reflect these changes.
Update 1/24/20: Adjusted Judicial Branch items in Appendix Figure 1 to reflect ongoing spending.
January 14, 2019 - This report presents our office’s initial assessment of the Governor’s Budget. The budget’s position continues to be positive. With $20.6 billion in discretionary resources available, the Governor’s budget proposal reflects a budget situation that is even better than the one our office estimated in the November Fiscal Outlook. The Governor’s Budget allocates nearly half of these discretionary resources to repaying state liabilities. Then, the Governor allocates $5.1 billion to one-time programmatic spending, $3 billion to reserves, and $2.7 billion to ongoing spending. Although the Governor’s allocation to discretionary reserves represents a smaller share of resources than recent budgets, the Governor’s decision to use a significant share of resources to pay down state debts is prudent. The Governor’s ongoing spending proposal is roughly in line with our November estimate of the ongoing capacity of the budget under an economic growth scenario. This was just one scenario, however. Recent financial market volatility indicates revenues could be somewhat lower than either we or the administration estimated.
February 28, 2020 - In this report, we provide an overview and assessment of the Governor's California Advancing and Innovating Medi-Cal (CalAIM) proposal, also known as Medi-Cal Healthier California for All. CalAIM would make far-reaching reforms to Medi-Cal that would increase the program’s focus on its high-cost and high-needs enrollee populations, transform and streamline Medi-Cal managed care, extend components of a current federal waiver, and rethink how behavioral health services are financed and delivered.
February 24, 2020 - This brief provides information, analysis, and key issues to consider in evaluating the Governor’s 2020-21 budget proposals for the major programs in Department of Social Services.
February 14, 2020 - In this report, we provide high‑level background on the Medi‑Cal program and an overview of the major drivers of year‑over‑year spending changes in the Governor’s budget. We also discuss the administration’s recent submittal (late January 2020) of a modified managed care organization (MCO) tax proposal. We then provide analysis and recommendations on a series of key issues: (1) Recently proposed draft federal regulations referred to as the “Medicaid Fiscal Accountability Regulation;” (2) proposals related to the Medi‑Cal pharmacy services benefit; (3) the Governor’s proposal to expand comprehensive Medi‑Cal coverage to otherwise eligible seniors regardless of immigration status; (4) proposed changes to rate‑setting for skilled nursing facilities; (5) issues related to county administration of eligibility and enrollment functions in Medi‑Cal; and (6) the Governor’s proposal to end dental managed care in the current two pilot counties and instead provide dental care as a fee‑for‑service benefit statewide. We conclude this report with a summary of our recommendations.
Corrected 2/20/20: Corrected to remove Alameda County from the list counties participating in the Coordinated Care Initiative.
October 17, 2019 - From the General Fund, the 2019-20 spending plan provides $26.4 billion for health programs and $15.5 billion for human services programs—an increase of 18 percent and 12.6 percent, respectively, over estimated 2018-19 General Fund spending in these two policy areas. Major health-related policy actions include the reauthorization of a tax on managed care organizations (which will reduce the above-noted General Fund health spending by $1 billion, pending federal approval) and over $400 million General Fund for state-funded subsidies for health insurance purchased on the individual market through Covered California. Major human services-related policy actions include General Fund support to increase CalWORKS cash grants and most developmental services provider rates, and to restore previously reduced service hours in the In-Home Supportive Services program. The spending plan also reflects the deposit of $700 million into a safety net reserve (bringing its balance to $900 million) that can be used for future CalWORKs and/or Medi-Cal expenditures.
October 17, 2019 - Each year, our office publishes California Spending Plan, which summarizes the annual state budget. In July, we published a preliminary version of the report. This, the final version, provides an overview of the 2019‑20 Budget Act, then highlights major features of the budget approved by the Legislature and signed by the Governor. In addition to this publication, we have released a series of issue‑specific, online posts that give more detail on the major actions in the budget package.
Correction (10/29/19): Figure 4 total.
May 17, 2018 - The Governor’s 2018 19 May Revision proposes a package of actions and funding augmentations aimed at alleviating homelessness. Several of the major elements of the proposal are in the HHS area of the budget. Specifically, the proposals would: (1) create the Senior Home Safe program at the Department of Social Services (DSS), (2) augment the current California Work Opportunity and Responsibility to Kids (CalWORKs) Housing Support Program and CalWORKs Homeless Assistance Program at DSS, and (3) provide one-time funding to the Department of Health Care Services (DHCS) for county mental health services. In this post, we describe these proposals and raise issues and questions for the Legislature to consider.
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.
October 10, 2017 - Presented to: Senate Human Services Committee and Assembly Human Services Committee.