April 16, 2020 - This post summarizes key COVID-19 federal actions that affect aging- and disability-related state programs.
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.
January 22, 2015 - In 2012, the Legislature authorized the development and pilot implementation of a universal assessment tool (UAT) to streamline eligibility and level-of-need determinations for three home- and community-based services (HCBS) programs that provide care to seniors and people with disabilities. Our analysis finds that the benefits of a UAT likely outweigh the costs associated with its development. To ensure the UAT achieves the benefits of creating a more effective and efficient approach to HCBS assessment, we recommend: (1) legislation specifying intent to eventually use the UAT on a statewide basis, (2) development of an automated UAT customized to fit within California’s programmatic and policy environment, (3) piloting of county welfare departments and managed care plans as administrators of the UAT, and (4) a formal evaluation of the UAT pilot.
February 2, 2022 - This post describes the Governor’s budget assumptions and proposals related to the In-Home Supportive Services program and offers relevant issues for Legislative consideration.
Update (2/7/22): Time requirement for incentive payment to IHSS providers in the state’s HCBS spending plan has been updated.
February 27, 2013 - In 2012, the Legislature authorized the Coordinated Care Initiative (CCI) as an eight-county pilot to demonstrate the integration of Medi-Cal and Medicare benefits for "dual eligibles"--beneficiaries eligible for both benefits. The CCI will also integrate long-term services and supports (LTSS) under Medi-Cal managed care in the eight counties for dual eligibles and seniors and persons with disabilities covered only by Medi-Cal. The Governor's budget delays the start date of CCI implementation to September 1, 2013, resulting in lower 2013-14 savings than initially anticipated. Joint federal-state decisions regarding key financing and operational aspects of CCI are pending, creating uncertainty regarding the timely and successful implementation of CCI. We recommend that the Legislature clarify the legal status of CCI to go forward and consider authorizing CCI to test greater integration of In-Home Supportive Services--a particular LTSS--under managed care.
February 24, 2020 - Presented to: Senate Human Services Committee Hon. Melissa Hurtado, Chair
March 15, 2021 - The California Advancing and Innovating Medi-Cal (CalAIM) proposal is a far-reaching set of reforms to expand, transform, and streamline Medi-Cal service delivery and financing. This post—the fourth in a series assessing different aspects of the Governor’s proposal—analyzes CalAIM proposals targeted at seniors and persons with disabilities, including new benefits and structural changes to how long-term services and supports (LTSS) are administered. (LTSS include, among other supports and services, institutional care in nursing homes and home- and community-based services such as home care and personal care services.)
November 28, 2016 - This report presents the results of our projections to inform the Legislature and stakeholders about levels of disability and the potential need for long–term supports and services (LTSS) among California’s seniors over the next several decades. These projections provide a useful starting point in understanding how California’s changing population demographics will impact the LTSS delivery system. The results presented in this report can also be built upon with further analysis focused on utilization and financing of LTSS over the long term.
A companion video and infographic highlight key findings from the report.
October 15, 2020 - From the General Fund, the 2020-21 spending plan provides $26.7 billion for health programs—an increase of 3 percent over estimated 2019-20 General Fund spending for these programs. The year-over-year net increase in General Fund spending is largely due to the projected COVID-19-related increase in the Medi-Cal caseload. The post describes major health-related actions (both policy actions and various budget adjustments) adopted by the Legislature as part of its 2020-21 spending plan. These actions include the offsetting of what would otherwise be General Fund costs with (1) revenues from the federally approved reauthorized tax on managed care organizations and (2) federal Medicaid funds that are being provided to the state at an enhanced level during the term of the public health emergency.