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The 2021-22 Budget: Analysis of CalAIM Financing Issues


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The 2020-21 Budget: Re-Envisioning Medi-Cal—The CalAIM Proposal

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.

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The 2021-22 Budget: CalAIM: Equity Considerations

March 12, 2021 - The California Advancing and Innovating Medi-Cal (CalAIM) proposal is a set of reforms to expand, transform, and streamline Medi-Cal service delivery and financing. This post—the third in a series assessing different aspects of the Governor’s proposal—analyzes CalAIM’s potential to reduce health disparities, and therefore promote health equity.

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The 2021-22 Budget: CalAIM: The Overarching Issues

February 9, 2021 - The California Advancing and Innovating Medi-Cal (CalAIM) proposal is a set of reforms to expand, transform, and streamline Medi-Cal service delivery and financing. This post—the first in a series assessing different aspects of the Governor’s proposal—provides a brief overview of CalAIM, summarizes key changes from last year’s withdrawn proposal, and analyzes overarching issues related to CalAIM.

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The 2021-22 Budget: CalAIM: New Directions for Services for Seniors and Persons With Disabilities

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.)

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The 2021-22 Budget: LAO Preliminary Comments on the May Revision Medi-Cal Budget

May 21, 2021 - In this post, we provide our preliminary comments on the Governor’s 2021‑22 May Revision proposal for Medi‑Cal. We first provide an overview of the proposal, noting the major changes made relative to the Governor’s January budget, as well as changes made to estimated 2020‑21 spending relative to the January estimates. We then describe, and provide our comments on, the Governor’s proposal to augment the January proposal for the California Advancing and Innovating Medi‑Cal (CalAIM) package. We follow with descriptions of, and comments on, the Governor’s modified telehealth policy proposal, the proposal to extend full‑scope Medi‑Cal coverage to older undocumented immigrants, and the proposal to use American Rescue Plan Act funding to provide financial relief for designated public hospitals.

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The 2022-23 Budget: Analysis of the Governor’s Major Behavioral Health Proposals

March 3, 2022 - This brief analyzes the Governor’s three major behavioral health budget proposals. We include analyses of the Governor’s proposals to (1) provide funding for behavioral health bridge housing, (2) provide funding to implement certain solutions developed by the felony incompetent to stand trial solutions workgroup, and (3) add mobile crisis intervention services as a new Medi-Cal benefit.

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The 2020-21 Budget: The Governor’s Homelessness Plan

February 11, 2020 - In this report we provide the Legislature context for the state’s homelessness crisis, provide an update on major recent state efforts to address homelessness, assess the Governor’s 2020‑21 homelessness plan, propose a framework to help the Legislature develop its own plan and funding allocations, and offer an alternative to the Governor’s 2020‑21 budget proposal.

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The 2021-22 Budget: Behavioral Health: Continuum Infrastructure Funding Proposal

February 17, 2021 - This post analyzes the Governor’s proposal in the Department of Health Care Services to provide $750 million General Fund—on a one-time basis—in competitive grants to counties to acquire or renovate facilities for community behavioral health services.

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[PDF] Overview of Major Recent Behavioral Health Initiatives

February 28, 2023 - Presented to: Assembly Committee on Health Assembly Budget Subcommittee No. 1 on Health and Human Services

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The 2021-22 Budget: Behavioral Health: Community Care Demonstration Project

February 19, 2021 - This post analyzes the Governor’s proposal in the Department of State Hospitals to provide $233.2 million General Fund in 2021-22 and $136.4 million General Fund in 2022-23 and ongoing to establish a demonstration project—that would be optional for counties to participate in—in which responsibility for treating individuals found incompetent to stand trial and facing a felony charge would be realigned to participating counties.

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Improving Parolee Substance Use Disorder Treatment Through Medi-Cal

April 14, 2021 - This report provides background on the ways parolees access substance use disorder treatment (SUDT) through providers who are typically either funded by the California Department of Corrections and Rehabilitation or through Medi-Cal (the state’s Medicaid program). It assesses the trade-offs between these two approaches and recommends steps to improve the quality of service and create savings by increasing the utilization of Medi-Cal for parolee SUDT.

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The 2021-22 Budget: Analysis of the Medi-Cal Budget

February 16, 2021 - This post analyzes the major adjustments to the Medi-Cal budget in 2020-21 and 2021-22, with a focus on the technical adjustments such as the administration’s caseload estimates. We will further analyze the major discretionary Medi-Cal proposals in separate publications and communications to the Legislature.

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[PDF] The 2023-24 Budget: Analysis of the Governor’s Major Behavioral Health Proposals

February 16, 2023 - This brief analyzes the Governor’s three major behavioral health spending proposals and two proposed behavioral health budget solutions involving delays in planned spending.

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The 2023-24 California Spending Plan: Health

October 23, 2023 - This post summarizes overall spending in the 2023-24 budget package for health programs. It is part of our California Spending Plan series, which contains posts focused on each major sector of the state budget.