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


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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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The 2017-18 Budget: Department of State Hospitals (DSH)

February 22, 2017 - In this web post, we provide an overview of the Department of State Hospitals (DSH) and the level of funding proposed for the department in the Governor’s 2017-18 budget. We also assess and make recommendations on four specific DSH budget proposals: (1) a $250 million shift in inpatient psychiatric programs from DSH to the California Department of Corrections and Rehabilitation, (2) a $10.5 million proposal to activate 60 beds for Incompetent to Stand Trial patients in the Kern County Jail, (3) an $ 8 million dollar funding increase to staff units designed specifically for violent patients, and (4) a $6.2 million General Fund loan for DSH-Napa earthquake repairs.

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[PDF] An Alternative Approach: Treating the Incompetent to Stand Trial

January 3, 2012 - Over the past several years, the state has experienced waitlists in county jails to transfer those deemed incompetent to stand trial (IST) to state hospitals for treatment. In response to the waitlist, which averages between 200 and 300 individuals a month, the Department of Mental Health began a pilot program in San Bernardino County to treat ISTs in county jail instead of at a state hospital. This report finds that the pilot program has greater flexibility to hold down costs and has been able to restore ISTs to competency in a shorter amount of time than state hospitals. We find that if the pilot program is expanded, it has the potential to significantly reduce the waitlist, as well as reduce costs to the public sector.

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[PDF] The 2018-19 Budget: Analysis of the Health and Human Services Budget

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.

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The 2015-16 Budget: Analysis of the Health Budget

February 12, 2015 - This report analyzes the Governor's 2015-16 state health program budget proposals. In the report, we review trends in the major health programs since 2007-08 (the last budget developed before the most recent recession), analyze the Governor's proposed restructuring of the managed care organization (MCO) tax, and describe the uncertainty regarding continued federal funding for the Children's Health Insurance Program (CHIP). The report also includes an analysis of the Department of State Hospitals budget and an analysis of the Governor's proposals to improve quality and increase staffing for the Licensing and Certification (L&C) Program administered by the Department of Public Health.

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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 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 2013-14 Budget: Analysis of the Health and Human Services Budget

February 27, 2013 - The Governor's budget proposes $28.3 billion in expenditures from the General Fund for health and human services programs in 2013-14. This reflects a 3.4 percent increase for health programs and a 7.9 percent increase for human services programs over 2012-13 estimated expenditures. For the most part, the year-over-year budget changes reflect caseload changes, technical budget adjustments, and the implementation of previously enacted policy changes, as opposed to new policy proposals. In the report, we find that the budget does not reflect the fiscal impact of the proposed Medi-Cal expansion, nor does it reflect potential costs and savings related to various other provisions of federal health care reform. We find that the Governor's Medi-Cal budget proposal assumes General Fund savings that are subject to significant uncertainty. We also provide a status update on the transition of the Healthy Families Program enrollees to Medi-Cal, finding that the transition is generally proceeding as planned, with some delays. We discuss problems in the operation of the state's Developmental Centers (DCs) by the Department of Developmental Services, and recommend that oversight of the DCs be strengthened by the creation of an independent Office of the Inspector General. We discuss the recent major program changes to the California Work Opportunity and Responsibility to Kids (CalWORKs) that are reflected in the budget, and recommend that the Legislature augment CalWORKs employment services funding--a Governor's budget proposal--to a level of funding it deems appropriate in light of its priorities for the program. We raise various fiscal and policy concerns about the Governor's budget assumption that a 20 percent across-the-board reduction in In-Home Supportive Services service hours will be implemented beginning on November 1, 2013. In light of these concerns, we recommend that the Legislature repeal the 20 percent reduction and instead continue a 3.6 percent across-the-board reduction that would otherwise sunset at the end of the 2012-13 fiscal year.

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[PDF] The 2015-16 Budget: Improved Budgeting for the Department of State Hospitals

February 9, 2015 - This report examines the budget of the Department of State Hospitals (DSH), which provides inpatient mental health services to patients in DSH’s eight facilities. It provides an overview of the various components of the department’s budget, and details how the department develops its annual budget requests. The report finds several shortcomings with the current budgeting process. To address these, the report provides recommendations for the Legislature to consider.

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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.