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The 2021-22 California Spending Plan: Home- and Community-Based Services Spending Plan


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The 2022-23 Budget: Update on Home- and Community- Based Services Spending Plan

February 10, 2022 - This post provides an update on the state's home- and community-based services spending plan, which was conditionally approved by the federal government in January 2022. We describe the quarterly updates the state will need to provide the federal government and ways to ensure legislative oversight over implementation of HCBS spending plan.

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[PDF] The 2022-23 Budget: In-Home Supportive Services

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.

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COVID-19: American Rescue Plan’s Major Health-Related Funding Provisions

May 6, 2021 - On March 11, 2021, the President signed into law the American Rescue Plan Act of 2021 (ARP Act)—a $1.9 trillion coronavirus disease 2019 relief package. This post highlights the health-related provisions of the ARP Act that provide significant funding directly to state/local health care and public health agencies, rural hospitals, home- and community-based services programs, subsidized individual market health coverage programs, and public behavioral health services. Where possible, based on currently available information, we provide an estimate of the funding allocations to California governments and other entities in the state. While this post reflects our best understanding of the high-level content and implications of this legislation as of late April, we will update the post as new information and clarifications become available.

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The 2021-22 Budget: Overview of the Spending Plan (Final Version)

October 27, 2021 - Each year, our office publishes the California Spending Plan to summarize the annual state budget. This publication provides an overview of the 2021-22 Budget Act, then highlights major features of the budget approved by the Legislature and signed by the Governor.

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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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[PDF] The 2017-18 Budget: California Spending Plan

October 18, 2017 - Each year, our office publishes the California Spending Plan to summarize the annual state budget. This publication discusses the 2017‑18 Budget Act and other major budget actions approved in 2017. In general, it reflects budgetary actions that the Legislature has taken through September 2017. In some cases, as noted, we discuss budget actions approved by the Legislature after June 15, 2017. In late July, for example, the Legislature passed and the Governor approved, an extension of authority for the Air Resources Board to implement the state’s cap‑and‑trade program from 2020 to 2030.

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Enhancing Federal Financial Participation for Consumers Served by the Department of Developmental Services—An Interim Update

April 19, 2021 - The Supplemental Report of the 2020-21 Budget Act requires our office to evaluate options for enhancing federal financial participation through Medi-Cal for consumers served by the Department of Developmental Services. This post provides an interim update of our initial findings and preliminary assessment. A final report will be delivered to the Legislature in the late summer.

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Federal COVID-19 Response Actions Affecting Older Adults and Persons with Disabilities

April 16, 2020 - This post summarizes key COVID-19 federal actions that affect aging- and disability-related state programs.

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Fiscal Outlook: Medi-Cal

November 15, 2017 - This online post discusses the major factors that we project will impact General Fund spending in Medi-Cal from 2017-18 to 2021-22.

This is part of a collection of material for The 2018-19 Budget: California’s Fiscal Outlook. See a complete list of this year's fiscal outlook material on our fiscal outlook budget page.

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The 2022-23 Budget: California’s Fiscal Outlook

November 17, 2021 - Our annual Fiscal Outlook publication gives our office’s independent assessment of the California state budget condition for the upcoming fiscal year and over the longer term. In this report, we anticipate the state will have a $31 billion surplus to allocate in the upcoming fiscal year and operating surpluses ranging from $3 billion to $8 billion over the multiyear period. We also find the state will need to allocate about $14 billion to meet the constitutional requirements of the State Appropriation's Limit (SAL) across 2020-21 and 2021-22.

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[PDF] The Universal Assessment Tool: Improving Care for Recipients of Home- and Community-Based Services

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.

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[PDF] Enhancing Federal Financial Participation for Consumers Served by the Department of Developmental Services

November 9, 2021 - Examines Medi-Cal enrollment of Department of Developmental Services (DDS) consumers and the fiscal effect that additional Medi-Cal enrollment would have on the DDS budget and on state costs overall.

Correction 11/19/21: Corrected average annual per person fee-for-service cost in Medi-Cal.

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[PDF] The 2010-11 Budget: How the Special Session Actions Would Affect Health Programs

January 22, 2010 - The Governor’s various proposed actions to obtain savings in the current and budget years through actions in the special session have significant implications for the state’s health services programs. In this report, we (1) discuss some of the key overriding issues relating to the Governor’s plan, (2) summarize the Governor’s health budget proposals, and (3) provide our initial comments on a number of the major proposals in each specific program area. We note that we are still receiving information about these proposals from the administration that may prompt us to modify our recommendations. (Revised: 1/24/2010)

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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.