The 2017-18 Budget: The Governor's May Revision In-Home Supportive Services Cost-Sharing Proposal

May 16, 2017 - When considering the appropriate levels of state and county cost shares for programs, fiscal responsibility for a program should be matched with the level of control over that program. Matching fiscal responsibility with the level of control gives both the state and counties an incentive to manage costs to the extent possible.
https://lao.ca.gov/Publications/Report/3671

The 2021-22 Budget: Department of Developmental Services (DDS) May Revision Budget Proposal

May 24, 2021 - DDS System Still Faces Challenges Today That Could Affect the Success of a Performance Incentives Program. While the pandemic demonstrated that the DDS system could be somewhat nimble in responding to consumers ’ needs, some of the same challenges facing the department in 2020 exist today.
https://lao.ca.gov/Publications/Report/4438

The 2026-27 Budget: Medi-Cal Fiscal Outlook

Nov 19, 2025 - As we have noted in previous publications , predicting pharmacy spending is inherently uncertain given the dynamic nature of the prescription drug market. Many of the pharmacy‑related budget solutions are subject to this uncertainty.
https://lao.ca.gov/Publications/Report/5092

The 2019-20 Budget: Analysis of the Medi-Cal Budget

Feb 13, 2019 - The increased size of the program and other changes may mean that the state could face many of the same challenges under an accrual budget as it faces today with a cash budget. Additionally, switching back to an accrual budget would involve a significant one ‑time cost as large payments, deferred in previous years to achieve savings, would be accelerated to match with the year in which the services and activities they fund occur.
https://lao.ca.gov/Publications/Report/3935

Considering Medi-Cal in the Midst of a Changing Fiscal and Policy Landscape

Oct 24, 2025 - Though current law generally will require this new tax to be much smaller, there is a way the state could maintain a similar level of revenue as today (before the required reduction in the revenue limit under federal law).
https://lao.ca.gov/Publications/Report/5083

The 2019-20 Budget: Undoing California’s Outstanding Budgetary Deferrals

Mar 26, 2019 - The Legislature could consider transitioning Medi-Cal back to an accrual budget as a way to increase legislative oversight and improve the predictability of the Medi-Cal budget. Doing so would match budgeted costs to when services are delivered, more closely align Medi-Cal ’s budget with the trends in underlying program dynamics, smooth year-to-year changes in the Medi-Cal budget, and could make the budget more predictable.
https://lao.ca.gov/Publications/Report/3988

The 2026-27 Budget: Department of Developmental Services

Mar 13, 2026 - The APD process allows the state to request a 90  percent match in federal funding (rather than California ’s standard 50  percent match) to design, develop, and install IT systems that enable the state to more efficiently administer Medicaid benefits.
https://lao.ca.gov/Publications/Report/5157

The 2023-24 Budget: Analysis of the Medi-Cal Budget

Feb 10, 2023 - Federal Match for Designated State Health Programs. In late January 2023, the Department of Health Care Services received federal waiver approval allowing the state to claim federal matching funds for certain existing programs that would otherwise be funded solely with state funds.
https://lao.ca.gov/Publications/Report/4675

The 2017-18 Budget: The Coordinated Care Initiative: A Critical Juncture

Feb 27, 2017 - When considering appropriate levels of state and county cost shares for programs, fiscal responsibility for a program should be matched with the level of control over that program. Matching fiscal responsibility with the level of control gives both the state and counties an incentive to manage costs to the extent possible.
https://lao.ca.gov/Publications/Report/3585

Climate Change Impacts Across California - Crosscutting Issues

Apr 5, 2022 - Moreover, many existing structures were built to different standards than are commonplace today, making them less resilient to the effects of climate change. For instance, many older homes were built with features —such as wood shake roofs, cedar siding, or single ‑paned windows —that make them more vulnerable to igniting during wildfires.
https://lao.ca.gov/Publications/Report/4575