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

May 24, 2021 - The recently passed ARP Act provided one-time Medicaid funding to “enhance, expand, or strengthen ” home- and community-based services (HCBS) by increasing the federal matching rate by 10  percentage points for a one-year period.
https://lao.ca.gov/Publications/Report/4438

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

Oct 24, 2025 - Beginning in October 2026, the federal government will only pay the state ’s  regular federal match rate (50  percent in California) for these  services. Other Key Changes Prohibits Enforcement of New Eligibility Rules.
https://lao.ca.gov/Publications/Report/5083

The 2020-21 Budget: Analysis of the Department of Developmental Services Budget

Feb 7, 2020 - In response, the federal government froze enrollment in the Medicaid waiver program until RCs implemented agreed ‑upon changes, which meant that the state could not access federal matching funds for services provided to consumers who would have otherwise been new waiver enrollees.
https://lao.ca.gov/Publications/Report/4147

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 2021-22 Budget: Analysis of CalAIM Financing Issues

Feb 16, 2021 - However, today we understand that the state ’s higher ‑cost plans often perform better in terms of access and quality. This raises questions about whether the transition to regional rate setting would improve efficiency at the cost of reduced access and/or quality.
https://lao.ca.gov/Publications/Report/4374

The 2026-27 Budget: Medi-Cal Fiscal Outlook

Nov 19, 2025 - Under H.R. 1, the federal match for these services will decrease from 90  percent to 50  percent for certain undocumented adults, requiring a backfill from the General Fund to maintain existing services.
https://lao.ca.gov/Publications/Report/5092

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 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

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 2024-25 Budget: Department of Developmental Services

Feb 13, 2024 - Under this plan, the final rate adjustment would occur in 2025 ‑26. The  original time line included the following steps: Year 1 (2021 ‑22). Service provider rates increase beginning April 1, 2022. Rate increases equal one ‑quarter of the difference between a provider ’s current rate and what the fully funded rate model (as of 2021 ‑22) would be according to the rate study.
https://lao.ca.gov/Publications/Report/4837