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Recidivism Reduction Proposal Requires Modification

February 23, 2006 - The Governor’s budget includes funds to develop and expand a number of prison inmate and parole programs designed to reduce recidivism. While some aspects of this proposal have merit, many aspects lack important staffing and implementation details, and it is questionable that the department will be able to successfully implement so many programs at one time. We identify steps that the state should take to improve programming in state prisons, and recommend a reduction of approximately $28 million pending receipt and review of additional information.


Report

Automatic Spending for the Entire Judicial Branch is Not Justified

February 23, 2006 - The Governor’s budget proposes to expand the use of formula-based budgeting to the entire Judicial Branch. However, the proposal lacks a clear policy rationale and would likely lead to over budgeting of the courts. We recommend rejection of this proposal.


Report

Some Practical Steps to Increase Children’s Enrollment in Health Coverage

February 23, 2006 - The budget plan includes a package of proposals to encourage the enrollment of uninsured children in state health coverage. Some of the proposals are reasonable, but we recommend others be rejected or modified because they are overbudgeted or are likely to be ineffective.


Report

Reform of Licensing and Certification of Health and Social Services Providers

February 23, 2006 - The administration is proposing changes to the way the state conducts licensing and certification of providers of certain health and social services. We concur in some proposals, recommend others be reduced to correct overbudgeted staffing and funding, and propose further changes to improve the way these functions are carried out.


Report

Proposition 36 at a Crossroads

February 23, 2006 - Proposition 36 provided annual appropriations from the General Fund through 2005-06 to implement a voter-approved initiative requiring drug treatment instead of incarceration in prison or jail for certain nonviolent drug possession offenders. The guaranteed appropriations for Proposition 36 are expiring, giving the Legislature discretion now to determine the level of funding for this measure. We comment on how the funding level should be set and proposals for making policy changes in the Proposition 36 law.


Report

Medi-Cal’s Bitter Pill: High Payments to Pharmacies

February 23, 2006 - Medi-Cal’s lack of accurate information about the prices of prescription drugs means that the program is reimbursing pharmacies much more than appears to be reasonable. We recommend legislation to ensure that reimbursement for drugs is set at more appropriate levels.


Report

Long-Term Care Caseload and Cost Trends

February 23, 2006 - An increasing portion of long-term care spending is for community-based services rather than institutional care. We examine the “cost-drivers” behind the growth in these costs and recommend that administration budget requests for long-term care projects be modified.


Report

Hospital Waiver Increasing State General Fund Costs

February 23, 2006 - A new federal hospital financing waiver is estimated to result in a net increase in Medi-Cal costs of $39 million over its first two years. We recommend that the waiver instead be implemented in a manner that avoids these costs and generates significant state savings.


Report

Future Federal Funding Shortfall for Healthy Families

February 23, 2006 - Future uncertainty about reauthorization of federal funding and the eventual exhaustion of unspent federal funds pose a risk of significant future increases in state costs for the Healthy Families Program (HFP). We present alternatives to hold down increases in overall HFP costs and to obtain additional financial support for the program.


Report

Better Oversight of Regional Center Purchases Needed

February 23, 2006 - Spending for some specific services and supports for persons with developmental disabilities varies so widely among regional centers (RCs) as to raise concerns about the fiscal controls over these expenditures. We recommend an audit to evaluate the situation.


Report

A Targeted Strategy to Constrain Costs and Improve Access to Community Care

February 23, 2006 - The Legislature should take steps to deter costly nonemergency visits to emergency rooms (ERs) and to improve access to care and quality of care in community settings. This should be accomplished by establishing effective copayments on the inappropriate use of ERs and by seeking available federal funds to improve access to primary care.


Report

Medi-Cal Budget Should Be Adjusted for Effects of Medicare Drug Benefit

February 23, 2006 - We review the state’s response to problems in the rollout of the new federal Medicare Part D prescription drug benefit and recommend Medi-Cal reductions of almost $335 million over two years to adjust for this rapidly changing situation.


Report

Retirement Contributions in 2006-07: New Policy Should Reduce Rate Volatility

February 23, 2006 - The retirement contribution rates set by CalPERS for the state and many local governments were volatile in the late 1990s and the early part of this decade. Governments had difficulty predicting annual contributions during their budgeting process. In 2005, CalPERS adopted a comprehensive rate stabilization policy. We believe the new policy promises more stability in contribution rates for the state and other public entities.


Report

Employee Compensation in 2006-07: Raises for Five of 21 Bargaining Units, Judges, and Others

February 23, 2006 - The budget includes $382million ($203 million General Fund) for compensation increases for: (1) memoranda of understanding with five of the 21 employee bargaining units, (2) supervisors and managers of employees in those five units, (3) judges, (4) prison medical personnel required to receive them by a court order in the Plata v. Schwarzenegger case, and (5) medical personnel in other departments.


Report

Reject More Autopilot Spending From the Administration

February 23, 2006 - The administration proposes to switch the Governor’s Office budget from traditional budgeting to an automatic annual adjustment. The change would cost about $1 million annually. The administration has offered no policy reason why the current process is not working. We therefore recommend that the Legislature reject the proposal to put the Governor’s Office budget on autopilot spending.