April 28, 2020 - This post summarizes recent federal legislative and other actions to allocate funding to California and other states in response to the coronavirus disease 2019 (COVID-19). Figures in this post summarize—as comprehensively as was feasible—the amount of funding that we expect to flow to governments and other public entities in California from the federal government. We also describe the major COVID-19-related federal funding that we expect to flow directly to private Californian entities, such as individuals and businesses.
April 27, 2010 - Presented to Assembly Budget Subcommittee No. 1 on Health and Human Services
March 23, 2020 - This initial post highlights key federal actions in response to the coronavirus disease 2019 (COVID-19)—through March 19, 2020—relating to public health broadly and individual health care. We discuss three sets of federal actions—(1) a federal legislative package focused on public health infrastructure, (2) a declaration of national emergency that opened the door for the state to apply for increased flexibility in the delivery of Medicaid services, and (3) a federal legislative package that provides for increased federal Medicaid funding and universal coverage of COVID-19 testing without cost sharing.
September 13, 2012 - The LAO’s annual "California Spending Plan" publication includes detailed descriptions of this year’s state budget package, as approved by the Legislature and the Governor. Included are highlights from the administration’s official scoring of the budget package. This final version of the publication reflects gubernatorial actions on budget-related bills through the end of September 2012. (Revised 10/4/12)
March 26, 2019 - In this report, we provide background on the current child support program. We then describe and assess the Governor’s 2019 20 proposal to create a new budgeting methodology that would increase funding for certain LCSAs by nearly $60 million General Fund. We recommend that the Legislature withhold action on the funding proposal until the administration submits the statutorily required report identifying potential state and local operational efficiencies.
February 27, 2013 - In 2012, the Legislature authorized the Coordinated Care Initiative (CCI) as an eight-county pilot to demonstrate the integration of Medi-Cal and Medicare benefits for "dual eligibles"--beneficiaries eligible for both benefits. The CCI will also integrate long-term services and supports (LTSS) under Medi-Cal managed care in the eight counties for dual eligibles and seniors and persons with disabilities covered only by Medi-Cal. The Governor's budget delays the start date of CCI implementation to September 1, 2013, resulting in lower 2013-14 savings than initially anticipated. Joint federal-state decisions regarding key financing and operational aspects of CCI are pending, creating uncertainty regarding the timely and successful implementation of CCI. We recommend that the Legislature clarify the legal status of CCI to go forward and consider authorizing CCI to test greater integration of In-Home Supportive Services--a particular LTSS--under managed care.
March 17, 2022 - This letter responds to the Assembly Rules Committee request for the LAO to analyze financing and other considerations related to AB 1400 (Kalra), which would create a single-payer health care delivery system known as “CalCare,” and ACA 11 (Kalra), which includes tax provisions related to the financing of CalCare.
April 5, 2020 - In recent weeks Congress has passed legislation that has directed funding to respond to the coronavirus emergency. This post discusses how some of the major pieces of funding could affect the state budget’s overall condition. In particular, we focus on how funding could help the state address some of the sources of a budget problem that could emerge as a result of the coronavirus emergency.
January 11, 2012 - The Governor’s proposed tax initiative is the cornerstone of his 2012-13 budget plan, which includes proposals to restructure education finance, reduce social services and child care programs substantially, and implement trigger cuts--primarily affecting schools--if voters do not approve the tax measure. The Governor’s plan would continue the difficult task of restoring the state budget to balance, but the difficulty in knowing how much taxable income will be attributable to high-income Californians makes the state’s revenue estimates an even bigger question mark than usual. With regard to the Governor’s major proposals, we think the Governor’s education restructuring proposals would institute lasting improvements to the system, and we observe that, while his social services and child care proposals have merit, they involve considerable drawbacks as well, given potentially severe impacts on affected families. Moreover, while the Governor’s tax initiative would improve the financial outlook of public education over the next several years, his trigger plan would create significant uncertainty for educational institutions in their planning for 2012-13. The Legislature needs to be very deliberate in structuring a workable trigger package and designing tools to help schools respond to potential trigger cuts.
November 5, 2020 - This post provides a high-level summary of state and federal funds provided to date to respond to the coronavirus disease 2019 (COVID-19). In this post we discuss: (1) the authorities, at both the state and federal levels, for COVID-19 spending; (2) the state, federal, and other funding sources for COVID-19 spending; and (3) the amounts of COVID-19 spending authorized so far, organized by different purposes and program areas.
Updated 11/12/20: State and federal government spending on certain activities to control the spread of COVID-19 revised upward to $8.6 billion.
March 22, 2017 - This report is intended to provide basic information about floods and flood management in California. (Whereas previous generations referred to “flood control” or “flood prevention” activities, experts now prefer the term “flood management” in acknowledgement that floodwaters are recurring and inevitable.) We begin by summarizing the history, causes, and risk of floods across the state. We then describe flood management agencies, infrastructure, and strategies, as well as how governmental agencies typically respond when floods occur. Next, we describe the spending levels and funding sources currently supporting flood management efforts, as well as estimates for how much additional funding may be needed to improve those efforts. We conclude by highlighting some key challenges confronting the state in contemplating how best to manage floods in California.
January 3, 2013 - Special education is the catch-all term that encompasses the specialized services that schools provide for disabled students. Developing a more thorough understanding of how California’s disabled students are served is the first step towards improving their educational outcomes. Toward this end, our primer is intended to provide the Legislature and public with an overview of special education in California—conveying information on special education laws, affected students, services, funding, and academic outcomes.
Also, see our 2016 animated video series Overview of Special Education in California.
February 17, 2012 - California’s system for providing health and social services to low-income seniors and persons with disabilities (SPDs) receiving Medicare and/or Medi-Cal is not coordinated. This lack of care coordination may lead to SPDs being unnecessarily hospitalized or placed in skilled nursing facilities rather than remaining in their own homes—resulting in poor outcomes for recipients and higher costs for the federal and state governments. As part of the 2012-13 budget, the Governor attempts to address this issue by proposing to integrate health and social services into managed care for most SPDs. In this report, we provide background information on the Medi-Cal and Medicare Programs and describe recent federal and state legislation to address fragmented care delivery. We discuss the potential merits of the Governor’s proposal, but raise several implementation issues and concerns. Finally, we make recommendations that encourage care coordination for SPDs by first completing and evaluating a currently authorized integrated care demonstration project in four counties rather than expanding the demonstration statewide as proposed by the Governor— an action that we think is premature. We also encourage the consideration of other ways to test the integration of benefits for SPDs.
May 5, 2023 - This post analyzes the Governor’s proposal to expand the Whole Child Model to additional counties.