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End-of-Life Choices

Trends in end-of-life care show that not only does the care given vary widely from region to region and hospital to hospital, but also patients often don't get the care they prefer. What can be done?

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Chronic diseases and the cost of care are rising. Are disease management programs improving outcomes for patients with complex, chronic conditions?

No Middleman

Under the "direct primary care" model, patients pay a monthly fee for basic medical services. Learn about the history and current landscape of physician practices offering this arrangement.

Tuesday, October 11, 2011

California Misses Sept. General Fund Revenue Target by $302 Million

California missed its general fund revenue goal for September by $301.6 million, according to state Controller John Chiang (D), Reuters reports.

Total revenue for the current fiscal year has fallen short of budget projections by $705.5 million, raising concerns that additional cuts to education, health and human services programs could be triggered in 2012 (Christie, Reuters, 10/10).

Background

Gov. Jerry Brown (D) signed an $86 billion state budget plan in June (Marois, Bloomberg, 10/10).

Lawmakers relied on an assumption that the state would receive $4 billion in new revenue over what previously was expected through June 2012.

If officials determine that revenue has fallen $1 billion short of expectations for this fiscal year, additional cuts could take place automatically. Most cuts would become effective Jan. 1, 2012.

Additional cuts could include:

  • $100 million from services for individuals with developmental disabilities; and
  • $100 million from the In-Home Supportive Services program for the elderly and people who are blind or have disabilities (California Healthline, 8/17).

According to other data from Chiang's office, July's general fund revenue was $538.8 million less than forecast, while August revenue was $135 million more than expected (Bloomberg, 10/10).

Likelihood of Automatic Cuts

Chiang said, "September's revenues alone do not guarantee that triggers will be pulled. But as the largest revenue month before December, these numbers do not paint a hopeful picture" (Reuters, 10/10).

Officials at the state Department of Finance and Legislative Analyst's Office said a significant portion of the projected $4 billion in revenue could come next spring (Yamamura, Sacramento Bee, 10/11).

Finance officials also noted that the controller's figures might not show all the money California has on hand.

H.D. Palmer, spokesperson for the Department of Finance, said a decision about the trigger cuts will be based on a 2012 revenue forecast that is made in December (Buchanan, San Francisco Chronicle, 10/11).



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