Governor Jerry Brown released his May Revision to the State budget, kicking off this year’s budget tango between the Governor, legislature, cities, counties, special districts, special interests, and the public. Local governments, and particularly counties, were anticipating further details on the Affordable Care Act and its implementation in California. Some detail was provided.

“In the budget summary released shortly after Governor Brown took the podium in the Capitol, The state currently dedicates about $1.5 billion annually to counties for health care, primarily for services for indigent adults — many of the same people who will move to Medi‑Cal under the new law. While the need for county indigent services will continue and preserving a safety net is a priority, the state cannot — and should not — pay for the same services twice. Consequently, the May Revision proposes that over time, as the state takes on more responsibility for health care, counties take on more financial responsibility for certain human services programs. To ensure adequate funding remains at the county level for safety net services, dollars would only be redirected based on actual county‑by‑county experience. The goal is to allocate risk fairly, strengthen local flexibility, and clearly delineate the respective responsibilities of the state and the counties.”

Like so many others, we will closely monitor what this means for counties and healthcare providers.