Legislators Hear May Revision Budget Proposals

Both houses of the Legislature convened hearings this week to act on the Governor’s May Revision Budget proposal. 

The Assembly Budget Subcommittee No. 1, chaired by Assembly Member Holly Mitchell, met on Wednesday, Thursday, and today. The Subcommittee left a number of the items open, including the realignment fiscal structure and programmatic trailer bills, public hospital budget items, and the Care Coordination Initiative. Today’s hearing on the Assembly side focused on the funding “superstructure” proposal for 2011 Realignment. 
The Senate Budget Subcommittee No. 3, chaired by Senator Mark DeSaulnier, met on Monday, Tuesday and Thursday and heard items such as the Care Coordination Initiative, the Healthy Families Program shift to Medi-Cal, Medi-Cal copays, a seven percent across-the-board cut to the In-Home Supportive Services program, Realignment 2011 implementation, and a one-time reduction of $45 million for CalFresh Administration. 
The Senate subcommittee kept most of the items open, meaning they did not vote on the issue and it may be resolved in the full Senate Budget Committee meetings. The Subcommittee did approce the onetime reduction of $45 million General Fund for CalFresh Administration and an extension of one-year of the match waiver. The Subcommittee also had a robust discussion on 2011 Realignment Implementation – but also left it open. 

Once budget subcommittee hearings wrap up, the full budget committee of each house will begin meeting. At this time, there are 70 health and human services-related draft budget trailer bills, each of which can be viewed here. 

Duals Demonstration Project Web Site Debuts

The state Department of Health Care Services (DHCS) has announced the creation of a new Duals Demonstration Project website. 

The website was launched as part of DHCS’ stakeholder outreach efforts regarding the Duals Demonstration project. Please recall that the state is working to erect a Duals Demonstration Project – which is part of the state’s larger Care Coordination Initiative – in eight counties by June of 2013. The project would integrate care for those who are eligible for both Medi-Cal and Medicare services, and includes In Home Supportive Services. 

CSAC is working with the eight proposed project counties and DHCS to better understand the impacts of the proposed Duals Demonstration Project. 

Blue Shield Announces Grants for Rural Safety Net Integration Projects
The Blue Shield of California Foundation has announced funding availability for Rural Safety Net Integration grants. The grants are available to California’s 32 smallest counties by population and require a coalition of local safety net providers working together on a care delivery integration project in a rural county. 

There will be an informational conference call on the new grants on Thursday, May 31 from 1:30 p.m. to 2:30 p.m. The call-in number is (800) 391-1709 and the bridge number is 390558. CSAC strongly encourages all rural counties to listen in and consider applying for this grant. 
Final applications for Rural Safety Net Integration Project grants are due by 5 p.m. on Friday, June 22, 2012.

To create a login and view the eligibility guidelines and application, please visit the following Blue Shield of California Foundation website.

CalWORKs

SB 1060 (Hancock) – Support
As Introduced on February 13, 2012

SB 1060, by Senator Loni Hancock, would allow parents who have been convicted of a drug-related felony and completed a government-recognized treatment program to qualify for CalWORKs program employment services and benefits. 

Senator Hancock’s SB 1060 would allow California to join with 13 other states in opting out of the federal lifetime ban on receiving Temporary Assistance to Needy Families (TANF grants – CalWORKs here in California) funding for those with past drug felonies. California already allows those with certain drug-related felonies to receive Supplementary Nutrition Assistance Program (SNAP or food stamps, called CalFresh in California) benefits. 

Counties believe that SB 1060 provides an important tool for counties post-2011 realignment. By removing the lifetime ban on receiving CalWORKs benefits for parents convicted of drug-related felonies, counties will be able to provide employment activities and services to recipients with the goal of achieving employment and self sufficiency, as well as safely reintegrating them back into our communities. Additionally, CalWORKs grants are primarily used by families towards housing costs. Access to CalWORKs will provide parents assistance with housing – a key component necessary to get and retain a job.

Counties believe that in the long-tern SB 1060 would assist in reducing recidivism, saving our counties, the state, and communities significant social and fiscal costs. The Senate Appropriations Committee placed SB 1060 on the Suspense File on April 30 due to concern about the costs of the measure. On May 24, the Committee held SB 1060, again due to concern about costs.

Health Care Reform

SB 970 (de Léon) – Support
As Amended on May 24, 2012

SB 970, as amended on May 24 by Assembly Member Kevin de Léon, would help integrate the process for applying for public programs such as CalFresh and CalWORKs with the new online health coverage application process that is under development by the state. 

SB 970 would build on California’s existing service integration by ensuring that people applying for health coverage through CalHEERS can also begin the application process for other public programs, including CalFresh and CalWORKs. A comprehensive stakeholder workgroup, including representatives from county human services departments, among others, would be established by the bill to review whether additional programs should be included in the process.

SB 970 also provides that if a health program renewal form has the necessary information to renew eligibility for CalWORKs or CalFresh, that the renewal for those other programs is satisfied. This is important not only to ensure that applying for and retaining eligibility for multiple programs does not become more difficult after 2014, but so that the state can continue working towards full participation in federally funded human services and work support programs. 

The Author took amendments to the measure in the Senate Appropriations Committee on May 24, and the Committee passed it as amended to the Senate Floor. 

SB 1517 (Wolk) – Support
As Amended on May 24, 2012

SB 1517, by Senator Lois Wolk, will assist the County Medical Services Program (CMSP) in providing health care services to low-income Californians in thirty-four rural counties. 

Senate Bill 1517 allows CMSP to consolidate the schedule of participation fees contributed by each county from 12 annual payments to 10. This will assist the organization in managing cash flow. 

The measure had also included a General Fund loan to CMSP to also assist in managing cash flow, but that piece was amended out of the bill in the Senate Appropriations Committee on May 24. The loan language now appears in draft budget trailer bill language here. 

CSAC supports SB 1517, which was passed as amended by the Senate Appropriations Committee on May 24.

Child Welfare Services/Foster Care

SB 1279 (Wolk) – Support
As Amended on April 9, 2012

SB 1279, by Senator Lois Wolk, would authorize the Department of Social Services to receive information from other systems about outcomes for children who have left foster care. 

CSAC, along with the County Welfare Directors Association (CWDA), support the continued evolution of outcome measurements for children who have left foster care, and support SB 1279. The Senate Appropriations Committee placed SB 1279 on the Suspense File on April 30 due to concern about the costs, and the Committee declined to pass the measure on May 24. 

Public Health

AB 2002 (Cedillo) – Oppose
As Amended on April 30, 2012

AB 2002 by Assembly Member Gil Cedillo, would expand the definition of a safety net provider in instances where a Medi-Cal beneficiary must be automatically assigned to a managed care plan. 

Assembly Member Cedillo’s AB 2002 seeks to add plan-owned clinics, certain medical groups, and independent practice associations to the definition of safety net providers, which would disrupt the current Auto Assignment Incentive Program selection process by crowding out existing safety net providers. Furthermore, AB 2002 comes at a pivotal time for the Medi-Cal program as approach the implementation of the federal Affordable Care Act. Both the California Department of Health Care Services and the state’s Health Benefits Exchange are currently working with stakeholder groups, including the Legislature, to develop a system to handle the expansion of Medi-Cal to some 3 million Californians in 2014. In light of those ongoing efforts, counties believe that any changes to the plan assignment process must occur within that framework, rather than a stand-alone measure that will benefit specific plans at the expense of existing safety net providers.

CSAC, along with the County Health Executives Association of California (CHEAC), the California Association of Public Hospitals (CAPH), and Los Angeles County, oppose AB 2002. The Assembly Appropriations Committee placed AB 2002 on the Suspense File on May 16 and has not reconsidered it to date.