Budget Hearings Continue with Mental Health and IHSS Issues
Both houses convened budget hearings this week, with the Assembly
Budget Subcommittee No. 1 meeting both on Monday and Wednesday.
The Senate Budget and Fiscal Review Subcommittee No. 1 met on
Thursday to hear mental health and alcohol and drug
issues.
New Community Based Adult Services Program Receives Final
Approval from Federal Government
The federal Centers for Medicare and Medicaid Services (CMS) has
given final approval to California’s request to implement a new
Medi-Cal adult day health care option called the Community-Based
Adult Services (CBAS) program.
State Will Not Pursue Legal Case Over Local First 5 Funding
Local First 5 funding remains intact after the state declined to
appeal a decision in last year’s legal battle to divert $1
billion in Proposition 10 revenue from counties to the
state.
State Releases Mental Health Needs Assessment Document
The State Department of Health Care Services (DHCS) released the
final Section 1115 Waiver Behavioral Health Services Needs
Assessment last week as part of the terms and conditions for the
federal Section 1115 Medicaid Bridge to Reform Waiver of
2010.
Assembly Budget Subcommittee No. 1 and Assembly Aging Committee
held a joint hearing this week on the Administration’s care
coordination proposals. Please recall that the January budget
includes a number of proposals to change the Medi-Cal program,
particularly for people eligible for Medi-Cal and Medicare
services.
Hearings on CalWORKs and Subsidized Child Care Budget Proposals
Begin
Both the Senate and Assembly budget committees held hearings to
examine Governor Brown’s proposed redesign of the CalWORKs
program, reductions to CalWORKs grants, and, in the case of the
Senate, proposed changes to subsidized child care
programs.
First, a quick recap of the Governor’s 2012-13 budget proposals
regarding CalWORKs and subsidized child care:
Supreme Court Kicks Medi-Cal Rate Cuts Back Down to Ninth Circuit
The United States Supreme Court issued an opinion Wednesday
regarding three California Medi-Cal Provider Cut cases that will
send them all back to the Ninth Circuit Court of
Appeals.
We reported last week on the Senate’s schedule for convening
budget hearings over the course of the next few months, and the
Assembly has joined in with a robust schedule of hearings through
May.
Please also note that the Assembly and Senate Health Committees
have scheduled a joint hearing on “Hospital Reimbursement
Mechanisms” in Los Angeles on February 24.
The Legislative Analyst’s Office (LAO) released their overview of
the Governor’s budget this week. The Analyst did provide comment
on the CalWORKs proposals and the dual eligible pilot. The
following is a short summary of the LAO analysis.
SB 7 (Steinberg) – Pending
As Amended on January 4, 2012
SB 7, by Senate President pro Tempore Darrell Steinberg, was
amended this week to include language regarding the Department of
Health Care Services’ plan to begin a pilot program in up to 10
counties for individuals who are eligible for both Medi-Cal and
Medicare.
New Report Pegs State Uninsured at Nearly Seven Million
The California Health Care
Foundation (CHCF) released a report this week as part of
its Almanac project finding that California still has the highest
percentage of uninsured individuals of any state in the
nation.
State Reaches Settlement in Lawsuit Affecting Foster Children
Needing Mental Health Services
A federal district court has approved a settlement that will
force the state to change how it treats and houses foster
children and children at imminent risk of foster care placement
who require mental health services.
State May Delay Provider Cuts Until After December Court Date
There are reports that the state Department of Health Care
Services may delay the implementation of 10 percent Medi-Cal
provider rate cuts until after a key federal court date scheduled
for December 19th.
The Medicaid Defense Fund has filed a federal suit seeking a
preliminary injunction to halt the cuts in this budget year, with
a motion to also permanently prevent the provider reductions in
the future.
Federal Health Care Innovation Grants Now Available
The Health Care Innovation Challenge initiative has announced the
availability of significant federal grants to help reorganize
care delivery to achieve improved patient and cost
outcomes.
Assembly Budget Subcommittee No. 1 on Health and Human Services
held an oversight hearing to discuss the role of the CalWORKs
program on Thursday, November 3, in Sacramento. Subcommittee
Chair Holly Mitchell was joined by Assembly Members Felipe
Fuentes, Richard Pan, and Wes Chesbro. The hearing focused on the
role of the CalWORKs program in meeting the needs of low-income
families and their children. The testimony focused on trends in
child poverty and homelessness and how CalWORKs functions as a
safety net.
California Gets OK to Proceed with Medi-Cal Rate Cuts
California has received federal approval to enact up to $623
million in cuts to the state’s Medi-Cal program, including
reductions to the rate the state pays to Medi-Cal providers.
AB 194 (Beall) – Support
Chapter No. 458, Statutes of 2011
AB 194, a bill by Assembly Member Jim Beall, grants foster youth
priority enrollment in a public university or community college
system until January 1, 2017. Governor Brown signed AB 194 into
law on October 4, 2011.
AB 212 (Beall) – Support
Chapter No. 459, Statutes of 2011
DHCS Releases Transition Plans for Transferring Certain Medi-Cal
Functions
The California Department of Health Care Services (DHCS) has
released two transition plans describing the state’s path for
transferring certain Medi-Cal functions from other existing
departments.
Specifically, the two plans describe how the state will transfer
Medi-Cal Related Specialty Mental Health Services from the
Department of Mental Health and also the Drug Medi-Cal Treatment
Program from the Department of Alcohol and Drug Programs to
DHCS.
Assembly Hearing Examines the Impact of Cuts on California Safety
Net Services
The Assembly Budget Subcommittee No. 1 on Health and Human
Services, chaired by Assembly Member Holly Mitchell, held an
oversight hearing on Thursday on the “Potential Impacts of
Federal Deficit Reduction on California’s Health and Human
Services Programs.”
The Department of Finance (DOF) released allocation schedules to
the State Controller for disbursing 2011 realignment funds. On
September 16, the DOF submitted schedules for 2011-12 for the
following accounts within the Health and Human Services Account:
LIHP Grants with Short Deadline Available from Blue Shield
Foundation
The Blue Shield Foundation of California is soliciting grant
proposals to help counties implement their Low Income Health
Programs (LIHPs). Proposals from counties are due to the
Foundation by September 27.
AB 210 (Solorio) – Pending
As Proposed to be Amended
AB 210, by Assembly Member Jose Solorio, would amend what is
commonly known as Section 201 (Health and Safety Code Section
1797.201-224) of the Emergency Medical Services (EMS) System and
the Pre-Hospital Emergency Medical Care Personnel Act (EMS Act)
to require grandfathered EMS transportation providers to enter
into a written agreement with their respective Local Emergency
Medical Services Agency (LEMSA) by 2014.
IHSS Fraud Prevention Funding On Hold Pending Potential Trigger
Cuts
The Department of Social Services notified counties in July that
the $10 million included in the Budget Act of 2011 for county
investigation and program integrity efforts related to In-Home
Supportive Services is subject to the Act’s “trigger cuts”
mechanism.
Department of Health Care Services Begins Work on Medi-Cal
Function Transfer from the Departments of Mental Health and
Alcohol and Drug Programs
The California Department of Health Care Services (DHCS) convened
the first in a series of stakeholder meetings to discuss the
transfer of Department of Mental Health (DMH) Medi-Cal related
mental health functions and Department of Alcohol and Drug
Programs (DADP) Drug Medi-Cal functions to DHCS.
AB 396 (Mitchell) – Support
As Amended on May 12, 2011
AB 396, by Assembly Member Holly Mitchell, would provide the
opportunity for counties to receive federal funding for the
inpatient medical costs of juvenile detainees.
Specifically, AB 396 would allow counties to draw down federal
matching funds for the inpatient medical treatment provided to
minors who are outside of a county detention facility for more
than 24 hours.
AB 396 (Mitchell) – Support
As Amended on May 12, 2011
AB 396, by Assembly Member Holly Mitchell, would provide the
opportunity for counties to receive federal funding for the
inpatient medical costs of juvenile detainees.
Specifically, AB 396 would allow counties to draw down federal
matching funds for the inpatient medical treatment provided to
minors who are outside of a county detention facility for more
than 24 hours.
AB 396 (Mitchell) – Support
As Amended on May 12, 2011
AB 396, by Assembly Member Holly Mitchell, would provide the
opportunity for counties to receive federal funding for the
inpatient medical costs of juvenile detainees.
AB 194 (Beall) – Support
As Amended on May 31, 2011
AB 194, a bill by Assembly Member Jim Beall, would grant foster
youth priority enrollment in a public university or community
college system.
AB 194 specifically would allow foster youth and former foster
youth to receive priority enrollment in the California State
University and community college system, if the specific campus
utilizes the required technology to grant priority enrollment. AB
194 also requests the participation of the University of
California system.
AB 212 (Beall) – Support
As Amended on March 29, 2011
AB 212, by Assembly Member Jim Beall, would implement technical
provisions related to last year’s landmark foster care
legislation, the California Fostering Connections to Success Act
of 2010 (AB 12).
AB 212 (Beall) – Support
As Amended on March 29, 2011
AB 212, by Assembly Member Jim Beall, would implement technical
provisions related to last year’s landmark foster care
legislation, the California Fostering Connections to Success Act
of 2010 (AB 12).
Foster Care Awareness Month Activities Inundate the Capitol
More than 30 foster youth gathered on the West Steps of the State
Capitol Building to kick off the“Take a Foster Youth to the
Capitol” day on Wednesday.
AB 1296 (Bonilla) – Support in Concept
As Amended on April 25, 2011
AB 1296, by Assembly Member Susan Bonilla, is a vehicle to
attempt to streamline the eligibility and application process for
the Medi-Cal, Healthy Families Program, and the new Health Care
Exchange. It is being developed with the goal of meeting the
requirements of the federal Affordable Care Act (ACA) in 2014,
and was amended on April 25.
AB 1296 (Bonilla) – Support in Concept
As Amended on April 25, 2011
AB 1296, by Assembly Member Susan Bonilla, is a vehicle to
attempt to streamline the eligibility and application process for
the Medi-Cal, Healthy Families Program, and the new Health Care
Exchange. It is being developed with the goal of meeting the
requirements of the federal Affordable Care Act (ACA) in 2014,
and was amended on April 25.
California Health Benefit Exchange Holds Historic First Meeting
The California Health Benefit Exchange Board held its first
meeting on April 20, 2011. The federal Affordable Care Act
requires the establishment of health benefit exchanges that allow
individuals and small businesses to purchase coverage. For more
information about the health benefit exchange provision in
federal law, see the CSAC
Fact Sheet.
Several county First 5 Commissions have filed suit against the
Brown Administration over the state’s redirection of $1 billion
in First 5 (Proposition 10, Children and Families Act of 1998)
funds to Medi-Cal.
Hospital Funding Package Heading to Governor’s Desk
The Legislature fast-tracked two measures related to hospital
funding and the state budget this week. SB 90 by President pro
Tempore Darrell Steinberg and AB 113 by Assembly Member Bill
Monning cleared both houses of the Legislature and will be sent
to the Governor for action.
AB 518 (Wagner) – Support
As Amended on March 23, 2011
AB 518, a bill by Assembly Member Donald Wagner, would continue
to protect elder and dependent adults from financial abuse by
eliminating the sunset date on the reporting of suspected abuse
by financial institutions.
Counties support AB 518, which was passed by the Assembly Aging
and Long-Term Care Committee on March 23. The bill will be heard
next in the Assembly Public Safety Committee, but has not yet
been set for a hearing.
SB 36 (Simitian) – Support
As Introduced on December 6, 2011
SB 36, by Senator Joe Simitian, would allow counties to draw down
federal Children’s Health Insurance Program (CHIP) funding for
children’s health insurance.
Conference Committee Actions on Health & Human Services
The Joint Budget Conference Committee took action to close out
items yesterday that, in most cases, would enact additional cuts
to health and human services programs. The outline below refers
only to actions taken by the Committee on March 3 – all other
actions previously reported in the CSAC Bulletin remain in the
Conference Committee’s final report. In total, the Legislature
adopted $6 billion in cuts to health and human services
programs.
AB 1066 (Pérez) – Pending
As Introduced on February 18, 2011
AB 1066, by Assembly Speaker John Pérez, has been introduced to
clean up some of the technical language contained in last year’s
Section 1115 Medicaid Hospital Financing Demonstration Waiver
bills, SB 208 (Steinberg) and AB 302 (Pérez).
Governor Proposes Streamlining State Oversight of Mental Health
Services Act Funds
The Department of Finance (DOF) released a letter to Senate
Budget and Fiscal Review Committee Chair Mark Leno yesterday
seeking to simplify state oversight of the Mental Health Services
Act (MHSA, or Proposition 63 of 2004) by amending the statute to
allow counties to receive MHSA funds directly.
Assembly Budget Subcommittee No. 1 and Senate Budget and Fiscal
Review Subcommittee No. 3 concluded their hearings last week.
Many of the significant budget cuts remain open and presumably
will be dealt with by the full budget committees in each house
and by the conference committee on the budget. The full budget
committees will be meeting later this week. The CalWORKs and
Medi-Cal cuts and the realignment proposal are open items.
The Assembly and Senate continued health and human services
budget hearings this week. Assembly Budget Subcommittee No. 1
discussed the Medi-Cal and Healthy Families cuts and the CalWORKs
cuts. The subcommittee held all the major cut proposals open.
Senate Budget and Fiscal Review Subcommittee No. 3 heard
testimony on the mental health budget and the mental health
realignment proposal. Additionally the subcommittee discussed the
In-Home Supportive Services budget. The subcommittee also held
all major cut proposals and realignment open.
The Assembly and Senate began their budget deliberations this
week. California Health and Human Services Secretary Diana Dooley
appeared before both committees to communicate the gravity of the
budget situation. She acknowledged the Legislature will be
considering difficult budget cuts that no one likes. Secretary
Dooley also made herself available to the Legislature as they
work on the budget.
