CALIFORNIA UCP UPDATE - PART II
December 6, 2002 - Friday evening
Note: see California UCP Update Part I for summary of cuts
impacting services and supports for people with developmental
disabilities (primarily Department of Development Services budget
- also Department of Rehabilitation)
SUMMARY OF CUTS IMPACTING MEDI-CAL SERVICES
Many of these cuts and reductions were proposed by the Governor
last year in his January 10 proposed budget for 2002-03 - all
which were rejected by the Legislature. However, the fiscal
situation now is even more grave. Many of the Medi-Cal cuts
impact people with developmental disabilities directly -
especially the proposed elimination of optional benefits. The
total cuts (and shifts) to Medi-Cal total $167,350,00. However
there was one small bright light in the fiscal mess - intermediate
care facility providers for the developmentally disabiled (ICF/DD)
could receive a rate increase as a result of a levy assessed on
them - which would then be matched by federal dollars. A portion
of that amount would then be given back to the ICF providers for a
rate increase - and the remainder to the State General Fund.
Adding these cuts to the cuts to the Department of Rehabilitation,
the Department of Developmental Services, and Department of Social
Services and one gets a total that is staggering and how that
impacts a person with developmental or other disabilities and
their families.
* MEDI-CAL (DEPT OF HEALTH SERVICES): Provider Rates
Davis Administration Proposes: The Administration proposes
to reduce all Medi-Cal provider rates by 10%
What Does This Mean: Would cut (and a corresponding $90.4
million savings to the State General Fund) effective April 1,
2003.
Background: The 2000-01 Budget Act included Medi-Cal
provider rate increases totaling $799.8 million ($402.8 million
General Fund, the remaining Federal). The 2002-03 Budget Act
maintained these increases.
Who Is Impacted: Primarily doctors (providers) however, if
doctors continue to leave, the loss of providers could
significantly reduce access to health care for people with
developmental and other disabilities.
* MEDI-CAL (DEPT OF HEALTH SERVICES): Selected Medi-Cal Optional
Benefits
Davis Administration Proposes: Legislation to eliminate the
following optional benefits from the Medi-Cal program for adults
above age 21 and not in long-term care: dental services, medical
supplies, podiatry, acupuncture, chiropractic services,
psychology, independent rehabilitation centers, and occupational
therapy.
What Does This Mean: Governor wants to eliminate these
services by APRIL 1 2003. The elimination of these optional
Medicaid benefits, effective April 1, 2003, will achieve,
according to the Davis Administration, a reduction of $63.3
million to this program in the 2002-03 fiscal year (and a
corresponding savings to the State General Fund for 2002-03).
Background: The Medi-Cal program currently offers 34
optional Medicaid benefits, the maximum number allowed under
federal law, many used by persons with developmental and other
disabilities - especially dental services.
Who Is Impacted: Significant critical impact to thousands
of adults with developmental disabilities who access these
optional benefits through Medi-Cal. Th
* MEDI-CAL (DEPT OF HEALTH SERVICES): Reinstate Medi-Cal Quarterly
Status Reports
Davis Administration Proposes: Legislation to reinstate
Medi-Cal quarterly status reporting, effective April 1, 2003.
Background: The 2000-01 Budget Act and Chapter 93, Statutes
of 2000, eliminated the requirement that families receiving Medi-Cal
submit quarterly eligibility status reports, which some advocates
felt was used to reduce eligibility - counting on the fact that
many families would not submit the reports. The Governor proposed
this in his January 10th 2002-03 budget proposal, which was
rejected by the Legislature. In January 2001, the Administration
established continuous
eligibility for children. This proposal will not affect the
eligibility of children in Medi-Cal.
What Does This Mean: Would result, according to the
Administration, in a current year cut of $10 million - of which $5
million would represent corresponding savings to the State General
Fund (the other $5 million is Federal dollars) and a reduction of
$170.1 million ($85 million of that coming from the State General
Fund) for the 2003-04 year.
Who Is Impacted: Mostly families with low-incomes - but
also could impact people with developmental and other
disabilities. Many advocates feel that thousands upon thousands of
families will end up losing eligibility.
* MEDI-CAL (DEPT OF HEALTH SERVICES) : Rescission of 1931(b) Medi-Cal
Eligibility Expansion
Davis Administration Proposes: Legislation to rescind this
expansion and limit eligibility to families with income up to
approximately 61% of the federal poverty level, consistent with
the income limits for the California Work Opportunity and
Responsibility to Kids (CalWORKs) program.
Background: Effective March 2000, eligibility for the
1931(b) Medi-Cal program was expanded to families with income up
to 100 percent of the Federal Poverty Level.
What Does This Mean: This proposal would affect mostly
two-parent income households. Effective April 1, 2003, this would
result in reduction and a corresponding savings of $12.4 million
($6.2 million of that State General Fund dollars) in 2002-03,
$235.9 million ($118 million of that State General Fund) in
2003-04, and annual reductions and corresponding savings of $985.1
million ($492.6 million of that from the State General Fund) after
full implementation.
Who Is Impacted: Mostly thousands of two parent families
with low incomes who would be denied or lose eligibility.
* MEDI-CAL (DEPT OF HEALTH SERVICES): Intermediate Care Facilities
for the Developmentally Disabled
Davis Administration Proposes: Legislation to levy an
assessment of 6.5 percent on intermediate care facilities for the
developmentally disabled. This assessment will be matched with
federal funds.
Background: A total of 75% of these funds would be provided
to these facilities as a provider rate increase. The remaining 25%
of these funds would be used to offset General Fund resources for
these facilities.
What Does This Mean: According to the Administration, this
action will result in a rate increase to ICF/DD providers (as a
result of the assessment levied on them which is then matched with
federal funds) and also result in revenues of $5 million in the
current fiscal year and $20 million annually (2003-04 beginning
July 1), according to the Administation. This proposal would
result in $2.5 million General Fund savings in the current year,
and $10 million General Fund savings in the 2003-04 year. The
total dollar amount of the provider increase was not available.
This was an innovative proposal advanced by a provider group
earlier this year - though there is always a risk that in future
years (or even this year) the State could keep the levy and and
not return any of the funds.
Who Is Impacted: Providers who operate intermediate care
facilities for people with developmental disabilities (ICF/DD) -
and indirectly, the residents of those facilities.
* MEDI-CAL (DEPT OF HEALTH SERVICES) : Outreach and Media
Campaigns (Healthy Families and Medi-Cal)
Davis Administration Proposes: That contracts that have not
been signed and funds that have not been invoiced or obligated be
reduced. The Administration also proposes to eliminate training
for certified application assistants.
Background: The 2002-03 Budget Act provided approximately
$26.1 million state General Fund for various outreach activities
and media campaigns. Additionally, the 2002-03 Budget included
$10.3 million ($3.9 million of that coming from the State General
Fund) for application assistance and a toll-free telephone line to
increase the enrollment of children in Medi-Cal and Healthy
Families.
What Does This Mean: Would result in a cut to the program
(and a savings to the State General Fund) of $1.7 million for
outreach, and a cut to the program (and a savings of $168,000
General Fund for this year's budget) for certified application
assistants.
Who Is Impacted: Community based groups and other
organizations involved with the outreach/media campaign. Children
with low incomes and families eligible for either program would be
impacted, if as a result, they do not enroll in either program and
have no access to health care.
SUMMARY OF CUTS IMPACTING SSI
* DEPT OF SOCIAL SERVICES: Supplemental Security Income/State
Supplementary Payment (SSI/SSP) Cost-of-Living Adjustment (COLA)
Davis Administration Proposes: To suspend the June 2003 and
January 2004 COLAs.1
Background: The 2002 Budget Act provided $22.3 million
General Fund for the
June 2003 cost of living for the SSI/SSP program based on the CA
Necessities Index.
What Does This Mean: This means persons receiving SSI/SSP
will not receive any cost of living increases for at least two
years. It represents a CUT to this program of $22.3 million (and
a corresponding savings to the State General Fund)
In addition, based on updated caseload projections, the cost to
provide the June 2003 cost of living adjustment is now estimated
to be $24.1 million in State General Fund dollars. This proposal
will also result in an additional State General Fund cost savings
of $1.8 million for the June 2003 cost of living adjustment. It
also results in $328 million in savings of State General Fund
money as a result of suspending the January 2004 cost of living
adjustment.
Who Is Impacted: Very significant and huge impact. People
with developmental and other disabilities, seniors, people with
low incomes.
SUMMARY OF CUTS IMPACTING SENIORS
Governor Davis proposes cuts that impact thousands of California
seniors, and also calls for the elimination of several senior
pgorams including foster grandparents, nutrition and brown bag
programs. The total cuts to the Department of Aging is $2.5
million.
* DEPT OF AGING: Nutrition Program
Davis Administration Proposes: The elimination of the
discretionary overmatch.
Background: The 2002-03 Budget Act provided $72.4 million
($9.5 million coming from the State General Fund) to serve meals
to seniors in a congregate setting and to deliver meals to
homebound seniors. Of the amount provided, $2.9 million General
Fund is a discretionary overmatch to the federal funds that
support the program.
What Does This Mean: This is a definite reduction to this
important program. Would result in State General Fund savings of
$614,000 (and a corresponding cut to the program) in the current
year, assuming an effective date of April 1, 2003. Funding of
$62.9 million of federal funds and $6.6 million General Fund
remains intact.
Who Is Impacted: Seniors who are homebound and community
based providers who prepare and deliver these meals.
* DEPT OF AGING: Respite Registry Program (RRP)
Davis Administration Proposes: The elimination of this
program
Background: The 2002-03 Budget Act provided $135,000
General Fund to the Respite Registry Program to recruit and screen
respite providers and match them to senior clients.
What Does This Mean: Would result in savings of $28,000 in
the current year, assuming an effective date of April 1, 2003.
Who Is Impacted: Seniors who use the registry
* DEPT OF AGNING: Foster Grandparent Program
Davis Administration Proposes: Legislation to eliminate the
Foster Grandparent Program.
Background: The 2002-03 Budget Act provided $1.1 million
State General Fund to the Foster Grandparent Program for tax-free
stipends to participating volunteers. In
What Does This Mean: Assuming an effective date of April 1,
2003, elimination of General Fund support for the program would
result in a cut and a corresponding State General Fund savings of
$219,000 in the current year.
Who Is Impacted: foster children who use this program - and
grandparents who participated.
* DEPT OF AGING: SENIORS: Senior Companion Program
Davis Administration Proposes: Legislation to eliminate the
Senior companion program.
Background: The 2002-03 Budget Act provided $2 million
General Fund to the Senior Companion Program for tax-free stipends
to participating volunteers.
What Does This Mean: Assuming an effective date of April 1,
2003, elimination of General Fund support for the program would
result in savings of $409,000 in the current year.
Who Is Impacted: seniors who participate in this program
* DEPT OF AGING: Brown Bag Program
Davis Administration Proposes: Legislation to eliminate
support for this program.
Background: The 2002-03 Budget Act provided $1.1 million
from the State General Fund to the Brown Bag Program to provide
surplus fruits, vegetables, and other unsold food products to
elderly persons on low incomes.
What Does This Mean: Additionally, there is $11 million in
direct funding available to local entities for similar food
programs. Assuming an effective date of April 1, 2003, elimination
of General Fund support for the program would result in savings of
$180,000 in the current year (and a corresponding cut to the
program).
Who Is Impacted: seniors on low incomes - many who depend
on this program
* DEPT OF AGING: Community-Based Services Program
Davis Administration Proposes: $500,000 be given back to
the State General Fund.
Background: The 2001-02 Budget Act included $18.5 million
in State General Fund money for this program to provide funding
through a variety of programs to support senior participation and
avoid institutionalization. Avoiding institutionalization results
in direct cost savings to the State.
What Does This Mean: The Davis Administration claims that
actual State General Fund expenditures for 2001-02 for this
program were $500,000 less than budgeted.
Who Is Impacted: seniors living in a community setting who
may face institutionalization (nursing facility, intermediate care
facility, etc).
* DEPT OF AGING: Adult Day Health Care Contract
Davis Administration Proposes: $500,000 be reverted to the
General Fund.
Background: The 2000-01 Budget Act appropriated $500,000
General Fund for construction of an Adult Day Health Care Center
in San Francisco. The amount was
reappropriated in the 2001-02 Budget Act.
What Does This Mean: Construction of this Center will be
appear to be permanently cancelled if this action is approved by
the Legislature. Contracts for the construction have not been
processed and funds not expended, and if approved by the
Legislature, the funds will be put back into the State General
Fund.
Who Is Impacted: Seniors would would have used the Center
in San Francisco
quired in 2002-03.
SUMMARY OF CUTS IMPACTING PEOPLE WITH MENTAL HEALTH NEEDS
Cuts to the Departmentof Mental Health add up to $4.8 million -
which does not include reductions into the 2003-2004 year. Mental
Health in particular was hard hit in the current budget by the
Governor last January and May, losing entire programs.
* DEPT OF MENTAL HEALTH: Early Mental Health Services
Davis Administration Proposes: To eliminate Early Mental
Health Services that were counted toward the Proposition 98
education guarantee and funded through the Department of Mental
Health, in order to protect other critical programs from reduction
or elimination.
What Does This Mean: This reduction will achieve
corresponding State General Fund savings of $549,000 in 2002-03
and $15 million in 2003-04.
Background: More than $1.1 billion is available in
Realignment funds for local mental health services, and an
additional $3.4 billion in special education funding is available
for the children that received Early Mental Health Services.
* DEPT OF MENTAL HEALTH: Mental Health Managed Care
Background: The Department of Mental Health provides mental
health services to Medi-Cal eligible clients through a system of
contracts between the Department and
county mental health departments.
Davis Administration Proposes: Will introduce statutory
changes to implement a 10% provider rate reduction effective April
1, 2003.
What Does This Mean: This $4 million reduction will result
in a corresponding State General Fund savings of $4 million in the
current budget year that ends June 30, 2003 and $16 million in
2003-04 budget year (and a corresponding cut to providers that
year).
Who Is Impacted: Very significant direct impact to
providers who provide these services.
* DEPT OF MENTAL HEALTH: Preadmission Screening and Resident
Review (PASRR)
Davis Administration Proposes: That $232,000 be reverted
back to the State General Fund, resulting in a savings the same
amount.
Background: The 2002-03 Budget Act included $3.2 million
($789,000 coming from the State General Fund) to expand the
current mental health evaluation process to include individuals
that are not eligible for Medi-Cal who are residents of or being
admitted to nursing facilities statewide.
What Does This Mean: According to the Davis Administration,
due to late implementation of the contract to provide PASRR
services, there will be General Fund savings in 2002-03.
Who Is Impacted: Persons with mental health needs who are
on Medi-Cal and are current residents (or just being admitted) to
a nursing facility.
* DEPT OF MENTAL HEALTH: 2nd Level Treatment Authorization Request
(TAR) Appeals
Davis Administration Proposes: To eliminate this process.
Background: The 2002-03 Budget Act included $64,000 General
Fund for the Department of Mental Health to process Second Level
TAR appeals. California is the only state that currently allows
second-level Treatment Authorization Request appeals, if mental
health providers are not satisfied with the results of the first
appeal to their county Mental Health Plans.
What Does This Mean: The $64,000 in state money would be
given back to the State General Fund.
Who Is Impacted: Mental Health providers.
SUMMARY OF CUTS IMPACTING EDUCATION AND CHILDREN
* Education - Proposition 98
Davis Administration Proposes: Across-the-Board Reductions:
The Administration proposes that K-14 local assistance programs
items be reduced across the board by 3.66 percent for a total of
$1.078 billion. The across-the-board reduction, combined with the
specific reductions proposed below, reduces total Proposition 98
appropriations to the current estimate of the required minimum
Proposition 98 spending level. The Administration proposes
separate legislation to help districts manage these reductions by
easing the three percent reserve requirement through June 2004 and
expanding the number of categorical programs among which funds can
be shifted.
Background: The spending required by Proposition 98, passed
in 1988, has been reduced due to the significant decline in
2002-03 estimated General Fund revenues and has also been adjusted
to reflect revised population figures and daily attendance. The
total 2002-03 Proposition 98 funding requirement is currently
estimated to be $44.645 billion.
What Does This Mean: Proposition 98 appropriations are
proposed to be reduced by a total of $1.734 billion, which is 3.7
percent of total Proposition 98 revenues including property taxes.
K-12 appropriations are reduced by $1.51 billion, a 3.6 percent
reduction of total K-12 revenues, and California Community College
programs are reduced by $135 million, a 2.8 percent reduction of
total revenues. Additionally, $143 million set-aside for
Proposition 98 cost increases at the time of Budget enactment is
no longer proposed to be appropriated.
Who Is Impacted: K-12, special education, community
colleges. The specific impact on special education (and adult
education programs that serve people with developmental
disabilities) are not known - but will be determined by local
school district boards.
* EDUCATION: State Special Schools, Student Assessment and
Counseling Center Capital Project
Davis Administration Proposes: That the $2.1 million for
this project be shifted from the General Fund to lease-revenue
bonds to complete this project.
Background: The 2001-02 Budget Act includes $2.1 million
General Fund for construction of a student assessment and
counseling center at the School for the Deaf in Fremont. This
project can be funded using lease revenue bonds.
Who Is Impacted: No direct impact.
* CHILDREN: Child Development Policy Advisory Committee
(-$367,000 in 2003-04)
Davis Administration Proposes: Legislation to repeal all
statutory provisions related to the CDPAC, effective July 1, 2003.
Background: In order to eliminate the CDPAC and to realize
full-year General Fund savings of $367,000 in 2003-04, enactment
of legislation is re
NEXT
STEPS
LEGISLATURE - the Legislature is scheduled to meet in special
session on Monday, December 9 to begin considering the Governor's
proposals. Monday is likely to besimply an organizing session
(Assembly is convening at noon and the Senate is meeting at 3:30
PM). Both houses still need to finalize membership of committees -
especially those that will deal with the Governor's proposal.
Last January the Legislature held joint hearings by the various
budget subcommittees on the Governor's special session proposal.
It is not certain yet how they will proceed this year. It is
likely that the special session will last several weeks, given the
massive cuts.
GOVERNOR - Will continue preparations for submitting his proposed
budget for 2003-2004 on January 10. Even if the Legislature
adopts every one of his spending cuts and reductions, that still
leaves a budget shortfall of at least $11 billion and growing
(some fiscal observers say the deficit will total $30 billion -
which means if the Legislature adopts the Governor's current year
cuts, the hole left would still be a staggering $20 billion).
WHAT
YOU CAN DO
* BE READY TO COME TO SACRAMENTO!!!!! - Watch for UCP ACTION
ALERT. People will be needed to testify and to be a presence at
hearings - and to visit legislators and staff.
* WATCH FOR NEW CA UCP ACTION ALERT that will be released Saturday
afternoon, along with sample letter, people to write to, and also
what you and your community can do to organize, mobilize and fight
back! Look for it on Dec 7!!!!!!!!!
NOTE: This is a report to Californians with developmental (and
other disabilities), families, providers and other advocates from
the California Coalition of United Cerebral Palsy Associations. If
you would like to get on the UCP Update distribution (and
conversely, get off of it) please send an email with that request
to: martyomoto@rcip.com. Please allow some time to be removed from
the list (it takes time to delete names from distribution
listing). Additions can be added immediately. Please also send
announcements of meetings,and any alerts or legislative reports
you or your organization sends out etc. Sharing information is
part of our organizing effort. Please feel free to forward or copy
this (attribution is nice, but so are new boots). Thanks!
Remember - we are all in this together.
FOR
MORE INFORMATION
Marty Omoto, Legislative Director
CA Coalition of United Cerebral Palsy Associations
1225 8th Street Suite 480 Sacramento, CA 95814
916/446-3204 FAX: 916/446-3206 email: martyomoto@rcip.com
Coalition Chair: Michael Williams (UCP of the Golden Gate)
