CA DISABILITY COMMUNITY ACTION
NETWORK
CAPITOL NEWS REPORT - ISSUE
#136-2004
Linking people to disability rights and
unified action
Website:
www.cdcan.org Toll-free info Lines Up!
July 28, 2004 - Wednesday afternoon
SCHWARZENEGGER ADMINISTRATION
TO ANNOUNCE NEXT WEEK SWEEPING CHANGES TO MEDI-CAL
SACRAMENTO - The Schwarzenegger
Administration is set to announce on Monday, August 2, what could possibly
be the most sweeping changes to the state's Medicaid program since it was
established in 1965. Information about the exact time or location of
where the announcement will take place or even what exactly will be
released is not available yet. The California Health and Human Service
Agency, which over sees the State's health and human service programs,
including Medi-Cal, says that any documents or proposals released on
Monday will also be posted on the Medi-Cal Redesign website at
www.medi-calredesign.org.
There was some reports that the announcement would be delayed - and that
could still happen.
Another potential restructuring proposal,
contained as recommendations in the Governor's California Performance
Review, was originally scheduled for release on June 30 - but postponed
due to the budget deadlock, may be released in the next coming days.
Those recommendations - which should be released in the next few days
now, are likely to have significant potential impact to the departments
and agencies that run or have over-all responsibility over programs that
serve people with disabilities and seniors, including Medi-Cal.
Advocates Raise Major Concerns -
Administration Says Changes Necessary
* Though no details have been released yet
regarding the Medi-Cal "redesign" proposal, some advocates for people with
disabilities and seniors and low income groups have expressed major
concerns about potential loss of services, changes in eligibility and
other reductions. Some advocates say that the major components for
"redesigning Medi-Cal" will be contained in a new proposal that the
Schwarzenegger Administration will submit to the federal government. Some
advocates fear that the proposal, which would seek to waive Section 1115
of the federal Medicaid regulations, would cap federal matching funds for
the program that the State receives and a cost more in state general fund
dollars - a claim that the Schwarzenegger Administration strongly
disputes.
* Other advocates worry about the impact to
people with disabilities, people with traumatic brain injuries and
seniors, of the Schwarzenegger Administration's Medi-Cal "redesign"
objectives for the 2005-2006 budget year which includes a reduction to the
Medi-Cal budget by at least $400 million.
* California Health and Human Services Agency
Secretary Kim Belshe has previously said that the status quo for the Medi-Cal
program is "not acceptable" and would mean deep cuts, and that the State,
due to limited resources, can no longer "sustain" the raising program
costs. She said that the Administration wanted to avoid deep cuts into
the program and chose to restructure or "redesign" the program instead.
The state budget, as passed by the Assembly
late this afternoon (the Senate will approve it tomorrow) contains no
major reductions or major changes to the Medi-Cal program - though the
Governor ended up withdrawing several major cuts, including a 10% Medi-Cal
provider rate reduction, enrollment caps and waiting lists for some
specific programs, earlier this year after major protests by disability
and other advocacy groups.
The changes or "redesign" to Medi-Cal
that the Schwarzenegger Administration will propose next week, if approved
by the federal government and also by the the Legislature, will begin to
take effect during the new budget year that starts July 1, 2005. The exact
timing of those approvals however is not certain at this point. The
Schwarzenegger Administration is likely to approach Medi-Cal "redesign" in
these ways
*State Legislation - Legislation
would be needed to change or eliminate existing laws as needed. The exact
time table is not certain, though any attempt to pass legislation
proposing massive changes to Medi-Cal with less than 30 days left in the
2004 legislative session seems daunting. It is also possible that the
Administration could hold off on legislation until next January. The
Governor could call a special session earlier or declare a fiscal
emergency and submit proposed legislative fixes that the Legislature must
respond to now.
It is not certain yet how the Legislature
will react to the proposal in general - or to any of the specifics.
Public hearings, at some point - whether in August or later, are
expected. The Administration could also opt to promote the changes in
stages over the course of several months or even a year, including as part
of the 2005-06 budget process.
* Proposal to Federal Government (waiver)
- this is a new proposal to the federal government seeking permission to
waive specific federal Medicaid rules (in this case Section 1115) that
would authorize major changes to the program in California and also work
with the federal government on any amendments to the Medicaid state plan
already in place.
* Regulations - In addition the
Schwarzenegger Administration can also seek to advance changes where
possible, through the state regulatory process.
IMPACT TO PEOPLE WITH DISABILITIES AND
SENIORS
* Over 6.5 million Californians, including
over 1.5 million who are low-income seniors, the blind or children and
adults with disabilities - a population that could be in particular,
tremendously impacted by the proposed changes to Medi-Cal - though the
specific impact is not known until details are available.
* The Governor's proposal could also have
major impact on other existing programs that serve children and adults
with developmental or other disabilities and seniors that receive federal
matching funds through waiving or making exceptions to other different
parts of the federal Medicaid regulations. The new proposal that will be
announced next week is separate from other existing proposals that are
either pending approval (such as the In-Home Supportive Residual Program's
Independence Plus Waiver) or the previously approved Home and
Community-Based Waiver that matches funding for community-based services
and supports funded through regional centers for children and adults with
developmental disabilities.
* Advocacy groups, including CDCAN are
looking at mobilizing people with disabilities and seniors across the
state to continue close scrutiny when the Schwarzenegger Administration
releases its new Medi-Cal proposal next week. The next Disability Rights
Townhall Telemeeting, scheduled for August 5, Thursday afternoon at 1:00
PM, will also focus on Medi-Cal Redesign and its impact on people with
disabilities and seniors (also will focus on budget updates and
legislation). For more information, visit the CDCAN website at
www.cdcan.org
* Clouding the issue is the normal "free for
all" that occurs in the final weeks of the legislative session - the same
exact time period that the Medi-Cal Redesign proposal will be released and
considered - and the change here in Sacramento that will occur in the
Senate legislative leadership when John Burton (D-San Francisco) is forced
to retire in December due to term limits. In addition, also clouding the
issue at the federal level, is the closeness of the presidential election
- and the possible change in Administrations in Washington if John Kerry
should defeat George W. Bush in November.
BACKGROUND
* Governor Schwarzenegger, in his proposed
budget for 2004-2005 released on January 9, announced his intention to
seek federal approval to "redesign" Medi-Cal in order to "contain costs
while avoiding deep cuts in eligibility or benefits". The California
Health and Human Services Agency said then that the types of changes
under consideration represent fundamental changes to Medi-Cal, and the
"most significant changes" since the program began in 1966. The Governor
then, set a target date of mid May to release a draft proposal for review
by the Legislature. This was postponed until August 2
* The California Health and Human Service
Agency held two community meetings in Los Angeles and Sacramento in late
January and early February to announce the process in developing a
proposal, seeking comments from advocates and other stakeholders from
across the state. In mid-March and April the Health and Human Services
Agency, partnering with two foundations, sponsored a series of work group
meetings focusing on specific issues on redesigning Medi-Cal, including
those issues impacting people with disabilities and seniors; financing
issues, benefit design and cost sharing; program eligibility and
simplification; organized service delivery, including managed care. Some
advocates criticized the work group meetings as "fixed" with "hidden
agendas", while other advocates praised the outreach effort by the Health
and Human Services Agency and the Department of Health Services, though
predicted a proposal they would not like.
FOR MORE INFORMATION ABOUT CA
DISABILITY COMMUNITY ACTION NETWORK
CONTRIBUTIONS NEEDED TO
CONTINUE EFFORT (AS OF JULY 27, 2004)
Many many, thanks again, to the
friends, people with disabilities and their families, community
organizations and others who have sent in generous and needed
contributions and donations. Contributions from people and organizations
is still very urgently needed to keep the advocacy efforts going for the
next several months, as we work to establish non-profit status.
Please make check or money
order to: California Disability Community Action Network (or abbreviate
CDCAN). A method to contribute by credit card (through Paypal) is NOW
set up on our website, at www.cdcan.org.
CDCAN is not yet a non-profit organization but will be soon. Send
contributions to: California Disability Community Action Network, 1225
8th Street Suite #480, Sacramento, CA 95814. A method to contribute by
credit card (through Paypal) is NOW set up on our website, at
www.cdcan.org.
* Who Is CDCAN?
The California Disability
Community Action Network is a non-partisan link to thousands of
Californians with developmental and other disabilities, their families,
community organizations and providers, direct care and other workers, and
other advocates. These action alerts and news reports is for all of them.
In addition it also goes to news organizations, state and local government
officials and staff.
* How To Receive CDCAN
Capitol News Reports and Alerts
If you would like to get on this
distribution (and conversely, get off of it) please send an email with
that request to:
martyomoto@rcip.com OR sign up via the CDCAN website at
www.cdcan.org. Sharing
information is part of our organizing effort. Please feel free to forward
or copy this (attribution is nice). We're all in this together!
* How To Contact CDCAN
Marty Omoto, director/organizer
- California Disability Community Action Network WEBSITE:
www.cdcan.org
1225 8th Street Suite 480
Sacramento, CA 95814 VOICE PHONE: 916/446-0013
FAX number: 916/446-0026
email: martyomoto@rcip.com
INFO HOTLINE TOLL FREE NUMBER:
1-877-260-0267 (cannot leave messages) SAME INFO HOTLINE FOR SACRAMENTO
AREA: 486-4652
