ALL MID-YEAR CUT PROPOSALS
AFFECTING PEOPLE WITH DEVELOPMENTAL AND OTHER DISABILITIES HAVE BEEN
WITHDRAWN BY THE ADMINISTRATION!
Congratulations to disability advocates and legislators for advocating
so effectively. And thanks and recognition to the Schwarzenegger
Administration for working through these issues with us and resolving them
in favor of the people.
On November 25, 2003, the Schwarzenegger Administration proposed a series
of massive cuts aimed at developmental services, IHSS, and Medi-Cal. On
December 18, 2003, the Governor withdrew those cuts in developmental
services. On April 22, 2004 he withdrew his proposal to eliminate the
IHSS state-only (residual) program. The May Revision issued on May 13,
2004 completed the withdrawal of all remaining mid-year proposals
affecting people with disabilities.
Later proposals from the Administration were also largely defeated.
Thanks again to our allies in the Legislature for standing firm on key
issues and to the Administration for working to minimize the damage.
Proposals defeated include an unraveling of IHSS and Statewide POS
Standards. A scaled back version of parental
co-pay was passed and signed into law. This will affect families
earning above 400% of the federal poverty limit. There will be a
co-pay for those families only for respite, day care, or camp. There
will be NO co-pay for families whose child is "institutionally deemed" and
therefore eligible for the Home and Community Base Waiver services which
allow the child to remain at home (ask your case manager!).
See background on the parental co-pay at DDS' website at
http://www.dds.cahwnet.gov/0405proposals/PDF/FCPAP_FinalReport_4_04.pdf
The mid-year cut proposals
(all withdrawn)
(1) Cap regional center caseload at the January 2004 estimated level.
Waiting lists would be established, and as attrition occurs, new
enrollments would be permitted up to the capped level. -
STATUS: WITHDRAWN
(2) Suspend the Lanterman Act, which provides an entitlement to
services for the developmentally disabled. - STATUS:
WITHDRAWN - BUT more recent proposals for parental co-pay and Statewide
Purchase of Service (POS) Standards would reduce our protections under the
Lanterman Act. See analysis of
May Revise for details.
(3) Loss of Due Process for services eliminated by the mid-year
reductions, or for individuals on the wait list. -
STATUS: WITHDRAWN - BUT trailer bill language
introduced April 1 contained provisions that would limit our due process
rights with respect to parental co-pay and POS standards.
(4) Eliminate "Non-Core" Regional Center Services - Respite, camping fees and
expenses, travel fees for camping, social and recreational activities,
non-medical therapies including equestrian therapy, music therapy, and art
therapy. - STATUS: WITHDRAWN
(5) Eliminate payment of relatives as providers for In Home Support
Services (IHSS). Eliminates other "state-only" IHSS services such as
protective supervision, heavy cleaning, transportation,
domestic chores
not coupled personal care, and respite. ($322M in 04/05)
- STATUS: WITHDRAWN.
The Administration applied for and received a federal Medicaid waiver to
bring in federal matching funds for this state-only program.
In-Home Supportive Services (IHSS) provides personal care and domestic
services to persons who are aged, blind or disabled and who live in their
own homes. IHSS is provided to those who otherwise might be placed in an
out-of-home care facility but who can safely remain in their own home if
IHSS services are received. Other devastating cuts proposed for IHSS
by the governor were also defeated.
(6) 10% Medi-Cal Provider Rate Reduction to be added onto the 5%
reduction already enacted for the current fiscal year. Total projected
cut would be $304M in the current budget year (only $152M is GF savings)
and $886M in 04/05 (only $443M is GF savings). The additional 10% Medi-Cal
provider rate cut would bring the total rate reduction to 15%.A 15% rate
reduction would seriously degrade access to healthcare for people with
disabilities. STATUS:
WITHDRAWN by May Revise.
May Revise Update: The May Revision reflects the
reality that the CMA v Bonita lawsuit effectively prevents the
Administration from pursuing this cut. This cut proposal is
withdrawn from consideration.
In a suit brought by the California Medical Association (CMA) and other
plaintiffs, a judge has blocked implementation of the 5% provider rate
reduction which was scheduled to go into effect on January 1, 2004.
The legal action is based on the assertion that a 5% rate cut would
severely limit access to medical care, contrary to Medicaid law. This
decision made the additional 10% reduction impractical to pursue.
(7) Cap Enrollment in Healthy Families at January 1, 2004 levels. -
STATUS: WITHDRAWN by May
Revise
Healthy Families provides access to basic health care for children of low
to moderate-income families whose income exceeds levels established for
the no-cost Medi-Cal programs. These children will continue to need
medical services irrespective of any waiting lists. The result of the cut
proposal (now withdrawn) would have been that emergency rooms become
providers of primary care at greater cost, both in human and fiscal terms.
This proposal was projected to
generate a wait list of over 100,000 children in less than a year.
Furthermore, this program is currently undersubscribed - the
Administration's proposal would have frozen out children who are currently
eligible but not enrolled. Projected saving were $32 million for 2004/2005.
(8) Cap California Children's Services (CCS) state-only program at the
January 2004 Caseload. - STATUS: WITHDRAWN by May
Revise
CCS pays for necessary medical treatment for children with medical conditions that include, but are not
limited to, cerebral palsy, spina bifida, muscular dystrophy, rheumatoid
arthritis, spinal cord injuries, arthrogryposis, and osteogenesis
imperfecta. The program is funded with state, county, and federal tax
monies, along with some fees paid by parents. CCS is primarily for
families with an income of less than $40,000 or would have out-of-pocket
medical expenses for the child of more than 20 percent of family income.
(9) Cap Genetically Handicapped Persons Program (GHPP) at the January
2004
Caseload. - STATUS: WITHDRAWN by May Revise
GHPP provides health coverage for Californians 21 years of age and older
who have specific genetic diseases including cystic fibrosis, hemophilia,
sickle cell disease, and certain neurological and metabolic diseases. GHPP
also serves children under the age of 21 with GHPP-eligible medical
conditions who are not financially eligible for CCS.
(10) Enrollment Caps for programs that serve immigrants with disabilities:
Medi-Cal Non-Emergency Services for Documented and Undocumented
Immigrants, Healthy Families for Documented Immigrants, and the Cash
Assistance Program for Immigrants (CAPI).STATUS:
WITHDRAWN by May Revision.
(11) Constitutional Spending Cap - STATUS:
DISASTER AVERTED - On December 12, the Governor signed a
compromise package that would put a $15B bond and a balanced budget
constitutional amendment on the ballot. The spending cap was NOT included
in the compromise, and the Governor was not given any extraordinary
authority for mid-year budget reductions. The proposals outlined
below are now off the table.
The Governor's original spending cap proposal was to go to the March
ballot tied to the $15B Bond package intended to pay off the current year
debt. The constitutional spending cap would have limited general fund spending to
2004-2005 levels, adjusted for inflation and California population growth.
The proposal also would give the Governor power to unilaterally enact
mid-year spending cuts and changes in law, unless overturned by a
two-thirds vote of the Legislature.
Analysis:
- The developmental services system needs to grow rapidly to keep pace
with the tremendous needs of families affected by the autism epidemic.
There are other cost pressures, such as the need to increase wages and
rates and aging of people with developmental disabilities and their
elderly care givers. Other systems serving our people are also
experiencing rapid growth, such as IHSS and Medi-Cal. However, a cap on
state spending would keep programs from growing to meet people's needs.
- The base year (04/05) would lock in expenditures at a level far below
historical rates of spending for health and social programs. And programs
would continue to be squeezed as California pays off its debt burden and
critical programs compete with each other to expand to meet caseload
growth and other needs.
- The spending cap would have been a constitutional limit on the size of government,
which will force severe cuts in health and social programs in future
years.
- The spending cap would have been a stealth attack on programs serving people with
disabilities, children, the poor and seniors. Without a cap these programs
would be debated on their own merits and decisions made according to the
values of the people of California. A spending cap would have hardwired the
political system for severe cuts in these programs, without debate on the
merits.
- If the Governor was given unilateral authority to cut budgets and change
law (unless vetoed by a 2/3rds vote of the Legislature), then he wouldn't
have had to ask next time he tries to wipe out whole categories of services.
This proposal is also counter to the balance of powers enshrined in the
California and US Constitutions. It would have given one person near dictatorial
powers.
Questions concerning these materials may be directed to
Mark Polit, California Alliance for Inclusive Communities, at
510-206-5227
