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CAIC UPDATE
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WITHDRAWN BY THE ADMINISTRATION!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The mid-year cut proposals (all withdrawn)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WITHDRAWN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 - STATUS: WITHDRAWN - BUT more recent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 - STATUS: WITHDRAWN -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 |
