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WHAT'S NEW AND SEMI-NEW

FEATURED (POSTED MAY 19, 2010) MARTY OMOTO COMMENTARY - "PRAYING FOR TIME"
SACRAMENTO, CALIF - These are - and have been for the past several years - hard times 
for our community of people with disabilities, mental health needs, people with traumatic brain 
and other injuries, people with MS, Alzheimer's and other disorders, seniors, their families, 
community organizations and workers who provide supports and services.  Year after year after 
year of facing threats of cuts or outright elimination of programs and services, rollbacks in 
eligibility, and actual loss of needed services, and loss of jobs or the constant fear of losing all of 
those things.  
.Many in our communities - including those people with disabilities, mental health needs, seniors 
in the Asian and Pacific Islander, Latino and other communities of color - do not understand the 
workings of state government and politics nor have first hand information of what will or will not 
happen.  More often than not, the politics that our communities know is simply about survival.  
It is about being deeply anxious, worried and frightened about how to cope with what is happening 
now - and what will happen next. In speaking to hundreds, sometimes thousands of people across 
the State, I know while they may not know about the "Olmstead Decision" or about the "ADA" [Americans
with Disabilities Act] they do know about their own life or the lives of their children and family.  They know
what is right - and they know what is happening to them is wrong.   
No one should tell them not to be scared.  
(Click here to view or download Marty Omoto Commentary "Praying for Time" )
(Click here to view or download previous Commentary "Defying Gravity"  - that outlines some budget solutions)
NEW (POSTED JUNE 30, 2010) FRESNO COUNTY IHSS WORKER WAGE CUT STOPPED BY FEDERAL
JUDGE - ADVOCATES CLAIM VICTORY FOR DISABILITY RIGHTS AND COMPLIANCE WITH 1999
US SUPREME COURT "OLMSTEAD DECISION"
SACRAMENTO, CALIF (CDCAN) [Updated 06/30/2010  07:45 AM  (Pacific Time)] - As reported 
late yesterday afternoon, federal district court judge Claudia Wilken blocked Fresno 
County from implementing an hourly wage  cut to their In-Home Supportive Services (IHSS) 
workers from $10.25 to $8 per hour, that was scheduled to go into effect in July, granting 
a temporary restraining order that was requested by lawyers representing SEIU on behalf of 
IHSS workers and persons receiving services under the IHSS program.  The federal district court judge ordered Schwarzenegger Administration officials to take 
all steps immediately to rescind any approval given to Fresno County to reduce those wages 
and to officially notify the court of compliance.  
Last week, Fresno County mailed notices to the more than 12,000 IHSS workers in that county 
informing them that their wages and benefits would be cut in July.
The action by the federal court represents at least a temporary victory for thousands of IHSS 
workers and people with disabilities, mental health needs, the blind and seniors in Fresno County 
who receive services under the IHSS program.  
The legal documents filed by the lawyers on behalf of the IHSS workers, claimed the issue had major 
impact on the state's compliance with the landmark 1999 US Supreme Court Olmstead Decision under the 
federal Americans with Disabilities Act (ADA).  
That 1999 decision, filed on behalf of two Georgia women with developmental and other disabilities - 
Elaine Wilson and Lois Curtis, among other things, required the states to take steps to avoid the 
unnecessary or unjustified institutionalization of people with disabilities, mental health needs & seniors.  
(Click here to read full report from CDCAN Report #131-2010)
(Click here for 3 page pdf file of federal district court judge's restraining order)
(Click here for 30 page pdf file of motion for restraining order requested by lawyers for IHSS workers)
(Posted June 28, 2010) Section 1115 Medicaid Waiver Proposal: Sweeping Changes To Medi-Cal Program 
Impacting Hundreds of Thousands Of People With Disabilities, Mental Health Needs, Seniors & People Uninsured 
Focus of 2 Bills Setc For Hearing June 29th in Assembly Health Committee (SB 208) and June 30th in Senate Health
 Committee (AB 342)
SACRAMENTO (CDCAN) - Sweeping changes to the State's Medicaid program - called "Medi-Cal" 
contained in the Schwarzenegger  Administration proposal submitted to the federal government earlier this
month that will have major impact to hundreds of thousands of children and adults with disabilities, mental 
health needs, the blind, seniors, and persons without health insurance,  is the focus of two identical bills to be 
heard Tuesday (June 29) at 1:30 PM  before the Assembly Health Committee (SB 208)  at the State Capitol in 
Room 4202 and Wednesday (June 30) at 1:30 PM  before the Senate Health Committee (AB 342) at the State 
Capitol in Room 3191.  Both hearings will be televised on CalChannel (see their website at www.calchannel.com) 
and people can still write letters to the committee regarding the issues in the two identical bills (see CDCAN 
Report for committee members and addresses).
(Click here for 6 page pdf CDCAN Report #128-2010 reporting on the two bills and hearings)
(Click here for 26 page pdf file of SB 208 as amended June 22, 2010 - identical to AB 342)
(Click here for 26 page pdf file of AB 342 as amended June 23, 2010 - identical to SB 208)
(POSTED JUNE 17, 2010)  Fate of Extension of Temporary Increase in Medicaid Funding to the State
Uncertain in the US Senate - US Senate Democrats Offer Up New Version of Bill - Keeps Extension of
Medicaid Funding In - But Reduces Overall Price Tag of Bill from $140 Billion to $118 Billion
The issue has major impact to California, which would receive about $2 billion of the Medicaid money if the
temporary increase in matching funds is extended from December 31, 2010 to June 30, 2011.  
If that increase is not extended, California's budget hole would increase by $2 billion, placing enormous 
pressure on policymakers to make major additional spending cuts.  
(Click here for CDCAN Report #119-2010 on the issue)
(Click here for 399 page pdf copy of June 16, 2010 substitute amendment by Sen. Baucus to HR 4213 - Medicaid funding page 300))
(Click here for 4 page pdf copy of summary of proposed substitute amendment by Sen. Baucus to HR 4213)
(POSTED JUNE 15, 2010) - Budget Conference Committee Meets June 15th at 1 PM - Will Begin 
With AB 3632 Mental Health Special Education Mandate Proposed Suspension & Finish Up Education Items
(Click here for CDCAN Report #113-2010 on the budget conference committee hearing)
(Click here for the errata -  addition - to the education budget conference agenda regarding AB 3632)
(POSTED JUNE 14, 2010) - US Senate Democrats May Have Votes For Final Passage of 
Bill To Extend Temporary Increase of Federal Medicaid Matching Funds to the States
(Click here for CDCAN Report #112-2010 on this issue)
(POSTED JUNE 10, 2010) - MEDICAID SECTION 1115 WAIVER PROPOSAL 
SUBMITTED BY SCHWARZENEGGER ADMINISTRATION TO FEDERAL GOVERNMENT
Major Impact to People with Disabilities, Mental Health Needs, the 
Blind, Seniors 
SACRAMENTO, CALIF (CDCAN) -  The Schwarzenegger Administration released 
today a 4 page letter and 71 page comprehensive Medicaid Section 1115  
Demonstration Project Waiver proposal, titled "A Bridge to Reform" that it 
submitted last week (June 4th) to the federal government for approval. 
Approval from the federal government could take several months.  
The proposed waiver seeks to renew and significantly expand the existing 
Section 1115 Medicaid Waiver that is due to expire August 2010, will have, 
as proposed,  sweeping impact on thousands of people with disabilities, 
mental health needs, the blind and seniors in the Medi-Cal program
(Click here for CDCAN Report #110-2010 on this issue)
(Click here for 71 page pdf official "Bridge to Reform" Section 1115 Medicaid Waiver Proposal)
(Click here for 4 page scanned pdf letter to federal government)
(Click here for 243 page pdf file Interim Evaluation Report of the HCCI in California with appendix A-H)
Note: "HCCI" stands for "Health Care Coverage Initiative"
(POSTED JUNE 7, 2010) - HEALTH INSURANCE PLANS AND CHILDREN WITH AUTISM SPECTRUM
DISORDERS & THEIR FAMILIES FOCUS OF JUNE 10TH SENATE AUTISM SELECT COMMITTEE HEARING
SACRAMENTO, CA (CDCAN) -  The Senate Select Committee on Autism and Related Disorders, chaired by 
Senate President Pro tem Darrell Steinberg (Democrat - Sacramento), [photo left of Sen. Steinberg]  will hold 
an informational hearing that will focus on the controversial issue of children with autism spectrum disorders 
and their families and the problems with their private health insurance plans in covering critical services, 
scheduled for June 10, 2010 (Thursday) from 10:30 to 1:00 PM, at the State Capitol in Room 3191.  The 
informational hearing is scheduled to be televised by on CalChannel (check your local cable listing) and webcast 
live on CalChannel's website, www.calchannel.com   CDCAN will issue a full report on the hearing Thursday
(Click here to view or download CDCAN Report #103-2010 on the upcoming informational hearing)
(Click here to view or download 2 page SCANNED pdf file of the June 10th committee agenda)
(Click here to view or download 10 page pdf file of SB 1283 (health insurance grievances) as amended May 28, 2010)
(Click here to view or download 10 page pdf file of SB 1282 (behavioral analysis) as amended May 26, 2010)
 (POSTED JUNE 2, 2010)  BUDGET CONFERENCE COMMITTEE HEARINGS BEGIN JUNE 3rd
SACRAMENTO, CA  (CDCAN ) - A special joint committee composed of members of both the Assembly and State 
Senate, called a  "conference committee" to be chaired this year by Sen. Denise Ducheny (Democrat - San Diego), will 
hold its first hearing June 3, Thursday afternoon at 1:00 PM at the State Capitol in Room 4203 to begin the process of 
resolving any different actions taken by the Assembly and Senate on a wide range of budget issues.   
An agenda for the conference committee - hundreds of pages long, was released today, including a 9 page section 
Focusing on human services budget issues and a 46 page section dealing with health budget issues (including Medi-Cal).
Only those budget issues where the Assembly and State Senate took DIFFERENT actions are issues on the conference
 committee agenda.  Budget issues where both houses took the same actions are, for now, part of Governor's proposed 
2010-2011 State Budget, as revised - but still requires approval of both houses of the Legislature and the Governor.  
Given the major differences that Legislative Democrats and Republicans and the Governor have on resolving the budget 
deficit, passage of a budget will not happen anytime soon, most Capitol observers agree.  
All 10 Conference Committee Members Named
The budget conference committee will be larger than in other years, with a total of 10 members - 5 from the Assembly and 
5 from the State Senate.
The State Senate announced on Tuesday  its members on the budget conference committee:
Senate Democratic Members (3):  Denise Ducheny (chair of the Senate Budget and Fiscal Review Committee),  Mark Leno
 (chair of the Senate Budget Subcommittee #3 on Health and Human Services)  and Alan Lowenthal, (chair of the Senate 
Transportation and Housing Committee)
Senate Republican Members (2):  Bob Dutton (vice chair of the Senate Budget and Fiscal Review Committee and incoming 
Senate Republican Leader) and Sen. Bob Huff (vice chair of the Senate Education Committee).  
The Assembly announced its 5 conference committee members today (Wednesday):
Assembly Democratic Members (3): Bob Blumenfield (chair of the Assembly Budget Committee), Felipe Fuentes (chair of the 
Assembly Appropriations Committee), and Nancy Skinner (chair of the Assembly Rules Committee)
Assembly Republican Members (2): Connie Conway (vice chair of the Assembly Appropriations Committee) and Jim Nielsen
 (vice chair of the Assembly Budget Committee)
Hearings Will Continue Possibly Through June 11th
After Thursday, budget conference committee hearings are scheduled through Friday, June 11th,  (including the weekend) at the 
call of the committee chair.  
All budget conference committee hearings are open to the public and televised - though public testimony is not taken at these hearings.  
At this point in the budget process, the Governor's proposed 2010-2011 State Budget that includes changes that both the Senate 
and Assembly Democrats passed in recent weeks, is contained in AB 190.  After the budget conference committee phase ends, that bill
 number will likely change as the process moves forward (CDCAN will report any changes).  
(Click here to view or download CDCAN Report #100-2010 reporting on the budget conference committee)
(Click here to view or download CDCAN Report #098-2010 reporting on the conference committee)
(Click here to view or download 9 page pdf file - Human Services budget items from the 2010 Budget Conference Committee Agenda)
(Click here to view or download 46 page pdf file - Health budget items from the 2010 Budget Conference Committee Agenda)
(Click here to view or download 30 page pdf file - Transportation budget items from the 2010 Budget Conference Committee Agenda)
(Click here to view or download 50 page pdf file - Education budget items from the 2010 Budget Conference Committee Agenda)
(Click here to view or download 23 page pdf file - General Government budget items from the 2010 Budget Conference Committee Agenda)
(Click here to view or download 13 page pdf file - Public Safety budget items from the 2010 Budget Conference Committee Agenda)
(POSTED MAY 25, 2010) - Governor's Medi-Cal, Mental Health Budget Proposals 
Focus of Senate Budget  Committee May 26th - Controversial Proposal to Renew and 
Expand Medi-Cal Quality Assurance Nursing Home Provider Fee Also on Agenda
Assembly Budget Subcommittee on Health & Human Services Also Scheduled 
to Meet At Same Time Though Mostly "For Vote Only" Items 
 SACRAMENTO, CALIF (CDCAN)  0 Several controversial budget proposals by the Governor 
will be the focus of the full Senate Budget and Fiscal Review Committee and the Assembly 
Budget Subcommittee #1 on Health and Human Services when they hold separate hearings 
Wednesday morning (May 26th) at nearly the same time.  
This is the final week of budget subcommittee hearings - though the Senate Budget and Fiscal 
Review Committee is meeting and taking final action instead of its 5 subcommittees this week
Both houses of the Legislature have held and scheduled their final budget subcommittee hearings 
Wednesday and Thursday this week, taking final action on several of the Governor's major proposals 
impacting people with disabilities, mental health needs, the blind, seniors and their families, before 
the budget process heads to the next phase of "budget conference committee" hearings in early June.   
Senate Budget Committee Likely Will Draw More Attention With Several Controversial Issues on Agenda
Of the two hearings on Thursday morning, the Senate Budget and Fiscal Review Committee hearing is 
likely to be longer and more important in terms of attendance by the public because it is taking up budget 
issues proposed by the Governor as part of his May 14th budget revisions that this committee has not yet 
heard before.  
The public will have an opportunity -as it did Tuesday before this same committee, to provide brief public 
testimony on these issues that focus largely on Medi-Cal and Mental Health proposed reductions, in addition 
to one "for vote only" item relating to increasing from 3% to 4.25% beginning July 1, 2010 through June 30,2010 
a reduction in payments for most regional center providers and to regional center operations.  
Controversial Proposal to Extend and Expand Quality Assurance Fee For Nursing Homes on Senate Agenda
A controversial proposal by the Schwarzenegger Administration to extend and expand the Quality Assurance Fee 
for nursing homes that imposes a provider "tax" that is matched by federal Medicaid funds that in turn is partially 
given back to the provider in the form of higher reimbursement rate is on the May 26th Senate Budget and Fiscal 
Review Committee agenda - though it is listed after many other controversial items that will be heard first.  
The State retains part of that increased funding that comes back to the State to help pay for other State general fund 
expenses.  
This issue is referred to sometimes as the "AB 1629 Reauthorization" - named after the bill that first authorized it in 2004.
The proposal was controversial then and now, with disability and some senior advocates deeply concerned or in opposition 
to the proposal because they have claimed the State has not done a good job in oversight to make sure nursing homes 
who received the increased reimbursement rate improved quality of care inaddition to passing on the increased funding to
 their workers.  Some nursing home providers raised concerns with some of the new proposed measures to improve oversight 
and limit how the increased funding can be used.  
(Click here to view Part ONE of Assembly Budget Subcommittee May 26, 2010 Hearing Agenda - 24  page pdf file)
(Click here to view Part TWO of the Assembly Budget Subcommitttee May 26, 2010 Hearing Agenda - 52 page pdf file)
(Click here to view Senate Budget & Fiscal Review Committee May 26th Hearing Agenda - 71 page pdf file)
(Click here to view 3 page information sheet from Department of Health Care Services on AB 1629 Quality Assurance Fee)
(Click here to view CDCAN Report #091-2010 on these hearings)
NEW (POSTED MAY 25, 2010) - ASSEMBLY SPEAKER PEREZ PROPOSES "CALIFORNIA JOBS BUDGET" THAT WOULD 
ELIMINATE MOST OF  GOVERNOR'S BUDGET CUTS
Governor's Proposed Budget Cuts Would Be Rejected - Funds Would Be Borrowed from Bottle Recycling Fund and  Raised 
From Other Revenues Including Oil Severance Tax - Proposal Called "Innovative" By Many Advocates - Would Propose IHSS 
Provider "Fee" But Would Reject $750 Million Cut Proposed by Governor
SACRAMENTO, CALIF (CDCAN) [Updated 05/25/2010  03:45 PM  (Pacific Time)] - In a dramatic move that could shake the 
State's budget picture completely, Assembly Speaker John A. Pérez (Democrat - Los Angeles) unveiled this afternoon a "California 
Jobs Budget" proposal that he said would reject  nearly all of the Governor's proposed budget reductions to education, health and 
human services, and save over 430,000 jobs in the State from being eliminated and create over 30,000 new jobs. 
"This is a creative approach at solving the two most urgent problems facing our state: creating jobs and closing our deficit," the 
Assembly Speaker said this afternoon Pérez, adding that "the California Jobs Budget gets us through a difficult period and puts us 
much further ahead on the path to economic recovery by focusing on jobs." 
While more details are yet to emerge from the Assembly Speaker's proposal, most advocates have praised it, though want to take a 
closer look at it over the coming days and nearly all Capitol observers said the proposal was innovative - even if one might not support 
the concept.  
Senior staff in the Assembly Speaker's office said the proposal was a "first step" in a long process and said it would move forward in 
the regular budget process in the coming weeks to allow both houses of the Legislature and the public to fully review and comment 
on the proposal.  
(Click here to view the California Jobs Budget proposal by the Assembly Speaker - 13 page pdf file)
(Click here to view CDCAN Report #090-2010 reporting on Assembly Speaker on this issue)
(POSTED MAY 24, 2010) - CALIFORNIA BUDGET CRISIS - UPDATED SCHEDULE OF 
FINAL ROUND OF BUDGET SUBCOMMITTEE HEARINGS - SCHEDULED TO END THIS WEEK
Both houses of the Legislature will hold their final budget subcommittee hearings Tuesday and 
Wednesday (and if needed, Thursday) this week, taking final action on several of the Governor's
 major proposals impacting people with disabilities, mental health needs, the blind, seniors and '
their families, before the budget process heads to the next phase of "budget conference committee" 
hearings in early June.   
The full Senate Budget and Fiscal Review Committee will be meeting this week instead of its budget 
subcommittees, to take final action - though in the Assembly, their budget subcommittees will take 
final action this week.State Senate Full Budget Panel Will Meet Instead of Subcommittees
* May 25th - In the State Senate, the full Senate Budget and Fiscal Review Committee will meet 
tomorrow at 09:30 AM at the State Capitol in Room 4203 focusing on human service including 
mental health and childcare budget issues.
* May 26th - On Wednesday the full Senate budget panel will meet to hear health related budget 
issues including developmental services and take final action, instead of its five budget 
subcommittees (Disability Capitol Action Day) 
* May 27th - It will hold what will likely be its final hearing to close out the Senate budget 
subcommittee phase of the budget process on Thursday (May 27) focusing on education issues. 
Assembly Budget Subcommittees Will Meet This Week To Take Final Action
In the Assembly, its five budget subcommittees held hearings last week and took several final 
actions and will be  holding their final hearings on Wednesday (May 26th)  and possibly Thursday to 
take any remaining final actions
(Click here to view or downloaded 24 page pdf file of the May 25th Senate Budget Committee Agenda)
(Click here to view or downloaded 9 page CDCAN Report 88-2010 Reporting on Hearings)
(POSTED MAY 21, 2010) - Senate Budget Subcommittee #3 on Health and Human Services May 21, 2010 
hearing agenda focusing on developmental services, some Department of Public Health issues, 2 issues under the
Department of Health Care Services, and several items (for vote only) under Department of Mental Health [neither 
deal with Governor's proposals to reduce by 60% county mental health funding or suspension of the AB 3632 
special education mandate for mental health services]
Also: proposed budget related language (referred to as "budget trailer bill") dealing with the Governor's proposal
for additional 1.25% reduction in payments to most regional center providers and to regional center operations, and
a proposal to temporarily suspend some reporting requirements and other rules to help providers deal with the 
additional reduction (that would be on top of the existing 3% cut imposed last February 2009 and that was extended
to continue through June 30, 2011.  The 1.25%, if approved, would increase that cut to 4.25% effective July 1, 2010 
through June 30, 2011)
(Click here to view or download 43 page pdf file May 21 Senate Budget Subcommittee hearing agenda)
(Click here to view or download 2 page proposed budget related language dealing with 1.25% reduction)
(Click here to view or download CDCAN Report #087-2010 on this hearing and update hearing schedule)
(POSTED MAY 19, 2010)  ASSEMBLY BUDGET SUBCOMMITTEE MAY 20TH AGENDA
Assembly Budget Subcommittee on Health and Human Services will meet May 20, Thursday
at the State Capitol in Room 4202.  The exact time depends on whenever the Assembly Floor
session, which is scheduled to begin at 09:00 AM, ends, which could be around 11:00 AM
Today's hearing will focus on the Governor's $750 million proposed cuts to Medi-Cal including
annual caps (limits) on the amount of money that can be spent on hearing aids and durable
medical equipment including wheelchairs; copayments on many services, and more; proposed
cuts by the Governor to mental health services, regional centers, and Healthy Families.
(Click here to view or download 31 page - pdf file - hearing agenda)
(Click here to view or download CDCAN Report #085-2010 about this hearing)
(POSTED MAY 7, 2010) - SECTION 1115 MEDICAID WAIVER DRAFT IMPLEMENTATION
PLAN RELEASED BY SCHWARZENEGGER ADMINISTRATION
This draft plan will discussed at the May 13 (Thursday from 09:30 AM to 12:30 PM) at the Section
1115 Medicaid Waiver Stakeholder Advisory Committee established by the Department of Health
Care Services (as required by budget related legislation passed last year).  This draft implementation
plan is the next step toward seeking from the federal government renewal and dramatic expansion of
an existing pilot demonstration project authorized under Section 1115 of the federal Social Security
Act (which is where the "Section 1115 Waiver" name comes from].  California is seeking to renew and
expand that waiver - which originally deals with providing Medicaid funding for hospitals who provide
health services to uninsured persons - to include that and tens of thousands of people with 
disabilities, mental health needs, and seniors - who would be required to receive services under a
"organized system delivery of care".  Details are still not yet available.  
(Click here to view May 2010 draft implementation plan issued by the Department of Health Care Services)
(Click here to view membership of the Section 1115 Medicaid Waiver Stakeholder Advisory Committee)
(Click here to view CDCAN Report 074-2010 dated May 7, 2010 reporting on the draft plan and meetings)
(Click here to view Department of Health Care Services' December 2009 concept paper on the proposal)
(Click here to view list of what other states are doing with their Section 1115 Medicaid Waivers]  
(Click here to view 2 page section regarding "vulnerable populations" from Department of Health Care Services)
(Click here to view May 13, Section 1115 Medicaid Waiver Stakeholder Advisory Committee Public Meeting Agenda)
(POSTED MAY 4, 2010)  Assembly Budget Subcommittee #1 on Health and
Human Services May 5 Hearing Agenda - Focus on IHSS, SSI/SSP, Regional
Centers and Proposed Closure of Lanterman Developmental Center
The Assembly Budget Subcommittee #1 on Health and Human Services, chaired
by Assemblymember Dave Jones (Democrat - Sacramento) will meet May 5th,
Wednesday, at the State Capitol in Room 4202 (note room change) upon 
adjournment of the Assembly Governmental Organization Committee, which meets
at 1:30 PM and is expected to finish its hearings on bills at about 2 PM.  The 
budget subcommittee hearing begins whenever that committee adjourns its hearing.
(Click here to view or download the 53 page subcommittee agenda - pdf file)
(Click here to view or download CDCAN Report #072-2010 on the hearing)

(POSTED MAY 1, 2010)  - ASSEMBLY BUDGET SUBCOMMITTEE #1 ON HEALTH AND
HUMAN SERVICES MAY 3rd HEARING AGENDA

The Assembly Budget Subcommittee #1 on Health and Human Services will meet next on May 3rd 
(Monday) at 1:30 PM in the State Capitol in Room 127 dealing certain budget issues under the 
Department of Mental Health including the Mental Health Services Oversight and Accountability 
Commission, overview of major community based program areas including Early and Periodic 
Screening, Diagnosis and Treatment Program (EPSDT).  The subcommittee will also hear three 
budget proposals by the Governor impacting programs under the Department of Social Services 
including the proposed elimination of the Cash Assistance Program for Immigrants (CAPI) that 
provides small grants to legal immigrants with disabilities, the blind and seniors who do not qualify 
for the SSI/SSP (Supplemental Security Income/State Supplemental Payment) program.  
(Click here to view or download a PDF file copy of the 47 page subcommittee agenda)
(Click here to view or download the CDCAN Report #071-2010 regarding this hearing)

(POSTED APRIL 29, 2010)  SENATE BUDGET SUBCOMMITTEE #3 ON HEALTH  AND
HUMAN SERVICES HEARING APRIL 29, 2010
The Senate Budget Subcommittee #3 on Health and Human Services is scheduled to hold a 
hearing on April 29, 2010 (Thursday) at 09:30 AM or upon adjournment of the Senate floor 
session, at the State Capitol in Room 4203.  
The proposed closure of Lanterman Developmental Center is on the agenda as a "Special 
Order" of business - meaning it will be heard first.  Certain items dealing with community-based
services (regional centers) follow in a separate agenda including the Governor's January 8th 
proposal for an additional $25 million reduction in State general funding. Late last week the
Schwarzenegger Administration announced it proposes to achieve that reduction with an 
Additional 1;.25% cut in payments to most regional center providers on top of the 3% 
reduction now in place since February 2009  and that was extended until June 30,2011.  If
the Legislature approves the reduction, the total payment cut would be 4.25% beginning
July 1, 2010.   Senate Budget Subcommittee staff is recommending that the proposal
Remain "open" until after the release of the Governor's budget revisions that are expected
to be released May 14th.  
(Click here to view Part 1 of  04/29/10 Senate Budget Subcommittee Agenda covering Lanterman Developmental Center)
(Click here to view Part 2 of 04/29/10 Senate Budget Subcommittee Agenda on community-based services)
(POSTED APRIL 23, 2010)  DEVELOPMENTAL CENTERS FOCUS OF LEGISLATIVE
AND BUDGET SUBCOMMITTEE HEARINGS IN COMING WEEKS - ISSUE OF PROPOSED
CLOSURE SUBJECT OF KQED PUBLIC RADION PROGRAM
Under the shadow of a still unresolved enormous state budget deficit, the issue of the 
state owned and operated developmental centers - formerly called state hospitals - 
where just over 2,100 people with developmental disabilities still reside, will be the 
focus of a legislative oversight hearing and budget subcommittee hearings next week, 
with another budget subcommittee hearing on the subject the first week of May.   
The issue of the proposed closure of the state facility was also the focus this week in
the KQED public radio series called "Health Dialogues" that included a segment on 
Lanterman Developmental Center - and also the closure of Agnews Developmental Center,  
cuts enacted impacting community-based services, the impact of the federal health care 
reform act, and recent budget reductions impacting dental and early intervention services.  .
(Click here to view CDCAN Report #065-2010 about Developmental Centers legislative & budget hearings)
(Click here to view or download Assembly Human Services Committee Background Briefing Paper on Agnews Closure Report)
(Click here to view or download April 27, 2010 Assembly Human Services/Assembly Select Committee on Disabilities hearing agenda)
(Click here to view or download April 22, 2010 KQED Public Radio "Health Dialogues" Program on Lanterman Developmental Center)
POSTED APRIL 7, 2010) AUDIO RECORDING - 3/17/2010 CDCAN TOWNHALL TELEMEETING
PROPOSED CLOSURE OF LANTERMAN DEVELOPMENTAL CENTEFEATURING DEPARTMENT OF DEVELOPMENTAL SERVICES 
DIRECTOR TERRI DELGADILLO & OTHER SENIOR STAFF
Over 350 people participated in this townhall telemeeting that was the last statewide public forum 
that gave people an opportunity to provide brief comments and ask questions about the proposed closure 
to directly to senior Schwarzenegger Administration officials before the proposed plan was finalized and 
submitted to the Legislature April 1st for approval in the coming months.  People across the state, including 
residents, families, workers, local providers, regional center staff, other state or local agencies, and others 
participated in this townhall using the toll free lines.   (Note: people will also have opportunities to make 
comments on the proposed plan after it is submitted, at budget subcommittee hearings scheduled for late 
April and early May
RIGHT CLICK HERE TO DOWNLOAD MP3 FILE AUDIO RECORDING OF THIS TOWNHALL
RIGHT CLICK HERE TO DOWNLOAD REAL MEDIA AUDIO RECORDING OF THIS TOWNHALL
(POSTED MARCH 3, 2010) - MORE LEGAL SETBACKS FOR SCHWARZNEGGER
ADMINISTRATION ON 5% MEDI-CAL PROVIDER RATE CUTS
In two more decisions issued today (March 3, 2010), a 3 judge panel of the US 9th Circuit Court
of Appeals ruled against the Schwarzenegger Administration and upheld in two separate federal
cases, federal district court injunctions that blocked a 5% rate reduction to Medi-Cal fee for
service pharmacies and the 5% cut to adult day health centers. Those cuts were part of 
the 2008-2009 State Budget passed in September 2008 and were scheduled to go into effect
March 1, 2009 last year - though both reductions were blocked by injunctions shortly before or
a few weeks after that effective date.  
(Click here to view or download the 6 page opinion released a memorandum by the court - in a pdf file)
(Click here to view or download CDCAN Report #049-2010 reporting on the court decision)
(Click here to view 21 page opinion by the 9th Circuit Court of Appeals on the Adult Day Health Care Medi-Cal Cut)
NEW! (POSTED MARCH 3, 2010) - US 9th CIRCUIT COURT OF APPEALS UPHOLDS LOWER FEDERAL
DISTRICT COURT ORDER THAT BLOCKED SCHWARZENEGGER ADMINISTRATION FROM 
IMPLEMENTING STATE CUT TOWARD IHSS WORKER WAGES
The US 9th Circuit Court of Appeals issued a ruling today (March 3, 2010) against the Schwarzenegger
Administration, upholding US Federal District Court Judge Claudia Wilken's order issued June 25, 2009
that blocked the state from implementing a reduction of the State's participation toward In-Home 
Supportive Services (IHSS) worker wages. That reduction was passed as part of the 2009-2010 State 
Budget package passed four months early February 2009 last year.  
(Click here to view 21 page opinion issued March 3, 2010 by the US 9th Circuit Court of Appeals pdf file)
(Click here to view the original injunction issued by Judge Wilken on June 25, 2009 -  2 page pdf file)
(Click here to view CDCAN Report 048-2010 covering the 9th Circuit Court of Appeals decision pdf file)
(Click here to view CDCAN Report #195-2009 covering Federal District Court's original injunction pdf file)
(Posted February 9, 2010) Assembly Budget Subcommittee on Health & Human
Services Agenda for the February 10th hearing on the Governor's special session budget
reduction proposals impacting In-Home Supportive Services (IHSS), SSI/SSP individual
grants, CalWORKS, Cash Assistance Program for Immigrants (CAPI), California Food
Assistance Program (CFAP), reduction or fund shifting of Proposition 10 funds (California
Children and Families Commission)
(Click here to view or download the Assembly Budget Subcommittee hearing agenda)
(Click here to view CDCAN Report #036-2010)
NEW (Posted February 9, 2010) Public Hearing on the Proposed Closure of Lanterman
Developmental Center in Pomona, February 24 12 noon to 7 PM in the auditorium at
Lanterman Developmental Center hosted by the Department of Developmental Services.
(Click here to view public hearing agenda)
(Click here to view CDCAN Report #037-2010 on this public hearing)
NEW (Posted February 9, 2010) Disability and Senior Advocate Maggie "Dee" Dowling
Slowly Recovering At Home After Complications from Major Cancer Surgery  - March 18th
Event To Honor Life and Work of Senior Advocate Bill Powers
(Click here to view CDCAN Report #035-2010)
(POSTED FEBRUARY 2, 2010) - STATE SENATE & ASSEMBLY BUDGET HEARINGS
ON GOVERNOR'S PROPOSED SPECIAL SESSION BUDGET CUTS
(CLICK HERE TO VIEW LATEST CDCAN REPORT 030-2010 ON HEARINGS)
(CLICK HERE TO VIEW CDCAN REPORT 031-2010 ON SENATE BUDGET COMMITTEE AGENDA)
(CLICK HERE TO VIEW FEB 2, 2010 SENATE BUDGET AND FISCAL REVIEW FINAL-REVISED AGENDA)
(POSTED FEBRUARY 2, 2010)  STATE CONTROLLER JOHN CHIANG QUESTIONS
OVERSIGHT OF IHSS WORKER PAYMENTS BY DEPARTMENT OF SOCIAL SERVICES AND
COUNTIES  
(CLICK HERE TO VIEW CDCAN REPORT #029-2010 ON THIS ISSUE)
(CLICK HERE TO VIEW  6 PAGE PDF FILE LETTER FROM CONTROLLER'S OFFICE) 
1925 Photo of Lanterman Developmental Center - then called "Pacific Colony"SCHWARZENEGGER ADMINISTRATION
PROPOSES CLOSURE OF 
LANTERMAN DEVELOPMENTAL CENTER
(Photo left of first residences in 1925 at what was
then known as "Pacific Colony" and later
in 1979 changed to "Frank D. Lanterman State
Hospital and Developmental Center" and by the 
1980's shortened to "Frank D. Lanterman Developmental
Center)
(POSTED JANUARY 29, 2010) - SCHWARZENEGGER ADMINISTRATION ANNOUNCES
PROPOSAL TO CLOSE LANTERMAN DEVELOPMENTAL CENTER IN POMONA 
CLICK HERE TO VIEW CDCAN REPORT #025-2010 ON BREAKING NEWS ANNOUNCEMENT OF CLOSURE)
(CLICK HERE TO VIEW CDCAN REPORT #026-2010 WITH MORE DETAILS ANNOUNCEMENT)  
(CLICK HERE TO VIEW OFFICIAL 01/29/2010 PRESS RELEASE FROM DEPT OF DEVELOPMENTAL SERVICES)
( CLICK HERE TO VIEW 01/29/2010 LETTER TO CONSUMERS, FAMILIES & STAFF AT LANTERMAN DEVELOPMENTAL 
CENTER FROM DDS DIRECTOR TERRI DELGADILLO)
(CLICK HERE TO VIEW 01/29/2010 LETTER TO LEGISLATURE FROM DDS DIRECTOR TERRI DELGADILLO)
 
(POSTED JANUARY 26, 2010)  BUDGET & OVERSIGHT HEARING AGENDAS
January 26, 2010 Senate Budget and Fiscal Review Committee agenda focusing on the
Governor's special session health budget reduction proposals, including proposals for
major cuts to Medi-Cal, elimination of Adult Day Health Care, continued 3% reduction
for most regional center provider payments and operations; cut to mental health services
by shifting funding from Proposition 63 Mental Health Services Act
(CLICK HERE TO VIEW JANUARY 26 SENATE AGENDA)
(CLICK HERE TO VIEW CDCAN REPORT #022-2010 ON THE HEARING)
(CLICK HERE TO VIEW CDCAN REPORT #021-2010 ON THE HEARING)
January 27, 2010 Assembly Budget Committee and Senate Budget Subcommittee #3
on Health and Human Services 3rd Oversight Informational Hearing on Implementation
of Recent In-Home Supportive Services Reforms
(CLICK HERE TO VIEW FINAL JANUARY 27 OVERSIGHT HEARING AGENDA)
(CLICK HERE TO VIEW BACKGROUND PAPER)
(CLICK HERE TO VIEW ATTACHMENT A - SUMMARY OF MAJOR REFORMS)
(CLICK HERE TO VIEW LETTER FROM CA ASSOCIATION OF PUBLIC AUTHORITIES - CAPA)
(CLICK HERE TO VIEW LETTER FROM IHSS COALITION)
(POSTED JANUARY 20, 2010)  SCHWARZENEGGER ADMINISTRATION RELEASES PROPOSED
SPECIAL SESSION BUDGET LEGISLATIVE LANGUAGE TO IMPLEMENT MEDI-CAL REDUCTIONS
Trailer Bill Language Includes Proposal to Implement $750 Million In Reductions to Medi-Cal Program
and Elimination of All Medi-Cal Funding for Adult Day Health Care
SACRAMENTO, CALIF (CDCAN) [Updated 01/20/10  09:20 PM  (Pacific Time)]  - The Schwarzenegger 
Administration released today proposed budget special session legislative language that, if approved by 
the Legislature, would eliminate all Medi-Cal funding for Adult Day Health Care (about $104 million in State 
general fund money), and implement other permanent reductions - called "cost containment strategies" of 
over $750 million in State general fund spending to the Medi-Cal program, and reductions impacting family 
planning services, and Medi-Cal benefits to newly qualified legal immigrants and other legal immigrants 
legally residing in the State.  The Governor's proposed special session budget reductions to the Medi-Cal 
program, if approved by the Legislature, would total  nearly $1 billion in State general fund spending
(CLICK HERE TO VIEW OR DOWNLOAD CDCAN REPORT #019-2010 FOR DETAILS)
(CLICK HERE FOR 1 PAGE PDF FILE TRAILER BILL LANGUAGE ON ADULT DAY HEALTH CARE)
(CLICK HERE FOR 2 PAGE PDF FILE TRAILER BILL LANGUAGE ON MEDI-CAL COST CONTAINMENT)
(CLICK HERE FOR 1 PAGE PDF FILE TRAILER BILL LANGUAGE ON FAMILY PLANNING SERVICES)
(CLICK HERE FOR 12 PAGE PDF FILE TRAILER BILL LANGUAGE ON MEDI-CAL CUTS TO LEGAL IMMIGRANTS) 
 (POSTED JANUARY 15, 2010)  CDCAN TOWNHALL TELEMEETINGS
January 12, 2010 CDCAN Townhall Telemeeting focused on Governor's proposed 
reductions to In-Home Supportive Services (IHSS), SSI/SSP (the federal Supplemental 
Security Income/State Supplemental Payment program grants), Cash Assistance 
Program for Immigrants (CAPI), CalWORKS (State's "welfare to work" program) and 
Featured senior Schwarzenegger Administration officials in the California Department of 
Social Services: John Wagner, Director - Bob Garcia, Chief Deputy Director - Pete Cervinka,
Deputy Director - Eva Lopez, Deputy Director and Eileen Carroll, Bureau Chief, Adult
Programs Division.  Over 370 people participated in this townhall telemeeting.
(RIGHT CLICK HERE TO DOWNLOAD MP3 FILE AUDIO RECORDING OF THIS TOWNHALL)
(CLICK HERE TO DOWNLOAD REAL MEDIA AUDIO RECORDING OF THIS TOWNHALL)
January 13, 2010 CDCAN Townhall Telemeeting focused on Governor's proposed 
reductions to the budget under the Department of Developmental Services that funds
community-based services through the 21 non-profit regional centers serving over 
240,000 children and adults with developmental disabilities and services in 
the 4 state owned and operated developmental centers and two smaller facilities.  
Updates on ongoing reductions passed last February 2009 and July was also provided.
Featured senior Schwarzenegger Administration officials from the Department of 
Developmental Services: Terri Delgadillo, Director - Mark Hutchinson, Chief Deputy Director 
- Julia Mullen, Deputy Director - Rita Walker, Deputy Director and Mary Lee Pennington, 
head of the Department's legislative unit. 
Over 800 people participated in this townhall telemeeting,
setting a record (previous record was over 750 people with Kim Belshe last year)
(RIGHT CLICK HERE TO DOWNLOAD MP3 FILE AUDIO RECORDING OF THIS TOWNHALL)
(RIGHT CLICK HERE TO DOWNLOAD REAL MEDIA AUDIO RECORDING OF THIS TOWNHALL)

NEW! (POSTED JANUARY 14, 2010)  SENATE BUDGET & FISCAL REVIEW
COMMITTEE ANNOUNCES SERIES OF BUDGET HEARINGS 
The State Senate Budget and Fiscal Review Committee, chaired by State Sen. 
Denise Ducheny (Democrat - San Diego) announced today a series of public
hearings on the Governor special session budget proposals that require action
by the Legislature before March 1, 2010 in order to take have the actual cuts
take effect on June 1, 2010.  Those proposals include major reductions to the
In-Home Supportive Services (IHSS) program that, if approved, would eliminate
eligibility for all services under IHSS for 87% of the current IHSS caseload - 
meaning over 420,000 children and adults with disabilities, the blind, mental
health needs and seniors would lose all services.  Proposals by the Governor
also call for elimination of the Adult Day Health Care Medi-Cal optional benefit,
reductions to the SSI/SSP individual grant level to the lowest level allowed by
the federal government and other major cuts.
(CLICK HERE TO VIEW CDCAN REPORT #017-2010 FOR DETAILS)

Photo of Ruth Shelton painting (with brush attached to her head) with instructor Val Fernandez - Photo by Gary Brown(POSTED JANUARY 11, 2010)  RUTH SHELTON PASSES AWAY AT AGE 85 - SERVICES SET FOR Proclaimed in 2002 Before Assembly Committee Hearing on Olmstead Decision
Implementation: "I Am of Worth!"

SACRAMENTO, CALIF  [Last updated 01/11/10 11:30 PM] (CDCAN) - Memorial services are scheduled  for Friday afternoon, January 15th  in Sacramento for Ruth Shelton,  a beloved and respected disability  and senior advocate, and artist, who once proclaimed in 2002 to  an Assembly Committee that was  looking at implementation of the 1999 landmark US Supreme Court  Olmstead Decision that "I have a mind!  I have a choice! I am of worth! I am important! I am a child of  God!"   
Shelton died Friday morning (January 8th)  in her home, with hospice services, that she shared with her  friend and partner Laura Lee.  Shelton, who was born in 1924, celebrated her birthday in December, and  was 85 years old. She had been ill for at least the last several months.  
[Photo from above left of Ruth Shelton painting at Short Center in Sacramento with instructor Val Fernandez   Photo by Gary Brown]
(CLICK HERE TO VIEW OR DOWNLOAD 5 PAGE CDCAN REPORT 012-2010 - FIRST REPORT OF  SHELTON'S PASSING)
(CLICK HERE TO VIEW OR DOWNLOAD 9 PAGE CDCAN REPORT 013-2010 ON SHELTON'S  PASSING AND REPORT ON SERVICE SCHEDULE & REPRINT OF PAI  ARTICLE)
(CLICK HERE TO VIEW OR DOWNLOAD 3 PAGE PDF PAI NEWSLETTER SUMMER OF 1999 REPRINT OF RUTH SHELTON'S LIFE)

(POSTED JANUARY 6, 2010) - DEPARTMENT OF HEALTH CARE SERVICES 
MEDI-CAL STAKEHOLDER ADVISORY COMMITTEE MEETING 
The Schwarzenegger Administration, authorized by budget related legislation (ABx4 6) 
as part of the revised 2009-2010 State Budget passed and enacted July 2009, will soon
be submitting to the federal government a finalized detailed proposal to renew and 
expand an existing Medicaid Waiver (Section 1115) due to expire August 2010 that 
seeks to make dramatic changes on how people with disabilities, mental health needs,
the blind and seniors receive Medi-Cal services.  The proposal, if approved, would take
effect gradually over a 5 year period.  
(CLICK HERE TO VIEW AGENDA FOR JANUARY 7,. 2010 STAKEHOLDER MEETING - 1 
PAGE PDF FILE)
(CLICK HERE TO VIEW CDCAN REPORT #008-2010 ON THIS MEETING AND ISSUE)
NEW! (POSTED JANUARY 6, 2010) -  TWO CDCAN TOWNHALL TELEMEETINGS
SCHEDULED FOR JANUARY 2010:
(CLICK HERE TO VIEW CDCAN REPORT #007-2010 ABOUT THESE TELEMEETINGS)
JANUARY 12, 2010 - TUESDAY 1:00 to 2:30 PM
FEATURING: 
John Wagner, Director, California Department of Social Services
Eva Lopez, Deputy Director - Adult Programs Division
FOCUS: 
Governor's budget proposals impacting In-Home Supportive Services (IHSS), 
SSI/SSP (Supplemental Security Income/State Supplemental Payment grant 
program), community care licensing, and also updates on impact to adoption 
assistance/foster care programs and CalWORKS, the state's "welfare to work" 
program  (all three programs impact many families with children and parents 
with special needs and disabilities)
JANUARY 13, 2010 - WEDNESDAY 1:00 to 2:45 PM
FEATURING: 
Terri Delgadillo, Director - Department of Developmental Services
Mark Hutchinson, Chief Deputy Director
Julia Mullen, Deputy Director
Rita Walker, Deputy Director
FOCUS:
Governor's budget proposals (and status of previous budget proposals enacted) 
impacting regional centers who coordinate community-based funded services and 
supports to over 240,000 children and adults with developmental disabilities, including
thousands of infants and toddlers in the California Early Start program (California's early 
intervention program).  Officials will also provide updates on Governor's proposals 
impacting the 4 remaining state owned and operated developmental centers and 2 smaller 
health facilities (one of which is scheduled for closure February 2010).  
HOW TO PARTICIPATE IN BOTH TOWNHALLS:
The instructions to participate in either CDCAN Townhall Telemeeting is the same below:
STEP 1: Dial toll-free number:  877-551-8082  (there is no passcode)
STEP 2: Wait for operator - who will ask for your name and the city you are from
Note: to protect people's privacy, only the first name and the city location will be announced 
on the townhall for anyone wanting to ask a question
STEP 3: Anyone can ask a question (or make brief comment) - wait for instructions that will 
be announced during the townhall telemeeting.  
Please Note:
1. Absolute zero tolerance for anyone who is rude or disrespectful (the audience or speakers) 
2. People Should Speak Simply - With a large and diverse audience of hundreds  of people, 
including those with all types of physical and developmental disabilities, language and cultural 
backgrounds, persons (both speakers and people asking questions) should speak simply and
not use insider government or program terms or abbreviations.  This is important because of 
people's backgrounds, experience and disabilities, but also because CDCAN is working to provide  
real time language translations.   
3. Pending Lawsuits - Officials from either department (or any state, federal or county government agency) 
cannot comment on specific issues subject to a pending lawsuit.  Officials may be able to provide 
general status information  on those specific cases where the State has already released information 
on how it is implementing a court order - meaning a previously or soon to be released All County Letter, 
Notice or other instructions sent out to the public.  However they will not be able to comment or provide 
details beyond what has already been publicly released)
(POSTED JANUARY 1, 2010)  STATE SUPERIOR COURT JUDGE ORDERS GOVERNOR TO
END FURLOUGHS FOR THOUSANDS OF STATE EMPLOYEES
[Updated 01/01//10  12:40 AM  (Pacific Time)]  - In another major legal setback for Governor Arnold Schwarzenegger, 
State Superior Court Judge Frank Roesch issued an order late afternoon on New Year's Eve, ordering the Governor and 
other state officials  to "cease and desist" the mandatory furloughs for tens of thousands of state employees represented 
by SEIU (Service Employees International Union) who are paid through funding other than the State General Fund and 
state employees who in "special fund" state agencies. The judge's order, which said that the Governor overstepped his 
legal authority, also impacts two other state employee unions.  
The Governor's office said the State will appeal the judge's decision.  
The Alameda County Superior Court judge issued the order in the lawsuit "Service Employees International Union Local 1000 
and Yvonne Walker v. Arnold Schwarzenegger, et al."  (case #RG09456750), that was heard on November 16, 2009 and combined 
with two other similar state lawsuits filed by the California Attorneys, Administrative Law Judges and Hearing Officers in State 
Employment (CASE), and the Union of American Physicians and Dentists (UAPD).  
The case is one of at least 20 different lawsuits filed to stop the mandatory furloughs.
The employees covered by the judge's order include those that have direct impact on people with disabilities, mental health needs, 
the blind and seniors.
(CLICK HERE TO VIEW 16 PAGE ORDER OF THE JUDGE - SCANNED IMAGE OF THE ORDER BY THE COURT PDF FILE)
(CLICK HERE TO VIEW GOVERNOR'S EXECUTIVE ORDERS REGARDING FURLOUGHS_
(CLICK HERE TO VIEW CDCAN REPORT #001-2010 ON THE COURT ORDER)

Photo of Attorney Lynn Carman of the Medicaid Defense Fund (photo by Marty Omoto Nov 2009)NEW!  (POSTED DECEMBER 21, 2009) – US 9TH CIRCUIT COURT OF APPEALS STRONGLY REBUKES SCHWARZENEGGER ADMINISTRATION AND ATTORNEY GENERAL BROWN’S OFFICE FOR “LYING” AND “MISLEADING” COURT IN MEDI-CAL PROVIDER  RATE CUT CASE  (photo of attorney lynn carman of medicaid defense fund)

(CLICK HERE TO VIEW 9 PAGE COURT ORDER – PDF FILE)

(CLICK HERE TO VIEW CDCAN REPORT #325-2009 DECEMBER 22, 2009 FOR DETAILS ON THE COURT DECISION) 

 
 (POSTED NOVEMBER 24, 2009)  ELLIS V. WAGNER COURT CASE UPDATE
State Superior Court Judge Frank Roesch Grants Temporary Restraining Order That Stops Temporarily the State
from implementing In-Home Supportive Services Felony Convictions Worker Requirements (until the
next scheduled court hearing on this case, currently set for January 29, 2010)
(click here to view 7 page CDCAN Report #316-2009 November 25, 2009 reporting on the case) (click here to view CDCAN Report #317-2009 )
(click here to view 1 page temporary restraining order pdf file) and 2 page detailed "writ of mandate" (click here to view)
(click here to view 7 page original lawsuit pdf file originally filed on November 12, 2009)
(click here to view attachments 29 page pdf file that was filed with original lawsuit on November 12, 2009 - includes copy of All County Letter and provider forms)
(POSTED NOVEMBER 4, 2009) - NOVEMBER 5, 2009 ASSEMBLY BUDGET COMMITTEE 
INFORMATIONAL HEARING ON IN-HOME SUPPORTIVE SERVICES (IHSS) PROGRAM CHANGES
09:00 AM - State Capitol - Room 4202
(note - this is a follow-up to the October 28, 2009 informational hearing held by the
Assembly Budget Committee (with the Senate Budget Subcommittee #3 on Health and Human
Services)
AGENDA
Second Oversight Hearing on Implementation of Recent Changes in the 
In-Home Supportive Services Program 
Topic:	Status of November 1 Implementation - 
Continuing Concerns Regarding Consumer Impact and County Liability
Kim Belshé, Secretary, California Health and Human Services Agency (Invited) 
John Wagner, Director, California Department of Social Services (Invited) 
Frank Mecca, Executive Director, County Welfare Directors Association of California 
Maggie Dee Dowling, IHSS Consumer, Contra Costa County (By Phone) 
Deborah Doctor, Legislative Advocate, Disability Rights California (formerly PAI)
(CLICK HERE TO VIEW 7 PAGE REVISED BACKGROUND PAPER INCLUDING DEPARTMENT OF SOCIAL SERVICES RESPONSE)
(CLICK HERE TO VIEW 2 PAGE TABLE OF NOTICES, LETTERS SENT BY DEPT OF SOCIAL SERVICES PER ABx4 4 IHSS CUTS)
(CLICK HERE TO VIEW 4 PAGE LETTER FROM DEPT OF SOCIAL SERVICES DIRECTOR TO ASSEMBLY BUDGET COMMITTEE CHAIR)
(CLICK HERE TO VIEW 6 PAGE PDF CDCAN REPORT #305-2009 ON HEARING AND OLMSTEAD MEETING)
(POSTED NOVEMBER 4, 2009) NOVEMBER 5, 2009 OLMSTEAD ADVISORY COMMITTEE MEETING
THURSDAY - 10:00 AM to 4:00 PM at the Department of Rehabilitation Building - Room 242, 721 Capitol Mall, Sacramento, CA 95814
Toll-Free Call In Number:  1-888-232-0362  Passcode:  785453
(CLICK HERE TO VIEW 2 PAGE AGENDA)  or see below:
OLMSTEAD ADVISORY COMMITTEE AGENDA 
(public comment time between each item)
1.  Welcome and Introductory Remarks:  Brenda Premo, Committee Chair 
2.  Secretary's Update: Secretary Kim Belshe
3.  Data Subcommittee: Budget Impacts and Data Needs
Members will discuss concepts for studying the Olmstead-related impacts associated with reductions in the Budget Act of 2009. 
4.  Legislative Discussion
Members will review legislation that has been introduced with Olmstead 	implications. Dave Lucas, Washington D.C. Office Representative will also be available to discuss issues of interest at the federal level.
5.  Working Lunch: Discussion of Workgroups and Olmstead Priorities
Members will discuss methods to advance recommended priorities of the Olmstead Advisory Committee through workgroups and initiative advisory 	capacity
6.  Factors in Nursing Facility Transition 					            
Kate Wilber and Kathryn Thomas will present a study of factors that increase the likelihood for individuals transitioning to the community after having 90-day and longer residence in nursing facilities. 
7.  Medi-Cal Hospital Waiver Renewal							    
The Department of Health Care Services (DHCS) is requesting input from members on the Concept Paper for California's proposed section 1115 Medicaid waiver. This waiver presents the best opportunity for advancing the goals of ABx4 6 to (1) strengthen California's healthcare safety net; (2) maximize opportunities to reduce the number of uninsured individuals; (3) increase federal participation; (4) promote long-term, efficient and effective use of state and local funds; (5) improve healthcare quality and outcomes; and (6) promote home and community-based care. 
DHCS will review the concept and review major points from the public discussion being held on November 2. Information about that meeting can be accessed via the following link.
http://www.dhcs.ca.gov/provgovpart/Documents/Waiver%20Renewal/Director%20Message10-19-09.pdf
8.  Newly Funded Olmstead Initiatives 						    
Members will hear from panelists about recently-funded home and community based service initiatives. The Department of Rehabilitation has announced their intent to award roughly $650,000 through ARRA in support of Olmstead initiatives for education and awareness, technical assistance and training, and peer mentoring programs. The State Independent Living Council was recently awarded an Aging and Disability Resource Center (ADRC) grant.  And as previously reported, DHCS was awarded a Hospital to Home/ADRC Enhancement grant. The OAC has members on several project advisory committees, but the committee as a whole can also serve to apply their perspective and collective expertise to related projects while being updated on progress and project outputs. We would also like input on ways to keep these initiatives coordinated to maximize outcomes. 
9.  California Community Choices
The report is in final stages of review and the Choices project Advisory Committee will be prioritizing recommendations from this report.  The OAC might also offer prioritization of the Study's recommendations relative to advancing existing Olmstead initiatives and workgroup efforts. An upcoming briefing session will be discussed as well as a survey process to garner your input.
10. Closing Remarks				
In consideration of attendees who are sensitive to environmental odors created by chemicals and perfumes, please restrict the use of fragrances at this meeting.  If disability-related accommodations are required for your attendance or you need materials in alternate formats, please contact Megan Juring at (916) 654-0662, TTY (916) 558-5807, or at mjuring@chhs.ca.gov at least seven (7) days prior to the meeting date.  
Please note:  The order in which the agenda items are considered may be subject to change. Opportunities for public comment will be provided throughout the agenda.		


 (POSTED NOVEMBER 4, 2009 12:19 AM)  SB 69 IHSS BILL FAILS PASSAGE
IN THE STATE SENATE - FALLS 4 VOTES SHORT OF PASSAGE
The State Senate, after recessing for over 8 hours, reconvened its floor session at 11:35 PM, and 
at midnight took a final vote on SB 69, with 23 votes in favor and 12 votes opposed and 5 members 
not voting or absent.  The bill -  which passed late Monday evening the Assembly by a vote of 68 to 0,
with support from Assembly Democrats and Republicans, would have delayed the November 1st
implementation of several new requirements for In-Home Supportive Services (IHSS) workers.  
No further action on the bill is expected at this point - and it is not certain what the Legislature, or 
what the counties and advocates will do next.  Both county officials, disability and senior advocates
across the state said "chaos" and "panic and confusion" would grow worse with counties unable to
comply with the new requirements.  Counties have said the state has failed to provide in time needed
direction, guidance, answers to problems and questions, translated materials, funding for staffing
to implement the new requirements by the November 1st date.  (see county letters to the State below)
CDCAN VOTE RECORD REPORT - SB 69 (FINAL VOTE)
STATE SENATE FLOOR VOTE 11/04/09: PASS AS AMENDED (AGREE OR CONCUR IN ASSEMBLY AMENDMENTS) 
VOTE NEEDED TO PASS:  27  
VOTING YES - 23 TOTAL:
SENATE DEMOCRATS (23):  Elaine Alquist, Ronald Calderon, Gil Cedillo, Ellen Corbett, Mark DeSaulnier, Denise Ducheny, Dean Florez, Loni Hancock, Christine Kehoe, Mark Leno, Carol Liu, Alan Lowenthal, Gloria Negrete McLeod, Alex Padilla, Fran Pavley, Curren Price Jr., Gloria Romero, Joe Simitian, Darrell Steinberg (Senate President Pro Tem), Patricia Wiggins, Lois Wolk, Roderick Wright, and Leland Yee.  
SENATE REPUBLICANS (0): ***none***
VOTING NO - 12 TOTAL:
SENATE DEMOCRATS (0): ***none***
SENATE REPUBLICANS (12):  Roy Ashburn, John Benoit, Dave Cogdill, Dave Cox, Jeff Denham, Bob Dutton, Dennis Hollingsworth (Senate Republican Leader), Bob Huff, Abel Maldonado, Tony Strickland, Mimi Walters and Mark Wyland
NOT VOTING, ABSTAIN OR ABSENT
SENATE DEMOCRATS (2):  Lou Correa and Jenny Oropeza 
SENATE REPUBLICANS (3): Sam Aanestad , Tom Harman, and George Runner
(POSTED NOVEMBER 3, 2009)  LATEST ON IHSS WORKER (PROVIDER) REQUIREMENTS
4 PAGE PDF COPY OF SB 69 AS AMENDED AND PASSED BY ASSEMBLY 11/02/09
HTML COPY OF SB 69 AS AMENDED AND PASSED BY ASSEMBLY 11/02/09
ASSEMBLY PASSES MONDAY EVENING AT 10:30 PM SB 69 BY VOTE OF
60 TO 0 - BILL WOULD DELAY NOVEMBER 1st IMPLEMENTATION OF NEW REQUIREMENTS FOR
IN-HOME SUPPORTIVE SERVICES (IHSS) WORKERS.  WINS SUPPORT OF ASSEMBLY 
REPUBLICANS INCLUDING REPUBLICAN LEADER SAM BLAKESLEE OF SAN LUIS OBISPO.
STATE SENATE WILL TAKE UP BILL PROBABLY ON TUESDAY MORNING WHEN THEY 
RECONVENE AT 11:30 AM AFTER AN ALL NIGHT SESSION LARGELY DEALING WITH THE
STATE'S WATER CRISIS.  
ASSEMBLYMEMBER NOREEN EVANS (DEMOCRAT - SANTA ROSA) INTRODUCED THE 
AMENDMENTS TO SB 69 ON THE ASSEMBLY FLOOR JUST BEFORE 10:30 PM MONDAY
EVENING.  THERE WAS NO OPPOSITION TO THE AMENDMENTS OR TO THE BILL.  
SEE CDCAN REPORTS ISSUED MONDAY EVENING FOR DETAILS
More letters - including from Santa Clara County - to the State regarding concerns and problems in
Implementing the IHSS worker requirements
(CLICK HERE TO VIEW OR DOWNLOAD VARIOUS LETTERS FROM COUNTIES - PDF FILES)

(POSTED OCTOBER 27, 2009) AGENDA FOR OCTOBER 28, 2009  JOINT INFORMATIONAL
HEARING OF THE ASSEMBLY BUDGET COMMITTEE AND SENATE BUDGET SUBCOMMITTEE #3
ON HEALTH AND HUMAN SERVICES FOCUSING ON IHSS

Informational hearing (no action or vote was taken) was was held October 28, 2009.
Informational hearing focused on implementation of recent In-Home Supportive Services budget cuts
and budget related program changes, including new requirements for IHSS workers (providers) for 
background checks and fingerprinting.  
(CLICK HERE TO VIEW OR DOWNLOAD 1 PAGE AGENDA PDF FILE)
(CLICK HERE TO VIEW OR DOWNLOAD 10 PAGE HEARING BACKGROUND DOCUMENT PDF FILE)

(POSTED OCTOBER 22, 2009) AUDIO RECORDING 
OF ENTIRE OCTOBER 21, 2009 CDCAN TOWNHALL TELEMEETING 
ON IN-HOME SUPPORTIVE SERVICES (IHSS) PROGRAM CUTS,
NEW REQUIREMENTS AND UPDATE ON LAWSUITS
(CLICK HERE TO DOWNLOAD OR LISTEN TO AUDIO REAL MEDIA 10/21/09 TOWNHALL )
(CLICK HERE TO LISTEN TO AUDIO MP3 FILE 10/21/09 TOWNHALL)
Note: both files could take a few minutes to download 
(POSTED OCTOBER 22, 2009) - US 9th CIRCUIT COURT OF APPEALS 
DENIES MOTION TO STOP ELIMINATION OF THE 9 MEDI-CAL  OPTIONAL BENEFITS
The US 9th Circuit Court of Appeals late this afternoon issued a decision that denied a motion 
by attorneys representing Medi-Cal recipients and advocacy organizations to require the Schwarzenegger 
Administration to stop the budget reduction that eliminated, as of July 1, 2009, 9 Medi-Cal optional benefits
 for adults, including adult dental and to restore those services.  The decision came after a 30 minute hearing 
October 22, 2009 (Thursday morning). 
The court's decision upholds a lower federal district court judge who, in August, declined to issue an injunction 
to stop the elimination of those 9 Medi-Cal benefits - called "optional" because the federal government does not
require the states to provide those services. 
The federal lawsuit - Gray Panthers of San Francisco, et. al v. Arnold Schwarznegger, et al. - was filed last August 
by the Medicaid Defense Fund on behalf of individual Medi-Cal recipients including people with disabilities and low 
income seniors impacted directly by the budget reduction.  
As of July 1, 2009, Medi-Cal will no longer pay for the following "optional benefits" and services for most adults in the 
Medi-Cal program (21 years or older) living in the community but not in nursing or health facilities.  (There are however 
certain important exceptions ):
Adult Dental services, Speech therapy services, Podiatric services, Audiology services, Chiropractic services, Acupuncture services,
Optometric and optician services (ophthalmology, which are doctor services for a person's  eyes, will still continue to be covered),
Psychology services (psychiatry services, and all services through county mental health programs will continued to be covered),
Incontinence creams and washes
 
FEDERAL JUDGE STOPS IHSS CUTS
ISSUES PRELIMINARY INJUNCTION
Photo of Loretta Stevens speaking to crowd outside Federal Courthouse in Oakland October 19, 2009 (Photo by Marty Omoto)OAKLAND, CALIF (CDCAN) [Updated 10/19/09 12:10 PM  (Pacific Time)- Federal 
District Court Judge Claudia Wilken in Oakland blocked the state from implementing 
cuts to eligibility and services under the In-Home Supportive Services (IHSS) program, 
granting a preliminary injunction requested by attorneys representing persons who 
receive In-Home Supportive Services, saying from the bench that substantial harm, 
damage and injury which would result if the cuts went forward. 
The judge's order represented a sweeping major victory for advocates for persons with
Disabilities, mental health needs, the blind, low income seniors, their families, IHSS
Workers and advocacy groups.  
The judge's order blocks the State from implementing major cuts to eligibility based on a 
person's "functional index score" and reductions in domestic and related services based on a 
person's "functional index rankings".  
Judge Wilken said that the State's use of the "functional index rankings" and "functional
index scores" were clearly not based on need, that essential services could be withdrawn 
arbitrarily, and that "people could lose something irreplaceable - the ability to remain 
safely in their homes."
Photo by Marty Omoto of crowd outside federal court building Oct 19, 2009 before hearing on IHSS budget cutsThe judge issued her injunction that stopped the cuts from going forward as scheduled 
Because she believed that the plaintiffs - the persons with disabilities and others who
filed the lawsuit were likely to win in a the trial that the cuts to services under IHSS using 
the "functional index score" and "functional index rankings" as the basis to make cuts to
eligibility and domestic and related services violated federal law.  The judge denied a request
(motion) from the State to "stay" (delay effect date of her injunction) until her ruling can 
be appealed ("staying" her injunction would have allowed the cuts to go forward until the case
could be heard in the US 9th Circuit Court of Appeals) 
The judge issued her ruling from the bench from a two hour hearing this morning.  
More details later today. 
 
POSTED OCTOBER 15, 2009) UPDATE ON IN-HOME SUPPORTIVE SERVICES
(IHSS) FEDERAL LAWSUIT FILED IN FEDERAL DISTRICT COURT IN OAKLAND
TEMPORARY RESTRAINING ORDER: Federal District Court Judge Claudia Wilken issued 
on October 14, a court order that temporarily stops until the judge can make a decision, 
the State (the Department of Social Services) from  issuing "notices of action" to persons 
receiving  In-Home Supportive Services (IHSS) on the  cuts that use "functional index scores" 
and  "functional index rankings" to determine eligibility for services under IHSS.  
This does not mean that the judge will rule in favor of the lawsuit to stop the IHSS cuts -
it only means that the judge does not want the state to send out notices to IHSS
recipients until she has made a decision on the case whether to stop or delay the cuts.
(CLICK HERE TO VIEW OR DOWNLOAD 1 PAGE PDF FILE OF THE ORDER)
Judge's preliminary injunction issued October 19, stopping the IHSS
cuts replaces this temporary restraining order.
 When a judge issues such an order - called a preliminary 
injunction - it basically means that the court believes that the lawsuit would likely win or
prevail if it went to trial.  The other side - in this case the State - can (and is certain to 
do so) file an appeal to the next higher court - the US 9th Circuit Court of Appeals (which
is the court just below the US Supreme Court) to ask that court to overturn the judge's
ruling. 
The motion comes from a federal lawsuit filed on October 1, 2009
 (V.L. v. John Wagner, case number C-09-4668)   
(CLICK HERE TO VIEW OR DOWNLOAD ENTIRE 43 PAGE PDF FILE)
(POSTED OCTOBER 8, 2009) - AUDIO RECORDING 
10/07/09 CDCAN TOWNHALL TELEMEETING ON IHSS BUDGET REDUCTIONS
Note: this townhall telemeeting was scheduled two weeks prior to October 7, with 
two officials from the Schwarzenegger Administration - Eva Lopez, deputy director 
and Eileen Carroll, bureau chief - of the Adult Programs Division of the Department
of Social Services, the state agency that oversees the In-Home Supportive Services
program (the counties administer the program locally).  Both were to provide updates
and answer questions regarding how the State was going to implement major budget
cuts and policy changes to the In-Home Supportive Services program. Two of those
changes would have major impact on over 136,000 children and adults with disabilities,
mental health needs, the blind and seniors, who could lose all of their services under
IHSS or some or all of their domestic and related services under the program.  
Less than 40 minutes before the start of the townhall telemeeting, CDCAN was 
notified by Eva Lopez that she - and Eileen Carroll, would have to back out due 
because legal counsel said they could not talk about "any changes to IHSS".  
Hundreds of people with disabilities, mental health needs, the blind and seniors, their 
families, community organizations and advocates were on the townhall as it was too
late too send out any cancellation notice.  In the 7 years of townhalls this has never happened before.
The townhall telemeeting began at 1 PM with the announcement that the two state
Officials had backed out at the last minute.  Before closing the townhall, which still
had to be paid for, several comments were taken from the audience. 
(CLICK HERE TO LISTEN TO AUDIO RECORDING - MP3 FILE - OF THE 10/07/09 TOWNHALL)
(CLICK HERE TO LISTEN TO REAL MEDIA FILE VERSION OF 10/07/09 TOWNHALL)
NEW!  (POSTED OCTOBER 7, 2009) - LATEST IN-HOME SUPPORTIVE SERVICES (IHSS)
"ALL COUNTY LETTERS" AND "ALL COUNTY INFORMATION NOTICES"  IMPLEMENTING
IHSS BUDGET REDUCTIONS:
ALL COUNTY LETTER (ACL-09-56) IHSS BUDGET REDUCTIONS 
This is the All County Letter from the Department of Social Services that provides instructions
and guidance to the counties on how to implement the budget reduction that uses the 
"functional index scores" , that will determine (effective November 1st) whether a person is
eligible for any services under IHSS (there are some exemptions to this).  
The All County Letter also provides guidance and instructions to the counties on use of 
"functional index rankings" that will now be used, effective November 1, 2009, to determine 
eligibility for any specific domestic and related service under IHSS (there are exemptions to this) 
 (CLICK HERE TO VIEW OR DOWNLOAD THIS 33 PAGE ALL COUNTY LETTER)
ALL COUNTY INFORMATION NOTICE (I-69_09) ON IHSS PROVIDER ENROLLMENT REQUIREMENTS
AND IHSS PROVIDER ENROLLMENT FORM  [Note: be sure to look at the All County Letter on this same
Subject - All County Letter 09-52)
(CLICK HERE TO VIEW THIS 6 PAGE ALL COUNTY INFORMATION NOTICE)
ALL COUNTY LETTER (ACL-09-52) IHSS PROVIDER (WORKER) ENROLLMENT REQUIREMENTS
AND IHSS PROVIDER ENROLLMENT FORM
(CLICK HERE TO VIEW OR DOWNLOAD THIS 27 PAGE ALL COUNTY LETTER)
ALL COUNTY LETTER (ACL-09-47) ON ELIMINATION OF THE IHSS SHARE OF COST  BUY-OUT
PROGRAM
(CLICK HERE TO VIEW OR DOWNLOAD THIS 7 PAGE ALL COUNTY LETTER)
NEW! (POSTED OCTOBER 1, 2009) - LAWSUIT (COMPLAINT), V.I. VERSUS JOHN WAGNER 
(DIRECTOR OF THE DEPARTMENT OF SOCIAL SERVICES),  FILED TO STOP CUTS
TO IN-HOME SUPPORTIVE SERVICES (IHSS) THAT ARE SCHEDULED TO TAKE
EFFECT NOVEMBER 1, 2009 (PASSED AS PART OF THE REVISED 2009-2010
STATE BUDGET IN LATE JULY BY THE LEGISLATURE AND APPROVED BY THE
GOVERNOR).  LAWSUIT FILED IN FEDERAL DISTRICT COURT IN OAKLAND ON
OCTOBER 1, 2009.
(CLICK HERE TO VIEW OR DOWNLOAD ENTIRE 43 PAGE PDF FILE)
NEW! (POSTED SEPTEMBER 30, 2009) AUDIO RECORDING 
OF ENTIRE SEPTEMBER 23, 2009 CDCAN TOWNHALL TELEMEETING 
ON NEW "PREVENTION PROGRAM" AND EARLY START BUDGET
CUTS - FEATURING DEPT OF DEVELOPMENTAL SERVICES DEPUTY
DIRECTOR OF COMMUNITY SERVICES AND SUPPORTS DIVISION
JULIA MULLEN.
(CLICK HERE TO DOWNLOAD OR LISTEN TO 09/23/09 TOWNHALL) OR 
(CLICK HERE TO LISTEN TO AUDIO MP3 FILE - COULD TAKE A FEW MINUTES TO DOWNLOAD)
NEW! (POSTED SEPTEMBER 30, 2009) AUDIO RECORDING 
OF ENTIRE SEPTEMBER 01, 2009 CDCAN TOWNHALL TELEMEETING 
ON DEVELOPMENTAL SERVICES (REGIONAL CENTERS) BUDGET
CUTS & UPDATES FEATURING DEPT OF DEVELOPMENTAL SERVICES 
DIRECTOR TERRI DELGADILLO AND OTHER SENIOR DEPARTMENT
OFFICIALS
(CLICK HERE TO DOWNLOAD OR LISTEN TO 09/0109 TOWNHALL)
(CLICK HERE TO LISTEN TO AUDIO MP3 FILE - COULD TAKE A FEW MINUTES TO DOWNLOAD)
NEW! (POSTED SEPTEMBER 29, 2009) - A SPECIAL COMMISSION FORMED LATE LAST YEAR WITH
APPOINTEES OF THE GOVERNOR AND DEMOCRATIC LEGISLATIVE LEADERS - ISSUED TODAY 
ITS FINAL REPORT CONTAINING RECOMMENDATIONS ON CHANGES  TO CALIFORNIA'S TAX SYSTEM.
9 OF THE 14 COMMISSION MEMBERS VOTED FOR THE RELEASING THE REPORT RECOMMENDATIONS.
THE GOVERNOR TODAY ISSUED A PROCLAMATION CALLING THE LEGISLATURE BACK INTO SPECIAL
SESSION TO REVIEW THE RECCOMENDATIONS.  LEGISLATIVE LEADERS TODAY SAID THAT THE 
ASSEMBLY AND STATE SENATE REVENUE AND TAXATION COMMITTEES WILL SOON HOLD PUBLIC
HEARINGS ON THE PROPOSAL.  
(CLICK HERE TO VIEW OR DOWNLOAD THE 452 PAGE REPORT (PDF FILE) 
NEW! - POSTED SEPTEMBER 18, 2009) - DRAFT ALL COUNTY LETTER (NOTICES TO COUNTIES AND 
TO OTHER PUBLIC AGENCIES AND GROUPS) ON IMPLEMENTATION OF IN-HOME SUPPORTIVE 
SERVICES (IHSS) CUTS THAT IS SET TO TAKE EFFECT NOVEMBER 1, 2009
(CLICK HERE TO VIEW OR DOWNLOAD 34 PAGE DRAFT ALL COUNTY LETTER)
ALSO POSTED-  REVISED DRAFT ALL COUNTY LETTER COVERING THE IN-HOME SUPPORTIVE
SERVICES WORKER (PROVIDER) ENROLLMENT FORM. 
(CLICK HERE TO VIEW OR DOWNLOAD 31 PAGE DRAFT ALL COUNTY LETTER)
(POSTED SEPTEMBER 14, 2009)  FINAL PREVENTION PROGRAM POLICES 
AND PROCEDURES FROM THE DEPARTMENT OF DEVELOPMENTAL SERVICES
(CLICK TO VIEW OR DOWNLOAD THIS 12 PAGE PDF FILE)
(POSTED SEPTEMBER 14, 2009)  FINAL REVISED MANDATORY UNIFORM
HOLIDAY SCHEDULE FROM THE DEPARTMENT OF DEVELOPMENTAL SERVICES
(CLICK TO VIEW OR DOWNLOAD THIS 2 PAGE PDF FILE)
(POSTED SEPTEMBER 10, 2009)  FEDERAL JUDGE'S ORDER BLOCKING
ADULT DAY HEALTH SERVICES BUDGET CUT PASSED IN JULY 2009 IN ABx4 5
(CLICK HERE TO VIEW OR DOWNLOAD 24 PAGE ORDER)
(POSTED SEPTEMBER 2, 2009) - DRAFT POLICIES AND PROCEDURES 
THAT OUTLINE NEW "PREVENTION PROGRAM" FOR ELIGIBLE AT-RISK BABIES. 
(CLICK HERE TO VIEW OR DOWNLOAD THE 10 PAGE PDF FILE)
 (POSTED AUGUST 11, 2009)  -- LAWSUIT FILED TODAY IN SAN FRANCISCO
SUPERIOR COURT (STATE COURT) BY ATTORNEYS REPRESENTING STATE SENATE
PRESIDENT DARRELL STEINBERG (DEMOCRAT - SACRAMENTO) TO BLOCK AND 
REVERSE THE GOVERNOR'S LINE ITEM VETOES MADE JULY 28TH TO THE REVISED
BUDGET BILL (ABx4 1).  (CLICK HERE TO VIEW OR DOWNLOAD 31 PAGE LAWSUIT)
(POSTED AUGUST 5, 2009)  CALIFORNIA LEGISLATURE'S LEGAL COUNSEL 
(LEGISLATIVE COUNSEL BUREAU) OPINION THAT GOVERNOR SCHWARZENEGGER 
EXCEEDED HIS  AUTHORITY UNDER STATE CONSTITUTION BY USING LINE ITEM 
VETOES ON ABx4 1 - THE REVISED BUDGET BILL.  HOWEVER LEGISLATIVE COUNSEL'S 
OPINION IS NOT BINDING ON ANYONE.
(CLICK HERE TO VIEW OR DOWNLOAD 4 PAGE OPINION)
(POSTED JULY 27, 2009)  COPIES OF BUDGET TRAILER BILLS 
PASSED BY ASSEMBLY AND STATE SENATE ON JULY 23-24, 2009 & 
SENT TO GOVERNOR IMPACTING PEOPLE WITH DISABILITIES, MENTAL 
HEALTH NEEDS, THE BLIND, SENIORS, LOW INCOME FAMILIES, 
COMMUNITY ORGANIZATIONS AND WORKERS WHO PROVIDE 
SUPPORTS AND SERVICES.
(CLICK HERE TO VIEW PAGE WITH BILLS)
(POSTED JULY 27, 2009)  FEDERAL DISTRICT COURT JUDGE CLAUDIA WILKEN ORDER
ISSUED JULY 24, 2009 STOPPING FRESNO & SANTA BARBARA COUNTIES FROM CUTTING THEIR 
IN-HOME SUPPORTIVE SERVICES WORKER WAGES AND BENEFITS UNTIL THEY RESUBMIT IN 
WRITING A NEW REQUEST TO THE STATE BASED ON A REASON OTHER THAN THE 2009-2010 STATE
BUDGET CUT IN IHSS STATE FUNDING FOR IHSS WORKER WAGES.  ALSO ORDERS STATE TO 
MAKE SURE IHSS WORKERS IN THOSE COUNTIES ARE PAID THE FULL WAGES AS IT WAS BEFORE 
JULY 1, 2009   (CLICK HERE TO VIEW OR DOWNLOAD ENTIRE 8 PAGE ORDER)
(POSTED JULY 17, 2009) SECOND CONTEMPT MOTION AGAINST THE STATE (SCHWARZENEGGER ADMINISTRATION) 
FILED BY ATTORNEYS FOR SEIU ON BEHALF OF IN-HOME SUPPORTIVE SERVICES (IHSS)
WORKERS & PERSONS RECEIVING IHSS, IN FEDERAL DISTRICT COURT IN OAKLAND.
[CLICK HERE TO VIEW OR DOWNLOAD 18 PAGE PDF FILE]
 (POSTED JULY 14, 2009) FEDERAL DISTRICT COURT JUDGE 
CLAUDIA WILKEN'S JULY 14th ORDER CLARIFYING JUNE 26th 
INJUNCTION THAT BLOCKS STATE FROM IMPLEMENTING STATE 
REDUCTION FOR IHSS WORKER WAGES THAT WAS SCHEDULED TO 
GO INTO EFFECT JULY 1, 2009  
[CLICK HERE TO VIEW OR DOWNLOAD 6 PAGE PDF FILE]
(POSTED JULY 9, 2009) - US 9TH CIRCUIT COURT OF APPEALS DECISION 
ON MEDI-CAL PROVIDER 10% RATE REDUCTION:
UPHOLDS LOWER FEDERAL DISTRICT COURT RULING LAST YEAR THAT BLOCKED THOSE CUTS FOR MOST MEDI-CAL PROVIDERS  
(CLICK HERE TO VIEW OR DOWNLOAD 39 PAGE OPINION)
 (POSTED JULY 2, 2009) - 
GOVERNOR'S "JULY REVISED BUDGET" PROPOSALS:
NO ADDITIONAL CUTS  TO HEALTH & HUMAN SERVICES
PROPOSED MAJOR CUTS TO EDUCATION 
(CLICK HERE TO VIEW OR DOWNLOAD 2 PAGE PDF FILE
(POSTED JUNE 30, 2009):  IN-HOME SUPPORTIVE SERVICES (IHSS) WORKER WAGE LAWSUIT: 
FEDERAL DISTRICT COURT JUDGE'S 12 PAGE WRITTEN ORDER ISSUED JUNE 26 THAT BLOCKS THE STATE FROM IMPLEMENTING 
REDUCTION IN STATE FUNDING (PARTICIPATION) TO $9.50 PER HOUR   
(CLICK HERE TO VIEW OR DOWNLOAD 12 PAGE PDF FILE)

JUNE 28, 2009 – REVISED BUDGET SPENDING CUTS BILL AND 10 BUDGET TRAILER BILLS AS PASSED BY THE ASSEMBLY JUNE 28, 2009  (CLICK HERE)

JUNE 25, 2009 - MAJOR VICTORY FOR IHSS WORKERS & PEOPLE WHO RECEIVE SERVICES UNDER IHSS: US DISTRICT COURT JUDGE CLAUDIA WILKEN'S "MINUTE ORDER" THAT INDICATES SHE WILL ISSUE A WRITTEN ORDER FORMALLY BLOCKING THE JULY 1, 2009 REDUCTION IN MATCHING STATE FUNDS FOR IN-HOME SUPPORTIVE SERVICES (IHSS) WORKER WAGES TO A MAXIMUM OF $9.50 PER HOUR(DOWN FROM MAXIMUM OF $12.10).  (CLICK HERE TO VIEW OR DOWNLOAD)

JUNE 18, 2009 - IN-HOME SUPPORTIVE SERVICES (IHSS):  ALL COUNTY LETTER (ACL) FROM DEPARTMENT OF SOCIAL SERVICES TO THE COUNTIES & OTHERS REGARDING IHSS   -  Includes an attachment, the “Annotated Assessment Criteria” to the Department of Social Services’ All County Letter (ACL), sent out May 4, 2007 (ACL 0634E2)  which describes each functional rank in more detail as it applies to a person’s capacity to perform certain types of tasks, as specified in state Manual of Policies and Procedures (MPP) Section 30-757  (CLICK HERE TO VIEW ACL 06-34E2)

 AS OF JUNE 16, 2009 - IN-HOME SUPPORTIVE SERVICES (IHSS) PROPOSED “PLACEHOLDER” TRAILER BILL LANGUAGE – “placeholder” means the language itself has not yet been given final approval but was approved by the Budget Conference Committee in concept. It is essentially an early draft proposed version – but it is meant to reflect the direction and intent of what the Budget Conference Committee approved on June 16, 2009.  (CLICK HERE TO VIEW 06/16/09 VERSION) 

AS OF JUNE 18, 2009  - PROPOSED BUDGET TRAILER BILL LANGUAGE IMPACTING REGIONAL CENTER FUNDED SERVICES FOR THOUSANDS OF INFANTS, CHILDREN & ADULTS WITH DEVELOPMENTAL DISABILITIES

Proposed Early Start trailer bill language (5 pages) includes major changes in eligibility and reductions – some previously proposed in May, and also a separate 3 page addendum to the Early Start trailer bill language.    (CLICK HERE TO VIEW 06/17/09 VERSION)    (CLICK HERE TO VIEW 06/17/09 VERSION-ADDENDUM TO 6/17/09 VERSION)   (CLICK HERE TO VIEW 06/12/09 VERSION)

Individual Choice Model trailer bill language would suspend regional center funding (if and when “Individual Choice Model” is implemented) for several services, effective as early as July 1, educational services for children ages 3 to 17, non-medical therapies including but not limited to specialized recreation, art, dance and music; social recreation services except those vendored as community based day programs; camping and associated travel services.   (CLICK HERE TO VIEW 06/16/09 VERSION(CLICK HERE TO VIEW 06/12/09  VERSION)

Proposed Standards on Regional Center spending trailer bill language (called “general standards”) (3 pages) and includes reductions that would result from use of services from the “least costly provider including transportation”.  (CLICK HERE TO VIEW 06/16/09 VERSION (CLICK HERE TO VIEW 06/12/09 VERSION)

Respite trailer bill language (2 pages) would impose new restrictions and cuts.    (CLICK HERE TO VIEW 06/16/09 VERSION(CLICK HERE TO VIEW 06/12/09 VERSION)

Behavioral Intervention Services trailer bill language (4 pages) would implement major changes and cuts to behavioral intervention services for young children with developmental disabilities.   (CLICK HERE TO VIEW 06/16/09 VERSION(CLICK HERE TO VIEW)

Proposed Residential trailer bill language (1 page) proposing limits on 16 bed facilities and other changes.(CLICK HERE TO VIEW 06/16/09 VERSION (CLICK HERE TO VIEW 06/12/09 VERSION)

Proposed Medicaid trailer bill (1 page) – this proposal would seek expansion of federal matching funds for persons receiving regional center services not currently covered by Medi-Cal or a Medicaid waiver.  This is the only proposal that does not – in its current form – propose reductions.   (CLICK HERE TO VIEW 06/17/09 VERSION)  (CLICK HERE TO VIEW 06/12/09 VERSION)

AS OF JUNE 7, 2009:  BUDGET CONFERENCE COMMITTEE AGENDA FOR HUMAN SERVICES

(Covers In-Home Supportive Services (IHSS), SSI/SSP (Supplemental Security Income/State Supplemental Payment) grants, CAPI (Cash Assistance Program for Immigrants), CalWORKS (state’s welfare to work program), and other programs under the Department of Social Services; several programs under the Department of Aging including Multipurpose Senior Services Program, and several community-based senior service programs – all proposed by the Governor for elimination. Originally scheduled to be heard on June 6th - no firm hearing date set, though it could be Wednesday June 10th.  (CLICK HERE TO VIEW OR DOWNLOAD)

AS OF JUNE 6, 2009:  15 PROPOSED DEPARTMENT OF HEALTH CARE SERVICES BUDGET RELATED (TRAILER BILLS) LANGUAGE (TO CHANGE STATE LAW IN ORDER TO IMPLEMENT GOVERNOR'S PROPOSALS   Note: Below are 15 of the Department of Health Care Services proposed budget related (trailer bill) language to be reviewed by the Budget Conference Committee in a hearing currently set for June 8, 2009, Monday, at 2:00 PM at the State Capitol in Room 4203.  Additional proposed trailer bill language will be presented by the Department at the Health Care Services on June 8. The Department of Health Care Services oversees the nation’s largest Medicaid program – called Medi-Cal in California See below for complete Budget Conference Committee Agenda on Health - and also 12 page excerpt of just the agenda items related to Department of Developmental Services (regional centers and developmental centers)

MEDI-CAL: INTERMEDIATE CARE FACILITIES/DEVELOPMENTALLY DISABLED-CONTINUOUS NURSING (ICF/DD-CN0 PILOT PROJECT (click for proposed budget related/trailer bill language for Budget Conference Committee June 8, 2009)

MEDI-CAL: SPECIAL NEEDS TRUST ESTATE RECOVERY (click for proposed budget related/trailer bill language for Budget Conference Committee June 8, 2009)

IN-HOME SUPPORTIVE SERVICES (IHSS)PLUS MEDICAID WAIVER (click for proposed budget related/trailer bill language for Budget Conference Committee June 8, 2009)

MEDI-CAL: SOCIAL SECURITY NUMBER DATA MARCH FOR DEFICIT REDUCTION ACT IMPLEMENTATION (click for proposed budget related/trailer bill language for Budget Conference Committee June 8, 2009)

MEDI-CAL DRUGS: REQUIRE 340B PRICING FOR PERSONS ON MEDI-CAL (click for proposed budget related/trailer bill language for Budget Conference Committee June 8, 2009)

MEDI-CAL PHARMACY PROVIDERS:  ESTABLISH UPPER BILLING LIMITS (click for proposed budget related/trailer bill language for Budget Conference Committee June 8, 2009)

HIV/AIDS/CANCER DRUG REBATES (click for proposed budget related/trailer bill language for Budget Conference Committee June 8, 2009)

ROLLBACK OF FAMILY PLANNING RATE (click for proposed budget related/trailer bill language for Budget Conference Committee June 8, 2009)

MEDI-CAL PROVIDER: REDUCE PAYMENTS BY 10% TO PRIVATE HOSPITALS (click for proposed budget related/trailer bill language for Budget Conference Committee June 8, 2009)

MEDI-CAL: ADULT DAY HEALTH CARE PROGRAM: REDUCE THIS PROGRAM (ONSITE TARS ONLY ) (click for proposed budget related/trailer bill language for Budget Conference Committee June 8, 2009)

MEDI-CAL: ADULT DAY HEALTH CARE PROGRAM: REDUCE THIS PROGRAM ( 3 DAY LIMIT AND ONSITE TARS) (click for proposed budget related/trailer bill language for Budget Conference Committee June 8, 2009)

MEDI-CAL: ADULT DAY HEALTH CENTERS PROGRAM - ELIMINATE THIS PROGRAM (click for proposed budget related/trailer bill language for Budget Conference Committee June 8, 2009)

MEDI-CAL ELIGIBILITY: REDUCTION OF SSI/SSP AND MEDI-CAL ELIGIBLITY CHANGES TO PRESERVE INCREASED FEDERAL MATCH UNDER THE AMERICAN RECOVERY AND REINVESTMENT ACT  (click for proposed budget related/trailer bill language for Budget Conference Committee June 8, 2009)

STATE ONLY PROGRAMS: PROPOSED ELIMINATION OF SEVERAL PROGRAMS AND RELATED SERVICES INCLUDING DIALYSIS AND PARENTAL HYPERALIMENTATION PROGRAMS. (click for proposed budget related/trailer bill language for Budget Conference Committee June 8, 2009)

SKILLED NURSING FACILITIES PROVIDERS: EXPAND REVENUE BASE TO FOR AB 1629 NURSING FACILITIES TO INCLUDE MEDICARE REVENUE (click for proposed budget related/trailer bill language for Budget Conference Committee June 8, 2009)

  MEDI-CAL NURSING HOME FACILITIES COST OF LIVING:  FREEZE RATES FOR AB 1629 FACILITIES & FOR NON-AB 1629 FACILITIEIS (click for proposed budget related/trailer bill language for Budget Conference Committee June 8, 2009)

NEW AS OF JUNE 5, 2009 – COMPLETE BUDGET CONFERENCE COMMITTEE AGENDA JUNE 5, 2009 COVERING HEALTH BUDGET ISSUES (includes Medi-Cal, Developmental Services, Mental Health) (CLICK HERE TO VIEW OR DOWNLOAD)  Note: the Budget Conference Committee will take up this budget issue on June 8, 2009, Monday at 2:00 PM at the State Capitol in Room 4203.  This was originally set to be heard on June 5.   

AS OF JUNE 5, 2009 – BUDGET CONFERENCE COMMITTEE AGENDA JUNE 5, 2009 COVERING DEVELOPMENTAL SERVICES – REGIONAL CENTERS & DEVELOPMENTAL CENTERS (UNDER DEPARTMENT OF DEVELOPMENTAL SERVICES) (CLICK HERE TO VIEW OR DOWNLOAD)    Note: the Budget Conference Committee will take up this budget issue on June 8, 2009, Monday at 2:00 PM at the State Capitol in Room 4203.  This was originally set to be heard on June 5.

 

AS OF JUNE 3, 2009:   BUDGET CONFERENCE COMMITTEE 46 PAGE AGENDA ON EDUCATION & HIGHER EDUCATION (JUNE 4-5 2009 HEARINGS)  (click here to download or view pdf file)

 

California Budget Crisis:

Budget Conference Committee Meets 6/5 Friday 1 PM

Focus on Higher Education and Child Care – Not Certain if Health Budget Issues Will Be Heard Today (June 5)

 

SACRAMENTO, CALIF  (CDCAN) [Updated 06/05/09  06:11 AM  (Pacific Time)  -  The Budget Conference Committee, chaired by Assemblymember Noreen Evans (Democrat – Santa Rosa), met for about two and half hours Thursday, adjourning just before 7 PM, and will reconvene today (June 5) at 1:30 PM, in the State Capitol, Room 4203.  The Budget Conference Committee at that time will continue on with two areas on their Thursday 46 page agenda that they were not able to get to:  higher education and child care.  [go to CDCAN website at www.cdcan.us for copy of the agenda, which also includes committee staff recommendations on some of the budget proposals]   

It is not certain at this point if the Budget Conference Committee will also later today focus on health issues (including Medi-Cal, regional centers, Healthy Families) as originally scheduled because of agenda change.  

The Budget Conference Committee did approve K-12 Education "for vote only" budget proposals as recommended by committee staff on largely non-controverisal issues.  None of those (one item dealing with adult education and another with a revised estimate of the state lottery funds that including a revised estimate on what the State Special Schools will reeive) have direct or major impact on children with disabiltieis or special needs.  The Budget Conference Committee did not take action yet on the higher education (including community college issues)

 yet, which it will review at 1:30 PM today.  Those issues include major proposed cuts to the community college Disabled Students Program and Services that impacts over 100,000 students with disabilities in the state's 110 community colleges.

 

This Round of Committee Hearings Focused on Details – And Some Actions

As reported yesterday, the Budget Conference Committee ended on Wednesday the public comment part of its hearing process on the Governor’s proposed budget reductions and will now focus hearing details in the next round of hearings. 

 

Since late Wednesday afternoon when the public comment part of the process ended, the Budget Conference Committee during this round of hearings, has taken several actions, though largely has not taken action on the more controversial budget proposals yet.  Any action by the Budget Conference Committee would still need final approval from by the entire State Senate and the Assembly – then approval from the Governor. 

 

This round of hearings also has included and will continue to include further details from the Governor’s Department of Finance and also more detailed analysis and recommendations from the Legislative Analyst Office, the office that reviews budget issues for the Legislature. 

 

The Legislature is looking at trying to pass revisions to the 2009-2010 State Budget – which the Legislature passed and the Governor signed in February four months early – in order to close a projected $24 billion shortfall, before July 1, 2009.

 

Budget Conference Committee Schedule Could Change

Because of the change in the agenda for Friday afternoon, it is not clear as of early Friday morning if the agenda for the rest of the day and for the weekend and Monday will remain the same or change. 

 

Originally, the hearings on today (June 5), Saturday and Monday will include hearing more details from the Schwarzenegger Administration on the Governor’s proposed cuts to a wide range of services and programs including Medi-Cal, regional centers (originally scheduled to be heard Friday);, In-Home Supportive Services, CalWORKS, SSI/SSP (originally scheduled for Saturday); local government budget issues (originally scheduled for Monday).  

 

Other hearings covering other issues will be announced – and the existing hearing schedule is subject to changes in dates, times and subject matter. 

 

No Public Comment For This Round of Hearings – But Letters Accepted

As previously reported, no public comment will be taken at these hearings – though the public can continue to send in letters to the Budget Conference Committee with comments, suggestions and concerns.  Persons can address letters to:

 

Assemblymember Noreen Evans, Chair

Budget Conference Committee

State Capitol

Sacramento , CA 95814

 

State Cash Flow Crisis Puts Enormous Pressure On Policymakers To Act Quickly

The July 1 deadline, which is the start of the state’s budget year, is much more critical this year than in past years because the state is facing an cash flow crisis in addition to the budget crisis.  That cash flow crisis – even more than the budget shortfall itself – is putting enormous pressure on the Legislature and Governor to act quickly. 

 

The state’s cash flow (meaning when revenues come in during the year) goes up and down through year.  When cash flow drops during certain times of the year, which is normal, the State is able to continue paying its bills – including payments on bonds and other loans - by using money from reserves or money it borrows with short term loans. 

 

This year the State’s has virtually no cash reserves to tap into and will be unable to borrow money through short term loans because investors will refuse to loan the State money until the budget crisis is resolved.   [While the issues are different – but linked.  In order to borrow the money needed to pay its bills, the State needs to resolve the budget crisis and show investors that there is a plan to close the $24 billion shortfall. That in turn means the Legislature and Governor need to have a plan passed and enacted to show that there is a plan in place to close the shortfall – which in turn will then give investors the confidence to lend the State money to pay its bills. ]

 

Unlike in past budget years, when the State Controller had funds to pay bills – but was not able to do so without a budget in place – this year there is a budget in place but no cash or funds to borrow to pay any bills. 

 

Unless the crisis is resolved, the State will not be able obtain short term loans that in turn provides the money to pay not only vendors and providers, but also what is owed on bonds and loans as required by law.  The failure of not paying money owed on bonds or loans – meaning the State defaulted on its loans and bonds -  is a situation that has never happened before at the State level and as one state official said would mean “fiscal disaster not only for California” and would have a “devastating tidal wave impact on the nation’s economy” . 

 

State Controller John Chiang, who is responsible for paying the state’s bills, warned the Legislature and Governor that action was within weeks of running out of money

 

BUDGET CONFERENCE  COMMITTEE HEARING SCHEDULE

Note:

·         Hearing dates, times, and subject matter can change at the last minute. 

·         “Upon call of the chair” means there is at the moment, no specific time yet that the committee will meet (the 9:30 AM posting is not current) and that the meeting time will be determined by the Budget Conference Committee chair – Assemblymember Noreen Evans. 

·         Persons can check for the hearing time by calling the Assembly Budget Committee office at 916-319-2099.

 

JUNE 5, 2009 - FRIDAY

BUDGET CONFERENCE COMMITTEE

TIME:   1:30 PM  (this could change – this was the time that the Budget Conference Committee chair announced at the end of the June 4th hearing last night)

WHERE:  State Capitol – Room 4203

WHAT:   Governor’s proposed reductions (and other changes) to Higher Education and child care.   It is not certain at this time whether the Budget Conference Committee will meet later today to cover health budget issues that was on its original Friday agenda.  Those health budget issues included the Governor’s proposed cuts to Medi-Cal, developmental services (regional centers), Healthy Families, Adult Day Health Centers and more. 

PUBLIC COMMENT TAKEN: No

CDCAN NOTE: This includes proposed cuts to community college including major cuts to Disabled Students Programs and Services that impact over 100,000 students with disabilities in the 110 community colleges and other categorical programs)

PRIORITY: VERY HIGH

 

JUNE 6, 2009 – SATURDAY

BUDGET CONFERENCE COMMITTEE

TIME:  Upon call of the committee chair

WHERE: State Capitol – Room 4203

WHAT:  Governor’s proposed reductions (and other changes) to Human Services budget related issues

PUBLIC COMMENT TAKEN: No

CDCAN NOTE:  The agenda and focus of this hearing could change as a result of changes that occurred on Thursday and Friday. 

As originally scheduled, this hearing on Saturday currently is likely include (subject to change)  the Governor’s proposed elimination of the CalWORKS program, the proposed elimination of the Cash Assistance Program for Immigrants (CAPI), major cuts and changes in eligibility to In-Home Supportive Services (IHSS), additional proposed cut to the SSI/SSP grant level, cuts to child welfare services, community care licensing and more.  However, this agenda could change because the committee was only able to act only on half its original Thursday agenda that focused on education and higher education (higher education issues and child care will be heard at 1:30 PM on Friday, June 5).

PRIORITY: VERY HIGH

 

JUNE 7, 2009 – SUNDAY

***No Budget Conference Committee hearing scheduled***

 

JUNE 8, 2009 – MONDAY

BUDGET CONFERENCE COMMITTEE

TIME:  Upon call of the committee chair

WHERE: State Capitol – Room 4203

WHAT:  Governor’s proposed reductions (and other changes) to local government budget related issues.  The agenda is subject to change especially with the changes that occurred on Thursday and Friday. 

PUBLIC COMMENT TAKEN: No. 

PRIORITY: HIGH

 

California Budget Crisis

May 7TH Senate Budget Subcommittee Agenda Released

Hearing Will Focus on Regional Center Budget Cuts

Big Crowd Expected For Hearing

 

SACRAMENTO, CALIF  (CDCAN) [Updated 05/06/09  09:55 AM  (Pacific Time)   -  The Senate Budget Subcommittee #3 on Health and Human Services agenda for its May 7th hearing on regional center budget cuts was released this morning.  The copy of the 35 page agenda (pdf file titled “SenateBudgetSub3AendaMay072009) can be viewed or downloaded from the CDCAN website(CLICK HERE)

 

A large crowd is expected to pack the hearing tomorrow, which begins at 09:30 AM or upon adjournment of the Senate floor session.  The hearing is at the State Capitol in Room 4203.

 

See separate CDCAN report for more details. 

California Budget Crisis

Department of Developmental Services Releases Budget Language   -  Impacts Several Regional Center Programs and Services   -  Senate Budget Panel Will Review “Trailer Bill” Language May 7th

Includes Changes in State Law To Achieve Over $100 Million In Reductions in State Spending For Regional Centers Beginning July 1, 2009

SACRAMENTO, CALIF  (CDCAN) [Updated 05/05/09  06:59 PM  (Pacific Time)  -  The Department of Developmental Services, which oversees the 21 non-profit regional centers and also state owned and operated developmental centers and two smaller health facilities, released early this evening budget related legislative language (referred to as “budget trailer bill” language)  that details proposed changes in state law to achieve over $100 million in reductions in state spending for several regional center funded services beginning July 1, 2009 through June 30, 2010. 

For a copy of the budget related legislative language titled “DDS REVISED TBL (MAY052009)”  CLICK HERE.

The $100 million reduction was previously approved as part of the 2009-2010 State Budget passed in February, four months early, but the details on how that reduction in state spending was left for the Department of Developmental Services to propose to the Legislature after April 1.  That amount does not include the loss of federal matching funds. 

The Senate Budget Subcommittee #3 on Health and Human Services, chaired by Sen. Mark Leno (Democrat – San Francisco) will review this budget language and the 15 proposals by the Department of Developmental Services that outline and detail how the cuts will achieve at least $100 million in reductions in state spending during the 2009-2010 State Budget year that begins July 1. 

That hearing is scheduled for May 7, Thursday morning, at 09:30 AM (or whenever the Senate floor session adjourns that morning), in the State Capitol in Room 4203.  [Note: CDCAN issued previously several action alerts urging people to attend this hearing. )

Regional centers coordinate community based services and supports for over 240,000 children and adults with developmental disabilities across the State. 

  California Budget Crisis Agenda for April 22 Assembly Budget Hearing - Focus on Regional Centers and Mental Health - Huge Crowds Expected To Pack Hearing Room

April 22 Protest March & Sidewalk Demonstration Will Focus on Those Cuts and Other Major Cuts Including IHSS, Medi-Cal, SSI/SSP, Mental Health, Senior Services That Impact People with Disabilities, Mental Health Needs, Seniors, Low Income Families, Workers and Providers

  SACRAMENTO, CA (CDCAN) [Updated 04/21/09  01:30 PM  (Pacific Time) ]  -   The Assembly Budget Subcommittee #1 on Health and Human Services released this afternoon its agenda for the April 22nd hearing that will focus on budget cuts to regional centers and also mental health budget issues.  The hearing is scheduled to start at 1:30 PM in the State Capitol in Room 4202.  For a complete official copy of the 29 page Assembly Budget Subcommittee April 22, 2009 hearing agenda from the CDCAN website (CLICK HERE)

  Hundreds of people with disabilities, mental health needs, seniors, low income families and workers, community organizations and providers are expected to march Wednesday morning at 11:00 AM from the west entrance of the Sacramento Convention Center to the State Capitol, protesting the budget cuts that advocates say violates basic civil rights protecting people with disabilities, mental health needs and seniors. 

  Many of those people are expected to also attend and pack the hearing room on April 22. 

  Assembly Subcommittee Agenda

As released this afternoon, the Assembly Budget Subcommittee on Health and Human Services agenda is as follows (public comments will follow each agenda item, though the subcommittee chair can change that.  Public comment – especially if there are large numbers of people who wish to testify, is usually limited to 1 or 2 minutes.  Additional comments can be submitted in writing to the chair, or submitted later to the subcommittee.  The outline of the hearing (with CDCAN notes) is listed below (copy of the entire 29 page hearing agenda can be downloaded or viewed at the CDCAN website  (CLICK HERE):

AGENDA  - SUBCOMMITTEE NO. 1 ON HEALTH AND HUMAN SERVICES

WEDNESDAY, APRIL 22, 2009  1:30 PM

STATE CAPITOL, ROOM 4202 (PLEASE NOTE ROOM CHANGE)

  VOTE-ONLY ITEMS

CDCAN Note:  These are considered routine issues and “for vote only” means the items here will not be discussed during the hearing.  Public comments normally aren’t taken at this part of the agenda, though the subcommittee chair can allow it. 

  BUDGET ITEM 4300

DEPARTMENT OF DEVELOPMENTAL SERVICES                     

Issue 1 Extend SB 962 Home Pilot and Evaluation – TBL (trailer bill language)

  BUDGET ITEM 4440

DEPARTMENT OF MENTAL HEALTH

Issue 2 April 1 Letter – MHSA (Mental Health Services Act) Funds (Issues 003 and 319)

  ITEMS TO BE HEARD

CDCAN Note: No final action will be taken on any of these items below.

  BUDGET ITEM 4300

DEPARTMENT OF DEVELOPMENTAL SERVICES                     

Issue 1 Budget Overview

Issue 2 Regional Center General Fund Reduction                 

CDCAN Note: this is the portion of the agenda that will contain the details of the various proposals to make changes to existing state laws to implement at least $100 million in state spending between July 1, 2009 and June 30, 2010

  BUDGET ITEM 4440

DEPARTMENT OF MENTAL HEALTH

Issue 1 Budget Overview

Issue 2 Mental Health Managed Care and DHCS (Department of Health Care Services) Spring Letter

Issue 3 Community Mental Health Fiscal Oversight and Related BCP (Budget Change Proposal)

Issue 4 Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program           

Issue 5 State Hospitals – Overview and Issues            25

  CDCAN NOTE: End of hearing (probably sometime after 5 PM depending on how many people testify and questions and comments from subcommittee members)

California Budget Crisis - ASSEMBLY BUDGET SUBCOMMITTEE MEETS APRIL 20TH  AT 4 PM ; FOCUS ON DEPARTMENT OF HEALTH CARE SERVICES ; MEDI-CAL OPTIONAL BENEFIT CUT NOT ON AGENDA ;' HEARING ON REGIONAL CENTERS, MENTAL HEALTH  4/20

Focus on Hearing Today Include Use by the Department of Health Care Services of “ All County Welfare Director Letters” Instead of Regulations – Also Review of Legislative Analyst Office Proposal of Medi-Cal Non-Emergency Medical Transportation Brokers

SACRAMENTO, CA (CDCAN) [Updated 04/20/09  08:55 AM  (Pacific Time) ]  -   The Assembly Budget Subcommittee #1 on Health and Human Services meets today (April 20) at 4:00 PM in the State Capitol in Room 127 (in the older part of the Capitol where the dome is located).   CLICK HERE TO SEE OR DOWNLOAD FULL AGENDA FROM THE CDCAN WEBSITE]

  Today’s (April 20th) hearing will focus on certain Department of Health Care Services budget issues, but will not hear the issue again today regarding the scheduled elimination of several Medi-Cal optional benefits including adult dental, incontinence creams and washes, podiatry and other services.  All items on the agenda were issues already passed and included in the 2009-2010 State Budget – approved 4 months early in February (the start of the state budget year is July 1) or issues that have been raised that neither house has acted on yet.  Many of the items however did not include details on how to implement a change or reduction.  The agenda items are as follows:

  APRIL 20, 2009 ASSEMBLY BUDGET SUBCOMMITTEE ON HEALTH AND HUMAN SERVICES AGENDA

  BUDGET ITEM 4260 DEPARTMENT OF HEALTH CARE SERVICES

ITEMS ON CONSENT

ISSUE 1  COUNTY ORGANIZED HEALTH SYSTEM EXPANSION

ISSUE 2  EXPANDED ACCESS TO PRIMARY CARE PROGRAM –SPRING

[DEPARTMENT OF FINANCE] LETTER

ISSUE 3  CALIFORNIA PRESCRIPTION DRUG DISCOUNT PROGRAM c-SPRING [DEPARTMENT OF FINANCE] LETTER

ITEMS TO BE HEARD

ISSUE 1  MAXIMUM ALLOWABLE INGREDIENT COSTS    

ISSUE 2  GENETICALLY HANDICAPPED PERSONS PROGRAM – CROWD OUT

ISSUE 3  GENETICALLY HANDICAPPED PERSONS PROGRAM – FEES

ISSUE 4  ELECTRONIC ASSET VERIFICATION   

ISSUE 5  SKILLED PROFESSIONAL MEDICAL PERSONNEL -SPRING [DEPARTMENT OF FINANCE] LETTER

ISSUE 6  NON-EMERGENCY MEDICAL TRANSPORTATION BROKER (LAO) 

ISSUE 7  DEPARTMENT OF HEALTH CARE SERVICES REGULATIONS (LEGISLATIVE ANALYST OFFICE)     

California Budget Crisis:  Los Angeles Times Front Page Story Hits IHSS Program - Article Cites LA and Sacramento County Grand Jury Reports – Advocates Say Story Not Accurate and Unfair But Article Will Likely Be Used by Those In Legislature Who Support IHSS Program Cuts

SACRAMENTO, CA (CDCAN) [Updated 04/13/09  05:00 PM  (Pacific Time) ]  -  With a major cut in state funding for In-Home Supportive Services (IHSS) worker wages scheduled to go into effect July 1, 2009 – barring a decision by the Legislature and Governor to rescind its earlier action in February and restore funding – the Los Angeles Times reported today (April 13) as its lead front page story that “fraud infects” the  program, which serves over 400,000 children and adults with disabilities, the blind and low income seniors.  The program also serves thousands of children and adults with developmental disabilities.  [photo of LA Times front page with lead IHSS story]  The article was written by respected Los Angeles Times reported Evan Hapler. 

To view or print the full CDCAN Report (CLICK HERE)

To view the 2007-2008 Los Angeles County Grand Jury Report that includes report on IHSS (CLICK HERE)

  To view the Sacramento County Grand Jury Report on IHSS released March 2009 (CLICK HERE)

CALIFORNIA BUDGET CRISIS: REGIONAL CENTER BUDGET CUT PROPOSALS RELEASED - PROPOSALS TOTALS $122 MILLION FOR 2009-2010 BUDGET YEAR

Targeted For Major Cuts and Changes by Department of Developmental Services Include Early Intervention Services (Early Start), Transportation, Day and Work Activity Programs, Supported Living Services, Respite and Increasing Parental Fees for Children in Out of Home Placements

SACRAMENTO, CA  (CDCAN) [Updated 04/07/09  03:20 AM  (Pacific Time) ]  -  The Department of Developmental Services, which oversees the 21 non-profit regional centers who coordinate services and supports to over 240,000 children and adults with developmental disabilities, submitted late Monday (April 6th) to the Legislature a package of 15 different proposals that detail how it will implement reductions of at least $100 million in state general fund spending for regional centers beginning July 1, 2009 through June 30, 2010 and beyond.  The proposals impact several regional center funded programs and services including early start, transportation, day and work activity programs, supported living services, respite (and home health agencies).  [FOR COPIES OF THE ACTUAL PROPOSAL BY THE DEPARTMENT OF DEVELOPMENTAL SERVICES, CLICK ON THE PROPOSALS BELOW]

1.  TRANSPORTATION

2  DAY AND WORK ACTIVITY PROGRAMS: UNIFORM HOLIDAY SCHEDULE

3. OLDER PERSONS WITH DEVELOPMENTAL DISABILITIES

4. INCREASED EMPLOYMENT AND VOLUNTEERISM

5. SUPPORTED LIVING SERVICES - IHSS

6  SUPPORTED LIVING SERVICES - REGULATIONS

7. EARLY INTERVENTION – NEIGHBORHOOD PRESCHOOLS

8. EARLY INTERVENTION -  ACCESSING PRIVATE INSURANCE

9. EARLY START (INTERVENTION) – ELIGIBILITY

10. RESPITE – EXPAND SCOPE OF DUTIES BY NON-LICENSED RESPITE WORKERS

11. REDUCTION IN ONE TIME REGIONAL CENTER FUNDING

12. QUALITY ASSURANCE REVIEW

13. PARENTAL FEE

14. LIFE QUALITY ASSESSMENT

15. IN-HOME BEHAVIOR INTERVENTION SERVICES

  The Department of Developmental Services 15 proposals total $122.2 million in reductions between July 1, 2009 and June 30, 2010 of which $102.8 million would be State general funds.  That reduction would grow in the  2010-2011 State Budget year and in subsequent budget years to $179.2 million  (of which $152.7 million would be a cut in State general fund spending).

  This reduction is on top of a 3% cut to regional center provider payments that was passed as part of the 2009-2010 State Budget, and was effective retroactively to February 1, 2009 and in addition to previous reductions approved as part of the 2008-2009 State Budget passed last September (three months late). 

  CDCAN will schedule a CDCAN Townhall Telemeeting with the Department of Developmental Services very soon regarding these proposals and other updates.

$100 Million Cut Already Approved in February – But Not Specifics

The reduction of at least $100 million in State general fund spending  – though not the specifics on how it would be achieved during the 2009-2010 State budget year – was already approved by the Legislature and Governor in February. 

The Department of Developmental Services was required by the 2009-2010 State Budget passed in February (four months early for the State budget year that begins July 1, 2009) to submit proposals to the Legislature by April 1, 2009 that provide details on changes to existing state laws that would achieve permanent reductions in State spending of at least $100 million – a total that does not include the loss of any federal matching funds.  The budget also required that the Department of Developmental Services receive input from stakeholders.

If the Legislature determines that the proposals as submitted by the Department of Developmental Services will not achieve at least $100 million reductions in State general fund spending between July 1, 2009 and June 30, 2010 (and beyond), then a “trigger” in the budget would be pulled that would, effective September 1, 2009, implement an additional 7.1% cut in payments to most regional center providers.

NEXT STEPS

The proposals require approval from both houses of the Legislature.  The Legislature can change the proposals.

• APRIL 22, 2009 - The Assembly has scheduled a Assembly Budget Subcommittee on Health and Human Services hearing on April 22, at 1:30 PM that could include on its agenda the proposals submitted today. 

• MAY 7, 2009 - The Senate Budget Subcommittee on Health and Human Services scheduled a hearing on May 7 at 9:30 AM (or upon adjournment of the Senate floor session) that will cover the proposals submitted today.  

• MAY 19, 2009 - SPECIAL ELECTION – the May 19 special election has several ballot measures linked to the 2009-2010 State Budget and depending on whether those measures pass or fail could determine whether the budget shortfall grows larger. 

• MAY 25, 2009 - GOVERNOR’S BUDGET CHANGES (REVISIONS) – On May 25th (or a few days after that) the Governor will release his proposed changes to the budget the Legislature passed and the Governor signed into law in February (four months early).  With revenues dropping sharply – and expenditures increasing, and depending on the results of the May 19th special election, more spending reduction proposals seem likely at this point, in addition to what was passed in February. 

• JUNE 2009 – Likely be the time when the Legislature holds final hearings on any proposal by the Governor not previously heard, and take final action on budget proposals – including whether or not to rescind cut of State funding (participation) for In-Home Supportive Services worker wages and elimination of several Medi-Cal optional benefits including adult dental, and other proposals – including possibly the April 6th Department of Developmental Services proposals if not acted on earlier. 

• JULY 1, 2009 – Start of the 2009-2010 State Budget year. 

  SUMMARY OF PROPOSALS BY DDS

CDCAN Note: copies of each proposal submitted to the Legislature on April 6, 2009 are available on the CDCAN website at www.cdcan.us

 1.  TRANSPORTATION

2009-2010 State Budget Year: $18.4 million reduction ($16.9 million State general funds)

2010-2011 and subsequent budget years: $39.9 million reduction ($36.6 million State general funds)

SUMMARY:

• This reduction would be achieved by maximizing “cost effective” transportation services that reduces costs to specialized or contract transportation services.

  If approved, effective July 1, 2009, at the time of development, scheduled review or modification of a consumer's Individual Program Plan (IPP) or Individualized Family Service Plan (IFSP), regional centers: shall not fund specialized transportation services for adults who can access and utilize public transportation; shall only fund the least expensive transportation modality that meets the consumer's need; fund transportation to the nearest program that can meet a consumer's needs as identified on the IPP/IFSP; and shall only fund transportation services for minor children when the family provides documentation that they can not provide transportation.

BACKGROUND

• Regional centers purchase transportation services for consumers of all ages.

• Transportation is provided so consumers can get to work, day and infant programs, social -recreation activities, therapies and medical care, etc.

• Regional center funded transportation services include specialized transportation, vouchers, taxis, bus passes for public transportation systems, and services provided by day and residential programs as an additional component of their vendored service.

• In the 2007-2008 State Budget year, regional centers spent $114.8 million purchasing transportation services for nearly 56,000 consumers. An additional $100 million was expended on contract transportation services.

• The January 10, 2009 Governor’s Budget projects regional centers will expend approximately $239.3 million for these services in 2009-2010 State Budget year that begins July 1, 2009.

PROS OF THIS PROPOSAL AS LISTED BY DDS:

Would result in savings in to the 2009-2010.State budget year that begins July 1, 2009

CONS OF THIS PROPOSAL AS LISTED BY DDS”

May create a barrier to receipt of services by minor children.

2  DAY AND WORK ACTIVITY PROGRAMS: INCREASED HOLIDAY SCHEDULE

2009-2010 State Budget Year:  $22.0 million reduction ($16.3 million State general funds) 

2010-2011 and subsequent budget years:  $22.0 million reduction  ($16.3 million State general funds)

SUMMARY:

         Reduction is achieved by implementing a 14 day Uniform Holiday Schedule for day programs, look-alike day programs, and work activity programs. 

         Assumes closure of all day programs, look-alike day programs, work activity programs and transportation services. Transportation savings adjusted for impact of transportation proposal.

         The savings would be achieved both through the closure of day programs, look-alike day programs, and work activity programs, and all the associated transportation costs to and from those programs.

         Should a program elect to remain open it would not be funded by the regional centers for services and regional centers would not fund transportation on the specified days

         To add four days and minimize the impact on residential services, it is proposed that those additional days be during the week between December 25th and January 1st.

         The proposal is specific to the following service codes/services: 954 Work Activity Program, 505 Activity Cente , 510 Adult Development Center, 515 Behavior Management Program, 525 Social Recreation Program, 605 Adaptive Skills Trainer, 805 Infant Development Program, 110 Program Support Group - Day Service, 028 Socialization Training Program, 048 Client/Parent Support Behavior Intervention Training, 055 Community Integration Training Program, 063 Community Activities Support Services, 091 In-Home Mobile Day Program, 094 Creative Arts Program, 425 Transportation-Family Member, 875 Transportation Company, 880 Transportation-Additional Component, 882 Transportation-Assistant, 883 Transportation Broker, 890 Transportation-Auto Driver, 895 Transportation-Public/Rental Car Agency/Taxi

BACKGROUND

         18 regional centers currently establish a uniform holiday schedule varying from six to twelve days annually. The other three regional centers estimate that, on average, service providers have nine to ten holidays annually.

          The Department of Developmental Services sets the uniform holiday schedule for work activity programs at ten holidays per year.

         By increasing the number of mandatory holidays to a uniform number statewide, savings to the general fund would be achieved.

PROS OF THIS PROPOSAL AS LISTED BY DDS

Potential savings (budget reduction) is significant.

CONS OF THIS PROPOSAL AS LISTED BY DDS.

1.  Will have some impact on residential services providers, although it has been minimized by specifying the four days between December 25th and January 1st.

2. Reduces the number of days consumers would be able to earn income in work activity programs, and any day or look-alike programs that support consumer employment.

3. Could impact the ability of work activity programs and day programs supporting consumers who are doing contract work to meet the contract production demands.

 3. DAY PROGRAMS & WORK ACTIVITY PROGRAMS: OLDER PERSONS WITH DEVELOPMENTAL DISABILITIES

2009-2010 State Budget Year:  $1.4 million reduction ($1.0 million State general funds)

2010-2011 and subsequent budget years: $1.4 million reduction  ($1.0 million State general funds)

SUMMARY:

         Reduction would be achieved by creating a new service for seniors at a reduced rate and with a corresponding increase in the staffing ratio.

         The new service is to be provided by the consumer’s existing provider. While the service is designed with consumers over the age of 50 in mind, it will be available to any consumer desiring a less rigorous day program.

         Participating providers would not be able to increase their current program capacity, as reflected in their program designs and/or by licensing requirements. 

         Assumption is that 5% of adults served in day programs, look-alike day programs, and work activity programs would like to retire.

         This service is intended enhance the quality of life of seniors with developmental disabilities who would are no longer interested in the current level of activities and services in their day program.

         This proposal hinges on being able to decrease the amount of support from 1 staff person to 3 consumers, 1 to 4, and 1 to 6 down to 1 to 8 for many of the seniors.

         To achieve savings, the rate of reimbursement would be reduced from as high as $72.42/day and as low as $35.34/day down to $35/day. Current service providers would not be able to increase their current program capacity. There are three service codes that would not have any rate change.

BACKGROUND

         This proposal assumes that older adults with developmental disabilities currently served by day programs, look-alike day programs, and work activity programs would want to “retire” and receive different services from the same providers at a reduced rate and increased staffing ratio.

         The current day program model is based on a staff to consumer ratio grounded in providing specific activities and services. An older person participating in a day program must participate in these activities and services.

          Individuals with developmental disabilities, similar to their counterparts without disabilities, may enjoy a less intense level of activity.

PROS OF THIS PROPOSAL AS LISTED BY DDS

1. Significant savings (budget reductions).

2. Creates a retirement option for consumers.

CONS OF THIS PROPOSAL AS LISTED BY DDS:

May decrease community integration

4.  INCREASED EMPLOYMENT AND VOLUNTEERISM

2009-2010 State Budget Year: $17.1 million reduction ($12.7 million State general funds)

2010-2011 and subsequent budget years: $17.1 million reduction  ($12.7 million State general funds)

SUMMARY

         Reduction would be achieved by creating the “Custom Endeavors Option” (CEO) which would will offer the opportunity to develop a customized employment or volunteer option with support from existing providers for 5% of current population.

          Participating providers would not be able to increase their current program capacity, as reflected in their program designs and/or by licensing requirements.

         Affected programs are: Community Integration Training Program (055), Community Activities Support Services (063), Activity Center (505), Adult Development Center (510), and Behavior Management Program (510).

BACKGROUND:

         Currently over 51,000 adults are served by day program and look-alike day program providers. Persons with developmental disabilities currently served by day programs and look-alike day programs often want to work, volunteer or become self-employed.

         Some of these persons are utilizing day programs because the supports needed to help them achieve their goals are not available. Utilizing existing service providers, five percent of existing persons with developmental disabilities could be supported to develop and maintain their employment or volunteer activities.

PROS OF THIS PROPOSAL AS LISTED DDS

1. Significant savings (budget reductions).

2. Increased income for persons with developmental disabilities and resulting decrease in spending (utilization) of “costly” day programs.

3. Increased independence of persons with developmental disabilities

CONS OF THIS PROPOSAL AS LISTED BY DDS

Persons with developmental disabilities may have additional time and may only have the option to spend it at home.

5. SUPPORTED LIVING SERVICES - IHSS

2009-2010 State Budget: $1.9 million reduction  ($1.3 million State general funds)

2010-2011 and subsequent budget years: $1.9 million reduction ($1.3 million State general funds)

SUMMARY

         This reduction would be achieved by prohibiting regional centers from purchasing personal care services for consumers who are Medi-Cal beneficiaries.

         All Supported Living Service (SLS) Agencies will be required to assist a consumer to apply for IHSS within five days of moving into a Supported Living arrangement.

          That component of the Supported Living Services  rate that covers personal care services provided during the lag period for IHSS approval shall not exceed the IHSS standard rate.

          By April 1, 2010, the Department of Developmental Services will collaborate with the California Department of Social Services to develop processes to allow: 1).   preliminary assessment for IHSS services to be conducted in California Department of Social Services and California Department of Public Health licensed facilities and the family home; and  2).   reimbursement for regional center costs for personal care services provided during the lag period (time between IHSS application to approval).

BACKGROUND:

         In-Home Supportive Services (IHSS) is a Medi-Cal service that allows a person in the program to hire an individual who provides in home supports, including domestic services.

          Among the people in the IHSS program are individuals with development disabilities eligible to receive services from regional centers under the Lanterman Developmental Disabilities Services Act.

         It is estimated that 10,909 regional center consumers currently receive IHSS Services.

         From the time a person with developmental disabilities applies for IHSS services to the time their application is approved; domestic personal care services are purchased through regional center funding in order for consumers to maintain living in a supported living arrangement. The amount of time between application to approval (lag period) varies from one to three months. Reimbursements for these services should be made from the IHSS program at the local county level.

         Currently, during this lag period, the State is paying a higher rate to the Supported Living Services (SLS) provider (and not benefiting from the county share of cost) than it would if the person with developmental disabilities were enrolled in IHSS.

         Payment for these services for the lag period to regional centers is at issue. The California Department of Social Services’ (DSS) policy is that county IHSS offices will reimburse only “out of pocket expenses” incurred in this period, referring to what is paid directly by the consumer for “like” services.

         In actuality, the person with developmental disabilities  does not pay out of pocket for services due to California ’s service delivery model with funding for all services coming through the regional center. This results in regional centers not getting reimbursed for the waiting period.

         To remedy this structural discrepancy, the Department of Developmental Services proposes that “like services” during consumers’ eligibility waiting periods should only be paid at the local IHSS rate for the support their staff provides, not the Supported Living Services (SLS) rate, until a consumer’s IHSS eligibility is finally determined.

         Further, the Department of Developmental Services estimates that a small number of consumers do not apply for IHSS. This is because of either the potential for a share of cost or because of the additional responsibility of being an IHSS employer.

         This proposal would prohibit regional centers from paying for services that are the responsibility of IHSS. A hardship exemption process would be developed.

PROS OF THIS PROPOSAL AS LISTED BY DDS

Recover costs in the regional center budget that funds community-based services (“purchase of services” budget or “POS”).

CONS OF THIS PROPOSAL AS LISTED BY DDS

Once receiving IHSS, person with developmental disabilities may have to pay share of cost.

6  SUPPORTED LIVING SERVICES - REGULATIONS

2009-2010 State Budget Year: $10.5 million reduction  ($6.9 million State general funds)

2010-2011 and subsequent budget years:  $21.0 million reduction  ($13.8 million State general funds)

SUMMARY: 

         Reduction would be achieved by amending the current Supported Living Services.

         Regulations that would be proposed for adoption:

         Proposal #1. Would require regional centers to review and renegotiate rates, if necessary, with supported living services (SLS)  agencies, at the time of renewal of the contract, to:  a) use the most cost effective rate methodology allowed by Title 17, Section 58660; b) specify allowable costs for administrative functions and ensure costs for administrative functions are reasonable given the number of consumers utilizing the agency; and  c) Include rates that are no higher than the supported living services (SLS) agency’s rate that was effective July 1, 2008.

         Proposal #2 would restrict the conditions under which a regional center can supplement a consumer’s rent, mortgage, or lease payment:  a) Establish the requirement that rent, mortgage, or lease payments and household expenses, such as utilities, are first responsibility of the consumer and/or their roommates;  b) If the regional center provides a supplement, require paid roommates and live-in support staff to pay their share of the rent, mortgage, or lease payment and household expenses;  c) require the consumer’s planning team, as evidenced in writing in the Individual Program Plan ( IPP), to confirm that all available sources of natural and generic supports have been utilized to the fullest extent possible; and  d) establish an exception process wherein the regional center executive director can authorize a time limited supplement to a consumer’s rent, mortgage, or lease payment, provided that: 1) Individual Program Plan ( IPP)  goals and objectives specify the period of time, not to exceed 6 months, during which the regional center will supplement the rent, mortgage, or lease payment, during which time the Supported Living Services agency is required to seek additional sources of natural and generic supports. If a long term supplement is deemed necessary, the necessity shall be reviewed annually.  2) the regional center executive director affirms in writing that the supplement of the consumer’s rent, mortgage, or lease:  A) is required due to the consumer’s developmental disability; or B) would result in General Fund savings to the regional center.

         Proposal #3 would, in  order to maximize available resources, require that regional centers shall, to the extent feasible and appropriate, utilize the same Supported Living Services agency to provide services that meet the individual needs, as determined through the Individual Program Plan process, of consumers who reside in the same home.

BACKGROUND

         Supported Living Services (SLS) consist of a broad range of services to adults with developmental disabilities who, through the Individual Program Plan (IPP) process, live in homes they themselves own, rent, or lease in the community.

          In the 2007-2008 State Budget year, approximately 9,500 individuals used Supported Living Services at a cost of approximately $300 million.

PROS OF THIS PROPOSAL AS LISTED BY DDS

1.  Each of the proposals is reflected in pending draft regulations the stakeholder community has already reviewed.

2.  Requires Supported Living Services (SLS) agencies to develop and promote the use of natural or generic resources (such as housing subsidies and SSI/SSP)

CONS OF THIS PROPOSAL AS LISTED BY DDS

Ceasing or limiting rent subsidies could limit consumers’ ability to use Supported Living Services.

7. EARLY INTERVENTION – NEIGHBORHOOD PRESCHOOLS

2009-2010 State Budget Year:  $8.9 million reduction ($8.9 million State general funds)

2010-2011 and subsequent budget years: $17.8 million reduction  ($17.8 million State general funds)

SUMMARY:

         Reduction would be achieved by expanding the availability and use of neighborhood preschools as a natural environment service setting which may be less costly than segregated center-based infant development programs.  This reduction assumes the following:

         In order for preschool services to be comparable to an infant development programs, an EI provider must be funded to provide specialized instruction in addition to preschool services.

         It is estimated that a preschool program funded at $19 per hour for 3 hours 3 times per week would result in a cost of $171 per week. Add an additional cost for an early interventionist or speech therapist to provide specialized EI services at a cost of $136 for 1 hour of intervention 3 times a week for a total cost of $307 per week for preschool and therapy services.

         Infant development program center-based services would be approximately $549 for 3 hours 3 times per week whereas neighborhood preschool services would be an estimated $242 less than the cost for the infant development program.

         Based on the Department of Developmental Services’ Expenditure Information Report by Budget Category for 2007-08, there were 30,700 children served by infant development programs. It is estimated that 5% of those children (1,535), 18 months of age or older, could be served in a neighborhood preschool program at a savings of $242 per week for six months resulting in a total savings of $8,915,280 for six months.

BACKGROUND:

         Early Start is California ’s system of interagency, coordinated early intervention (EI) services provided to infants and toddlers and their families with or at risk for developmental delays or disabilities.

          Early Start is available statewide through regional centers, local education agencies, and family resource centers.

         Currently, Early Start serves children who are at high risk for developmental disability, manifest established risks for developmental delay, or who have developmental delays. Of the over 60,000 infants and toddlers served annually in Early Start, approximately 23% enter the regional center caseload at age 36 months as ongoing regional center consumers.

         Regional Center purchase of services budget (the budget that funds community based services) expenditures totaled $278 million in the 2007-2008 State Budget year ($39 million federal funding for the regional center’s community based services budget or “purchase of services” ) at an average growth rate of 19% while population growth has averaged 11%.

         Early Start provides specialized EI services in the home, community and center-based settings through infant development programs (IDP) by a team of qualified interdisciplinary professionals that often include early interventionists, physical therapists, occupational therapists, and speech and language therapists.

         Usually toddlers begin attending center-based programs after turning 18 months of age. Typical attendance at an infant development program  ranges from two to three times per week for approximately three hours each day. The rates for infant development programs range from $28.66 to $48.34, using a staff ratio of 1 to 3, or $42.58 to $73.65, using a staff ratio of 1 to 2.

         In some areas of the state, regional center funds social/recreational programs (525) at $13.12 to $24.74 per hour or preschool using the Child Day Care (851) service code at a “usual and customary” or negotiated rate. These programs are used to enhance social/emotional or language development.

         However, they do not meet the description for specialized instruction or therapeutic services. Occasionally, individually vendored early interventionists and therapists are funded to provide EI services in a preschool setting at the “usual and customary” or Medi-cal rate.

         Neighborhood preschools provide a variety of child care and development programs to young children and youth up to 12 years of age. Preschools may include public and private programs.

         Specific services and age ranges offered are based on program design. Preschool programs under California Department of Education’s Child Development Division serve three to five year olds and are state and federally funded. Their rates are based on “usual and customary rates” in each region of the state.

PROS OF THIS PROPOSAL AS LISTED BY DDS

1.  Could result in a cost savings of $242 per child per week for children over 18 months of age who are currently served in infant development programs.

2.  Consistent with research supporting the delivery of services in natural environments such as integrated preschools.

3.  Would increase the use of natural environments and could be an alternative solution to infant development programs that do not provide services in natural environments.

4.  Takes advantage of preschools that provide a clean, safe, and positive environment for children with special needs, especially in high crime areas.

CONS OF THIS PROPOSAL AS LISTED BY DDS

1.      Neighborhood preschools may not provide a multidisciplinary team approach which is recommended by research.

2.       Multiple preschools may need to be vendored to ensure that the setting remained integrated resulting in increased workload for regional centers.

3.       To ensure positive child outcomes, training would be needed to support the interagency collaboration necessary for effective early intervention services.

8. EARLY INTERVENTION -  ACCESSING PRIVATE INSURANCE

2009-2010 State Budget Year:  $6.5 million reduction  ($6.5 million State general funds)

2010-2011 and subsequent budget years:  $13.0 million reduction  ($13.0 million State general funds)

SUMMARY:

         Reduction would be achieved by requiring families to access private insurance for all identified medical services, other than evaluation and assessment, for service provision or denial prior to service provision by the regional center as payer of last resort (already required for children age three years and older).

          Identified medical services are:  Specialized Therapeutic Services for children younger than 3 years, Hearing & Audiology Facility, Acute Care Hospital, Licensed Vocational Nurse, Durable Medical, Equipment Dealer, Registered Nurse, Laboratory/Radiological Services, Other Medical Services, Other Medical Equipment/Supplies, Audiology, Orthoptic Services, Speech Pathology, Orthotic/Prosthetic Services, Physical Therapy, Pharmaceutical Services, Physician/Surgeon, Occupational Therapy, Genetic Counselor

BACKGROUND

         Early Start is California ’s system of interagency, coordinated early intervention services provided to infants and toddlers and their families with or at risk for developmental delays or disabilities.

         Early Start is available statewide through regional centers, local education agencies and family resource centers.

         Currently, Early Start serves children who are at high risk for developmental disability, manifest established risks for developmental delay, or who have developmental delays.

         Of the over 60,000 infants and toddlers served annually in Early Start, approximately 23% enter the regional center caseload at age 36 months who will continue to receive regional center funded services.

         Regional center purchase of services budget (the budget that funds community-based services) spending totaled $278 million in the 2008-2009 State Budget year ($39 million federal funding ). The 2009-2010 State Budget spending for Early Start is expected to be: $50,674,000 from the Federal Grant and another $349,567,000 in State general funds.

PROS OF THIS PROPOSAL AS LISTED BY DDS

1.      Complies with federal guidelines and state family cost participation guidelines.

2.       Conforms to Lanterman Act mandating regional centers pursue other sources of funding for services, thereby reaffirming regional center as payer of last resort per federal and state laws.

CONS OF THIS PROPOSAL AS LISTED BY DDS

1.      Health plans may determine the medical service is not ‘medically necessary’ but is ‘developmentally necessary’.

2.       If this occurs, the service becomes a required early intervention service per federal regulations.

3.       Could result in delay of needed medical services while family’s insurance carrier determines if the service is covered.

4.      Requires collaboration and consistent processes with the California Department of Education because of the dually-served and solely low incidence children for which school districts have responsibility.

5.      Requires redefining Early Start “system of services and payments” on federally approved documents and subsequent statewide training of service coordinators and vendors.

9. EARLY START (INTERVENTION) – ELIGIBILITY

2009-2010 State Budget Year:  $15.5 million reduction ($15.5 million State general funds)

2010-2011 and subsequent budget years: $15.5 million reduction  ($15.5 million State general funds)

SUMMARY:

         This reduction would be achieved by prospectively (from date this proposal is effective) limit eligibility for Early Start services to only those infants/toddlers at the highest risk of a developmental disability in most need of program services entering Early Start at 24 months of age or older as follows:\

         A).  Current eligibility: Those who are determined ‘at risk’ can enter the Early Start Program at any age.  Proposed change: Those who are determined ‘at risk’ and are aged 24 months or older would not be eligible for the Early Start Program.

         B).  Current eligibility: Those who have a ‘developmental delay’ of 33% or greater in one of five domains can enter the Early Start Program at any age.  Proposed change: Those who have a ‘developmental delay’ in only one domain and are aged 24 months or older would need to have a ‘developmental delay’ of 50% or greater.

BACKGROUND

See proposal on changing Early Start eligibility for background on Early Start program

PROS OF THIS PROPOSAL AS LISTED BY DDS:

1.  This proposal does not impact the eligibility of any infant or toddler under the age of 24 months.

2.   Promotes regional center Early Start focus and resources on those infants with delays or with established risk conditions who are at greatest risk for developmental disability.

3. May result in fewer children transitioning to regional center caseloads at age 36 months.

CONS OF THIS PROPOSAL AS LISTED BY DDS:

1.  Without early intervention, some infants and toddlers may enter the regional center system and/or special education at an older age.

2. Costs saving (reduction)  in Early Start may be shifted to special education and other public programs for long term services.

10. RESPITE – EXPAND SCOPE OF DUTIES BY NON-LICENSED RESPITE WORKERS

2009-2010 State Budget Year: $4.0 million reduction  ($3.0 million State general funds)

2010-2011 and subsequent budget years:  $4.0 million reduction  ($3.0 million State general funds)

Note: Department of Developmental Services estimates costs of this proposal at $56,800 ($42,600 of that State general funds) each budget year for training of the non-licensed workers. 

SUMMARY:

         Reduction would be achieved by expanding the scope of duties performed by non-licensed In-Home Respite Agency workers to include routine skilled services such as medication administration, diabetic care, g-tube feedings, consistent with those allowed to be provided by licensed day program staff per Title 22, Division 6, Chapter 3, (Adult Day Program Regulations, Article 8, Section 82092), with the exception of tracheostomy care.

         Compensate in-home respite workers by providing a $.50/hour wage increase for hours they are providing the increased skill services (and cover the employer’s social security, unemployment, workers’ compensation costs associated with the wage increase).

         This reduction assumes the following:  1). A 10% reduction in the number of respite hours purchased from Home Health Agencies ($31.38/hour) and Licensed Vocational Nurses ($26.05/hour).  2). A corresponding increase in the number of respite hours purchased from In Home Respite Agencies to compensate for the skilled respite worker when they are providing the skilled respite services and the training and administrative costs for the In-Home Respite Service Agencies.

          The Department of Developmental Services proposes a $0.50/hourly wage increase (limited to hours providing skilled respite services), plus 16.76% for the employer costs due to the wage increase (social security, workers’ compensation, unemployment compensation) 16.76%=$.58) =$18.16.

BACKGROUND

         Many persons with developmental disabilities are “medically fragile” but medically stable and receive respite services from Home Health Agencies (HHA) (Service Code 854) or Licensed Vocational Nurses (LVN) (Service Code 742). Welfare and Institutions Code, Section 4686, now allows in-home respite workers to provide gastrostomy care and feeding of clients, after successful completion of training.

         This proposal would allow non-licensed employees of In-Home Respite Services Agencies (Service Code 862) to provide additional routine skilled services.

         Title 22, Division 6, Chapter 3, (Adult Day Program Regulations, Article 8, Section 82092) specifies that adult day programs may accept or retain medically stable consumers who have certain restricted health conditions, which include use of inhalation-assistive devices, fecal impaction removal, enemas, and suppositories colostomy/ileostomies, and catheters, insulin-dependent diabetes, wounds, Stage 1 and 2 pressure sores, Staph or other serious, communicable infections, as specified, if certain requirements are met. One of these requirements is that program staff complete training provided by a licensed professional sufficient to meet the needs of the client.

PROS OF THIS PROPOSAL AS LISTED BY DDS

1.      Generates savings (budget reductions) to the State, by reducing reliance on higher cost in-home health professionals.

2.      Families would benefit from having respite workers who could provide these routine services.

CONS OF THIS PROPOSAL AS LISTED BY DDS

1.      Change in state law needed for exclusion from nursing scope of practice.

2.      Requires time and training for non-licensed workers to properly learn these skills. 1

3.      May increase respite utilization (use) for some families who were previously unable to utilize respite due to a shortage of licensed personnel.

11. REDUCTION IN ONE TIME REGIONAL CENTER FUNDING

2009-2010 State Budget Year:  $3.5 million reduction ($3.5 million State general funds)

2010-2011 and subsequent budget years: $3.5 million reduction ($3.5 million State general funds)

SUMMARY:

         This reduction is achieved by reducing funding for regional center costs associated with moving and/or expansion.

         The 2009-2010 State Budget year requests from regional centers for one-time costs total $6.5 million. This proposal would cap the amount available for a savings of $3.5 million in State general funds.

BACKGROUND

         Funding for one time costs associated with relocation and/or expansion is provided to regional centers through the budget process.

         This unique, one time funding is provided, for instance, to assist a regional center in opening a new branch office in an outlying county with rapid population growth.

         Funding may also be provided for office expansion (e.g. communication system) to accommodate increased staffing needs associated with caseload growth and/or new mandates.

PROS OF THIS PROPOSAL AS LISTED BY DDS:

Would generate State general fund savings (budget reductions)

CONS OF THIS PROPOSAL AS LISTED BY DDS:

May result in insufficient funding to regional centers for this purpose in a given year to meet all needs

12. REGIONAL CENTERS – QUALITY ASSURANCE REVIEW

2009-2010 State Budget Year:  $1.5 million reduction ($1.0 million State general funds)

2010-2011 and subsequent budget years:  $1.5 million reduction ($1.0 State general funds)

SUMMARY:

This reduction would be achieved by eliminating Regional Center funding and requirement for conducting a Triennial Quality Assurance Review of vendored Community Care Facilities.

BACKGROUND

         Funding is provided through the core staffing formula to regional centers to meet this regulatory mandate.

         Current regulations require a quality assurance evaluation be conducted a minimum of once every three years.

         This evaluation includes record reviews, consumer observation and interviews to determine satisfaction with facility services, and an assessment of the facility in assisting consumers in achieving the individual life quality outcomes. A written report is issued with regional center follow up as needed which may include the provision of technical assistance.

         This proposal would eliminate this requirement and associated funding.

PROS OF THIS PROPOSAL AS LISTED BY DDS:

Generates State general fund savings (budget reductions)

CONS OF THIS PROPOSAL AS LISTED BY DDS:

This review is included in the Department’s approved federal Medicaid Home and Community-Based Services (HCBS) Waiver so an amendment will be needed.

13. REGIONAL CENTERS – PARENTAL FEE

2009-2010 State Budget Year:   $900,000 reduction ($900,000 State general funds)

2010-2011 and subsequent budget years: $2.2  million reduction ($2.2 million State general funds)

SUMMARY

         This reduction is achieved by updating the Parental Fee Program applying to parents of children under the age of 18 who live in any out-of home care arrangement, whether in a community or Developmental Center .

          The current fee was last fully adjusted in 1989. Department of Developmental Services estimates that this proposal would result in additional State general fund revenues of approximately $0.9 million (total funds) for first year implementation; $1.7 million (total funds) in the second year; and $2.2 million (total funds) after full implementation. [CDCAN Note: this is a different program than the family cost participation (sometimes referred to as the parental or family share of cost or co-payment program)]

BACKGROUND:

         The Parental Fee Program applies to parents of children under the age of 18 who live in any out-of-home care arrangement, whether in the community or a Developmental Center .

         Parents are assessed a fee based on a sliding scale that varies by family size and income. The fee is the same regardless of where the child is placed out of home. The Department determines the parents’ ability to pay, assesses the fee, and bills the parents monthly until the child turns 18.

         Revenues produced by this program are deposited in the Program Development Fund and used for developing expanded community resources.

         In order for this proposal to be considered, the increase in parental fees would need to be deposited into the General Fund, rather than the Program Development Fund.

         The Parental Fee Schedule would be adjusted in two ways:  1).  The first change would be to raise the minimum income level upon which to base the fee to the current federal poverty level (FPL). The current federal poverty level (FPL) is $18,310 for a family of three. The current parental fee schedule has the lowest fee based on an income level of $12,501.   This change to the minimum income level will reduce the families subject to a fee by about 10%  and  2).  The second change would be to adjust the fee schedule to reflect the 2007 data available from the US Department of Agriculture’s survey on the cost of raising a child in California , adjusted for the consumer price index (CPI) from the survey date to present. This would raise the maximum amount billable for families at all levels of income above the federal poverty level (FPL) and raise the maximum fee from $662 per month to approximately $1,875 for the highest income families with the oldest children.

         For parents currently paying a fee, the increase will be phased in over three years. For parents of children who begin living in a out-of-home care arrangement after June 30, 2009, the full fee amount will be assessed. The maximum fee may not exceed (1) the cost of caring for a normal child at home, or (2) the cost of services provided, whichever is less. The current Parental Fee was last adjusted in 1989, except for an increase in the maximum fee amount in 2003 to $662.

         Currently, any change to the parental fee schedule requires the approval of the State Council on Developmental Disabilities. Language will be drafted to make this change without Council approval.

PROS OF THIS PROPOSAL AS LISTED BY DDS

1.  Ensures families with resources are reimbursing the state actual costs for which they would otherwise be responsible if their children were living with them at home.

2.  Creates a disincentive for some families who otherwise may place their children out-of-home in costly publicly-funded living arrangements, but for the liability of the parental fee.

CONS OF THIS PROPOSAL AS LISTED BY DDS

Imposes a significant increase in fee amount on parents.

14. REGIONAL CENTERS – LIFE QUALITY ASSESSMENT

2009-2010 State Budget Year:  $2.0 million reduction ($2.0 million State general funds)

2010-2011 and subsequent budget years:  $2.2 million reduction ($2.2 million State general funds)

SUMMARY:

         Reduction achieved by consolidating the Quality Assurance Evaluation process.

         Would redirect funding for the Life Quality Assessment (LQA) and the Evaluation of People with Developmental Disabilities Moving from Developmental Centers into the Community (Movers Study) into a single quality assessment tool and data collection effort.

         The tool will be nationally recognized and programmatically up-to-date.

         The Department of Developmental Services will contract for administration of the tool with the State Council on Developmental Disabilities.

         In consultation with stakeholders, the Department of Developmental Services  will establish a set of nationally recognized quality assurance performance and outcome indicators that will:  1).  Provide consistent and measurable data for the Department of Developmental Services’ Quality Management System;  2).  Enable the Department of Developmental Services, regional centers, and policy makers to benchmark the performance of California against that of other states, as well as a comparison of quality measures across all 21 California regional centers;  3). Provide a stratified, random sample of surveys among the entire Department of Developmental Services  consumer population; and  4). Avoid the duplicative data collection of personal outcome elements (e.g. school, work, health, safety), currently generated by the Client Development and Evaluation Report (CDER).

BACKGROUND:

         State law currently required the Department of Developmental Services to administer two consumer quality assurance evaluations, the Movers Study (Welfare and Institutions Code 4418.1) and the Life Quality Assessment (LQA) (Welfare and Institutions Code 4570).

          These two evaluations are in addition to the regular oversight and monitoring conducted by the regional centers and the periodic state licensing agencies’ reviews.

         Conceived over ten years ago, these surveys do not provide adequate quantifiable data to inform current quality assurance efforts and meet the evolving continuous quality assurance expectations the Centers for Medicare and Medicaid (CMS) have for the Home and Community Based Services Waiver (HCBS).

PROS OF THIS PROPOSAL AS LISTED BY DDS:

1.      Elimination of duplication of effort.

2.      Provides ability to compare the performance to other states.

3.      Quantifiable results that make it possible to identify areas where the system is performing well and areas requiring improvement.

4.      Potential to utilize the Area Board on Developmental Disabilities’  existing statewide data collection structure and cadre of trained surveyors.

CONS OF THIS PROPOSAL AS LISTED BY DDS:

1.   Information would not be available at the individual level to assist regional centers and consumers with the Individual Program Plan (IPP) development.

2.   Reduction in State staff.

 

15.  REGIONAL CENTERS:  IN-HOME BEHAVIOR INTERVENTION SERVICES

2009-2010 State Budget Year:  $8.1 million reduction ($6.4 million State general funds)

2010-2011 and subsequent budget years: $16.2 million reduction  ($12.8 million State general funds)

SUMMARY: 

         Reduction achieved by reducing costs for in-home behavior intervention services by requiring parents to complete group instruction on behavioral intervention, prior to being provided with in-home behavioral services.

         Would reduce regional centers’ cost to their budgets that fund community-based services (called “purchase of services” or “POS”) costs for in-home behavior intervention services by refining (changing) regional centers’ Service Code (Client/Parent Support Behavior Intervention Training) and Service Code 077 (Parent Coordinated Home Based Behavior Intervention Program for Autistic Children). These service codes will refine the two services so that group instruction on behavior intervention for parents (and/or guardians) must be completed prior to receipt of in-home behavioral services.

         Training would include the basics of behavior intervention, how to manage less severe behavioral challenges, and the role and responsibilities of parents (and/or guardians) in the provision of in-home behavioral services.

         Training would be provided by a Board Certified Behavior Analyst with teaching experience and costs approximately $1,200 per training. For an average size regional center, the assessed need is about 24 trainings per year.

BACKGROUND

         In the State budget year 2007-2008, regional centers spent at least $44,527,003 on in-home behavior services for consumers residing in their families’ homes.

         These costs include those billed to Service Code 048 (Client/Parent Support Behavior Intervention Training) and Service Code 077 (Parent Coordinated Home Based Behavior Intervention Program for Autistic Children).

         Behavior intervention services are often critical to a consumer remaining with their family at home.

         According to the Department of Developmental Services, this has been a proven model of providing cost-effective behavior intervention services. Currently, at least three regional centers ( Valley Mountain Regional Center , North Los Angeles Regional Center , and Frank D. Lanterman Regional Center ) provide group training to parents on behavior intervention. In-home behavioral interventions require a significant time commitment on the part of family members.

         Some family members are not aware of the time commitment and/or could benefit from group training in lieu of in-home behavioral services.

PROS OF THIS PROPOSAL AS LISTED BY  DDS:

This proposal could save the state General Fund while improving the capacity of parents to address the behavioral needs of their children.

CONS OF THIS PROPOSAL AS LISTED BY  DDS:

1.      The total savings in this proposal are offset by the costs of providing the group training.

2.      Some families, including those who are not English speaking, or who live in remote rural locations, may not be able to access group instruction.

3.      In-home behavior intervention services are customized to meet the needs of the particular consumer, and also involve the siblings and extended family in interventions. As a result, in some cases, in-home behavior services may be more effective than parent training.

  MARTY OMOTO COMMENTARY - "FEDERAL TRIGGER CUTS" AND THE FIGHT FOR JUSTICE  (March 27, 2009) - This coming Monday (March 30th) is California ’s observance of the birthday of an authentic American hero, Cesar Chavez.  It is perhaps fitting that we think of him, his work and legacy as we ponder how it is that California can allow terrible things to happen to its own people.  His legacy was about fighting for what was right and decent.  The struggle was a moral issue as much as it was a legal one in fighting for the rights of farmworkers and others who worked the fields.And the impact of that struggle sent a ripple of hope far beyond the boundaries of any field.  (CLICK FOR FULL COMMENTARY)

BREAKING NEWS:  "FEDERAL FUNDS TRIGGER" WON'T BE PULLED - TREASURER & FINANCE DIRECTOR SAY GOAL OF $10 BILLION OF FEDERAL FUNDS WON'T BE REACHED - SEVERAL MAJOR CUTS TO HEALTH & HUMAN SERVICES WILL NOW HAPPEN 

Pulling "Trigger" Would Have Stopped Permanent Cuts To IHSS Worker Wages, Elimination of Several Medi-Cal Optional Benefits, Cuts to SSI/SSP & CalWORKS Grant Levels From Taking Place - Those Cuts Will Now Happen Barring A Change of Mind By Governor and Legislature To Restore Funding

SACRAMENTO, CA (CDCAN) [Updated 03/27/09 10:18 AM (Pacific Time) ] - State Treasurer Bill Lockyer and the Governor's Department of Finance Director Mike Genest announced this morning (March 27) that California will fall short of receiving at least $10 billion in federal funds by June 30, 2010 that "may be used" to replace (off-set) the spending of State general fund money which means that the so-called "federal funds trigger" in the 2009-2010 State Budget that if pulled, would have prevented several major cuts from taking place in July, will not be pulled. 

(CLICK HERE FOR COPY OF STATE TREASURER'S MARCH 27, 2009 DETERMINATION AND LETTER TO LEGISLATURE AND GOVERNOR]

(CLICK HERE FOR COPY OF MARCH 27, 2009 DEPARTMENT OF FINANCE FEDERAL STIMULUS FUNDS DETERMINATION DOCUMENT)

Barring a change of mind by the Legislature and Governor in the coming months that either cuts education funding to make available more federal funds or restoring funding that reverses their action in the budget passed in February, that means several major permanent budget cuts will now happen after July 1, 2009, including elimination of several Medi-Cal optional benefits, rolling back of State funding for In-Home Supportive Services worker wages to a maximum of $9.50 per hour, and cuts to the grant levels for SSI/SSP (by 2.3% and cutting the January 1, 2009 federal cost of living increase) and CalWORKS (cutting grants by 4%). Those cuts will have a dramatic and wide spread impact on hundreds of thousands of people with disabilities, mental health needs, the blind, seniors and low income families and In-Home Supportive Services workers and other providers across the State.

The announcement - which comes 4 days earlier than the April 1 deadline was required by the Legislature and Governor as part of the 2009-2010 State Budget that was passed and signed into law in February (the budget was passed four months early in order to implement major cuts and increases in revenues to close a then budget gap of over $42 billion. However many details on how certain cuts would be implemented were left to be decided later - like the $100 million cut to regional centers to take effect July 1, 2009)

While California is expected to receive well over $31 billion in federal money from the federal economic stimulus bill by December 2010, and billions more in federal competitive grants - much of that money is restricted in how it is spent or does not replace spending of state general fund money.

Cuts That Will Now Happen Because "Federal Funds Trigger" Was Not Pulled Several major permanent cuts will take place as scheduled and also one of the tax increases would also take effect in July 2009 because the State Treasurer and Governor's Finance Director's determination today (March 27) that the $10 billion threshold in federal funds will not be met. Those cuts - all similar to what the Governor previouly proposed in nearly every budget year since 2003 - are as follows:

MEDI-CAL "OPTIONAL" BENEFIT ELIMINATION:  These Medi-Cal "optional" benefits are called "optional" because the federal government does not require the states to provide them - though these benefits are provided in Medi-Cal covered health facilities. Another cut to the Medi-Cal program impacted by the federal trigger cut decision is a reduction of $54.1 million in State funding for South Los Angeles Medical Services

*  The Treasurer and Finance Director's report released today (March 27) means that the "federal funds trigger" will not be pulled - which means this cut - barring a change in mind in the coming months by the Legislature and Governor to reverse their action in February and restore this funding in the budget - WILL happen. 

* When This Cut Takes Effect: July 1, 2009 Description of This Cut: The following Medi-Cal optional benefits will be permanently eliminated as of the effective date: 1. adult dental 2. acupuncture services 3. audiology and speech therapy services 4. chiropractic services 5. optometric and optician services including services provided by a fabricating optical laboratory 6. podiatric services 7. psychology services, and 8. incontinence creams and washes. 

* This reduction was originally proposed by the Governor and will mean a cut to the Medi-Cal program of over $258.8 million ($129.4 million of that in State general funds) during the 2009-2010 State Budget year that begins July 1, 2009. 

* Who Is Exempted By This Cut: medical and surgical services that may be provided by a doctor regardless of whether the service is actually provided by either a doctor or dentist, pregnancy-related services, and services for treating conditions that might complicate pregnancy. Also exempted for this specific cut are persons in the Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT) and long-term care in a skilled nursing facility or intermediate care facility.

IN-HOME SUPPORTIVE SERVICES (IHSS) There are two cuts impacted by the "federal trigger cut" determination. The first reduction would permanently cut back what the State will provide toward IHSS worker wages (called "State participation") back to the maximum amount of $9.50 per hour. While not specifically rolling back wages by itself - the counties who pay more than that amount in IHSS worker wages would have to make up the difference. Nearly every county in California is facing mounting budget deficits of their own and would not be able to replace the lost State funding - and that in turn would lead to a permanent rollback in IHSS worker wages. This action does not have immediate direct impact on those counties who are only paying IHSS workers the State minimum wage - though it will impact future collective bargaining in those counties. The second reduction cuts funding by limiting the IHSS share of cost buy-out to those people who are receiving it before July 1, 2009.

STATE FUNDING (PARTICIPATION) OF IHSS WORKER WAGES 

* The Treasurer and Finance Director's report released today (March 27) means that the "federal funds trigger" will not be pulled - which means this cut - barring a change in mind in the coming months by the Legislature and Governor to reverse their action in February and restore this funding in the budget - WILL happen. 

* When This Cut Takes Effect: July 1, 2009 

* Description of This Cut: Will limit the state funding (participation) in IHSS worker wages to a total cost of wages up to $9.50 per hour and individual health benefits up to $0.60 per hour. 

* This reduction will mean a cut to the In-Home Supportive Services program of $74.2 million in State general fund money during the 2009-2010 State Budget year that begins July 1, 2009.

IHSS SHARE OF COST BUY-OUT

* The Treasurer and Finance Director's report released today (March 27) means that the "federal funds trigger" will not be pulled - which means this cut - barring a change in mind in the coming months by the Legislature and Governor to reverse their action in February and restore this funding in the budget - WILL happen. 

* When This Cut Takes Effect: July 1, 2009 

* Description of This Cut: Will limit the share-of-cost buy-out for persons in the In-Home Supportive Services program who receive Medi-Cal personal care services to those people who were receiving this supplementary payment before July 1, 2009 (meaning no one else would be eligible for this share of cost buy-out after that date). 

* This reduction will mean a cut to the In-Home Supportive Services program of $3.8 million in State general fund money during the 2009-2010 State budget year that begins July 1, 2009.

SSI/SSP GRANT LEVEL REDUCTION:  The federal "trigger cuts" is linked to one but not all of the cuts to SSI/SSP (Supplemental Security Income - funded by the federal government - and the State Supplemental Payment program, funded by the state).

* The Treasurer and Finance Director's report released today (March 27) means that the "federal funds trigger" will not be pulled - which means this cut - barring a change in mind in the coming months by the Legislature and Governor to reverse their action in February and restore this funding in the budget - WILL happen. 

* When This Cut Takes Effect: July 1, 2009 

* Description of This Cut: Will reduce by 2.3% the SSI/SSP grant level in effect on December 1, 2008 by 2.3%., reducing the monthly grant levels by $20 for individuals and $35 for couples. This would also continue the cut (withholding) of the federal cost of living increase that went into effect for SSI/SSP on January 1, 2009 - but is scheduled to be cut on May 1, 2009 (that action was passed as part of the 2009-2010 State Budget). 

* Exempts from this reduction are people receiving SSI/SSP living in SSP living arrangements for Non-Medical Out-of-Home Care and Title XIX medical facilities, as well as those receiving a Restaurant Meal Allowance. * This 2.3% grant reduction means a cut to the SSI/SSP program of over $267.8 million State general fund money during the 2009-2010 State budget year. 

* The cuts (suspension) of the State cost of living money owed to SSI/SSP on June 1, 2010 will continue (it was not linked to the "federal funds trigger" decision).

CALWORKS GRANT LEVEL REDUCTION: The California Work Opportunity and Responsibility to Kids program - called "CalWORKS" is the state's "welfare to work" program which includes thousands of low income children and their parents who have disabilities or other special needs, including mental health needs. Other cuts to CalWORKS are happening or will happen, regardless of today's decision by the State Treasurer and Department of Finance Director on the $10 billion threshold.

* The Treasurer and Finance Director's report released today (March 27) means that the "federal funds trigger" will not be pulled - which means this cut - barring a change in mind in the coming months by the Legislature and Governor to reverse their action in February and restore this funding in the budget - WILL happen. 

* When This Cut Takes Effect: July 1, 2009 

* Description of This Cut: Would permanently reduce the CalWORKs maximum grant payments by 4%, resulting in a loss of $29 monthly for a family of three, reducing their monthly grants from $723 to $694. [this is in addition to other cuts to the CalWORKS program not impacted by the "federal funds trigger" decision] 

* This grant reduction will mean a cut to the CalWORKS program of $146.9 million in State general fund money during the 2009-2010 State Budget year..

OTHER PROGRAMS IMPACTED BY FEDERAL TRIGGER 

* Cuts to Courts (new judges, trial court operations) of $171.3 million in State general funds. 

* University of California cut of $50 million in State general funds. 

* California State University cut of $50 in State general funds. 

* The increase in personal income tax drops from 0.25% to 0.125%

What the Treasurer and Finance Director Were Required To Decide 

* The 2009-2010 State budget signed into law by the Governor on February 20, 2009 required the State Treasurer and the Governor's Director of Finance to determine by April 1, 2009 whether California will receive at least $10 billion from the $789 billion federal economic stimulus bill (signed into law by President Obama on February 17, 2009), called the American Recovery and Reinvestment Act (ARRA) and, possibly, other federal legislation. 

* To qualify, the federal funds have to be "made available" to California by June 30, 2010, and must replace or offset spending that would otherwise be made from the State general fund. 

* There are differences of opinion on what is meant by "make available" and "may be used" in terms of what federal funds can be counted toward the $10 billion 

* If State funds must be spent to access the federal funds, those State expenditures, at least in some cases, will be subtracted from the dollars counted toward the $10 billion benchmark.

LEGISLATIVE BUDGET LANGUAGE 

The following is the legislative budget (trailer) bill language in ABx3 16 that was passed and signed by the Governor in February along with the main budget bill and other budget related bills, dealing with the federal "trigger cuts":

SECTION 1. Section 99030 is added to the Government Code, to read: 99030. (a) On or before April 1, 2009, the Treasurer and the Director of Finance shall meet and confer in a public hearing for the purpose of determining whether federal legislation has been enacted that will make available, by June 30, 2010, additional federal funds that may be used to offset not less than ten billion dollars ($10,000,000,000) in General Fund expenditures. (b) Notwithstanding any other provision of law, the Treasurer may send a designee and the Director of Finance may designate a deputy of his or her office to act in his or her place and stead for purposes of subdivision (a). (c) If, on or before April 1, 2009, the Treasurer and the Director of Finance determine that sufficient federal funds have been made available as described in subdivision (a), the Director of Finance immediately shall notify, in writing, the Joint Legislative Budget Committee and the Controller of this determination. (d) This section shall be operative only until July 1, 2010, and as ofhat date is repealed. 

SEC. 2. This act addresses the fiscal emergency declared by the Governor by proclamation on December 19, 2008, pursuant to subdivision (f) of Section 10 of Article IV of the California Constitution. SEC. 3. This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the Constitution and shall go into immediate effect. The facts constituting the necessity are: In order to reduce General Fund expenditures at the earliest possible time, it is necessary that this act take effect immediately.

SENATE ADJOURNS UNTIL 11 AM MONDAY - ASSEMBLY ALSO ADJOURNS AND WILL MEET AT NOON MONDAY - BUDGET REMAINS STALLED IN SENATE

  SACRAMENTO, CALIF (CDCAN) [Updated 02/15/09  09:25 PM (Pacific Time) ]   -  The State Senate adjourned, after a grueling non-stop session that began Saturday afternoon, but will come back in session at 11:00 AM on Monday, February 16 to attempt again to pass the budget.  The budget, which passed out of the Assembly early Sunday morning, remains stalled in the State Senate, unable to win one more vote from the Senate Republicans to pass it.  Passage of a budget requires 27 State senators to vote for it out of the 39 members (one vacancy).  Democrats hold 24 seats and Republicans 15, which means, if every Democrat votes for it, the budget still would need 3 Republican votes. 

The Assembly also adjourned after a more than 24 hour session and will reconvene again on Monday at noon. 

  Senate President Darrell Steinberg (Democrat – Sacramento ) showed anger at some Senate Republicans for the continued budget impasse,  warnined that “what is at issue here…the fact of the matter the State is days away from financial collapse” .  and that the Assembly is ready to pass a bill to raise the revenues to balance the cuts “to allow California to live another day”.

  Only one Senate Republican – Senate Republican Leader Dave Cogdill of Fresno , voted for the budget agreement, with Sen. Roy Ashburn (Republican – Bakersfield ) a likely vote for it, but who abstained.  Focus has been on Sen. Abel Maldonaldo (Republican – San Luis Obispo ) who said earlier on Sunday that he is “open” to considering providing the crucial vote to pass the stalled budget plan. 

  Assembly Passed the Main Budget Bill

The Assembly earlier on Saturday evening passed the bill with mid-year budget cuts (SBx3 2) by a vote of 64 to 14 earlier Saturday evening and later – at 2:43 AM on Sunday morning, the main budget bill for the 2009-2010 State Budget year (SBx3 1) by a of 59 to 16.   Both those bills however also needed final approval in the State Senate – where it remains stalled as of Sunday morning 10:34 AM.     

  The Assembly earlier passed several budget related bills – called “trailer bills” that made necessary changes in existing state law to implement the budget reductions and changes in both the main budget bill for 2009-2010 and the bill that makes mid-year budget cuts for 2008-2009. 

California Budget Crisis:

* NO BUDGET YET – STALEMATE IN SENATE

* STATE EDGES TOWARD FINANCIAL DISASTER

* DETAILS OF HEALTH & HUMAN SERVICES CUTS

* CUTS STILL NEED APPROVAL IN SENATE

* Regional Centers , SSI/SSP, CalWORKS Hit Hard

Budget Remains Stalled In State Senate - Both Houses Remain In Session Early Sunday Morning - Assembly Passed Budget Bill Earlier

 

SACRAMENTO, CALIF (CDCAN) [Updated 02/15/09  07:19 AM (Pacific Time) ]   -   With California edging toward financial disaster, passage of a budget agreement remains stalled in the State Senate early Sunday morning, falling two votes short of the 27 senators needed for passage, and as of 4 AM early Sunday morning, both houses remain in session in hopes of breaking the stalemate.  As reported earlier, it is not clear if the Governor, the Governor and the Democratic legislative leadership – and the Republican legislative leaders can put enough pressure on moving 2 Senate Republican votes needed to pass the budget. 

 

The Assembly had better luck, passing a bill with mid-year budget cuts (SBx3 2) by a vote of 64 to 14 earlier Saturday evening and later – at 2:43 AM on Sunday morning, the main budget bill for the 2009-2010 State Budget year (SBx3 1) by a of 59 to 16.   Both those bills however also needed final approval in the State Senate – where it remains stalled. 

 

At 3:34 AM Sunday morning, Assembly Speaker Karen Bass (Democrat – Los Angeles ) told Assemblymembers that the Assembly was in “recess under call” – meaning they are still in session, and can be called back onto the floor at any time.  Members unless granted special permission, have to remain in the State Capitol building because the Assembly is still in session.  They are still in recess. 

 

The Assembly earlier passed several budget related bills – called “trailer bills” that made necessary changes in existing state law to implement the budget reductions and changes in both the main budget bill for 2009-2010 and the bill that makes mid-year budget cuts for 2008-2009. 

 

It is not certain what the State Senate and Assembly will do now, but the stalemate means that California is at the very edge of slipping into the worst financial disaster scenario that State officials  – including Governor Schwarznegger and State Controller John Chiang and Legislative leaders – feared. 

 

Senate Democrats Need 2 Republican Votes

State Sen. Dave Cox (Republican – Fair Oaks) was seen by many as a “yes” vote but ended up voting against the budget bill in the initial roll call, while another likely “yes” vote, Sen. Roy Ashburn (Republican – Bakersfield) abstained.  Only Senate Republican Leader Dave Cogdill (Republican – Fresno ) voted for the budget, along with all 24 Senate Democrats. 

 

In the 40 member State Senate, 27 votes are needed to pass a budget bill (or 2/3rds members).  The Senate Democrats were faced with a greater burden to secure Republican votes because of the vacancy of a Democratic seat caused by the resignation earlier by Sen. Mark Ridley-Thomas, who now sits on the Los Angeles County Board of Supervisors.  His resignation meant that Democrats in the Senate needed 3 Republican votes rather than just 2. 

 

In the 80 member Assembly, 54 votes are needed to pass a budget – and the budget bill passed there earlier received 59.  Democrats control 51 seats, while Republicans hold 29 seats. 

 

SUMMARY OF BUDGET AS PASSED BY ASSEMBLY

Meanwhile, details of the major cuts impacting a wide range of health and human services, education, transportation, emerged as budget related (“trailer bills”) were passed, before the main budget bill. 

 

While the State Budget for 2009-2010 and the bill that would make mid-year cuts to the current (2008-2009) State budget year passed the Assembly, both bills still need approval in the State Senate, where it remains, as of early Sunday morning, stalled.  It is not certain as of Sunday morning what will happen next. 

 

However many of the cuts – while not taking effect unless the main budget bill and mid-year cut bills are passed also by the State Senate – shows where the Democrats and Republicans in the Legislature were willing to agree on spending reductions, 

Most of these cuts will show up in any future budget agreement, should the budget deal put together this weekend falls short. 

CDCAN Note: due to space, see separate CDCAN Report later this morning for budget issues impacting transportation, education, and also revenues. 

 

DEVELOPMENTAL SERVICES

Includes the 21 non-profit regional centers who coordinate the funding – under the Department of Developmental Services – of services and supports provided by community-based organizations and individuals for over 230,000 children and adults with developmental disabilities.  In addition, the Department of Developmental Services owns and operates 5 developmental centers (formerly known as state hospitals) and 2 smaller health facilities.  One developmental center, Agnews in San Jose , has been slated for closure last year – with final closure expected sometime early this year.

 

REGIONAL CENTER PROVIDER PAYMENTS

Reduction of  3%, proposed by the Governor, of certain regional center provider payments for services delivered from February 1, 2009 to June 30, 2010.

2008-2009 State Budget Year: Cut of $40.4 million ($24.1 million of that State general fund money)

2009-2010 State Budget Year: Cut of $100.8 million ($60.2 million of that State general fund money)

CDCAN Note: budget related (“trailer bill”) language contains the necessary changes in existing state law to make these reductions.  It is not certain how this reduction can be made retroactively – since the Director of the Department of Developmental Services had previously said publicly that this particular cut would be made prospectively.  This reduction was previously announced in December by the Governor and was part of the December 18th budget compromise passed by Legislative Democrats (but was vetoed by the Governor on January 6th)

 

REGIONAL CENTER GROWTH & POSSIBLE ADDITIONAL PROVIDER PAYMENT CUT

* Reduction of $100 million (all State general funds) instead of the Governor’s January proposal calling for a reduction of $334 million (State general funds) that was money needed to fund the growth in caseload and use of services in the 2009-2010 State Budget year. 

* Budget related (“trailer bill”) language would require that the Department of Developmental Services conduct a stakeholder process to receive input on how to achieve this savings (reduction) while maintaining the integrity of the Lanterman Developmental Disabilities Services Act and maintaining access to high quality services. 

* The budget related language also contains a new proposal – a “trigger” to impose automatically an additional 7.1% reduction in payments to regional center providers, effective September 1, 2009,  on top of the 3% that would already be in effect, if the stakeholder process does not achieve success. 

2008-2009 State Budget Year:  does not effect this year

2009-2010 State Budget Year:” $100 million (State general funds only)

CDCAN Note: The reduction in the 2009-2010 does not include the loss of any federal matching funds.  That loss – depending on how the cuts are applied – could easily raise the total cut to the regional center system by another $50 to $75 million or even more.

The cut would come, as mentioned, either through the reductions coming from stakeholder process or from the additional 7.1% cut to payments to providers (effective September 1, 2009)/.  It is not certain what standards are used to measure “success” in terms of the stakeholder process.

It also does not take into account the impact of the passage of any change in the State Constitution implementing a spending limit or cap. 

Also not mentioned – and a potential major crisis on top of this reduction to growth or additional reduction to provider payments is the growing funding shortfall that regional centers as a whole are experiencing that could surpass over $120 to 150 million.

 

REGIONAL CENTER OPERATIONS

* Reduction of Regional Center Operations by $6.6 million in the 2008-09 State Budget year  and $17.4 million  in the 2009-2010 State budget year by suspending several administrative and case management requirements in existing State law.

* Would go into effect from February 1, 2009 to June 30, 2010.

* Budget related (“trailer bill”) language will make the necessary changes in existing state law. 

2008-2009 State Budget Year: Cut of $6.6 million ($4.6 million State general funds)

2009-2010 State Budget Year: Cut of  $17.4 million ($12.2 million State general funds)

CDCAN Note: Not certain how this reduction can go into effect retroactively. 

 

REGIONAL CENTERS – EARLY START PROGRAM

* Budget agreement assumes voter approval of amendments to the California Children and Families Act of 1998 which would provide $265 million (Proposition 10 Health and

Human Services Fund) to be instead, spent for the Early Start Program, which provides supports and services for  infants who are high risk up to the age of three, instead of using Stateo general fund money.

* Budget related (“trailer bill”) language would make the necessary changes to existing State law for this proposal to be placed on a statewide special election ballot for voter approval (if budget is passed in February, the special election will be May 19, 2009)

2008-2009 State Budget Year:  does not effect this year

2009-2010 State Budget Year: $265 million shifted to Early Start from Proposition 10 funds

CDCAN Note: This is a funding shift that requires approval from voters. 

 

SSI/SSP (SUPPLEMENTAL SECURITY INCOME/STATE SUPPLEMENTAL PAYMENT)

CASH ASSISTANCE PROGRAM FOR IMMIGRANTS

 

SSI/SSP – FEDERAL COST OF LIVING

Suspends (cuts) the pass through of the federal cost of living adjustment (COLA) for the SSI part of the SSI/SSP grant, that went into effect January 1, 2009, for the SSI portion of the SSI/SSP grant by rolling back the grant level to what it is was as of December 1, 2008.   

2008-2009 State Budget Year: Cut of $79.8 million (State general funds)

2009-2010 State Budget Year: Cut of $487.3 million (State general funds)

CDCAN Note: The State Senate says the pass through of the federal cost of living adjustment is effective May 1, 2009, which is not correct – and omits the January 1, 2009 cost of living adjustment (which would have to be rescinded if the grant levels were rolled back to what it was on December 1, 2008).  What is not clear is how this would be done retroactively and if that is even possible or legal to do.   This cut is not part of the “trigger cuts” – cuts that would not happen if enough funds come to California from the federal economic stimulus bill comes/.

 

SSI/SSP – STATE COST OF LIVING

Suspends (cuts), as proposed by the Governor, the state cost of living adjustment (COLA) due June 1, 2010. 

2008-2009 State Budget Year:  does not effect this year

2009-2010 State Budget Year: Cut of $27 million (State general funds)

2010-2011 State Budget Year: Cut of $323.9 million (State general funds)

CDCAN Note:  There is a reduction resulting from suspension (cut) of the State cost of living that was due in 2008, that impacts the current State budget year.  This cut is not part of the “trigger cuts” – cuts that would not happen if enough funds come to California from the federal economic stimulus bill comes/.

 

SSI/SSP – ROLL BACK SSP GRANT LEVEL

* Unless notified by  the Director of Finance to the Joint Legislative Budget Committee that California received sufficient federal funds from the economic stimulus bill, the SSI/SSP grant level in effect on December 1, 2008, would be reduced by 2.3% (this specific cut will not happen if enough federal money comes)

* This rollback in grant levels would reduce the monthly grant for individuals by $20 and the monthly grant for couples by $35 each month.

* Exempt from this reduction are pweaona living in State Supplemental Program (SSP) living arrangements for Non-Medical Out-of-Home Care and Title XIX medical facilities, and also  those persons receiving a Restaurant Meal Allowance.

2008-2009 State Budget Year:  does not effect this year

2009-2010 State Budget Year:  Cut of $267.8 million (State general funds)

CDCAN Note: This reduction is part of the “trigger cuts” that will NOT happen if enough funds come to California from the economic stimulus bill, which nearly everyone believes it will. 

 

SSI/SSP – ROLLBACK OF GRANTS TO FEDERAL MINIMUM

Budget agreement REJECTED the Governor’s proposal in January to rollback SSI/SSP grant levels to the minimum allowed by the federal government.

 

CASH ASSISTANCE PROGRAM FOR IMMIGRANTS (CAPI)

This program provides state funded grants (at the same level of the State Supplemental Payment  or SSP) to persons with disabilities, the blind and low income seniors who are legal immigrants but do not qualify for the federal SSI program.  

Budget agreement REJECTED the Governor’s proposal to eliminate this program

 

IN-HOME SUPPORTIVE SERVICES

 

IN-HOME SUPPORTIVE SERVICES (IHSS) – JANUARY PROPOSALS BY GOVERNOR

Budget agreement REJECTED  the Governor’s proposals made in January to restrict non-medical services to only those person receiving IHSS with the highest level of need, to eliminate the state’s share of cost contribution for persons receiving IHSS with lower levels of need, and to limit state participation in the wages of IHSS workers to the state minimum wage.

CDCAN Note: The budget agreement replaced the Governor’s proposals with two proposals – with cuts that will NOT happen if sufficient funding comes to California from the federal economic stimulus bill.  Nearly everyone agrees that sufficient funding is coming. 

 

IN-HOME SUPPORTIVE SERVICES – SHARE OF COST

Unless notified by the Director of the Department of Finance to the Joint Legislative Budget Committee that California has received sufficient funding from the federal stimulus bill, would eliminate the state’s share of cost contribution to new IHSS recipients prospectively (not retroactively)  If notified of sufficient funding, this cut will NOT happen,

2008-2009 State Budget Year:  does not effect this year

2009-2010 State Budget Year:  Cut of $3.8  million (State funds only)

CDCAN Note: This reduction is part of the “trigger cuts” that will NOT happen if enough funds come to California from the economic stimulus bill, which nearly everyone believes it will.

 

IN-HOME SUPPORTIVE SERVICES – STATE FUNDING FOR WAGES

Unless notified by the Director of the Department of Finance to the Joint Legislative Budget Committee that California has received sufficient funding from the federal stimulus bill, would reduce state participation (funding) for the wages of IHSS workers to up to $9.50 per hour (down from the current $12.10 per hour) plus up to $0.60 per hour for individual health benefits. If notified of sufficient funding, this cut will NOT happen,

2008-2009 State Budget Year:  does not effect this year

2009-2010 State Budget Year: Cut of $74.2 million (State funds only)

CDCAN Note: This reduction is part of the “trigger cuts” that will NOT happen if enough funds come to California from the economic stimulus bill, which nearly everyone believes it will. 

 

MEDI-CAL

Over 1.6 million persons with disabilities, the blind and low income seniors receive Medi-Cal services in California .

 

MEDI-CAL – GOVERNOR’S JANUARY PROPOSALS

* Budget agreement REJECTED  the Governor’s entire proposal to eliminate over 500,000 people from receiving health care services within the Medi-Cal Program that included rolling back eligibility for working families eligible under the Medicaid 1931(b) program; rolling back eligibility for the Medi-Cal Aged, Blind and Disabled program; changing to a month-to-month eligibility for persons without citizenship documentation; and rolling back eligibility for legal immigrants and individuals permanently residing under the color of law (PRUCOL).

* This action would restore $485.1 million (State general funds) to the Medi-Cal program to continue eligibility in these areas.

* Budget agreement contains an “unspecified” reduction of $646.6 million ($323.3 million State general funds) as proposed by the Governor which is a continuation of a Governor’s veto of the Budget Act of 2007.  The  Governor contends that on average Medi-Cal spending have been more than $800 million (both state and federal funds) lower than the Medi-Cal Estimate package calculated by the Department of Health Care Services, and as a result an on-going adjustment is being made.

 

MEDI-CAL – OPTIONAL BENFITS

* Unless notified by the Director of the Department of Finance to the Joint Legislative Budget Committee that California has received sufficient funding from the federal stimulus bill, would cut $258.8 million for certain Medi-Cal Optional Benefits as proposed by the Governor, unless notification

* Budget related (“trailer bill”) language includes the necessary changes to existing state law for this reduction, including the “trigger” mechanism. Cut will NOT happen if sufficient funding comes from economic stimulus bill. 

2008-2009 State Budget Year:  does not effect this year

2009-2010 State Budget Year:  Cut of  of  $258.8 million ($129.4 million of that State general funds)

CDCAN Note: This reduction is part of the “trigger cuts” that will NOT happen if enough funds come to California from the economic stimulus bill, which nearly everyone believes it will. 

 

MEDI-CAL – PUBLIC HOSPITALS

* Unless notified by the Director of the Department of Finance to the Joint Legislative Budget Committee that California has received sufficient funding from the federal stimulus bill, would cut (shift to different other programs)  $54.2 million (federal funds), or 10% , from certain public hospitals and safety net care hospitals and use these funds to backfill for State general fund costs in the California Children Services Program, the Medically Indigent Adult-Long Term Care Program, and the Genetically Handicapped Persons Program as proposed by the Governor,

* Budget related (“trailer bill”) language includes the necessary changes to existing state law for this reduction, including the “trigger” mechanism.

CDCAN NOTE:  This reduction is part of the “trigger cuts” that will NOT happen if enough funds come to California from the economic stimulus bill, which nearly everyone believes it will. 

 

MEDI-CAL - OTHER

* Budget agreement eliminates the cost-of-doing-business paid to the counties for them to conduct Medi-Cal eligibility processing as an agent for the state. This proposal by the

Governor results in a reduction of $49.4 million ($24.7 million General Fund) in the 2009-2010 State Budget year. Budget related (“trailer bill”) language makes the necessary changes to existing State law to implement this change.

* Budget agreement does not contain any adjustments which may be necessary for implementation of the recently passed federal stimulus bill  regarding the Medicaid Program (Medi-

Cal Program in California ).

• Included funding necessary to implement AB 1183, Statutes of 2008, which requires the Department of Health Care Services to adjust Medi-Cal rates effective as of March 1, 2009, including  a Medi-Cal provider rate cut of 1% for fee-for-service providers, and a 5% reduction for Medi-Cal pharmacy and certain long term care providers. 

* Budget agreement  assumed continued implementation of Adult Day Health Care reforms as proposed by the Governor, including unbundling the rate into its component services, tightening

medical necessity criteria, performing post-payment reviews of participant charts, and changing reimbursement to a prospective cost-based methodology, for savings of $34 million ($17 million  of that State general funds).

* Budget agreement assumed the realigning of payment rates to reimburse Federally Qualified Health Centers and Rural Health Clinics with those used to reimburse Adult Day Health Centers as proposed by the Governor, pending discussion of changes to existing state law to happen at a later date/.

* Budget agreement includes an increase of $42.7 million ($21.4 million in State general funds)  for Federally Qualified Health Centers and Rural Health Clinics to reflect the Medicare Economic Index adjustment.

* Budget agreement assumed the implementation of a Maximum Allowable Ingredient Cost for Generic Drugs for savings of $2 million ($1 million of that State general fund money) as proposed by the Governor, pending discussion of any need changes to existing state laws at a later date.

* Agreement included an increase of $365.6 million (federal and state funds – all funds) to reflect a 5% increase for certain nursing homes (those reimbursed under the AB 1629 nursing home quality assurance program) effective as of August 1, 2009. This reflects the existing methodology, including the use of the Quality Assurance Fee to provide additional federal funds.

*  Budget agreement includes the deferral of Medi-Cal reimbursements (totaling $260 million)  made to Medi-Cal Managed Care organizations and entities that contract with the Department of Health Care Services in order to provide assistance with the state’s cash management as proposed by the Governor and as contained in the Omnibus General Government trailer bill.

* Continues, in the budget agreement, the authority of the Department of Health Care Services  to delay up to two Fee-for-Service Medi-Cal Program checkwrites, if necessary, to manage the state’s cash flow.

• Deletes, in the budget agreement,  a total of $331,000 ($166,000 of that State general funds) and 3 positions for the Department of Health Care Services to monitor the Mental Health Managed Care Specialty Waiver.

CDCAN NOTE: the 10% Medi-Cal rate reduction that went into effect July 1, 2008 for most Medi-Cal providers, as part of the emergency budget legislation passed in February 2008, in ABx3 5, was blocked by a federal court judge for most providers in August 2008, and for others in November 2008.  The State has appealed that order, which still is in effect and the subject of a hearing before the US 9th Circuit Court of Appeals on February 18.  The 10% reduction goes out of effect due to AB 1183 however, at the end of February.  A lawsuit was also filed to block the March 1, 2009 new Medi-Cal provider rate cuts. 

 

MENTAL HEALTH

 

MENTAL HEALTH SERVICES ACT FUNDS

* Budget agreement assumes  voter approval of changes (amendments) to the Mental Health Services Act of 2004 for the shifting of $226.7 million in funding to the EPSDT (Early and Periodic Screening, Diagnosis and Treatment) program, which would receive those mental health instead of State general fund money.

* Budget related (“trailer bill”) language makes the necessary changes in existing State law in order for this proposal to be placed on the next statewide election ballot for approval from the voters.

2008-2009 State Budget Year:  no fund shift or reduction from this proposal

2009-2010 State Budget Year:  Cut (shift) of $226.7 million (to EPSDT)

2010-2011 State Budget Year:  Cut  (shift) up to $334 million (to EPSDT)

CDCAN NOTE: If voters reject this proposal, this fund shift (or cut) would not take place.  Special election currently is targeted for May 19, 2009. 

 

MENTAL HEALTH – OTHER

* Budget agreement included $226.7 million (in State general funds) for the Mental Health Managed Care Program in the 2009-2010 State Budget year.

* Budget agreement reduced  by $17 million (State general fund)s the amount provided for capital outlay projects for the State Hospitals.

 

HEALTH – OTHER HEALTH CARE PROGRAMS

HEALTH FAMILIES

Included  funding as proposed by Governor, for the Healthy Families Program but  does not reflect the federal State Children’s Health Insurance Program (SCHIP)

reauthorization recently signed by President Obama. 

GENETICALLY HANDICAPPED PERSONS PROGRAM (GHPP)

* Budget agreement assumes a savings of $1.4 million (State general funds) by increasing enrollment fees to: 1.5%  of  Adjusted Gross Income for families with incomes greater than 200% but not more than 300% of the federal poverty level; and 3% of Adjusted Gross Income for families with incomes greater than 300% of the federal poverty level. This reduction is waiting for discussion of needed changes in existing state law to occur later.

* Assumes savings of $600,000 (State general funds) in this program through the state’s assistance in coordinating enrollment of persons who are eligible into commercial insurance product lines and fund their premium payments, pending discussion of the needed changes in existing state law, to occur later.

 

CalWORKS

California ’s “welfare to work” program impacts thousands of children and parents with special needs and disabilities.  The program is officially known as the “California Work Opportunity and Responsibility to Kids” or “CalWORKS”.

 

CalWORKS – GOVERNOR’S JANUARY PROPOSALS

* Budget agreement REJECTED  the Governor’s January  proposals to modify the Safety Net Program, impose a 60-month time limit on assistance for certain child-only

cases, implement a six-month self-sufficiency review requirement, and reduce grants by 10%.

* Budget agreement REJECTED  the Governor’s proposed shift of $216.9 million in federal funds from CalWORKs to the Department of Developmental Services and the

California Student Aid Commission.

 

CalWORKS – COST OF LIVING

Suspends (cuts) the July 2009 CalWORKs  cost of living adjustment (COLA)  as proposed by the Governor,

2008-2009 State Budget Year:  does not effect this year

2009-2010 State Budget Year:  Cut of $79.1 million (State general funds)

 

CalWORKS – PAY FOR PERFORMANCE COUNTY INCENTIVE PROGRAM

Suspends (cuts) this program as proposed by the Govenror.

2008-2009 State Budget Year:  does not effect this year

2009-2010 State Budget Year: Cut of  $40 million (State general funds)

 

CalWORKS – LA COUNTY AUTOMATED BENEFIT  SYSTEM

Delays by six months the replacement of Los Angeles County ’s automated benefit and eligibility determination system, as proposed by the Governor,

2008-2009 State Budget Year: does not effect this year

2009-2010 State Budget Year: Savings of  $14.6 million (State general funds)

 

CalWORKS – GRANT LEVEL

Unless notified by the Director of the Department of Finance to the Joint Legislative Budget Committee that California has received sufficient funding from the federal stimulus bill, would reduce CalWORKs grants by 4%., For a family of 3, this cut will result in a loss of $29 per month, reducing the grant from $723 to $694,

2008-2009 State Budget Year:  does not effect this year

2009-2010 State Budget Year: Savings of  $146.9 million (State general funds)

CDCAN Note: This reduction is part of the “trigger cuts” that will NOT happen if enough funds come to California from the economic stimulus bill, which nearly everyone believes it will.

 

 

Photo of People Protesting At Rally at State Capitol December 2003 organized by CDCAN - Over 4,500 People showed up

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ACTION ALERT – PROTESTS NEXT WEEK:

February 18th in San Francisco

February 19th in Sacramento

And more to come!

Decisions are made by those who show up – and also are made by others when people don’t.  Show up – whether in San Francisco on the 18th or in Sacramento on the 19th or by taking action in your own communities or coming to the State Capitol. 

Be angry, be outraged, but also be hopeful that we can do something. We can fight back, we can say “no” to more cuts and say “yes” that the State keep its promise to our communities across California  

 

Photo of Protestors, including Anna Wang a parent of a child with disabilities, outside Capitol on January 15, 2009 (Photo by our friend, Stephen Dale)FEBRUARY 18, 2009 (WEDNESDAY)

09:00 AM to 11:00 AM

WHERE: SAN FRANCISCO

US 9th Circuit Court of Appeals Courthouse

95 Seventh Street in San Francisco [sidewalk]

Sidewalk Protest Against Medi-Cal and Other Cuts That Harm People with Disabilities, Mental Health Needs, Seniors

  • The court will be hearing that day at 10 AM lawsuits dealing with blocking the State from implementing Medi-Cal rate reductions for most providers that went into effect July 1, 2008 (most of those cuts have been stopped by the lawsuit – this hearing – among other things - is to consider an appeal from the State to overturn that ruling that stopped the cuts from taking place).  Please Note: please be respectful to the people going into the courthouse – including the judges. 
  • But the protest will also be about OTHER cuts that impact our communities – including those to regional centers, SSI/SSP, senior programs, CalWORKS, mental health services,  and other proposed cuts that could happen to In-Home Supportive Services and Medi-Cal optional benefits, and more.  This is about lives that matter – and about rights and promises that must be kept. 
  • REMEMBERING JOAN LEE AND DONALD ROBERTS – AND OTHER LIVES THAT MATTER  - Like the demonstration on February 19th in Sacramento, this protest is being held in memory of our friends Joan Lee, Sacramento Gray Panther (passed away last August)  and Donald Roberts, disability advocate and People First Member (passed away January 11). Also – remembering Maggie Dee Dowling – who is having some health problems, and can’t be at the court hearing or demonstration – but WILL be with us in her strong spirit and will be checking out the evening news!  
  • DIRECTIONS AND SOME LOGISTICS: peaceful protest will happen outside on the sidewalk area in front of the courthouse entrance between Mission Street and Stevenson Steet (Market is the next major street that crosses 7th.  The nearest BART Station is Civic Center- but elevator will not be in service until May. Nearest BART Station with working elevator is Powell Street Station (a few blocks further away – but still within walking distance).  I checked out the stations and the protest site (it is free of construction barriers, etc) on February 6th
  • WHAT TO BRING: signs, pictures of loved ones impacted – dress warmly and bring umbrella (just in case) or other protection from the rain.  If you have protection against bad budget cuts – bring that too.
  • WHO SHOULD COME:  People with disabilities, mental health needs, seniors and their families, low income children and their families, community organizations, facilities, workers who provide supports and services and advocacy.   Join Gray Panthers, CDCAN, People First, ADAPT, other senior and disability advocacy groups and organizations in this action. 

 

Photo of protestors - family members, people with disabilities, outside on the sidewalk in front of the State Capitol, January 15, 2009 (Photo by our friend, Stephen Dale)FEBRUARY 19, 2009 (THURSDAY)

11:30 AM to 1:00 PM

WHERE: SACRAMENTO

Department of Health Care Services building

1501 Capitol Avenue (crosses 15th Street – near Capitol)

Sidewalk Demonstration for Rights of People with Disabilities, Mental Health Needs, Seniors and against Budget Cuts (including Major Cuts to Regional Centers, SSI/SSP) that Harm Our Communities

  • Inside the building, at 1 PM will be the first of at least two public forums by the Department of Developmental Services, in the East End Complex Auditorium to receive public input on the issue of regional center funding – including controlling costs  
  • By the time of this meeting, a budget agreement would have likely been passed that will include major new cuts to regional centers that fund (to community organizations and other vendors) a wide range of community-based supports and services to over 230,000 children and adults with developmental disabilities – including those with down syndrome, autism spectrum disorders and other disabilities.  In addition, many also receive In-Home Supportive Services, adult or senior services, Medi-Cal, SSI/SSP, mental health services, accessible transportation and housing services.   This is about lives that matter – and about rights and promises that must be kept. 
  • ALSO ATTEND PUBLIC FORUM BY DEPT OF DEVELOPMENTAL SERVICES AT 1 PM INSIDE - We want people to come to the demonstration outside – but also come inside to voice your concerns and give your input to the Department of Developmental Services.  Please note: please be respectful during the meeting – one can be strong and angry without being rude and disrespectful.  Self determination and one’s rights means respect for others.  Not just ourselves.  The director of the Department of Developmental Services, Terri Delgadillo and her staff deserve that respect – and also, have earned it, in their positions with the state, as advocates for our communities. We may like the proposals – but we can respect each other and still fight hard for what we believe in. 
  • This sidewalk protest is for the rights of all children and adults with disabilities, mental health needs, seniors, low income children – their families – community organizations and workers who provide supports, services and advocacy outside on the sidewalk in front of the Department of Health Care Services – the agency that oversees Medi-Cal, and where the public forum for the Department of Developmental Services is being held.  .
  • Photo of Anna Wang, parent and advocate, at January 15, 2009 protest outside State Capitol organized by CDCAN (Photo by Stephen Dale)REMEMBERING LIVES THAT MATTER -  Like the protest in San Francisco on February 18, this demonstration is being held in memory of our friends Joan Lee, Sacramento Gray Panther (passed away last August)  and Donald Roberts, disability advocate and People First Member (passed away January 11).
  • Directions and Some Logistics: peaceful protest will happen outside on the sidewalk area in front of the Department of Health Care Services in Sacramento – I will provide more details on directions and logistics on Monday (February 16)
  • WHAT TO BRING: signs, pictures of loved ones impacted – dress warmly and bring umbrella (just in case) or other protection from the rain.  If you have protection against bad budget cuts – bring that too.
  • WHO SHOULD COME:  Everyone – we are one community fighting for our rights – and against cuts that harm any of us.  People with disabilities, mental health needs, seniors and their families, low income children and their families, community organizations, facilities, workers who provide supports and services and advocacy.   Join people with disabilities, families, workers,, CDCAN, People First, ADAPT, other senior and disability advocacy groups and organizations in this action

For older news, go to page 2