004-2006 SSI/SSP Recipients Hit Hardest In Governor's Proposed Budget.htm

CDCAN
CALIFORNIA DISABILITY COMMUNITY ACTION NETWORK
DISABILITY RIGHTS NEWS REPORT
#004-2006 January 10, 2006 Tuesday
Connecting people with disabilities & seniors to rights and unified action
1225 8th Street Suite 480 - Sacramento, CA 95814 916/446-0013 Fax: 916/446-0026
Marty Omoto - director email: martyomoto@rcip.com    website: www.cdcan.us

GOVERNOR'S BUDGET PROPOSES:
* EXTENDING SUSPENSION OF SSI/SSP '07 FEDERAL INCREASE TO 7/08
* MANDATORY ENROLLMENT INTO MEDI-CAL MANAGED CARE IN 2 COUNTIES
* 3% RATE INCREASE FOR SOME REGIONAL CENTER PROVIDERS
* CONTINUATION OF ALL REGIONAL CENTER PROGRAM/CONTRACT RATE FREEZES
* CONTINUATION OF MEDI-CAL PROVIDER RATE 5% CUT
* $10 MILLION CUT TO REGIONAL CENTER COMMUNITY SERVICES BUDGET

SACRAMENTO - Gov. Arnold Schwarzenegger unveiled his proposed state spending plan for the budget year that begins July 1, 2006, this afternoon (January 10) that proposes a mixture of new spending and new reductions in programs and services that impact millions of children and adults with developmental and other disabilities and seniors. Unlike in the previous two budget years, the Governor is not proposing any major reductions to the In-Home Supportive Services (IHSS) program that provides supports and services to over 350,000 children and adults with disabilities and seniors. Advocates have still raised concerns about how a quality assurance effort begun a year ago, will impact the IHSS program with reductions.

Senate President Pro Tem Don Perata (D-Oakland) and Assembly Speaker Fabian Nunez (D-Los Angeles) generally praised the proposed budget as a good first step, but that several areas of concern - including the proposed reductions to grants to people with disabilities and seniors - will need to be addressed and resolved. Democratic leaders seemed unwilling at this point to agree to additional reductions to those cash grants, called SSI/SSP (Supplemental Security Income/State Supplemental Payment), and possibly even continuation of the 5% Medi-Cal provider rate reduction.

Poorest of State's Poor Who Have Disabilities, Blind or Elderly Hit Hardest
Biggest hit were the poorest of the State's low income residents who depend on cash grants from the state and federal government called SSI/SSP (Supplemental Security Income/State Supplemental Payment). The Governor proposes that the federal increase due in January 2007 but delayed until April 2007 by the budget passed last year be delayed further, by another year and three months - until July 1, 2008. The
delay would result in a reduction (or savings to the state) to the SSI/SSP program budget of $48 million in the July 2006 - June 2007 budget, and another $185 million in the July 2007 - June 2008 budget. Last year's budget suspended for two years (January 2006 and January 2007) the state cost of living increase to the SSP portion of the grant, and delayed passing the federal increase to recipients until April of both years. That reduction to the program was the largest single budget cut impacting people with disabilities and seniors in the 2005-2006 budget.

Governor Proposes 3% Regional Center Provider Increase To Some - But New Cuts To Budget
The proposed state budget did contain other mixtures of good news and bad news for people with disabilities and seniors regarding education and other areas of health and human services.
The Governor did propose a 3% cost of living increase for many community-based service programs, including supported employment and work activity programs funded by the 21 non-profit regional centers to provide services to children and adults with developmental disabilities.   However the program and contract service rate freezes, first put in place nearly 4 years ago, will remain in place under the Governor's 2006-2007 budget. The Governor also is moving forward in implementing unspecified "structural changes" that will result in additional permanent reductions to the regional center budget that funds those same community-based services (called "purchase of services" or POS) of $10.6 million in the July 2006 - June 2007 budget, and $31.7 million in budget years after that. The reduction would be additional cuts to that budget in addition to cuts made in the last three years.

The effort to require the movement of over 500,000 persons with disabilities and seniors in Medi-Cal managed care was not in the budget, but the Governor will require the mandatory enrollment by April 2008 of persons with disabilities and seniors in Medi-Cal managed care plans in two unspecified counties.

In addition, the 5% cut to Medi-Cal providers - originally proposed by Gov. Davis and passed as part of the budget for July 2003 - June 2004, went into effect January 1 this year after a 2 year court battle that delayed implementation until this year. The Governor's proposed budget would continue that reduction.

CDCAN note: A detailed CDCAN report on all budget proposals impacting people with disabilities and seniors will be released tomorrow in addition to the January 12 CDCAN Disability Rights Townhall Telemeeting scheduled for January 12, Thursday between 1 PM and 3 PM. The Townhall Telemeeting will feature at 1 PM an update from California Health and Human Services Agency Secretary Kim Belshe. Legislative budget consultants on health and human service issues, including Michael Dimmitt of the Assembly Budget Committee, will later participate and provide updates and answer questions on budget issues impacting people with disabilities.

SUMMARY OF MAJOR PROPOSALS
SSI/SSP
* Proposes to delay by another 15 months, the federal SSI cost of living increase that is due to be paid to recipients on April 2007. The Governor is proposing to delay payment until July 1, 2008. The Governor proposed last year and the Legislature approved a two year suspension of the state cost of living increase for SSI/.SSP recipients effective January 2006 and 2007. Last year's budget also delays passing on the federal increase also due in January 2006 and 2007 for those recipients by three months (April 2006 and 2007).
N-HOME SUPPORTIVE SERVICES (IHSS)
No major reductions proposed for the July 2006 - June 2007 budget but reductions made due to assumptions made as a result of savings due to implementation of the IHSS Quality Assurance program. The IHSS Quality Assurance program, passed as part of the July 2003 state budget, moves forward that includes significant changes to the program and regulations that govern it and the budget does assume cost savings - or reductions to the IHSS budget due to a decease in the number of hours people need IHSS services as a result of the IHSS Quality Assurance program. The Governor's proposed budget assumes however that the figures could change as a result of a survey of hours assessed by IHSS recipients that is being distributed across the State.
REGIONAL CENTERS
* Calls for a 3% cost of living increase to community-based programs that were rate freezes that first were implemented nearly four years, including to habilitation services (supported employment and work activity programs). The increase means an additional $67.8 million, ($46.1 million in state funds) to the regional center budget for this purpose. The 3% cost of living increase is for specific programs that the Department of Developmental Services sets rates: community care facilities, community-based day programs, habiliation services (work activity and supported employment programs), respite agencies and vouchered respite. In addition, a 3% cost of living increase is proposed for specific contracted services programs (supported living, transportation and "look-alike" day programs).
* Proposes to continue - at least for another budget year, the existing rate freezes.
* Proposes to implement beginning January 2006, that the Department of Developmental Services (DDS) will authorize through contract language, to give regional centers "additional responsibilities and tools" to "control growth" in the spending in the part of the regional center budget that funds community-based services (called "purchase of services"). Budget calls for $7.6 million in additional state funds to regional centers to implement these changes., which would result in $10.6 million reductions to the regional center budget that funds community-based services (purchase of services) beginning in the July 2006 - June 2007 budget, $21.1 million in the July 2007 - June 2008 budget, and $31.7 million every year after that. This is in addition to previous reductions to that budget made over the past four years.
* Proposes an increase of $2.5 million to expand the Autism Spectrum Disorder Initiative to "meet the immediate and future needs of people with autism and their families.
DEVELOPMENTAL CENTERS
* Budget assumes continued process and transition to close Agnews Developmental Center by June 2007.
MEDI-CAL
* Continues 5% Medi-Cal provider rate cut that was passed as part of the July 2003 state budget and proposed by then Gov. Davis. That took effect January 2006 but its implementation was held off due to a court order until last August. The Governor's budget would continue with the 5% reduction at least for the July 2006 - June 2007 budget.
* Managed Care: Would require, by April 2008, the movement of persons with disabilities and seniors in two (not specified) counties into Medi-Cal managed care, providing that performance standards and other standards are met. Would encourage movement of persons with disabilities and seniors into Medi-Cal managed care in other areas of the state.
* Proposes a 5.4% rate increase to freestanding level B nursing homes and adult sub-acute facilities that provide long term care to Medi-Cal recipients.
* Coordinated Care Management Pilot Project - proposes $473, 00 in funding for a pilot project to coordinate health care services for Medi-Cal recipients with on-going or chronic health conditions who may be seriously ill or near the end of life, and also persons with serious mental health needs and chronic health conditions. Kim Belshe,. Secretary of the Health and Human Services Agency said that In-Home Supportive Services would be coordinated separately.
MENTAL HEALTH
* Special Education (AB 3632 services): Governor proposes to provide $100 million in special education funding for mental health services to special education students required by the federal Individuals with Disabilities Education Act (IDEA). The Governor also proposes including $50 million of non-Proposition 98 (the school funding constitutional amendment passed in 1988) state funds to be set aside in the Commission on State Mandates budget for categorical program funding for mental health services to students beyond those that are required by federal law. The budget proposes to consult with stakeholders and the Legislature to determine how the new categorical program should be structured to ensure "continued services and to maximize" federal funding for services.
* Early and Periodic Screening, Diagnosis and Treatment Program (EPSDT) - Over 185,000 Medi-Cal eligible children and young adults receive services to help with their mental health needs under this program. The budget proposes $714.4 million for the program - a net decrease of $100.6 million from the July 2005 - June 2006 budget. This includes a decrease of $19.1 million for audit disallowances, county self-corrected claims, and other adjustments, and a removal of $139 million in one time reimbursements from the Department of Health Services in the current budget for the settlement of 2002-2003 claims by the counties.
COMMUNITY CARE LICENSING
* Proposes $6.7 million and 75.8 positions for a licensing reform program for the purpose of increasing protections for persons (including those with disabilities and seniors) who live in licensed group homes and residential facilities, and to improve the overall efficiency and effectiveness of the state licensing program. The proposal would increase random sample licensing visits from 10% to 20% every year.
ADULT DAY HEALTH PROGRAMS
Proposes reforms to combat fraud and increase program efficiency including hiring nurses to inspect facilities and the elimination the use of a flat rate. The Governor's budget assumes that these reforms will result in a reduction (or savings to the state) of about $19.3 million ($9.8 million of that in state funds) for the July 2006 - June 2007 budget.

NEXT STEPS
* The Assembly and State Senate Budget Committees will look at the proposed budget and issue by the end of the week a quick general analysis. Both committees have subcommittees dealing with health and human services, another with transportation and housing, another with education, employment and education and by late February or early March begin to hold the first hearings at the State Capitol .
* The Governor's budget requires 2/3rds approval of both houses in order to pass. The new budget year begins July 1.
*CDCAN Disability Rights Townhall Telemeeting scheduled for January 12, Thursday between 1 PM and 3 PM. The Townhall Telemeeting will feature at 1 PM an update from California Health and Human Services Agency Secretary Kim Belshe. Legislative budget consultants on health and human service issues, including Michael Dimmitt of the Assembly Budget Committee, will later participate and provide updates and answer questions on budget issues impacting people with disabilities.

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The California Disability Community Action Network is a non-partisan link to thousands of Californians with developmental and other disabilities, people with traumatic brain and other injures, seniors and their families, community organizations and providers, direct care and other workers, and other advocates. These action alerts and news reports is for all of them.   If you would like to get on this distribution (and conversely, get off of it) please send an email with that request to: martyomoto@rcip.com OR sign up via the NEW CDCAN website at www.cdcan.us Sharing information is part of our organizing effort. Please feel free to forward or copy this (attribution is nice). We're all in this together!