038-2006 Governor To Extend Emergency Drug Coverage to May 16

CDCAN
CALIFORNIA DISABILITY COMMUNITY ACTION NETWORK
DISABILITY RIGHTS NEWS REPORT
Thoughts & Prayers for the Eccles Family & 6 Year Old Daughter Ayla
#038-2006 April 14, 2006 Friday morning
Advocacy Without Borders:
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

BREAKING NEWS
* GOVERNOR EXTENDS EMERGENCY DRUG COVERAGE TO MAY 16
* OFFICIAL ANNOUNCEMENT EXPECTED TODAY
* IMPACTS THOUSANDS PEOPLE WITH DISABILITIES & SENIORS

SACRAMENTO - Gov. Arnold Schwarzenegger is expected to announce today that he is authorizing another 30 day extension of the State's emergency drug coverage, which is set to expire on April 16. The new extension will continue the emergency drug coverage program until at least May 16, 2006 and cannot be extended unless there is new legislation that would authorize the Governor with the authority to continue the program beyond that date. SB 1233 passed earlier by the Legislature, gives authority to the Governor to extend the emergency drug program in 30 day segments up to May 16. A CDCAN Report will be issued when the Governor officially releases his announcement.

Advocates have widely praised the Governor's action in extending the emergency program that potentially impacts over 1 million persons with disabilities (including people with developmental disabilities) and seniors who are eligible for both Medi-Cal and Medicare services and unable to obtain medications under the new federal Medicare Part D Drug Program that began January 1. The State has estimated that over 200,000 of those who are eligible for both programs who had or continue to have problems in getting their medications under the new federal drug program. The extension of the emergency drug coverage program by the Governor will ensure that people with disabilities and seniors who are dually eligible for both Medi-Cal and Medicare will still be able to obtain their medications.

Department of Health Services officials say that about 5,000 persons with disabilities and seniors who are eligible for both Medi-Cal and Medicare are still using the emergency drug program on a average daily basis throughout the State as of early April. The cost of the emergency drug program as of April 14 is over $53 million, of which $47 million the State says will be reimbursed by the federal government. The State however said that those costs are up to and including the date of March 31 which the federal government promised to reimbursed states for emergency drug coverage costs. The State said it is seeking reimbursement beyond March 31 but has received no commitment from the federal government yet.

SB 1233 Gives Governor Authority To Extend Emergency Drug Program
SB 1233 provided temporary relief to tens of thousands of persons with disabilities and seniors by extending the emergency program originally established by the Governor through an executive order he issued on January 12, and later extended in January by the passage of AB 132, which expired on February 11. SB 1233 does the following:
* Continues the emergency drug coverage program the state originally established on January 12 through February 15. Provides the Governor with the authority to extend it further with additional 30 day extensions each, but not beyond May 16, 2006 (unless new legislation extends it beyond that date).
* Authorizes the Governor and the California Department of Health Services to be the "payer of last resort" for persons who are dually eligible for Medicare and Medi-Cal and unable to get their medications through the Medicare program to ensure no person who is dual eligible leave the pharmacy without their needed prescription drugs.
* This means that pharmacies who are participating in the Medi-Cal or Medicare drug programs are required to fill prescriptions, and will be paid for medications under the emergency drug coverage program. This means that people who are dually eligible for both Medi-Cal and Medicare who need the medications can receive it, even if there names do not show up on the Medicare computer program, or their plan or the price of the medications is not correct.
* Continues authorization for the Department of Health Services to spend up to the $150 million cap in state funds, originally authorized in AB 132, for the purpose of the emergency drug coverage program and to seek reimbursement from the federal government..

A new Medi-Cal provider bulletin will likely be issued later today or early next week by the California Department of Health Services and is available at the official Medi-Cal website at http://www.medi-cal.ca.gov OR visit the CDCAN website at www.cdcan.us for a copy of the latest Medi-Cal bulletins, or see the special CDCAN Bulletin that will be issued when the provider bulletin is released.

Hundreds of Thousands of People With Disabilities & Seniors Impacted
* In mid-January, the California Department of Health Services, which oversees the state's Medicaid program (called Medi-Cal) estimated that over 200,000 of the State's 1 million persons with developmental or other disabilities and seniors who are dually eligible for both Medi-Cal and Medicare, were unable to obtain their needed medications or had significant problems - an error rate by the federal government of over 20%.
* The State says that most of these people have received their medications through the emergency drug coverage program.
Adding to that number, at the beginning of each month (February 1, March 1, April 1, etc), the number of Californians who could be impacted by the Medicare Part D Drug Program crisis increases by 10,000 persons with disabilities and seniors who are newly eligible for both Medicare and Medi-Cal. These newly eligible persons are likely to experience problems due to backlog by the federal government and/or by the eight designated drug plans in California.
* As of January 19, 2006, the State had filled 77,514 prescriptions under the emergency drug plan.
* As of January 25, 2006, the State had filled 141,211 prescriptions at a cost of $11.4 million
* As of February 8, 2006, the State had filled 278,929 prescriptions at a cost of $20.3 million in state general fund dollars.
* As of March 16, 2006, the State had filled 585,864 prescriptions for 190,846 people who are eligible for both Medi-Cal and Medicare with at a cost of nearly $39.7 million under the emergency drug coverage plan (the cost being reimbursed by the federal government).
* As of April 14, the state has spent over $53 million on the emergency drug program - of which about $47 million the Department of Health Services says will be reimbursed by the federal government (which covers emergency drug coverage costs up to and including March 31). The State is seeking further reimbursement beyond March 31.

How To Receive CDCAN Capitol News Reports and Alerts
The California Disability Community Action Network is a non-partisan link to tens of thousands of Californians in every community, including people of color, people of every type of disability, including people with physical disabilities, people with developmental and other disabilities, people with traumatic brain and other injures, people with mental health needs, seniors, people with MS, Alzheimer's and others, and all of 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 but not necessary). We're all in this together!
MANY THANKS to Training Toward Self Reliance, UCP, California NAELA, The University Affiliated Programs, CHANCE Inc, Parents Helping Parents, Arriba, Strategies Toward Empowering People, Parents Helping Parents, Asian American parents groups, Resources for Independent Living and many other Independent Living Centers, several regional centers, People First chapters, IHSS workers, other self advocacy and family support groups California Disability Rights Inc , developmental center families, and hundreds of individuals like Maureen Fitzgerald, Terri Lantz, Christal Hopkins, Lisa Brown, Anna Wang, Dennis Dishaw, Bob Benson, David Engberg, Connie Arnold, and so many others who through their support and contributions, make the non-partisan CDCAN reports and townhall telemeetings possible. Thanks also to partnerships and the good people with the State Council on Developmental Disabilities, and also the Department of Health Services, the Department of Developmental Services, Department of Social Services and the CA Health and Human Services Agency and other agencies, and the State Legislature and staff, the Legislative Analyst Office. Good people who do good things can make a difference together!