048-2006 Budget Conference Committee Begins Meeting Today.htm

CDCAN
CALIFORNIA DISABILITY COMMUNITY ACTION NETWORK
DISABILITY RIGHTS NEWS REPORT
#048-2006 May 31, 2006 - Wednesday
Advocacy Without Borders:
Connecting people with disabilities & seniors to rights and unified action
IN MEMORY OF WARREN A. MATTINGLY WHO PASSED AWAY MAY 24
1225 8th Street Suite 480 - Sacramento, CA 95814 916/446-0013 Fax: 916/446-0026
To Respond to THIS email report reply to: martyomoto@rcip.com
CDCAN website: www.cdcan.us

BUDGET CONFERENCE COMMITTEE TO MEET WED MAY 31
BIG ISSUES IMPACTING PEOPLE WITH DISABILITIES/SENIORS:
* Supported Employment Program Increased Funding
* Restoring Jan-March 2007 SSI/SSP Federal Cost of Living
* Additional Increases In Funding for Many Regional Center Programs
* Proposed Elimination of Governor's Regional Center Cost Containment
* Major New Health Care Coverage for Low Income Children
* Medi-Cal Provider Rate Increase

SACRAMENTO -   The State budget process moves a major step forward with the first meeting of a joint budget committee scheduled this morning (May 31, Wednesday morning at 10:00 AM in the State Capitol, Room 4203) to resolve differences in actions on the budget taken by either the Assembly or the State Senate. The State Legislature leaders - barring an unforeseen events - are pushing to pass a State Budget on or close to the state constitutional deadline of June 15 for the first time in nearly 20 years. The budget conference committee is scheduled to meet daily through the next several days going through the 290 page agenda before sending the budget package for what legislative leaders hope will be final votes on the floor of each house.

Members of the Budget Conference Committee
The 6 member special joint budget committee - called a "conference committee" is composed of two Democrats and one Republican members from each house and is chaired this year by Sen. Wes Chesbro (Democrat - Arcata, 2nd District) who is the chair of the Senate Budget and Fiscal Review Committee. The other Conference Committee members are:
* Sen. Denise Ducheny (Democrat - San Diego, 40th District)
* Sen. Dennis Hollingsworth (Republican - Murrieta, 36th District), Senate Budget & Fiscal Review Committee vice chair
* Assemblymember John Laird (Democrat - Santa Cruz, 27th District), and Assembly Budget Committee chair.
* Assemblymember Judy Chu (Democrat - Monterey Park, 49th District), Assembly Appropriations Committee chair
* Assemblymember Rick Keene (Republican - Chico, 3rd District), Assembly Budget Committee vice chair

Advocates Urge Support for Employment, SSI, & Other Community Program Funding
Advocates are urging the budget conference committee to adopt actions taken earlier in April and May by the Assembly Budget Subcommittee #1 on Health and Human Services including:
* A significant increase in funding for supported employment program that provides employment opportunities for thousands of persons with developmental disabilities
* A substantial increase in funding for many community-based programs beyond the 3% in the Governor's budget, as proposed by the a statewide association (California Rehabilitation Association);
* The ending of cost containment measures for several regional center funded community-based services and programs including repealing the "narrowing of the eligibility standard" for regional center services that was adopted as part of the budget several years ago
* Restoring the January-March 2007 federal cost of living increase for SSI/SSP recipients that currently will be withheld as a result of last year's budget deal (both houses rejected the Governor's proposal to extend the withholding of the federal cost of living increase for SSI/SSP recipients by another 15 months beginning April 2007. What remains in place is the withholding of the January-March 2006 and 2007 federal cost of living increase for SSI/SSP recipients, and also the state cost of living increase which was suspended for two years beginning January 2006.
* Other advocates are pushing hard for the development of a major health care coverage program under the Department of Health Services for low income children of families at or below 300% of the federal poverty level, while others are pushing for increases proposed also by the Assembly for increases in rates paid to Medi-Cal providers.

A CDCAN Alert was issued this morning (Wednesday, May 31) and a CDCAN Disability Rights Townhall Telemeeting will focus on the issue of supported employment program funding - and also employment of persons with disabilities on June 1, Thursday from 1 PM to 2:45 PM. See CDCAN notice or go to the CDCAN website at www.cdcan.us

SUMMARY OF SOME OF THE MAJOR ISSUES
This is a summary of the major issues where actions by the Assembly and State Senate were different - issues that impact people with disabilities and/or seniors covering regional centers, IHSS, Medi-Ca/Health. A full CDCAN Report of other issues before the budget conference committee will be issued later today covering aging, mental health, special education and other issues impacting people with disabilities and seniors.

SSI/SSP BUDGET ITEMS IN CONFERENCE COMMITTEE
* ISSUE: Eliminate 3 Month (January-March 2007) Withholding of Federal Cost of Living Increase for Supplemental Security Income (SSI) Recipients (Budget Item 5180-111-001, Issue #606)
State Agency: Department of Social Services
What Assembly Did in April-May: Allocated $42.3 million from State general funds and adopted budget related legislative language ("trailer bill") to repeal the 2005-2006 State Budget action that withholds for 3 months (January-March 2007) the federal cost of living increase to SSI/SSP recipients. No action was taken on rescinding the withholding that occurred for the first three months of 2006.
Budget Amount Changed by Assembly: $42,291,000 added to proposed budget
What Senate Did in April-May: Did not take this action.
Budget Amount Changed by Senate: -0- ( No change made)
Difference Between the Two Houses:
- $42,291,000
Impact: Major impact to people with disabilities and seniors receiving SSI/SSP

REGIONAL CENTER BUDGET ITEMS IN CONFERENCE COMMITTEE
* ISSUE: Rate Adjustments for Specific Programs Including Supported Employment
Budget Item: 4300-101-001, Issue #300 and budget related legislative ("trailer bill") language and Budget Item #5160, Issue 100A relating to supported employment programs
State Agency: Department of Developmental Services (and the Department of Rehabilitation also has some jurisdiction over Supported Employment Programs)
What Assembly Did in April-May: Increased by $45.2 million ($34.6 million of that State general funds) above the Governor's proposed one-time 3% rate increases for Community Care Facilities, Day Programs, Supported Employment Programs, Transportation, Supported Living, Look Alike Day Programs and Respite Care to do the following:
- A wage pass through for certain direct care staff as provided through rate adjustments ($27.7 million)
- Adjustments to Supported Employment Program ($17.5 million)
- Conforms action on supported employment program under the Department of Developmental Services budget with action on budget item regarding supported employment program under the Department of Rehabilitation budget (Issue 100A)
Budget Amount Changed by Assembly: $34,562,000 added to budget
What Senate Did in April-May:
- Increased above what the Governor proposed by $6.1 million ($4.3 million from State funds) above the Governor's proposed 3% one-time rate increases for specific community programs by providing an additional increase of 10% for Supported Employment Programs.
Budget Amount Changed by Senate: -0- (not applicable)
Difference Between the Two Houses:
- $30,296,360 and also adopted different budget related legislative ("trailer bill") language to implement.
Impact: Huge. Major impact to people with developmental disabilities and their families, community providers, regional centers if Assembly action is adopted by the conference committee.

* ISSUE: Start-up and Development of New Community Programs
Budget Item 4300-101-001, Issue #102 A and budget related legislative ("trailer bill") language)
State Agency: Department of Developmental Services
What Assembly Did in April: Rejected the Governor's proposal to continue the freeze on the start-up and development of new community programs by restoring the full amount and deleting the "freeze" provision in the proposed budget related legislation ("trailer bill").
Budget Amount Changed by Assembly: $5,962,000 added to the budget for this purpose.
What Senate Did in May: Also denied the Governor's proposal to continue the freeze on new start-up and development of new community programs and but instead allocated $3 million in State general funds to focus program development on "integrated living options, employment and integrated social activities". Adopted budget related legislative ("trailer bill") language for this.
Budget Amount Changed by Senate: $3,000,000 added to the budget for this purpose
Difference Between the Two Houses:
- $2,962,000 and also adopted different budget related legislative ("trailer bill") language to implement.
Impact: Huge. Major impact to children and adults with developmental disabilities and their families and community providers who want to develop and start-up new community programs.

* ISSUE: Cost Containment Measures on Regional Center Funded Community-Based Programs
Budget Item: 4300-101-001, Issue #102 B and budget related legislative ("trailer bill") language)
State Agency: Department of Developmental Services
What Assembly Did in April-May: Rejected the Governor's proposal to continue for another year the "cost containment" measures on several regional center funded community-based programs and restored funding of $19.7 million ($17.1 million of that from State general funds) that would lift the various cost containment measures:
- Ended the narrowing of eligibility changes made in 2003 ($2.1 million),
- Eliminated the freeze of certain temporary rates for day programs and in-home respite programs ($2.8 million).
- Reduced the amount of time for regional centers to conduct assessments of new consumers back to 60 days. from the 120 days that was put into effect as a cost containment measure a few years ago ($4.5 million);
- Ended the use of SSI/SSP cost of living adjustments passed through to fund residential care to offset State general funds going for residential services ($3.3 million);
- Ended the unspecified or "unallocated" reduction from previous year for the regional center budget that funds community-based services (POS or "purchase of services") ($7 million);
- Adopted budget related legislative ("trailer bill") language for this purpose.
Budget Amount Changed by Assembly: $19.7 million added to budget to lift cost containment measures
What Senate Did in April-May: Except for start-ups and development of new community programs, the Senate approved continuing the Governor's cost containment measures for at least one more budget year (2006-2007).
Budget Amount Changed by Senate: -0-
Difference Between the Two Houses:
- $17,138,000 and also adopted different budget related legislative ("trailer bill") language to implement.
Impact: Huge. Major impact if Assembly action is adopted to children and adults with developmental disabilities, community organizations and providers, especially the ending of the narrowing of eligibility standards and lifting the freezes.

* ISSUE: Regional Center Case Managers
Budget Item: 4300-101-001, Issue #102 C & budget related legislative ("trailer bill") language)
State Agency: Department of Developmental Services
What Senate Did in April-May: Increased above what the Governor proposed by $3.2 million ($1.7 million from State funds), to hire case managers and related staff to ensure compliance with federal Medicaid Home and Community Based Waiver requirements.
Budget Amount Changed By Senate: $1,700,000 added to budget
What Assembly Did in April-May: Agreed with the action taken by the Senate and also increased by an additional $26.6 million ($18.4 million of that State general funds) to adjust the case manager back from 1 for every 66 persons to 1 for every 62 persons. Also adopted budget related legislative language to implement this new ratio.
Budget Amount Changed by Assembly: $20,064,0000 added to budget
Difference Between the Two Houses:
- $18,364,000 and Assembly adopted budget related legislative ("trailer bill") language to implement while the Senate did not.
Impact: Major impact if Assembly action is adopted by the conference committee

* ISSUE: Rejection of Governor's Proposal For New Regional Center Contract Language to Restrict Use of Services
Budget Item: 4300-101-001, Issue #223 & budget related legislative ("trailer bill") language)
State Agency: Department of Developmental Services
What Senate Did April-May: Rejected the Governor's proposal to implement substantial policy changes through new contract language with the 21 non-profit regional centers that also called for increase of $7 million (State general funds) in regional center operations to hire 58 new positions to control the spending of services and supports for persons with developmental disabilities, and reducing the the regional center budget that funds community-based services and supports by $10.9 million in State general funds for the 2006-2007 budget year. No budget related legislative language was adopted.
What Assembly Did in April-May: Agreed with the Senate action and rejected the Governor's proposal, but also adopted budget related legislative ("trailer bill") language that specifically prohibits the Department of Developmental Services from achieving budget savings as proposed by the Governor through regional center contract language.
Difference Between the Two Houses:
- Assembly adopted budget related legislative language and the Senate didn't (no difference in budget amount)
Impact: Major impact in rejecting the Governor's proposal, which both houses agreed on. The "trailer bill" language proposed by Assembly may provide more assurances that it won't be implemented - but the major impact is the actual rejection of the proposal that both houses agreed on.

* ISSUE: Supported Employment Program and Work Activity Program Reporting Language
Budget Item: 5160, Issue #100B
State Agency: Department of Rehabilitation (shares some oversight with Department of Developmental Services over these programs)
What Senate Did in April-May: Senate adopted language in the budget bill itself that will require the Department of Rehabilitation and the Department of Developmental Services to report to the Legislature by April 1, 2007 on the flow of people with developmental disabilities (consumers) in Supported Employment Programs and Work Activity Programs between the two departments.
Budget Amount Changed by Senate: -0-
What Assembly Did in April-May: Did not take any action on this issue.
Budget Amount Changed by Assembly: -0-
Difference Between the Two Houses:
- $30,296,360 and also adopted different budget related legislative ("trailer bill") language to implement.
Impact: Important impact to those people with developmental disabilities in those programs and to community-based organizations providing those programs and to regional centers.

SOME KEY MEDI-CAL BUDGET ITEMS IN CONFERENCE COMMITTEE
* ISSUE: Governor's "Right Sizing" Licensing and Certification Fee Proposal
Budget Item: 4260-004-001, Issue #103 & budget related legislative (trailer bill) language
State Agency: Department of Health Services
What Senate Did April-May: Changed Governor's proposal which provides 141 positions for increased surveys, significant increases of licensing and certification fees paid by health care facilities, provides for $4.570 million to pay for state-owned facilities and "certified only" facilities that cannot be charged fees and deletes the existing fee exemption for all other public entities. The Senate instead approved:
- Approved a total of 141 positions
- Approved $4.570 million for state-owned facilities
- Increased by $1.2 million to continue paying fees for District Hospitals
- Increased by almost $10 million to reduce the fee increase to be paid by primary care clinics, specialty clinics, home health agencies, psychology clinics, hospice facilities, ICF DD-H, and ICF-DD-N facilities, skilled nursing home facilities
- Adopted draft budget related legislative (trailer bill) language instead of the language proposed by the Department of Health Services.
Budget Amount Changed by Senate: $15,745,000
What Assembly Did April-May: Assembly approved the following
- Approved a total of 141 positions
- Rejected the Governor's the May Revised Budget proposal to provide $4.570 million for state operated facilities
- Rejected the budget related legislative (trailer bill) language for fee adjustments proposed by the Department of Health Services
- Did not off-set licensing and certification fees with State general fund money.
Budget Amount Changed by Assembly : -0- (
Difference Between the Two Houses:
- $15,745,000
Impact: Major potential impact to many Medi-Cal community-based providers, and other health providers serving people with disabilities and seniors if the Senate action is adopted by the conference committee. Delays in licensing and certification has been a huge issue.

* ISSUE: Medi-Cal Provider Rate Increase (Fee-For-Service) to at least 50% Medicare Rates
Budget Item: 4260-101-001, Issue #159 & budget related legislative (trailer bill) language
State Agency: Department of Health Services
What Assembly Did April-May: Assembly added to the budget $30 million ($15 million of that State funds) to increase the reimbursement rates paid to Medi-Cal "fee for service" providers to at least 50% of the reimbursement rates paid by the federal Medicare program. Also adopted budget related legislative (trailer bill) language to implement this.
Budget Amount Changed by Assembly : $15,000,000
What Senate Did April-May: Did not take this action.
Budget Amount Changed by Senate: -0-
Difference Between the Two Houses:
- $15,000,000 and budget related legislative language adopted by Assembly
Impact: Huge. Major impact to Medi-Cal "fee for service" providers (including private doctors that people with disabilities and seniors select) if the conference committee adopts the Assembly action.

* ISSUE: Medi-Cal Managed Care Rate Adjustments (Increase)
Budget Item: 4260-101-001, Issue #130 & budget related legislative (trailer bill) language
State Agency: Department of Health Services
What Senate Did April-May: Senate added by $16.9 million ($8.4 million of that from State general funds) to correct the Governor's May Revised budget amount of $61.2 million ($30.6 million of that from State general funds) to provide a rate adjustment to six managed care healthcare plans, as financially reviewed by the Department of Health Services, to maintain 200% of their tangible net equity. Senate did not believe budget related legislative (trailer bill) language was necessary.
Budget Amount Changed by Senate: $39,025,000
What Assembly Did April-May: Assembly added by an additional $18.7 million ($9.3 million State funds) above what the Senate approved to provide the following:
- $8.6 million more to the Central Coast Alliance
- $6.1 million more to Santa Barbara
- $4 million more to the Health Plan of San Mateo
- Also adopted budget related legislative (trailer bill) language to reflect rate increases for these three plans.
Budget Amount Changed by Assembly : $48,374,000
Difference Between the Two Houses:
- $9,349,000 and budget related legislative language adopted by Assembly
Impact: Important impact to the six health plans and to the people with disabilities and seniors enrolled in those plans.

* ISSUE: Program for All Inclusive Care (PACE) New Rates at 95% Upper Payment Level
Budget Item: 4260-101-001, Issue #160 & budget related legislative (trailer bill) language
State Agency: Department of Health Services
What Assembly Did April-May: Assembly added to the budget $8.1 million ($4 million State funds) to establish new rates for the Program for All Inclusive Care for the Elderly (PACE) program at 95% of the upper payment level.
Budget Amount Changed by Assembly : $4,039,000
What Senate Did April-May: Did not take this action.
Budget Amount Changed by Senate: -0-
Difference Between the Two Houses:
- $4,039,000 and budget related legislative language adopted by Assembly
Impact: Important.

* ISSUE: State Staff for Medi-Cal/Two New Managed Care Models
Budget Item: 4260, Issue #026
State Agency: Dept of Health Services
What Senate Did April-May: Rejected the Governor's proposal to increase by $1.1 million and 11 positions to create through budget related legislative language (budget "trailer bill") two separate and new Medi-Cal Managed Care models for persons with disabilities and seniors eligible for both Medicare and Medi-Cal called "Access Plus" and "Access Plus Community Choices" because the issue requires "substantial" policy discussion first.
Budget Amount Changed by Senate: -$525,000 reduced from Governor's proposed budgeted amount
What Assembly Did April-May: Approved Governor's proposal and new positions, but rejected the proposed budget related legislative language (budget "trailer bill" language)
Budget Amount Changed by Assembly : -0- (No change made to Governor's proposed budgeted amount)
Difference Between the Two Houses:
- $525,000
Impact: Important to people with disabilities & seniors dually eligible for Medicare and Medi-Cal where pilots will be conducted.

* ISSUE: State Staff for Medi-Cal/Coordinated Care Pilots
Budget Item: 4260, Issue #094
State Agency: Dept of Health Services
What Senate Did April-May: Changed the Governor's proposal that proposes $473,000 ($208,000 of that State funds) for 5 staff positions to establish two "coordinated care pilot projects" for "Fee ForService" (private physician) Medi-Cal recipients who are "high end" users of Medi-Cal services, by eliminating two of the five positions.
Budget Amount Changed by Senate: -$84,000 reduced from Governor's proposed budgeted amount
What Assembly Did April-May: Approved Governor's proposal and positions.
Budget Amount Changed by Assembly: -0- (No change made to Governor's proposed budgeted amount)
Difference Between the Two Houses:
- $84,000
Impact: Important

* ISSUE: State Staff for Medi-Cal/Outreach for Enrollment for Medi-Cal Managed Care for Persons with Disabilities, Seniors and the Persons who are Blind
Budget Item 4260, Issue #095
State Agency: Department of Health Services
What Senate Did April-May: Changed the Governor's proposal to increase enrollment of persons with disabilities, seniors and the blind into the Medi-Cal managed care by eliminating 4 of the proposed 9 requested positions and replacing the Governor's proposed budget related legislative language ("trailer bill") with new language that is not codified (does not add to or change or delete existing state codes).
Budget Amount Changed:: -$168,000 reduced from Governor's proposed budgeted amount
What Assembly Did April-May: Approved Governor's proposal of 9 positions but agreed with the Senate's budget related legislative language ("trailer bill").
Budget Amount Changed: -0- (No change made to Governor's proposed budgeted amount)
Difference Between the Two Houses:
- $168,000
Impact: Important

* ISSUE: Medi-Cal Processing
Budget Item: 4260-101-001 - budget related legislative (trailer bill) language
State Agency: Department of Health Services
What Assembly Did April-May: Approved budget related legislative language (trailer bill) to require the Department of Health Services to estab lish an automated procedure to give Medi-Cal providers access to designated information about providers' patients who are Medi-Cal enrollees, regarding their annual eligibility and redetermination schedules.
Budget Amount Changed by Assembly : -0- (budget related legislative language only)
What Senate Did April-May: Did not take this action.
Budget Amount Changed by Senate: -0-
Difference Between the Two Houses:
- Budget related legislative language adopted by Assembly
Impact: Important.

IN-HOME SUPPORTIVE SERVICES BUDGET ITEMS IN CONFERENCE COMMITTEE
* ISSUE: State Staff for Dept of Health Services Audits: IHSS Investigations
Budget Item: 4260, Issue #162)
State Agency: Dept of Health Services
What Assembly Did April-May: Added $408,000 to Governor's original proposal ($204,000 of that State funds) to provide 4 Fraud Investigator positions (2 year limited term) to conduct In-Home Supportive Services investigations.
Budget Amount Changed by Assembly: $204,000 added to Governor's proposed budgeted amount
What Senate Did April-May: Did not take this action.
Budget Amount Changed by Senate: -0- ( No change made to Governor's proposed budgeted amount)
Difference Between the Two Houses:
- $204,000
Impact: Of interest especially to people with disabilities and seniors and their families using IHSS, county agencies

HEALTH CARE BUDGET ITEMS IN CONFERENCE COMMITTEE
* ISSUE: State Support to Establish Health Care Coverage for All Low-Income Children
Budget Item: 4260, Issue #160 and budget related legislative language)
State Agency: Dept of Health Services
What Assembly Did April-May: Adopted budget related legislative language ("trailer bill") to establish a health care program for low income children in families with incomes at or below 300% of the federal poverty level and increased funding to the Department of Health Services by $4.250 million ($2.125 million state funds) to provide state resources for the development of this new program. Is linked to another issue, Budget item 4280-103-0001, Issue 128)
Budget Amount Changed by Assembly: $2,125,000 added to proposed budget
What Senate Did April-May: Did not take this action.
Budget Amount Changed by Senate: -0- ( No change made)
Difference Between the Two Houses:
- $2,125,000 and Assembly adopted budget related legislative ("trailer bill") language to implement (Senate did not take either action)
Impact: Major potential impact to low income families with children with disabilities, mental health needs with incomes 300% at or under the federal poverty level.

REHABILITATION BUDGET ITEMS IN CONFERENCE COMMITTEE
Note: see Regional Center Budget Items In Conference Committee section for one budget issue impacting supported employment program and work activity program under the Department of Rehabilitation.
* ISSUE: Vocational Rehabilitation Cooperative Programs
Budget Item: 5160, Issue #002
State Agency: Department of Rehabilitation
What Assembly Did April-May: Adopted the Governor's May Revision of his proposed budget increasing by $1,050,000 (federal funds) for Vocational Rehabilitation Cooperative Programs.
Budget Amount Changed by Assembly: $1,050,000 (approved Governor's proposed increase)
What Senate Did April-May: Did not take this action.
Budget Amount Changed by Senate: -0- (
Difference Between the Two Houses:
- $1,050,000
Impact: Important

CDCAN Capitol News Reports and Alerts
These CDCAN Reports are partially funded by a small grant from the USC UCEDD, Grant #90DD0540 from the Administration on Developmental Disabilities. The opinions expressed or content in these reports do not necessarily reflect the views or opinions of the USC UCEDD.
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MANY THANKS to Training Toward Self Reliance, UCP, California NAELA, Californians for Disability Rights, Inc (CDR), 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, developmental center families, and hundreds of individuals. 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.