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CAIC
UPDATE
Developmental Services, Medi-Cal, SSI/SSP
Summary of 2004 Budget Act
Department of Developmental Services
In January, the Governor proposed $100M (million) in General Fund
savings in the regional centers' Purchase of Service (POS) budget.
Because of the potential loss of federal matching funds for services
that would be cut, the total cut would likely have been about $140M of
services. The January budget relied on Statewide POS Standards and a
system of parental co-payments as mechanisms to help achieve that
$100-140M in POS savings. However, the manner of reduction and the type
of services reduced remained unknown.
The May Revise proposes to achieve $100M in General Fund savings by:
- Statewide POS Standards ($11.9M savings in 2004/05 and $35.8M when
fully implemented). (Status: This was rejected by both houses of the
Legislature and is dead for this year) replaced by a $7M unallocated POS
reduction.
- Family Cost-Participation Program ($570,000 savings in 2004/05 and
$3.5M when fully implemented). (Status: The Senate version was adopted
by both houses of Legislature and signed into law).
- $6.5M cut to Regional Center Operations. Coming on top of the
continuing cuts from last year, the total cut to Regional Center
Operations would be roughly 10% of their budget. And this happens at a
time when regional centers are expected to do the intensive work in
expanding the use of federal matching dollars. (Status: Adopted and
signed into law).
- $11.9M to develop community housing for Agnews residents - Status:
Signed into Law.
- Savings from the ongoing impact of last year's temporary cost
containment measures ($67.5M), decreased rate of growth ($11.3M), and
new federal funds ($8.7M).
For more information on the proposed Statewide POS Standards and co-pay,
see:
Administration's Full POS and Co-Pay Proposals
PAI's Detailed Analysis of POS Standards
SEIU's Opposition Statement on POS Standards
SEIU's Statement on Parental Co-Pay
Medi-Cal
10% Medi-Cal Provider Rate Reduction - WITHDRAWN - This proposal made by
the Governor in November would have been added onto the 5% reduction
already enacted for the current fiscal year. The additional 10% Medi-Cal
provider rate cut would have brought the total rate reduction to 15%. A
15% rate reduction would have seriously degraded access to healthcare
for people with disabilities.
In a suit brought by the California Medical Association (CMA) and other
plaintiffs, a judge has blocked implementation of the 5% provider rate
reduction which was scheduled to go into effect on January 1, 2004. The
legal action is based on the assertion that a 5% rate cut would severely
limit access to medical care, contrary to Medicaid law. This decision
made the additional 10% reduction impractical to pursue.
Medi-Cal Redesign - Last Spring, the Schwarzenegger Administration held
extensive public input sessions with the goal of developing a federal
waiver proposal for the restructuring of Medi-Cal and achieving $400M in
annual savings. Subjects such as co-payments for Medi-Cal services,
multi tiered service design, and managed care have been under
consideration.
The Administration was expected to unveil Medi-Cal reform proposals in
conjunction with the May Revise and then again on August 2. However, due
to the complexity of the redesign process and the interaction of the
California Performance Review, the Administration delayed release of a
package until the new Legislature convenes.
SSI/SSP
The Legislature negotiated a three month suspension of both the January
2005 state cost of living adjustment (COLA) for SSI/SSP and the pass
through of the federal SSI COLA. The result would be that SSI/SSP
payments would remain the same, without any cost of living increase
three months The Administration had recommended eliminating both the
pass-through and the SSI COLA.
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