2009-2010 Budget Items Affecting
Families of Children with Special Health Care Needs

Budget Items

How Will This Affect Children and Families?

Medi-Cal

• Eliminates cost-of-doing business funds to counties to conduct Medi-Cal eligibility processing ($49.4 million)
• Deletes $54.2 million (10%) from certain public hospitals and safety net care hospitals to backfill General Fund expenditures

• Will result in delays in determination of eligibility
• If triggered: could affect capacity of hospitals to serve low-income and trauma patients

In Home Support Services (IHSS)

• Reduces state’s share of cost contribution to new IHSS recipients to limit wages of IHSS workers to $10.10/hour
• Limits IHSS share-of-cost program to current recipients in 2009-10 fiscal year

• If triggered , could result in difficulties gaining access/obtaining/retaining home health workers
• If triggered, could result in inability of new beneficiaries to obtain services

Regional Centers

• In addition to continual yearly reductions, this budget cuts 3% in funding to all Regional Centers and all programs they fund, impacting all community programs
• An initial statewide cut of $100 million to Regional Centers. Regional Centers are required to find ways to maintain services in light of this cut, but if they are unable to, there will be an additional cut of 7.1% in provider reimbursement rates as of September 1, 2009.
• Reduces Regional Center Operations by 3% by suspending several administrative and case management requirements in existing law.

• Would contribute to continuing loss of providers from system, with accompanying loss of access for children
• Would result in reduced availability of services (e.g. increased delays) for children and youth, particularly those over age three who lack federal mandate protection; if further payment reductions triggered, would contribute to continuing loss of Medi-cal providers from system, with accompanying loss of access for children
• Would result in reduced availability of services (e.g. increased delays) for children and youth, particularly those over age three.

Genetically Handicapped Persons Program (GHPP)

• Reduction of $1.4 million in GHPP by increasing enrollment fees by 1.5% to 3% of Adjusted Gross Income for families with incomes ranging between 200% and above 300% of FPL

• Increased enrollment fees may push some enrollees off GHPP

Suspend Supplemental Security Income/State Supplementary Payment (SSI/SSP) Cost of Living Adjustment (COLA)

• Reductions of $79.8 million in 2008-2009 and $487.3 million in 2009-2010 by suspending the state’s portion of the SSI/SSP COLA.
• Reductions of $27 million in 2009-2010 State SSP COLA and $323.9 million annually starting in 2010-2011

• Despite not having a cost of living adjustment for many years, increases in cost of living expenses (housing, food, transportation etc.) continue to rise. Without a cost of living increase in income, families will have to make choices that adversely impact the health of their family and children with special health care needs.

CalWorks Program

• Suspends the July 2009 CalWorks COLA, a reduction of $79.1 million

• Reduces CalWorks grants by 4%, a reduction of $146.9 million. For a family of three, this cut will result in a loss of $29 monthly, reducing a grant of $723 to $694

• Increases in cost of living expenses (housing, food, transportation etc.) may require families to make choices that may adversely impact the health of their family and children with special health care needs.
• If triggered, this will require families to make choices that may adversely impact the health of their family and children with special health care needs.  

Additional Budget Issues

Reductions in Local California Children’s Services (CCS) Program Funding

• Reductions averaging 17% per county (but as high as 58% in some counties) in local administrative funding for CCS programs implemented as part of new state “capped allocation” methodology for local CCS administrative budgets
• Reductions of 4.5% in administration of Medical Therapy Program in combination with capped allocation for CCS

• Resulting in hiring freezes and lay-offs of county staff (nurses, social workers, clerks and others) and accompanying delays in CCS eligibility determinations and authorizations for services
• Cancellation of contracts for Parent Health Liaisons who assist in providing family-centered care, information, education and support
• Resulting in hiring freezes and lay-offs of therapists and support staff and delays in access to services

May 19th 2009 Special Election:
Proposition 1D
Would transfer $268 million annually from the California Children and Families Trust Fund to a newly established “Proposition 10 Health and Human Services Fund,” to be appropriated to the state budget, during fiscal years 2009-10 through 2013-14 and would redirect up to $340 million from the state First 5 commission’s current fund balance to the 2009-10 state budget.

• Will redirect more than 50% of First 5 Revenues, primarily from local First 5 commissions, that are currently funding prevention and early intervention services for California’s youngest and most at-risk children
• Limits First 5 commissions to “direct services,” potentially eliminating core programs including: Children’s Health Initiatives, insurance premium payments, training and recruiting health and early education providers, preschool and quality child care in underserved communities,  and coordinating services for young children.

• Threatens children at greatest risk by reducing available funds for health care, developmental screening, dental care, child safety programs, obesity prevention, quality child care, preschool and support for their families
• First 5 is one of the few efforts in California to fund prevention and early intervention strategies that eliminate long-term and costly problems. In the long term, these cuts are likely to worsen future budget problems.