CDCAN REPORT #042-2011: Agenda (40 pages) for Feb 16th Senate budget committee hearing released

Major Medi-Cal Budget Issues and Healthy Families On Senate Budget Committee’s Hearing Agenda For February 16

• No Public Testimony Will Be Taken Because Issues Previously Heard
• Adult Day Health Care and MSSP Not On February 16th Agenda
• Major Proposed Medi-Cal Cuts Dealing With 10% Provider Cut, Hard Caps or Limits on Services, Co-Payments on Agenda

SACRAMENTO, CALIF  (CDCAN) [Updated 02/15/2011 – 07:20 PM  (Pacific Time)] – Governor Jerry Brown’s proposals calling for sweeping permanent reductions to the Medi-Cal and Healthy Families Program is the focus of the first part of the February 16th 40 page hearing agenda of the Senate Budget and Fiscal Review Committee, scheduled to meet at 1:00 PM at the State Capitol in Room 4203.  The full Senate budget panel, chaired by Sen. Mark Leno (Democrat – San Francisco, 3rd State Senate District) will be taking final action on  the items in the agenda [the 40 page agenda, saved as a document pdf file  - which can be read by persons who are blind or sight impaired using a screen reading device - is attached to this CDCAN Report titled “2011-02-06 - Senate Budget Committee - Agenda.pdf”]

The Governor’s proposed cuts to Medi-Cal – the State’s federally funded Medicaid program that is matched by State general funds – would impact hundreds of thousands of people with disabilities – including those with developmental disabilities, people with mental needs, the blind, low income seniors and low income persons in the Medi-Cal program.  The Governor is proposing $1.7 billion in reductions in State general fund spending for the Medi-Cal program.

Not on the agenda for this hearing is the Governor’s proposal to eliminate two Medi-Cal funded programs – Adult Day Health Care services and the Multipurpose Senior Services Program (MSSP), which could be on the agenda for this committee on February 17th under the California Department of Aging budget issues.   Regional centers and other developmental services will likely be heard by the Senate Budget committee on Thursday.

The agenda, while containing comments by Senate budget committee staff, contains – at least for health issues – no specific recommendations for the full committee.

Sweeping Cuts Proposed to Medi-Cal and Healthy Families

The Medi-Cal proposed cuts proposed by the Governor include:

• 10% permanent reduction in payments to Medi-Cal providers including, for the first time, Intermediate Care Facilities for the Developmentally Disabled (ICF-DD).
• Permanent “hard caps” or limits on several Medi-Cal services and benefits – including limit of 10 office visits per year for adults (except those in long term care facilities and pregnant women and children) to doctor’s offices, rural health clinics, federally qualified health clinics, outpatient clinics, and hospital outpatient department.  Hard cap or limit for adults (children, women who are pregnant and persons in long term care facilities exempt) for six prescription drugs per month.  Would also include yearly dollar caps on what can be spent for durable medical equipment, hearing aids and other services.
• Co-payments for several Medi-Cal services, including doctor visits, use of emergency rooms, pharmacy services, and a $200 maximum co-payment for hospital stays.

Senate Budget Panel Also Meeting February 17th and 18th

As previously reported the Senate budget committee is also meeting on February 17 and 18th to take final actions – including any health budget issues not taken up or acted on February 16th), and the Adult Day Health Care issue could be taken up on either of those dates.

Budget issues impacting regional centers and other developmental services likely will be taken up on Thursday (February 17).

The Assembly Budget Committee, as previously reported earlier today, will take up all open budget issues – including Medi-Cal, regional centers, In-Home Supportive Services, CalWORKS, in one single hearing scheduled for Friday (February 18).  See  below for details.

FEB 16th AGENDA OF SENATE BUDGET & FISCAL REVIEW COMMITTEE

Note: the agenda is 40 pages long.  The Medi-Cal and Healthy Families agenda items take up the first 22 pages and will be heard first.

Agenda
February 16, 2011
Room 4203
1 p.m.

MEDI-CAL/HEALTHY FAMLIES

Department of Health Care Services (Budget Item 4260)

1. Medi-Cal Provider Payment Reduction
2. Intermediate Care Facilties for the Developmentally Disabled
3. Nursing Home Level B (AB 1629 Facilities)
4. Additional General Fund Savings
5. Hard Cap: 10 Visits for Physicians and Clinics
6. Mandatory Copayments for Physician and Clinic Visits
7. Hard Cap: Six Prescription Outpatient Drugs
8. Mandatory Copayments for Pharmacy
9. Mandatory Copayments for Hospital Services
10. Mandatory Copayments for Dental Services
11. Elimination of Over-the-Counter Cough & Cold
12. Limit Enteral Nutrition Products for Adults
13. Establishes Maximum Annual Dollar Limit for Durable Medical Equipment
14. Establishes Maximum Annual Dollar Limit for Durable Medical Supplies  
15. Establishes Maximum Annual Dollar Limit for Hearing Aid Expenditures
16. Proposition 10 Funds for Medi-Cal for Children
17. Trailer Bill Language: Medi-Cal Rates for Lanterman Managed Care Clients
18. Trailer Bill Language: Medi-Cal Eligibility Processing by Counties
19. Trailer Bill Language: 250% Working Disabled Program Change.

Managed Risk Medical Insurance Board (Budget Item 4280)

1. Proposed Increases to Monthly Premiums for Children Enrolled in Healthy Families Program
2. Conforming Issue to Medi-Cal: Mandatory Copayments for Hospital Services
3. Elimination of Vision Coverage

Other Agenda items (detail not listed in this CDCAN Report)

• RESOURCES - (several items)
• TRANSPORTATION - (3 items)
• GENERAL GOVERNMENT - (3 items)

Budget Committees Will Hold Final Hearings This Week

• As previously reported earlier today, both the Senate and Assembly budget committees intend to “close out” (take final action) on most of the Governor’s proposals by this Friday (February 18th)  – that will then move the process into the next phase sometime early next week. 
• Unresolved budget issues between the Senate and Assembly (issues where the houses took different actions) will likely go to a special joint committee called a “Budget Conference Committee”, that will likely meet early next week, with the budget proposal and package of budget related bills (called budget trailer bills that make necessary changes in State law to implement cuts and other changes in the main budget bill) going to the Assembly and State Senate floor possibly the last week of February.

Full Budget Committees Schedule Final Meetings on Budget This Week

• The full Senate Budget and Fiscal Review Committee, chaired by Sen. Mark Leno (Democrat – San Francisco, 3rd State Senate District) has scheduled three hearings over three days beginning Wednesday (February 16th at 1:00 PM) to close out (take final action) on most of the Governor’s proposals – including major spending cuts proposed to Medi-Cal, regional centers (developmental services), In-Home Supportive Services, CalWORKS and other programs. 
• The Assembly Budget Committee, chaired by Assemblymember Bob Blumenfield (Democrat – Van Nuys, 40th Assembly District) however is planning only to meet once – on Friday (February 18th) in a single mammoth hearing to take final action on all of the Governor’s proposals – including those impacting CalWORKS, health, Medi-Cal, regional centers (developmental services), In-Home Supportive Services and other programs.
• No further public testimony will be taken at any of the Senate or Assembly budget committee hearings because the issues have been previously heard with public comment taken.

FINAL BUDGET COMMITTEE HEARING SCHEDULED (UPDATED)

Full Senate Budget Committee Set To Meet 3 Times This Week

All hearings will be televised live and webcasted live on CalChannel). All hearing dates and times and agenda items are subject to change.

FEBRUARY 16, 2011 – WEDNESDAY    ***UPDATED***
SENATE BUDGET & FISCAL REVIEW COMMITTEE
01:00 PM – State Capitol – Room 4203
Budget Items On Agenda:

• Medi-Cal and Healthy Families
• Resources
• Transportation
• General Government

PUBLIC TESTIMONY TAKEN: No – all these issues were previously heard with public testimony taken
CDCAN COMMENT: Adult Day Health Care Medi-Cal issue is NOT on the agenda for this hearing – but could be on this committee’s agenda either for Thursday or Friday.
PRIORITY: EXTREMELY HIGH

FEBRUARY 17, 2011 – THURSDAY    ***UPDATED***
SENATE BUDGET & FISCAL REVIEW COMMITTEE
09:00 AM – State Capitol – Room 4203
Budget Items On Agenda:

• Human Services - including Office of Systems Integration (OSI); Department of Social Services (DSS) that includes In-Home Supportive Services, SSI/SSP; Department of Child Support Services (DCSS); and California Department of Aging (CDA) that could include the Multipurpose Senior Services Program or MSSP budget item.
• Other Health Programs (could include regional centers and other developmental services and other remaining “open” health budget items)
• Public Safety budget items
• Higher Education budget items (includes community colleges)

PUBLIC TESTIMONY TAKEN: No – all these issues were previously heard with public testimony taken
CDCAN COMMENT:  Senate Budget Committee staff says the bulk of human services budget items still “open” will be part of the hearing on February 17 (Thursday).  The hearing dealing with “realignment” (shifting State programs to the counties) proposals for Child Welfare Services, Adoptions Assistance Programs, Drug Medi-Cal and Adult Protective Services is part of the hearing agenda for Friday (February 18th)
PRIORITY: EXTREMELY HIGH

FEBRUARY 18, 2011 – FRIDAY      ****UPDATED***
SENATE BUDGET & FISCAL REVIEW COMMITTEE
09:30 AM (or whenever the State Senate floor session, which convenes at 09:00 AM on Friday, adjourns – which is expected to be around 09:30 AM)
State Capitol – Room 4203
Budget Items On Agenda:

• Revenues
• Redevelopment budget items
• Realignment budget issues (includes certain mental health related community-based services)
• Education – K-12 budget items
• And other remaining “open” budget items

PUBLIC TESTIMONY TAKEN: No – all these issues were previously heard with public testimony taken
CDCAN COMMENT:  While the main focus of this hearing is non-health and human service budget items, the agenda could include health and human services budget items that the Senate committee does not take action on Wednesday or Thursday.
PRIORITY: EXTREMELY HIGH

FEBRUARY 18, 2011 – FRIDAY
ASSEMBLY BUDGET COMMITTEE
Meets Upon Adjournment of Assembly Floor session – which could be anywhere from 09:30 AM to about 10:00 AM
State Capitol – Room 4202
Budget Items On Agenda:

• ALL “open” budget items proposed by the Governor including health (Medi-Cal, Healthy Families, regional centers and other developmental services), human services (In-Home Supportive Services, CalWORKS, SSI/SSP, Child Welfare Services, etc), education, realignment, revenues, etc.

Public Testimony Taken: No – all these issues were previously heard with public testimony taken
PRIORITY: EXTREMELY HIGH

NEXT STEPS

NO MAJOR ACTION YET FROM EITHER HOUSE

• As of February 15th,8:00 PM, both the Assembly and Senate Budget Subcommittees completed their subcommittee budget hearings on all of the Governor’s major proposed reductions in hearings that began the week of January 24th and ended last week on February 10th, including taking in public comment.
• All of the Governor’s major proposals have been kept “open” for later action this week by the full budget committees in both houses.  Those actions where the Assembly and Senate disagree on will likely go to a Budget Conference Committee (composed of members from both houses) to resolve sometime during the week of February 21st.

WHEN WILL LEGISLATURE TAKE FINAL ACTION

• As reported, the full budget committees in both houses have scheduled what will likely be final hearings this week (see above for details) to close out most  “open” budget items (meaning those budget items previously heard in subcommittee hearings but where no action was taken)
• This process by the full budget committees is scheduled to be completed by the end of this week – February 18th in what is a unusually fast paced compressed process.
• Those items not closed (final action taken) or those items where the Senate and Assembly took different action will likely then go to a budget conference committee (which would be chaired by Assemblymember Blumenfield this year) – and then for a final vote by the entire Assembly and Senate.
• It is not certain yet when a final vote by both the full Assembly and State Senate will take place – though the Governor wants the Legislature to send him a budget bill and budget trailer bills by March.

BUDGET PROCESS ON FAST TRACK

• As previously reported, the Governor and Legislature – at the Governor’s urging – have put his proposed 2011-2012 State Budget spending plan on a fast track, to take action on his major proposals before March 1st. 
• The normal State budget process takes usually a half a year or longer  – with subcommittee hearings normally spread out from late February to May. 
• Governor has urged the Legislature to move quickly because a key part of his plan is to place on a special election ballot in June for voter approval his proposal to extend for five years temporary tax increases that are scheduled to expire this year. 
• The Governor also wants quick action on his spending reduction proposals in order for the State to be able to move to implement them by July 1st – and in some cases, within a few months – in order to achieve the greatest savings in State general funding from the cuts.

MORE BUDGET HEARINGS LIKELY IN MAY OR JUNE

• While last week was likely the final time for public comment at a budget subcommittee or full budget committee hearing (people can still contact their own legislators or write letters to members) before the Legislature takes final action on the Governor’s proposals , there will likely be additional budget hearings in May or early June. 
• Those hearings – which will likely take public comment – will likely hear  whatever details the Brown Administration submits to the Legislature on how it plans to achieve whatever reduction amount is targeted for regional centers and other developmental services. 
• Other issues – possibly In-Home Supportive Services – might come up for hearing at that time as further details on various proposals become available.

File Attachments: 

2011-02-16 - Senate Budget Committee - Agenda.pdf