How the New Budget Impacts People with Disabilities:
A Summary by Disability Rights California’s Legislative Unit
October 18, 2010
On October 8, 2010, the governor signed the state budget, 100 days past the constitutional deadline. The plan addresses the $18 billion gap through cuts, new federal funds, loans, transfers, and fund shifts. Below is a summary of the major items affecting people with disabilities in the final budget. Our budget chart will be updated and posted on our website soon. For additional information, please see:
- http://www.ebudget.ca.gov/pdf/Enacted/BudgetSummary/FullBudgetSummary.pdf
- http://www.cbp.org/pdfs/2010/100618_Budget_Comparision.pdf
- http://www.lao.ca.gov/reports/2010/bud/major_features/major_features_101210.pdf
Adult Day Healthcare:
Rejects the governor's proposal to eliminate Adult Day Health Care.
Medi-Cal:
Rejects:
- Eliminating over the counter drug benefits;
- Enforcing annual caps on durable medical equipment and hearing aids;
- Limiting the number of physician visits and prescription drugs per year;
- Implementing co-payments on emergency room visits, hospital stays, physician and dental visits and pharmacy.
In Home Supportive Services:
Reduces the IHSS budget by $300 million through:
- Establishing a provider fee to generate approximately $190 million in new revenue without cost to consumers or providers;
- $75 million from reduced caseloads; and,
- $35 million in savings from a temporary 3.6% across the board reduction to authorized hours. The reduction will be taken first from any unmet need reported in the consumer's assessment. Consumers can direct how the 3.6% cut is applied to the approved IHSS tasks. The 3.6% cut will be statutorily sunset on June 30, 2012. The effective date for the cut is 90 days following the governor’s signature.
Additional IHSS Changes:
As part of the IHSS package, the service cuts and cuts in the state participation in wages that were part of last year's budget are suspended until July 1, 2012,[1] even if the courts rule in favor of the state.
The final budget expanded the list of crimes which prohibit an individual from providing IHSS services. The current list of crimes (e.g. child abuse, elder abuse, or fraud against a government health care or supportive services program) is now identified as Tier One crimes from which there are no exceptions or expungements. There are however, limited appeal rights.
The crime list was expanded to include “Tier Two” crimes. This change broadens the list of felony convictions that could disqualify a person from working in the program. The care recipient would be informed that the person they have chosen to provide their care has been disqualified and given the reason why. But the recipient would also have the option of getting a waiver that would allow the individual to care for them, as long as the conviction does not fall into the Tier One categories child abuse, elder abuse or government fraud.
Education:
The governor’s budget suspends Proposition 98. The budget funds K-12 education at $49.7 billion, which is $4.1 billion less than the $58.3 billion required by law. The budget will also fund special education by using $340 million that was previously dedicated to the K-3 class size reduction program.
CalWORKS Program:
The budget maintains the CalWORKS program by securing an advance in future federal Temporary Aid to Needy Families payments (a welfare benefit). This allows for a reduction of $366 million in state funds. The CalWORKs program helps families, prevents homelessness and helps detect learning disabilities in CalWORKS recipients as a way to help get services needed to find employment. CalWORKs serves 580,527 families each month, including 1.1 million children. This program brings in over $5 billion in federal funds to the state.
Child Care:
The budget eliminates CalWORKs Stage 3 child care for about 55,000 children beginning November 1, 2010. Stage 3 serves low income families who have successfully transitioned off CalWORKs cash assistance.
Health:
The budget fully funds the Healthy Families program. The governor had proposed to reduce the program by 63.9 million in 2010-11 by reducing the eligibility level. Healthy Families is low cost insurance for children and teens. It provides health, dental and vision coverage to children who do not have insurance and do not qualify for free Medi-Cal.
SSI/SSP/CAPI:
Supplemental Security Income (SSI) makes monthly payments to people with limited income and few resources and who are age 65 or older; blind; or have a disability. The budget maintains current grant levels for individuals. The governor proposed to reduce grants to individuals to the federal minimum from $845 a month to $830 a month.
CAPI provides state cash assistance to immigrant seniors and persons with disabilities who do not qualify for federal SSI. The governor’s budget proposed to eliminate CAPI. The budget retains the CAPI program.
Department of Developmental Services:
The final budget adopts the governor's additional 1.25 percent reimbursement reduction for providers to save the state $25 million. In the 2009-10 budget, a 3.00 % rate reduction was adopted.
Budget language permits, with certain restrictions or exceptions, temporary modifications to personnel requirements, functions, qualifications, or staff training requirements of providers as part of the rate reduction.
The final budget also adopts the closure of Lanterman Developmental Center to transition residents into the community. Adult Residential Facilities for Persons with Special Health Care needs, (also known as 962 Homes) are expanded to accommodate the transition of Lanterman residents. Unfortunately, the budget did not adopt the proposal to expand the 962 homes beyond individuals transitioning from Lanterman. Continuity of care is ensured by allowing Lanterman Developmental Center staff to be contracted out in the community.
The changes to the Lanterman Act made as part of the 2009-10 budget reduced services such as respite and supported living services; suspended services (like camping and social recreation); and, required the use of private insurance and least costly vendors. Regional centers did not always tell people with developmental disabilities and their families about exceptions and exemptions to the service limits or the process for requesting exceptions/exemptions. Therefore, as part of the 2010-11 budget, legislation was adopted that required regional center consumers and families be given notice about the exceptions and exemptions.
Community Mental Health:
The final budget rejected the governor’s proposals that would have reduced community mental health services. Advocates were concerned that if these proposals were adopted, they would have increased crime, and increased state mental health hospital, emergency room, and jail costs. These proposals would have lead to the institutionalization of people needing mental health services, including children. It increased accountability and contained costs by capping rates paid for outside medical care for state hospital residents. The governor did not make any changes to the legislature’s budget in this area.
AB 3632 (Mental Health Special Education Related Services) Mandate Reform:
The final budget rejected the governor’s proposal to suspend the AB 3632 mandate. It allocated money to reimburse counties for providing services in past years. It established a technical assistance program for school districts interested in providing mental health services to children receiving special education. However, the governor vetoed the $133 million the California Legislature had included in its budget package to reimburse county mental health for back monies owed to them for providing AB 3632 services. He also stated that he was suspending the mandate on counties to provide mental health services for special education students for 2010-11. This means that county mental health may no longer be required to provide special education mental health related services. School districts will have to provide the mental health services that had been provided by county mental health.
[1] The 2009-2010 budget eliminated domestic and related services for recipients with FI rankings below level 4 in the activity of daily living related to the particular service (e.g., housework, laundry, shopping and errands, meal preparation and meal cleanup). This eliminates those domestic or related services for individuals who cannot provide the service for themselves without human assistance (FI 3) or who cannot provide the service for themselves without verbal assistance such as reminding, guidance or encouragement (FI 2). Last year’s budget also eliminated IHSS services entirely for individuals with FI scores below level 2 (i.e., the individual may have difficulty performing the function, but completion of the function by the individual poses no substantial risk to his or her safety). These cuts from last year which have been stopped by the courts – the functional index-based cuts and the lowered state participation in provider wages – will be suspended through 7/1/2012 even if the courts rule in favor of the state.
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