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Glossary of Terms Related to the May Revise Budget
AB 3632: The state has an obligation to provide a free, appropriate public education under the Individuals with Disabilities Education Act (IDEA). This includes an obligation to provide mental health services for individuals with emotional disturbance if needed in order to benefit from the education being provided. Under AB 3632 the state elected to provide required mental health services through county mental health departments.
Adult Day Health Care (ADHC): Community-based day care programs providing a variety of health, therapeutic, and social services to those at risk of being placed in a nursing home.
Budget Year Proposals: The California fiscal year (FY) goes from July 1 through June 30th. The budget proposed by January 10th is for the fiscal year starting July 1 of the year it is introduced, and ending June 30 of the following year. For example the 2010-11 FY budget is the budget for the period that begins July 1, 2010 and ends June 30, 2011. In this example, any proposals that are considered by the legislature for implementation on July 1, 2010 through June 30, 2011 are considered “budget year proposals”.
Cash Assistance Program for Immigrants (CAPI): Cash Assistance Program for Immigrants (CAPI) provides cash assistance to immigrant seniors and persons with disabilities who do not qualify for federal Social Security Income (SSI) because of their immigration status.
California Children's Services (CCS): A state program for children with certain diseases or health problems. Through this program, children up to 21 years old can get the health care and services they need.
California Food Assistance Program (CFAP): A program that provides food stamps for immigrants who do not qualify for federal SSI or food stamps.
The California Health and Human Services Agency (CHHS): Oversees state departments, offices, and boards that provide a range of health care, social, mental health, alcohol and drug treatment, income assistance, and public health services. Departments under CHHS include the Departments of Aging; Alcohol and Drug Programs; Child Support Services; Community Services and Development; Developmental Services; Health Care Services; Mental Health; Public Health; Rehabilitation; and Social Services. Also included are the Offices of Statewide Health Planning and Development; Health Information Integrity; Office of Systems Integration; Managed Risk Medical Insurance Board; and the Emergency Medical Services Authority.
CalWorks (California Work Opportunity and Responsibility to Kids): CalWorks provides cash aid, employment services and other benefits to very low-income families based on eligibility standards set by the state, and is funded under the federal Temporary Assistance for Needy Families (TANF) Program. Unlike its predecessor, Aid to Families with Dependent Children (AFDC), CalWorks/TANF is not an entitlement program, meaning eligible families are not guaranteed benefits. One of the main goals of CalWorks/TANF is to transition recipients to employment, so that cash benefits are no longer necessary. Recipient families must fulfill ongoing work requirements, and there is a time limit on benefits. The federal government sets basic rules for administering TANF cash assistance, but states have the responsibility for developing their programs.
County Mental Health Realignment Funds: Consists of state sales tax and vehicle license fees. Realignment refers to a shift of state funds and program responsibility to counties for various health and social services programs including certain mental health programs. Realignment was enacted through state legislation in 1991.
Current Year Budget: The California fiscal year (FY) goes from July 1 through June 30th. The budget proposed by January 10th each year is for the fiscal year starting July 1 (of the year it is introduced) and ending June 30 of the following year. When the term “current year” is used in the budget context, it means a budget signed in the previous legislative cycle so that the state can operate in the current fiscal year. For example the current FY budget for 2009-10 was introduced in January 2009 and signed in 2010. It provides for operating expenses for the state from July 1, 2009 through June 30, 2010. In this example, if the legislature adjusts any proposals in the already implemented 2009-10 FY budget - prior to June 30, 2010 - then the legislature is making changes to the current budget year because the state is currently in the 2009-10 fiscal year.
Department of Developmental Services (DDS): DDS is the state agency that provides services and supports to individuals with developmental disabilities. These disabilities include mental retardation, cerebral palsy, epilepsy, autism and related conditions. Services are provided through state-operated developmental centers and community facilities, and contracts with 21 non-profit regional centers. The regional centers serve as a local resource to help find and access services and supports available to individuals with developmental disabilities and their families.
Department of Developmental Services (DDS) Budget Advisory Group: Stakeholders that were pulled together in 2009 by DDS/community members to help achieve a reduction of $334 million. The goal for DDS budget 2010 is to achieve an additional $25 million in general fund savings, while maintaining the entitlement to services under the Lanterman Act and ensuring program and service integrity.
Department of Education (DOE): The California Department of Education (CDE) oversees the state’s public school system. The CDE and the State Superintendent of Public Instruction are responsible for enforcing education law and regulations, and for continuing to reform and improve public elementary school programs, secondary school programs, adult education, some preschool programs, and child care programs.
Department of Health Care Services (DHCS): DHCS administers a number of individual health care service delivery programs, including the California Medical Assistance Program (Medi-Cal), California Children’s Services program, Child Health and Disability Prevention program and Genetically Handicapped Persons Program. DHCS also helps maintain the financial viability of critical specialized care services, such as burn centers, trauma centers and children’s specialty hospitals. DHCS funding helps hospitals and clinics located in underserved areas and those serving underserved populations.
Department of Mental Health (DMH): DMH responsibilities include providing leadership for local county mental health departments, evaluation and monitoring of public mental health programs, and administration of federal funds for mental health programs and services. It is responsible for the care and treatment of people at the five state mental hospitals (Atascadero, Metropolitan, Napa, Coalinga and Patton State Hospitals) and at Acute Psychiatric Programs located in the California Medical Facilities in Vacaville and Salinas Valley. DMH is also responsible for implementation of the Mental Health Services Act of 2004 (Proposition 63) which provides state tax dollars for specific county mental health programs and services.
Department of Social Services (DSS): Provides administration and oversight of programs for foster children and youth, children and families receiving aid through the California Work Opportunities and Responsibility to Kids (CalWORKs), adults and elderly in licensed community care facilities, the aged, blind and recipients with disabilities requiring In-Home Supportive Services (IHSS) or Supplemental Security Income/State Supplementary Payment (SSI-SSP) assistance.
Early and Periodic Screening, Diagnosis and Treatment (EPSDT): EPSDT requires states to provide children with all services listed in the Medi-Cal schedule of benefits that are appropriate for children, as well as all other medical services that are eligible for federal matching funds. These services include Therapeutic Behavioral Services and Therapeutic Foster Care.
FMAP or FFP: Ordinarily, the federal government provides 50% of the cost of Medi-Cal services, which is called Federal Medical Assistance Percentages (FMAP) or Federal Financial Participation (FFP). As part of the economic recovery package enacted by Congress in January 2009, this amount was temporarily increased from 50% to 61.59% to provide the state with fiscal relief. This increase in federal funds saves the state $1.5 billion.
Functional index (FI) rank and score: As part of the assessment for services in the IHSS program, the county determines a person’s ability to complete certain tasks. The county then gives a “functional index rank” from “1” to “6” for each of the tasks. This ranking, with a weight to consider other factors, is then averaged out. The result is called the “functional index score”.
Healthy Families Program: Provides 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.
In Home Supportive Services (IHSS): IHSS is a statewide public program providing personal care and domestic services to aged, blind, and disabled Californians who are unable to remain safely in their own homes without such assistance. The IHSS program is successful at keeping people out of more costly and less desirable out-of-home placement in nursing homes or other institutions. IHSS services include personal services such as bathing, dressing and assistance with walking and transferring from bed to chair; domestic assistance such as meal preparation, shopping, heavy house cleaning; and protective supervision. A combination of state, county, and federal funds through Medicaid support the IHSS program. The average monthly number of IHSS hours per consumer is around 84; the average wage for home care workers is around $10.50.
Institutional providers: Providers receiving Medicaid reimbursement for their services, including inpatient and outpatient hospitals and nursing homes.
LPR: Legal permanent residents (LPRs) are individuals from other countries who have been granted the right to reside permanently in the United States. LPRs are often referred to simply as "immigrants," but they are also known as "permanent resident aliens" and "green card holders."
Mandatory Medi-Cal Services: Services which federal law requires state to provide, such as: Inpatient hospital services; Outpatient hospital services; Rural health clinic services; nursing homes; Laboratory and x-ray services; Physician services; Home health services; Pregnancy-related services; and Early and Periodic Screening, Diagnosis and Treatment (EPSDT) services for individuals under age 21.
May Revision: In May of each year, the governor releases a revision to his January budget proposal that reflects updated estimates of state revenues and state taxes. The May Revise can reflect major policy and program changes.
Medi-Cal: California’s version of the federal Medicaid program; most Medi-Cal programs are housed in the Department of Health Care Services. The Medi-Cal program provides health care coverage for more than six million low-income children and families as well as the elderly, blind, or individuals with disabilities. Medi-Cal is jointly funded by the state and federal government. IHSS is part of Medi-Cal, although it is administered by Department of Social Services (DSS). Medi-Cal funds some mental health services as well. California receives matching funds from the federal government which partially support Medi-Cal programs meeting federal requirements.
Medi-Cal County Mental Health Services: Services provided by counties that include inpatient hospital services, outpatient mental health services (including residential services), and targeted case management.
Medi-Cal “Optional” Services: Services that the state provides which are not required under federal law. These include: medical supplies such as diabetic test strips, prosthetic limbs, orthotics, wheelchairs and other durable medical equipment, hearing aids, personal care services (IHSS) and other benefits.
Medically Indigent (MI) Program: Provides low-cost healthcare to former foster youth, nursing facility residents between the ages of 25 and 65, and pregnant women under the age of 25.This includes individuals between 19 and 21 who do not have a disability, are not pregnant, or are not a caretaker relative.
Medically Needy (MN) Program: Provides healthcare coverage to low-income individuals who have a disability and are under age 65. This includes individuals who have a share of cost for Medi-Cal.
Mental Health Managed Care: Counties provide what are called “specialty mental health services” through managed care. These are mental health services that are not provided by physical health care providers or by Medi-Cal fee-for-service providers. These include inpatient hospital services, outpatient mental health services including residential services, and targeted case management. Outpatient services can be provided by psychiatrists, psychologists, licensed clinical social workers, marriage and family therapists, and peer counselors.
Mental Health Services Act (MHSA/Proposition 63) -The MHSA/Proposition 63, passed by voters in 2004, authorized a 1% income tax surcharge on incomes over $1 million. The purpose of the MHSA is to provide funding for innovative community mental health programs to offer support so that people with psychiatric disabilities do not end up institutionalized, in jails or homeless.
Non-Trigger Cuts: Cuts proposed by the governor which are not contingent upon the receipt of federal funds.
PRUCOL Immigrants: Immigrants, who are not citizens, but remain in the U.S. indefinitely with government permission—also known as Permanently Residing in the United States under Color Of Law. These are situations where the United States Citizenship and Immigration Services (USCIS) are aware of the person’s unlawful presence, but are not actively pursuing deportation. Therefore the individual is eligible for benefits and public assistance.
Special Education Services: Services designed to address the individualized educational and related service needs of children with disabilities. Special education services include Early Intervention Services for infants and toddlers, pre-school for students starting at age three, services for school age children in grades K-12, and transition services for eligible students up to age 22.
Supplemental Security Income/State Supplementary Program (SSI/SSP): Supplemental Security Income (SSI) is a monthly payment to people with limited income and few resources who are age 65 or older, blind or have a disability. Children with disabilities can receive SSI. The basic SSI amount is the same nationwide. However, many states, including California, add money (SSP) to the basic benefit.
Trigger cuts: The Governor is asking the federal government to permanently increase the FMAP from 50% to 57%. This would be in addition to the temporary 11.59% increase that is already in effect. He proposed cuts which would go into effect if that increase and other federal funds did not materialize by July 15, 2010, calling them trigger cuts because non-receipt of the federal funds would “trigger” the cuts.
1115 Medicaid Waiver: California’s current section 1115 Medicaid waiver entitled Medi-Cal Hospital/Uninsured Care Demonstration expires on August 31, 2010. The Administration and Legislature have begun planning for a new, more comprehensive 1115 waiver. Recent legislation passed by the California legislature and signed by the Governor (ABx4 61) outlines the goals of the comprehensive waiver: to strengthen California’s health care safety net; reduce the number of uninsured individuals; optimize opportunities to increase federal financial participation; promote long-term, efficient, and effective use of state and local funds; improve health care quality and outcomes; and promote home and community-based care. ABx4 6 also establishes a stakeholder committee that will inform development of a waiver implementation plan and provide ongoing advice to the state during the term of the waiver.
250% Working Disabled Program: Provides affordable healthcare coverage to working individuals with a disability who have a net family income of less than 250 percent of the federal poverty level. For example, 250% of the poverty level for one individual is a gross income of $27,075.