On June 13, the Legislature sent to the Governor its 2019-2020 budget bill (AB 74), two days before the June 15 constitutional deadline. The $215 billion budget follows nearly six months of budget hearings in the Legislature on the Governor’s budget that he proposed in January and his updated May Revise and final negotiations between the leaders of the two houses of the Legislature and the Governor. The Legislature will begin taking up the package of approximately 15-20 “trailer bills,” some that are still being finalized, that contain the policy necessary to implement the funding levels and priorities in the budget bill on June 17. Those bills are not subject to the June 15 deadline. The Governor has twelve days to sign or veto the budget bill. He can also exercise his line item veto authority (known as “blue pencil”) and strike or reduce any particular budget item included in the budget. It is expected that he will sign the budget bill very soon and it is unknown whether he will use his blue pencil. Since the budget bill is negotiated between the leadership, it is expected there would be few, if any, blue penciled items.

The budget includes new spending for special education, homelessness, developmental disability provider rates, Medi-Cal expansions, health care for undocumented immigrants, an Earned Income Tax Credit expansion and nearly $20 million in reserves. The budget, once again, does not include an increase in the Supplemental Security Income/State Supplemental Program (SSI/SSP). Overall, the continuing strong economy and revenue stability provided the opportunity for the Governor, in his first budget, and the Legislature to advance a progressive budget.

Major provisions in the budget, and those that are expected to be included in trailer bills, that impact persons with disabilities, are discussed below.

Covered California-Health Benefit Exchange

• Approves of $450 million over three years for the Health Benefit Exchange to provide subsidies to persons below 138% of the federal poverty level to cover full premium cost and additional subsidies for individuals between 400% and 600% of the federal poverty level.
• Imposes an individual mandate penalty for individuals that do not purchase minimum essential coverage.

Developmental Services

System Reform Discussion Group

• Requires the department to consult, commencing in the summer of 2019, with specified stakeholders, including representatives of the Developmental Services Task Force, the Department of Rehabilitation, and DRC to discuss system reforms to better serve consumers with developmental disabilities, and to perform various duties, such as evaluating compliance with federal rules relating to specified services, to report on the progress of these efforts, and to post specified material on its internet website, including a summary of public comments.

Regional Center Transparency and Accountability

• Provides, in trailer bill, that regional centers will be required to provide a list of agreed upon services and supports at the end of an IPP meeting, including the amount and duration of the services, which must be translated into the consumer’s or the consumer’s family’s native language.
• Provides in trailer bill that regional centers must post on their website the assessment tools and guidelines for determining the need for some of the most common services: independent living, supported living, personal assistance and transportation along with the post respite assessment tools and guidelines already required.
• Provides $8 million dollars for additional DDS staff to support increased transparency and accountability and includes the following reporting by regional centers:
  • Regional center boards to hold an annual meeting regarding the National Core Indicators, identify needed areas for improvement in consumer services and a meeting regarding contract performance measures and needed improvements. Both meetings must provide language access for consumers and families who do not speak English.
  • Development of standard informational packets for consumers and families that provide an overview of the early start and regional center system, provide a resource guide, and information about consumer rights and translate these packets.
  • Regional Centers must provide DDS with copies of corrective action plans and sanctions issued to providers. DRC may receive these corrective action plans or sanctions upon request.
  • Increased reporting to the legislature regarding HCBS compliance, safety net for individuals in crisis or complex behavioral needs, and disparities identification and improvement.

Services for Individuals in Crisis or Who Have Complex Behavior Needs

• Provides lower service coordinator caseloads for individuals with complex service needs.
• Limits the use of restraints in community crisis homes and requires the department to develop restraint guidelines by March 2020.
• Requires, effective January 1, 2020, a 6500 commitment order for individuals placed in Institutions for Mental Disease (IMD) not to exceed 13 months.
• Limits the proposed use of Canyon Springs, a state-run community institution, to individuals transitioning from a short-term acute crisis unit, an IMD, or a provisional placement from a developmental center. The use of Canyon Springs for this purpose ends on June 30, 2022.
• Provides $4.7 million one-time, temporary funding to open an acute crises unit at Porterville Developmental Center until additional central valley-based state-operated community-based acute crises units are developed and operational.
• Expands the number of community crisis homes, including crisis homes for children, and requires the department to develop guidelines for the use of restraint in these homes.
• Requires the department to identify new service models and the state’s role in providing services for individuals private providers will not serve.
• Did not approve $5 million for the development of safety net targeting regional center consumers who also have mental health disabilities.
• Requires DDS to notify the clients’ rights advocate (CRA) of individuals when the regional center initiates a 6500 commitment petition for an individual in an IMD, and when a regional center consumer is placed in a psychiatric hospital or at the Canyon Springs state-run community facility.

Provider Rates

• Approves an across-the-board $100 million rate increase for all services eligible for a rate increase in the rate study effective January 1, 2020 with additional total increases of $100 million in subsequent fiscal years subject to a rate suspension trigger on December 31, 2021. Sheltered workshops, where individuals with disabilities work in segregated settings at subminimum wages, will not receive a rate increase.
• Suspends the Uniform Holiday Schedule, a predetermined 14 days when all regional center funded programs were closed until January 1, 2022.

Early Start

• Approves $11 million in funding and prohibits requiring families to use private insurance and make co-payments, as required by federal law.

Social Recreation and Camping

• Does not restore social recreation and camping. These services, suspended during the great recession, allowed regional centers to fund camp and services such as swim lessons and integrated recreation programs.

Education

Special Education

• Provides $152.6 million in ongoing Proposition 98 funding to bring all LEAs to the statewide base rate for special education funding and $493.2 million to provide grants to LEAs serving three and four year olds with Individualized Education Plans. Adopts trailer bill language to require ongoing funding to be contingent upon the passage of legislation in 2020-21 budget to reform the special education system to improve outcomes for students.

K-12

• Provides $50 million in Proposition 63 funding ($10 million of this is ongoing) for the Mental Health Student Services Act to provide competitive grants to partnerships between county mental or behavioral health departments and school districts, charters schools and county offices of education.
• Provides $10 million in ongoing General Fund (suspended December 31, 2021) for the Emergency Childcare Bridge Program for Foster Children to provide additional access to early care and education services for abused and neglected children.

Early Childhood

• Provides $300 million in one-time General Fund for the Full-Day Kindergarten Facilities Grant program and prioritizes schools converting part-day to full-day Kindergarten programs and allows for any remaining grant funding to be used for other one-time costs to implement the full-day kindergarten program.
• Approves 10,000 full-day State Preschool slots for non-LEAs beginning April 1, 2020 and allocates $31 million in ongoing funds in 2019-20 and approximately $125 million in 2020-21 to annualize these additional slots.
• Provides $195 million in one-time funds for the Early Learning and Care Workforce Development Grants Program to increase the educational attainment of the childcare workforce.
• Approves of $23 million Proposition 56 for Medi-Cal trauma screenings and $60 million Prop 56 one-time for provider trainings on administering trauma screenings.

Earned Income Tax Credit

• The Governor proposed in his May Revise to expand the Earned Income Tax Credit (EITC) from $400 million to $1.2 billion to make it available to approximately 3 million households. A resolution has not been reached between the Legislature and the Governor on the amount of the EITC and accompanying tax conformity.

Equal Access Fund/Access to Justice

• Increases the Equal Access Fund by $20 million one-time General Fund to provide legal aid for renters in landlord-tenant disputes, including legal technical assistance, training, advice and consultation, and representation.
• Provides $2.5 million General Fund for the Sargent Shriver Act Civil Counsel Act.

Homelessness

• Provides $500 million in one-time funds for housing related infrastructure to help boost needed construction, $500 million (one-time) for a mixed income loan program through CalHFA, $500 million in one-time funds to expand the Low Income Housing Tax Credit, $250 million for planning grants to help local jurisdictions work through the Regional Housing Needs Assessment, and $650 million in one-time funds to help local jurisdictions address the homelessness crisis.

IHSS

• Includes trailer bill language requiring that the development and implementation of the electronic visit verification system adhere to specified principles including the prohibition that it not utilize geo-tracking or GPS capabilities.
• Restores the IHSS seven percent reduction to service hours through December 31, 2021.

Long-Term Care

• Approves of $1 million General Fund one-time and budget bill language to require DHCS to conduct an actuarial study related to the creation of a state-run long-term care insurance program.
• Approves increase of $1 million to provide additional one-time funding to local Long-Term Care Ombudsman programs.
• Approves of $4.2 million in 2019-20 and $5.2 million in 2020-21 and ongoing for the Long-Term Care Ombudsman Program, with trailer bill language to require quarterly visits to Skilled Nursing Facilities and Residential Care Facilities for the Elderly.

Medi-Cal

• Approves of the full-scope Medi-Cal expansion for young adults, regardless of immigration status, beginning January 1, 2020.
• Approves of $124.9 million ($62.4 million General Fund) ongoing and trailer bill to raise Medi-Cal eligibility to 138% of FPL for the Aged and Disabled program (individuals 65 and older).
• Approves of $17.4 million General Fund in 2019-20, $40.5 million General Fund ongoing, and trailer bill to restore all Medi-Cal optional benefits (including audiology; incontinence creams; optical; podiatry; and speech therapy) beginning January 1, 2020.

Mental Health

• Approves of $100 million General Fund for Whole Person Care Programs to increase housing for homeless mentally ill individuals, and approves of $20 million General Fund for counties without Whole Person Care Pilot Programs to provide similar services.
• Approves of $50 million General Fund one-time for mental health workforce, including: $1 million one-time for the Mental Health Practitioner Education Fund and $2.65 million one-time for the UC Primary Care Psychiatric Fellowship Program.
• Approves trailer bill to extend Medi-Cal eligibility from 60 days to one year for post-partum women diagnosed with a mental health disorder.
• Approves of $3 million General Fund one-time for technical assistance to counties, and $5 million General Fund one-time for a competitive grant program, and placeholder trailer bill, on reducing mental health disparities.
• Approves of $50 million (Mental Health Services Fund, $40 million one-time, $10 million ongoing) for school-mental health partnerships.
• Approves of $15 million (Mental Health Services Fund) one-time to establish local centers to provide integrated youth mental health services.
• Approves the Governor’s Budget proposal to provide $5.3 million ongoing General Fund to support student mental health services at the University of California.
• Provides $3 million one-time from Proposition 63 state administration account to support student mental health services at California State University.
• Provides $7 million one-time Proposition 63 state administration fund to support student mental health services at California Community Colleges.

Public Safety

• Approves moving the Division of Juvenile Justice from CDCR to the Health and Human Services Agency and creates a committee within the Child Welfare Council to provide recommendations on juvenile justice policies that will improve youth outcomes and reduce recidivism. Provides $1.2 million ongoing General Fund for key staff to plan the transition and to launch a new independent training institute that will train all staff on best practices.

SSI / SSP

• The budget does not include any increase in the SSI/SSP grant.

State Hospitals

• Approves of $3.2 million for minimum wage for patient-workers at DSH and trailer bill to prohibit sweeping of patient funds for housing and treatment costs.

Voting

• Approves of $87.3 million General Fund to help fund the upgrade and replacement of county voting systems. This level of funding provides counties with more than 50 precincts a match of $3 from the state for every $1 of county money spent and no matching requirement for counties with fewer than 50 precincts. This will provide an additional 25 percent of the estimated vote center model costs for counties with over 50 precincts ($65.7 million), which brings the state’s investment to 75 percent of total estimated costs; full funding of the estimated polling place model costs for counties with 50 or fewer precincts ($3.6 million); and $18 million for county election management system replacements.