May 28, 2019
Senator Holly J. Mitchell, Chair, Budget Conference Committee
Assembly Member Philip Ting, Vice Chair
Senator Jim Nielsen
Senator Richard D. Roth
Senator Nancy Skinner
Senator John Moorlach
Assembly Member Kevin McCarty
Assembly Member Chad Mayes
Assembly Member Jay Obernolte
Assembly Member Shirley Weber
RE: California Community Transitions (CCT) Program – Item 4260
Dear Chair Mitchell, Vice Chair Ting, and Conferees:
Disability Rights California and East Bay Innovations cosponsored and support the Assembly Budget Committee action for the CCT Program:
Item: 4260 – $14.3 million GF in 2019-20 and $19.1 million GF ongoing, resulting in net GF savings, to continue the CCT program.
The Senate Budget Committee took no action on this item.
This budget request supports funding for SB 214 (Dodd) which unanimously passed the Senate. The bill and this budget request would continue the successful California Community Transitions Program (CCT), which has assisted more than 3,500 individuals in moving out of a nursing home and into their own home or other community setting.
In January 2007, the Centers for Medicare and Medicaid Services (CMS) awarded California a grant under the Money Follows the Person (MFP) demonstration. California established CCT to help people who want to transition out of institutional living. There are three key segments. Pre-transition involves identifying people who would like to move, determining if necessary supports are available in the community, and undertaking the preparations needed to insure a move can happen.
Preparations include home modification, first and last month rent, utilities, buying food and household supplies, and more. Pre-transition preparation is individualized to the needs of each person, aimed at making sure the move will be successful. After the transition itself, CCT provides up to a full year of follow-up support so that the adjustment is as smooth as possible.
CCT has successfully demonstrated the State is able to accomplish three goals simultaneously: (1) Medi-Cal beneficiaries living in skilled nursing institutions for longer than 90 days can be transitioned back into community living; (2) California can comply with the Olmstead decision requiring the State to enable people with disabilities to live in the most integrated setting possible; and (3) the State can realize savings since community living is more cost effective for the State.
MFP had a federal sunset of December 31, 2018. Despite efforts to secure federal or state funding before the end of 2018, agencies performing transition services had to begin planning for loss of the program. Some have laid off staff or eliminated transition services altogether because of the uncertainty of the federal funding. The modest extension through September recently approved by Congress and signed by the Senate gives us optimism for more federal funding but that is far from certain. Even without federal funding, this budget request and SB 214 would continue the program without federal funding.
The CCT Program has realized significant GF savings. The average savings per participant per year average approximately $60,000. According to the Department’s estimate pages, in FY 2018-19 the total program costs are estimated to be $10.3 million ($1.5 million GF and $8.7 million FF) and the total savings are estimated at $24.5 million for a net savings of $12.5 million. In FY 2017-18 the total costs were estimated to be $12.9 million ($2 million GF and $10.8 million FF) and the total savings were $28.8 million for a net savings of $14.6 million. Thus, even if the program were funded entirely with GF it would still generate savings for the state.
Moreover, beyond the savings CCT generates, the program helps move people out of institutions and into their homes and communities. Significantly, of the CCT transitions, 83% remained in the community for at least a year.
Very truly yours,
Curtis Child
Legislative Director
Disability Rights California
cc:	Christopher Woods, Senate Budget Director
Joe Stephenshaw, Senate Budget Staff Director
Scott Ogus, Senate Budget Consultant
Kirk Feely, Senate Republican Budget Director
Jason Sisney, Assembly Budget Director
Christian Griffith, Assembly Budget Chief Consultant
Andrea Margolis, Assembly Budget Consultant
Cyndi Hillery, Assembly Republican Budget Director
Marisol Prieto-Valle, Legislative Aide, Office of Senator Bill Dodd