May Revise Items Heard by Budget Subcommittees

This week, the Senate and Assembly Budget Subcommittees on Health and Human Services, Sub. 3 and Sub. 1 respectively, convened hearings on May Revise items, in addition to voting on items previously before the Subcommittees. Highlights are provided below.

Note, that in order to meet the June 15 Constitutional deadline for the Governor to sign the budget, the Senate and Assembly Subcommittees will close out remaining items next week. The budget Conference Committee will then work to reconcile differences between the two houses, followed by full Budget Committee hearings.

 

CCI/IHSS

Both Subcommittees heard the Governor’s revised CCI/IHSS proposal as outlined in the May Revision (see page 1 of the CHEAC May Revise Memo). The Administration provided an overview of the proposal remarked that updated proposal accomplishes three key considerations related to concerns put forth by counties:

• No longer shifts $623 million to counties, but instead through General Fund assistance, significantly decreases the costs counties will bear;
• Provides counties with predictability through establishing an new MOE structure; and
• Allows time for counties to ease into assuming increased costs by providing a higher amount of General Fund relief in the initial years (years 1 and 2).

The Legislative Analyst’s Office (LAO) presented their recommendations based on their understanding of the proposal. They recognized that it does achieve some county priorities, however noted the Administration’s proposal is very complex and limited details are currently available. The LAO did question the policy bases behind the MOE as they recommend matching the fiscal responsibility with the level of control the state and county would have over the costs of the program. Additionally, the LAO put forth two potential short-term options for consideration:

1. Provide some level of General Fund relief to counties for two years, which would not require changes to 1991 Realignment during those years.
2. Adopt the Governor’s proposal for two years.

CSAC testified before the Subcommittees, thanking the Administration for their continued conversation and willingness to mitigate the impact to counties. They provided support for the first two years of the Administration’s proposal, but noted the out-years would have devastating impacts counties and the services we provide. They emphasized that reopening the agreement before the out-years it critical for counties. CSAC’s budget letters can be found here and here.

Both Subcommittees held the item open. A vote is expected next week.

 

CCS Medical Therapy Program

Both the Subcommittees heard the Administration’s trailer bill related to the provision of medically necessary physical therapy (PT) and occupational therapy (OT) services within the California’s Children’s Services (CCS) Medical Therapy Program (MTP) (TBL No 642). During the Administration’s overview, they alluded to litigation and challenges at the state level requiring the CCS program to continue MTP services beyond those that are medically necessary, when included in the child’s individual education program (IEP). The proposed trailer bill clarify the provision of these services are limited to those deemed medical necessity and would further require the CCS appeals process to be used for disputes. CHEAC has taken a SUPPORT position on the trailer bill, given litigation and challenges at the local level. Our letter of support can be viewed here and here.

The Senate Subcommittee No. 3 rejected the Administration’s proposal after raising concerns around ensuring children have adequate access to services. The Assembly Subcommittee No. 1 held the item open.