Budget Hearings Continue with Mental Health and IHSS Issues 

Both houses convened budget hearings this week, with the Assembly Budget Subcommittee No. 1 meeting both on Monday and Wednesday. The Senate Budget and Fiscal Review Subcommittee No. 1 met on Thursday to hear mental health and alcohol and drug issues. 

The Assembly Budget Subcommittee No. 1, chaired by Assembly Member Holly Mitchell, heard items related to the new Department of State Hospitals. Please recall that the state is proposing to increase the bed rate that counties pay state hospitals by $20 million. The Department indicated that it will return in May with a methodology for the new rates. Initially, they are considering a tiered rate based on level of acuity. The Subcommittee asked the Office of State Audits and Evaluations to do a follow-up audit of state hospital finances, and adopted placeholder trailer bill language (TBL) to expand the Incompetent to Stand Trial pilot program in county jails. Currently, the pilot only operates in San Bernardino county. The state is seeking authority to expand it statewide.

On Wednesday, the Assembly Subcommittee heard aging issues and the Governor’s proposed cuts to the In-Home Supportive Services (IHSS) program. The Subcommittee rejected both the Governor’s proposal to cut domestic and related services for IHSS recipients, as well as the trigger cut from December 2011 that would have reduced all IHSS hours by 20 percent. The Subcommittee also repealed the Medication Dispensing Machine Pilot Project and held open both the Public Authority Rate-setting Methodology and proposed clean-up technical language on provider background checks.

The Assembly Subcommittee will reconvene on Monday to hear issues related to the Governor’s proposal to shift Healthy Families Program children into the Medi-Cal program. The Subcommittee will also hear child support and social services issues on Wednesday. 

The Senate Budget and Fiscal Review Subcommittee No. 3, chaired by Senator Mark DeSaulnier, met on Thursday to hear issues related to the community mental health, state hospitals and alcohol and drug programs. The Subcommittee discussed the realignment of Medi-Cal Specialty Mental Health, the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program, and the transition of these programs within both counties and the state. 

The Senate Subcommittee members expressed their displeasure with the Administration that the realignment trailer bill language is not complete. A number of provider groups and stakeholders expressed concerns about the realignment of EPSDT, suggesting that the realignment proceed slower or be delayed. If the mental health programs are not realigned this year but realigned at a later date, the constitutional protections would not apply. Providers also expressed concerns that counties were cutting contracts to a federal entitlement program and that was impeding children’s access to services.

The Subcommittee also discussed the transition of Drug Medi-Cal to counties as part of realignment. In testimony, provider groups expressed concern that some counties were limiting or capping services. Please recall that Drug Medi-Cal is a federal entitlement program and that counties cannot limit access or approved services. Under federal law, beneficiaries are entitled to freedom of choice and statewide access to services.

The Senate Subcommittee will reconvene next Thursday, April 19 to hear issues related to Child Welfare Services, Adult Protective Services and realignment.

CalWORKs

SB 970 (de Léon) – Support
As Amended on April 9, 2012

SB 970, as introduced by Assembly Member Kevin de Léon, would help integrate the process for applying for public programs such as CalFresh and CalWORKs with the new online health coverage application process that is under development by the state. 

SB 970 would build on California’s existing service integration by ensuring that people applying for health coverage through CalHEERS can also begin the application process for other public programs, including CalFresh and CalWORKs. A comprehensive stakeholder workgroup, including representatives from county human services departments, among others, would be established by the bill to review whether additional programs should be included in the process.

SB 970 also provides that if a health program renewal form has the necessary information to renew eligibility for CalWORKs or CalFresh, that the renewal for those other programs is satisfied. This is important not only to ensure that applying for and retaining eligibility for multiple programs does not become more difficult after 2014, but so that the state can continue working towards full participation in federally funded human services and work support programs. 

Finally, SB 970 would maximize enrollment into health coverage by enabling CalFresh recipients who are uninsured to allow the information in their CalFresh case file to be used to file an application for health coverage. This will ensure that as many eligible individuals and families as possible get the health coverage they need through the Medi-Cal expansion and subsidies in the Exchange. 

The Senate Health Committee passed SB 970 on April 11, and it goes next to the Senate Appropriations Committee. 

AB 1691 (Lowenthal, B.) – Support
As Introduced on February 15, 2012

AB 1691, by Assembly Member Bonnie Lowenthal, would allow non-English speaking CalWORKs recipients, which include refugees and other legal immigrants, to participate in English as a Second Language (ESL) instruction for eight months. Time spent in ESL instruction would count as a core activity and counties would have the option of extending ESL participation for up to 12 months on a case-by-case basis. 
CSAC supports AB 1691, which was passed by the Assembly Appropriations Committee on March 28 and is now on the Third Reading File of the Assembly. 

AB 1970 (Skinner) – Support
As Introduced on February 23, 2012

AB 1970, by Assembly Member Nancy Skinnner, would streamline the eligibility structure across the CalWORKs, CalFresh, and Medi-Cal programs.

This measure, titled the Social Services Modernization and Efficiency Act of 2012, would conform eligibility requirements for the above programs to existing federal law, allow recipients to choose electronic forms for certain types of communication, interviews, and notices, and simplifies the interview process for people in immediate need of benefits. The measure will also codify the practice of recertifying CalFresh households at the end of their Traditional CalFresh Period to prevent lapses in nutritional benefits. 
Counties also support the provision requiring the state to make state plans for changes in service to the federal government electronically available, and we understand that Assembly Member Skinner will take an amendment to ensure that individuals with small children are not penalized if they are meeting the federal 20-hour work requirement in CalWORKs. 

Taken all together, these small modernization changes will streamline human service programs for recipients and counties, and serve to illustrate the efficiencies to be gained from the careful use of technology. The Assembly Human Services Committee passed AB 1970 on April 10, and it goes next to the Assembly Appropriations Committee. 

AB 1998 (Achadjian) – Support
As Amended on March 29, 2012

AB 1998, by Assembly Member Katcho Achadjian, would help bridge the “digital divide” by allowing counties to donate surplus computer property directly to recipients of public assistance to aid in employment and assistance efforts.

CSAC supports AB 1998, which will be heard by the Assembly Local Government Committee on April 18. 

AB 2352 (Hernández) – Support
As Introduced on February 24, 2012

AB 2352, by Assembly Member Roger Hernández, would allow CalWORKs applicants and recipients to own reliable cars by deleting the requirement that counties assess the value of a motor vehicle when determining or redetermining CalWORKs eligibility.

AB 2352 is similar to last year’s AB 1182, which was vetoed by the Governor. Counties believe that this change will promote work participation and self-sufficiency among low-income California families and eventually help CalWORKs recipients move off of public aid. It is for these reasons that we support Assembly Member Hernández’s measure again this year. 
The Assembly Human Services Committee will hear AB 2352 on April 24. 

Child Welfare Services/Foster Care

SB 1279 (Wolk) – Support
As Amended on April 9, 2012

SB 1279, by Senator Lois Wolk, would authorize the Department of Social Services to receive information from other systems about outcomes for children who have left foster care. 

CSAC, along with the County Welfare Directors Association (CWDA), support the continued evolution of outcome measurements for children who have left foster care, and support SB 1279. The measure was passed by the Senate Human Services Committee on April 10, and will next be heard by the Senate Appropriations Committee. 

SB 1319 (Liu) – Support
As Amended on April 11, 2012

SB 1319, by Senator Carol Liu, is a highly technical measure that would make three small changes to existing law, but it will streamline certain components of the foster care system for the foster family homes, agencies, and treatment facilities that treat and house our state’s most vulnerable children.

The technical changes in the measure were proposed by San Bernardino County and are supported by the County Welfare Directors Association. The Senate Human Services Committee passed SB 1319 on April 10, and it next goes to the Senate Appropriations Committee. 

AB 1712 (Beall) – Support
As Amended on March 21, 2012

AB 1712, by Assembly Member Jim Beall, is a technical clean up measure relating to 2010’s Fostering Connections to Success Act. The Act extended foster care services to youth up to age 21 and helps the state draw down additional foster care funding from the federal government. 

AB 1712 was created with input from counties, foster family agencies, and myriad other stakeholders, all with a singular goal in mind: To make foster care services as accessible and efficient as possible for all youth and non-minor dependents that need them. 

The Assembly Human Services Committee will hear AB 1712 on April 24.

Medi-Cal

AB 1785 (Lowenthal, B.) – Support
As Introduced on February 21, 2012

AB 1785, by Assembly Member Bonnie Lowenthal, allow federally qualified health centers (FQHCs) and rural health clinics to draw down federal funding for patient visits with marriage and family therapists.
The Assembly Health Committee passed AB 1785 on April 11, and the measure will be heard next in the Assembly Appropriations Committee.

CalFresh

AB 1560 (Fuentes) – Support
As Introduced on January 30, 2012

AB 1560, by Assembly Member Felipe Fuentes, will help low-income families who are eligible for the state’s Medi-Cal program to also receive CalFresh nutritional benefits. 

Specifically, AB 1560 would waive the gross income test for any individual who receives, or is eligible to receive, Medi-Cal medical benefits. The measure would also allow those who live in households with those who receive or are eligible to receive Medi-Cal benefits to qualify for the CalFresh program. 

CSAC supports AB 1560, which was passed by the Assembly Human Services Committee on April 10. The measure will be heard next in the Assembly Appropriations Committee.

Public Health

SB 1329 (Simitian) – Support
As Amended on March 29, 2012

SB 1329, by Senator Joe Simitian, would simplify the way counties may establish a local prescription drug collection and distribution program.
Senator Simitian’s SB 798, signed into law in 2005, allows counties that pass a local ordinance to collect unused prescription medications from skilled nursing facilities and pharmaceutical manufacturers for the purpose of distributing these surplus supplies to those who may not be able to afford medications. This program has been successfully implemented in San Mateo and Santa Clara counties. SB 1329 would simplify the process for counties to authorize a program by a Board of Supervisors action or by the action of the county’s public health officer. The bill also widens the pool of entities that may participate in a local program thereby casting a wider net for eligible pharmaceuticals available for the program.

CSAC and the County Health Executives Association of California (CHEAC) support SB 1329, which was passed by the Senate Health Committee on April 11. The measure will next be heard by the Senate Business, Professions, and Economic Development Committee. 

AB 2109 (Pan) – Support
As Introduced on February 23, 2012

AB 2109, by Assembly Member Richard Pan, would require a parent or guardian seeking an immunization personal belief exemption for their child to provide a document signed by themselves and a licensed health care practitioner acknowledging that the parent or guardian has been informed by the health care practitioner of the benefits and risks of immunization as well as the health risks associated with communicable diseases. 

CSAC and the County Health Executives Association of California (CHEAC) support AB 2109, which will be heard by the Assembly Health Committee on April 17. 

AB 2246 (Pérez, J.) – Support
As Amended on March 29, 2012

AB 2246, by Assembly Speaker John A. Pérez, requires the new California Healthy Food Financing Initiative Council to establish and maintain a web site that outlines information on the Council’s actions to support access to healthy foods by March 31, 2013. 

The measure builds upon the Speaker’s AB 581 from 2011, which created the California Healthy Food Financing Initiative to promote access to healthy food throughout California. Counties support these efforts to combat “food deserts” within communities – areas with little to no access to quality foods that are both healthy and affordable. 

CSAC supported AB 581 last year and now supports AB 2246. The measure was passed by the Assembly Health Committee on April 10 and will be heard next in the Assembly Agriculture Committee. 
In-Home Supportive Services

AB 1841 (Silva) – Oppose
As Introduced on February 22, 2012

AB 1841, by Assembly Member Jim Silva, would remove the right of In-Home Supportive Services (IHSS) recipients to choose a provider and dismantle an effective system that identifies former offenders and protects counties and the state from liability for a recipient’s hiring decision. 
CSAC, along with the County Welfare Directors Association (CWDA), and the California Association of Public Authorities for IHSS (CAPA), opposed AB 1841. The measure failed passage in the Assembly Human Services Committee on April 11. 

Adult Protective Services

AB 2149 (Butler) – Support
As Introduced on February 23, 2012 

AB 2149, by Assembly Member Betsy Butler, would allow victims of elder abuse to continue to contact, cooperate with or file a claim of elder abuse regardless of whether a civil settlement action has been rendered. 
AB 2149 failed passage in the Assembly Judiciary Committee on April 10, but the committee has granted a reconsideration of the measure at a future date.