CSAC Bulletin Article

Health and Human Services 10/19/2012

CSAC and Partners Release In-Home Supportive Services FAQ 

CSAC, with the County Welfare Directors Association (CWDA) and the California Association of Public Authorities (CAPA), has released a helpful guide of frequently asked questions about the new In-Home Supportive Services (IHSS) statewide bargaining and county maintenance of effort requirements enacted in the 2012-13 State Budget Act. 

The guide, now available on the CSAC website, includes a short background about the interplay of the state’s Coordinated Care Initiative (CCI) and the two major new IHSS policies: moving collective bargaining to the state and implementing a new county maintenance of effort (MOE). Currently, the collective bargaining policies affect eight counties (Alameda, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo and Santa Clara), but the new county MOE applies to all 58. The state may also expand the CCI through legislation in the future.

The FAQ document includes information related to the timing of the new policies, liability, negotiations on wages and benefits, and calculations related to the MOE. For questions about the document, please contact either Kelly Brooks-Lindsey at (916) 327-7500 ext. 531 or Eraina Ortega at ext. 521.

Senate Holds Joint Hearing on Impending Healthy Families Program Transition to Medi-Cal

The Senate Budget and Fiscal Review Committee, chaired by Senator Mark Leno, and the Senate Health Committee, chaired by Senator Ed Hernandez, held a joint oversight hearing on Tuesday to hear updates on the transition of about 800,000 Healthy Families Program (HFP) children to Medi-Cal. 

The elimination of the HFP was included in the 2012-13 Budget Act. The HFP children will be transitioned from the program in four phases throughout 2013. By moving them to the Medi-Cal program, the state will streamline the health coverage for children in time for the implementation of the federal Affordable Care Act in 2014. 

The Senate oversight hearing focused on a series of topics and concerns related to the transition, including health plan readiness, communication activities and county readiness. Further, there were panels on the dental services component and mental health services. It was noted throughout the hearing that federal approval for the HFP shift is pending. Find the agenda, with background materials, here

CSAC supported the shift of HFP participants into Medi-Cal, citing the expanded scope of coverage under the Medicaid program, including more robust behavioral health and substance use disorder services for children. Counties are also ready to provide eligibility services and ongoing case management for the transitioning HFP participants. Both of these points were communicated at the hearing by Cathy Senderling-McDonald, Deputy Executive Director of the County Welfare Directors Association. 

Patricia Ryan, Executive Director of the California Mental Health Directors Association, was also a panelist at the hearing, and she illustrated some of the unknowns regarding the interplay of mental health services for the transitioning children and the funding available to serve them. 

Other groups, including children’s advocates and medical providers, raised serious concerns about access for HFP children. The basic question is this: will HFP children be able to access the care they need under the Medi-Cal program? Lower provider rates in Medi-Cal may prevent physicians from serving the transitioning participants, and there is real concern about access for children in the rural areas of the state. 

Senator Mark Leno indicated to the state representatives at the hearing that the Legislature continues to have reservations about the ambitious timeline for transitioning the children (i.e. starting by January 1, 2013, which may arrive even before federal approval has been granted). Senator Leno encouraged the state Department of Health Care Services to slow down and make an effort to “get it right” so that children’s health care will not be jeopardized. 

Meanwhile, CSAC continues to participate in a number of stakeholder meetings related to the transition, including subgroups concerned with eligibility, access, and communications. We share the goal of ensuring continuity of care and access for HFP children, and will continue to update counties as this policy change moves forward.

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