CSAC Bulletin Article

Health and Human Services update 5/30/2014

Budget Actions

The Assembly Budget Committee conducted its final business on Wednesday, May 28 – adopting the subcommittee reports. The Assembly adopted a number of health and human services items of interest to counties. Please note that Dr. Shirley Weber, Chair of Assembly Budget Subcommittee No. 1 on Health and Human Services, is a member of the Budget Conference Committee this year. Highlights of the Assembly actions include:

  • Approved $55 million General Fund to reinvest in the state’s public health infrastructure, including funding specifically for: Black Infant Health, Adolescent Family Life, Pre-Exposure Prophylaxis Demonstration, HIV Demonstration, OA Family Size Eligibility Syringe Access, STD prevention, Teen Pregnancy Prevention, Injury Control, Asthma Public Health Initiative, Dental Disease Prevention, Public Health Lab Training, School Based Health Centers, Drug Overdose Grant, Biomonitoring and Early Mental Health Initiative.
  • Approved $30 million General Fund ongoing to raise rates for non-federally eligible relative caregivers in foster care. Please note that non-federally eligible caregivers receive a child-only CalWORKs grant, which is significantly less than the grant a federally eligible caregiver receives.
  • Approved $20 million General Fund to build the county program support to serve minors who have been commercially sexually exploited or trafficked.
  • Approved start-up capital for two counties to create or expand specialized youth permanency programs.
  • Approved placeholder language to require DSS to begin collecting data on county Child Welfare Services social worker caseloads
  • Approved a monthly $25 per child food benefit for all CalWORKs households also receiving CalFresh, effective April 1, 2015, for a cost of $78 million General Fund in FY 2014-15 (full year cost is $313 million).
  • Approved an increase in the CalWORKs Earned Income Disregard (EID) from $225 to $700, effective April 1, 2015, for a cost of $45 million General Fund (full year cost is $180 million).

Senate Democrats Budget proposals on Public Safety and Mental Health

Senate President Pro Tempore Darrell Steinberg and Senate Democrats have unveiled their budget proposals on public safety and mental health. This was released in conjunction with the Stanford Law School Three Strikes Project report. This report focuses on prisons being the mental health provider in California. The Senate Democrats’ proposals derive from the desire to have more compassionate and cost-effective mental health treatment options. 
The Senate Democrats’ proposal includes:

  • Reforming Sentencing of the Mentally Ill: $20 million from the Recidivism Reduction Fund. Expands the number of Mental Health and Behavioral Health Courts in California.
  • Re-establish the Mentally Ill Offender Crime Reduction Grant Program – $50 million from the Recidivism Reduction Fund
  • Providing Mental Health Training
  • $12 million General Fund for local police departments
  • $24 million General Fund for CDCR
  • Expanding Substance Abuse Treatment – $11 million General Fund to expand to 10 state institutions without reentry hubs
  • Mental Health Parity
  • Reentry for Offender with a Mental Health Diagnoses (Administration Proposal) – $25 million from the Recidivism Reduction Fund. Expand reentry programs to include mentally ill offenders.
  • Integrated Services for Mentally Ill Parolees (ISMIP) – $11.8 million from the Recidivism Reduction Fund. ISMIP program will provide an array of mental health and crisis care services to facilitate independent living.
  • Parole Out-Patient Clinic (POC) Case Managers – $20 million from the Recidivism Reduction fund for 21 social worker positions for case managers for parolees with mental health illness.
  • Prop 36 Offenders to Receive State Services –Services will include transitional housing, mental health and substance abuse treatment to offenders released under Proposition 36, subject to availability. There are no additional state costs associated with the proposal.

To the extent that the Senate’s proposals differ from the Assembly, these items will be heard during the Conference Committee. Leadership in the legislature will then enter into discussions with the Governor.

New Senate Human Services Committee Chair

Senator Jim Beall (D- San Jose), of Santa Clara County was appointed Chair of the Senate Human Services Committee. Prior to the Senate, Senator Beall served as Santa Clara County Supervisor. Additionally, Senator Beall is the former chair of the Assembly Committee on Human Services Committee.

CalWORKs

AB 1029 (Hancock) – Support
As Amended on May 27, 2014

SB 1029, by Senator Loni Hancock, would authorize CalFresh benefits for individuals in the community who were convicted of a drug felony after December 31, 1997. CSAC supports the measure, which was amended in Senate Appropriations Committee to remove CalWORKs eligibility for this population. On May 29, SB 1029 was ordered to the inactive file by request of Senator Hancock. Please note that both the Senate and Assembly versions of the budget include $9 million to fund CalFresh and CalWORKs benefits for drug felons.

AB 1654 (Bonilla) – Support
As Introduced on February 11, 2014 

AB 1654, by Assembly Member Susan Bonilla, would increase the amount of the child support pass through for those on CalWORKs aid from $50 for one child and $100 for a family with two or more children to $100 and $200 respectively. 

CSAC supports the measure, which passed off the Assembly Floor and is awaiting committee assignment in Senate Rules.

Emergency Medical Services

AB 1621 (Lowenthal) – Oppose
As Amended on May 23, 2014

AB 1621, by Assembly Member Bonnie Lowenthal, would create a State Emergency Medical Services Data and Information Systems (SEMSDIS), mandate the use of electronic patient care record systems, and require local EMS agencies to submit patient and system data to the EMS Authority.
CSAC and CHEAC are generally supportive of the concept of expanding the use of electronic emergency medical services data. However, this bill creates a costly regulatory mandate on counties and EMS providers. The cost of implementing an electronic patient care record system can be measured in the tens of thousands of dollars, and funds for this purpose are virtually nonexistent for most counties, most acutely in our rural counties.
For these reasons, CSAC has joined with CHEAC to oppose AB 1621. This measure passed off the Assembly Floor and is awaiting committee assignment in Senate Rules.

Mental Health 

SB 1054 (Steinberg) – Support
As Amended on April 7, 2014

SB 1054, by Senate President pro Tempore Darrell Steinberg, would resurrect the Mentally Ill Offender Crime Reduction (MIOCR) grant program by providing $25 million for juvenile offenders and $25 million for adult offenders in 2014-15. 

The competitive grant program would be administered by the Board of State and Community Corrections and disbursements would be made from the Recidivism Reduction Fund to counties that expand or establish a continuum of swift, certain, and graduated responses to reduce crime and criminal justice costs related to mentally ill offenders over four years. 
CSAC strongly supports Senator Steinberg’s efforts to target funding for intensive services to those who suffer from mental illness in the criminal justice system. SB 1054 passed off the Senate Floor this week.

SB 1161 (Beall) – Support
As Amended on April 29, 2014

AB 1161, by Senator Jim Beall, would require the Department of Health Care Services to expand substance use disorder (SUD) residential treatment capacity and medical detoxification services in California by pursuing a federal Medicaid waiver with the Center for Medicare and Medicaid Services.
SB 1161 seeks to ensure that residential care facilities for substance use disorder and medical detoxification services are available to Medi-Cal beneficiaries. Expansion of provider capacity is a critical component of ensuring that the Medi-Cal expansion meets the needs of those seeking substance use disorder treatment. As California looks to expand treatment capacity, it should partner with the federal government in seeking flexibility in the models for delivering care that will allow for the most cost effective expenditure of public funds. 
CSAC is also supportive of DHCS’s pursuit of a broad federal waiver to test a new model for better access and care coordination within the Drug Medi-Cal program and SUD services at the county level. SB 1161 has moved to the second house, where it is awaiting referral to a committee.

General Assistance

AB 2311 (Bradford) – Oppose
As Amended on May 23, 2014

AB 2311, by Assembly Member Steven Bradford, would alter locally-established General Assistance (GA) eligibility to allow honorably discharged veterans to receive GA benefits for a longer period of time. 
Each county establishes GA benefit eligibility and award levels to best serve the needs of their communities. While counties strive to serve veteran populations, AB 2311 would increase county-funded benefits for a specific population and remove local authority to set GA levels that meets the needs of each community. It was amended in the Assembly Appropriations Committee today; CSAC will review the amendments when they become available. 
AB 2311 passed off the Assembly Floor and is awaiting committee assignment in Senate Rules.

Medi-Cal

AB 1341 (Mitchell) – Support
As Amended on May 6, 2014

SB 1341, by Senator Holly Mitchell, would codify the existing agreement between the Administration, Covered California, and the counties regarding the respective roles of the State Automated Welfare System (SAWS) and the California Health Eligibility Enrollment and Retention System (CalHEERS). 
Specifically, SB 1341:

  • Specifies SAWS as the system of record for Medi-Cal and that SAWS shall contain all Medi-Cal eligibility rules and case management functionality. The bill permits the MAGI rules for Medi-Cal to continue to be housed in CalHEERS as they currently are; and,
  • Requires that Notices of Action (NOAs) for Medi-Cal be programmed into the Medi-Cal system of record: the SAWS systems.

SB 1341 passed out of the Senate 35-0 on May 28 and awaits committee assignment in the Assembly.

Homeless Assistance

AB 1452 (Stone) – Support
As Amended on April 2, 2014

AB 1452, by Assembly Member Mark Stone, would increase the amount of CalWORKs homeless assistance funding available to a family of four from $65 to $75 and increase the daily maximum based on family size to $135. It would also require annual adjustments of the amount based on increases or decreases in cost of living expenses. 

CSAC supports the measure, which passed off the Assembly Floor this week. 

AB 1733 (Quirk-Silva, Maienschein, Atkins) – Support
As Amended on May 23, 2014

AB 1733, by Assembly Members Sharon Quirk-Silva, Brian Maienschein and Assembly Speaker Toni Atkins, allows a fee waiver for a homeless person to obtain a certified certificate of live birth from the county registrar or recorder or an identification card from the Department of Motor Vehicles (DMV). 
CSAC supports AB 1733. As the service provider of last resort for indigent Californians, counties deal with the effects of homelessness across our systems, including health, human services and public safety. AB 1733 will facilitate access for homeless people to services that are critical to helping them move towards self-sufficiency. Government and non-governmental entities fund a variety of services that help ensure the health and safety of homeless and low-income people. However, eligibility must be established in order to access these services, which often requires proof of identity with a birth record or valid identification card. Providing these services to homeless persons reduce costs to government and society overall, but particularly counties. 
AB 1733 passed off the Assembly Floor 77-0 on May 28. The measure is awaiting assignment to committees in the Senate.

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