CSAC Bulletin Article

Health & Human Services Budget Items

May 23,2019

CSAC is following a number of budget-related items as the legislative budget process proceeds toward the constitutional deadline of June 15 for the Legislature to pass the state budget.  

The health and human services-related budget subcommittees of both houses have concluded their work, and the Senate Budget and Fiscal Review Committee convened yesterday to approve their version of the budget proposal. The Assembly Budget Committee will meet tomorrow.

We are highlighting the health and human services items below on which CSAC has engaged and the Legislature is diverging from the Governor’s May Revision Budget, either in policy or funding, or both. Any items where actions from the Governor, the Assembly, and the Senate differ will need to be settled in the Budget Conference Committee or final budget negotiations.

For the CSAC May Revision Budget Action Bulletin, click here.  
For the CSAC January Budget Action Bulletin, click here.

IHSS MOE Proposal

Both the Senate and Assembly Budget Subcommittees approved the Governor’s proposal to revise the County In-Home Supportive Services (IHSS) Maintenance of Effort (MOE), which counties strongly support as it will create a more sustainable IHSS fiscal structure. However, the subcommittees also adopted placeholder trailer bill language to approve the request from the United Domestic Workers of America (UDW) that a county’s MOE inflation factor would only be reduced to four percent if they have a collective bargaining agreement in place that pays IHSS providers an amount that exceeds the state minimum wage. CSAC is opposed to this request and outlined our concerns in a coalition letter this week with the Urban Counties of California and the Rural County Representatives of California. We will continue advocating that UDW’s language to link collective bargaining and the reduced inflation factor not be included in the final budget agreement to enact the revised IHSS MOE.

CalWORKs Stage One Child Care and Single Allocation

In the May Revision, the Administration proposed $40.7 million State GF in 2019-20 to expand CalWORKs Stage One Child Care from the current six month eligibility to a 12 month eligibility period. Additionally, the May Revision included a $41.4 million increase for the employment services component of the Single Allocation and to separate out the child care component from the Single Allocation. The subcommittees took various actions on these related proposals. The Senate Budget and Fiscal Review Subcommittee No. 3 approved a proposal to provide $25 million ongoing GF, expand authorization to full-time care until families are transferred to Stage Two or 12 months, specify eligible child care activities, and fund a data sharing system between county welfare departments and child care contractors. The Assembly Budget Subcommittee No. 1 and the Senate Budget and Fiscal Review Committee both took action to delay the separation of the child care component until 2020-21. CSAC supported the increased funding for both the Single Allocation and child care expansion, as well as the one-year delay of the change to the Single Allocation.

Bringing Families Home (BFH)

The BFH program is intended to reduce the number of families in the child welfare system experiencing homelessness, to increase family reunification, and prevent foster care placement on the basis of a lack of housing. CSAC, the County Welfare Directors Association (CWDA), and coalition partners have been advocating for an investment of $25 million to continue and expand this program. While this investment was not included in the May Revision, both houses did adopt funding for BFH. The Assembly Budget Subcommittee No. 1 approved a one-time investment of the requested $25 million and the Senate Budget and Fiscal Review Subcommittee No. 3 approved a one-time GF investment of $10 million.

Adult Protective Services (APS), Public Administrator, Public Guardian, and Public Conservator PA|PG|PC Training

In 2016, the Governor and Legislature provided a $3 million one-time investment to implement the needed training infrastructure for APS social workers, but this funding is set to expire at the end of this fiscal year and no new funding was included in the May Revision. CSAC has supported the CWDA, California State Association of Public Administrators/Guardians/Conservators (CAPAPGPC), and coalition partner effort for an investment of $5.75 million GF over the next three years. Both the Senate and Assembly Budget Subcommittees on Health and Human Services approved a State GF investment proposal to continue the training program. The Assembly Budget Subcommittee No. 1 proposed a $2.1 million one-time State GF. The Senate Budget and Fiscal Subcommittee No. 3 approved the stakeholder request for the $5.75 million GF over the next three years.

Disaster CalFresh Automation

In April, the Assembly and Senate Budget Subcommittees heard the CWDA stakeholder request of a $900,000 GF investment to allow the California Department of Social Services to automate Disaster CalFresh eligibility determinations. The current process relies heavily on county welfare departments to manually track applications and determinations. The request’s intent was to eliminate this administratively onerous process and support faster issuance of benefits to those impacted by a disaster. CSAC supported the investment in both the Senate and Assembly Budget Subcommittees as they were heard. While the May Revision did not include this funding, both the Assembly Budget Subcommittee No. 1 and the Senate Budget and Fiscal Review Committee approved a State GF investment of $900,000 to automate Disaster CalFresh.

Family Urgent Response System (FURS)

The Family Urgent Response System (FURS) is a request sponsored by CWDA, the County Behavioral Health Directors Association (CBHDA) and coalition partners for $15 million in 2019-20 and $30 million ongoing to support foster youth and caregivers. The proposal would establish and maintain a response system to provide foster youth and their caregivers with the immediate support they need during times of emotional crisis, and link youth and families to needed supports and services to help stabilize the situation. CSAC has been supportive of this proposal request, which was not included in the Governor’s May Revision. The Assembly and Senate Budget Subcommittees both approved and adopted placeholder trailer bill language for $15 million in 2019-20 and $30 million ongoing to establish and maintain the response system.

Child Support Funding Increase

The Governor’s January budget proposal included an increase of $56 million ($19.1 million GF and $36.9 million federal funds) for local child support agencies (LCSAs) in 2019-20. The additional funding is proposed to be allocated to 21 counties that have relatively lower funding levels as part of the implementation of a new budget methodology. Both the Senate and Assembly Budget Subcommittees approved the funding increase for 2019-20 as an interim methodology for one year and with a requirement to further develop an ongoing methodology by January 2020. Additionally, the Assembly Budget Subcommittee No. 1 took action to indicate the TBL will be revised to include a prohibition against privatization of the services associated with the new methodology. CSAC supported the overall funding increase and new methodology and will continue to engage on this issue in partnership with the Child Support Directors Association.

Whole Person Care

The May Revision included a new proposal for one-time funding of $20 million in state Mental Health Services Funds for counties that currently do not operate Whole Person Care Pilots. This is in addition to the $100 million one-time General Fund proposed in the Governor’s Budget for counties that currently operate pilots. Both the Senate and Assembly Subcommittees approved this new $20 million in funding, and the Assembly approved the $100 million funding proposal with placeholder trailer bill language proposed by CSAC and county affiliates to allow for maximum spending flexibility and require consultation with counties on the allocation methodology.

County Medical Services Program

While the Governor modified his proposal regarding the County Medical Services Program (CMSP) in his May Revision to allow the CMSP Board to reserve two years’ worth of operating costs, he sustained his proposal to divert 75 percent of health realignment funding from the CMSP Board once the above reserve level is met.

A diversion of 75 percent of realignment funding would effectively eliminate revenue for the CMSP Board and its indigent health care programs. For these reasons, CSAC opposed the 75 percent proposal in the budget subcommittees of both houses. The Assembly Budget Subcommittee No. 1 heard these concerns and adopted placeholder trailer bill language to modify the Governor’s 75 percent proposal. We expect both houses and the Department of Finance to develop language on this in the coming weeks, and CSAC will continue to work with CMSP to ensure the long-term viability for this rural safety net program.

Infectious Disease Prevention and Control Funding

The May Revision included $40 million one-time General Fund to help counties slow infectious disease epidemics and assist in providing prevention, testing, and treatment services. Of the $40 million, the Governor proposed to allow the state Department of Public Health (DPH) to retain $8 million. However, both Subcommittees approved placeholder proposals to halve that amount to $4 million for DPH, and also carved out $1 million specifically for tribal public health efforts. The Legislature also directs the state to work with counties on the allocation methodology. Because both houses adopted the same proposal, this item is expected to be included in the final budget. CSAC urges counties to continue to support the new $40 million allocation as the budget process continues.

Mental Health Services Act Innovation Funds Technical Change

CSAC is supporting a technical amendment to the Mental Health Services Act approval process for county innovation projects to allow counties to align project timelines with the full term of the project plan. This proposal was heard and approved by the Senate Budget and Fiscal Review Committee yesterday. It may be included in the upcoming Budget Conference Committee.  

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