Final Budget Conference Committee Hearing Today Focusing on Human Services Cuts – IHSS, SSI/SSP, CAPI, MSSP, & More

Final Budget Conference Committee Hearing Today Focusing on Human Services Cuts – IHSS, SSI/SSP, CAPI, MSSP, & More

Yesterday June 15th, the Budget Conference Committee of the California Legislature made some severe cuts based on the Governor’s proposals, yet they also largely rejected full-scale eliminations of programs, such as Healthy Families.

Today June 16th, the Budget Conference Committee will complete its work focusing on proposed cuts to human services, education, higher education, and general government.

Several big issues to be discussed under human services include the Governor’s proposed cuts he made in May to In-Home Supportive Services, Supplemental Security Income/State Supplementary Payment (SSI/SSP), several Department of Aging programs, community care licensing, and the Cash Assistance Program for Immigrants (CAPI).

The Budget Conference Committee’s actions, however, are not final. The full Assembly and State Senate must give their final approval to any budget choices that the legislative leaders and the Governor make – which is predicted to happen before the end of this month.

Below is a summary of some of the budget decisions made yesterday, Monday June 15th, according to Health Access:

  • A $1 billion cut in Medi-Cal as part of the Governor’s flexibility and stabilization negotiations with the federal government.
  • A $70 million cut to Healthy Families, which would establish a waiting list for children to receive coverage, unless other sources of funding or donations were made. (For example, last year, the First Five Commission provided $17 million to Healthy Families to prevent a waiting list from being established, but this year’s proposed cuts present a significantly bigger funding gap.)  Without additional assistance, a $70 million cut could mean that no new children can enroll in  the Healthy Families program for an extended time, denying well over 200,000 children coverage.
  • The rejection of the elimination of Medi-Cal coverage for legal immigrants, both legally residing and those with PRUCOL status.
  • A 30% cut to state funding of community clinic programs.
  • A $35.5 million cut for AIDS and HIV programs (as opposed to the proposed $80 million cut), both education and prescription drug service programs.
  • A $26.5 million reduction in Adult Day Health Care Centers, as opposed to a full elimination as the Governor and the Republicans on the committee supported (which would’ve reduced state spending by $170.5 million). The proposed compromise would cap the use of ADHCs to 3 days a week, among other provisions.
  • A smaller cut to small and rural hospitals that what the Governor proposed.
  • A near 50% cut, rather than complete elimination, of the state’s poison control system.

Below is a summary of some of the specific proposed cuts on the agenda for discussion today, according to CDCAN’s 6/16 Alert:

  • Community Care Licensing – Governor’s proposal to eliminate state funding for this program. (reduction would total over $19 million in state general fund spending)
  • In-Home Supportive Services Share of Cost Buy-out – Governor’s proposal to reduce spending and limit who can participate in the buy-out program (reduction would total over $41 million in state general fund spending)
  • In-Home Supportive Services Domestic & Related Services – Governor’s proposal to limit domestic and related services to only persons with a functional index ranking of 4.0 or higher  (reduction would total over $53 million in state general fund spending)
  • In-Home Supportive Services Cost Containment– Governor’s proposal to make ineligible for any services under IHSS, persons with a functional index score (different from functional index ranking) 2.99 or lower; would provide for some services under IHSS but not domestic and related services for persons with a functional index score between 3.0 and 3.99.  Would make no changes for persons with functional index scores of 4.0 or higher.  “Functional index score” is the average of the activities of daily living that each person on IHSS is assessed by their county social worker.  A person is “ranked” in each of the activities of daily living.  (Reduction would total over $705 million in state general fund spending.)
  • In-Home Supportive Services State Funding for Worker/Provider Wages – Governor proposed reducing the state’s funding (participation) for IHSS worker wages to a maximum of $8 an hour – the state minimum wage, plus 60 cents for health benefits, effective October 1, 2009. (Total reduction would be over $161 million in state general fund money.)  This would impact currently 46 counties who pay higher than the minimum wage.  This proposal would be a further reduction to state funding of IHSS worker wages, which, unless reversed by the Legislature or stopped by legal action, is scheduled to be reduced to $9.50 per hour (plus 60 cents for health benefits) effective July 1, 2009.  That action was previously approved by the Legislature as part of the 2009-2010 State Budget passed in February.
  • In-Home Supportive Services Integrity Initiative – Governor’s proposal that would result in reduction in IHSS due to increased fraud and abuse efforts. (Reduction would total over $32 million in state general fund spending.)
  • In-Home Supportive Services Public Authority Administration – Governor’s proposal to provide for a $699,000 increase due to caseload and other related adjustments for the 2009-2010 State Budget year.
  • Multipurpose Senior Services Program (MSSP) – Governor’s proposal to eliminate the program.
  • Linkages Program – Governor’s proposal to eliminate  this program. (Reduction would total over $13 million in state general fund spending.)
  • Senior Community Based Services Programs (Including Alzheimer’s Day Care Resource Center, Brown Bag, Respite Purchase of Services and the Senior Companion Program) – Governor’s proposal to eliminate these programs. (Reduction would total over $4 million in state general fund spending.)
  • Supplemental Security Income/State Supplementary Payment (SSI/SSP) – Governor’s proposal to reduce SSI/SSP grant levels to the lowest amount allowed by the federal government, effective October 1, 2009 (reducing grants for individuals to $830 per month and couples to $1,407 per month).  Grants were already reduced due to suspension of cost of living increases on May 1, 2009 and June 1, 2009. The 2009-2010 State Budget passed in February also included a 2.3% reduction to the SSI/SSP grant level, effective July 1, 2009 (lowering grants to $850 for individuals and $1,489 for couples).  That grant level will be lowered further on October 1, 2009 if this new proposal by the Governor is approved.  (Reduction would total over $264 million in state general fund spending.)
  • Cash Assistance Program for Immigrants (CAPI) – Governor proposed elimination of this state funded program that provides similar SSI/SSP level grants to over 10,000 persons with disabilities, the blind and seniors who are legal immigrants but do not qualify for SSI/SSP due to federal law changes in 1996.  (Reduction would total over $85 million in state general fund money.)
  • California Food Assistance Program (CFAP) – Governor’s proposal to eliminate this program which provides food stamp benefits to legal immigrants not eligible for the federal food stamp program.  (Reduction would total over $33 million in state general fund spending.)

For more information on the California state budget, see:

Information in this article is edited in part from Health Access’ and CDCAN’s budget update alerts, 6/16/09.

Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical expertise, writing and research on Medicare, health disparities and other health care issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer and consultant. See her current articles.