Preserve Services for Seniors in Final Budget

Preserve Services for Seniors in Final Budget

California Health Advocates submitted the following letter to Governor Newsom strongly opposing his proposed cuts to older adult programs in the state’s final budget. Californians age 65 and over account for nearly 80% of all COVID-19 deaths and those of color are dying at rates up to 3 times their percent of the population. The elimination of MSSP and CBAS and the reductions to nearly every program older adults rely on, proposed in the Governor’s May Revision of the budget, increase the likelihood that older adults and people with disabilities will be hospitalized or need care in a nursing facility or other congregate setting where over 50% of all deaths have occurred. This is not acceptable.

 

Additionally, further federal relief may include increased funding for Medicaid including an additional targeted increase for home and community based services (HCBS). The HEROES Act passed in the House of Representatives in May includes an across-the-board 7.8% federal medical assistance percentage (FMAP) increase as well as an additional 10% specifically for Medicaid HCBS. By cutting or eliminating these programs, California not only places older adults at a higher and unacceptable risk but jeopardizes increased federal funding.

 

In the letter below, CHA urges the Governor to enact a budget responsive to the incredible risk low-income older adults, particularly those of color, face. We vehemently oppose cutting and reducing access to these programs during a pandemic that has ravaged this population. Read the letter for details.

_________________________________________________________________________

 

June 22, 2020

 

The Honorable Gavin Newsom
Governor of the State of California
California State Capitol
Sacramento, CA 95814

 

RE: Preserve Services for Seniors in Final Budget

 

Dear Governor Newsom:

 

California Health Advocates (CHA) strongly urges you to maintain health care and supportive programs for low-income older adults in the state’s final budget. CHA, a non-profit organization founded in 1997, is the leading Medicare Advocacy and educational voice for more than 5.6 million Medicare beneficiaries in California. Our members, the Health Insurance and Advocacy Programs (HICAPs) serve every county across the state and continually deal with the population served by MSSP, CBAS and IHSS and Medi-Cal.

 

Californians age 65 and over account for nearly eighty percent of all COVID-19 deaths and those of color are dying at rates up to 3 times their percent of the population. The elimination of MSSP and CBAS and the reductions to nearly every program older adults rely on, proposed in your May Revision of the budget, increase the likelihood that older adults and people with disabilities will be hospitalized or need care in a nursing facility or other congregate setting where over fifty percent of all deaths have occurred.

 

Additionally, further federal relief may include increased funding for Medicaid including an additional targeted increase for home and community based services (HCBS). The HEROES Act passed in the House of Representatives in May includes an across-the-board 7.8% federal medical assistance percentage (FMAP) increase as well as an additional 10% specifically for Medicaid HCBS. By cutting or eliminating these programs, California not only places older adults at a higher and unacceptable risk but jeopardizes increased federal funding.

 

We urge enacting a budget responsive to the incredible risk low-income older adults, particularly those of color, face. We vehemently oppose cutting and reducing access to these programs during a pandemic that has ravaged this population.

 

In view of these considerations CHA advocates for:

 

Preserving CBAS and MSSP

 

These programs have successfully served clients during the Covid-19 pandemic using telehealth, and addressing their needs due to self-isolation and struggles with access to services and supplies. People using these programs either already qualify for nursing facility coverage or will without these services. Making cutbacks in these programs will inflict maximum harm on older adults without savings to the state given that many will need to move to more expensive nursing home care and into a setting in which contracting and dying from COVID-19 is so high. The MSSP Site Association notes, “if just 18% of MSSP patients statewide (2,289) are placed in a nursing home, the entire “savings” from MSSP elimination is immediately wiped out.”

 

Maintaining IHSS Hours

 

The budget should maintain In-Home Supportive Services (IHSS) hours at current levels and reject the across the board 7% reduction. A reduction in hours means recipients will have to make hard choices between what care they must give up, like being bathed or getting groceries, leading to increased risk for hospitalization and institutionalization.

 

Ensuring Access to Medi-Cal for Low-Income Seniors

 

Medi-Cal funds programs for older adults and people with disabilities that Medicare does not pay for and that help individuals remain in their homes and communities. It is essential that these programs continue to be available as the pandemic affects these people more seriously so that access to health care and long-term services and supports are imperative if they are to stay healthy. Cutting Medi-Cal eligibility and benefits puts their well-being and lives at risk.

 

Accordingly, it is critical that California move forward with the expansion of the Medi-Cal Aged, Blind, and Disabled program to 138% of the federal poverty level set to take effect in August, expansion to undocumented older immigrants, and the implementation of the Medicare Part B disregard rules. The budget should also maintain Medi-Cal dental coverage and other Medi-Cal covered services including audiology, incontinence creams and washes, speech therapy, optician/optical lab, podiatry, acupuncture, optometry, nurse anesthetist services, occupational, and physical therapy.

 

Also, California should maintain the Medi-Cal estate recovery rules which have been in place since January 1, 2017. The return to the prior estate recovery rules will only exacerbate existing race and class disparities in intergenerational wealth by targeting people with low incomes and preventing any wealth from being passed down to their families.

 

Maintaining SSI/SSP

 

The budget should maintain current levels of SSI/SSP. Taking income used for basic needs like housing from these individuals who are already living far below the poverty line would simply put more older adults and people with disabilities at risk of homelessness and disproportionately impact people of color.

 

Maintaining Senior Programs

 

Programs operated through the Department of Aging provide meals, provide caregivers the much-needed resources to care for their loved ones, and administer adult protective services. The budget should maintain funding for these services including senior nutrition, caregiver resource centers, long-term care ombudsman, aging and disability resource connections, and Independent Living Centers.

 

Sincerely,

Douglas Shaw
Board Chair

Karen Fletcher
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.