Many Health Measures in Budget Plan Advanced by Lawmakers

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On Sunday, California lawmakers approved a $156.4 billion state budget plan that includes several provisions that affect the state Department of Health Care Services, the Department of Public Health and other health care-related agencies, the Sacramento Bee reports.

The plan was approved by a 25-11 vote in the state Senate, with one Republican lawmaker voting in favor of the proposal, and by a 55-24 vote along party lines in the Assembly. The budget proposal now heads to Gov. Jerry Brown (D), who has until the end of June to sign it (Siders/White, Sacramento Bee, 6/15).

The budget plan approved by lawmakers is about $1.2 billion more than proposed by Brown (Marois, Bloomberg Businessweek, 6/15).

For more information about the budget deal, see today's Capitol Desk.

DHCS Provisions

The budget plan includes $438 million to expand Medi-Cal under the Affordable Care Act. Medi-Cal is California's Medicaid program. However, lawmakers kept in place a 10% cut to Medi-Cal reimbursements (Sacramento Bee, 6/15).

Other provisions related to DHCS include:

  • $1.8 million to increase rates beginning April 1, 2015, for the Program of All-Inclusive Care For The Elderly;
  • $3.2 million for a one-time Major Risk Medical Insurance Fund for health plans funded by agricultural workers;
  • $3.75 million for a one-time Major Risk Medical Insurance Fund to qualify for $37 million in funding for electronic health record support;
  • The creation of a $16.5-million "wrap program" allowing women to carry both Covered California and Medi-Cal policies if they have incomes between 139% and 213% of the federal poverty level; and
  • The establishment of a 3-year pilot program to provide mobile vision services to students.

The budget plan also would require Medi-Cal to cover behavioral health services when they are required by the federal government.

However, lawmakers denied a proposal by the Brown administration that called for the creation of a $32.5 million statewide contract drug list.

DPH Provisions

Under DPH, the budget plan includes:

  • $1.9 million and the creation of 18 limited-term positions to investigate long-term care complaints;
  • $3 million for HIV demonstration projects;
  • $4 million to restore the Black Infant Health Program; and
  • $26 million for the Office of AIDS.

The plan calls for the creation of a State Dental Director position and would establish a statewide dental health program. It also would create a stakeholder group to report on licensing and certification requirements for nursing homes and other health facilities.

Under the plan, the state's Drinking Water Program would be removed from DPH and placed under the jurisdiction of the State Water Resources Control Board.

Other Health-Related Provisions Affecting State Agencies

Under the Department of State Hospitals, the budget plan includes a total of $39.6 million to increase the capacity of psychiatric programs in Salinas Valley and Vacaville.

In addition, the budget plan called for $4.8 million and 40 new positions under the Department of Managed Health Care to advance health care reform, Medi-Cal expansion, health information technology and mental health parity.

Under the plan, the Office of Statewide Health Planning and Development would receive nearly $3 million to expand a program that supports medical residency slots in underserved areas of the state and $4 million specifically to add new residency slots (Budget plan, 6/15).

Lucy Quacinella
DHCS will be saving, not spending, $16.5 million by shifting many working poor women off Medi-Cal and onto federally-funded Covered California policies for their pregnancy services. These women must not lose access to Medi-Cal’s Comprehensive Perinatal Services Program (CPSP) benefits. California’s CPSP program was the first and remains the best in the nation at improving birth outcomes for women with income at or below 213% of poverty. A solution for CPSP access must be found before the new “wrap” program takes effect next year. The budget agreement includes a stakeholder process to address just that.
Michael Bertaut
By my count the Medicaid rolls in California have just swelled by about 2 million people (once all the stuck applications are processed). Their providers already get paid signficantly below cost to treat their existing Medicaid population. With millions more holding a Medi-Cal card, is this the right time to cut provider reimbursements by 10%? Won't that lead to fewer docs, longer wait times, devalueing the Medi-Cal card even more? Is that something to call "success"? Somebody help me with this. mrb

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