CALIFORNIA STATE BUDGET

A brief update on the Governor's May Revise of the budget for Fiscal Year 2010-2011.  There are a number of proposed reductions in health and social services that will affect children.  The summary also includes some comments from the Legislative Analyst's Office analysis, as well as a link to the LAO report.

NATIONAL HEALTH CARE REFORM

On March 23, 2010 President Obama signed historic national health care reform legislation (HR 3590, the patient Protection and Affordable Care Act) that may have a profound effect on health care delivery in California.

In short, the health reform package will:

• require most U.S. citizens and legal residents to have health insurance;
• create state-based American Health Benefit Exchanges through which individuals can purchase coverage, with premium and cost-sharing credits available to individuals and families with income between 133-400% of the Federal Poverty Level (the 2009 FPL is $18,310 for a family of three);
• create separate Exchanges through which small businesses can purchase coverage;
• require employers to pay penalties for employees who receive tax credits for health insurance through an Exchange, with exceptions for small employers;
• impose new regulations on health plans in the Exchanges and in the individual and small group markets; and
• expand Medicaid income eligibility to 133% of the FPL.

Click here for a detailed summary on national health care reform. If you would like more information, please visit Center for Children and Families, Georgetown University Health Policy Institute and Kaiser Family Foundation.

FAMILY HEALTH OUTCOMES PROJECT: TITLE V REPORT

The Family Health Outcomes Project (FHOP) has submitted the final Title V CSHCN Assessment report to the state. The report is available on the state CCS website. You can also download the report directly here.

CCS REDESIGN AND FEDERAL WAIVER RENEWAL PLANNING

In August of 2009 the State Department of Health Care Services (DHCS) contracted with a consulting group, Health Management Associates (HMA), to convene a stakeholder process to look at CCS and consider options for redesign of the program.  CRISS submitted comments to HMA and DHCS on the CCS Stakeholder Discussion Guide circulated for consideration by stakeholders.  CRISS comments are available here.  HMA subsequently completed its written report on CCS, “Considerations for Redesign of the California Children’s Services (CCS) Program”, submitted to the state in September, 2009.  A copy of that report is available here.

In addition, the State Department of Health Care Services has embarked on a stakeholder process to contribute to planning for the state’s federal 1115 Medi-Cal waiver effort.  California must submit a new waiver application to the federal government by August, 2010 to replace the expiring current waiver.  DHCS is looking to the waiver process as a means to reorganize health care delivery for several high-cost populations of Medi-Cal recipients, including:

• children in CCS;
• seniors;
• persons with disabilities (including children);
• adults with severe mental illness; and
• people who are dually eligible for both Medicare and Medi-Cal. 

The state issued a draft concept paper for the new waiver in October, 2009.  CRISS submitted comments on the draft concept paper; those comments are available here. The state issued its final version of the concept paper in December, 2009; a copy of that paper is available here.

The state’s Waiver Stakeholder Advisory Committee is holding meetings in 2010.  CRISS anticipates that the state will establish a subcommittee focused specifically on CCS and will monitor developments concerning CCS redesign.  Information on the waiver and the Advisory Committee is available on the state Waiver Renewal website.

• February 9, 2010 Minutes
• March 16, 2010 Minutes
• March 30, 2010 Minutes
• April 12, 2010 Minutes