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Governor Will Cut Health and Other Services To the Bone

By Anthony Wright
Executive Director of Health Access California

Tuesday, Governor Arnold Schwarzenegger released details of new, additional cuts totaling over $5.5 billion to the state budget, on top of what he proposed a few weeks ago. And because of the continued deterioration in the economy, the Administration has promised to release by Friday another $3 billion in cuts to be considered on top of that.

On May 14th, he had proposed a variety of "budget solutions"--including many cuts and no revenues--to address a $21.3 billion deficit in the 2009-10 budget year, with some cuts contigent on the failure of Propositions 1C, 1D & 1E. Last week, he announced he was abandoning a plan to borrow over $5 billion dollars, and instead simply proposing to make additional cuts. Today's list of cuts detailed those cuts, which include the wholesale elimination of Healthy Families, CalWORKS, CalGrants, CFAP/CAFI, Cand other programs and services.

The economic crisis has caused the budget agreed to by the Governor and legislative leaders to fall out of balance by a projected $3 billion additional dollars. Yet the Governor has yet to budge from his cuts-only approach to the budget, and has indicated he will seek even more cuts.

BUDGET CONFERENCE COMMITTEE HEARING WEDNESDAY: Today, Wednesday, May 27th, the Budget Conference Committee, chaired by Assemblywomen Noreen Evans, will take public testimony on the cuts to health and human services, starting at 9:00am in Room 4203 of the State Capitol. This may be the only public hearing that will allow testimony on these cuts. The agenda is as follows:

9:00 – 10:30 Medi-Cal and Healthy Families Program Issues
10:30 – 11:30 Public Health, Drug Medi-Cal, Prop 36, & Emergency Medical Services Authority
Noon – 1:30 Developmental Services
1:30 – 3:00 In-Home Supportive Services
3:00 – 4:00 CalWORKs, SSI/ SSP , CFAP/CAPI
4:00 – 5:00 Child Welfare Services, Foster Care

COMMITTEE DISCUSSION ON NEW CUTS: The Budget Conference Committee heard the outlines of the new cuts Tuesday, which sparked some limited discussion, and calls from legislators for more analysis about the budget, financial, and economic, as well as health, impacts of these cuts.

Some members, like Senator Denise Ducheny, asked whether some of these cuts would not create more costs, as people end up in emergency rooms or elsewhere, even within the budget year. "What makes you think this doesn't create a cost shift?... Will people just die and we won't have to take care of them?" she asked.

Senator Mark Leno talked about how the AIDS Drug Assistance Program "literally keeps people alive," and asked for information about the increased cost of ermegency room visits as a result of the cut. Senator Alan Lowenthal asked if there was a "longitudinal" analysis, and asked for the "long-range implications" of these cuts.

Assemblywoman Noreen Evans was alarmed when she noted that dialysis would be cut for some patients, exclaiming that her father was going through such treatment, and was not optional. She also noted that some cuts, like the elimination of HIV Testing, would have public health impacts. Assemblyman Kevin DeLeon pointed out the cuts to community clinics, arguing that for many Californians, "this is the only safety-net they have."

THE NEWLY PROPOSED CUTS: The cuts detailed Tuesday include both increases in previously-announced cuts, and new services targeted for reductions or eliminations. They include:

* $302.3 million from the elimination of the Healthy Families program, denying coverage to over one million children. The Governor had previously proposed to limit eligibility to just twice the poverty level, to deny 225,000 children, but he has now expanded his proposal to include full elimination.

* $1 billion in unspecified cuts to Medi-Cal, through a negotiation with the federal government to cut eligibility. The Governor has proposed an additional cut of $250 million to the Medi-Cal program, adding to the already $750 million cuts already proposed in the May 14th budget. Using past eligibility cut proposals that the Administration continues to support, both the California Budget Project and Health Access have estimated that this cut could deny coverage to nearly 1 million California children, parents, seniors and people with disabilities.

* $34.8 million in additional Medi-Cal cuts to eliminate certain "state-only" programs that don't get federal funds, thus denying coverage to specific populations for breast and cervical cancer treatment, postpartum care, dialysis, and non-digestive nutrition.

* $55.5 million in new cuts to the AIDS Drug Assistance Program (ADAP) to impose additional costs and restrict drug coverage for tens of thousands of Californians with AIDS. This proposal would also reduce or eliminate other Office of AIDS programs, including HIV Counseling and Testing, Epidemiologic Studies, Therapeutic Monitoring Program, and Home and Community Based Care.

* $34.2 million from the elimination of funds for various community clinic programs that provide preventative and primary care, including funding for Indian Health, Seasonal and Agricultural and Migratory Workers, Rural Health Services Development, and Expanded Access to Primary Care (EAPC).

* $20.2 million from the elimination of state funding for Maternal, Child, and Adolescent Health programs. This proposal goes beyond the significant cuts proposed on May 14th.

* $64 million in new cuts in Mental Health Managed Care Services.
* $28 million in new cuts to Early and Periodic Screening, Diagnosis, and Treatment Services (EPSDT), eliminating general fund support for certain county programs.

PREVIOUSLY PROPOSED CUTS: These cuts are on top of the cuts the Governor announced May 14th. Those that are not mentioned above include:

* $132.2 million in reduced health benefits to those in CALPERS;
* $125 million in reducing health services for legal immigrants;
* $60 million out of Proposition 99 funded-programs, redirecting money from county health funds, clinics, the Breast Cancer Early Detection, Asthma, rural health, the Access for Infants and Mothers program which provides prenatal care, and the Major Risk Medical Insurance Program, which provides coverage for those denied for "pre-existing conditions."
* $36.8 million by cutting rates for family planning services;
* $25.5 million in reducing adult day health care benefits to three days a week;
* $24.6 million to local health jurisdictions of HIV education and prevention;
* $20 million by cutting payments to private hospitals, a 10% cut in general support; and
* $8.8 million through a 10% rate reduction for certain substance abuse treatment services in Medi-Cal;
* $2.9 million in suspending a comprehensive school-based prevention program on dental disease; and
* $2.7 million by eliminating application assisters that help children & families enroll in coverage.

In Medi-Cal, there is also a new prescription drug purchasing effort to save $75 million, and a new anti-fraud initiative targeted at adult day health centers, pharmacy, doctors, durable medical equipment, and transportation, with the goal of saving $47.9 million.

There are other human services cuts as well, to IHSS home care, SSI/SSP for seniors, and also includes the elimination of CalWORKS, as well as the elimination of CAPI and CFAP for legal immigrants. Senator Ducheny began to total that the cuts seemed to negatively impact over two million California children.

More commentary will be available on the newly-redesigned Health Access website at http://www.health-access.org, and our blog, at http://blog.health-access.org.

Health Access California is a statewide health care consumer advocacy coalition of over 200 groups. This article has also been published on the Health Access Weblog.

Posted on May 27, 2009

Comments

OVERPOPULATION--should be classed as the paramount issue when it comes to illegal immigration. The corporate elitists who are partnered with many corrupt politicians do not live in the real world. The business entities who lobby for cheap labor are isolated from the traffic chaos on our highways. They do not live in the pollution of our cities, amongst the gangs and criminals who have swarmed across the borders. Only mainly the middle class will be subjected to a new push for a second path to citizenship or better known as AMNESTY. This revised so-called immigration reform will sweep across America, without any voice allowed to repudiate it from—THE PEOPLE--who must pay for everything. Business pay NOTHING, nor the farmers and using slave labor at cheap rates without any benefits, that lowers American wages across the board. Here are the issues that voters must consider:

1. Are Americans expected continually to pay for the hiring practices of businesses and farmers? 2. Why have the agricultural community not advanced in using mechanized machines to harvest crops, when they are well subsidized by government agencies? Sen. Feinstein is reintroducing an AGJOB bill that would allow at least 2 million foreign nation legalization. The issue here is 3. Why are our legislators drafting a 2nd AMNESTY, when the 1986 Simpson/Mazzoli bill was weakened on not even enforced and full of fraud? 4. If another AMNESTY is forced on Taxpayers are they expected to cover the costs of an almost impossible regimen of processing 20 million plus foreign nationals? 5. Who is going to pay for the--CHAIN MIGRATION--for the extended family members who will want to live with newly legalized migrant? Then Sen. Chuck Schumer (D-NY), stated “the borders are now safe enough to take a step forward. We can pass strong, fair, practical and effective immigration reform this year," he said. Perhaps he should take a trip to the fence and reverse his initial statement. The border is definitely not secure. It's a place of death at the hands of criminal drug cartels that have even infiltrated the American communities. 6. Isolated border sheriff's voices of alarm, fell upon deaf ears for years in Washington, repeatedly stating of their limited manpower, could not stem the tide of drugs crossing our border.

Our Washington elitists, who are adamant free traders and open border zealots, have not only ruined small Mexican farmers living standards, because of the inception of CAFTA, but now unable to scratch a living have poured across the border along with other impoverished peoples. 7. If millions illegal aliens are legalized, why should honest potential immigrants waiting patiently for years, bother with a employment visa and not just slip past an undermanned, poorly erected border fence? 8. Why are taxpayers forced by mandated law to support hired illegal labor, when businesses pay nothing for them being here. 9. Although not the illegal children's fault, why should our own children suffer under the controversial Dream Act? This gives an academic education within state lower tuition fees, while American students must pay higher fees? 10. In conclusion, should the anti-sovereignty, pro-illegal immigrant, open border pass AMNESTY, how are they going to halt the next daunting waves of indigent people looking for a better life in the United States and placing in jeopardy poorly skilled American workers, who should not have to compete with alien labor?

We now know the major Democratic culprits who under funded, weakened or otherwise killed strong immigration legislation such as E-Verify. Sen. Harry Reid, Speaker Pelosi, Sen. Burris, and others, including even Republican Party members involved in this travesty to cut-out the Real ID Act, 247(g) giving the power of arrest to the police. NUMBERSUSA is the site to reveal the poor grades of Senators and Congressman. They are the ones who approve the laws and added weight to your taxes. California--A Sanctuary State--is a great example of out-of-control illegal immigration, where taxpayers have been stung by higher taxes to pay for the benefits by an unfit Sacramento Liberal Democrat assembly. Next in line is New York that is staring into a chasm of potential bankruptcy. IF THIS IS NOT "TAXATION WITHOUT REPRESENTATION" what is?

Posted by: Brittancus at May 27, 2009 11:20 AM

That is perfectly fine cutting health and other services, after all state of California is facing around 24billion dollars shortfall. State has no choice but to cut health care, education and other service in order to have balance budget as required by California constitution.

Posted by: rep at May 27, 2009 12:20 PM

Thanks for this article. I've searched for info on what's happening
with ADAP and can't find much. I'm on that program and this
is literally life & death for me and folk in our position. Scary stuff.

Posted by: Marc H at May 27, 2009 06:09 PM

Thanks for this article. I've searched for info on what's happening
with ADAP and can't find much. I'm on that program and this
is literally life & death for me and folk in our position. Scary stuff.

Posted by: Marc H at May 27, 2009 06:09 PM

Thanks for this article. I've searched for info on what's happening
with ADAP and can't find much. I'm on that program and this
is literally life & death for me and folk in our position. Scary stuff.

Posted by: Marc H at May 27, 2009 06:09 PM

Re: IHSS
I have scoliosis and since 6/05 - 1/09 I have had 8 excruciating spinal surgeries. I have aprox. 2- 24" rods in my back with 22 - 3" screws/cemented in holding my spine up from S1-T6 and from S1 I have 2 - 5" screws bolted to my pelvic bone to hold my back up. I am on pain medication and also psych meds for being Bipolar. I also have Hepatitis-C I am just getting started on a treatment course that the side effects of the medication make you feel very sick (like chemotherapy). This is a 6 month plan but may go another 6 months for a cure rate of 60-80%. I am quite scared as this can become liver cancer at any time.My IHSS person is my life line to everything.Please save IHSS. please save me. Do not cut their pay or our the quality of our care/health could suffer greatly. Or we could be neglected or abused by persons that truly don't care about us. This is a vital service. I am so scared about the IHSS support system for we that need it being tampered with I can't begin to tell you. I pray to God that all will be safe for we the disabled and disadvantaged. Thankyou.

Posted by: michelle mann at May 28, 2009 08:55 AM

Posted by: michelle mann at May 28, 2009 08:56 AM

Posted by: michelle mann at May 28, 2009 09:00 AM

Posted by: michelle mann at May 28, 2009 09:02 AM

Well Duh! The chickens have come home to roost. We've been providing free education, health care, and welfare for too long for too many. How many folks are partaking of these services without ever having put a nickel into the state coffers that support the service?!

Posted by: Don at May 28, 2009 02:59 PM

The only solution is a new state constitution and reversal of Prop 13.

MIchelle --

ALL of the people getting services pay taxes. You pay tax when you buy a candy bar, or buy a gallon of gas or 1000 other things.

MOST of the people we are talking about are legal residents. Is is REALLY in the state's best interest to cut metal health programs, AIDs testing, child abuse support? Deny coverage to people with disabilities?

Your post remind me of this quote:

"They we should just LET them die and decrease the excess population!"

E. Scrooge
A CHRISTMAS CAROL

Posted by: james Robinson at June 3, 2009 01:48 PM

The only solution is a new state constitution and reversal of Prop 13.

MIchelle --

ALL of the people getting services pay taxes. You pay tax when you buy a candy bar, or buy a gallon of gas or 1000 other things.

Your post remind me of this quote:

"They we should just LET them die and decrease the excess population!"

E. Scrooge
A CHRISTMAS CAROL

Posted by: james Robinson at June 3, 2009 01:49 PM

Illegal immigration is out of control. Too many are drawn by the magnet of easy jobs, lots of social programs and large immigrant communities and sanctuary cities they can disappear into.

Due to the recession, the easy jobs are gone.

Due to the budget shortfall, we need to cut the social programs, at least for the illegal aliens and their children.

Sanctuary cities should be sanctioned. The U.S. and California governments should deny monies to them for any program they provide that also covers services to illegal aliens that are NOT FEDERALLY MANDATED. Quite simply, if your community clinics provide free care to illegals, no state money to clinics, or if need be, to entire cities or counties. If a school district gives non-federally mandated food or care to an illegal alien, all funding for that program should be cut to that school or school district.

Only by providing a DISINCENTIVE to agencies to give nonMandated benefits out, will we see results.

We need to do everything possible to discourage illegal immigration: cut all programs for them, make it difficult for them to get jobs. Perhaps Sacramento should follow up on SSA no matches that come through their computers (public assistance clients, UIB/SDI, workers comp, criminal offenses, etc. Do everything to encourage illegal aliens and welfare lifers to leave California.

Posted by: JSC at July 11, 2009 01:25 PM

"easy jobs"

You've obviously never worked in the fields.

Posted by: Doug at July 11, 2009 02:00 PM

What is this? Attack on the illegal Mexicans looking for a better way to feed themselves and their families?
How about the europeans and asians who come here and drag along their entire extended families and enroll them in government sponsored programs?
Why should I pay social security benefits and food stamps for a legal immigrant? Take your raggedy ass back to where ever you came from.

Posted by: Storm at August 23, 2009 09:12 AM

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