Increasing Health Care Access and Affordability

• $37 billion ($14.3 billion General Fund) for Medi-Cal expenditures, an increase of $1.6 billion over the revised 2006 Budget Act. 
• $108 million ($54 million General Fund) to provide rate adjustments to the Medi-Cal managed health care plans as determined by a new rate methodology, which will be implemented at the beginning of each plan’s new rate year. These plans are a crucial in ensuring adequate access to health care for vulnerable Californians. 
• $146.3 million (73.1 million General Fund) for a 5.5-percent rate increase to freestanding level B nursing homes and adult sub-acute care facilities that provide long-term care to Medi-Cal beneficiaries.
• Total General Fund expenditures for the Supplemental Security Income/State Supplementary Payment (SSI/SSP) program are $3.7 billion in 2007-08, an increase of $118.7 million from the revised 2006 Budget Act level. The average monthly caseload in this program is estimated to increase to 1.3 million recipients, a 1.8-percent increase over the 2006-07 projected level. California's SSI/SSP payment levels for individuals and couples are projected to maintain rankings of second and first in the nation, respectively.

Protecting Public Health

o        $11.1 million ($5.6 million General Fund) in 2007-08 to provide the HPV vaccine to approximately 52,000 Medi-Cal-eligible women ages 19 through 26. The United States Food and Drug Administration recently approved this new vaccine, and has been shown to reduce the risk of contracting cervical cancer by up to 70 percent.

• $47.3 million Proposition 84 bond funds and 15.7 two-year limited-term positions to administer a program to provide emergency and infrastructure improvement grants and grants and loans for drinking water projects.
• The Budget includes $118.4 million from the Genetic Disease Testing Fund, a net increase of $20.7 million above the Budget Act of 2006.

• The Budget includes $4.2 million from the Birth Defects Monitoring Fund.
• $16.1 million from the Genetic Disease Testing Fund and 5.7 positions to implement Chapter 484, Statutes of 2006 (SB 1555), which expands research efforts and prenatal screenings for birth defects.

• $903,000 General Fund and 4.7 positions to enhance the state's capabilities to respond to foodborne illnesses and outbreaks such as E. coli. These resources will allow the Department of Public Health (DPH) to quickly respond to and investigate the source of future outbreaks.

HIV/AIDS Care and Treatment

o        $288.9 million to fully fund the AIDS Drug Assistance Program (ADAP). ADAP provides life-saving medications to low-income persons living with HIV/AIDS. The ADAP will serve nearly 32,905 clients in 2007-08.

o        As a result of additional drug rebate revenues, the Budget Act reflects one-time General Fund savings of $9.3 million and a one-time redirection of $7.8 million General Fund to other HIV care and treatment programs. 

·         With the federal Ryan White HIV/AIDS Treatment Modernization Act the total funds are approximately $122 million in 2007-08.

o        $2 million General Fund to provide additional local assistance funding to increase surveillance staff for HIV reporting activities. This funding will accelerate the state's implementation of names-based HIV reporting, which is critical for the state's continued receipt of $50 million in federal grants to support critical services for persons living with HIV.

Quality of Life

o        $4.4 billion ($2.6 billion General Fund) for the Department of Developmental Services (DDS), an increase of $289.9 million ($93.9 million General Fund) above the revised 2006-07 budget.

o        Access for Infants and Mothers (AIM) program expenditures of $133.2 million, an increase of $8.8 million above the revised 2006 Budget Act level. Enrollment is expected to reach 13,912 women, an increase of 1,815 women compared to 12,097 in 2006-07.

o        Healthy Families Program (HFP) expenditures of $1.1 billion ($398.7 million General Fund), an increase of $93.6 million ($36.5 million General Fund) above the revised 2006 Budget Act level. Year-end caseload is expected to reach 908,912 children, an increase of 64,629 children compared to 844,283 in 2006-07.

·         $58.9 million ($21 million General Fund) to continue program changes that promote and maximize enrollment in the HFP, improve retention of children already enrolled, and support county-based efforts to enroll eligible children. These changes include streamlining of the application process, providing incentives to Certified Application Assistants, and developing an electronic application for public use. These changes are expected to increase HFP enrollment by over 38,800 children.

o        Total General Fund expenditures for the In-Home Supportive Services (IHSS) program are $1.6 billion in 2007-08, an increase of $97.1 million from the revised 2006 Budget Act level. The average monthly caseload in this program is estimated to increase to 389,100 recipients, a 5.1-percent increase over the 2006-07 projected level.

o        $6.1 million ($3 million General Fund) to increase the waiver cap for the Nursing Facility A/B waiver, that provides services and support to Medi-Cal beneficiaries to allow them to remain safely in their homes and avoid institutional placements.

Licensing and Certification

The Budget includes $83.6 million ($9.1 million General Fund) for Licensing and Certification (L and C) activities including:

o        $2.8 million General Fund to help offset L and C fee increases to facilities.

o        $7.2 million L and C Program Fund and 42.7 positions to implement Chapter 647, Statutes of 2006 (SB 1301) related to the reporting of and follow up on adverse events in hospitals.

o        $2.5 million L and C Program Fund and 15.2 positions to conduct periodic licensing surveys of long-term care facilities, pursuant to Chapter 895, Statutes of 2006 (SB 1312).

o        $0.7 million ($0.4 million L and C Program Fund and $0.4 million Federal Funds) and 5.7 positions to provide legal and administrative support for the 155.5 new L and C staff included in the 2006 Budget Act.

o        $0.2 million and 1.4 positions in the DPH and $0.5 million ($0.3 million General Fund) and 4.3 positions in the DHCS to ensure hospitals apply fair pricing to uninsured and underinsured patients, pursuant to Chapter 755, Statutes of 2006 (AB 774).

Regional Centers

o        $3.6 billion ($2.2 billion General Fund) for regional centers, a net increase of $302.9 million ($107.6 million General Fund) above the revised 2006-07 budget, primarily due to increases in the costs of community care facilities, day programs, support services, miscellaneous services and the increase in the minimum wage.

o        The Budget continues to provide funding to achieve the authorized closure of Agnews Developmental Center in June 2008. The regional centers' budget is projected to increase by $45.1 million ($30.3 million General Fund) for the costs of providing services to the additional consumers in the community.

·         The Budget includes $503,000 ($126,000 General Fund) to provide health care community specialists to facilitate the transition of Agnews consumers into residential placements and to act as coordinators between the health care plans, consumers, families and other community-based services.

·         $1 million redirected from the Wellness Initiative grant to provide two mobile health clinics in the Golden Gate Regional Center, Regional Center of the East Bay, and San Andreas Regional Center areas to help ensure the continuity of health care as Agnews consumers transition into the community.

 

Mental Health Services

o        $4.8 billion ($1.9 billion General Fund) for the Department of Mental Health (DMH), an increase of $1.2 billion ($48.7 million General Fund) from the revised 2006 Budget Act level. This net change primarily reflects continued growth in the Early and Periodic Screening, Diagnosis and Treatment Program, the impact of Proposition 83, also known as Jessica's Law,.

State Mental Health Hospitals

o        $1.2 billion ($1.1 billion General Fund) and 10,445 positions for 2007-08, an increase of $137.4 million ($110.2 million General Fund) and 821.2 positions from the revised 2006-07 budget. This funding will support a total population of 6,095, an increase of 506 patients from the revised 2006-07 population level. This includes an increase of $4.3 million General Fund to contract for competency restoration services at the local level. Contracting for local mental health beds will expand services and address state hospital capacity issues.

·         The Administration recognizes the importance of providing mental health services in communities to reduce institutionalization. $3.5 billion ($776.8 million General Fund), an increase of $1.1 billion (a decrease of $72.9 million General Fund) compared to the revised 2006-07 budget for community mental health services.

o        $1 billion ($454 million General Fund) for Early and Periodic Screening, Diagnosis and Treatment Program. In addition, $86.7 million General Fund is available to begin reimbursing counties for prior years' costs, which will be repaid over a three-year period commencing in 2007-08. Under this program, approximately 186,000 Medi-Cal-eligible children and young adults receive services to ameliorate a diagnosed mental illness.

o        A $5 million increase in Proposition 98 General Fund to augment the Early Mental Health Initiative program, which provides grants to local education agencies for supportive, non-clinical mental health intervention and prevention services to children (grades K-3) who have mild or moderate school adjustment difficulties. This augmentation will increase total program funding to $15 million in 2007-08.

CalWORKs and Children’s Welfare

o        The Budget includes total California Work Opportunity and Responsibility to Kids (CalWORKs) expenditures of $7.2 billion. The caseload projections are 461,200 cases in 2006-07 and 457,500 in 2007-08.

o        $4.1 billion ($1.6 billion General Fund) to provide assistance payments and services to children and families under Child Welfare Services, Child Abuse Prevention, Foster Care, Adoption Assistance, and Adoptions to children who are either at risk of or have suffered abuse and neglect. This is a $175.4 million, or a 4.5-percent increase, from the revised 2006 Budget Act level.

·         An increase of $3.7 million ($2 million General Fund), effective February 1, 2008, to double the reimbursement rate for non-profit private adoption agencies that specialize in finding permanent homes for children with high needs.

·         An increase of $17.2 million ($9.6 million General Fund), effective January 1, 2008, to provide a 5-percent increase to foster family home base rates, specialized care increments, and group home rates; Adoption Assistance Program cases prospectively; and all Kin-GAP and Emergency Assistance cases.

·         An increase of $30.8 million ($15.2 million General Fund) to create a standard rate paid to foster care and adoptive families who care for children with developmental disabilities. These children are served by both the Department of Social Services and the Department of Developmental Services.

·         An increase of $20.2 million General Fund to increase participation in the Transitional Housing Plus Program, which provides services to youth between 18 and 24 years of age emancipating from the foster care system.

Corrections and Prison Health Services

o        $526.4 million General Fund to fund various program enhancements for the medical, mental health and dental care programs for the California Department of Corrections and Rehabilitation (CDCR).

o        $125 million for the Receiver in 2007-08, which is intended to address costs associated with the California Prison Health Care Receivership Corporation's operational budget.  This is in addition to $200.8 million to address costs associated with salary enhancements, the establishment of various medical and custody positions, and additional medical equipment.

o        $79.2 million to comply with the Perez lawsuit.  Included in these funds are $22.5 million to rollout Phase IV of the Inmate Dental Services Program in response to a stipulation agreement and to provide additional headquarters staffing within the Dental Program as ordered by the court, and $56.7 million is to provide salary enhancements for various dental classifications.

o        $121.4 million to comply with the Coleman lawsuit.  This includes:

·         $40.2 million to implement the Revised Program Guide for the Mental Health Services Delivery System.

·         $17.8 million to retrofit administrative segregation and mental health cells to help prevent suicides in those cells. 

·         $7.7 million to staff a new Mental Health Crisis Bed Unit at the California Medical Facility that was constructed in response to a Coleman court order. 

·         $5.1 million to implement the Reception Center Enhanced Outpatient Program to deliver mental health treatment to individuals who have been identified as having a serious mental disorder resulting in a serious level of impairment in functioning. 

·         $50.6 million to provide salary increases for mental health professionals.