AAP-CA Update - December 19, 2003

From the Desk of Kris Calvin, MA AAP-CA Executive Director
District Update, December 19, 2003

Good news...

* Medi-Cal Access: Status of the Lawsuit

AAP-CA is one of a dozen public health and medical specialty organizations that has joined the California Medical Association in suing the state to prevent the 5% physician reimbursement cuts under Medi-Cal enacted in this year's budget. The primary basis for the suit is our belief that the state did not do any analysis of access or efficiency implications of the cuts, but rather enacted them solely to save money. With another 10% provider rate reduction now on the table for Medi-Cal, the stakes for demonstrating the illegality of such arbitrary reimbursement cuts have been raised considerably.

Wednesday, December 17th, oral arguments were heard in the case. Based on the judge's comments during the hearing it appears that DHS did not supply evidence that satisfied him that it had appropriately analyzed what the rate cut might do to affect access to care.

The judge said he would try and rule by early next week. He indicated that he will be in touch with both the state's and our lawyers to work on details "if he decides to enjoin the cuts. "

While the outcome is far from certain, the tone of the hearing suggests that we can be hopeful. I will keep you posted as news on this breaks.

* Proposed Budget Reductions: The Governor Moves to Protect Children and the Disabled

Governor Schwarzenegger surprised many when his first budget proposal included sweeping cuts in programs for the disabled, including children. Many felt that these cuts came largely from his new Director of Finance, Donna Arduin, who has a history of targeting such programs in other states when large deficits are an issue. The cuts included a proposal to "suspend" the Lanterman Act, a critically important statute enacted in 1969 that guarantees developmentally disabled Californians certain civil rights and services, including access to regional centers. The Governor's proposed cuts also included establishing a waiting list for CCS-eligible patients that are not on Medi-Cal or Healthy Families (so-called "state-only" CCS).

Many of us in the child advocacy community held out hope that at some point the Governor would realize the glaring incompatibility of these proposed cuts with his longstanding leadership and support for children with special health care needs.

Following a public outcry and an appeal to the legislature, which included testimony and strong advocacy by AAP-CA, the Governor has taken these cuts off the table.
Parent groups, including the California Disability Community Action Network, played a critical leadership role in getting the message to the Governor. It has been speculated that Secretary of Health and Human Services Kim Belshe may also have had some influence in protecting and promoting children's health to the Governor.

This Governor does not do anything by halves. These cuts, extraordinary in their scope, (nearly $300 million) came and went without the usual "compromise" wrangling that occurs. The Governor may be, as Ms. Belshe has put it, "evolving in his thinking", such that he is not willing to accept the proposals that are put before him without testing them against his own values regarding children, which appear to be heartfelt.

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While the above items reflect good news relative to Medi-Cal rate cuts, CCS and the programs for special needs children, there are still many onerous health services cuts in play, including a Healthy Families enrollment freeze. I will be back in Sacramento next week as our lobbyist, Jackie Miller, and I continue to work to stay on top of the many moving budget targets.

I hope you all have a very nice holiday. I'll be back in the New Year with the next update...

Kris