CDCAN Report 160-2011 – AUGUST 17, 2011

* 2nd Meeting This Year Convened by CA Health & Human Services Secretary Dooley

* Focus on Key Health & Human Services Budget Issues Including Trigger Cuts Impacting IHSS – Medication Machine Pilot Program and Community First Choice Option

* Update on Adult Day Health Care Elimination

SENATE BUDGET SUBCOMMITTEE TO HOLD ADULT DAY HEALTH HEARING

* Oversight Hearing On Brown Administration’s Transition Plan Aug 25th 1:30 PM

SACRAMENTO, CALIF (CDCAN)  [Last updated 08/17/2011 03:30 PM] - The Olmstead Advisory Committee, composed of state health and human services department heads and appointed advocates and convened by California Health and Human Services Agency Secretary Diana Dooley, will hold its second meeting under the Brown Administration on August 18th (Thursday) from 10:00 AM to 4:00 PM, at the Department of Rehabilitation building, Room 242, 721 Capitol Mall (corner of Capitol Mall and 8th Streets), Sacramento, CA.   Persons can also participate in the meeting by calling in using a toll free number:  1-888-232-0362    Passcode: 785453  (persons not on the Olmstead Advisory Committee can make public comments either at the meeting site or on the phone at stated times on the agenda – usually after each agenda item, and as the chair announces).  [CDCAN Note: Marty Omoto has been a member of this committee since it was established in 2005 - there will be a full separate CDCAN Report on the meeting on Friday]
 
The committee will hear updates on various health and human services issues including implementation and transition plan regarding the elimination of Adult Day Health Care as a Medi-Cal optional benefit, currently with an effective date of December 1, 2011.  The committee will also hear information regarding the “triggers” in the 2011-2012 State Budget that impacts health and human services – including those dealing with In-Home Supportive Services, and updates on efforts to obtain new federal funding for IHSS.  [see text of full agenda below]

Committee Focus Is California’s Implementation and Compliance of 1999 US Supreme Court Decision

The title of the committee refers to the landmark 1999 US Supreme Court ruling regarding the rights of two women with developmental and other disabilities from the State of Georgia, who wanted to live in community-based settings instead of the state facility that they lived in. 

The two women – Elaine Wilson (who died in December 2005) and Lois Curtis, eventually prevailed in a ruling by the US Supreme Court known as the “Olmstead Decision” (the lawsuit was filed against Tommy Olmstead, the then head official of the Georgia health and human services agency).  That ruling among other things, required the states to take steps to avoid the unnecessary or unjustified institutionalization of persons with disabilities, mental health needs and seniors.  The decision did provide certain exceptions for the states – those none of applied in the case involving Elaine Wilson and Lois Curtis. 

Since then the states have taken steps and efforts to implement the decision, with some creating statewide committees (like California’s), and developing “state plans” and other measures.  Many of those efforts have been sharply criticized by advocates in many states, including California, as falling far short of compliance and implementation, especially as continued cuts and reductions in community-based services and supports have continued in the past 10 years. 

The committee was created originally in September 2004 by an executive order issued by Governor Arnold Schwarzenegger, with members appointed in January 2005, and the first meeting held, presided over then California Health and Human Services Agency Secretary Kim Belshe in March 2005.  The committee has been meeting regularly – usually once a quarter – since then. 

The heads of nearly all of the health and human services departments, along with the California Health and Human Services Agency Secretary, have regularly attended nearly every meeting since March 2005 and in January, Secretary Dooley said she would maintain that commitment.  She held her first meeting of the advisory committee in March. 

Adult Day Health Care Elimination as Medi-Cal Benefit Focus of Another Legislative Hearing on August 25th

The Senate Budget Subcommittee #3 on Health and Human Services, chaired by Sen. Mark DeSaulnier (Democrat – Concord, 7th State Senate District), will hold an oversight hearing on August 25th, Thursday afternoon at 1:30 PM, at the State Capitol in Room 112,  on the transition plan for the elimination of Adult Day Health Care as a Medi-Cal benefit scheduled for December 1st.

This hearing will likely be webcasted live from the California Channel website at www.calchannel.com (click under “LIVE webcast and scroll down to the 2:00 PM time).  The hearing may also be broadcast live on the Cal Channel cable channel – check your local listings

As previously reported, the Brown Administration is moving forward on it’s controversial implementation and transition plan to eliminate by December 1, 2011, Adult Day Health Care as a Medi-Cal benefit impacting over 34,000 persons with disabilities and seniors and over 300 community providers and over 7,000 workers. The elimination of the Medi-Cal “optional benefit” was proposed by Governor Brown in January as part of a larger package of sweeping major permanent reductions to health and human services to help close what was then an over $25 billion on-going budget shortfall.      
The Senate Budget Subcommittee’s hearing follows yesterday’s nearly four hour oversight hearing by the Assembly Aging and Long Term Care Committee, chaired by Assemblymember Mariko Yamada (Democrat – Davis, 8th Assembly District) on the same issue, hearing from the Brown Administration, recipients and representatives of the Adult Day Health Care centers and other advocates, who packed the small hearing room.

The testimony and updates from advocates, recipients and representatives of community-based providers – many who face imminent closure after the Medi-Cal benefit is eliminated – was often emotional and compelling.  Many of the Assemblymembers on the committee or who participated as non-committee members raised what they said were major concerns or even outright criticisms of the Brown Administration’s transition plan.

The hearing was attended by the vice chair of the committee, Assemblymember Linda Halderman (Republican – Clovis, 29th Assembly District), Assemblymember Richard Pan (Democrat – Sacramento, 5th Assembly District), Assemblymember V. Manuel Perez (Democrat – Cathedral City, 80th Assembly District), and Assemblymember Norma Torres (Democrat – Pomona, 61st Assembly District).

While an oversight hearing is not unusual – especially by this committee, the attendance of several other non-committee members who chair other key Assembly committees was noteworthy.  Assemblymember Bob Blumenfield (Democrat – Van Nuys, 40th Assembly District), chair of the Assembly Budget Committee, Assemblymember Bill Monning (Democrat – Santa Cruz, 27th Assembly District ), chair of the Assembly Health Committee, Assemblymember Holly Mitchell (Democrat – Los Angeles, 47th Assembly District), chair of the Assembly Budget Subcommittee #1 on Health and Human Services, and Assemblymember Mike Eng (Democrat – Monterey Park, 49th Assembly District), chair of the Assembly Business and Finance Committee and member of the Assembly Health Committee were among the non-committee members who attended – with all four asking questions

CDCAN will issue a full report on yesterday’s hearing later today and other news regarding Adult Day Health Care, including a CDCAN Commentary and Action Alert. 

Also Next Week: Informational Hearing on Employment Issues for Persons With Developmental Disabilities August 23rd by Assembly Human Services Committee

Also next week is an informational hearing by the Assembly Human Services Committee, on August 23rd, Tuesday afternoon, at 1:30 PM, at the State Capitol in Room 437, covering the issue of employment of persons with developmental disabilities.  The committee is chaired by Assemblymember Jim Beall, Jr. (Democrat – San Jose, 24th Assembly District). 

The title of the committee’s informational and oversight hearing is “Employment First: A Priority for California.An Opportunity for People with Developmental Disabilities” .

OLMSTEAD ADVISORY COMMITTEE MEETING AGENDA

Olmstead Advisory Committee Meeting
August 18, 2011:  10 am – 4 pm
Department of Rehabilitation, Room 242
721 Capitol Mall, Sacramento, California
Toll-Free Call-In Number: 1-888-232-0362    Passcode: 785453  

Please note:  The order in which the agenda items are considered may be subject to change. Opportunities for public comment will be provided end the end of each topic.  
 
10:00 AM
1.     Introductions: Brenda Premo, Chair; members

10:15 AM
2.    Welcoming Remarks: California Health and Human Services Agency Secretary Diana Dooley   
Secretary Dooley will provide opening remarks and updates on long term services and supports in California.   

11:00 AM 
3.  Panel Discussion:  Models for Integrated Care  
In some California communities, Medi-Cal beneficiaries have access to an integrated system of providing acute care and long term services and supports.

The Department of Healthcare Services has recently received information from dozens of organizations interested in how pilot sites might expand upon these models to integrate services for individuals eligible for both Medicare and Medi-Cal (dual) coverage. Panelists will discuss existing models.

[Olmstead Committee] Members are asked provide input on the issues that pilot sites should test, measure and report.
 

11:45 AM
4.    Adult Day Health Care (ADHC) Transition Plans
Toby Douglas, Director of the Department of Health Care Services will review strategies to enable participants of ADHC programs to access necessary long term services and supports following the elimination of ADHC as a Medicaid State Plan service, which is planned for December 2, 2011. 
 

12:00 [Noon]
5.    Working Lunch                             

Members will take a short break to get food and will convene separately in two discussion groups on Data and Housing.

* The data group will discuss the next steps for the California Community Choices’ Data Warehouse Study and CalCareNet Pilot, as well as current research of the California Medicaid Research Institute (CaMRI).
*  The housing group will discuss a partnership between State departments to expand Tenant Based Rental Assistance (TBRA) for Medi-Cal beneficiaries.   

1:45 PM 
6.    Subgroup Reports

2:30 PM 
7.    LTSS Initiatives & Budget Triggers
Department of Health Care Services Director Toby Douglas; Will Lightbourne, Director, and Eileen Carroll, Deputy Director of the Department of Social Services will discuss  proposals in the 2011-12 Budget to achieve significant savings in the Medi-Cal program:

 (1) the Medication Dispensing Machine Pilot and

(2) the Community First Choice Option which was authorized in the federal Patient Protection and Affordable Care Act of 2010.
 

3:45 PM
8. Closing Remarks: Diana Dooley
 
4:00 PM 
Meeting adjourns at 4 p.m.
 
Reasonable Accomodations

*  In consideration of attendees who are sensitive to environmental odors created by chemicals and perfumes, please restrict the use of fragrances at this meeting. 

* If disability-related accommodations are required for your attendance or you need materials in alternate formats, please contact Megan Juring at (916) 558-5820, TTY (916) 558-5807, or at mjuring@chhs.ca.gov at least five days prior to the meeting date. American Sign Language interpreters will be available at the meeting.