November 2, 2015 - 1115 Medicaid Waiver Deal Reached
The DHCS and CMS have been in
negotiations regarding the renewal of California's 1115
Medicaid Waiver. On Saturday, October 31st (the day of
the deadline) DHCS and CMS announced a conceptual
agreement on the Waiver which will include a temporary
extension to December 31st of the existing Waiver while
the details of the renewal are worked out through the
official Special Terms and Conditions (STCs).
The total initial federal funding in this new proposed
Waiver is $6.218 billion, with the potential for
additional federal funding in the global payment program
to be determined after the first year. This is much
higher than the reported amounts during negotiations
last week, but is also significantly lower than the
original Waiver proposal from March of this year.
The conceptual agreement includes the
following core elements:
Global Payment Program (GPP) for
services to the uninsured in designated public
hospital systems (DPH). The GPP converts existing
DSH and Safety Net Care Pool (SNCP) uncompensated
care funding - which is hospital-focused and
cost-based-- to a system focused on value and
improved care delivery. The funding of the GPP will
include 5 years of the DSH funding that otherwise
would have been allocated to DPHs along with $236M
in initial federal funding for one year of the SNCP
component. SNCP component funding for years two
through five would be subject to an independent
assessment of uncompensated care.
Delivery system transformation
and alignment incentive program for DPHs and
district/municipal hospitals (DMPH), known as PRIME
(Public hospital Redesign and Incentives in Medi-Cal).
The federal funding of PRIME for the DPHs is a total
of $3.2655 billion over the five years of the
Waiver, which includes $700 million for each of the
first three years, $630 million in year four, and
$535.5 million in year five. The federal funding for
the DMPHs is a total of $466.5 million over the five
years of the Waiver, which includes $100 million for
each of the first three years, $90 million in year
four, and $76.5 million in year five.
Dental transformation incentive
program. The funding of this program is $750M in
total funding over 5 years.
•Whole Person Care Pilot (WPC) program which would
be a county-based, voluntary program to target
providing more integrated care for high-risk,
vulnerable populations. The funding of this program
would be up to $1.5B in federal funds over 5 years.
Independent assessment of access
to care and network adequacy for Medi-Cal managed
Independent studies of
uncompensated care and hospital financing.
August 31, 2015 -
REQUEST FOR LEGAL SERVICES
The Urban Counties Caucus is looking
for Legal Services for a specific project. Please click
here to see the RFQ. For more
information contact Jolena Voorhis at (916)327-7531.
Deadline for submittal is September 25, 2015.
July 1, 2015 -
Governor Calls Two Special Sessions
As part of the Budget agreement, the
Governor called two special sessions to address issues
that were not included in the final budget agreement:
Also to consider and act upon
legislation necessary to:
Establish clear performance
objectives measured by the percentage of pavement,
bridges, and culverts in good condition.
Incorporate project development
efficiencies to expedite project delivery or reduce
Shoring Up Health Care
Financing. The Governor proposes that the
Legislature enact permanent and sustainable funding
to provide at least $1.1 billion annually to
stabilize the General Fund costs for Medi-Cal,
sufficient funding to continue the restoration of
the 7 percent of IHSS hours beyond 2015-16;
sufficient funding for additional rate increases for
providers of Medi-Cal and developmental disability
Also requests that the Legislature
enact legislation necessary to:
Establish mechanisms so that any
additional rate increases expand access to services.
Increase oversight and the
effective management of services provided to
consumers with developmental disabilities through
the regional center system.
Improve the efficiency and
efficacy of the health care system, reduce the cost
of providing health care services, and improve the
health of Californians.
Attached please find the press releases for both
June 23, 2015 -
Budget Package Passed by the Legislature
Both houses passed the revised budget bill and several
trailer bills on Friday, June 19, 2015. This version is
the package deal agreed to among the Democratic
Leadership and the Governor.
Major issues in this version are as
Creation of the Earned Income Tax
Restorations to Adult Dental and
the IHSS 7% reduction in hours.
Change to $15 million for
CalWORKs Housing Support program (previous version
was $30 million).
$20 million for City Law
Funding for Incompetent to Stand
Trial including funding for the Restoration of
Competency program ($4 million).
Attached please find the list of the
Trailer Bills and the
UCC Summary of the Final Budget.
There are some issues that are NOT in this package
including changes to the redevelopment dissolution
process, and the detailed cap and trade provisions.
May 14, 2015 - Today
Governor Jerry Brown released the May Revision for
Attached please find UCC's preliminary summary of
the Governor’s May Revision, which includes a full
repayment of the mandate reimbursements due to counties
– a total of $765 million.
January 9, 2015 - Today the
Governor released his proposed 2015-16 Budget.
The Budget proposes a total budget of $113 billion that
provides more funding for education and health care
coverage, holds college tuition flat and delivers on
Proposition 1 and 2 by investing in long overdue water
projects. At the same time the Governor’s Budget
proposes to continue to deal with states other long term
liabilities – debt, infrastructure, retiree health care
and climate change.
Key proposals include:
Paying local governments $533
million in mandate payments.
Investment in Medi-Cal of $150
million to help counties with the implementation of
the Affordable Care Act.
Restoration of the 7% across the
board cut to IHSS, dependent on a new MCO tax.
Caution regarding the CCI program
and the possibility of winding down in future years.
Continued funding of SB 678 for
$7 million for deferred
maintenance at California fairs.
Addressing poverty and income
equality through workforce investment.
For UCC's Summary of the budget
here. To review the Realignment
Funding Chart please click
January 5, 2015 - Today
Edmund G. Brown Jr. was sworn into office for a record
fourth time as the Governor of California. To read his
Inaugural Address please click
September 4, 2014 -
End of Legislative Session - It was a strange
end of session with very little last minute bills or gut
and amends moving through the Legislature. Many of the
gut and amends were held in the Senate Rules Committee.
Both houses adjourned early Saturday morning and will
not reconvene until December.
Here are some of the bills UCC was following:
AB 39 (Skinner) – Public Hospitals
This bill would convert Doctor’s Medical Center to a
Designated Public Hospital. The California Association
of Public Hospitals and Health Systems (CAPH) are
opposed to the bill due the concerns regarding the
precedent to expand the number of Designated Public
Hospitals without any rationale or analysis. In
addition, AB 39 does not require a Section 17000
obligation or any commitment to serving vulnerable
UCC Position: Concerns.
Status: Held in Senate Rules – see SB 883.
AB 1522 (Gonzalez) – Sick Leave
This bill would require employers to provide sick leave
to their employees. Recent amendments exempted IHSS
workers and any employee under collective bargaining
agreements. For counties, this would still apply to
temporary or contract employees.
UCC Position: Concerns.
AB 1582 (Mullin) – Redevelopment
This bill would modify the Redevelopment Dissolution
Law’s provisions to allow for the restoration of
“contracts or arrangements” between a former
redevelopment agency and its sponsoring city. Current
law only allows for the restoration of “loans.” In
addition, this bill would increase the interest rate on
UCC Position: Oppose.
Status: Held in Senate Rules.
AB 2493 (Bloom) – Redevelopment
This bill would allow specific successor agencies of
dissolved redevelopment agencies to spend funds that
were not under contract in 2011.
UCC Position: Oppose.
SB 556 (Padilla) – Providers of health and
safety labor or services: identification
This bill would require local agencies to provide
labeling on uniforms, vehicles and badges if we are
contracting for those services.
UCC Position: Oppose.
SB 883 (Cmte on Budget) - West Contra Costa
This bill would provide $3 million to the West Contra
Costa Healthcare District for Doctor’s Medical Center
from the Major Risk Medical Insurance Fund.
UCC Position: Neutral.
August 12, 2014 -
The UCC Board of Director’s voted to OPPOSE Proposition
46 on August 6, 2014. - Proposition 46, the
Troy and Alana Pack Patient Safety Act of 2014, would
make changes to the Medical Injury Compensation Reform
Act (MICRA) cap. Attached is the
staff memo and background information on Proposition
Under existing law, MICRA allows an injured patient to
recover unlimited economic damages for past and future
medical expenses; unlimited economic damages for lost
wages and lifetime earning potential; unlimited punitive
damages for willful misconduct; and up to $250,000 in
Proposition 46 would make the following changes:
Raise the noneconomic damages cap
for medical malpractice from $250,000 to
approximately $1.1 million (based on CPI) and would
also increase the award amount limits on a
prospective basis as measured by the CPI.
Require hospitals to randomly
test physicians for alcohol and drug use.
Require health professionals and
pharmacists to consult the Controlled Substance
Utilization Review and Evaluation System (CURES)
maintained by the state Department of Justice prior
to prescribing or dispensing controlled substances
to a patient for the first time.