Governor's Budget Released 3 Days Early

Yesterday afternoon Governor Brown announced his January 2012-2013 budget plan three days early due to an inadvertent leak on the Department of Finance website earlier in the day. The budget estimates a $9.2 billion general fund deficit that is proposed to be bridged with increased taxes and cuts. The tax increase would materialize if voters pass the Governor sponsored November ballot initiative that seeks to raise the sales tax and income tax for high-income earners to yield an estimated $6.9 billion in revenues. The proposed budget also includes a list of trigger cuts if the voters do not approve the tax increase in November. These trigger cuts are almost all in the areas of education and public safety. With or without increased revenue from the governor's tax initiative, the Governor's budget calls for $4.2 billion in cuts.

California Family Health Council (CFHC) along with our statewide coalition of partners is still working to analyze the impact of the Governor's budget proposal but key elements in the Health and Human Services area of the budget that could impact California's low-income patient population and the Title X provider network are below.

The Governor's budget:

• Proposes to transfer Family PACT from the Department of Public Health (DPH) to the Department of Health Care Services (DHCS). The Administration stated this shift is consistent with their goal of placing direct health care service programs with the DHCS to improve service delivery. *CFHC will be exploring any potential impacts this transfer might have on the Family PACT program and will keep you updated.*

• Proposes to create more flexibility in the Medi-Cal delivery system outside of the regulations process. Some of the areas that could potentially see changes are benefits, services, rates methodologies and payment policies within federal requirements. This proposal is slated to achieve $75 million General Fund savings.

• Proposes to reform the payment methodology for federally qualified health centers (FQHCs) and rural health clinics (RHCs) funded under Medi-Cal. Under this proposal, payments made to FQHCs and RHCs participating in Medi-Cal managed care plan contracts will change from a cost and volume based payment to a fixed payment. Additionally a waiver will allow these clinics to perform multiple services on the same day, provide group visits, telehealth, and telephonic disease management. This proposal is slated to achieve $27.8 million General Fund Savings.

• Proposes to expand managed care into rural counties that are now fee-for-service only starting in June 2013. This proposal is slated to achieve $2.7 million in General Fund savings.

• Proposes an annual open enrollment period for beneficiaries to select their preferred plan. Currently Medi-Cal allows beneficiaries to change plans every month. This proposal is slated to save $3.6 million.

• Proposes to reduce Healthy Families managed care rates by 25.7 percent effective October 1, 2013. This reduction will achieve $64.4 million General Fund savings.

Many of the proposals above and other areas of the Governor's budget have yet to be fully flushed out. CFHC will work to obtain clarification and advocate on behalf of California's low-income patient population and Title X provider network. We will continue to provide updates as the budget process moves forward.

In the meantime, if you have any questions please contact Amy Moy, Vice President of Public Affairs, at moya@cfhc.org.