Policy & Advocacy News – June 2022

Policy & Advocacy News – June 2022

June 3, 2022

A Note from the CEO…

On May 13, California Governor Gavin Newsom unveiled his FY2022-23 budget revisions and revenue projections. While there were several items included in the revised budget that will have a positive impact on the lives of Californians with disabilities, it falls short of adequately addressing the needs of people with disabilities in this challenging economy and extremely tight labor market.

It is often said that a budget is a reflection of the values and priorities of the state. I was pleased to learn that the administration included an extension of the 10% rate enhancement for intermediate care facilities (ICFs). It also included a six-month delay of the carve-in to Medicaid managed care for people living in ICFs which, while encouraging, is simply not long enough.

I was extremely disappointed that an acceleration of the implementation of the disability provider rate study, approved by the legislature last year, is not included in the budget despite unprecedented state revenues. Acceleration of the implementation is needed to help offset increased costs related to the continuing COVID-19 pandemic, the ongoing workforce crisis, and the rapidly escalating rate of inflation.

The next two weeks will be critical as the legislature hammers out their version of the budget and works with the Governor’s office to pass the FY2022-23 state budget. I ask that you take a moment to contact your elected representatives to ask them to pass a budget that reflects the values and priorities of California by ensuring that people with disabilities have access to the same opportunities that you and I enjoy. Please act today by visiting Momentum’s Voter Voice site by clicking here.

Thank you for your continued advocacy!

Lori Anderson, President & CEO

California News

In May, Governor Gavin Newsom released his May Revision to the budget and updated revenue projections. The projected tax revenues for California increased by more than $55 billion over the estimate used to draft the initial FY2022-23 state budget.

You can watch a recording of the Governor’s budget briefing by clicking here.

The state legislature will now review the revised budget and develop their versions. Assembly and Senate committees are expected to wrap up their budget hearings by early June. The California state constitution mandates that a final budget must be passed by the legislature and sent to the Governor by June 15.

The budget included some, but not all, of Momentum’s disability policy priorities. An extension of the 10% rate adjustment for ICF supports was included in the revised budget. However, the budget did not include a much-needed acceleration of the implementation of the disability rate study and calls for only a six-month delay in the carve-in to the state Medicaid managed care program for all people receiving supports in an ICF-DD setting.

Please take a moment to contact your state representatives to advocate for inclusion of a minimum one-year delay in CalAIM expansion, continuation of the 10 percent ICF rate adjustment. and an acceleration of the approved disability rate study. It is critical that you act today by clicking here.

Extension of the 10% Rate Enhancement for IFC Settings

Momentum has advocated for a continuation of a 10% rate adjustment, effective July 1, 2022, and proceeding forward to avoid a significant rate reduction in 2022-23.

ICF settings have been economically ravaged by the COVID-19 public health emergency (PHE) for two-years now. Providers did not have operating reserves prior to the PHE due to the Recession Era rate-freeze instilled in 2008-09 and continued until August 1, 2021, a total of 12 years. As such, ICF baseline rates, which would have been adjusted based upon retrospective cost reporting, were held flat. A small Proposition 56 supplemental rate began in 2018. Due to the COVID-19 PHE, a temporary rate increase of 10% commenced as of March 1, 2020.

A continuation of this adjustment is critical, as Lori Anderson wrote above, to help offset increased costs related to the continuing COVID-19 pandemic, the ongoing workforce crisis, and the rapidly escalating rate of inflation.

Delay ICF Carve-In to CalAIM Managed Care

Momentum has called for a minimum one-year delay to ensure a successful transition to managed care for people residing in ICF-DD settings. Currently, the California Department of Health Care Services (DHCS) is planning to integrate or “carve-in” ICF-DD into managed care under CalAIM on January 1, 2023, while the Governor’s revised budget calls for a six-month delay.

Given the complexity of the CalAIM transition for homes and residents, the myriad of other delivery system changes occurring in Medi-Cal, as well as the current operating environment from ongoing COVID related impacts, it is essential that more time be given to work out the details and to allow for additional stability in the disability support system before this significant change takes place.

Acceleration of Rate Study to Address DSP Workforce Crisis

Momentum has joined advocates and disability service providers throughout California in calling for an acceleration of the $1.8 billion investment in California’s intellectual and developmental disability service system that was included in last year’s state budget. These funds were scheduled to be invested over five years.

Specifically, the request seeks to accelerate the implementation of the Department of Developmental Services rate study by one year at an approximate cost of $330 million. The request also seeks to update the rate models based on lessons learned through the pandemic, to support California’s transition to an outcome-based system. This request was not included in the Governor’s May Revision and will need to be added through negotiations between the administration and the legislature.

Other budget items of importance to California’s intellectual and developmental community included in the budget include:

Training Stipends—$127.8 million to provide up to two $500 training stipends (with an additional $150 for taxes and administration) for Direct Support Professionals (DSPs)
Internships for Workers who Provide Direct Services—$22.5 million to implement a three-month training and internship program intended to establish an entry point into DSP career paths. This proposal also includes up to two $500 retention stipends for workers.
Pilot for Remote Supports—$5 million to pilot a program aimed at developing remote supports using technology systems to increase consumer independence and, when chosen and safe, reduce in-person and around-the-clock services.
Half-Day Billing – The Governor’s proposed May Revision includes a proposal to permanently eliminate the half day billing policy for regional center providers.
SSI/SSP – The May Revision includes $3.1 billion from the General Fund in 2022-23 for the SSI/SSP program. The average monthly caseload in this program is estimated to be 1.1 million recipients in 2022-23. A 5.9% federal SSI cost-of-living adjustment and 24% SSP increase took effect on January 1, 2022, bringing the maximum SSI/SSP grant levels to $1,040 per month for individuals and $1,766 per month for couples.

It is important to remember that items included in the Governor’s revised budget can be removed through budget negotiations with the legislature. Therefore, it is critical that all disability advocates take action today to ensure the needs of people with disabilities are reflected in the state budget.

National News

Senate Faces September 30 Deadline for HCBS Investment

Last Summer, the Administration announced that a historic investment in the Medicaid Home and Community Based Services (HCBS) program would be an integral provision in the Build Back Better infrastructure bill.

Although 2021 ended with Congress at a stalemate over the Build Back Better Act, the HCBS funding initiative is not dead. Senate Democrats have indicated that they are working to advance HCBS funding through the budget reconciliation process.

However, the Senate faces a September 30 deadline for wrapping up the budget reconciliation process, and the impending midterms mean lawmakers’ focus will shift this summer from passing laws to campaigning for reelection. That means that if a historic investment in HCBS is to pass the Senate, it realistically needs to happen in the next few weeks.

ANCOR, a national disability provider organization and Momentum’s federal advocacy partner, has posted a video explaining the importance of HCBS funding and highlighting the HCBS advocacy campaign “Going All in for HCBS.” You can view the video here.

You are encouraged to use Momentum’s online advocacy center to advocate to go all in for HCBS. Click here to act today.

Bipartisan Effort to Increase Supplemental Security Income Asset Limit Initiated in U.S. Senate

Bipartisan legislation has been introduced in Congress to, at long last, give people with disabilities and older Americans significantly more freedom to earn and save money without risking the loss of vital benefits, their livelihoods, and their ability to support themselves and members of their family. The SSI Savings Penalty Elimination Act, introduced by U.S. Senators Sherrod Brown and Rob Portman increases Supplemental Security Income (SSI) asset limits for the first time since the 1980s. Current SSI asset limits prevent individuals who receive the modest benefit from saving more than $2,000.

The bill raises SSI asset limits from $2,000 to $10,000 for individuals and from $3,000 to $20,000 for married couples and indexes them to inflation moving forward. SSI provides money to eight million adults and children with disabilities and older Americans.

Disability advocates have long sought this update to SSI asset limits and to adjust for inflation moving forward, so that people with disabilities have added financial opportunities. You can urge passage of this bill by visiting Momentum’s online advocacy center by clicking here.

Advocacy Resources

The 2022-23 Budget: Initial Comments on the Governor’s May Revision

This report, published by the non-partisan Legislative Analyst’s Office (LAO), provides a summary of the Governor’s revised budget, focusing on the overall condition and structure of the state General Fund—the budget’s main operating account. Access the briefing by clicking here.

The 2022‑23 Budget – Department of Developmental Services

This report, published by the California Legislative Analyst’s Office, provides an overview of the proposed 2022‑23 Department of Developmental Services (DDS) budget and an assessment of the three, main discretionary proposals. Access the report by clicking here.