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Hospitals, Providers, Advocates Irked by What’s Left Out of Budget Revision

Health care stakeholders were not too pleased with Gov. Jerry Brown’s May budget revision released yesterday.

Increased spending on Medi-Cal was an expected byproduct of Medi-Cal expansion, said Michele Stillwell-Parvensky, senior policy and communications associate for the Children’s Defense Fund California. What was unexpected was that a number of axed programs and budget reductions remained the same, she said.

“Even though the state is financially better off right now, there were some programs that didn’t get restored,” Stillwell-Parvensky said. “Now that we’re doing much better, we have the resources to fund these things.”

“The revised state budget … presents a false choice between fiscal responsibility and reinvestment in public services,” said Chris Hoene, executive director of the California Budget Project.

“We see it as missing an opportunity,” said Suzie Shupe, executive director of California Coverage & Health Initiatives. “We wanted to focus on restoring some key programs that were dramatically cut in the past. It was disappointing to see that some of these proven programs were not restored.”

Programs cut in previous years that were not restored in Brown’s revised budget include:

  • Early Mental Health Initiative;
  • State Children’s Dental Disease Prevention Program;
  • 10% Medi-Cal provider reimbursement rate reduction; and
  •  Black Infant Health Program.

In addition, the governor’s proposed budget has no funding for coverage of applied behavior analysis, a popular but expensive treatment for autism that was covered under the Healthy Families program. When Healthy Families was eliminated, hundreds of kids lost coverage for the treatment, known as ABA therapy. Advocates were hoping the governor would make ABA therapy a covered Medi-Cal benefit.

Programs like the Black Infant Health Program and the effort to curb children’s dental disease, said Shupe, came with relatively low price tags.

“They are small cost relative to the bigger-ticket items,” Shupe said, “but they also are powerful and crucial programs.”

Shupe also expressed concern that with the expansion of Medi-Cal, the cuts in reimbursement to providers could make it difficult for newly covered beneficiaries to find providers willing to take new Medi-Cal patients

“We are quite disappointed not to see any movement on the 10% Medi-Cal rate cuts,” Shupe said. “With about one-third of Californians now in Medi-Cal, that shows the need to finally address access issues. It’s disappointing not to see any kind of provider rate relief.”

It’s likely movement on some of those issues will come during budget negotiations over the next few weeks, along with pressure to cover the residually uninsured in California.

“We’re going to continue pressing the Legislature,” Stillwell-Parvensky said, “because these things can make a really big difference for children, they’re the kind of thing that really makes sense and it’s unfortunate they’re not in there.”

In particular, she said, the Black Infant Health Program seems ripe for addition to the budget revision. “It seems like the kind of thing the governor might add as a concession later in the process,” she said.

It’s possible the cuts made on a temporary, emergency basis during previous tough financial times might become permanent now, Shupe said.

“It sure seems to be the case that, more and more, policy decisions are being made through the budget,” Shupe said. “From a policy perspective, we’d love to have more opportunity for stakeholder participation. Because there doesn’t seem to be rhyme or reason to some of these cuts.”

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