4260 Department of Health Care Services
Major Program Changes
- Managed Care Organization Tax - The Administration proposes a new, broad-based tax that complies with federal law. The new proposal is intended to offset the same amount of General Fund expenditures as the current tax, as well as fund a restoration of the 7 percent reduction of IHSS hours required by a settlement agreement for two class-action lawsuits that challenged the reduction in IHSS hours: Oster v. Lightbourne and Dominguez v. Schwarzenegger.
- Extension of Skilled Nursing Quality Assurance Fee - Current law authorizes a quality assurance fee on free-standing skilled nursing facilities until July 31, 2015 and three percent increases in reimbursement rates in 2013-14 and 2014-15. The fee is matched with federal funds to increase reimbursements to these facilities. The fee will be extended with annual reimbursement rate increases of 3.62 percent for a period of five years.
- Behavioral Health Therapy - Pursuant to federal guidance, the Medi-Cal program began providing behavioral health treatment services on July 1, 2014, including Applied Behavioral Analysis, for individuals with autism up to 21 years of age under its Early and Periodic Screening, Diagnosis and Treatment activities.
- Limited Benefit Programs - Several state-only health programs including the Medi-Cal Access Program, California Children's Services, the Genetically Handicapped Persons Program, and Every Woman Counts currently provide health services that do not qualify as comprehensive coverage. Due to the Affordable Care Act, individuals can receive comprehensive health coverage that typically cover the services provided in these non-comprehensive programs. Consistent with a policy of encouraging comprehensive coverage, the Budget proposes to require individuals in state-only programs seek comprehensive coverage offered through Covered California or Medi-Cal in order to become eligible for these programs.
- Enrollment Stabilization - Medi-Cal beneficiaries enrolled in managed care will be permitted to change their plans only during a 90-day open enrollment period similar to the open enrollment period utilized by Covered California. Exceptions would be granted for qualifying life events, such as marriage, unemployment, or divorce.
- Pediatric Palliative Care - The Department of Health Care Services will expand its existing 11-county pediatric palliative care pilot project to an additional seven counties. This project improves the quality of life for children with life threatening illnesses.