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HomeMy WebLinkAboutMINUTES - 12051995 - C61 C.60,C.6 and C.62 THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Adopted this Order on December 5, 1995, by the following vote: AYES: Supervisors Rogers, DeSaulnier, Smith and Bishop NOES: None ABSENT: Supervisor Torlakson ABSTAIN: None SUBJECT: Correspondence C.60 LETTER dated November 10, 1995, from R.L. Jacoby, Manager, Environmental Conservation Department, Martinez Manufacturing Complex, Shell Oil Products Company, P.O. Box 711, Martinez, CA 94553, informing residents that as a part of the United States Environmental Protection Agency Facility Permit process, Shell's Martinez Manufacturing Complex will cease burning hazardous waste in its incinerator on December 31, 1995. ****REFERRED TO HEALTH SERVICES DIRECTOR AND COMMUNITY DEVELOPMENT DIRECTOR. C.61 LETTER and REPORT dated November 17, 1995, from Annette Rose, President, the Board of Supervisors of Marin County, Administration Building, Ste. 315, 3501 Civic Center Drive, San Rafael, CA 94903, advising that they unanimously voted to request the House of Representatives and the United States Senate to refrain from passing the current Health and Welfare "Reform" Proposals until appropriate public hearings and a completely objective analysis can be obtained. ** *REFERRED TO COUNTY ADMINISTRATOR AND SOCIAL SERVICES DIRECTOR. C.62 RESOLUTION dated November 20, 1995, from Susan M. Lantrip, Administrative Secretary, City of Antioch, Third and H Streets, Antioch, CA 94509, adopted by the Antioch City Council requesting that the Board grant the City of Antioch jurisdiction to participate with the County in the "L" Street Utility Undergrounding District. * "REFERRED TO PUBLIC WORKS DIRECTOR. hereby certify that this Is a true and correct copy of an actio,:t_%,c:. cnd cn;orcd on the minutes of the Board of Sup r isors on the data shown. ATTESTED :5 Igg PHIL BATCHELOR Clerk o the Board of Supervisors Unty Administrator c.c.Correspondents Health Services, Director f3 �pUty Community Development, Director County Administrator Social Services, Director Public Works, Director ADMINISTRATION BUILDING SUITE 315,3501 CIVIC CENTER DR. SAN RAFAEL,CALIFORNIA 94903.4193 TELEPHONE(415)499-7331 FAX(415)499-3645 TDD(415)499-6172 THE BOARD OF SUPERVISORS OF MARIN COUNTY November 17, 1995 RECEIVE® Board of Supervisors Nov 2 Contra Costa County 651 Pine Street ARK g6W OF SUPERVISORS Martinez, California 94553 "W. T -+COSTA CO. Dear California Supervisors: Re: Health and Welfare "Reform" The Marin County Board of Supervisors, at their meeting of November 14, 1995, voted unanimously to request that the House of Representatives and the United States Senate refrain from passing the current Health and Welfare "reform" proposals until appropriate public hearings and complete. objective analysis can be obtained. At issue for our Board are the frightening fiscal and humanitarian impacts of the legislation as currently drafted, as well as the County's ability to fulfill its obligation to provide support and services for the women, children, .elders and disabled in our population. We are enclosing a copy of a summary report prepared by Dr. Thomas Peters, Director of Marin County's Health and Human Services, regarding the current legislation being considered in Washington. Included in the report is a list of selected questions which might be posed either during congressional hearings or during reconciliation negotiations. We are also enclosing copies of our letters to Congresswoman Woolsey, Senator Boxer and Senator Feinstein in this regard. We acknowledge and applaud the number of Boards of Supervisors throughout California which also have raised concerns regarding these sweeping and draconian proposals. We believe that, if every local government in California would contact their legislators, Congress may, even at this 11 th hour, reconsider and revamp these potentially dangerous proposals. Failing that, we would urge President Clinton to veto the legislation in its current form, and insist that meaningful reform take its place. We invite you to join us in this effort. If you have any questions or comments, I would be happy to hear from you, and look forward to further discussions at the CSAC meeting in San Jose. Since bC� AN EROSE President, Board of Supervisors AR:IS\H&HSRfrm'. ' Enclosures: Letters to Congresswoman Woolsey and Senators Boxer and Feinstein Report from Dr. Peters VICE-PRESIDENT PRESIDENT 2ND VICE-PRESIDENT CLERK JOHN KRESS • HAROLD C.BROWN ANNETTE ROSE GARY CiIACOMQVI HARRY J.MOORE SAN RAFAEL SAN ANSELMO SAUSALITO SAN GERONIMO NOVATO • REGULAR MEETING 1ST DISTRICT 2ND DISTRICT 3RD DISTRICT 4TH DISTRICT STH DISTRICT TUESDAY,9 A.M. ADMINISTRATION BUILDING 1 SUITE 315,3501 CIVIC CENTER DR. SAN RAFAEL,CALIFORNIA 94903-4193 TELEPHONE(415)499-7331 FAX(415)499-3645 TDD(415)499-6172 THE BOARD OF SUPERVISORS OF MARIN COUNTY November 17, 1995 Senator Dianne Feinstein 331 Hart Senate Office Building Washington, D.C. 20515 Dear Senator Feinstein: With the unanimous support of the Marin County Board of Supervisors, I am writing to urge your continued support of constructive health and welfare reform, and your rejection of the current destructive proposals which do not reform, but ravage, these essential services. We join you in wanting a meaningful reform of the welfare system, so that it is structured to facilitate and support individuals' movement to self-sufficiency. And we, like you, want to see comprehensive health reform that assures care for those in need, while also protecting the public's health-and its treasury. But the health and welfare proposals currently before Congress obviously do not achieve these objectives, and this Board therefore supports your every effort to block their enactment until they can be more carefully and constructively fashioned. There are many in our community who stand with this Board in offering any input and expertise which might be helpful. Our Commission on Aging, the Health Council, the Mental Health Board and many others are ready to bring the suggestions of an informed citizenry to this discussion. This Board's Director of Health and Human Services, Dr. Thomas Peters, his staff and the private providers are prepared to provide technical support and testimony. The Marin County Board of Supervisors applauds your efforts to insist on meaningful health and welfare reform. Please let us know of any ways in which we and the community" might be of help. ER OSE President, Board of Supervisors AR:I$,H&HSRfm2 VICE-PRESIDENT PRESIDENT 2ND VICE-PRESIDENT CLERK JOHN RRESS • HAROLD C.BROWN • ANNETTH ROSE • GARY GiAcommi • HARRY J.MOORE • MARTIN I NICHOLS SAN RAFAEL SAN ANSELMO SAUSALITO SAN GERONIMO NOVATO REGULAR MEETING 1ST DismiCT 2ND DISTRICT 3RD DISTRICT 4TH DISTRICT 5TH DISTRICT TUESDAY,9 A.M. ADMINISTRATION BUILDING SUITE 315,3501 CIVIC CENTER DR. SAN RAFAEL,CALIFORNIA 94903-4193 TELEPHONE(415)499-7331 FAX(415)499-3645 TDD(415)499-6172 THE BOARD OF SUPERVISORS OF MARIN COUNTY November 17, 1995 Congresswoman Lynn Woolsey 439 Cannon Office Building Washington, D.C. 20515 Dear Congresswoman Woolsey: With the unanimous support of the Marin County Board of Supervisors, I am writing to urge your continued support of constructive health and welfare reform, and your rejection of the current destructive proposals which do not reform, but ravage, these essential services. We join you in wanting a meaningful reform of the welfare system, so that it is structured to facilitate and support individuals' movement to self-sufficiency. And we, like you, want to see comprehensive health reform that assures care for those in need, while also protecting the public's health and its treasury. But the health and welfare proposals currently before Congress obviously do not achieve these objectives, and this Board therefore supports your every ,effort to block their enactment until they can be more carefully and constructively fashioned. There are many in our community who stand with this Board in offering any input and expertise which might be helpful. Our Commission on Aging, the Health Council, the Mental Health Board and many others are ready to bring the suggestions of an informed citizenry to this discussion. This Board's Director of Health and Human Services, Dr. Thomas Peters, his staff and the private providers are prepared to provide technical support and testimony. The Marin County Board of Supervisors applauds your efforts to insist on meaningful health and welfare reform. Please let us know of any ways in which we and the community might be of help. Sincerely, 12 ROSE President, Board of Supervisors AR:IS\H&HSRfm2 VICE—PRESIDENT PRESIDENT 2ND VICE—PRESIDENT CLERK ro JOHN KRESS • HAROLD C.BROWN • ANNETTE ROSE • GARY GIACOMIN[ • HARRY J.MOORE • MARTIN J.Nrmms SAN RAFAEL SAN ANSELMO SAUSALITO SAN GERONIMO NOVATO - REGULAR MEETING 1ST DT.STRICT 2ND DISTRICT 3RD DISTRICT 4TH DISTRICT 5TH DISTRICT TUESDAY,9 A.M. • ADMINISTRATION BUILDING SUITE 315,35501 CIVIC CENTER DR. SAN RAFAEL,CALIFORNIA 94903-4193 TELEPHONE(415)499-7331 FAX(415)499-3645 TDD(415)499-6172 THE BOARD OF SUPERVISORS OF MARIN COUNTY November 17, 1995 Senator Barbara Boxer 112 Hart Senate Office Building Washington, D.C. 20515 Dear Senator Boxer: With the unanimous support of the Marin County Board of Supervisors, I am writing to urge your continued support of constructive health and welfare reform, and your rejection of the current destructive proposals which do not reform, but ravage, these essential services. We join you in wanting a meaningful reform of the,welfare system, so that it is structured to facilitate and support individuals' movement to self-sufficiency. And we, like you, want to see comprehensive health reform that assures care for those in need, while also protecting the public's health and its treasury. But the health and welfare proposals currently before Congress obviously do not achieve these objectives, and this Board therefore supports your every effort to block their enactment until they can be more carefully and constructively fashioned. There are many in our community who stand with this Board in offering any input and expertise which might be helpful. Our Commission on Aging, the Health Council, the Mental Health Board and many others are ready to bring the suggestions of an informed citizenry to this discussion. This Board's Director of Health and Human Services, Dr. Thomas Peters, his staff and the private providers are prepared to provide technical support and testimony. The Marin County Board of Supervisors applauds your efforts to insist on meaningful health and welfare reform. Please let us know of any ways in which we and the community might be of help. Sincerely, i ANNETTE ROSE President, Board of Supervisors AR:Is\H&HSRfm2 VICE-PRESIDENT PRESIDENT 2ND VICE-PRESIDENT CLERK 'JOHN KRESS HAROLD C.BROWN • ANNEITE ROSE GARY GIACOMINI HARRY J.MOORE MARTIN J.NICHOLS SAN RAFAEL SAN ANSELMO ` SAUSALITO SAN GERONIMO NOVATO REGULAR'MEEPING 1ST DISTRICT 2ND DISTRICT 3RD DISTRICT 4TH DISTRICT 5TH DISTRICT TUESDAY,9 A.M. r 0 COUNTY OF MARIN DEPARTMENTOF HEALTH & HUMAN SERVICES THOMAS PETERS, Ph.D.DIRECTOR November 14, 1995 Marin County Board of Supervisors Civic Center San Rafael, CA 94903 RE: FEDERAL HEALTH AND WELFARE "REFORM" Dear Board Members: Presented below is a brief summary of the current health and welfare proposals being considered in Washington. As you know, reconciliation discussions between the House and Senate are underway as we speak, so certain details are likely to change. Nevertheless, the broad outlines and budget targets of these congressional proposals have been determined, and they reveal a scope and impact that is nothing short of dramatic, and a moment of decision which is nothing less than historic. Sections I through III of the report summarize key points in the Welfare, Medicaid and Medicare proposals, with a range of estimated fiscal impacts based on the parameters set by House and Senate provisions. Section IV is a set of questions, selected from a much longer list, concerning the assumptions, analyses and impacts which should-be discussed in public sessions before such sweeping legislation is enacted. Indeed, it is shocking to note that such sweeping national proposals have been shrouded in secrecy, and held back from public hearings and objective analysis. At the end of the report, an issue of essential importance to California counties is raised: Section 17000 of the California Welfare and Institution Code. At a time when Washington is on the verge of shedding the fundamental concept (and protection) of "entitlement," particularly for children, the poor and the frailest of elders, Section 17000 would seem to leave California counties in a starkly conflicted position. 20 N.SAN PEDRo ROAD,Surm 2028,SAN RAFAEL,CALIFORNIA 94903,(415) 499-3696,TELEcopy(415) 499-3791 IQ PRINTED ON RF.C'V('LFD PAPFR Y Section I - Welfare Status • Sweeping restructuring of social service safety net • Block-grant major programs (AFDC, SSI, JOBS, and nutrition programs) to the states • Mandate significant work goals, impose time caps, and set certain categorical restrictions • Remove concept of "entitlement," leaving most eligibility requirements to the states • Eliminate eligibility for many disabled children, and all drug & alcohol-related adults, on SSI • Prohibit eligibility for legally resident non-citizens Fl fiscal Impact • $65 to $90 billion reduction from current 7-year federal expenditure plan • California's Legislative Analyst's Office (LAO) estimates loss to California of $6.6 to $8.3 billion over first 5 years of implementation of AFDC & SSI reductions, and non- citizen exclusions • LAO estimates cost shift to counties potentially of$2 to $3 billion Section H - Medicaid Status • Cap federal expenditures for Medicaid, and use a distribution formula to block-grant funds to the states • Eliminate "entitlement" status, leaving most eligibility criteria to the states • Still debating whether to "guarantee" some coverage to pregnant women, children under 13, and certain disabled individuals, and whether to direct a specific "set-aside" for coverage of elders • Medicaid eligibility for non-citizen legal residents would be forbidden under current welfare proposals discal Impact • Reduce current federal expenditure plan by approximately $180 billion (30%) over the next 7 years • If states also reduce their expenditures in tandem with federal reductions, total Medicaid drop in spending will be between $409 to $438 billion over the next 7 years, according to analysis by the Center on Budget and Policy Priorities (CBPP) in Washington. t • California's cumulative loss in federal funds will be between $5.9 billion and $10.8 billion, and if California decides"to "match only to the cap," reduction in total Medi-Cal spending would be between$39.1 billion and $47.3 billion, according to CBPP analysis. Section III - Medicare Status • Major restructuring and reductions, but program remains in federal administration, with enrollees maintaining "entitlement" status • Proposals to strongly encourage seniors to enroll in HMO's or to use individual allocation to a Medical Savings Account to purchase catastrophic insurance Escal Impact • Reduction of$270 billion from current expenditure plan over the next 7 years • Nearly $200 billion of this reduction to come from reduced payments to hospitals, clinics, nursing homes, and physician offices, according to Congressional Budget Office analysis. Section IV - Selected Questions: • Given that recent data show that an additional 500,000 to 1.2 million American children would fall into poverty as a result of these proposals, has there been any analysis of the net social and financial costs that would be generated? • The termination of SSI benefits to disabled children who can live at home would likely mean an increase in care responsibilities, and a decrease in work opportunities, for many of the parents involved. Has there been an estimate of lost productivity and tax revenue? • The wholesale ineligibility for benefits, even those temporary in duration, to non-citizen legal residents would have a disproportionate impact in California and several other port- of--entry states. Has this been figured into the formula for distribution of administrative and benefit dollars? • The down-sizing and elimination of a number of employment and training programs, particularly those focused on disadvantaged youth, seems to run counter to the employment goals mandated in these proposals. Has the imposition of monetary sanctions to the states already been calculated into the estimate of reduced federal participation in this area? • The double reduction of Medicare and Medicaid would clearly target the elderly and disabled patients whose economic and medical conditions are covered by benefits in both programs. Has there been a consideration of an uncapped allocation formula for these dual beneficiaries, or should plans be made for rationing nursing home and in-home care? r • What actuarial data supports the need for a$270 billion reduction in Medicare spending? • The establishment of a Medical Savings Account, and the selective recruitment of seniors into HMO's, would tend to destabilize the base of Medicare. Is there a timetable for phasing out Medicare? • The elimination of the Surgeon General's Office and the fractionalization of Medicaid means that public health goals and programs would largely be determined according to 50 different prioritization schemas. Is there any federal set-aside for supporting uniform disease control, for example, with HIV and TB? • Certain states, like California, have already been through a lengthy period of consolidations, reconfigurations, and market-driven cost cutting. Will this be given consideration in the final Medicaid distribution formula? • Public hospitals and clinics traditionally provide much of a community's specialty care, from trauma and psychiatric care, to disease control and school-based services. Has there been any consideration of categorical funding for these community-wide programs? • The two major factors driving an increase in Medicare spending will be the rate of growth in eligible enrollees and in medical inflation. If these two gradients exceed the reduced rate of Medicare spending, how will rationing of care be avoided? These questions are only a small sampling of the issues that would properly be discussed before enacting such sweeping legislation. It is hoped there will be an opportunity, even at this 11th hour, to raise these and other critical considerations. Also, please find appended to this report the text of California Welfare and Institution Code 17000. This would appropriately be the subject of focused discussions among the counties of California, given the revolutionary changes Washington is debating. I look forward to working with Your Board and the Administrator as these proposals are debated and negotiated. Respectfully submitted, as Peters, Ph.D. Director of Health and Human Services r 4. W & I SECTION 17000 Section 17000 of California's Welfare & Institution Code reads: "Every county and every city and county shall relieve and support all incompetent, poor, indigent persons, and those incapacitated by age, disease, or accident, lawfully resident therein, when such persons are not supported and relieved by their relatives or friends, by their own means, or by state hospitals or other state or private institutions. " Section 17030 provides a certain limitation of obligation to the counties for services cut from Medi-Cal, but other than that section and certain case law, a sweeping though non-specific obligation would seem to pertain.