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HomeMy WebLinkAboutMINUTES - 05071991 - 2.2 TO:'' BOARD OF SUPERVISORS ?�.SE-,L-- f Contra FROM: Phil Batchelor, County Administrator Costa n. s �� .-:•.: -- -� May 2 1991 County DATE: srq-(56u- STATUS -REPORT ON DECISIONS REGARDING STATE/COUNTY PROGRAM SUBJECT: REALIGNMENT PROPOSALS SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATIONS 1. Concur in general with the direction being taken by the Conference Committee on SB 88, and that being taken by the CSAC State Budget Task Force, co-chaired by Supervisor McPeak in regard to program realignment and specifically endorse the attached "County Principles/Conditions for State Program Transfers" . 2. Urge the Conference Committee on SB 88 and the CSAC State Budget Task Force to press for state assumption of at least 500 of the cost of the General Assistance Program as opposed to county assumption of 1000 of the costs of the In-Home Supportive Services ( IHSS) Program. 3 . Urge the Conference Committee on SB 88 and the CSAC State Budget Task Force to oppose the transfer of the Medi-Cal Program to any local health authorities which may be established. 4. Adopt a position in SUPPORT of SB 41 (Robbins) and SB 855 (Robbins) , as described below. BACKGROUND: We have been making periodic reports to the Board of Supervisors as events have unfolded in Sacramento over the past several months. Events are now moving rather rapidly and we felt it was Yes ���_✓� ��u���d�l� CONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE w^ X APPROVE OTHER SIGNATURES ACTION OF BOARD ON May APPROVED AS RECOMMENDED X OTHER X The report is REFERRED to the Finance Committee for further review and recommendation. VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE X UNANIMOUS(ABSENT _ ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. CC: ATTESTED May 7 ,. 1991 Members, Board of Supervisors . PHIL BATCHELOR,CLERK OF THE BOARD OF County Administrator SUPERVISORS AND COUNTY ADMINISTRATOR Health Services Director Social Services Director BY A/� ,DEPUTY M382 (10/88) about time to share with the Board again a status report on what direction is being taken in the area of state/county program realignment. CSAC has adopted a set of Principles/Conditions for State Program Transfers, a copy of which is attached to this report. Currently, some $2 .3 billion in programs are under serious discussion for transfer to counties, along with appropriate revenue sources to finance their continued operations. Counties generally are agreeable to such transfers, as long as the terms of the CSAC Principles are followed in choosing and financing such transfers. Extensive work has been done by CSAC and its various health-related affiliates to prepare a set of issue papers on the implications of various combinations of health program transfers to counties. The Board has already addressed the implications of various welfare and social service program transfers. We would, at this time suggest two cautions which County staff should bear in mind in developing further recommendations on program realignment in the health and welfare are: 1) The Board of Supervisors should oppose any efforts to transfer the full financial responsibility of the In-Home Supportive Services Program (IHSS) from the State to the counties. 2) The Board of Supervisors should resist any efforts to transfer to local Health Authorities which may be established the full responsibility for the administration of the Medi-Cal Program. In both cases, the programs are significantly underfunded at the present time. Assuming responsibility for the administration and funding for either or both of these programs, whether through a Health Authority or directly, may expose the County to an open-ended responsibility to meet the needs of all individuals who may be eligible for services under either or both programs. This could readily become such an expensive liability that it would overshadow all other fiscal problems this County has faced to date. Additional documentation on a number of the health programs which are being discussed with a view to possible transfer to the counties is attached. SB 88 (Alquist) is the likely vehicle which will be used to effect any realignment of state and local health and welfare programs. This legislation is currently in Conference Committee which has met on several occasions to date. As is indicated in the attached "Realignment Guidelines" dated April 30, 1991, the Conference Committee has already agreed on a number of points which, if actually enacted in legislation, will have a profound affect on counties. It is also recommended that the Board of Supervisors support SB 41 and SB 855. SB 41 seeks to maximize federal financial participation in the Medi-Cal Program by, among other things, authorizing the State Department of Health Services to include all local government expenditures for health care provided to Medi-Cal beneficiaries in determining the state match of federal Medicaid funds. The bill requires local governments to certify that local contributions are eligible for federal participation. SB 855 specifies that one priority for the expenditure of funds in the County Health Services Fund is the gathering of statistics which are required under the Medi-Cal Program. -2- Because of the speed with which changes are occurring, it is impossible to expect the Board of Supervisors to provide detailed direction to its members or staff on the specific details of proposed program transfers. What is perhaps most appropriate at this point is for the Board to endorse the CSAC "County Principles/Conditions for State Program Transfers" and ask staff to report back on a regular basis to the Board on events as they occur. -3- 141.E.0.._-4-Z_.:_�.2_..S U P V S U N ht E M C P E A K �. P 4t-brand fax"Mmittai memo 76Th 1 f of pop" r �' `� rift• ?�.3 — April 22, 1941 TO. - Members, CSAC Board of Directors CSAC Policy Committee Chairs All County Administrative Officers FROM: Larry E. Neake, Executive Director SUBJECT: RgOED -COUNTY PFUNCIPLEWMN12MONS FOR STATE PROGRAtU� ,TRANSFERS; AND WORKING PAPER FOR STATEICOUNTY PROGRAM REAUGNM Enclosed Is a revised.copy of the `County PrnapleslConditions for State Program Transfers," as adopted by the CSAC'Board of Director last Thursday,April 18,1991. We wanted to mal to you this revised policy as soon as possible, along with a general explanation and definition of terms as outlined below. Also enclosed Is, ra #t of a"worldnq paper'for state/county Program Reaflgnment,as developed by the CSAC Stste Budget Task Force. The Task Force stayed over until Friday,April 19 and worked on beginning to implement the Board of directors adopted policy. Please note this Is a Nycxki'nci P.Ic.W&dlscuft RWpM9 and does noteY t�ect adopted C-SAC policy. The Task Force will be refining the working paper and presenting it to the Board of Directors at your May 17, 1991 meeting to be held as follows: CSAC BOARD OF DtREC�ONS MEETING REGARDING STATE BUDGET DATE: Friday, May 17, 1891 TIME: 9,30 am•2:00 pm PLACE: Shot of Class 1020. 11th Street(across from CSAC office) Sacramento, CA 95614 (916) 447-5390 ff evEts In Sacram2 o�rteyft more auickiv than anticipated,we may hold an eMgencyCSAC Board of Directors meetino in S§gMM2nto on•MondgY, May 6. 1991. Please teMative�l),mac Your calendars with tlls date. The Task Faroe met three tirnes during a one-week period ending fast Friday and plans two more meetings, on April 29 and May 16, before your next Board of Directors meeting. In addition, Task Force representatives will be meeting with the Legislative leadership and Administration representatives to discuss the adopted Principles and working paper. To date,the Task Force has worked on Program Realignment proposals.but Will now also turn their attention to other State Budget Issues such as proposed county program reductions and state and county revenue Increases. MAY- 1 -91 we" 1 3 S 33 SURY SI./NNE MCPE �iK r cr.c April 22, 1991 Page two 7o hel0}Mu in discussing the 149M ed TOWN_PAngkieslConditlons for State Prosrram Transfers" pow A41 other Board o(SuR vOdM M2Mbers the{cess and constitmots.we have deveto22d the following!MMlan on• of t1`12 RDJI y indudi deinftions of terms mgvg: EXPLANA-11ON OF'COlM PRINCIPLESMLOITIONS FOR STATE PMRW TRANSFERS The preamble of the policy statement is relallmety straightbrward. The main paint to be emphasized Is that counties would be willing to accept program transfers it the transfers are accompanied by an adequate and growing.revenue source to fund the transferred programs and the counties are given the flexibility to manage the programs within the resources provided. With respect to specific principles and conditions,the following explanation and definitions are offered: - 1. The principle states that Program Realignment should solve both *cynical` and 'structural' budget crises. "Cyclical'budget problems refer to the imparts of the economy on state and local revenue sources. 'Structural'budget problems refer to such things as Ineffectim program relationships between the state►and the counties, programs that grow at a faster rate than the revenues available to support those programs, and such budgetary constraints as COLAs, earmarking revenues, earmarking expenditures (Le. Proposition 98), and super majority requiremwft for the passage of budget and appropriations bills. 2. self explanatory. 3. The reference to a 'trigger' mechanism means that if the revenues provided to fund the program transfer do not grow as much as the expenditures for the programs transferred,then this fact shook! 'trigger' an automatic reduction In the expenditures,to meet the revenues ava Mable. 3-5. The term"designated revenues'used in these three principles refers to a specific and dedicated source of revenue that will be provided by the state to the counties to fund the programs that have been transferred. The designated revenue source must be a statewide revenue such as the safes tau or motor vehicle In-lieu tax and must be allocated to counties on the basis of Program transferred. This means that counties do not want the state to transfer programs and then ask them to raise revenues Wit» county boundaries to fund those program tram. 5. The last two sentences of the principles Indicates that the revenue source may "require Implementation by -county governing boards,' but should not require a focal vote. "Implementation' means that a Board of Supervisors may be asked to "ratify" a statewide revenue source such as the sales tax or the motor vehicle in-lieu tax,but should not be required to levy the tax on a county-by-county basis, either by a vote of the Board of Supervisors or a vote of the people. £r12. Self explanatory. , 1 WED 13 C 34 SUPY S'UNNE MCPEAK April 22, 1991 Page three The only other term that needs to be defined and understood is'Prograrn Realignment.' By Program Realignment,counties mean that programs may be transferred not only from the state to the counties, but also from the counties to the state. The best example of a program transferred from the counties to the state,would be AFDC and General Assistance. Counties have long advocated transferring these programs to the state,which has a broader economic base to fund these income maintenance program N you have arty specific or general questions about any of the attached materials, please do not hesitate to call me or members of the Task Force(membership fist attached). Also,may we ask that you return the enclosed postcard to CSAC In order to cwArri your attendance at the May,1T, 1991 meeting. LEN:sgm Attachments cc: Members, CSAC State Budget Task Force