After years of devastating cuts to the health and human services budget, this year's small surplus brought restoration of some programs.
Mental health programs will get a one-time boost of $140 million. The adult dental program, Denti-Cal, cut back in 2009 and leaving tooth extraction as just about the only service being covered, has been restored, albeit partially. Benefits won't start until next May.
But lost in the deal was a proposal to provide some therapies to 500 children with autism. Those children had lost some services when the state moved them from Healthy Families and to Medi-Cal.
Then there's the issue of funding to county health programs. Counties bear the cost for providing health care to the uninsured. Gov. Brown has been arguing since he introduced his budget in January that counties will gain federal money in January under the full implementation of the Affordable Care Act and so the state could reduce its own health funding to counties. But counties have fought that idea, saying that there would still be plenty of uninsured people after Jan. 1 -- and that now is not the time to cut the safety net.
While we're still waiting for final language, the legislature seems to have agreed with the governor's numbers, and it appears $300 million in county health funding cuts are coming.
Alex Briscoe, Director of Alameda County’s Health Care Services Agency, called it a "money grab" that will "threaten the stability of local safety nets."
Briscoe says the cuts presume that safety net providers are adequately funded right now, a presumption he called "offensive."
"The state has overestimated savings it will achieve, underestimated the burden of the residually uninsured and put forward a proposal that is divorced form the reality of local safety nets," he said.
The budget deal also leaves in place a 10 percent cut in Medi-Cal provider rates -- cuts that were approved by the legislature in 2011 and then held up in a long court challenge. The appeals process was exhausted last month, and the cuts will likely move forward this summer.
California has some of the lowest Medicaid reimbursement rates in the nation, advocates say.