COUNTY OF SAN MATEO

Inter-Departmental Correspondence

County Manager's Office

 

DATE:

May 7, 2002

BOARD MEETING DATE:

May 14, 2002

 

TO:

Honorable Board of Supervisors

FROM:

John Matbie, County Manager

SUBJECT:

County Manager's Report-Legislation #5

 

1.

Community Access Program (CAP) Grant Reauthorization

   
 

Recommendation:

 

Adopt a resolution in support of HR 504 (Green), the "Community Access to Health Care Act of 2001," and a resolution in support of S. 1533 (Kennedy), the "Health Care Safety Net Amendments Act of 2001"

 

Background

In 1999, the federal government established the Community Access Program (CAP) to expand health care access for the uninsured by increasing the effectiveness and capacity of the nation's health care safety net at the community level. The program represents one component of an initiative that seeks to expand insurance coverage for five million uninsured Americans by providing new, affordable health insurance options for families and by accelerating enrollment of uninsured children eligible for Medicaid and the Children's Health Insurance Program (Healthy Families program in California). CAP funds have been distributed to 136 communities through a competitive grant process for a period of three years.

 

In March of 2001, after a site visit by Health Resources Services Administration (HRSA) staff, Health Services was notified it would receive $897,773 for a grant year commencing March 1, 2001. The grant funds nine unclassified positions. The purpose of the grant is to provide financial and technical support to design and implement innovative approaches to the financing and delivery of health care to low-income, uninsured individuals.

 

The President's Proposed 2003 Budget recommends elimination of the $120 million categorical Community Access Program.

 

House Resolution 504 (Green) would enact the "Community Access to Health Care Act of 2001" and S. 1533 (Kennedy), the "Health Care Safety Net Amendments Act of 2001" to continue CAP.

 

It is estimated there are 42 million uninsured Americans and this number is increasing by over a million persons each year. Nearly one in five Californians are uninsured-most are children. CAP grants support a variety of projects to improve access for all levels of care for the uninsured and under-insured with each community designing the best program to address their needs. Most importantly, CAP funding is intended to encourage safety net providers to develop coordinated care systems for the target population. CAP funded programs can improve a community's health care network by improving infrastructure and communication among agencies to ensure that care is continuous. With better information, agencies can provide preventive, primary and emergency clinical health services in an integrated and coordinated manner.

 

Vision Alignment

Full funding for the federal CAP grants keeps the vision commitment to Ensure Basic Health and Safety For All and achieves goal number five: residents have access to healthcare and preventative care.

 

Recommendation

Attached for your consideration are resolutions in support of H.R 504 and S. 1533 to continue the "Community Access Program" grant program.

 

2.

State Budget Update #2

 

Of concern to counties is the April 22, 2002 vote by Assembly Budget Subcommittee No. 1 to shift up to $28 million in the Early Periodic Screening, Diagnosis and Treatment (EPSDT) program funds to counties. This action is consistent with the Legislative Analyst Office recommendation that the state is free to shift costs to counties based on the Appellate Court decision in Sonoma v. the Commission on the State Mandates. The current year EPSDT budget is approximately $700 million, which includes the federal, state and counties funds. Counties currently pay more than $55 million for a share of base cost for the EPSDT program. EPSDT is a mandated program that California is required to provide Medi-Cal recipients under the age of 21.

 

Attached is CSAC's Budget Action Bulletin No. 4 that provides greater detail to the EPSDT shift and other budget subcommittee actions.

 

I will continue to keep you apprised of changes to the proposed state budget.

 

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