State Budget Constraints Lead to Delays in Two California Health Programs

Two California programs that were expected to roll out this year — one for children with special needs and one for low-income people seeking palliative care — are now scheduled to be delayed due to state budget constraints.

A controversial plan to move children with special health care needs into a different state insurance program has been postponed until July 2018, according to the Lucile Packard Foundation for Children’s Health.

“Originally scheduled for July 2017, the transition has been delayed due to constraints in the newly proposed California budget and other factors,” an email from the foundation states.

Under the restructuring, about 30,000 children who are enrolled in the California Children’s Services program will be moved to Medi-Cal, the state’s low-income insurance program.

In September, Gov. Jerry Brown signed a bill that should allow some of the children, who are among California’s most medically fragile, to keep the health services they rely on.

Senate Bill 586 aims to prevent potentially life-threatening disruptions in care while the state restructures California Children’s Services, a health program for children with certain chronic conditions, including cystic fibrosis, hemophilia, cerebral palsy, heart disease and cancer.

Many of these children have seen the same specialists for years, who are well versed in the intricacies of their conditions and medications. The bill will allow the children to keep their existing providers for 12 months. Those who want to keep their doctors after the first year may be able to through an appeals process.

Palliative care delay

State budget constraints have also slowed the implementation of a palliative care program for Medi-Cal. The state Department of Health Care Services had previously said that the program would begin in April 2016, but the draft budget now calls for an implementation date “no sooner than July 1, 2018,” according to the Coalition for Compassionate Care of California.

Palliative care, which is medical care that aims to improve the quality of life for people with chronic or serious illnesses, is not widely available in California. A state law, Senate Bill 1004, passed by the Legislature in 2014, directs the state to create a palliative care program for people enrolled in Medi-Cal.

Advocates hope the law will eventually open the gates to palliative care for all Californians, including those with private insurance.

Judy Thomas, CEO of the Coalition, said she was frustrated by the delay.

“SB 1004 is a cost-neutral bill — it was not designed to give additional money to health plans or pay providers,” she said in a release. “Delaying the implementation of this bill not only creates confusion among California’s health plans, it continues to deny the most vulnerable people in our state access to quality, palliative care when they are seriously ill or nearing the end of life.”

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