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133 Aging and Disability Stakeholders’ Response to May Revision of Proposed 2024- 25 State Budget

133 Aging and Disability Stakeholders’ Response to May Revision of Proposed 2024- 25 State Budget

Dear Governor Newsom, Speaker Rivas, Pro Tem McGuire, Assemblymember Gabriel and Senator Wiener:

The undersigned 133 organizations representing aging and disability stakeholders in California, write to you with our comments on Governor Newsom’s May Revision to the proposed 2024-25 state budget. The May Revision includes a number of cuts to IHSS, workforce initiatives, housing and homelessness programs, CalFresh/CFAP, APS, and CDA programs including the Older Californians Act.

Health Care

We are deeply alarmed that the Governor’s May Revision includes the elimination of the In-Home Supportive Services (IHSS) benefit for undocumented Californians in MediCal. The IHSS program provides essential support services to ensure that individuals can remain living in the community and avoid costly institutionalization. By eliminating IHSS, the state will be turning its back on its commitment to providing health care for all Californians regardless of immigration status. Given that the proposed cut targets immigrant and disability communities, we also have serious concerns that it violates the Americans with Disabilities Act and the Supreme Court’s decision in Olmstead, the Equal Protection Clause of the California Constitution, and California’s Government Code section 11135 and recently amended regulations.

IHSS is a key health care program, and by revoking access to the program, low-income undocumented Californians will have to forgo care at home or seek long-term services and supports through institutional care, which would ultimately be exponentially more expensive for the state. This elimination also puts a significant economic burden on family caregivers, who may now have to leave the workforce to provide that care uncompensated. Family caregivers are often low-income women of color, and if they must leave the paid workforce to provide care to their aging and disabled family members, this proposal will exacerbate economic disparities.

Eliminating access to IHSS will also undermine the trust that California has worked to build with immigrant communities and will raise doubts about its commitment to health access for all Californians. Since the first expansion of Medi-Cal to children in 2016, the Department of Health Care Services, in conjunction with enrollment navigators and consumer advocacy organizations, have put in considerable work to assuage fears of enrolling in Medi-Cal. Eliminating IHSS now for this specific population will lead to confusion and fear that other Medi-Cal services or coverage entirely will be stripped away. Additionally, Medi-Cal paid placement at LTC facilities is one of the public benefits considered in the public charge assessment – making this IHSS benefit cut particularly cruel for undocumented Californians.

We are also disappointed that the Governor proposes to eliminate the IHSS Permanent Backup Provider program. The shortage of available caregivers has had a significant adverse impact on the quality of life of people with disabilities and older adults. IHSS recipients who have gaps in their care face a risk of costly hospitalization and institutional placement. Eliminating the Backup Provider system exacerbates an already critically under-resourced program. California must ensure that IHSS recipients do not go without the care they need to remain safely in their homes when their regular caregivers are sick or experience an emergency. We urge the Legislature to reject this proposal, and prioritize programs like the Backup Provider program that further health equity and support community living for all Californians.

We appreciate and acknowledge that the May Revision maintains other investments in health care eligibility and benefits, like the elimination of the asset test in Medi-Cal and the 2025 implementation of Part A Buy-In. We also appreciate that important home and community-based services programs like the Community-Based Adult Services and the Multipurpose Senior Services Program were not cut, as they were in previous cycles of fiscal downturn. However, we are disappointed in the May Revision proposal to cut funding for the Community Health Navigators who play an important role in enrolling older adults and people with disabilities in Medi-Cal.

We are disappointed that the May Revision delays the implementation of the MediCal Share of Cost reform. We recognize the difficult budget environment this year; however, the current inequitable Medi-Cal Share of Cost program forces older adults and people with disabilities to live on $600 a month in order to receive health benefits. The Legislature and Governor should remain committed to implementing this reform as quickly as possible.

Older Californians Act Modernization

We are opposed to the proposal in the May Revision to substantially reduce the funds to modernize the Older Californians Act. The May Revision proposes to eliminate $111 million of this vital funding for senior nutrition programs. Senior nutrition programs are a core service of many Area Agencies on Aging. There is incredible need in the community for meals, and cutting this funding would be shortsighted, harmful, and counter to the goals of California’s Master Plan for Aging. We urge the Legislature to reject this proposal.

Food Security

We are disappointed in the two-year delay in implementing the expansion of the California Food Assistance Program for undocumented older adults. Food insecurity is a fundamental element of the social determinants of health. All Californians deserve access to food, and low-income undocumented Californians have been unjustly excluded for too long. Further delaying the expansion only exacerbates these harms. We urge the Legislature to reject this proposal.

We are also disappointed in the proposal to eliminate the CalFresh Minimum Benefit Pilot, which would provide additional CalFresh food benefits for households that are only receiving the federal minimum allotment of $23 per month, bringing them up to $50 per month. We urge the legislature to reject this cut. Hunger needs in California remain high, and cutting this pilot program only harms older adults and individuals with disabilities already struggling to afford food.

Housing and Homelessness

California has experienced an alarming spike in older adult housing precarity and homelessness; almost half of unhoused adults are now age 50 and older, a number that continues to grow. There could not be a worse time to cut funding to programs that specifically target the housing needs of older adults and people with disabilities. The May Revision proposes cuts to Home Safe and the Housing and Disability Advocacy Program, two of the only programs focused on preventing older adult homelessness. When paired with the severe reductions in HHAP, Behavioral Health Continuum Infrastructure Program (BHCIP) and Behavioral Health Bridge Program (BHBH), localities will have few resources to help older and disabled adults get and stay housed. We urge the Legislature to reject this proposal. We appreciate the $500 million of state tax credit funds available to create more LIHTC housing.

Elder Justice

We’re also deeply concerned about the proposed cuts to Adult Protective Services, which provides important services to vulnerable older adults. The May Revision proposes to cut the expansion of the Adult Protective Services program, reduces the additional training funds for APS workers and puts the innovative Home Safe program in jeopardy. The Home Safe program has been critical in reaching older adults experiencing homelessness throughout the state. Further, without these additional training funds, the APS workforce will be unprepared to support the complex needs faced by older adults and persons with disabilities experiencing abuse and neglect. The APS program is a critical safety net program for older adults and is recognized by the State’s Master Plan on Aging as a continuum of care to promote healthy aging and equitable access to community-based services. We urge the Legislature to reject this proposal.

Workforce

We are disappointed to see that the May Revise proposes to eliminate $820 million in health care workforce development funding through Fiscal Year 2027-28. These cuts would be felt across multiple health care professions, such as community health workers, nurses, social workers and more. As our aging population grows and access to trained caregivers declines, there has never been a more critical time to bolster investments in our health care workforce.

Behavioral Health

We are disappointed in the May Revision proposal to significantly reduce the California Department of Aging’s Older Adult Behavioral Health funding. There are significant needs for behavioral health services amongst older Californians – research indicates that fewer than half of older adults with mental and/or substance use disorders receive necessary treatment. In addition, we know that older adult isolation and loneliness results in real harm and requires proactive interventions, including behavioral health support. We urge the legislature to consider ways to continue investing in the behavioral health infrastructure to support older adults.

Economic Security

We sincerely appreciate that the May Revision does not include any cuts to the SSI/SSP grants, which provide critical income support to the lowest-income Californians. In the last recession, severe cuts were made to SSI/SSP, resulting in one million older adults and people with disabilities being pushed into poverty. We are still grappling with the impacts of that recession, and it is important that the SSI/SSP grants are not cut in this current budget environment.

California’s Commitment to the Master Plan for Aging (MPA)

Over the last several years, California has been committed and engaged in the MPA development and implementation. The MPA’s goal is to remedy longstanding inequities in the systems of care for older adults and people with disabilities. We must ensure that the final budget agreement remains aligned with the goals of the MPA, and therefore we urge the Legislature to reject the harmful cuts proposed in the Governor’s May Revision.

We look forward to continuing to engage with the Legislature and Administration during this difficult budget cycle to ensure that older adults and people with disabilities are not harmed.

Sincerely,

A.B.L.E Community Development
Foundation
Abrazar, Inc.
Aging Services Collaborative of Santa Clara County
Alameda Alliance for Health
Alameda County Older Adults, Healthy Results
Alzheimer’s Association
Alzheimer’s Los Angeles
American Federation of State, County and Municipal Employees
Archstone Foundation
Ashby Village
Asian Pacific Caregiver Network
Bet Tzedek Legal Services
Brilliant Corners
Buen Vecino
CA Foundation for Independent Living Centers
California Advocates for Nursing Home Reform
California Alliance for Retired Americans
California Assocation for Adult Day Services
California Association of Area Agencies on Aging
California Association of Food Banks
California Association of Public Authorities for IHSS
California Collaborative for Long-Term
Services and Supports (CCLTSS)
California Domestic Workers Coalition
California Elder Justice Coalition
California Health Advocates
California Immigrant Policy Center
California Pan-Ethnic Health Network
California Senior Legislature
California State Association of Public
Administrators, Public Guardians and Public Conservators
California Women’s Law Center
Californians for Disability Rights
CalPACE
Cardea Health
Caring Across Generations
Central Valley Immigrant Integration
Collaborative
Centro Laboral de Graton
Chinatown Service Center
Choice in Aging
City of Oakland
Coalition for Humane Immigrant Rights, CHIRLA
Communities Actively Living Independent & Free
Community Living Campaign
Community Resources for Independent Living
Community Tech Network
County Welfare Directors Association of California
Courage California
Crisis Support Services of Alameda County
DayBreak Adult Care
Disability Community Resource Center
Disability Justice League Bay Area
Disability Rights California
Disability Rights Education and Defense Fund (DREDF)
Disability Voices United
Eden Area Village
Elder Law & Advocacy
Empowered Aging
Fat Legal Advocacy, Rights, and Education project of Solovay Law
Filipino Advocates for Justice
Food for People
FREED Center for Independent Living
Friends Committee on Legislation of California
Hand in Hand: The Domestic Employers Network
Hmong Cultural Center of Butte County
Home Match | Front Porch
Homebridge
Immigrant Defense Advocates
Independent Living Resource Center San Francisco
Indivisible CA: StateStrong
Inland Counties Legal Services
Inland Empire Immigrant Youth Collective
J Gould Consulting
Jewish Family Service LA
Jewish Family Services of Silicon Valley
Justice in Aging
Latino Coalition for a Healthy California
Leading Age California
Legal Assistance for Seniors
Legal Assistance to the Elderly
Let’s Kick ASS Palm Springs (AIDS Survivor Syndrome)
Lifelong Medical Care
LifeSTEPS
Little Tokyo Service Center
Long Beach Gray Panthers
Maternal and Child Health Access
Mercy Brown Bag Program
Mixteco/Indigena Community Organizing Project (MICOP)
Mujeres Unidas y Activas
Multi-faith ACTION Coalition
National Health Law Program
Neighborhood Legal Services of Los Angeles County
Northeast Valley Health Corporation
On Lok
Openhouse
Pacific Asian Counseling Services
Pangea Legal Services
Partners in Care Foundation
Personal Assistance Services Council (PASC)
Pilipino Workers Center
Placer Independent Resource Services
PNHP California – South Bay Chapter
Resources for Independence Central Valley (RICV)
San Francisco AIDS Foundation
San Francisco Gray Panthers
San Francisco Human Services Agency
San Francisco IHSS Public Authority
San Francisco-Marin Food Bank
SEIU CA
Senior Advocacy Network
Senior and Disability Action
Senior Coastsiders
Senior Services Coalition of Alameda County
Seniors Council of Santa Cruz & San Benito Counties
Service Center for Independent Life
Service Opportunity for Seniors / SOS Meals on Wheels
SF IHSS Task Force
Silicon Valley Independent Living Center
Sistahs Aging with Grace & Elegance
Sourcewise
St. Mary’s Center
The Arc of California/ El Arc de California
The California IHSS Consumer Alliance (CICA)
The Center for Independent Living
The Central Valley Urban Institute
The East Oakland Collective
The Unity Council
United American Indian Involvement
United Domestic Workers/AFSCME 3930
United Seniors of Oakland and Alameda County
United Way of Greater Los Angeles
Urban & Environmental Policy Institute, Occidental College
Venice Family Clinic
Vietnamese American Community Center of the East Bay
Western Center on Law and Poverty