A School-Based Medicaid Perspective on California’s 2012-13 Proposed Budget

On January 5, 2012, Governor Jerry Brown released his proposed budget for 2012-13, addressing a $9.2 billion projected shortfall. The proposed budget assumes the passage of a planned November 2012 ballot measure that would raise $6.9 billion through tax increases on the wealthy and a temporary sales tax hike, and also includes information on automatic trigger cuts in the amount of $5.4 billion if the ballot measure is rejected by voters.


Key Provisions: School-Based Medicaid Program (SMAA and LEA Billing Option) Perspective

The next few years will see significant changes in policy, organization, and operation of the Medi-Cal program, both as a result of the lingering economic downturn and the approaching implementation deadline for health reform compliance in 2014. While most of these changes will not directly impact school-based Medicaid programs, they are important to track when analyzing indirect affects and potential areas of increased opportunity or obstacles to reimbursement claiming.

Along with some help from the California Budget Project (CBP) budget proposal summary, below are a few key provisions to keep your eye on as California’s 2012-13 budget moves through the legislature:


    1. Rebench Proposition 98, the guaranteed minimum funding level for K-14 education, to include a permanent increase to, in part, cover educationally related mental health services. Responsibility for these services was realigned from county mental health (CMH) departments to schools in the 2011-12 budget following the elimination of the AB 3632 mandate.


Medi-Cal Program

    1. Shift all children enrolled in the Healthy Families program to the Medi-Cal program, to take place between October 2012 and June 2013 (currently, Healthy Families covers approximately 875,000 children)
    2. Expand managed care into rural counties that currently offer Medi-Cal services only on a fee-for-service basis
    3. Change in the method used to determine payments for federally qualified health centers (FQHCs) and rural health clinics (RHC) from a “cost and volume” model to “performance, risk-based” model in which clinics would receive a “fixed payment to provide a broad range of services.”


Related Links and Resources

Read the 2012-13 Proposed California Budget…

Read the California Budget Project (CBP) Summary of the 2012-12 Proposed Budget…