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Judicial Watch • 2011 lacounty-docs-1-12202010

2011 lacounty-docs-1-12202010

2011 lacounty-docs-1-12202010

Page 1: 2011 lacounty-docs-1-12202010

Category:Obtained Document

Number of Pages:43

Date Created:December 20, 2010

Date Uploaded to the Library:July 30, 2013

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Alsop, 
From: Alsop, Ryan Sent: Wednesday, April 28, 2010 10:08 To: Wall, Daniel FWD
Cc: 'Donna Seitz'; 'Martha Flammer'; Berends, Edw -FWD; 'Steve Kawamura'; 'Paula Chafey
Merrill'; Rivas, Jr., Manuel Subject: County Los Angeles Board Supervisors Federal Issues Brief Talking Points 
Washington -May 2010 Attachments: Board Federal Issues BriAfing Talking Polr.ts -May 2010.pdf 
Ryan Alsop 
Assistant Chief Executive Officer Intergovernmental External Affairs County Los Angeles 
(213) 974-1100 
Alsop, Ryan  
From:  Alsop, Ryan  
Sent:  Wednesday, April 28, 2010 7:48  
To:  Wan, Cindy; 'phong@bos.lacounty.gov'; 'Drew Ivie, Sylvia'  
Subj ect: Attachments:  Board Washington Trip Briefing -THIS WEEK -Request for Briefing Board Federal Issues Briefing Talking Points -May 201 O.pdf  

Board Washington Trip Briefing -THIS WEEK

Request for Briefing 
Supervisor, Peter, Cindy: 
Burt Margolin, Reggie Todd and are requesting meet with you this week discuss next week's trip Washington DC. this meeting will specifically discuss our recommended Board issues and advocacy, your TENTATIVE Itinerary meetings, transportation arrangements and other important logistical detail. 
Attached, please find for your review and consideration copy this year's Fed eral Issues Briefing Book that are using brief those participating the trip. This book contains executive summary our issues/advocacy, detailed briefing papers each issue and talking points that you may use your meetings. you have any questions, suggestions, comments, concerns requests, please call right away 4,-1100 email 

Ryan Alsop 
Assistant Chief Executive Officer Intergovernmental External Affairs County Los Angeles 
(213) 974-1100 

Alsop, Ryan  
From: Sent: To: Subject: Attachments:  Alsop, Ryan Wednesday, April 28, 2010 7:45 'PhilipBrowning@dpss.lacounty.gov'; 'John SchBoard Washington Trip Briefings -THIS WEEK Board Federal Issues Briefing Talking Points  unhoff; Andrizzi, Gwen; Cervantes, Elena -CEO, OHS, DPSS -May 201 O.pdf  

Board Washington Trip Briefings -THIS WEEK -CEO, 
OHS, DPSS 
Bill, Brence, Phillip and John: you are aware, Burt Margolin, Reggie Todd and are scheduled meet with you later this morning 11:00pm discuss next week's trip Washington DC. this meeting will specifically discuss our recommended Board issues and advocacy, your TENTATIVE itinerary meetings,transportation arrangements and other important logistical detail. 
Attached, please find for your review and consideration copy this year's Federal Issues Briefing Book that are using brief those participating the trip. This book contains executive summary our issues/advocacy, detailed briefing papers eah issue and talking points that you may use your meetings. the meantime,if you have any questions, suggestions, comments, concerns or requests, please call right away 
4-1100 email 

Ryan Alsop Assistant Chief Executive Officer Intergovernmental External Affairs County Los Angeles 
(213) 974-1100 

Alsop, Ryan  
From:  Alsop, Ryan  
Sent:  Wednesday, April 28, 201 7:41  
To:  Fujioka, William Culp, Brence; 'PhilipBrowning@dpss.lacounty.gov'; 'John Schunhoff;  
PhilAnsell@dpss.lacounty.gov; Allan Wecker; Andrizzi, Gwen; Cervantes, Elena  
Cc:  Todd, Reginald -FWD; Campbell,Greg -FWD; 'Burt Mar golin'; Tajima, Mark  
Subject:  Board Washington Trip Briefings THIS WEEK -CEO, OHS, DPSS  

Board Washington Trip Briefings -THIS WEEK -CEO, OHS, DPSS 
Bill, Brence, Phillip and John: you are aware, Burt Margolin, Reggie Todd and are scheduled meet with you later this morning 11:00pm discuss next week's trip Washington DC. this meeting will specifically discuss our recommended Board issues and advocacy, your TENTATIVE itinerary meetings,transportation arrangements and other important logistical detail. 
Attached, please find for your review and consideration copy this year's Federal Issues Briefing Book that are using brief those participating the trip. This book contains executive summary our issues/advocacy,detailed briefing papers each issue and talking points that you may use your meetings. the meantime, you have any questions, suggestions, comments, concerns req uests,please call right away 
4-1100 email 

Rya Alsop 
Assistant Chief Executive Officer Intergovernmental External Affairs County Los Angeles 
(213) 974-1100 

Alsop, Ryan  
From: Alsop,Ryan  
Sent: Wednesday, April 28, 2010 7:17  
To: Hertzberg, Gerry; 'Jimenez, Martha'; 'Luftig Viste, Amy'; 'Weiner, Karen'  
Cc: Todd, Reginald -FWD; Campbell ,Greg -FWD; 'Burt Margolin'; Tajima, Mark; Fujioka, William Culp, Brence  
Subject: Board Washington Trip Briefings -THIS WEEK -1st District  
Attachments: Board Federal Issues Briefing Talking Points -May 201 O.pdf  

Board Washington Trip Briefings -THIS WEEK 1st

District 
Supervisor, Gerry, Martha Amy: 
Burt Margolin, Reggie Todd and are scheduled meet with you tomorrow afternoon 2:30pm discuss next week's trip Washington DC. this meeting will specifically discuss our recommended Board issues and advoca cy,your TENTATIVE itine rary meetings, transportation arrangements and other important logistical detail. 
Attached, please find for your review and consideration copy this year's Federal Issues Briefing Book that are using brief those participating the trip. This book contains executive summary our issues/advocacy, detailed briefing papers each issue and talking points that you may use your meetings. you have any questions, suggestions, comments, concerns requests, please call right away 4-1100 email 

Ryan Alsop 
Assistant Chief Executive Officer Intergovernmental External Affairs County Los Angeles 
(213) 974-1100 

Alsop, Ryan  
From:  Alsop, Ryan  
Sent:  Wednesday, April 28, 2010 7:13  
To:  Executive Officer; 'And (aordin@courisel.lacounty.gov)'; 'Ashton, Don'; 'County Counsel';  
Montes, Angie  
Subject: Attachments:  Board Washington Trip Briefings -THIS WEEK Board Federal Issues Briefing Talking Points -May 201 O.pdf  

Board Washington Trip Briefings -THIS WEEK -Exec Office; County Counsel 
Andrea, Sachi: 
Burt Margolin, Reggie Todd and are scheduled meet with you tomorrow morning lO:OOam discuss next week's trip Washington DC. this meeting will specifically discuss our recommended Board issues and advocacy, the TENTATIVE itinerary meetings, transportation arrangements and other important logistical detail. 
Attached, please find for your review and consideration copy this year's Federal Issues Briefing Book that are using brief those participating the trip. This book contains executive summary our issues/advocacy, detailed briefing papers each issue and talking points that you may use your meetings. you have any questions, suggestions, comments, concerns requests, please call right away 4-1100 email 

Assistant Chief Executive Officer Intergovernmental External Affairs County Los Angeles 
(213) 974-1100 
Alsop, Ryan  
From:  Alsop, Ryan  
Sent:  Wednesday, April 28, 2010 7:07  
To:  Antonovich, Michael; 'Barger Leibrich, Kathryn'; Glasgow, Lori; Pembedjian, Anna;  
'Balderrama, Linda'  
Cc:  Todd, Reginald -FWD; 'Burt Margolin'; Campbell, Greg -FWD; Tajima,Mark; Fujioka, William Culp, Brence  
Subject:  Board Washington Trip Briefings -THIS WEEK -5th District  
Attachments:  Board Federal Issues Biiefing Talking Points -rv1ay 201 O.pdf  

5th

Board Washington Trip Briefings -THIS WEEK District 
Supervisor, Kathryn, Lori and Anna: 
Burt Margolin,Reggie Todd and are scheduled meet with you this afternoon 3:00pm discuss next week's trip shington DC. this meeting will specifical discuss our recommended Board issues and advocacy, your TENTATIVE itine rary meetings, transportation arrangements and other important logistical detai 
Attached, please find for your review and consideration copy this year's Fed eral Issues Briefing Book that are using brief those participating the trip. This book contains executive summary our issues/advocacy, detailed riefi papers each issue and talking points that you may use your meetings. you have any questions, suggestions, comments, concerns requests, please call right away 4-1100 email 

Ryan Alsop 
Assistant Chief Executive Officer Intergovernmental External Affairs County Los Angeles 
(213) 974-1100 
Ryan 

From: 	Alsop,Ryan 
Sent: Tuesday, April 27, 201 :48 To: Fujioka,William Culp, Brence; 'John Schunhoff; 'PhilipBrowning@dpss.lacounty.gov'; Executive Officer; 'And (aordin@counsel.lacounty.gov)' 
Cc: 	PhilAnsell@dpss.lacounty.gov; BilfTaylor@dpss.lacounly.gov; Allan Wecker; Carol Meyer; 'Ashton, Don'; Montes, Angie; 'Burt Margolin'; Todd, Reginald -FWD; Tajima, Mark; Gerardo 
Pinedo 
Subject: Board Federal issues Br!efing Bocks= Washington -.ay 2010 Attachments: Board Federal Issues Briefing Tal kin Points -May 201 O.pdf 

Board Federal Issues Briefing Books -Washington DC-May 2010 
All: 
Attached, please find electronic copy our Federal Issues Briefing Book for next week's trip. Burt Margolin,Reggie Todd and will using this document brief you and the Supervisors this week. 
Meeting/event itineraries are still developing. Please give until mid week begin sharing these with you they continue change rapidly. Things are coming together nicely.However, meeting itineraries should remain TENTATIVE until next week (Sachi, will have understanding our ublicly noticed meetings Wednesday). 
Questions, comments, concerns x4-1100. 
Ryan Alsop 
Assistant Chief Executive Officer Intergovernmental External Affairs County Los Angeles 
(213) 974-1100 

From: Alsop, Ryan Sent: Tuesday, April 27, 201 11:43 To: Hertzberg, Gerry; 'Jimenez, Martha'; 'Luftig Viste, Amy'; 'Weiner, Karen'; 'Drew Ivie, Sylvia'; 
'phong@bos.lacounty.gov'; Rosenfeld, Dan; 'Alisa Katz'; 'Pedersen, Curt'; 'Velasquez, Rick'; 
'Sommers, David'; Barger Leibrich,Kathryn; 'Glasgow, Lori'; Pembedjian ,Anna Cc: 'Burt Margolin'; Todd, Reginald -FWD; Campbell, Greg -FWD; Tajima, Mark Subject: Board Federal Issues Briefing Books -Washington -May 2010 
Attachments: Board Federal issues Briefing Taiking Points -May 20iO.pdf 

Board Federal Issues Briefing Books Washington
DC. May 2010
All: 
Attached, please find electronic copy our Federal Issues Briefing Book for next week's trip.Burt Margolin, Reggie Todd and will using this document brief you and the Supervisors this week. 
Meeting/event itineraries are still developing. Please give until mid week begin sharing these with you they continue change rapidly.Things are coming together nicely. However, meeting itineraries should remain TENTATIVE 
until next week. 
Questions, comments, concerns x4-1100. 
Ryan Alsop 
Assistant Chief Executive Officer Intergovernmental External Affairs County Los Angeles 
(213) 974-1100 

Alsop, Ryan 
From: Alsop, Ryan 
Sent: Tuesday, April 27, 2010 :13 To: Todd, Reginald -FWD; Campbell, Greg -FWD; Byers, Carol -FWD Cc: Tajima, Mark; 'Burt Margolin' 
Subject: Board Supervisors Federal Issues Briefing Talking Points -May 2010 Attachments: Board Federal Issues Briefing Talking Points -May 2010.pdf 
Attached, please find electrnnic copy our Federal Issues Briefing Book for next week's trip. We'll using this document brief Bill Fujioka and Supervisors/staff this week. 
Ryan Alsop 
Ass.istant Chief Executive Officer Intergovernmental Externa Affairs County Los Angeles 

(213) 974-1100 

Alsop, Fram: Sent: To: Cc: Subject:  Alsop, Ryan Tuesday, April 27, 2010 7:53 'Welner, Karen' Hertzberg, Gerry; 'Jimenez. Martha'; Luftig Viste, Amy; 'Marquez, Roxane' Next Week's Trip -Meeting with Times  

All: 
I've made arrangements with Rich Simon (LA Tirnes Bureau Chief) have breakfast with GM, John Schunhoff, Phil Browning next week, Thursday, May 6th, Bistro Bis, 8:00am (near the Senate side the Capitol). wil discuss the Boards trip, issues/advocacy with Rich, with John and Phil providing details specific impact back home. Rich will making reservations. will have near complete itinerary share with you later this week. 
Ryan Alsop Assistant Chief Executive Officer Intergovernmental External Affairs 
County Los Angeles 
(213) 974-1100 

Alsop, Ryan  
From:  Alsop, Ryan  
Sent:  Monday, April 26, 201 5:20  
To:  Rodriguez, Elaine; Morikawa, Lisette; Babakhan, Sharon  
Cc:  Tajima, Mark; 'Burt Margolin'; Todd, Reginald FWD; Campbell, Greg -FWD; Byers, Carol  
FWD  
Subject:  Final Federal Issue Executive Summary and Briefing Papers  
Attachments:  Board Issues, Advocacy Executive Summary.docx; New Medicaid Waiver.docx; Hospital  
Provider Fee.docx; TANF ECF.docx; SCAAP.docx  

These really are the final documents! changes unless mission critical. 
For IGR staff, I'm transferring these over the shared drive. Thanks much for your assistance. 
Ryan Alsop 
Assistant Chief Executive Officer Intergovernmental External Affairs County Los Angeles 
(213) 974-1100 

Alsop, Ryan 
From:  Alsop, Ryan  
Sent:  Monday, April 26, 2010 4:55  
To:  Rodriguez, Elaine; Morikawa, Lisette  
Cc:  Tajima, Mark; 'Burt Margolin'; Todd, Reginald -FWD; Campbell, Greg -FWD; Byers, Carol 
FWD  
Subject:  Final Federal Issue Talking Points -May 2010  
Attachments:  New Medicaid Waiver Talking Points.docx; Hospital Provider Fee Talking Points.docx; TANF  
ECF Talking Points.docx; SCAAP Talking Points.docx  

Ryan Alsop 
Assistant Chief Executive Officer Intergovernmental External Affairs County Los Angeles 
(213) 974-1100 

From: 	Alsop, Ryan 
Sent: 	Friday, April 23, 2010 2:12 
To: 	'Burt rgol in'; Todd, Reginald -FWD; Campbell, Greg -FWD; White, Sabra; Randy Davis; Angie Buckingham Melton; Tajima, Mark 
Subject: 	RE: Talking Points -Please review and provide any comments you may have ASAP 
From: Burt Margolin [mailto:bmargolin@margolingroup.com] Sent: Friday, April 23, 2010 2:10 To: Alsop, Ryan; Todd, Reginald -FWD; Campbell, Greg -FWD; White, Sabra; Randy Davis; Angie Buckingham Melton; Tajima, Mark Subject: RE: Talking Points -Please review and provide any comments you may have ASAP thin the TANF-ECF needs have leg islative update included with more specific sense what are hoping will happen the Senate. also think bullet one too technical for talking point -the reference 80% reimbursement and the listing the three categories not what Supervisor would say actual meeting. would focus more bullet two and the subsidized jobs and summer jobs that are risk. also would not include the thank you the final bullet with the reference only Democratic House members. would save this type commentary for notes the final schedule. Judy Chu, for example, needs special thank you etc. 
From: Alsop, Ryan [mailto:ralsop@ceo.lacounty.gov] Sent: Friday, April 23, 2010 1:42 
To: Todd, Reginald -FWD; Campbell, Greg -FWD; Burt Margolin; White, Sabra; Randy Davis; Angie Buckingham Melton; Tajima, Mark 
Subject: Talking Points -Please review and provide any comments you may have ASAP 
Please give your feedback these. I'd like have them done the end the day today. Thank you. 
Ryan sop Assistant Chief Executive Officer Intergovernmental External Affairs County Los Angeles 
(213) 974-1100 

Alsop, Ryan 
From: 	Alsop, Ryan 
Sent: 	Friday, April 23, 2010 :42 

To: 	Todd, Reginald -FWD; Campbell, Greg-FWD; Burt Margolin; White, Sabra; 'Randy Davis'; 'Angie Buckingham Melton'; Tajima, Mark 
Subject: 	Talking Poin1s -Please review and provide any comments you may have ASAP 
Attachments: 	New Medicaid Waiver Talking Points.docx; Hospital Provider Fee Talking Points.docx; SCAAP Talking Points.docx; TANF ECF Talking Points.docx 
Please give your feedback these .1'd like have them done the end the day today. Thank you. 
Ryan Alsop Assistant Chief Executive Officer Intergovernmental External Affairs County Los Ang.eles 

(213) 974-1100 

Tracking: 

Recipient Recall 
Todd, Reginald -FWD Campbell, Greg -FWD Burt Margolin 
White, Sabra Failed: 4/23/2010 2:28 
'Randy Davis' 
'Angie Buckingham Melton' 
Tajima, Mark Failed: 4/23/2010 2:37 

Alsop, Ryan  
From:  Alsop,. Ryan  
Sent:  Thursday, April 22, 201 10:45  
To:  'bmargolin@margolingroup.com'  
Subject:  Re: Waiver Taiking Polnts  

Thks 
Sent from BlackBerry Wlreless Handheld 
From: Burt Margolin  To: Alsop, Ryan 
Sent: Thu Apr 19:23:57 2010 Subject: Waiver Talking Points 
Attached draft the Waiver talking points. 

FEDERAL ISSUES 

MAY 2010 

Gloria Molina, Chair 
First District 
Mark Ridley-Thomas 
Second District 
Zev Yaroslavsky 
Third District 
Don Knabe 
Fourth District 
Michael Antonovich 
Fifth District 
FEDERAL ISSUES 
Issues 

Executive Summary ................................. .................................. ............ 

Approve California's New Medicaid Waiver -The Bridge Health 
Care Reform Implementation ............................................................... 

Talking Points......................................................................................... 

Approve Provider Fee for Public Private Hospitals .... .... 
Talking Points......................................................................................... 

Extend the Temporary Increase the Federal Match Rate (FMAP) for Medicaid, Foster Care, and Adoption Assistance ........................... 
Talking Points......................................................................................... 

Extend the Temporary Assistance for Needy Families Emergency Contingency Fund Create More Subsidized Jobs ...................... ....... 
Talking Points......................................................................................... 

Fully Fund the State Criminal Alien Assistance Program ..................... 

Talking Points......................................................................................... 

Contact: Reginald Todd, Chief Legislative Representative 

Office (202) 393-2404 
Email: 

Executive Summary 
Federal Issues 

Supervisors seek approval new Medicaid Waiver bridge health care reform implementation; urge passage legislation that provides critical State, local fiscal relief; job creation 
The Los Angeles County Board Supervisors will travel Washington D.C., May 5th and 6th, meet with Congressional leaders and The White House urge the approval new Medicaid Waiver for California that will help prepare the County Los Angeles implement health care reform, and seek passage legislation that will provide hundreds millions dollars local fiscal relief, and the creation tens thousands jobs across the region. 
Approve New Medicaid Waiver for California August 2010 new Medicaid Waiver bridge health care reform implementation Los Angeles County. The County urges the Centers for Medicare and Medicaid Services (CMS} approve California's Medicaid Waiver request which will help the County health care delivery system prepare implement health care reform. California's current Medicaid Waiver, which set expire August 315 provides $900 million annual financial assistance the County's public health care safety-net system. 
The State California has shared concepts the potential components its new Medicaid Waiver request with CMS officials while continues work with stakeholders, including the County, developing its request. 
California's new Medicaid Waiver should build upon the existing Waiver help transform the County's health care delivery system successfully implement health care reform. This means reorganizing the delivery care more efficient and effective way. estimated that over half the County's current patients are uninsured adults who, thanks health reform, will join the Medi-Cal program 2014. Consistent with the new health care reform law, the County hopes utilize the Waiver provide improved coordinated care for medically indigent adults who will become eligible for Medicaid health care reform phases in; seniors and persons with disabilities; individuals with multiple chronic health conditions; and persons with serious health mental health problems. 
Approve Provider Fee for Public Private Hospitals 
California hospitals that serve the Medi-Cal population face serious financial challenges. effort stabilize hospital financing, the State Legislature and the Governor negotiated agreement 2009 that would enable the State fund new supplemental payments hospitals that serve Medicaid patients imposing new Hospital Provider Fee that would used attract federal matching funds. 
The County requesting immediate .approval this fee, which still under consideration the Centers for Medicare and Medicaid Services (CMS). Annually, this provider fee would finance supplemental payments totaling $1.9 billion for California's hospitals, including $1.3 billion for private hospitals and $600 million for public hospitals throughout the State. Los Angeles County's public health care safety-net system would receive $137 million annually sorely needed funding. 
Extend the Temporary Increase the Federal Match Rate for Medicaid, Foster Care and Adoption Assistance for Additional Six Months essential that Federal jobs legislation currently being considered Congress include significant fiscal relief, through extension the American Recovery and Reinvestment Act's (ARRA) temporary increase the Federal Medical Assistance Percentage (FMAP) rate for Medicaid, Foster Care and Adoption Assistance. The County asking Congress for six-month extension through June 30, 2011, which would provide more than $2.5 billion urgently needed Federal fiscal relief California and reduce the County's share Medicaid, foster care and adoption costs roughly $170 million. 
Extend the Temporary Assistance for Needy Families Emergency Contingency Fund for Additional Year 
The billion Temporary Assistance for Needy Families (TANF) Emergency Contingency Fund (ECF) another critically important fiscal relief and job creation tool, created ARRA. financing percent increased expenditures basic assistance and subsidized employment, TANF ECF has enabled California avoid making deep cuts CalWORKs cash grants time increased need while also enabling thousands unemployed low-income persons placed into subsidized jobs. The County urges Congress extend this program, with increased funding, for additional year. April 26, 2010, the County had created 7,300 subsidized jobs for CalWORKs recipients and other low-income adults under its subsidized employment program. Besides using TANF ECF create thousands additional subsidized jobs for adults, the County also will use the fund implement 2010 summer youth employment program, which could provide subsidized jobs more than 15,000 low-income youth (including eligible foster youth) collaboration with Workforce Investment Boards the County. 
Fully fund the State Criminal Alien Assistance Program 
The State Criminal Alien Assistance Program (SCAAP) reimburses previously incurred state and local costs inarcerating undocumented criminal aliens. Inadequate SCAAP funding has 

resulted unfair shift costs state and local governments, especially California. FFY 2010, SCAAP was funded $330 million -far below its authorized funding level $950 million. Every dollar spent the County jailing undocumented criminal aliens not reimbursed SCAAP means dollar less that can spent other essential public safety services, which, turn, endangers public safety. 
President Obama's Proposed FFY 2011 Budget includes $330 million for SCAAP, which represents the first time that President has requested any funding for SCAAP since 2001. The 
County thanks the President for including runding his budget, and requests that Congress fund SCAAP its authorized level $950 million FFY 2011. SCAAP were funded 
$950 million, the State California and its counties should receive nearly $380 million, and the County's SCAAP reimbursement would increase from estimated $12.7 million FFY 2010 over $36 million. 
APPROVE CALIFORNIA'S NEW MEDICAID WAIVER -THE BRIDGE 
HEALTH CARE REFORM IMPLEMENTATION 

Position 
California's new Section 1115 Medicaid Waiver should structured manner that strengthens the State's health care safety net and enables the County Los Angeles transform its public health care delivery system successfully implement health care reform. 
The Centers for Medicare and Medicaid Services (CMS) should approve the State's Medicaid Waiver request because replaces existing Waiver, set expire August 31, 2010, which providing $900 million annually the County's public health care safety net system. 

The Los Angeles County Department Health Services (DHS) operates the nation's second largest local public health care system, and serves the primary health care provider the County's uninsured and indigent residents. DHS provides medical care nearly 700,000 individual patients. Its hospitals train percent all medical residents the County and provide percent all trauma care and percent all emergency room visits. 
Medicaid is, far, the largest source health financing for Los Angeles County's public health safety net system. California has Section 1115 Medicaid Hospital Financing Waiver, set expire August 31, 2010, that governs Medicaid payments and provides the County's OHS with $900 million annual funding, including "coverage initiative" funds that enabled the County create "Healthy Way LA," program which enrolls medically indigent adults into system coordinated care. 
The County plays pivotal role the financing California Waivers since the State relies upon the counties provide the State match for all new federal funds that are provided public hospitals. Los Angeles County and other counties with public hospitals generate this match through the use Certified Public Expenditures (CPEs), which are unreimbursed healthcare expenses identified public systems. This State/County partnership allows the State avoid new general fund expenditures, increasingly critical factor the State battles solve its own budget crisis. 

The State's new Medicaid Waiver should build upon the existing Waiver helping transform the County's health care delivery system successfully implement health care reform. This means reorganizing the delivery care more efficient and effective way. estimate that over half the County's current patients are uninsured adults who, thanks health reform, will join the Medi-Cal program 2014. Consistent with the new health care reform law, the County hopes utilize the new Waiver provide improved coordinated care for the medically 

indigent adults who will become eligible for Medicaid health care reform phases in; seniors and persons with disabilities; individuals with multiple chronic health conditions; and persons with serious health mental health problems. 
Health care reform also creates new challenges for the State's health care delivery system, such the challenge serving far greater number Medicaid beneficiaries. The Medicaid financing provided through the new Waiver wi!I important not only ensuring that current needs can met, but also strengthening California's safety net building the increased capacity that will needed maximize opportunities reduce the number uninsured individuals under the health care reform expansions. 

The State California has shared concepts the potential components its new Medicaid Waiver request with CMS officials while continues work with stakeholders throughout the State developing its Waiver request. The CMS should work closely with the State expedite the review and approval the new Medicaid Waiver can take effect September 2010 after the current one expires August 31, 2010. 
APPROVE CALIFORNIA'S NEW MEDICAID WAIVER -THE BRIDGE 

HEALTH CARE REFORM IMPLEMENTATION 

TALKING POINTS 

  The State about send the Obama Administration proposal for new Medicaid  
Waiver. This Waiver will greatly impact the County's public health system.  
  First, key the stability our system  -which always challenge for  us.  

 	
Second, this Waiver should our bridge health care reform. Over half our current 
are uninsured adults thanks health will the Medi-Cal 2014. 

 serve these new Medi-Cal patients, the new Waiver should help reorganize how deliver care. should help expand our managed care capacity and provide better care coordination for our most medically vulnerable patients. 

 	
While Waivers are State proposal, Los Angeles County needs heard this issue. 

The State finance the State match for 

 	
When the State sends its Waiver proposal the Centers for Medicare and Medicaid Services (CMS), may need call our delegation 
ensure with favorable terms for California and the Los 

APPROVE PROVIDER FEE FOR PUBLIC PRIVATE HOSPITALS 

Position Governor Schwarzenegger and the Legislature reached agreement 2009 Hospital Quality Assurance Fee which, subject Federal approval, would generate Medicaid funding for supplemental payments Caiifornia hospitais. 
The County urges the Centers for Medicare and Medicaid Services (CMS) approve this fee. effort stabilize hospital financing, the Legislature and the Governor negotiated agreement 2009 create Hospital Provider Fee that would enable the State fund new supplemental Medicaid payments hospitals that serve Medicaid patients. This new fee would used finance the non-Federal share the Medicaid costs for supplemental payments. California already imposes provider fees ("Quality Assurance Fees") Medi-Cal managed care plans, skilled nursing facilities, and intermediate care facilities help finance non-Federal Medicaid costs. 
The Centers for Medicare and Medicaid Services must approve the Medicaid State Plan Amendment submitted the State implement the new Hospital Quality Assurance Fee order for the fee become effective. There are other states which currently impose hospital provider fees finance non-Federal Medicaid costs, such fee also should allowed California. 
Approval this fee extremely important Los Angeles County's Department Health Services (DHS), which operates the nation's second largest public hospital system, and which faces major ongoing structural budget deficits. annual basis, this provider fee and the supplemental payment will generate $137 million needed Medicaid funding for OHS. The total annualized value public hospitals statewide $600 million and value private hospitals statewide $1.3 billion. 
Status 
Assembly Bill 1383, the bipartisan enabling legislation, was signed into law October 11, 2009. April 26, 2010, the State Plan Amendment implement the new Hospital Quality Assurance Fee, which was submitted CMS, has not yet been approved. Although the fee was structured meet the basic CMS criteria, implementation issues have reportedly delayed its approval. 

APPROVE PROVIDER FEE FOR PUBLIC PRIVATE HOSPITALS 

TALKING POINTS 

  Our health system continues struggle financially. Los Angeles County's public health care safety net system facing $300 million shortfall.  
  That's why the County was very pleased last year when the Governor and the Legislature worked out agreement with the hospitals create new provider fee.  
  The provider fee will supplemental payment.  allow  the  State  use  Medi-Cal  give  hospitals  new  

 	
The final hurdle getting this fee enacted CMS approval. 

 	
The State Plan Amendment {SPA) asking for this approval now being reviewed CMS. 

 understand from the State that CMS asking the State various implementation related questions and that taking additional time. 

 	
Not only Los Angeles County, but the entire California hospital industry 

 
Please CMS finish their review and act the State 

EXTEND THE TEMPORARY INCREASE THE FEDERAL MATCH RATE {FMAP) FOR MEDICAID, FOSTER CARE, AND ADOPTION ASSISTANCE 
Position 
The County supports fiscal relief for state and local governments, extending the temporary increase the Federal Medical Assistance Percentage (FMAP) rate for Medicaid, Foster Care, and Adoption Assistance for additional six months through June 30, 2011. 

The enactment Federal jobs legislation which includes fiscal relief for state and local governments critically important for California and Los Angeles County, who have been hit the current economic downturn exceptionally hard. Unemployment February hit 
12.4 percent compared just 4.8 percent 2007. result, the County's monthly average General Relief caseload has grown from 58,599 2007 estimated 93,860 this year; percent increase four year period. Compounding matters, economic recovery and job creation throughout California have been hindered the State's huge budget shortfall -the largest, far, any state. the past two years, this budget shortfall has forced the State enact $72 billion budget cuts. essential that Federal jobs legislation include significant fiscal relief which would enable the State avoid even deeper cuts essential services that would lead further weakening economic activity and more job losses. extension the American Recovery and Reinvestment Act's (ARRA) temporary increase the Federal match rate for Medicaid, Foster Care, and Adoption Assistance one the most important fiscal relief measures that Congress could provide California and its counties. six-month extension through June 30, 2011 would provide California more than $2.5 billion fiscal relief which roughly $170 million would available reduce the County's share Medicaid and Title IV-E Foster Care and Adoption Assistance costs. 
The Federal Medical Assistance Percentage ("FMAP") the Federal match rate for assistance provided under the Medicaid and Title IV-E Foster Care and Adoption Assistance programs. Under ARRA, California's FMAP was increased from the statutory minimum percent 
60.59 percent for Medicaid and 56.2 percent for Title IV-E costs from October 2008 through December 31, 2010. Increased Federal matching funds are especially important during deep recession when medical assistance, foster care, and adoption assistance needs increase the same time State and county revenues decrease. California, counties help finance the non-Federal share Medicaid-funded assistance, including mental health and In-Home Supportive Services, and Title IV-E-funded Foster Care and Adoption Assistance. Extending ARRA's FMAP increase, therefore, would lessen the need for the County, well the State, make deeper cuts essential services for persons hurt the recession. 

Unlike last year when economic stimulus, state fiscal relief, and job creation measures were consolidated into single omnibus bill (H.R. 1), the American Recovery and Reinvestment Act 2009, multiple legislative vehicles are being used move job-related and fiscal relief proposals this year, including language extend ARRA's temporary FMAP increase. six-month extension the temporary FMAP increase included H.R. 4213, the American Workers, State and Business Relief Act 2010, passed the Senate. The House version H.R. 4213 does not include six-month FMAP increase extension, but the House record supporting this extension based passage H.R. 2847, the Jobs for Main Street Act, and H.R. 3962, its health care reform bill, which longer are available legislative vehicles. 
EXTEND THE TEMPORARY INCREASE THE FEDERAL MATCH RATE 
(FMAP) FOR MEDICAID, FOSTER CARE, AND ADOPTION ASSISTANCE 

TALKING POINTS 
 you're aware, the County's unemployment rates have been above percent since August while the national unemployment rate has been under percent. 

recovery and job creation throughout California continue hindered 

 extension the FMAP for Medicaid, Foster Care, and Adoption Assistance important fiscal relief measure that Congress could provid.e California and its counties. 

 six-month extension through June 30, 2011 would reduce Los Angeles County's share Medicaid, Foster Care, and Adoption Assistance costs roughly $170 million. would provide $2.S bill1on statewide fiscal relief. 

 	
Such Federal fiscal relief would lessen the need for the State and County make deeper cuts essential services. 

 	Your continued efforts extend the increased FMAP are appreciated. 
EXTEND THE TEMPORARY ASSISTANCE FOR NEEDY FAMILIES EMERGENCY CONTINGENCY FUND CREATE MORE SUBSIDIZED JOBS 
Position The County supports one-year extension the Temporary Assistance for Needy Families (TANF} Emergency Contingency Fund (ECF} with sufficient new and/or carryover funds enable all states, including California, maintain expand their TANF ECF-funded subsidized employment programs. 

The 1996 welfare reform law created the Temporary Assistance for Needy Families (TANF) Block Grant, which funds cash grants, employment services, supportive services, and other services low-income families and children. Each state receives fixed annual TANF allotment that has remained the same, without adjustment, since TANF was created 1996. The American Recovery and Reinvestment Act (ARRA) 2009 established and appropriated billion for the TANF Emergency Contingency Fund (ECF) help states meet the growing needs low-income families and children during the worst recession and fiscal crisis facing states, far, many years. This new fund reimburses percent increased TANF-related expenditures basic assistance (cash grants), non-recurrent short-term benefits, and subsidized employment during Federal Fiscal Years (FFYs) 2009 and 2010. 
The new TANF ECF has been extremely important California because has provided the State with greatly needed fiscal relief while, the same time, enabling fund cash grants growing number low-income families and create thousands subsidized jobs. California has been hit harder the recession than the rest the nation, reflected the fact that the State alone has more than percent all unemployed persons the U.S. California also has roughly one-third all TANF cash assistance recipients. 

California's counties have played leadership role using percent TANF ECF financing create subsidized jobs. Los Angeles County has used TANF ECF create the most subsidized jobs, far, any county -7,300 subsidized jobs for TANF recipients and other low-income adults April 22, 2010. Besides creating thousands subsidized jobs for adults, the County also using TANF ECF implement 2010 summer youth employment program, which could provide subsidized jobs more than 15,000 low-income youth (including eligible foster youth) collaboration with seven Workforce Investment Boards the County. 
The County urges that the TANF ECF extended for additional year through September 30, 2011 with additional funding that would enable the number subsidized jobs maintained expanded. minimum, sufficient new and/or carryover funding should provided that would enable all states, including California, guarantee employers that they will 
continue receive wage subsidies during FFY 2011 for anyone TANF ECF job created before October 2010. 
Employers will. reluctant hire TANF recipients and other low-income individuals unless they can assured receiving wage subsidy for more than one month two. Without the assurance continued percent TANF ECF financing, counties financially strapped 
California vvould unab!e guarantee vJage subsidies bevond the current sunset date 
September 30, 2010. result, there could major loss TANF ECF funded subsidized jobs beginning October 2010, including tens thousands California alone. passed the House March 24, 2010, H.R. 4849, the Small Business and Infrastructure Jobs Tax Act, appropriates $2.S billion for TANF ECF for FFY 2011 cover percent increased qualifying expenditures basic assistance, non-recurrent short-term benefits, and subsidized employment incurred FFY 2011. The bill, however, would not allow unused TANF ECF funds allocated states FFY 2011, which means that nearly $1.S billion ARRA's billion TANF ECF appropriation would not available states, estimated the Congressional Budget Office (CBO). result, California's available TANF ECF funding unlikely sufficient enable the State assure counties that their subsidized employment expenditures would reimbursed FFY2011. Counties then would not able guarantee wage subsidies employers beyond September 30, 2010. April 26, 2010, the Senate had not scheduled any action H.R. 4849. 

EXTEND THE TEMPORARY ASSISTANCE FOR NEEDY FAMILIES 
EMERGENCY CONTINGENCY FUND CREATE MORE SUBSIDIZED JOBS 

TALKING POINTS 
 	
Temporary Assistance for Needy Families (TANF) Emergency Contingency Fund (ECF) was created and funded originally the American Recovery and Reinvestment Act provide 80% reimbursement states for increases TANF-related expenditures during FFYs 2009 and 2010 three categories --basic assistance (cash grants), non-recurrent short-term benefits, and subsidized employment. Since its creation, TANF ECF funds have been used states. 

 	
Los Angeles County leading the nation the number subsidized jobs created. utilizing federal TANF ECF funds, the County has created 7,300 subsidized jobs April 26, 2010. also are using TANF ECF funds create 15,000 summer jobs this year for low-income youth collaboration with the County Workforce Investment Boards. 

 	
TANF ECF has allowed provide wage subsidies that make affordable for employers hire additional workers, including hard-to-employ CalWORKS recipients who lack work experience and job skills. 

 	
These wage subsidies also have reduced Food Stamp and TANF cash grant costs enabling families move from welfare work. 

 	
TANF ECF Authority set expire the end the fiscal year, and without legislation extend and fund it, all the subsidized created will have 

 one-year TANF ECF extension contained H.R. 4849, the Small Business and Infrastructure Jobs Tax Act, that has passed the House. still under consideration the Senate. 

 	
Please extend and fund TANF ECF this 

FULLY FUND THE STATE CRIMINAL ALIEN ASSISTANCE PROGRAM 
Position 
The County supports full funding the State Criminal A!ien Assistance Program {SCAAP) Federal Fiscal Year (FFY) 2011 reimburse state and local criminal alien incarceration costs. 
The County appreciates the Obama Administration's decision include $330 million for SCAAP the President's proposed budget. 

State and local taxpayers should not have pay for criminal justice costs resulting from the Federal government's inability control illegal immigration. The 1994 Crime Act established the State Criminal Alien Assistance Program (SCAAP) reimburse previously incurred state and local costs incarcerating undocumented criminal aliens. total eligible state and local costs exceed available SCAAP funding, each jurisdiction reimbursed pro rata basis. 
Funding for SCAAP was reduced from $400 million FFY 2009 only 330 million FFY 2010, which far below SCAAP's annual authorization level $950 million. also well below the $577 million average annual SCAAP appropriations FFYs 1998 through 2002. Because total undocumented criminal alien incarceration costs nationally have grown significantly since that time, state and local governments are reimbursed SCAAP for smaller share their total costs. The County's SCAAP reimbursement has fallen from high $34 million FFY 2002 its most recent SCAAP payment $15.4 million FFY 2009. The County will receive only $12.7 million SCAAP reimbursement FFY 2010 receives the same percentage 
U.S. total SCAAP funding FFY 2009. 
Inadequate SCAAP funding has resulted unfair shift costs state and local governments, especially California, which receives nearly percent total SCAAP funding, commensurate with its percentage share total reimbursable costs. other Federal formula grant program comes close providing California with high share total available funds. Every dollar spent the County jailing undocumented criminal aliens not reimbursed SCAAP means dollar less that can spent other essential public safety-net services, which, turn, endangers public safety. For example, response its budget shortfalls, the County's Sheriff's Department must release many jail inmates before they serve their entire sentences. The State also struggling with how reduce the size its State prison inmate population comply with Federal court order and help balance its huge State budget deficit. 
The County urges that SCAAP fully funded its authorized level $950 million FFY 2011. SCAAP were funded $950 million, the State California and its counties should receive 

nearly $380 million, including over $36 million SCAAP reimbursement for Los Angeles County. Such increased funding more important than ever the State still faces projected $20 billion budget shortfall, even after enacting $72 billion budget cuts the past two years. 

President Obarna's Pioposed FFY 2011 Budget proposes $330 million for SCAAP, which the same its FFY 2010 funding level. While that amount far below the SCAAP authorization level $950 million, represents the first time that President has requested any funding for SCAAP since 2001 when former President Bush requested $265 million for SCAAP FFY 2002. Congress has not yet begun action the FFY 2011 Commerce-Justice-Science Appropriations Bill, which would fund SCAAP and other Department Justice programs. 
FULLY FUND THE STATE CRIMINAL ALIEN ASSISTANCE PROGRAM 

TALKING POINTS 

 	The 1994 Crime Act established the State Crimina! A!ien ,fssistance Program (SCA.AP) reimburse costs incurred state and local governments for incarcerating undocumented criminal aliens. 
 	
Funding for SCAAP was reduced from $400 million FFY 2009 $330 million FFY 2010, which far below SCAAP's annual authorized spending level $950 million. 

 	
Because total undocumented criminal alien incarceration costs continue grow, state and local governments continue get reimbursed for smaller share their total costs. For instance, the County's SCAAP reimbursement has fallen from high $34 million FFY 2002 its most recent payment $15.4 million. 

 	
Inadequate SCAAP funding results unfair shift costs state and local governments, especially California, where these costs are the highest any other state. 

 	
Every dollar spent the County jailing undocumented criminal aliens not reimbursed SCAAP means dollar less that can spent other essential public safety services, which, turn, endangers public safety. 

 SCAAP were funded its authorized level, the State California and its counties would receive nearly $380 million, including over $36 millin for Los Angeles County alone. 

 	
For nine straight years, SCAAP has been given zero funding Administration budget requests. are grateful that this Administration least proposing level funding 

 need your support, that SCAAP fully funded its authorized level $950 million. 
APPROVE PROVIDER FEE FOR PUBLIC PRIVATE HOSPITALS 
TALKING POINTS 

 	
Our health system continues struggle financially. County's public health care safety-net system facing another $300 million shortfall. 

 	
That's why the County was very pleased last year when the Governor and the Legislature worked out agreement with the hospitals create new provider fee. 

 	
The provider fee will allow the State use Medi-Cal give hospitals new supplemental payment. 

 
 	
The final hurdle getting this fee enacted CMS approval. 

 	
The State Plan Amendment (SPA) asking for this approval now being reviewed CMS and could approved whenever they are ready. 

 understand from the State that CMS asking the State various implementation related questions and that taking additional time. 

 	Not only County, but the entire California hospital industry
both and 

 
Please CMS finish their review and act the State 

APPROVE CALIFORNIA'S NEW MEDICAID WAIVER -THE BRIDGE 
HEALTH REFORM 

Position 
California's new Section 1115 Medicaid waiver should structured manner that strengthens the State's health care safety net and enables the County Los Angeles transform its public health care delivery system successfully implement health care reform. 
The Centers for Medicare and Medicaid Services (CMS) should approve the State's Medicaid waiver request because replaces existing waiver, set expire August 31, 2010, which providing $900 million annually the County's public health care safety-net system. 

The Los Angeles County Department Health Services (OHS) operates the nation's second largest local public health care system, and serves the primary health care provider the County's uninsured and indigent residents. OHS provides medical care nearly 700,000 individual patients. Its hospitals train percent all medical residents the County and provide percent all trauma care and percent all emergency room visits. 
Medicaid is, far, the largest source health financing for Los Angeles County's public health safetynet system. California has Section 1115 Medicaid hospital financing waiver, set expire August 31, 2010, that governs Medicaid payments and provides the County's DSH with $900 million annual funding, including "coverage initiative" funds that enabled the County create "Healthy Way LA," program which enrolls medically indigent adults into system coordinated care. 
The County plays pivotal role the financing California Waivers since the State relies upon the counties provide the State match for all new federal funds that are provided public hospitals. Los Angeles County and other counties with public hospitals generate this match through the use Certified Public Expenditures (CPEs), which are unreimbursed healthcare expenses identified public systems. This State/County partnership allows the State avoid new general fund expenditures, increasingly critical factor the State battles solve its own budget crisis. 
The State's new Medicaid Waiver should build upon the existing waiver helping transform the County's health care delivery system successfully implement health care reform. This means reorganizing the delivery care more efficient and effective way. estimate that over half the County's current patients are uninsured adults who, thanks health reform, will join the Medi-Cal program 2014. Consistent with the new health care reform law, the County hopes utilize the new waiver provide improved coordinated care for the medically indigent adults who will become eligible for Medicaid health care reform phases in, such seniors and persons with disabilities, individuals with multiple chronic health conditions, and persons with serious health mental health problems. 
Health care reform also creates new challenges for the State's health care delivery system, such the 
challenge serving far greater number Medicaid beneficiaries. The Medicaid financing provided through the new waiver will important not only ensuring that current needs can met, but also strengthening California's safety-net building the increased capacity that will needed maximize opportunities reduce the number uninsured individuals under the health care reform expansions. 

The State California has shared concepts the potential components its new Medicaid Waiver request with CMS officials while continues work with stakeholders throughout the State developing its waiver request. The CMS should work closely with the State expedite the review and approval the new Medicaid Waiver can take effect September 2010 after the current one expires August 31, 2010. 
FULLY FUND THE STATE CRIMINAL ALIEN ASSISTANCE PROGRAM 

TALKING POINTS 

 	
The 1994 Crime Act established the State Criminal Alien Assistance Program (SCAAP) reimburse costs incurred state and local governments for incarcerating undocumented criminal aliens. 

 	
Funding for SCAAP was reduced from $400 million FFY2009 $330 million FFY2010, which far below SCAAP's annual authorized spending level $950 million. 

 	
Because total undocumented criminal alien incarceration costs continue grow, state and local governments continue get reimbursed for smaller share their total costs. For instance, the County's SCAAP reimbursement has fallen from high $34 million FFY2002 its most recent payment $15.4 million. 

 	
Inadequate SCAAP funding results unfair shift costs state and local governments, especially California, where these costs are the highest any other state. 

 	
Every dollar spent the County jailing undocumented criminal aliens not reimbursed SCAAP means dollar less that can spent other essential public safety services, which, turn, endangers public safety. 

 SCAAP were funded its authorized level, the State California and its counties would receive nearly $380 million, including over $36 million for County alone. 

 	
For nine straight years, SCAAP has been given zero funding Administration budget requests. are grateful that this Administration least proposing level funding 

 need your support, that SCAAP fully funded its authorized level $950 million. 

EXTEND THE TEMPORARY ASSISTANCE FOR NEEDY FAMILIES 
EMERGENCY CONTINGENCY FUND CREATE MORE SUBSIDIZED JOBS 
TALKING POINTS 
 	
Temporary Assistance for Needy Families (TANF) Emergency Contingency Fund (ECF) was created and funded originally the Recovery Act provide 80% reimbursement states for increases TANF-related expenditures during FFYs 2009 and 2010 three categories --basic assistance (cash grants), non-recurrent short-term benefits, and subsidized employment. Since its creation, TANF ECF funds have been used states. 

 County leading the nation the number subsidized jobs created. utilizing federal TANF ECF funds, the County has created over 6,000 subsidized jobs last month. also have plans utilize TANF ECF funds create 15,000 summer jobs this year for low-income youth conjunction with the County Workforce Investment Boards. 

 	
Subsidized jobs allow unemployed individuals the opportunity gain work experience and job skills, they provide employers the opportunity give employees low-risk trial 
period, and individuals TANF cash earn real 

 
TANF ECF Authority set expire the end the fiscal year, and without legislation extend and fund it, all the subsidized created will have 

 one-year TANF ECF extension contained H.R. 4849, the Small Business and Infrastructure Jobs Tax Act, that has passed the House. still under consideration the Senate. 

Los Angeles County Board Supervisors 
Issues/ Advocacy -Washington D.C. -May 2010 

Supervisors seek approval new Medicaid Waiver bridge health care reform implementation; urge passage legislation that provides critical State, local fiscal relief; job creation 
The Los Angeles County Board Supervisors will travel Washington D.C., May 5th and 6th, meet with Congressional leaders and The White House urge the approval new Medicaid Waiver for California that will help prepare the County Los Angeles implement health care reform, and seek passage legislation that will provide hundreds millions dollars local fiscal relief, and the creation tens thousands jobs across the region. 
Approve New Medicaid Waiver for California August 2010 new Medicaid Waiver bridge health care reform implementation Los Angeles County. The County urges the Centers for Medicare and Medicaid Services (CMS) approve California's Medicaid waiver request which will help the County health care delivery system prepare implement health care reform. California's current Medicaid Waiver, which set expire August 31't, provides $900 million annual financial assistance the County's public health care safety-net system. 
The State California has shared concepts the potential components its new Medicaid waiver request with CMS officials while continues work with stakeholders, including the County, developing its request. 
California's new Medicaid Waiver should build upon the existing waiver help transform the County's health care delivery system successfully implement health care reform. This means reorganizing the delivery care more efficient and effective way. estimated that over half the County's current patients are uninsured adults who, thanks health reform, will join the Medi-Cal program 2014. Consistent with the new health care reform law, the County hopes utilize the waiver provide improved coordinated care for medically indigent adults who will become eligible for Medicaid health reform phases in, such seniors and persons with disabilities, individuals with multiple chronic health conditions, and persons with serious health mental health problems. 
Approve Provider Fee for Public Private Hospitals 
California hospitals that serve the Medi-Cal population face serious financial challenges. effort stabilize hospital financing, the State Legislature and the Governor negotiated agreement 2009 that would enable the State fund new supplemental payments hospitals that serve Medicaid patients imposing new Hospital Provider Fee that would used attract federal matching funds. 
The County requesting immediate approval this fee, which still under consideration the Centers for Medicare and Medicaid Services (CMS). Annually, this provider fee would finance supplemental payments totaling $1.9 billion for California's hospitals, including $1.3 billion for private hospitals and $600 million for public hospitals throughout the state. Los Angeles County's public health care safety-net system would receive $B7 
million annually sorely needed funding. 
Extend the Temporary Increase the Federal Match Rate for Medicaid, Foster Care and Adoption Assistance for Additional Six Months essential that Federal jobs legislation currently being considered Congress include significant fiscal relief, through extension the American Recovery and Reinvestment Act's (ARRA) temporary increase the Federal Medical Assistance Percentage (FMAP) rate for Medicaid, Foster Care and Adoption Assistance. The County asking Congress for six-month extension through June 30, 2011, which would provide more than $2.5 billion urgently needed Federal fiscal relief California and reduce the County's share Medicaid, and foster care adoption costs roughly $170 million. 
Extend the Temporary Assistance for Needy Families Emergency Contingency Fund for Additional Year 
The billion Temporary Assistance for Needy Families (TANF) Emergency Contingency Fund (ECF) another critically important fiscal relief and job creation tool, created ARRA. financing percent increased expenditures basic assistance and subsidized employment, TANF ECF has enabled California avoid making deep cuts CalWORKs cash grants time increased need while also enabling thousands unemployed low-income persons placed into subsidized jobs. The County urges Congress extend this program, with increased funding, for additional year. April 26th 2010, the County had created 6,612 subsidized jobs for CalWORKs recipients and other 
low-income adults under its subsidized employment program. Besides using the TANF ECF create thousands additional subsidized jobs for adults, the County also will use the fund implement 2010 summer youth employment program, which could provide subsidized jobs more than 15,000 low-income youth (including eligible foster youth) collaboration with Workforce Investment Boards the County. 
Fully fund the State Criminal Alien Assistance Program 
The State Criminal Alien Assistance Program (SCAAP) reimburses previously incurred state and local costs incarcerating undocumented criminal aliens. Inadequate SCAAP funding has resulted unfair shift costs state and local governments, especially California. FFY2010, SCAAP was funded $330 million -far below its authorized funding level $950 million. Every dollar spent the County jailing undocumented criminal aliens not reimbursed SCAAP means dollar less that can spent other essential public safety services, which, turn, endangers public safety. 
President Obama's Proposed FFY 2011 Budget proposes $330 million for SCAAP, which represents the first time that President has requested any funding for SCAAP since 2001. The County thanks the President for including funding his budget, and requests that Congress fund SCAAP its authorized level $950 millio'n FFY 2011. SCAAP were funded $950 million, the State California and its counties should receive nearly $380 million, and the County's SCAAP reimbursement would increase from estimated $12.7 million FFY2010 over $36 million.



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