California State Association of Counties
NEWS

RELEASE

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HOOK Street
Suite 101
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California
95814
Telephone
916.327.7500
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916.441.5507

September 27, 1995

Contact; Steven C. Szalay

For Immediate Release

CSAC Executive Director

(916)327-7500

COUNTY AND FEDERAL OFFICIALS MEET TO DISCUSS HEALTH AND
WELFARE REFORM IMPACTS TO CALIFORNIA COUNTIES

Representatives from the California State Association of Counties(CSAC) met with key
members of President Clinton's staff earlier this week to discuss health and welfare reforms

that directly impact California counties. Attending the meetings were Mike Graves, a San
Benito County supervisor and president of CSAC, Francie Sullivan, a Shasta County
supervisor and Chair of the CSAC Agriculture and Natural Resources Policy Committee, Jim
Beall, a Santa Clara County supervisor and Chair of the CSAC Health and Human Services
Policy Committee and Steve Szalay, CSAC Executive Director .
The CSAC delegation discussed Medicaid Block Grants, Medicare, Welfare Reform and
Solid Waste Flow Control issues during the three-day round of meetings with Leon Panetta,
Clinton's Chief of Staff, John Emerson, Deputy Assistant to Clinton for Intergovernmental
Relations, Congressman Norm Mineta, Congressman Bill Baker, Senator Barbara Boxer and
David Whetmore, Director for Governor Wilson's Office in Washington D.C.
"California counties have met some tough budgetary challenges in the last few years and
actions in Washington could have serious implications for our counties' ability to deliver
needed health care. We wanted to make sure that the people influencing these decisions
heard our voice," said Graves. With most federal actions centering on a shift from
entitlement programs to block grants, counties want maximum flexibility and sufficient
funding for administering these programs at the local level."

In discussing Medicaid Block Grants, CSAC emphasized that the allocation formula should
be adjusted to reflect incidents of poverty and California's unique population. Counties also
want federal recognition in the formula for California's reduction in MediCal costs already
achieved through managed care programs. "We are expecting an increase in the allocation
formula — currently California receives only $1,300 per capita in Medicaid funds, while the
state of New York receives $4,700. This imbalance clearly needs to be addressed,"
commented Beall, CSAC representatives also called for a reasonable means income test to
be considered in the debates on Medicare Reform.

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Focusing on welfare reform, CSAC expressed concern that one ofthe current proposals
restricts legal aliens from receiving benefits under AFDC block grants. "The impact to
counties could be very significant if the responsibility for the population, who will no longer
be eligible for block grants, shifts to counties. This would force counties to divert people to
programs such as General Assistance, which is very costly to California counties," said Beall.

"This could have a terrible effect on local General Assistance programs and those affected
ultimately are the most needy among our citizens," said Graves. CSAC also stressed the

importance offunding childcare and job training programs to transition people back into the
workforce.

On another front, counties expressed support for a Solid Waste Flow Control amendment

that would allow counties to retain the ability to enter into franchise agreements and to
determine the flow of waste to appropriate disposal sites. "We urge a common sense
approach on this issue. Counties must have flexibility to determine where and how to dispose

of waste. Many counties already operating under severe budget cutbacks don't have funding
available to site new waste disposal facilities. It makes good sense to allow local jurisdictions
the ability to negotiate agreements that appropriately dispose of waste and that allows for
collaborative efforts at problem solving." said Sullivan.

" The next few weeks are critical in the decision making process. Overall, the counties'

positions were well received and we expect the administration to address our concerns during
the reconciliation process over the next month," said Graves.
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