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Issue Papers - Crippled Children
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Issue Papers - Crippled Children
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Ronald Reagan Presidential Library
Digital Library Collections
This is a PDF of a folder from our textual collections.
Collection: Reagan, Ronald: Gubernatorial Papers,
1966-74: Press Unit
Folder Title: Issue Papers - Crippled Children
Box: P30
To see more digitized collections visit:
https://reaganlibrary.gov/archives/digital-library
To see all Ronald Reagan Presidential Library inventories visit:
https://reaganlibrary.gov/document-collection
Contact a reference archivist at: [email protected]
Citation Guidelines: https://reaganlibrary.gov/citing
National Archives Catalogue: https://catalog.archives.gov/
CRIPALED CHILOREN
STATEMENT TO ASSEMBLY PUBLIC HEALTH COMMITTEE ON
PROPOSED CRIPPLED CHILDREN LEGISLATION - JANUARY 30, 1968
by JAmes M. Shumuray, (Title) atr
Mr. Chairman, Ladies and Gentlemen:
When the 1967-68 budget for the various Crippled Children programs in
the State of California was passed by the Legislature and signed by
Governor Reagan, there was specific language inserted in the budget by
the Legislature that the/counties having Crippled Children programs
State your required to this within The funds hudgeted first
impludly
Crippeled Children
were/mandated to live within the/money budgeted to them by the State of
my
California.
Their
A majority of the counties have SO attempted to live within this amount
of money but, unfortunately, nine counties have or will use up the money
budgeted to them before June 30, 1968, based upon the projection of
expenditures
-eoses for the second six month period of this fiscal year evidenced by
BY is to Be notes
the experience of the first six month period of this fiscal year.
That M formal required for additional warry the him record by the state from
It is the position of Governor Reagan and his Administration that no
any > Mr.
HP
none
crippled child in each of the nine counties should suffer or be deprived
of necessary health care services because of the failure of the Crippled
Childrens program to abide by the legislative mandate and, therefore,
Governor Reagan has directed the State Department of Public Health to
contact each of the nine counties that anticipate budget deficiencies
and to report back within two weeks from today those programs that desire
additional State funding and the amount of such request so that appropriate
steps can be taken to work out funding requirements together with changes
in present law SQ that future occurances of this nature will be forever
prevented.
Governor Ronald Reagan, concerned by state health department
a handful of
projections that some counties were runsing short of funds for
the crippled children's program, asked the counties today if they
wanted additional money.
"Although no county has initiated a request for additional
funds, I have taken the unusual step of asking if money is wanted
because I do not want to see essential medical treatment denied to
any crippled child," Gov. Reagan said.
"If the counties do need additional funds, I am willing to ask
the legislature to put aside the ban on extra funding that it
expressly wrote into the budget act," the governor said. II I
will also ask for revision and simplification of this complex
The governor acted immediately after a presentation of a
report from the health department showing expenditures for
the first six months of the program and projecting expenditures
for the remainder of the year.
The 1967 legislature added language to the budget act directing
that the state expenditures shall not exceed the ammount appropriated. Il
the budget requested by the xxxx administration and approved by
the legislature was based on amounts requested by the counties and
when taken together with medi-cal funds actually represented a
modest increase over the prior year, the governor said.
Some weeks ago the governor augmented the program further by
authorizing the use of the state's share of reimbursement from
parents for expenditure by the counties.
it was expected the total amount needed would be known in about
two weeks since county boards of supervisors would have to vote
on asking additional funds if any are needed.
MEMBERS
LOUIS J. ANGELO
E. RICHARD BARNES
COORDINATOR
FRANK P. BELOTTI
EUGENE R. LEYVAL
CARL A. BRITSCHGI
CONSULTANT
JOHN L. E. COLLIER
CHARLES J. CONRAD
California Tegislature
JOHN H. SIMONS
PAULINE L. DAVIS
CONSULTANT
LEROY F. GREENE
GAIL VESSELS
STEWART HINCKLEY
COMMITTEE SECRETARY
CHARLES W. MEYERS
DON MULFORD
Committee
MARIA HUSUM
SECRETARY
CARLEY V. PORTER
LEON RALPH
on
JEANNE SPENCE
LEO J. RYAN
SECRETARY
WINFIELD SHOEMAKER
and Means
VICTOR VEYSEY
CHARLES WARREN
CAPITOL, ROOM 2140
GEORGE ZENOVICH
CALIFORNIA 95814
445-8160
FRANK LANTERMAN
VICE CHAIRMAN
W. CROWN
CHAIRMAN
November 8, 1967
Honorable Ronald Reagan
Governor of the State of California
First Floor, State Capitol
Sacramento, California
Dear Governor Reagan:
I am writing to respectfully request that you place the
subject matter of financing the Crippled Children's Service
program on special call. This would allow the Legislature
to consider appropriating additional funds to Item 277 of
the 1967-68 Budget Act (A.B. 303). The reason for the
request is that the C.C.S. program was cut back by the State
Department of Public Health as of August 15, 1967, apparently
due to an insufficiency of funds appropriated this year.
The cut backs mean that children with any one of approx-
imately 100 medical conditions who were eligible to be treated
prior to August 15 are no longer eligible to receive C.C.S.
treatment unless they come from poverty stricken families or
started treatment prior to August 15. These are handicapped
youngsters who are cross-eyed, have mild hearing loss, drooping
eyelids, lop-ears, and clubfeet, to give just a few of the more
graphic examples. It is estimated by the Department of Public
Health that 5,000-7,000 children, who otherwise would have
received C.C.S. care, will not receive C.C.S. services during
the current fiscal year as a result of the cut backs. Many
of these children come from low income families who do not
meet the poverty standard (income of $4,000 or less) but to
whom large medical bills can be catastrophic.
Honorable Ronald Reagan
Page Two
November 8, 1967
I am sure that these facts are no more comforting to you
than they are to me or any other fair-minded citizen. I know
of your concern for handicapped youngsters, as evidenced by
your signing of S.B. 1292 (Petris, 1967) and as manifested by
your statement to me in March, 1967, when you said you would
support an additional deficiency appropriation for the C.C.S.
program if this proved to be necessary during the balance of
fiscal year 1966-67 to prevent a cut back of C.C.S. services.
This statement followed our agreement on the amount of money
to be appropriated by A.B. 595 (Crown, 1967) for C.C.S.
I would like to add a word to two regarding the amount of
money appropriated for C.C.S. during the past budgetary session.
The Legislature granted the full amount of the appropriation
proposed by the Department of Finance during budgetary proceed-
ings--$9,740,763. I understand that at no time did the Depart-
ment of Finance indicate to the Assembly Ways and Means Com-
mittee that the amount requested was insufficient to continue
the program at the ongoing level of service. I am confident that
if members of the Legislature had known in advance that the
C.C.S. appropriation was insufficient to maintain current program
levels, they would have attempted to provide the necessary
financing.
Be that as it may, we now have the opportunity to rectify
past decisions. With your consent and assistance, I am prepared
to introduce the appropriate legislation to lift the Crippled
Children's program out of the financial abyss into which it has
fallen. Preliminary indications are that from $500,000 to
$750,000 is needed, an amount I think the taxpayers of California
are willing to expend for the care of deserving crippled children.
I look forward to hearing from you and working with you
on this important matter. Thank you.
Sincerely,
Rx
ROBERT W. CROWN
Assemblyman
RWC:jm
CC: Mr. Spencer Williams
Mr. Gordon Smith
Mr. Jack Lindsey
Mr. Vernon Sturgeon
All Members of the Legislature
State of California
DEPARTMENT OF PUBLIC HEALTH
2151 Berkeley Way
Berkeley, California 94704
CCS BULLETIN 67-4
August 15, 1967
TO:
All CCS County Program Directors
SUBJECT:
Bureau of Crippled Children Services
Manual of Procedure
Chapter 2, Medical Eligibility
MODIFICATION OF MEDICAL ELIGIBILITY FOR FISCAL YEAR 1967-68
In order to keep expenditures within funds appropriated, the attached list are conditions
which should not be accepted for treatment services under Crippled Children Services in the
fiscal year 1967-68. This applies to new cases only. Cases already under care should be
continued until treatment is completed. (An alphabetical list is also attached.)
Exceptions:
GROSS INCOME
1. For those families living at or below the poverty level $2,000 individual;
$4,000 family) and for whom there is no other resource for medical care
(county hospital, Department of Rehabilitation), the county may at its
option, review individual cases and consider accepting a child with these
conditions under the CCS program.
2. Children with conditions on this list who are eligible for Medi-Cal benefits
will continue to be accepted for case management services if they are referred
to CCS.
The Modification in general eliminates conditions which are not chronic in nature, do not
need complex multidisciplinary services and are not financially catastrophic.
Eligibility for diagnostic services for these restricted conditions (before the nature of
the handicap and the family's financial situation is determined) remains unchanged.
WOULD
FOR
Orthodontia screening clinic
be used
children whose families live at or under the poverty level.
The modification of medical eligibility covers one or more of the following points:
1. Limits eye conditions to severely handicapping conditions of the eye, such
as cataract, corneal opacity, malignant tumors, detachment of retina,
glaucoma, and severe eye injury.
2. Limits the provision of orthodontia care essentially to children with cleft
lip and palate.
3. Limits ear conditions to those requiring hearing aids, reconstructive surgery
of the middle ear, or mastoid surgery.
4. Limits cosmetic surgery to functional restoration.
5. Limits orthopedic coverage to major or -thopedic handicaps.
6. Limits care for other comparable conditions or cases involving relatively
minor costs or limited need for specialized medical care.
Ralph C. Hornberger, M.D., Chief
Bureau of Crippled Children Services
Attachments 2
248
CRIPPLED CHILDREN SERVICES
EXCLUSION LIST - TREATMENT SERVICES
Medical Eligibility
1967-68
Alphabetical
"A"
"F"
Abscess, bone
Facial paralysis, Bell's palsy
Absence of teeth (congenital or
Femoral torsion
acquired)
Flat feet
Amblyopia including anisometropia
Ankyloblepharon
"G"
Aphakia
Genu recurvatum
Aural polyp
Genu valgum
Genu varum
"B"
"H"
Baker's cyst
Benign melanoma of skin
Hallux valgus
Benign neoplasm of skin
Hallux varus
Bowed legs
Hammer toe or finger
Bursitis
Hearing loss (Except for cases requiring
hearing aid, reconstructive surgery
"C"
of middle ear or mastoid surgery)
Hemangioma (Except major or grossly
Calcaneal spur
disfiguring)
Chondroma
Hymen, imperforate
Choroiditis
Cicatrix (Unless functionally
"I"
handicapping)
Imperforate hymen
Club foot (Except when surgery needed)
Incontinentia pigmentia
Conjunctivitis
Internal derangement of knee joint
Cyst, Baker's
Iritis
"D"
"J"
Dacryocystitis
Joint mice
Deflected nasal septum
Deformity, external ear (Except
"K"
agenesis or hypoplasia)
Deformity, nose
Keloid scar (Unless functionally
Deviated septum
handicapping)
Digits, supernumerary
Keratitis (Except interstitial)
Knock knees
"E"
"L"
Ear, deformity, external (Except
agenesis or hypoplasia)
Lacrimal duct stenosis
Ear, inflammatory diseases of
Lateral meniscus, knee, rupture of
Exostosis, bone
Lipoma
Eyelid, ptosis
Loose body in joint
Lop ear
(1)
"M"
"R"
Malocclusion (Except with cleft palate)
Radial, ulnar, synostosis
Melanoma, benign, of skin
Rheumatic fever (Except chronic
Metatarsus varus
rheumatic heart disease)
Meniscus, lateral, knee, rupture of
Rupture of lateral meniscus, knee
Mole
Multiple exostosis
"S"
"N"
Scar (Unless functionally handicapping)
Serous otitis media
Nasal polyp
Stenosis, lacrimal duct
Nasal, septum deviation
Strabismus
Neoplasm, benign, of skin
Supernumerary digits
Nevus
Nevus, pigmented
Supernumerary ear
Nose, deformity
Supernumerary lacrimal duct
Synostosis, radial ulnar
"0"
Synovitis
Ophthalmia (Except sympathetic)
"T"
Osteomyelitis, acute or subacute
Otitis externa
Tattoo
Otitis media (Except requiring
Teeth, absence of, congenital or acquired
reconstructive surgery of middle
Tenosynovitis
ear or mastoid surgery)
Tibial torsion
Otitis media, serous
Torticollis
Trigger finger
"P"
"W"
Paralysis, facial (Bell's palsy)
Pes cavus
Webbed fingers or toes (If single
Pes planus
anomaly)
Pigeon toes
Pigmented nevus
Polydactylism
Polyp, aural
Polyp, nasal
Pronated ankle
Pronated feet
Pterygium
Ptosis of eyelid
State of California
Department of Public Health
Bureau of Crippled Children Services
080167
(2)
250
CRIPPLED CHILDREN SERVICES
EXCLUSION LIST - TREATMENT SERVICES
Medical Eligibility
1967-68
Chapter II - Procedure Manual
2.4
Neoplasms (WHO 140-239)
Benign melanoma of skin
Benign neoplasm of skin
Chondroma, bone
Exostosis, bone
Hemangioma (Except major or grossly disfiguring)
Lipoma
Mole
Nevus
Pigmented nevus
2.8
Diseases of Nervous System (WHO 330-369)
Facial paralysis (Bell's palsy)
2.8.3
Eye Conditions (WHO 370-389)
Amblyopia including anisometropia
Ankyloblepharon
Choroiditis
Conjunctivitis
Dacryocystitis
Iritis
Keratitis (Except interstitial)
Ophthalmia (Except sympathetic)
Pterygium
Ptosis of eyelid
Stenosis of lacrimal duct
Strabismus
2.8.4
Ear Conditions (WHO 390-398)
Aural polyp
Deformity of external ear (Except agenesis or
hypoplasia)
Hearing loss (Except requiring a hearing aid,
reconstructive surgery of middle ear or
mastoid surgery)
Otitis externa
Otitis media (Except requiring reconstructive
surgery of middle ear or mastoid)
Serous otitis media
2.9
Diseases of the Circulatory System (WHO 400-468)
Rhoumatic fovor (Except chronic rhoumatic heart disease)
(1)
2.10
Diseases of the Respiratory System (WHO 470-527)
Deflected nasal septum
Deformity of nose
Deviated septum
Nasal polyp
2.11
Diseases of the Digestive System (WHO 530-587)
Congenital or acquired absence of teeth
Malocclusion (Except with cleft palate)
2.14
Diseases of Skin and Cellular Tissue (WHO 690-716)
Cicatrix (Unless functionally handicapping)
Keloid (Unless functionally handicapping)
Scar (Unless functionally handicapping)
Tattoo
2.15
Diseases of Bones and Organs of Movement (WHO 720-749)
Baker's cyst
Bowed legs
Bursitis
Calcaneal spur
Club foot (Except requiring surgery)
Femoral torsion
Flat foot
Genu recurvatum
Genu valgum
Genu varum
Hallux valgus or varus
Hammer toe or finger
Internal derangement of knee joint
Knock knees
Loose body or cartilage in joint (Joint mice)
Metatarsus varus
Osteomyelitis, acute or subacute
Pes cavus
Pes planus
Pigeon toes
Pronated ankle
Pronated feet
Rupture of lateral meniscus of knee
Synovitis
Tenosynovitis
Tibial torsion
Torticollis
Trigger finger
(2)
2.16
Congenital Malformations (WHO 750-759)
Unless Multiple, the following are excluded:
Ankyloblepharon
Aphakia
Deformity of external ear (Except agenesis or
hypoplasia)
Imperforate hymen
Lop ear
Multiple exostosis
Polydactylism
Ptosis of eye lid
Radial ulnar synostosis
Supernumerary digits
Supernumerary ear
Supernumerary lacrimal duct
Webbed fingers or toes
State of California
Department of Public Health
Bureau of Crippled Children Services
080167
(3)
249
Crippled Childrens' Services Original Budget Estimates Submitted
to the Department of Finance and action taken by Finance and Legislature:
1965-66
1966-67
1967-68
Departmental Estimate:
State
9,848,246
10,743,569
11,086,567
Federal
930,732
1,146,290
1,128,160
10,778,978
11,889,859
12,214,727
Governor's Budget:
State
9,848,246
9,519,610
9,740,763
Federal
930,732
1,146,290
1,128,160
10,778,978
10,665,900
10,868,923
Appropriated:
State
9,848,246
9,073,140
9,740,763
Federal
926,896
1,128,160.
1,128,160
10,775,142
10,201,264
10,868,923
Deficiency Appropriation:
300,000
Fee Increase Item 340
367,659
10,868,923
Hemophilia Appropriation
56,200
10,925,123
Reverted appropriation
66,048
900,423
Increased Federal funds used to save
General Fund (reverted)
260,944
Pml
FYI
11/15/67
Spiner