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Why flush California still takes child support from low-income families

“When the parent who is no longer living with the children makes a payment, which we all want them to do, the children don’t get the money,” said Mike Herald, director of policy advocacy for the Western Center on Law & Poverty. “The public doesn’t understand this. People think that the reason we have a harsh child support system is so we can get money to kids, but actually it’s to get money to the government.”

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Analysis of Governor Newsom’s 2022-2023 California Budget Proposal

Governor Newsom released his January proposal for the 2022-23 California state budget. In total, the administration projects a $45 billion surplus — a combination of higher revenue collections for the past two budgets and higher than anticipated revenue for the 2022-23 budget. As the governor noted in his press conference, if current economic trends continue, the surplus could grow even more by the time the proposed budget is revised in May. The budget includes a record $36 billion reserve.

SUMMARY

The governor’s proposed budget includes a historic investment in health care by expanding Medi-Cal eligibility for those currently excluded from the program due to immigration status, and by eliminating Medi-Cal premiums for children, pregnant people, and people with disabilities. It does not eliminate the burdensome “share of cost” that many people on Medi-Cal still pay as a monthly deductible.

The budget also includes expanded funding to house people experiencing homelessness, a large investment in health care related workforce development, and an expansion of proposals intended to reduce poverty such as increasing CalWORKs grants, passing on all child support to families formerly on public assistance, and expanding the state child tax credit to households with no reported income. The budget also proposes to fund 36,000 new childcare slots for working families, but this means approximately 150,000 families will remain on the waiting list.

Unfortunately, this proposal misses an opportunity to build on significant progress made through existing poverty-reduction initiatives. Despite the expiration of the very effective federal child tax credit increase, the governor’s proposed budget does not backfill that lost income for California families. It also fails to fund more stimulus payments for Californians with low incomes. Additionally, it does not provide a cost-of-living increase for the SSI/SSP grant as required by state law, and it does not accelerate the SSI/SSP grant restoration scheduled for January 2024.

The need for rental and utility assistance in California has greatly outpaced federal funds allocated to the state. While California was recently allocated an additional $62 million in federal funds to address the growing need, the state needs about $2 billion. The governor missed an opportunity to supplement the federal dollars with surplus from the General Fund. However, California will continue to advocate for additional funding from the federal government.

Despite the large surplus and number of proposed initiatives, the governor’s proposal uses just $20 billion for the needs of Californians. More than half of the surplus is being used to fund reserves and to pay off long term debt. Of the $20 billion being spent, the governor proposes to use 86 percent for one-time expenditures. The reluctance to invest in ongoing needs means proposals that could make a major impact, like funding a broadly available rental assistance program, are not part of the discussion. The legislature should review the governor’s budget with an eye toward meeting more of the short- and long-term needs of all Californians.

HEALTH CARE

The governor’s proposal expands Medi-Cal to all adults regardless of immigration status. This would make California the first state in the nation to cover all adults, and together with the recent increase in the income level for seniors and people with disabilities, as well as the scheduled elimination of the Medi-Cal assets test by January 1, 2024, all adults under 138 percent of the poverty level will be eligible for free, full-scope Medi-Cal. The governor’s proposal also eliminates premiums for children, pregnant people, and the Working Disabled Program, and expands Medi-Cal coverage of custom crowns for back teeth. In addition, there are affordability, provider payment, and workforce investments.

Medi-Cal

  • Health4All: The governor’s proposal expands full-scope Medi-Cal coverage to an estimated 700,000+ undocumented adults ages 26 through 49, effective no sooner than January 1, 2024, with estimated costs of $819 million total funds ($614 million General Fund) in FY 2023-24 and $2.3 billion total funds ($1.8 billion General Fund) at full implementation.
  • Zero out premiums: The proposed budget includes $53 million total funds ($19 million General Fund) in FY 2022-23 and $89 million total funds ($31 million General Fund) ongoing and trailer bill language to reduce premiums to zero for Medi-Cal and other Children’s Health Insurance Program (CHIP) programs. This includes Medi-Cal premiums for children above 160 percent of the poverty level, the 250 percent Working Disabled Program premiums, as well as the premiums for pregnant women and infants under the Medi-Cal Access Program (MCAP) and County Children’s Health Insurance Programs (C-CHIP).
  • Justice-related initiatives: The proposal includes $50 million total funds ($16 million General Fund) in FY 2022-23 to implement the CalAIM justice-related initiatives with implementation beginning January 2023. This includes pre-release applications, pre-release “in-reach” services, and coordinated re-entry. There will also be trailer bill language to extend the duration of suspension of Medi-Cal benefits when an individual is incarcerated to increase the likelihood that coverage is maintained.
  • Dental Lab Processed Crown (AKA Custom Crown) Coverage: The budget includes $37 million total funds ($13 million General Fund) in FY 2022-23 and trailer bill language to update adult coverage requirements to include lab processed crowns for posterior teeth, in place of stainless-steel crowns. Also related to dental, the administration proposes to extend dental managed care contracts and procure new contracts no sooner than January 1, 2024.
  • The governor’s proposal includes the following provider payment investments:
    • Proposition 56 Supplemental Provider Payment Backfill: To address declining tobacco revenue, the proposal includes an increase of $29 million from the General Fund to fully fund remaining Proposition 56 payments at their current level in FY 2022-23.
    • Equity and Practice Transformation Payments: To close health equity gaps in preventive, maternity, and behavioral health care measures and address gaps in care arising out of the pandemic, the proposal includes $400 million total funds ($200 million General Fund) in one-time funds, aligning with the goals of the Medi-Cal Comprehensive Quality and Equity Strategy.
    • Elimination of Certain AB 97 Provider Payment Reductions: The budget includes $20 million total funds ($9 million General Fund) in FY 2022-23 and $24 million total funds ($11 million General Fund) ongoing to eliminate AB 97 payment reductions for nurses, alternative birthing centers, audiologists/hearing aid dispensers, respiratory care providers, durable medical equipment, oxygen and respiratory services, chronic dialysis clinics, non-emergency medical transportation, and emergency air medical transportation.
  • Discontinue Child Health and Disability Program (CHDP) and Expand Children’s Presumptive Eligibility (PE): The Department is proposing to sunset CHDP by July 1, 2023 via trailer bill language and replace with the Children’s Presumptive Eligibility Program, which will include all Medi-Cal providers.
  • Mobile Crisis Services: The proposal includes $108 million total funds ($16 million General Fund) and trailer bill language to add qualifying 24/7 community-based mobile crisis intervention services as a Medi-Cal benefit as soon as January 1, 2023. The benefit will be implemented through county behavioral health delivery systems by multidisciplinary mobile crisis teams in the community.

Other Health Proposals 

  • Office of Health Care Affordability: The proposal reappropriates funding for the Office that was originally included in the 2021 Budget Act (originally $11.2 million in 2020-21 and $24.5 million in 2022-23) and proposes statutory changes for its establishment. The Office is charged with increasing cost and quality transparency, developing cost targets for the health care industry, enforcing compliance, and filing gaps in market oversight.
  • Covered California: The proposal continues to deposit into a reserve fund to be used for future Covered California affordability programs the $333.4 million General Fund that would have been used for Covered California state premium subsidies (not currently needed due to American Rescue Plan Funds).  The administration intends to work with the Legislature to determine the best use of these funds based on the recent AB 133 affordability report produced by Covered California, after determining what ongoing federal support will be available. In addition, the proposal continues to include $20 million General Fund in 2022-23 to support the One-Dollar Premium Subsidy program, which zeros the cost of Covered California consumers for health plans due to federal policy concerning abortion coverage.
  • Behavioral Health Bridge Housing: The proposed budget includes $1.5 billion General Fund ($1 billion in FY 2022-23 and $500 million in FY 2023-24) for behavioral health bridge housing to address the immediate housing and treatment needs of people experiencing unsheltered homelessness with serious behavioral health conditions by purchasing and installing tiny homes and providing time-limited operational supports in various bridge housing settings.
  • Workforce Development: The proposal includes $1.7 billion in Care Economy Workforce investments, including $350 million General Fund to recruit and train 25,000 new community health workers as well as additional health care providers.

HOUSING & HOMELESSNESS

In total, the governor’s 2022-2023 budget dedicates $9 billion for housing and $8 billion for homelessness. Largely building on last year’s efforts, this budget proposal attempts to chip away at the housing and homelessness crisis by streamlining production, increasing housing accountability, and funding homelessness solutions through a climate focused lens.

This “Housing as a Climate Strategy’’ focuses on preservation and production of affordable housing near schools, jobs, transit, density, and community hubs to fight climate change. Despite the well-placed investments in climate resilient housing, the budget falls short in supporting struggling Californians from eviction with the notable lack of state funding for eviction protection. The budget also proposes to battle the state homelessness crisis with an eye toward housing and behavioral health. While on the surface this plan addresses the long-standing need for better mental health for the unhoused community, it plays on the trope that all people experiencing homelessness have mental health conditions, rather than recognizing the very tangible fact that most Californians simply cannot afford the high cost of living, which has steepened since the start of the pandemic.

The governor is also increasing funding for “beautification” and “hazardous material removal” in encampments, which translates to increased sweeps, harassment, and further ostracization of people experiencing homelessness. With another budget surplus, we hope the budget’s May revision will use the additional funding to preserve and increase affordable housing, prevent needless evictions with increased funding for California’s Emergency Rental Assistance Program, and provide tangle solutions to get people off the streets and into safe, stable, affordable, and permanent housing.

Affordable Housing and Climate 

  • $300 million one-time General Fund for the Affordable Housing and Sustainable Communities program to support land-use, housing, transportation, and land preservation projects for infill and compact development that reduce greenhouse gas emissions.
  • $100 million one-time General Fund to expand affordable housing development and adaptive reuse opportunities on state excess land sites.
  • $100 million one-time General Fund for adaptive reuse incentive grants to remove cost impediments to adaptive reuse (e.g., structural improvements, plumbing/electrical design, exiting) and help accelerate residential conversions, with a priority on projects located in downtown-oriented areas.
  • $500 million in Low-Income Housing Tax Credits.
    • $4.6 million in farmworker Housing Assistance Tax Credits.
  • $200 million one-time General Fund for the California Housing Finance Agency (CalHFA) to provide loans to developers for mixed-income rental housing, specifically for households with incomes between 30 percent and 120 percent of the Area Median Income.
  • $200 million one-time General Fund for the Portfolio Reinvestment Program to further preserve targeted units in downtown-oriented areas and continue increasing the state’s affordable housing stock.

Mobile Home Rehab

  • $100 million one-time General Fund for HCD’s Mobile Home Park Rehabilitation and Resident Ownership Program. These funds will finance the preservation and development of affordable mobile home parks.

Infill Housing

  • Infill Infrastructure Grant Program—$500 million one-time General Fund ($225 million in 2022-23, and $275 million in 2023-24).

Emergency Rental Assistance Program

  • California requested an additional $1.9 billion in federal funding to address the growing need for rental assistance and utility assistance for Californians. California was allocated an additional $62 million from the U.S. Department of Treasury. While grateful that California was allocated 30 percent of the total federal reallocation, this amount is woefully short of the need.  Currently, California needs almost $2 billion more than what we were originally allocated, and the need is growing. California will continue to advocate with the federal government to obtain additional rental and utility assistance.

Formerly Incarcerated Housing

  • $10.6 million one-time General Fund over three years to the Returning Home Well program that will provide transitional housing to parolees at risk of housing insecurity or homelessness.

Legal Services for Renters

  • $40 million investment in legal assistance for renters and homeowners.

Homelessness

  • $2 billion one-time General Fund, multi-year grant to cities, large counties and Continuums of Care working with the California Interagency Council on Homelessness (Cal-ICH). Cal-ICH will work with grantees on their homelessness accountability plans.
  • $500 million one-time general fund dollars in housing encampment resolution efforts that will expand program jurisdictions investment in short- and long-term rehousing strategies for people experiencing homelessness.
  • $25 million in Clean California and $20.6 million for hazardous material removal at encampments.
  • $1 million investment in homeless youth programs.
  • $1.5 billion in General Funds over two years dedicated to resources to address the immediate housing and treatment needs of people experiencing homelessness who have behavioral health conditions. This funding will be administered through DHCS’ Behavioral Health Continuum Infrastructure program to purchase tiny homes and facilitate bridge/transitional housing. Such funding can also be used for bridge housing including an expansion of Project Homekey Acquisition.
  • $5 million for Housing Opportunities for Persons with AIDS (HOPWA).

PUBLIC BENEFITS & ACCESS TO JUSTICE

CalWORKs Grants

The governor is proposing a 7.1 percent grant increase to CalWORKs grants starting October 1, 2022. The funding for the increase comes from Child Poverty Subaccount, a stream of revenue dedicated to CalWORKs grant increases. As a result of the 7.1 percent increase, maximum CalWORKs grants will equal 54 percent of the federal poverty level. For families not subject to sanctions, timed off aid or with an ineligible adult, the grant levels exceed the deep poverty level, which means a reduction in the well-documented, long-term negative impacts of deep poverty on children. Despite the increase in the grant level, the administration’s budget does not fulfill the commitment to increase CalWORKs grants so that no child is living in deep poverty. The so-called AU+1 approach requires significantly more investment than this budget provides. Below is a chart which shows current grant amounts, grant amounts with the 7.1 percent increase, the percent of the federal poverty level, what the grant would need to be to ensure an end to deep poverty, and lastly, the gap between the current grant and an end to deep poverty.

Workforce Development

The administration is proposing two major investments in workforce development. One is a $1.5 billion Proposition 98 General Fund effort to support the development of college and career pathways focused on education, health care, technology, and climate-related fields. Promoting pathways that allow students to move seamlessly from high school to college and career will improve the number of students who pursue and achieve post-secondary education and training.

The governor is also proposing to invest $1.7 billion over three years in care economy workforce development—across both the Labor Agency and California Health and Human Services Agency—that will create more innovative and accessible opportunities to recruit, train, and hire, and will advance an ethnically and culturally inclusive health and human services workforce, with improved diversity and higher wages. These programs will target students such as those in CalWORKs welfare to work.

Safety Net Reserve

The budget provides no increase in the safety net reserve, maintaining a $900 million level. While this amount represents an important safeguard against Medi-Cal and CalWORKs program reductions in lean budget years, the continuing growth in spending in both programs might require additional funds to preserve the effectiveness of the reserve.

Child Support Pass Through

The governor is proposing a major change to child support rules by allowing all child support paid by non-custodial parents to go to families formerly receiving CalWORKs or Medi-Cal. For decades it has been state policy for the state to retain any child support for the state to pay off the cost of providing welfare and medical benefits. In short, the state has reimbursed itself and made the families live with less income. When fully implemented, these families are estimated to receive an additional $187 million. While the idea of passing through all child support is certainly welcome, it is notable that the administration is proposing to do this only for families no longer receiving government assistance. The governor chose not to allow a 100 percent pass through to families currently on aid. The legislature may wish to consider expanding this proposal to pass through all child support to all families.

SSI/SSP Grants

The administration did not propose an increase in the SSI/SSP grants for 2022-23 budget, citing last year’s agreement to a two-step increase in SSP funding to restore grant cuts made by the state in the 2010 and 2011 budgets. The first of these grant increases went into effect on January 1, 2022, and in conjunction with a federal cost of living increase for the SSI portion of the grant, SSI/SSP grant levels went from $954 a month up to $1,040 a month for a single individual. The second step of grant increases is set to go into effect in January 2024.

In 2018, the legislature and then Governor Brown agreed to provide a state cost of living adjustment on the SSP portion of the grant beginning in January 2023. While that agreement is subject to funding in the budget, the administration chose not to include it in the January budget. As it currently stands, SSI recipients would not see any increased state funding for two years. The legislature may wish to consider whether to accelerate the second SSP increase to 2023 or to provide a cost-of-living adjustment.

Home Visiting

The administration proposes to increase funding for Home Visiting by $50 million ongoing for the Department of Public Health (CDPH) to expand the California Home Visiting Program and the California Black Infant Health Program, serving approximately 6,000 additional families over five years on top of 3,700 currently served by the Home Visiting Program and 1,650 served by the Black Infant Health Program. The administration does not propose increased funding for the CalWORKs Home Visiting program, which was cut in 2020 during the early days of the pandemic. The budget proposes greater flexibility for home visiting models offered to meet the diverse needs of families across the state, expands home visiting services to additional counties, and makes them accessible to families with the highest need. Additionally, this proposal will support early literacy by including books and early literacy programming provided by home visitors, and will be further supported by a $350 million General Fund investment to recruit, train, and certify new community health workers.

Earned Income Tax Credit

The administration is proposing to allow families with zero reported income to be eligible for the $1,000 state child tax credit so long as the family would otherwise be eligible. The concept of a zero-earnings tax credit potentially opens the door for allowing people receiving SSI, SSDI, and Social Security to get the same state assistance that families receive from the state EITC and Child Tax Credit.

Civil Assessments

The administration is proposing to reduce the impact of fines and fees on low-income Californians by reducing civil assessments from a maximum of $300 to a cap of $150. Civil assessments are imposed on people in criminal and traffic courts when they fail to appear for a hearing, or they fail to pay a fine in a timely fashion. Legal service advocates tell us that many clients receive multiple civil assessments that increase the amount they owe and make it even harder to pay court ordered fines and fees. While this proposal goes part way in meeting the goals of legislators and advocates, as proposed, civil assessments would still impact Californians with the lowest incomes most, and leaves open the question of whether retroactive civil assessment debts would continue to be subject to collection.

California Food Assistance Program

The administration proposes phasing in the expansion the California Food Assistance Program to all Californians ages 55 and older, regardless of immigration status. This year’s budget proposal includes $35.2 million for initial planning phases of the expansion and allocates $113.4 million annually starting in the 2025-26 budget year for the full expansion.

Golden State Stimulus/Grants

The administration chose not to provide another round of pandemic stimulus payments. These payments, which went out to low- and moderate-income households, were instrumental in allowing families and individuals to absorb some of the costs of the pandemic and to give breathing room in household budgets. The grants were also a method for the state to reduce state expenditures below the Gann Limit, which caps the amount the state budget can increase from year to year. The governor noted in his press conference that the door is not closed on this and it may be under consideration for the May Revise.

For questions, contact:

  • Public Benefits/ Access to Justice: Michael Herald, Director of Policy Advocacy – mherald[at]wclp.org
  • Food Access: Christopher Sanchez, Policy Advocate – csanchez[at]wclp.org
  • Health Care: Jen Flory, Policy Advocate – jflory[at]wclp.org; Linda Nguy, Policy Advocate – lnguy[at]wclp.org
  • Housing: Cynthia Castillo, Policy Advocate – ccastillo[at]wclp.org; Tina Rosales, Policy Advocate – trosales[at]wclp.org

The California DMV restored more than half a million driver licenses. Here’s why

“A driver’s license is essential to one’s economic security,” said Western Center on Law & Poverty attorney Rebecca Miller in a statement. “In the majority of cases, California suspended licenses of people who could not afford to pay their traffic tickets. The result did very little to make our roads safer, but it imposed a severe penalty on drivers with low incomes, making it harder for them to work and care for their families.”

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Unemployment Insurance Bolsters Child Support Payments, But Future Remains Uncertain

“Jessica Bartholow, a policy advocate for the California-based Western Center on Law & Poverty, thinks a lack of awareness about public assistance repayments led to what she sees as an oversight in the federal CARES Act. It allowed federal stimulus payments to be intercepted for child support debt, thus letting the money flow away from families who have received public assistance and back to the government.

“Congress incorrectly made the assumption that all the money goes to a custodial parent,” she said. “We believe Congress just didn’t understand that.”

Unemployment Insurance Bolsters Child Support Payments, But Future Remains Uncertain

Full Analysis of Governor Newsom’s proposed 2020-2021 state budget

For a PDF of this analysis, click here.

Last week, Governor Newsom unveiled his $222 billion 2020-21 budget proposal. Western Center’s summary of the proposal can be found here.

The state is in its 11th year of increasing tax revenue, and estimates a $5.6 billion budget surplus over existing obligations. The budget continues the practice of prioritizing saving state revenue for future years by increasing the Rainy Day fund to $18 billion and paying down state debts to reduce state payments in future years.

Governor Newsom is focused on addressing many long standing issues, particularly the homelessness and housing crisis. The budget proposes to allocate $1.4 billion to a variety of solutions, including $750 million in one-time funding to shore up board and care facilities, provide rental assistance to those at risk of or experiencing homelessness, and to fund adaptive re-use of existing structures to create additional housing that people experiencing homelessness can afford. The budget also includes substantial new funding for health care, including a proposal for the state to manufacture prescription medications and to expand health care to undocumented seniors.

The budget proposal does not include the third step of CalWORKs funding that would bring grants to 55 percent of the federal poverty level. Instead, the budget proposes a 3.1 percent increase for CalWORKs grants in October 2020. The budget also provides no increase in state funding for Supplemental Security Income (SSI/SSP) grants, keeping in place recession era cuts that have still not been restored.

Homelessness

The Governor’s budget proposes $750 million in one-time funds to be deposited in the new California Access to Housing and Services Fund, which the Governor recently created by executive order. The fund would be administered by the Department of Social Services, which would allocate dollars to “regional administrators” to be used to provide short- and long-term rental subsidies to people at risk of or experiencing homelessness, create additional housing units affordable to people with extremely low-incomes, and stabilize licensed board and care facilities around the state. How funds would be allocated and administered remains open to negotiation.

Housing

The budget proposes a one-time $500 million increase in the state Low-Income Housing Tax Credit program, which funds the production and rehabilitation of housing affordable primarily to households with incomes between 30% and 80% of area median income (AMI).

Financial Security

CalWORKs: CalWORKs has gone through a period of substantial investment. In 2019, the budget included funding for a 13 percent grant increase, expanded the earned income disregard to $500 a month, and stabilized CalWORKs child care for families. This budget is not as ambitious as prior years, though it does provide a 3.1 percent increase in grants beginning October 2020. This will increase grants for a family of three by about $25 a month. However, it was anticipated that CalWORKs grants would be raised to 55 percent of the federal poverty level to ensure no child lives in deep poverty. This budget proposal will not achieve that goal.

The budget does include funding to increase the CalWORKs child support pass through. Under current law, the first $50 of child support paid by the non-custodial parent goes to the CalWORKs family, but any amount over that is used to pay for the cost of welfare benefits to the state and federal government. Beginning January 2022, CalWORKs families with one child will keep the first $100 of child support, and families with two or more children will keep the first $200 of child support.

We are grateful the Governor heard parents and families in their call for a child support program that works for children. The increases to child support pass through and relief from government-owed, uncollectable debt proposed by the Governor look like a good start. We are eager to see the associated proposed trailer bill law changes so we have more details, and look forward to working with the Governor and legislature to achieve the goals of conforming with federal law and regulation, and ensuring the program works to benefit the children it purports to help.

Fines and Fees: The budget proposes to expand the traffic court ability to pay pilot program statewide. Currently, an eight county pilot program (operational in four counties) allows persons to adjudicate traffic tickets through an online portal and reduce fines by at least 50 percent for low income drivers. The budget would expand this pilot statewide over several years to all counties. The pilot has yet to be evaluated.

Additionally, the budget makes a $92 million investment in reducing criminal justice fees and their harmful, recidivistic impact on people with low-incomes and people of color, their families, and their communities. We are grateful to Budget Chair Mitchell for her leadership on this issue and look forward to working on details with her, the Governor, and other budget leaders.

SSI/SSP: The SSI/SSP caseload continues to decline, and as a result, state funding for the state supplemental program (SSP) is declining. In the 2020-21 budget the administration projects a 1.6 percent decline in SSP spending to $2.66 billion, down from $2.73 billion in the 2019-20 budget. This continues a trend of declining state spending for disabled and elderly adults. As recently as the 2016-17 budget, the state spent $2.87 billion. Rather than invest savings from caseload declines into grants, the savings are going into the General Fund for other purposes. SSI/SSP grants are critical for paying the cost of housing; this failure to invest in SSI grants will put more recipients at risk of homelessness.

Health care

Expands full-scope Medi-Cal to all income-eligible undocumented adults age 65+ (Health4AllSeniors): Building on the 2019 Budget, which made California the first in the nation to expand full-scope Medi-Cal to adults up to age 26 regardless of immigration status, the Governor’s recent proposal includes $80.5 million ($64.2 million General Fund) to expand full-scope Medi-Cal to all income-eligible undocumented adults age 65 and older. This would benefit about 27,000 older adults, to be implemented no sooner than January 1, 2021. Full implementation costs are projected to be approximately $350 million ($320 million General Fund) in 2022-23 and ongoing.

Delays 2019 Budget Act suspensions from December 31, 2021 to July 1, 2023: The 2019 Budget made important Medi-Cal investments that were to be suspended on December 31, 2021 and the proposal delays these suspensions by 18 months. This includes restoration of Medi-Cal benefits (optical, audiology, podiatry, speech therapy, and incontinence creams and washes), extension of Medi-Cal eligibility from 60 days to one year for post-partum women diagnosed with a mental health disorder, expansion of Medi-Cal screening for the overuse of opioids and illicit drugs, and Prop 56 supplemental payments to providers.

Funding for CalAIM (recently renamed to Medi-Cal Healthier California for All Initiative): The Governor’s proposal includes $695 million ($348 million General Fund) for CalAIM effective January 1, 2021 and ongoing. Despite the name change, the administration continues to advance policy changes released in October’s proposal. The proposal still terminates the Health Homes Program (HHP) despite loss of enhanced federal match rate and the Whole Person Care (WPC) program, and includes $225 million to implement the new statewide enhanced care management benefit through plans. Plans will have the option of providing housing transition services, currently provided under HHP and WPC, and other services In Lieu of Service. The Dental Transformation Initiative will end December 2020, but $112.5 million is proposed to continue and expand program elements including provider incentives for preventive services (expanded to adults); provider incentive payments for continuity of care (expanded to adults); caries risk assessment, and adding silver diamine fluoride as a covered service for children.

Termination of Dental Managed Care in Medi-Cal: The administration proposes transitioning Medi-Cal dental services from a managed care delivery system, currently mandatory in Sacramento and optional in Los Angeles, to a fee-for-service (FFS) system in January 2021. A net zero fiscal impact is estimated due to small administrative savings offset by higher dental utilization in FFS system. However, any transition will have to ensure existing consumer protections for enrollees in dental managed care, including network adequacy requirements, continuity of care protections, and a strong grievance and appeal process.

Medi-Cal Medication Assisted Treatment Benefit Changes: The administration proposes adding all FDA approved drugs (specifically buprenorphine and buprenorphine-naloxone combination) to treat opioid addiction as a Medi-Cal benefit. Currently, only methadone and naltrexone is covered for Medi-Cal enrollees needing Medication Assisted Treatment; adding two new drugs is estimated to cost $876,000.

Prescription Drug Cost Containment: The Governor proposes to continue last year’s Executive Order to carve-out the Medi-Cal managed care benefit from managed care to fee-for-service effective January 1, 2021 to include savings that are partially offset by creation of a new supplemental payment pool for non-hospital clinics for 340B pharmacy services. The Governor also proposes to establish the state’s own generic drug label to manufacture certain generic drugs, establish a single market for drug pricing within the state to combine purchasing power, and expand authority to negotiate with manufacturers internationally for Medi-Cal supplemental rebates.

Potential Public Option: With more details to come, the Health and Human Services Agency will develop options to strengthen enrollment, affordability, and choice through Covered California, including leveraging the network of existing public Medi-Cal managed care plans.

Office of Health Care Affordability: The administration proposes the establishment of the Office of Health Care Affordability in spring 2020 to increase price and quality transparency, and to reduce costs to generate savings to directly-impacted consumers.

Hearing Aids for Children: The budget proposes to create a state program to assist families with the cost of hearing aids and related services for children without health insurance coverage for households with incomes up to 600% FPL.

Behavioral Health: The administration proposes to establish the Behavioral Health Task Force Agency and strengthen enforcement of behavioral health parity laws. The Department of Managed Health Care’s enforcement will focus on timely access to treatment, network adequacy, benefit design and plan policies. The administration also supports updating the Mental Health Services Act to focus on people with mental illness experiencing homelessness, those involved in the criminal justice system, and for early youth intervention.

 

 

 

Western Center Reaction to Governor Newsom’s Proposed 2020-2021 Budget

First and foremost, Western Center is pleased that Governor Newsom’s proposed budget includes significant and innovative proposals to address the homelessness crisis in California, which will not only help the thousands of people currently experiencing homelessness, but will also prevent more people from losing their housing. We are also pleased to see the Governor take another major step toward providing health care for all by expanding Medi-Cal coverage to undocumented adults over age 65, and to see the extension of the tax ban on period products and diapers, which makes our tax code more equitable for women, girls and young families.

We were hoping to see additional investments for CalWORKs and SSI grants in this proposal, since they are both crucial for lifting Californians out of poverty. We will continue to advocate for those increases in the final budget agreement.

Below are our initial reactions to the proposed budget by issue area. We will release an in-depth analysis next week.

Housing

The proposed budget appropriately treats the state’s homelessness crisis as an emergency. The proposal devotes additional resources to help people at risk of homelessness remain stably housed and to increase both temporary shelter capacity and permanent housing options for people already experiencing homelessness. We are pleased to see the Governor’s sustained commitment to addressing homelessness and look forward to working in partnership with his administration and legislative leaders to further develop effective, sustainable solutions to the crisis that prioritize residents living in poverty.

We agree with the Governor that the state must ramp up efforts to address the state’s shortage of housing, which is primarily a shortage at lower income levels. We are eager to work with the Governor to ensure that policies and programs to speed housing production prioritize the creation of units for households with the lowest incomes who are priced out of the rental market in every county in the state, protect low-income communities and communities of color from displacement, and increase access to high opportunity areas for our clients.

Financial Security

The budget includes funding to increase the CalWORKs child support pass through (read about it here). Currently, the first $50 of child support paid by a non-custodial parent goes to the CalWORKs family, but any amount over that is kept by state and federal governments. In the Governor’s newly proposed budget, CalWORKs families with one child will keep the first $100 of child support, and families with two or more children will keep the first $200 of child support, beginning January 2022. It also includes funding to provide debt relief for child support owed to the government that is deemed uncollectable. We are grateful that the Governor has heard from parents and families in their call for a child support program that works for children, and we are eager to see proposed associated trailer bill law changes for details. We look forward to working with the Governor and legislature to achieve the goals of conforming with federal law and regulation, and ensuring the program works to benefit the children it purports to help.

The budget also includes the extension of the tax ban on period products and diapers, which will make our tax code more equitable, since taxes on period products and diapers are regressive to poor families and young people. We look forward to continuing work in the legislature to end unmet diaper need and period poverty in California.

Additionally, the budget makes a $92 million investment in reducing criminal justice fees and their harmful, recidivistic impact on people with low-incomes and people of color, their families, and their communities. We are grateful to Budget Chair Mitchell for her leadership on this issue and look forward to working on details with her, the Governor, and other budget leaders. We’re also happy to see that Californians with low incomes will soon be able to reduce the cost of their traffic fines and the overall impact of expensive traffic tickets, with this budget proposing to expand the traffic court ability-to-pay pilot program (currently operational in four counties) statewide over several years. The pilot has yet to be evaluated, so we look forward to details from the Judicial Council to see if the program’s reductions in fines and fees are adequate or need to reduced further.

Finally, to further enhance financial security for Californians, the Governor’s budget creates a new state version of the Consumer Financial Protection Bureau (CFPB). The proposed financial watchdog will hold banks and other financial firms accountable when they engage in unfair and abusive debt collection and banking practices. Medical, student loan, school lunch, and other forms of debt disproportionally burden people experiencing poverty; we expect this new agency to offer important protections for our clients.

Health Care

We applaud the Governor for continuing to move toward universal coverage by making California the first in the nation to expand full-scope Medi-Cal to all income-eligible seniors regardless of immigration status, taking a whole person approach to Medi-Cal, and cost containment with an eye toward quality and equity. We look forward to working with the administration and legislature to advance a budget that ensures equitable access to affordable, comprehensive, quality health care for poor Californians.

The Governor’s proposal also delays suspension of benefits and eligibility, by extending certain Medi-Cal benefits (optical, audiology, podiatry, speech therapy, and incontinence creams and washes), extending Medi-Cal eligibility from 60 days to one year for post-partum women diagnosed with a mental health disorder, and expanding Medi-Cal screening for the overuse of opioids and illicit drugs, all until July 2023.

 

Newsom vetoed two bills aimed at reforming child support payback system

Gov. Gavin Newsom has vetoed two child support reform bills that anti-poverty advocates had hoped would give a boost to low-income families in California.

The bills would have sent more child support money to families receiving public benefits and eliminated interest on overdue child support payments owed to the government. Supporters had argued that the legislation would provide more resources to low-income families disproportionately affected by the existing policies

…Jessica Bartholow, a policy advocate with the Western Center on Law and Poverty, which co-sponsored the bills, said she was disappointed the legislation did not pass.

“The current system is unjust and it needs to change,” she said. “The money comes with great sacrifice from people who are low-income.”

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California lawmakers take aim at ‘punitive’ child support system for low-income families

When Ronnell Hampton was growing up, his father wrote a $600 check every month to pay his child support.

But only $50 of that amount actually made it to Hampton’s family; the rest was sent back to the government to repay the cost of public assistance.

The family could have used the extra cash, Hampton said. He recalled days with the electricity turned off, selling candy and pumping gas to make ends meet, and school outings he couldn’t go to because they didn’t have enough money.

…“Once it becomes a debt owed to the government, that money never gets sent to the child,” says Jessica Bartholow, a policy advocate with the Western Center on Law and Poverty, which co-sponsored the bills. “It’s kind of the original sin of the child support system we have in place today, which is, how do we call it a child support system where none of that money goes back to the child?”

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