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Analysis Of Governor Newsom’s 2023-2024 May Revision Budget

The Newsom Administration released its 2023-24 May Revision budget, projecting a $31.5 billion deficit. After years of a budget surplus, California is forecasting a downturn in funding due to a combination of capital gains losses and delayed tax filings due to natural disasters, but California remains strong. The May Revision reflects a $37.2 billion in total budgetary reserves and additional funds from the Managed Care Organization tax.  

Governor Newsom maintains many of the Administration’s and legislature’s previous commitments and proposes no new trigger cuts. He also proposes no new corporate or personal taxes, despite calls from the Senate and advocates to increase taxes on wealthy corporations and the state’s highest earners.  

We appreciate that the May Revision maintains past budget agreements including expansion of Medi-Cal to all regardless of immigration status, reforming the Medi-Cal share-of-cost, and on-time implementation of food assistance for Californians 55 years of age or older, regardless of immigration status 

As the fourth largest economy in the world, California has made great strides in addressing poverty and systemic inequities, but there is more work to be done. We look forward to working with the legislature and Administration to protect low-income Californians as the State enters more uncertain fiscal circumstances.  

Below are our initial reactions to the proposed budget by issue area, with a focus on changes from the January budget proposal.   

HEALTH CARE 

Health4All: The May Revision maintains full funding to expand full-scope Medi-Cal eligibility to all income eligible adults ages 26-49 regardless of immigration status on January 1, 2024. The May Revision includes increases for previous expansions for adults 50 and older and ages 26-49 due updated managed care rates, higher share of state-only costs, higher caseloads, and higher acuity members. 

Managed Care Organization (MCO) Tax: The May Revision proposes a bigger MCO tax with an earlier start date (April 2023 through end of 2026). This results in $19.4 billion in total funding, including $3.4 billion for 2023-24. $8.3 billion is proposed to offset General Fund and $11.1 billion is proposed to support Medi-Cal investments that improve access, quality, and equity over an 8- to10-year period. These investments include rate increases to at least 87.5% of Medicare for primary care, birthing care, and non-specialty mental health providers and the remainder will be put into a special fund reserve for future consideration.  

Covered California Affordability Sweep: The May Revision maintains proposal to sweep Covered California reserve fund to General Fund totaling $333.4 million. 

Distressed Hospital Loan Program: The May Revision includes up to $150 million one-time General Fund to provide interest-free cashflow loans to not-for-profit and public hospitals in significant financial distress or to governmental entities representing a closed hospital, for purposes of preventing the closure of, or facilitating the reopening of, those hospitals.  

Home and Community-Based Services Spending Plan Extension: The May Revision includes a six-month extension until September 30, 2024 for specified programs such as the IHSS Career Pathways Program and the Senior Nutrition Infrastructure Program to fully spend allocated funding based on critical programmatic needs.  

Doula Services Implementation Evaluation: To align with later implementation date, TBL is proposed to extend the timeline of the Doula Stakeholder Workgroup (from April 1, 2022 until December 31, 2023) and to extend the evaluation of the doula benefit implementation in the Medi-Cal program (from April 1, 2023 until June 30, 2025).  

Medical Interpreter Pilot Program: Through TBL, the May Revision proposes to extend the expenditure authority of the Medical Interpreter Pilot Project for 12 months, from June 30, 2024 to June 30, 2025.  

988 Update: The May Revision includes a one-time augmentation of $15 million for a total of $19 million, from the 988 State Suicide and Behavioral Health Crisis Services Fund for California’s 988 centers. This increase will support workforce expansion to handle increased answered call volume, extensions of service hours, and the availability of chat and text options for callers utilizing the 988 services.  

BH-CONNECT Demonstration (formerly referred to as CalBH-CBC Demonstration): The May Revision includes an update to the BH-CONNECT Demonstration to include a new Workforce Initiative and includes $480 million in funding for each year of the five-year demonstration period ($2.4 billion total funding and no General Fund).  

CalRX and Reproductive Health: The May Revision includes TBL and $2 million one-time General Fund reappropriation from the Capital Infrastructure Security Program and allows the use of these funds for reproductive health care if necessary. 

Community Assistance, Recovery, and Empowerment (CARE) Act: The May Revision includes additional funding to support the implementation of the CARE Act. Compared to the Governor’s Budget, the annual increase is between $43 million and $54.5 million to account for refined county behavioral health department cost assumptions, additional one-time $15 million General Fund for Los Angeles County start-up funding. The May Revision also includes an additional $16.8 million in 2023-24, $29.8 million in 2024-25, and $32.9 million ongoing to double the number of hours per participant for legal services from 20 hours to 40 hours. 

HOMELESSNESS

The May Revision preserves the full $3.7 billion in funding for homelessness programs, as committed in previous budgets, including $1 billion for the Homeless Housing, Assistance and Prevention grant program. 

May Revision Adjustments:  

Behavioral Health Bridge Housing Program: $500 million one-time Mental Health Services Fund in 2023-24 in lieu of General Fund. This investment eliminates the January Budget proposed delay of $250 million General Fund to 2024-25 and restores the $1.5 billion commitment funded in the 2022 Budget Act for the program. 

HOUSING

While the May Revision reflects a steady commitment to Homelessness investments, the May Revision also culminated in a weakening of housing investments totaling $17.5 million in General Fund reductions and $345 million in deferrals related to housing programs. Funding for housing programs remains at approximately 88% of the allocations made in 2022-23 and proposed for 2023-24 ($2.85 billion). This outlook could change if there are sufficient General Fund dollars in January 2024. If that occurs, the Governor has committed to restoring $350 million of these reductions. Overall, the proposal includes $500 million continued annual investment in the state Low-Income Housing Tax Credit program, $225 million for the Multifamily Housing Program, and $100 million for the Portfolio Reinvestment Program. These programs have a proven track-record of addressing housing affordability and homelessness across California. 

May Revision Adjustments: 

Foreclosure Intervention Housing Prevention Program: Provides funds to various non-profit organizations to acquire foreclosed property and operate as affordable housing. Deferral of $345 million of the $500 million one-time General Fund over four fiscal years—for a revised allocation of: $50 million in 2023-24, $100 million in 2024-25, $100 million in 2025-26, and $95 million in 2026-27 

Downtown Rebound Program: Funds adaptive reuse of commercial and industrial structures to residential housing. Reverts $17.5 million in unexpended funding that remained in this program after the Notice of Funding Availability. 

In contrast, the Senate’s Budget Plan, which was released two weeks ago, both prevents funding cuts and delays, and builds on our progress by including ongoing investment in homelessness and resources for key housing production programs. Notably, that Plan provides $1 billion in ongoing funds to support the Homeless Housing Assistance, and Prevention Program, $1 billion towards the state Low-Income Housing Tax Credit Program, and an additional $300 million flexible allocation towards affordable housing programs.  

Western Center is a proud member of a coalition of California’s leading affordable housing, homelessness, and housing justice advocacy organizations championing a comprehensive coalition investment strategy for affordable housing production, preservation, and tenant stability. While the May Revision falls short of our requests to meet the housing and homelessness crisis at scale, we look forward to continuing our budget advocacy and encourage the Governor and Legislative leadership to finalize a budget that includes ongoing, significant resources like those included in the Senate budget plan and our coordinated housing budget letter. 

PUBLIC BENEFITS AND ACCESS TO JUSTICE  

CalWORKs Grant Increase: The May Revision reflects a 3.6-percent increase ($111.2 million in 2023-24) to CalWORKs Maximum Aid Payment levels, effective October 1, 2023. These increased grant costs are funded through the Child Poverty and Family Supplemental Support Subaccount.  

Supplemental Security Income/State Supplementary Payment (SSI/SSP): The May Revision continues to include an 8.6% increase in funding for the SSI/SSP and Cash Assistance for Immigrants (CAPI) program providing a $3.6 billion from the general fund. This allocation provides recipients with an increase in grant levels to $1,134 per month and $1,928 per month for couples. 

California Food Assistance Program (CFAP) Expansion Update: The May Revision moves up the issuance of food benefits for older undocumented immigrants to start October 2025, instead of the January Proposal that delayed it until 2027, which we appreciate but we still need Food4All regardless of age and immigration status. 

Summer Electronic Benefit Transfer (EBT) Program: The May Revision includes $47 million ($23.5 million General Fund) for outreach and automation costs to phase in a new federal Summer EBT program for children who qualify for free or reduced-price school meals beginning summer 2024.  

Safety Net Reserve: The May Revision withdraws $450 million (half of $900 million) from the Safety Net Reserve. The reserve is intended to maintain existing Medi-Cal and CalWORKs program benefits and services when program cost may increase due to economic conditions, which may occur if recession occurs, so we argue it is prudent to not draw from Safety Net Reserve until those conditions are met. 

Services for Survivors and Victims of Hate Crimes Augmentation: The May Revision includes an additional $10 million General Fund to support services for victims and survivors of hate crimes and their families and facilitate hate crime prevention measures in consultation with the Commission on Asian and Pacific Islander American Affairs. 

For questions, contact: 

  • Health: Linda Nguy, Senior Policy Advocate – lnguy[at]wclp.org; Sandra Poole, Policy Advocate – spoole[at]wclp.org 
  • Housing and Homelessness: Cynthia Castillo, Policy Advocate – ccastillo[at]wclp.org; Tina Rosales, Policy Advocate – trosales[at]wclp.org 
  • Public Benefits/ Access to Justice: Christopher Sanchez, Policy Advocate – csanchez[at]wclp.org 

Western Center’s Analysis of Governor Newsom’s 2022-23 May Budget Revision

The Newsom Administration released its 2022-23 May Revise budget, which includes a massive three year budget surplus of over $90 billion. While the budget includes many noteworthy proposals, overall it fails to provide robust help to those who need it most. Rather than target the surplus on increased tax credits and emergency relief for people with low incomes, the budget proposal provides more than $11 billion in tax credits to car owners, including households with incomes up to $250,000.

Paradoxically, the state has so much extra revenue that General Fund spending is limited since the increased revenue exceeds the State Appropriations Limit (aka the Gann limit). As such, the May Revise proposes large infrastructure spending that is not counted towards the Gann limit. While those proposals are not without merit, the Revise fails on fundamental anti-poverty measures, like backfilling the lost federal child tax credits proven to reduce child poverty, leaving hundreds of thousands of children at risk of unnecessarily falling back into poverty. The Revise also fails to fully eliminate civil assessment fees that disproportionately punish people experiencing poverty who cannot afford to pay a traffic ticket or take time to appear in court.

Care Court

The governor proposes $65 million to fund a new court process called Care Court, which would force unhoused individuals with schizophrenia and other psychotic disorders into a court ordered treatment plan. Western Center has been tracking the proposal and vocal about our opposition since the governor revealed it in March, as it touches on each of our issue areas.

The Revise provides $39 million to the Judicial Council to run the court process, $10 million to finance a supporter program within the state Department of Aging, and $15 million to counties for training and technical assistance.

With its lack of necessary interventions, like a clear budget strategy and mechanisms for creating housing, we believe the framework of the proposal is fundamentally flawed. If implemented, it is likely CARE Court will lead to unnecessary institutionalization of people with disabilities and unhoused people and likely create a chilling effect that will prevent people from seeking services for fear of being institutionalized. Additionally, by involving the court system the proposal will perpetuate institutionalized racism and exacerbate existing disparities in health care delivery since Black, Indigenous and other people of color are significantly more likely to be diagnosed with psychotic disorders than white people. All evidence shows that adequately-resourced, intensive, voluntary outpatient treatment – not court-ordered treatment – is most effective for treating the population CARE Court seeks to serve.

HOUSING & HOMELESSNESS

The governor’s May Revise proposes a $2.5 billion dollar increase for housing and homelessness programs from last year for multi-year investments to build housing and behavioral health housing. The Revise includes an additional $150 million to fund Homekey projects, $50 million to build interim housing and $500 million to accelerate affordable housing production and conversions of retail space in downtown corridors.

Even with the economic fallout of the pandemic raging on, the proposal does not include additional funding for tenants at the brink of eviction for their inability to pay rent. To confuse matters, the governor announced a $2.7 billion budget allocation for rental assistance, but it is not a new commitment. Rather, it’s part of the commitment the legislature made in February via Senate Bill 115, designed to ensure full coverage for rental assistance applications submitted before March 31. However, because of the burdensome application process, tenants accrue debt while they wait for approval and still face the threat of eviction for the months their application was being processed.

The governor’s proposal fails to comply with the legal requirement for the state to fully fund rental assistance applications submitted before March 31 by paying those tenants 100% of their accrued debt at the time they are approved. To keep tenants housed and fulfill the promise of the rental assistance program, the massive budget surplus must be used to fully fund tenants’ rental debt and ensure that vulnerable Californians remain housed.

Western Center will continue to advocate for other sponsored proposals missing in the May Revise, including $500 million in the Community Anti-Displacement and Preservation Program (CAPP) to acquire unsubsidized affordable housing and make them permanently affordable, $200 million in the Reentry Housing and Workforce Development Program to provide stable housing and supportive services to formerly incarcerated people as outlined in AB 1816 (Bryan), and $150 million for eviction defense funding and community education and outreach.

PUBLIC BENEFITS & ACCESS TO JUSTICE

CalWORKs

The May Revise proposes an 11.1 percent increase in CalWORKs, the largest one-year increase in the grant levels in recent memory. The funding for this comes from the Child Poverty subaccount which has seen a significant increase along with the overall budget. Even with this increase, CalWORKs grants for most families are still not out above deep poverty (50 percent of the federal poverty level). That is because most families have an excluded adult. We are calling on the legislature to fulfill the commitment made four years ago to fund CalWORKs grants at the assistance unit plus one level. See the chart below for what the gap will remain at:

Child Support Pass Through

The May Revise makes no change in the administration’s proposal to pass through all child support to former CalWORKs families. While advocates support the proposal, we seek to have it extended to current CalWORKs cases where families have lower incomes and could use the child support assistance immediately.

Food Assistance

The May Revise makes no change to the governor’s January proposal seeking to expand the California Food Assistance Program to Californians regardless of immigration status for those 55 years of age and older. Western Center stands with our partners advocating for the expansion of the program to include Californians of all ages. Many immigrant families were excluded from pandemic relief and continue to be left behind as we rebuild the state’s safety nets.

SSI/SSP

The governor’s May Revise budget makes no proposal to increase grants for blind, aged and disabled Californians. There is a provisional agreement to restore the remainder of the 2009 SSP grant cuts beginning in January 2024 but the governor did not include CA4SSI’s request to accelerate the grant increase to January 2023. By delaying the second restoration, the value of the grant will decline when compared to the federal poverty level.

HEALTH CARE

The governor’s May Revision maintains the expansions proposed in the January proposal, including expanding Medi-Cal to all adults regardless of immigration status (Health4All), zeroing out premiums and copayments for Medi-Cal, and expanding Medi-Cal coverage of custom crowns for back teeth. In addition, the May Revision makes new investments to increase the Medi-Cal doula reimbursement rate, provides navigator funding, and permanently extends presumptive eligibility for older adults and individuals with disabilities. Unfortunately, the May Revision does not update the Medi-Cal share of cost, fully fund SB 65, or implement Health4All sooner than January 2024.

Below is summary of health proposals in the May Revision, which still needs to be negotiated with the legislature by the budget deadline of June 15th.

Medi-Cal

  • Increased Doula Reimbursement Rate: The May Revision proposes to increase the average doula service reimbursement rate from $450 to $1,094, which includes antepartum visits, delivery, and postpartum visits. The implementation date for the doula benefit will be shifted from July 2022 to January 2023 resulting in $974,000 total funds ($377,000 General Fund) in 2022-23 for this benefit.
  • $60M One-time Navigator Funding: The May Revision proposes to add $60 million total funds ($30 million General Fund) to the Health Enrollment Navigators available over four years through fiscal year 2025-26 to assist in outreach, application assistance, enrollment, and retention for difficult-to-reach populations, including the implementation of Health4All.
  • Presumptive Eligibility for Individuals 65 +, Blind, or Disabled: The May Revision includes $73 million total funds ($37 million General Fund) to continue Medi-Cal presumptive eligibility for older adults and individuals who are blind or disabled. Already permanent for other populations, this gives eligible older adults and individuals who are blind or disabled instant Medi-Cal eligibility for a limited time. Advocates are working to ensure this means two Presumptive Eligibility periods per year, as is currently available during COVID.
  • Equity and Practice Transformation Payments: To close health equity gaps in preventative, maternity, and behavioral health care measures, and to address gaps in care, the May Revision proposes an additional $300 million ($150 million General Fund) to the $400 million proposed in January for a combined $700 million in total funds.
  • Transitions to Managed Care: Under CalAIM, various populations are shifting to mandatory managed care effective January 2022 and January 2023. The May Revision proposes to delay the transition of ICF/DDs and Subacute Care Facilities into managed care from January 1, 2023 to July 1, 2023 to prepare for the transition. The administration also identified additional individuals subject to mandatory managed care that were assumed to already be included and will provide details on specific populations once determined.
  • LA Care Sanctions: The May Revision proposes budget bill language to use monetary sanctions collected from LA Care in the budget year to award grants to qualifying non-profit legal aid programs and organizations that serve Medi-Cal managed care enrollees in Los Angeles County or other impacted counties, for purposes of improving access to care in the Medi-Cal program.
  • Medi-Cal Media and Outreach Campaign: In an April budget change proposal prior to the May Revision, the Department of Health Care Services (DHCS) requested $25 million ($12.5 million General Fund) for a media and outreach campaign to encourage members to update their contact information with their counties, and to educate members of potential Medi-Cal termination if requested information is not submitted.
  • Additional AB 97 Provider Payment Reductions Elimination: In addition to elimination of AB 97 payment reductions in the January proposal, the May Revision proposes to include doula services, community health worker services, asthma prevention services, health care services delivered via remote patient monitoring, dyadic services, Medication Therapy Management, and continuous glucose monitoring system, supplies and accessories.

Other Health Proposals

  • Covered California: The May Revision proposes $304 million to extend California’s premium subsidy program for middle income Californians with incomes between 400 and 600% FPL. This represents a fraction of potential loss if federal relief is not extended.
  • Children and Youth Behavioral Health Initiative Grants: The May Revision includes $85 million General Fund for Children and Youth Behavioral Health Initiative (CYBHI) grants to schools, cities, counties, tribes, and/or community-based organizations. This includes grants to wellness and mindfulness programs as well as parent support and training programs.
  • Reproductive Health: The May Revision includes $57 million one-time General Fund to support safe and accessible reproductive health care, for a total of $125 million including investments in the January budget. Specifically, $40 million to DHCS for uncompensated reproductive health care, $15 million for the California Reproductive Justice and Freedom Fund at the Department of Public Health (DPH); $1 million to DPH for the Comprehensive Reproductive Rights Website, and $1 million to DPH for research on unmet needs for reproductive health care.

____________________________________________________________

PDF of this document available here.

For questions contact:

 

Western Center Roundup – January 2022

Welcome to Western Center’s first newsletter of 2022! The new year also brings a fresh look for our monthly newsletter. Welcome to the roundup!


From North to South, Two Suits Settled 

Two lawsuits settled since our last newsletter: Warren v. City of Chico and Banda v. County of San Bernardino. 
Legal Services of Northern California and Western Center brought the case in Warren v. City of Chico last year to challenge ordinances criminalizing homelessness in Chico. Now under the settlement, the city must build individual pallet shelters for people experiencing homelessness, and is prohibited from issuing citations and arrests for people who live outside when shelter is unavailable. Read more about the case and settlement here.

In December, Western Center, Inland Counties Legal Services, and Public Interest Law Project settled our case against the County of San Bernardino, resulting in several changes to the county’s General Relief program to help more people in extreme poverty access vital financial assistance. General Relief is the program administered by California counties that provides cash assistance to adults who don’t have enough resources or income to meet their basic needs. Our case prompted the county to make substantial changes to its General Relief process, making General Relief easier to access and maintain moving forward. The biggest change is the dollar increase in assistance. Read more about the case and settlement here.


Let the Budget Process Begin

Governor Newsom released his 2022-23 California budget proposal in mid-January – revealing yet another dramatic surplus for the State of California due to rapidly increasing wealth among the state’s top earners. Western Center’s analysis of the governor’s budget proposal outlines its potential impact on Californians — from the positive, like the proposal to expand Medi-Cal eligibility to those currently excluded due to immigration status, to challenges, like the need for more state-funded rental assistance than was included in the governor’s proposal. Read our analysis here.

Despite the large surplus and number of proposed initiatives, the proposal shows reluctance to invest in the state’s ongoing needs. Leading up to the budget’s May Revision, Western Center will advocate for the legislature to review the governor’s proposal with more of an eye toward meeting the short- and long-term needs of all Californians. To learn more about Western Center’s 2022-23 budget priorities and advocacy, you can view the recording of this month’s Meet the Advocate conversation with our Director of Policy Advocacy, Mike Herald.


February Reads    

If you’re looking for an informative read or three heading into February, our blog has you covered!

  • Western Center’s Executive Director Crystal D. Crawford and Manal J. Aboelata, Deputy Executive Director at Prevention Institute and author of a new book, Healing Neighborhoods, reflect on the federal Infrastructure Investment and Jobs Act and what it could mean for ensuring all Americans the right to live in a healthy neighborhood. Read here.
  • Abraham Zavala, Western Center’s Outreach and Advocacy Associate, wrote an eye-opening post about the struggles facing long-term tenants at City Center Motel in Long Beach, and how the untimely death of one tenant spurred others to mobilize and organize. Read here.
  • Western Center’s senior policy advocate Jen Flory and senior attorney Helen Tran co-wrote a post outlining new patient protections for hospital billing available this year. Read here.

Analysis of Governor Newsom’s May Revision of California’s 2021-2022 Budget

*PDF of this analysis available here.

Over the past year, millions of Californians experienced the most devastating pandemic and economic downturn in nearly a century. The cumulative impact of COVID-19 has caused financial devastation and a prolonged period of wealth and asset stripping from Californians unlike anything in recent memory. With that in mind, we see this budget revision by the Governor as a mixed bag.

While it includes notable investments in homelessness and housing funding and health care, it falls short in meeting the existing needs of Californians with low incomes. Doing so would include providing health care for ALL, restoring decade-old cuts to grants for SSI recipients, insuring CalWORKs families have enough income to allow children to thrive, and helping those who are in debt and threatened with eviction due to the pandemic receive justice. The $76 billion budget surplus is more than adequate to meet those needs, and we call on the Legislature to revise the Governor’s budget proposal to ensure that families with low incomes receive a truly historic investment.

OVERVIEW

Governor Newsom’s 2021-22 May Revision of the California budget includes an unprecedented level of state funding. Despite high unemployment for the past year and increased state costs in responding to the pandemic, the budget has $41 billion more in state revenue than anticipated in the January budget. When combined with federal funds, the total surplus is more than $75 billion. These figures could change (likely higher) since the April tax deadline was pushed back by one month.

For the first time in nearly 40 years, budget funding exceeds the Gann Limit, which caps state budget spending based on a formula that limits budget growth to population increases and inflation. The budget anticipates that state funding will exceed the Gann Limit by $16.2 billion in 2023, and in response expands the Golden State Stimulus tax refunds to families earning less than $75,000 and increases state funding for K-12 education.

The proposed budget includes substantial reserve funds including $15.9 billion in the Proposition 2 Budget Stabilization Account (Rainy Day Fund) for fiscal emergencies, $450 million in the Safety Net Reserve, $4.6 billion in the Public School System Stabilization Account, and $3.4 billion for the state’s operating reserve.

The Senate Budget and Fiscal Review Committee analysis provides more specifics on the Governor’s budget.

ACCESS TO JUSTICE

Traffic Fines

The budget includes $300 million in one-time spending for debt forgiveness on uncollectible traffic court debts, which would eliminate 100 percent of debt for applicants with low incomes. However, this funding level is inadequate to meet the actual need, as there is more than $8 billion in uncollected traffic debt outstanding.

We are encouraged by the proposal for traffic fines but urge the Governor and Legislature to go far beyond what the Governor proposed. The state needs to undo the archaic policies that criminalize people in poverty – predominately in Black and brown communities, and eliminate criminal system administrative fines and fees. We are co-sponsoring SB 586 (Bradford) to eliminate the rest of the fines and fees that were not eliminated last year.

Legal Aid for Renters in Landlord-Tenant Disputes

The May Revision includes $20 million federal ARPA funds annually for three years ($60 million total) to provide legal aid services for renters and homeowners to avoid eviction and foreclosure. Specifically, these additional funds will provide free legal services for landlord-tenant issues, including legal assistance for counseling, renter education programs, and preventing evictions. More about this can be found below in the housing section.

HEALTH

The Governor’s May Revision includes major health care expansions, including expanding full-scope Medi-Cal to all income-eligible seniors age 60+ regardless of immigration status (Health4AllElders), adding the services of doulas and community health workers as Medi-Cal benefits, extends Medi-Cal eligibility for postpartum individuals, eliminating Medi-Cal program suspensions, and making $4 billion in behavioral health investments for children and youth under age 25. Unfortunately, the May Revision does not include a repeal of the Medi-Cal asset test, funding to build out housing support service capacity as part of CalAIM, or complete Health4All by adding adults ages 26-59.

Medi-Cal

  • The May Revision proposes to expand full scope Medi-Cal for adults 60 years and over regardless of immigration status, to be implemented no sooner than May 1, 2022. Health4AllElders is expected to cost $68 million ($50 million General Fund), fulfilling and building upon last year’s budget commitment of elders age 65+, and is expected to cover an additional 80,000 people. Trailer bill language (TBL) is forthcoming.
  • The proposal adds doula services as a Medi-Cal benefit to be implemented January 1, 2022 and includes $402,584 ($152,043 General Fund) in FY 2021-22 and approximately $4.4 million ($1.7 million General Fund) annually at full implementation. TBL is forthcoming.
  • The proposal adds Community Health Workers to the class of individuals who can provide Medi-Cal covered services to be implemented January 1, 2022 at a cost of $16.3 million ($6.2 million General Fund) in FY 2021-22 and increasing to $201 million ($76 million General Fund) by 2026-27.
  • The proposal includes one-time $315 million ($31.5 million General Fund) to provide population health management services as part of a CalAIM initiative that would centralize administrative and clinical data from the Department, health plans, and providers to better identify and stratify member risks and allow providers and beneficiaries to see what additional services are available.
  • The May Revision includes one-time $200 million ($100 million General Fund) to build capacity for effective pre-release care for justice-involved populations to enable coordination with justice agencies and Medi-Cal coverage of services 30 days prior to release.
  • The proposal includes an additional one-time budget allocation of $9.3 million to expand a current pilot that provides medically tailored meal intervention services to a broader population, which includes Medi-Cal participants with diabetes, chronic obstructive pulmonary disease, renal disease, chronic kidney disease, cancer, and malnutrition, and adds Fresno, Kings, Madera, Santa Cruz, and Tulare counties to the service area.
  • The proposal permanently ends the suspension of Medi-Cal benefits and provider rate funded through Medi-Cal and will have TBL. Specifically, the following will no longer sunset:
    • Optional benefits restored in the 2019 budget, specifically audiology and speech therapy services, incontinence cream and washes, eyeglasses and contacts, and podiatric services.
    • Supplemental provider payments and elimination of the AB 97 rate freeze.
  • The proposal expands accelerated enrollment to adults, ages 19 through 64, to provide immediate and temporary benefits while income verifications are pending at a cost of $14.3 million ($7.2 million General Fund) in FY 2021-22. Also see our earlier announcement of settlement in our Rivera Medi-Cal case.
  • The proposal revises its telehealth policy (TBL forthcoming) to set rates for audio-only telehealth at 65% of the Medi-Cal rate for the service rendered in fee-for-service, and comparable alternative to prospective payment system (PPS) rates for clinics. Only providers who can provide in-person services to each client served by synchronous and audio-only telehealth can claim Medi-Cal reimbursement for the service.
  • Federal funding from American Rescue Plan Act:
    • Medi-Cal eligibility extension from 60 days to 12 months for all postpartum individuals for 5 years.
    • Increased Federal Funding for Home and Community-Based Services (HCBS).
    • Increase in payments to disproportionate share hospitals of $1.1 billion ($105 million General Fund) in FY 2021-22.
    • Increased Substance Abuse and Mental Health Services Administration (SAMHSA) Block Grant Funding.
  • The proposal includes $5 million ($2 million General Fund) in FY 2020-21 and $18 million ($9 million General Fund) in FY 2021-22 to provide specialty mental health services to foster youth returning from out of state and other youth with similar level of needs that otherwise would have been placed out of state.
  • The May Revision proposes ending dental managed care and restoring dental fee-for-service in Sacramento and Los Angeles to be implemented January 1, 2022 for a savings of $20 million ($8 million General Fund.) TBL forthcoming.
  • The May Revision includes $4 billion investment in behavioral health services for children and youth, including:
    • Procuring a business services vendor to implement an all-payer behavioral health direct service and supports virtual platform to be integrated with screening, app-based supports, and direct behavioral health services for children and youth age 25 and younger.
    • Building infrastructure, partnerships, and capacity statewide to increase access to ongoing behavioral health prevention and treatment services on or near school campuses.
    • Grants to Support Development and Expand Age-Appropriate and Evidence-Based Behavioral Health Programs for Children and Youth.
    • Behavioral Health Continuum Infrastructure Program to provide competitive grants to qualified entities to construct, acquire, and rehabilitate real estate assets to expand the community continuum of behavioral health treatment resources funded at $2.455 billion over three years.
    • $50 million one-time provider training in FY 2022-23.
    • New Dyadic Services Benefit in Medi-Cal that provides integrated physical and behavioral health screening and services to the whole family funded at $200 million total ($100 million General Fund) ongoing.
  • The May Revision includes $12.6 million ($4.4 million General Fund) to reimburse specialty pharmacies for services provided to beneficiaries with complex drug therapies in the fee-for-service delivery system, effective July 1, 2021.
  • The May Revision includes one-time funding of $73 million ($36.5 million General Fund) in each of 2021-22 and 2022-23 to resume annual Medi-Cal redeterminations upon conclusion of the federal public health emergency and continuous coverage requirement.
  • The May Revision includes $300 million one-time federal fund to help public health hospitals cover costs associated with critical care delivery needs provided during and beyond the pandemic.

Other Health Proposals                                                  

  • The proposal includes $20 million ongoing to zero out $1 premium for health plans due to federal policy concerning abortion coverage.
  • The proposal sets aside $333.4 million in a Health Care Affordability Reserve Fund to deposit individual mandate penalty revenue in the event the federal subsidies are not extended, and to allow for future investment in Covered California subsidies for future affordability investments, but returns $732 million to the General Fund in unspent state subsidies.
  • The proposal includes $20 million one-time General Fund for language access services across Health and Human Services programs and builds upon January’s proposal to develop and implement an HHS-wide policy framework to improve language access standards across programs and services.

HOUSING & HOMELESSNESS

The Governor’s May revise increases funding for housing and homelessness programs to a grand total of $9.3 billion and $12.4 billion respectively. Building on Legislative efforts to keep Californian’s housed throughout the pandemic and protect renters from eviction, $5.2 billion have been assigned to bolster California’s Emergency Rental Assistance Program (ERAP) to pay 100% of retroactive and several months of prospective rent for Californian’s unable to pay their rent due to the pandemic.

Record unemployment and loss in hours and wages has left many Californians struggling to pay rent and utilities including water, power, and gas. In recognition of this hardship, the revise has allocated an additional $2 billion to cover the costs of utility bills. We commend this critical investment and urge the Governor and Legislature to continue to work with community and equity partners to improve the program and ensure the rollout of the funds is as quick as possible. We also implore the Governor and Legislature to critically examine and improve the HCD ERAP application so renters and landlords can receive the full benefits of the rental assistance program. We cannot take our foot off the pedal now.

The revise allocates $12.4 billion to combat the issue of homelessness in California, which has the highest number of people experiencing homelessness in the United States. The Governor’s proposal focuses on current state programs such as Project HomeKey, which focuses on the acquisition and rehabilitation of facilities for housing, and Project RoomKey which uses empty motels and hotels to provide temporary shelter during the pandemic for people experiencing homelessness.

Additional attention is given to encampment cleanup and safety inspections — we are concerned that the proposed partnership with CalTrans may encourage sweeps, and incorrectly targets trash cleanup as a priority instead of investing in the avoidable humanitarian crises at hand. We should focus our resources on ensuring that all Californians have access to safe, stable, affordable housing and target the root of the problem.

The revise also allocates $20 million a year for three years for legal services for those who are at risk of eviction. This minimal investment fails to recognize the increasing need for legal services, which was already severely underfunded. With eviction protections set to expire on June 30, 2021 and reports of a slow roll out of the rental assistance funding, there will be an eviction tsunami that the courts and legal services providers are simply not prepared or funded for. The revise also does not include any additional funding for the state to comply with the U.S Supreme Court decision, Jameson v. Desta, which is critical to ensuring that litigants have full access to their due process rights. Thus, the $20 million allocated by the Governor does not match the need from community.

Lastly, the revise includes funding for housing production, one of the main contributing factors in California’s housing shortage. Among other proposals, the Governor proposes $1.75 billion in one-time funding to support Housing and Community Development affordable housing projects, 6,300 of which are currently shovel ready.

In summary, the May Revise makes the following investments:

Rent and Housing Relief

  • $5.2 billion in federal rental relief aid for state and local entitlement jurisdictions from the U.S. Treasury.
  • $331 million in national mortgage settlement funds for mortgage assistance for homeowners.
  • $1 billion to the California Housing Finance Agency (CalHFA) for mortgage assistance and principal reductions.

Housing Production

  • $1.75 billion in one-time general funds to support Housing and Community Development affordable housing projects, 6,300 projects that are currently shovel ready.
  • $81 million in one-time funds to expand CalHFA’s Accessory Dwelling Units (ADU) program.
  • $45 million to scale up excess land development.
  • $500 million for Housing and Community Development to provide planning and implementation grants to regional entities for infill developments, the goal of which is to reduce vehicle miles traveled (VMT) and align with the state’s climate goals.
  • $300 million in one-time funds to sustain Housing and Community Development legacy project affordability requirements.

Homelessness

  • $3.5 billion in one-time funds for HomeKey program to acquire and rehabilitate more housing facilities.
    • $1 billion of this funding is dedicated to families experiencing or at risk of experiencing homelessness.
  • Project RoomKey Transition
    • The budget provides $150 million to help transition individuals from short term Project RoomKey housing into permanent housing. Trailer bill language is anticipated that would provide more information on how these funds are to be used.
  • $40 million one-time general fund available over five years to Homeless Coordinating Financing Council for grants and tech assistance to jurisdictions.
  • $53 million in one-time general funds to “coordinate encampment outreach services” with CalTrans to connect unhoused individuals with services.
  • $475 million in general funds in both 2021- 22 and 2022-23 to expand the existing CalWorks housing support program.
  • $280 million in general funds in both 2021-2022 and 2022-2023 to expand program which will provide housing related supports to eligible families experiencing homelessness in the child welfare system.
  • $100 million in general funds dollars in 2021 and 2021 to support access to health, safety, and housing support for people experiencing or at risk of Adult Protective Services involvement.
  • $20 million one-time funding for deferred maintenance for seasonal farmworker rental housing.
  • $175 in general funds annually through 2023-2024 for people with disabilities who are experiencing homelessness under the Housing and Disability Advocacy program.

Student Housing

  • $4 billion in one-time general funds split evenly for fiscal years 2021-20221 and 2022-23 to invest in the low-cost student housing grant program.
  • An increase of $130,000 for the Homeless Youth Project through the California State Library.

Homeownership

  • $100 million to expand CalHFA First Time Homebuyer Assistance Program.

PUBLIC BENEFITS

The pandemic exposed significant gaps in our state’s social safety net that leaves many Californians to fend for themselves as the federal, state, nor local governments were able to find solutions during the global pandemic. However, the pandemic also provided a chance to build from the current safety net. We are encouraged by proposals in the May Revise that advance the goal of building a permanent safety net that captures everyone who calls the golden state home.

Food Security

Efforts by the Governor to tackle hunger are appreciated, however, the state must go far beyond the investment laid out in the May Revise to truly address hunger for all Californians. Many Californians continue to lack access to food, so the Governor and Legislature must make an investment that significantly invests in providing emergency food to all Californians, regardless of their immigration status.

  • In January, Newsom put in $35 million one-time to food banks to provide emergency food assistance, but no additional funding is included in the May Revise.
  • We are advocating for $800 million in emergency food assistance to all Californians, a proposal championed by Assembly member Santiago and prioritized by the Latino Caucus. The Governor must do a lot in in this budget to truly make a make a significant dent on hunger.

Free School Meals

During the pandemic, we’ve seen success in providing every school aged child free grab and go meals throughout California — we applaud the Governor for prioritizing Universal School Meals in the May Revise for all students to access free breakfast and lunch. This is a critical program that tackles hunger for children who live in food insecure homes. We look forward to working with the Governor and Legislature to ensure that all children have access to free breakfast and lunch.

  • Governor’s proposal: $150 million ongoing Proposition 98 General Funds to encourage local educational agencies to participate in one of the federal universal meal provisions. The flexible language is questionable; however, we believe that we may see this as a competitive grant.

Food Distribution

Another result of the pandemic is the disruption of how food arrives to communities. The Governor’s proposal creates additional funding to get older Californians enrolled in the CalFresh program and allocates funding to direct California grown food to reach urban communities.

  • Governor’s proposal:
    • $2 million ($1 million from general fund) ongoing allocated to the Department of Aging for outreach to older adults to enroll in the CalFresh program.
    • $68 million (in addition to the $10 million in the January budget for a total of $78 million) one-time funding to increase access to California grown food in urban communities. The proposal heavily supports small and urban farmers.
    • The ideas and intentions for these proposals are good, but the lack of detail does not promise that food will be redirected to existing food deserts or other communities where produce is not readily available.

CalWORKs

The May Revise provides a 5.3 percent increase for CalWORKs grants, an increase from the January budget proposal of 1.5 percent. This will raise grants for all family sizes above 50 percent of the federal poverty level. However, this increase fails to complete the agreement to raise CalWORKs grants to assistance unit plus one which would ensure that no child receives a CalWORKs grant that is less than half the federal poverty level.

The chart below compares current grant levels, where grants would be if funded under the 2019 agreement, and what the grant would be under the Governor’s May Revise budget. We call on the Legislature to fully fund CalWORKs grants to AU+ 1.


One Time CalWORKs Payments

The budget proposes to use $203 million in federal TANF Emergency Pandemic funds to provide a $640 one-time payment to all CalWORKs households. This payment will be provided in July and will be the second payment CalWORKs families receive in 2022.

CalWORKs Family Re-Unification Funding

The budget proposes $8,776,000 ongoing to provide cash assistance to parents whose children have been removed from the home and placed in out-of-home care and who would not otherwise qualify for CalWORKs.

CalWORKs Overpayments

The budget proposes to reduce the monthly amount collected from CalWORKs grants where a family got a cash assistance overpayment during the pandemic due to delays in re-determining eligibility and grant levels. Currently, such overpayments take ten percent of the monthly grant; under this proposal, the reduction would be five percent of the grant amount. Western Center supports waiving all such overpayment collections.

CalWORKs Housing Support Program

The budget proposes a massive $475 million increase in funding for the CalWORKs Housing Assistance Program (HSP) in each of the next two years. This funding will be on top of the existing $90 million in funding for the program and will include statutory changes that may allow counties to serve households before they receive a three-day notice of eviction.

Golden State Stimulus II

The proposed budget includes $8.1 billion for an additional Golden State Stimulus (GSS) payment, including $600 payments for families earning up to $75,000 who did not already receive a GSS payment. The budget includes an additional $500 payment to families with dependent children making up to $75,000 and an additional $500 to ITIN filers that earn up to $75,000 and have a dependent. This would bring the total investment in the GSS to $11.9 billion when combined with the earlier funding provided in February.

We support the Governor’s providing an additional state stimulus that includes ITIN holders, however, barriers remain for providing pandemic relief to undocumented Californians who lack an ITIN, Californians who do not file taxes because they do not make enough in earnings, and those most in need who are currently enrolled in public benefit programs, including General Assistance recipients.

Guaranteed Basic Income Pilot

The budget proposes to provide $35 million to cities and counties to establish guaranteed basic income pilot programs. Western Center supports this as a solid step toward providing people with low incomes more economic autonomy and dignity.

SSI/SSP

The budget proposes a 6.4 percent increase in the SSP portion of the grant for individual SSI recipients only. This would increase the overall grant amount by approximately $10 a month beginning January 1, 2022. This is the first SSP grant increase since at least 2008 (the 2017 increase was a one-time COLA) but falls far short of the level needed to restore the SSI/SSP grant to the federal poverty level. When combined with the anticipated federal cost of living adjustment, SSI grants for individuals would rise from $954 a month to $998 a month.

Housing Disability Advocacy Program

This program provides grants to counties to assist homeless individuals to apply for SSI and to provide housing while the application is pending. The budget proposes to increase funding by $175 million over each of the next two budgets for HDAP. The budget also proposes to eliminate the requirement that counties collect interim assistance payment reimbursements.

Immigration Programs

The budget proposes $20 million in one-time funding to provide additional support for Unaccompanied Undocumented Minors (UUMS) through the Opportunities for Youth pilot project and UUM legal services.

Deferred Action for Childhood Arrivals (DACA) and Naturalization Filing Fees: The budget provides $25 million for immigration services for work on behalf of clients involved in federal DACA status.

 

 

 

Statement on Governor Gavin Newsom’s May Revision of California’s 2021-2022 Budget

Over the past year, millions of Californians experienced the most devastating pandemic and economic downturn in nearly a century. The cumulative impact of COVID-19 has caused financial devastation and a prolonged period of wealth and asset stripping from Californians unlike anything in recent memory.

With that in mind, we see today’s budget proposal by the Governor as a mixed bag. While it includes notable investments in homelessness and housing funding and health care, it falls short in meeting the existing needs of Californians with low incomes. Doing so would include providing health care for ALL, restoring decade-old cuts to grants for SSI recipients, ensuring CalWORKs families have enough income to allow children to thrive, and helping those who are in debt and threatened with eviction due to the pandemic receive justice. The $76 billion budget surplus is more than adequate to meet those needs, and we call on the Legislature to revise the Governor’s budget proposal to ensure that families with low incomes receive a truly historic investment.

Western Center will release its full, detailed analysis of the Governor’s May Budget Revision on Monday, May 17, 2021.