“Linda Nguy, a policy advocate with the Western Center on Law and Poverty, said it would be difficult to pass the bill if funding for it isn’t included in this year’s state budget. Funding for this proposal was not included in the governor’s May revision of the budget.”
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.
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
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.
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.
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.
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.
- 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.
For questions contact:
- Housing & Homelessness:
- Health Care:
- Linda Nguy, Policy Advocate – [email protected]
- Public Benefits/ Access to Justice:
$600 a month. Imagine living on that in an expensive state like California. That’s exactly what the state requires older adults and people with disabilities to do in exchange for health care through Medi-Cal. This year, the California Legislature and Governor Newsom must change that. Health care is one of the most expensive basic needs in our society — any commitment by state leaders to address inequality must include health care.
AB 1900 by Assembly member Arambula and co-author Assembly member Wood, which Western Center is co-sponsoring with Justice in Aging, Bet Tzedek Legal Services, Disability Rights California, Senior & Disability Action, and California Advocates for Nursing Home Reform, will address the problem by increasing the amount of monthly income older adults and people with disabilities can keep for basic needs.
Currently, elders and people with disabilities with incomes below $1,564 a month qualify for free Medi-Cal. But low-income older adults and people with disabilities who are just a $1 over the limit are required to pay over $900 of their monthly income as a share-of-cost.
The share-of-cost works like a health insurance deductible, but resets on a monthly basis. This Medi-Cal program establishes a monthly amount that older adults and people with disabilities are allowed to keep to meet their basic needs, called the maintenance need income level. The rest of their income must go toward health care expenses. The maintenance need income level of $600 hasn’t been changed since 1989, even though it is nearly impossible for anyone in California to live on $600 a month now.
By increasing the amount of monthly income older adults and people with disabilities can keep for their basic needs — up to 138% of the federal poverty level (the Medi-Cal income level for nearly all adults), AB 1900 ensures that older adults and people with disabilities don’t have to wait another 30+ years for an adjustment since the federal poverty level is updated every year.
Most people with low incomes receive their health care for free or pay up to 8.5% of their income on health care coverage. It is unfair that older adults and people with disabilities are the only population forced to pay over 60% of their income to obtain essential health care. The current policy forces aging adults, people with disabilities and their families to make impossible choices between health care, paying rent, and affording food. When people cannot access needed Medi-Cal services they often end up hospitalized or institutionalized, or forced to rely on already stretched family members to provide unpaid care.
Ten other states have higher maintenance need income levels than California. It’s time to ditch the deductible and lead the nation in health care affordability. State leaders must fund AB 1900 in this year’s state budget.
Western Center’s policy advocates are hard at work in Sacramento to pass this year’s slate of bills to make California better for everyone. Here is our full 2022 Legislative Agenda.
(co-sponsored with Housing California, Corporation for Supportive Housing, Californians for Safety and Justice, People Assisting the Homeless (PATH), and Los Angeles Regional Reentry Partnership)
This bill will establish a funding source for permanent affordable housing and workforce development for formerly incarcerated people at risk of or currently experiencing homelessness. The bill is necessary to support people reentering society after incarceration to reduce recidivism and homelessness – 70 percent of Californians experiencing homelessness have a history of incarceration.
(co-sponsored with Coalition of California Welfare Rights Organizations)
This bill will make significant improvements in the CalWORKs Homeless Assistance Program (HAP) to minimize homelessness that CalWORKs families experience by repealing the limitations for receiving assistance through HAP. HAP is meant to assist families who have become unhoused and need immediate assistance. It is Western Center’s firm belief that families should not be burdened with additional program requirements to receive critical assistance for the health and safety of their family.
(co-sponsored with California Rural Legal Assistance Foundation and the Public Interest Law Project)
There are upwards of 160,000 people experiencing homelessness in California, and 72% are completely unsheltered. While some California localities provide enough shelter beds, in others, there are either no shelter beds or only a small number. AB 2339 strengthens housing element law to ensure that zones identified for shelters and other interim housing are suitable and available. The bill also requires jurisdictions to demonstrate sufficient capacity on the sites to meet the identified need for interim housing for those experiencing homelessness.
(co-sponsored with California Partnership to End Domestic Violence, Crime Survivors for Safety and Justice, Dr. Beatriz Maria Solis Policy Institute – Women’s Foundation of California, Family Violence Appellate Project)
This bill allows domestic violence survivors who are tenants to maintain their current housing and avoid eviction by expanding allowable documentation for lease termination policies, allowing survivors to use eviction protections when the abusive person is on the lease but no longer residing in the residence, and by allowing survivors who live with an abusive person to remain in the unit on the same lease terms while removing the abusive person.
While not a bill, Western Center and California Rural Legal Assistance Foundation are working to obtain an extension of the current eviction protections implemented in response to the pandemic. To prevent mass evictions, displacement, and economic instability, the state must extend these protections as hundreds of thousands of tenants wait for rental assistance from the state’s Emergency Rental Assistance Program.
(co-sponsored with California Housing Partnership, California Coalition for Rural Housing, Non-Profit Housing Association of Northern California and San Diego Housing Federation)
AB 1911 creates an Affordable Housing Preservation Tax Credit to support the preservation of tens of thousands of affordable housing units at risk of converting to market rate housing or displacing low-income tenants. California cannot afford to lose tens of thousands of affordable housing units in the midst of our current housing crisis. A targeted tax credit that encourages property owners to sell to affordable housing developers committed to long-term affordability would allow thousands of lower-income households to stay in their homes.
(co-sponsored with California Rural Legal Assistance Foundation, Inner City Law Center, Leadership Council, Regional Asthma Management and Prevention (RAMP)
AB 2597 will address a long-standing issue that is rapidly exacerbated by human-induced climate change: the safety of renters in their homes when outdoor temperatures rise. Excessive heat has a negative impact on health and quality of life and leads to an increasing number of deaths. State law has long required that rental units be able to maintain a safe indoor air temperature when it’s cold outside, but there is no analogous requirement that applies when the weather is hot. This gap leaves many renters living in homes that reach unhealthy and often dangerous temperatures indoors and disproportionately impacts low-income households and people of color. AB 2597 will update the state’s habitability standards to ensure that all rental units have a means of maintaining a safe indoor air temperature regardless of the temperature outside.
(co-sponsored with California Rural Legal Assistance Foundation)
This bill cleans up loopholes in AB 1482, California’s first statewide just cause eviction protection and anti-rent gouging law. Since AB 1482 was enacted in 2019, several key loopholes (owner move-in, substantial renovation, and intent to remove the unit from the rental market) have been exploited by landlords attempting to evict vulnerable tenants. This law will require owners attempting to evict tenants for owner move-in to move into the unit within 90 days and stay at the unit for a minimum of three years. For owners attempting to evict based on substantial renovation, it will require owners to obtain the necessary permits for the renovations and justify why the improvements cannot be completed with the tenants in place. For evictions based on withdrawal from the rental market, the owner will be required to clearly explain in the notice to the tenant what the alternative use of the property will be and the necessary permits to convert the unit to the intended use. If the landlord does not meet those conditions post eviction, the tenant has the right to rent the unit under the previous terms of the agreement.
SCA 2 (Allen, Wiener): Public Housing Projects – Two-year bill
(co-sponsored with California Rural Legal Assistance Foundation, California Coalition for Rural Housing, California Housing Consortium, California Housing Partnership, California Association of Realtors, California YIMBY, Housing California, Nonprofit Housing Association of Northern California, and Southern California Association of Nonprofit Housing)
SCA 2 will place the repeal of Article 34 of the California Constitution on the ballot. Passed by voters in 1950, Article 34 requires a majority approval by the voters of a city or county for the development, construction, or acquisition of publicly subsidized housing. For decades the requirement has stifled the development of subsidized housing creating and perpetuating racially and economically segregated communities. The passage of SCA 2 would give voters an opportunity to eliminate an obstacle, enshrined in our Constitution, which currently undermines the ability to address California’s acute housing and homelessness challenges.
AB 470 (Carrillo): Eliminating the Non-MAGI Assets Limit – Two-year bill
(co-sponsored with Justice in Aging)
This bill will clean up code for when the Medi-Cal assets test is eliminated on January 1, 2024, following the 2021 budget agreement that also raises the asset limits effective July 1, 2022.
AB 1355 (Levine): Expanding Independent Medical Review – Two-year bill
This bill will ensure more fairness in the Medi-Cal appeals process by expanding Independent Medical Reviews to all Medi-Cal members and services, and by standardizing the process state departments must follow when alternating judges’ decisions in fair hearings. Independent Medical Reviews use medical professionals with expertise in the medical service at issue, resulting in more favorable and clinically sound outcomes for patients than plan appeals and state fair hearings.
(co-sponsored with Bet Tzedek, California Advocates for Nursing Home Reform, Disability Rights California, Justice in Aging, and Senior and Disability Action)
This bill will make the Medi-Cal Share of Cost program more affordable by updating the maintenance need levels to 138% of the federal poverty level. Today, older adults and people with disabilities who are just $1 over the free Medi-Cal limit are forced to pay over $800 of their monthly income on health care and are expected to survive on just $600—the maintenance need level—to pay for rent, food, utilities, and all other expenses.
(co-sponsored with Children Now)
Medi-Cal premium requirements place an undue economic burden on families already living on very limited incomes and create barriers in access to care and unnecessary breaks in coverage for eligible individuals. This bill will ensure pregnant people, children, and people with disabilities can access the health care services they need to stay healthy by eliminating their monthly Medi-Cal premiums.
(co-sponsored with Health Access and California Pan-Ethnic Health Network)
This bill will require the Employment Development Department (EDD) to share with Covered California contact and income information about people who have recently applied for or lost unemployment, state disability insurance, paid family leave, and other EDD programs. This will allow Covered California to reach out and help enroll individuals in Medi-Cal or Covered California.
(co-sponsored with Break The Binary LLC, California LGBTQ Health and Human Services Network, California TRANScends, Equality California, Gender Justice LA, National Health Law Program, Orange County TransLatinas, Queer Works, Rainbow Pride Youth Alliance, San Francisco Office of Transgender Initiatives, The TransPower Project, TransCanWork, Trans Community Project, Transgender Health and Wellness Center, Tranz of Anarchii INC, Unique Woman’s Coalition (UWC), and Unity Hope)
This bill will improve access to gender affirming care for transgender, gender non-conforming, and intersex (TGI) people by mandating health plans require TGI cultural competency training for contracted providers, their staff, and the staff of health plans. It would also require plan provider directories to identify providers who offer gender affirming services.
(co-sponsored with Loyola Law School, SJI Anti-Trafficking Policy Initiative)
California has one of the highest rates of human trafficking in the nation, yet only two state agencies, the Department of Justice and the Department of Fair Employment and Housing, are responsible for prosecuting human trafficking cases. This bill will provide the Department of Industrial Relations with statutory authority to investigate and prosecute claims of human labor trafficking. This a priority for Western Center because many workers who are victims of labor trafficking are exploited because of poverty.
(co-sponsored with Coalition of California Welfare Rights Organizations)
The pandemic has impacted the timeliness with which some children can complete high school. This bill will allow children receiving CalWORKs to obtain aid until age 20 if they are attending their last year of high school.
(co-sponsored with Legal Aid at Work, Women’s Foundation of California, and WorkSafe)
This bill will expand good cause exemptions for the CalWORKs welfare to work program to allow parents with children under two years old not to participate in welfare to work for up to 12 months. This bill incorporates many legal protections created by the legislature, like the Crown Act and domestic worker protections, into CalWORKs.
(co-sponsored with Coalition of California Welfare Rights Organizations)
This bill will remove barriers for accessing the CalWORKs program – a critical social service that assists families in financial need, by waiving program requirements for survivors of domestic violence. Currently, counties have the authority to waive CalWORKs program requirements for survivors of domestic violence. However, despite their ability to do so, many counties do not. This bill will require counties to waive the requirements.
(co-sponsored with Coalition of California Welfare Rights Organization)
This bill will eliminate the eligibility requirement for CalWORKs families to prove that they have less than $10,211 in their possession, and the 100-hour rule which requires parents to work no more than 100 hours to qualify for the program. Removing these archaic requirements will ensure that all eligible CalWORKs families can access the social service.
(co-sponsored with Coalition for Humane Immigrant Rights (CHIRLA), Community Power Collective, Inclusive Action for the City, Insurance Commissioner Ricardo Lara, Public Counsel)
Street vendors are a part of California’s culture and have been for decades. In recent years, street vendors became part of the formal economy with the decriminalization of street vending in 2018. However, many street vendors who sell food are unable to obtain health permits from their local county health departments, so this bill will modernize the California Retail Food Code to reduce barriers for street vendors to obtain local health permits. Creating this pathway will allow street vendors to further enter the formal economy and put an end to fines issued to these entrepreneurs with limited incomes.
This bill will reduce the interest rate on unpaid debt from 10 percent annually to 3 percent annually. New York became the first state to reduce the interest rate on debt and California should follow the example.
ACCESS TO JUSTICE
Grand Juries play a critical role in the lives of Californians involved in the legal system — particularly people of color and those living in poverty who are over-policed. Currently, juries are disproportionately made up of retirees who can afford to take time off to serve. AB 1972 will diversify grand juries in California so they are representative of their populations and will ensure people are fairly compensated when they serve so jury duty is more accessible for Californians with low incomes.