Newsom’s budget prioritizes CalAIM and behavioral health, organizations have mixed responses – State of Reform

On January 10, Governor Gavin Newsom released his proposed budget for fiscal year (FY) 2022-23, proposing a total of $217.5 billion for all health and social service programs. This includes $93.5 billion in general funds, 52.4% of which is assigned to the Department of Health Care Services (DHCS) for Support many DHCS initiatives and services related to behavioral health, CalAIM programs, health equity, and the COVID-19 response.

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Below is a breakdown of general fund allocations.

Image: California Governor’s Budget 2022-23

Here are some budget highlights we will be watching:

  • Total funds of $2.8 billion in 2022-23, total funds of $2.4 billion in 2023-24 and total funds of $1.6 billion in 2024-25 are dedicated to CalAIM Initiatives. Total funds of $50 million are specifically allocated to implement CalAIM justice-related initiatives. This funding includes resources to support the design and launch of these initiatives that aim to provide key services to incarcerated individuals (90 days prior to release) by enrolling them in Medi-Cal coverage and connecting them to health behaviour, social services and other providers. who can support their reintegration.
  • The proposed budget understand $819.3 million in total funds in 2023-2024 and $2.7 billion annually for expand full Medi-Cal eligibility to all income-eligible adults between the ages of 26 and 49, regardless of immigration status.
  • To fund the new Providing Access and Transforming Health (PATH) initiative, which aims to support communities that have been historically underserved, Newsom is requesting total funding of $1.3 billion over five years for PATH to support the development of improved care management and Community supports in CalAIM, as well as $561 million to support the implementation of CalAIM’s justice-related initiatives.
  • Total funds of $400 million are proposed for payments for equity and practice transformation intended to provide resources to eligible Medi-Cal providers to help them close health equity gaps, close gaps in preventive, maternity, and behavioral health care measures, and close gaps in care resulting from the COVID-19 public health emergency.
  • The budget also includes total funds of $20 million in 2022-2023 and total funds of $24 million ongoing to eliminate Assembly Bill 97 payment reductions for nurses, respiratory care providers, alternative birth centers and other providers.
  • As a member of Child and Youth Behavioral Health Initiativethe proposed budget includes $87 million in total funds to implement dyadic services, $429 million in evidence-based behavioral health practices, $450 million in total funds for partnerships and health capacity. Behavioral Health Services and $230 million in total funds for the Behavioral Health Services and Supports Platform and related online counseling service and provider training.
  • Total funds of $53 million in 2022-23 and total ongoing funds of $18 million, along with follow-up bill wording, are included to zero premiums for services under the Children’s Health Insurance Program (CHIP) and the 250% disabled people program.
  • DHCS Receives Total Funding of $1.5 Billion to behavioral health bridging housing that will address the immediate housing and treatment needs of homeless people with severe behavioral health issues. This support will include the installation of mini-houses and assisted living facilities.
  • Mobile crisis services are also being funded in the proposed budget, with total funds of $108 million for the addition of 24/7 Community Mobile Crisis Response Services as a mandatory Medi-Cal benefit for eligible recipients statewide beginning January 1, 2023. This benefit will be implemented through county behavioral health service delivery systems.
  • Total funds of $96 million will go towards the expansion of the Medication Assisted Treatment (MAT) program for people struggling with opioid abuse.
  • DHCS Receives Total Funding of $304 Million for the Renewal of the Waiver of Home and Community Alternatives (HCBA). This waiver renewal will implement several changes, including the expansion of the community transition service and the addition of assistive technology as a new waiver service.
  • Funds totaling $12 million will be allocated to restore funding for Local Assistance Grants in the Indian Health Programwhich will be distributed to 45 tribal and urban Indian health clinic companies through a competitive grant program on a “needs” and “performance” based basis.
  • Newsom is allocating total funds of $11.1 billion for Response to the COVID-19 pandemic for the 2022-2023 fiscal year, encompassing ongoing medical coverage requirements, testing in schools, vaccine administration, and funding for county redeterminations.

The California Association of Health Plans (CAHP) said it strongly supports the governor’s legislative priorities, particularly expanding Medi-Cal coverage for undocumented Californians.

“CAHP supports the extension of health care coverage to all Californians, regardless of immigration status. The Governor’s commitment to expand Medi-Cal to remaining uninsured undocumented Californians of all ages is a historic step toward achieving universal coverage in California. With 94% of Californians currently covered, this will bring us closer than ever to closing the uninsured gap forever. »

CAPE also declared its support for inclusive funding for CalAIM initiatives.

Our Medi-Cal Managed Care Plans look forward to working with the Department of Health Services on implementing this innovative program designed to address complex health needs, reduce health disparities and improve health outcomes. for the most vulnerable in our state.

However, several community-based organizations (CBOs) have expressed disappointment with Newsom’s failure to directly allocate funds to CBOs, clinics and tribal organizations. In particular, they are disappointed that the Governor has allocated no funding to establish the Health Equity and Racial Justice Fund.

The co-sponsors of the Health Equity and Racial Justice Fund said:

“Today we expected no less than $100 million to be contributed to our historic, bold and innovative fund… The proposals in the budget continue to be top-down, with the administration prescribing both the problems and solutions. This approach has failed to eliminate health disparities. Community organizations, clinics and tribal organizations… are at the forefront of addressing racial and health disparities on the State data does not always reflect local data and specific local needs, which community organizations, clinics and tribal organizations are directly linked and informed about.”

The California Pan-Ethnic Health Network also criticized Newsom’s failure to directly fund community organizations:

“California continues to invest in addressing the symptoms of racial and economic inequality, without resourcing or funding communities to address the root causes. Government funds health care when people get sick and go to hospital, but does not pay for what makes them sick. The places where people live, work and play are riddled with the impacts of redlining, segregation and centuries of disinvestment and exclusion.

… With another surplus, projected at $45.7 billion, California has more than enough resources to address both health equity and racial justice. What we lack year after year is the political will to directly fund anti-racism work. We are disappointed that the Governor’s proposed budget excludes continued funding for community organizations, clinics and tribal organizations to fight racial equity.

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