Disability Rights California’s Summary of the 2023-24 State Budget
Disability Rights California’s Summary of the 2023-24 State Budget
Governor Newsom has signed the California budget for 2024. The 2023-24 budget includes total spending of $310.8 billion with a focus on protecting core programs. The Budget covers a $31.7 billion deficit with a combination of funding delays, fund shifts, and some reductions. A summary of the enacted budget can be found at https://ebudget.ca.gov/budget/2023-24EN/#/BudgetSummary
In the infrastructure package, leadership reached agreements that include ways to focus on equity by ensuring that the most vulnerable communities will be hired first on impactful state infrastructure projects.
The Legislature and Governor maintained spending in education. Families who have lower incomes and receive state subsidies to pay for child care would see a near-elimination of copayments known as “family fees” under the budget bill agreement. These fees can potentially be hundreds of dollars a month. The Budget includes $1 million for the California Department of Education to form an independent task force that would compile a list of screening tools used to test students for difficulties with reading. California is currently one of ten states that doesn’t screen all students for dyslexia, despite having a governor who’s been outspoken about his past struggles with the learning disability.
The Budget includes an additional $1 billion to the Homeless Housing, Assistance, and Prevention (HHAP) Program. Collectively the state has allocated nearly $21 billion to housing and homelessness since 2018-19 but has failed to provide ongoing funding.
CARE Court Implementation begins on October 1. The Budget includes close to $130 million for implementation this year with higher amounts in out-years. DRC will monitor implementation closely.
Other important pieces of the Budget include health care victories, including Covered California for consumers, and the creation of an Employment First Office to coordinate Employment First policies across state agencies to support employment opportunities for individuals with intellectual and/or developmental disabilities.
DRC is also pleased to see the final budget includes $60.7 million ($27.9 million General Fund) ongoing investment in IHSS to better serve minor recipients and their families, a priority issue for DRC. This investment will help resolve access to services for a number of our minor clients, including kids with undocumented parents who will now be able to hire a non-parent provider.
While this year’s Budget is far from perfect in a number of areas that DRC cares about, we appreciate that this is a difficult financial time for the state, and keeping most of our highest priorities from falling through the cracks was vital in this year’s budget.
The following are some of the key items in the final budget agreement impacting persons with disabilities and the programs that assist them:
Table of Contents
- CARE Act Community Assistance, Recovery & Empowerment (CARE) Act
- Department of Developmental Services (DDS)
- Department of State Hospitals (DSH)
- Emergency Response
- Foster Care
- Health and Human Services
- Homelessness and Housing
- In-Home Supportive Services (IHSS)
- Mental Health
- Public Safety
- Supplemental Security Income / State Supplemental Program
Advancing Older Adult Behavioral Health
$20 million General Fund in 2023-24, $20 million General Fund in 2024-25, and $10 million General Fund in 2025-26 at the California Department of Aging to support the continuation of the Older Adult Friendship Line, a targeted ethnic media campaign for older adults, and competitive grants to local jurisdictions to build organizational capacity to identify and address older adult behavioral health and substance use disorder needs.
Mello-Granlund Older Californians Act Modernization Pilot Program
$37.2 million General Fund annually across five years starting in 2022-23 for pilot programs supporting community-based services programs, senior nutrition support, family and caregiver supports, senior volunteer development, and/or aging in place. This reflects $186 million General Fund spent over five years instead of three years as originally planned in the 2022 Budget Act.
Home and Community-Based Services (HCBS) Spending Plan Extension
The Budget includes an extension for all HCBS initiatives to fully spend allocated funding until December 31, 2024.
CARE Act Community Assistance, Recovery & Empowerment (CARE) Act
CARE Act implementation begins October 1 with the first of two cohorts of counties (Glenn, San Diego, San Francisco, Tuolumne, Stanislaus, Orange and Riverside). The remaining counties must begin implementation by December 1, 2024; Los Angeles has announced its intention to begin this year on December 1.
The Budget provides funding for the CARE Act in two buckets. All funding is from the General Fund:
- Department of Health Care Services – the Budget provides funding for county behavioral health costs of $67.3 million in 2023-24, $121 million in 2024-25, and $151.5 million in 2025-26 and annually thereafter. The Budget also includes $15 million of one-time funding for Los Angeles County’s early implementation.
- Judicial Branch - The Budget includes $55.5 million General Fund in 2023-24, $107 million in 2024-25, and $133 million in 2025-26 for the Judicial Branch. Of these amounts, $32.7 million in 2023-24, $55.3 million in 2024-25, and $68.5 million ongoing is for administration of the program. The remaining $22.8 million in 2023-24, $51.7 million in 2024-25, and $64.5 million ongoing will support public defender and legal service organizations to represent individuals against whom a petition is filed.
Department of Developmental Services (DDS)
The Department of Developmental Services (DDS) budget includes several changes:
- Access to Social Recreation Services, Camping Services, and Non-Medical Therapies — The Budget clarifies previous language in order to facilitate access to social recreation and camping services. The new language aims to prevent barriers such as co-pays or policies requiring that consumers exchange other types of service hours. These changes take effect July 1, 2023.
- Employment First Office — The Budget creates a new office in Cal HHS to coordinate Employment First policies across multiple state agencies, including DDS and DOR. The Employment First Office aims to close gaps and reduce administrative burden for people with I/DD seeking employment. This change will take effect July 1, 2024.
- Service Provider Rate Reform: Independent Living Services — $15 million ($8.5 million General Fund) in 2023-24 and $60 million ($34 million General Fund) in 2024-25 and ongoing to adjust Independent Living Services rate assumptions to be comparable to similar occupations.
- Regional Center Consistency — $7.8 million one-time ($6.2 million General Fund) to support statewide efforts at standardizing certain procedures across the 21 regional centers: initial intake, IPP, and vendorization.
- Access to Generic Resources — The Budget clarifies that when an IPP or IFSP determines a medical service necessary, the regional center will pay for that service if the service is not available through a generic resource (Medi-Cal or private insurance) within 60 days.
- Coordinated Family Support Services — $18 million one-time ($10.8 million General Fund) to continue funding the Coordinated Family Support pilot program through June 2024.
Department of State Hospitals (DSH)
DSH funding increased by $332.3 million (12%) to $3.4 billion. Recent data places the waitlist for Incompetent to Stand Trial beds at 895, with 167 of those receiving early stabilization services.
The 2022 Budget provided a multi-year approach to incrementally require State Preschool Program providers to serve at least 10 percent students with disabilities over the 2022-25 fiscal years. The Budget delays increased funding for this effort by two years.
Revises the family fee schedule for the State Preschool Program to limit family fees to one percent of a family’s monthly income, and prohibit the assessment of a fee for families with an adjusted monthly income below 75 percent of the state median income.
Forgives State Preschool Program family fee debt that accrued but remained uncollected prior to October 1, 2023.
Delays $550 million for the Preschool, Transitional Kindergarten (TK), and Full Day Kindergarten Facility Grant program to 2024-25.
Requires Local Education Agencies (LEAs) that have contracted with third-party providers to operate expanded learning opportunity programs and California State Preschool programs to submit program information to the Department of Education (CDE) and the Department of Social Services (DDS).
Universal Transitional Kindergarten
The Budget makes the following changes to TK programs:
- Requires TK classrooms to maintain 1 adult to 10 students in 2025-26.
- Allows LEAs to enroll children whose fourth birthday falls between June 2 and September 1, or early enrollment children, as long as pupil to teacher ratios are maintained.
- Imposes fiscal penalties if the ratio or class size requirements are not met for TK classrooms that include the early enrollment children.
The enacted budget fully funds the Local Control Funding Formula (LCFF) and funds an 8.22 percent cost-of-living-adjustment, using a total of $1.7 billion in one-time funds to pay for LCFF costs in the 2022-23 and 2023-24 fiscal year.
Provides $80 million ongoing to support county court and community school operations, include declining enrollment protections, and to establish the Student Support and Enrichment Block Grant.
Budget delays $1.1 billion of funding for the Learning Recovery Emergency Block Grant through the 2027–28 school year. This grant provides tutoring, additional instructional time, early literacy intervention, biliteracy and accelerating English language development.
Appropriates $250 million to expand the Literacy Coaches and Reading Specialists Grant Program and makes clarifying amendments to the existing program.
Universal School Meals
The enacted budget maintains funding for free breakfast and lunch to all K-12 students during the academic year, and free lunch during summer break. Pending legislation seeks to extend free school lunches to parents/guardians of pupils during summer break, and permit pupils to purchase additional meals if requested.
The enacted budget reduces the appropriation for the School Facility Program from $4.2 billion to $4.1 billion General Fund.
Extends the moratorium on the creation of new single-district Special Education Local Plan Areas (SELPAs) by two years to June 30, 2026.
Limits the amount of additional funding that SELPAs are allowed to retain for non-direct student services before allocating special education base funding to member LEAs.
Convenes an Individuals with Disabilities Education Act workgroup to provide recommendations related to county court and community schools.
The enacted budget continues funding and implementing dyslexia screenings. Specifically, the Budget requires:
- An expert panel to approve a list of screening instruments to assess pupils in kindergarten through second grade for risk of reading difficulties and appropriates $1 million for this.
- Requires LEAs serving pupils K-2 to screen pupils for risk of reading difficulties using the instruments they will adopt from the approved list by 2026.
Appropriates $7 million one-time Proposition 98 General Fund to provide support for local educational agencies opting to implement the Restorative Justice best practices that will be developed and posted on the CDE website by June 1, 2024.
Maintains the multi-year compact with the University of California (UC), California State University (CSU), and California Community Colleges (CCC) which increases funding with the condition of expanding student access, equity, and affordability. The increases in funding are as follows:
- UC will receive an increase of $215.5 million ongoing,
- CSU will receive an increase of $227.3 ongoing, and
- CCC will receive $26.4 million ongoing for enrollment growth.
See Foster Youth section below for additional higher education funding proposals.
The Office of Emergency Services (Cal OES) serves as the state’s leadership hub during emergencies and disasters. This includes responding, directing and coordinating local, state and federal resource and mutual aid assets across all regions of the state. The state is still remaining prepared for Extreme Heat, which can result in wildfires and smoke, energy blackouts etc.
The state is dedicating the following funds:
- $135.5 million General Fund over two years to support local agencies working to reduce urban flood risk.
- $40.6 million General Fund and bond funds ongoing to Delta projects that reduce risk of levee failure and flooding, provide habitat benefit and reduce the risk of saltwater intrusion contaminating water supplies.
- $25 million General Fund to support projects that will reduce the risk of flooding for Central Valley communities and contribute to ecosystem restoration and agricultural sustainability.
Student Success Completion Grant Program
Provides a grant of $5,250 per semester for specified current and former foster youth at the community colleges.
Middle Class Scholarship Program
Provides an additional one-time $289 million to expand eligibility for Middle Class Scholarship Program awards to UC and CSU students who are current or former foster youth.
Housing Supplement for Foster Youth in Supervised Independent Living Placements (SILPs)
Provides $909,000 in first-year funding to implement a housing supplement for foster youth living in SILPs at an ongoing cost of $25.5 million beginning in 2025-26.
Foster Family Agency Bridge Funding
The Budget provides $10.1 million one-time to increase rates paid to foster family agencies.
Health and Human Services
Managed Care Organization Provider Tax
The Budget reflects a new Managed Care Organization (MCO) Provider Tax effective April 1, 2023 through December 31, 2026. The MCO tax provides a benefit of $19.4 billion in funding to the state over the period of the tax, resulting in a total of $8.3 billion to support the Medi-Cal Program and achieve a balanced budget and $11.1 billion Medi-Cal Provider Payment Reserve Fund to support investments in Medi-Cal that maintain and expand access and quality of care. Specifically, these funds will:
- Preserve eligibility and benefit expansions in the Medi-Cal program;
- Strengthen Medi-Cal’s foundation by providing long-term certainty for provider rate increases to drive greater Medi-Cal provider participation especially in underserved areas and in primary and preventive care and advance equity in the Medi-Cal program; and
- Maximize opportunities to draw additional federal matching funds to the Medi-Cal program.
Medi-Cal Provider Payment Reserve Fund
The Budget includes the following investments supported by the Medi-Cal Provider Payment Reserve Fund:
- Rate Increases in the Medi-Cal Program—$237.4 million ($98.2 million Medi-Cal Provider Payment Reserve Fund) in 2023-24 and $580.5 million ($240.1 million Medi-Cal Provider Payment Reserve Fund) annually thereafter to increase provider rates to at least 87.5 percent of Medicare for primary care (including those provided by physicians or nonphysician health professionals); maternity care (including doulas); and non-specialty mental health services, effective January 1, 2024.
- Future Targeted Rate Increases and Investments—As part of the 2024-25 Governor’s Budget, the Administration will return with a subsequent set of targeted investments to support the Medi-Cal program. The targeted investments which are anticipated to be effective January 1, 2025 will be designed to further advance access, quality, and equity for Medi-Cal beneficiaries and promote provider participation in the Medi-Cal program. Specifically, in addition to the primary care, maternity care, and non-specialty mental health rate increases effective January 1, 2024, DHCS will submit detailed proposals for rate increases and investments in services and supports in primary care, maternity care, and non-specialty mental health services, specialty care services, community or hospital outpatient procedures and services, family planning services and women’s health providers, hospital-based emergency and emergency physician services, ground emergency transport services, designated public hospitals, behavioral health care for members in hospital/ emergency departments and institutional long-term care settings, and investments to maintain and grow the health care workforce.
Other Significant Adjustments
- Designated State Health Program — In 2023-24 through 2026-27, for total General Fund savings of $646.4 million, from the Designated State Health Program funding to cover Providing Access and Transforming Health Initiative costs.
- Indian Health Program — $11 million General Fund in 2023-24, for total funding of $23 million General Fund in 2023-24, and $23 million ongoing General Fund for the Indian Health Program, which provides grants to improve the health status of American Indians living in urban, rural, and reservation or rancheria communities throughout California.
- Pediatric Subacute Facilities — $836,000 General Fund in 2023-24 and $227,000 General Fund in 2024-25 to maintain reimbursement rates at 2022-23 fiscal year levels for freestanding pediatric subacute facilities.
- Reproductive Health Services 1115 Waiver — $200 million ($15 million General Fund) in 2024-25 for a one-time grant program through an 1115 federal demonstration waiver focused on supporting access to family planning and related services, system transformation, capacity, and sustainability of California’s safety net. This funding builds on the 2022 Budget Act investments for reproductive health services and continues California’s progress to provide comprehensive family planning and related services as California responds to the effects of recent federal actions.
- Naloxone Distribution Project Expansion — $74.8 million in 2023-24, $35.8 million in 2024-25, $24.8 million in 2025-26, and $24.1 million in 2026-27 from the Opioid Settlements Fund to expand the Naloxone Distribution Project to increase distribution to first responders, law enforcement, community-based organizations, and county agencies.
COVID-19 Response — $126.6 million one-time General Fund to continue the state’s efforts to protect the public’s health against COVID-19 and maintain significant information technology systems, including the California COVID Reporting System for laboratory data management and CalCONNECT for case and outbreak investigation.
Homelessness and Housing
Maintains existing $15.3 billion in total homelessness spending, and provides an additional $3.5 billion paired with new accountability measures on local government programs.
- Includes an additional $1 billion to the Homeless Housing, Assistance, and Prevention (HHAP) Program.
- Includes $400 million one-time for a third round of Encampment Resolution Funding grants. These grants are awarded to counties and cities to clear homeless encampments and purport to place displaced populations in to stable housing.
Maintains existing spending commitments on housing and includes a package of $14.7 billion for 2023-24.
- Includes an additional $100 million for the Multifamily Housing Program for a total of $325 million in 2023-24.
- Maintains existing $500 million to the California Housing Finance Agency for the Dream for All program, which provides shared-appreciation loans to help low- and moderate-income first-time homebuyers achieve homeownership.
- Reduces funding for CalHome by $50 million, leaving $300 million in total. CalHome provides grants to local and nonprofit agencies to assist low- and very-low-income first-time homebuyers with counseling and technical assistance.
- Defers majority of funding for the Foreclosure Intervention Housing Prevention Program over four fiscal years. This program provides funds to non-profit organizations to acquire foreclosed property and operate as affordable housing.
In-Home Supportive Services (IHSS)
- $1.5 million one-time General Fund to analyze the costs and benefits of a statewide or regional approach to IHSS collective bargaining, and statutory changes to amend the current penalty structure for counties that fail to reach an IHSS collective bargaining agreement from 7 percent one-time to 10 percent ongoing.
- IHSS Minor Recipient Provider Eligibility—$60.7 million ongoing ($27.9 million General Fund) and statutory changes to eliminate provider eligibility requirements that only apply to minor recipients and allow all minor children to have access to their provider of choice.
CalAIM –Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) Demonstration
- The Department of Health Care Services will seek federal approval of a Medicaid 1115 demonstration waiver to expand behavioral health services for Medi-Cal members living with serious mental illness and serious emotional disturbance. The waiver is expected to include Institutions for Mental Disease (IMD) to allow funding that is currently disallowed for facilities with more than 16 beds.
- The Budget includes $6 billion ($185 million General Fund, $87.5 million Mental Health Services Fund, $2.1 billion Medi-Cal County Behavioral Health Fund, and $3.6 billion federal funds) over five years to implement BH-CONNECT. The Budget also includes a new workforce initiative with funding of $480 million each year of the five-year demonstration.
- Transitional Rent will be part of BH-CONNECT and DHCS will seek to amend the CalAIM waiver to provide up to six months of rent or temporary housing to eligible individuals who are unhoused or at risk of being unhoused and transitioning out of institutional levels of care, a correctional facility, or the foster care system and who are at risk of incurring other Medicaid state plan services, such as inpatient hospitalizations or emergency department visits. The funding will not begin until 2024-25.
The Budget includes a one-time augmentation of $15 million from the 988 State Suicide and Behavioral Health Crisis Services Fund for California’s 988 centers to maintain operations and services, including 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.
The Budget shifts funding support for CalHope services by $50.5 million in one-time Mental Health Services Act (MHSA) funds in lieu of General Fund dollars.
The prison population has been in decline in recent years, which has given CDCR opportunities to eliminate the reliance on contract prison capacity. Discontinuing several contracts has saved the state hundreds of millions of dollars. The state plans on performing an assessment this year to determine if more prisons can continue to be closed. This assessment will include operating capacity for each prison, space for educational and rehabilitative programming, health care services and specialized and flexible bed needs.
Health Care Services for Incarcerated Individuals
The Budget includes $3.9 billion General Fund for 2023-24 for health care programs, which provide incarcerated individuals with access to medical, mental health, and dental services that are consistent with the standards and scope of care appropriate within custodial environment.
Expansion of Tele-Mental Health Services
The Budget includes $11 million General Fund and 85 positions in 2023-24 and $17.3 million and 144 positions beginning 2024-25 to expand the use of tele-mental health within the Statewide Mental Health Program. This investment will help to ensure that people who are incarcerated can receive accessible tools to have the mental health care that they need.
Supplemental Security Income / State Supplemental Program
The federal Supplemental Security Income (SSI) program provides a monthly cash benefit to individuals with disabilities, including children and adults, and individuals who are ages 65 and over who meet the program’s income and resource requirements. California adds to this benefit through the State Supplemental Program (SSP). The final Budget approves $146 million GF in 23-24 and $292 million ongoing for an additional, planned state supplemental program (SSP) and increase of approximately 8.6%, effective Jan 1, 2024z.
The Budget includes $14.9 billion in various funds – an increase in $1.1 billion from the 2022 Budget Act for transportation programs and projects. The focus of these addition funds will be on improving Greenhouse Gases in vehicles and transit programs. There are also infrastructure priorities and funds for transit programs.