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Newsom Administration Releases Preliminary 2023-24 State Budget Blueprint – Disability Rates Study Implementation Fully Funded For Now
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On January 10, Governor Gavin Newsom released his proposed $296.9 billion FY2023-24 California state budget. Despite a projected $22.5 billion state revenue shortfall, the initial budget proposal does not draw down state reserves, which are projected to total $35.6 billion.
The budget release is preliminary based on the administration’s forecast of the California economy in the upcoming year. The Governor will release a revised budget proposal in May 2023 when revenue projections for the upcoming year are clearer.
This year, there is a significant difference of opinion between the Newsom Administration and the bi-partisan Legislative Analyst’s Office (LAO) regarding projected state revenues. The Governor has highlighted the strength of the state economy and based his budget on the forecast that there would not be a recession. The LAO estimates that state revenues will be lower than administration projections and recommends additional reductions in one-time appropriations and temporary spending to eliminate projected budget deficits of $4 to $9 billion in future state budgets.
The recent storms and disaster declarations have further complicated the budget process. The Internal Revenue Service (IRS) has extended the deadline for filing personal income tax returns to May 15, 2023, for anyone living in the 30 California counties under a disaster declaration on January 11, 2023. Because the state will not have those returns on April 15, 2023, there will be added uncertainty regarding state revenues prior to the May 2023 budget revisions.
Stakeholders in the California disability services system were encouraged to learn that the $1.2 billion investment in the disability services rate model remains intact and untouched by reductions or trigger cuts. The budget for the Department of Developmental Services maintains existing priorities with increases of $10.1 million in transportation rate model assumptions to address increased mileage rates based on updated IRS guidance, $78.2 million to address increases in the state minimum wage on January 1, 2024, and $12.7 million to update electronic records systems.
The budget proposal also includes $146 million in FY 2023-24 and $292 million ongoing for a State Supplementary Payment (SSP) increase of approximately 8.6%, effective January 1, 2024. SSP is a state contribution providing additional cash assistance for Californians using the federal Supplemental Security Income (SSI) program.
For more information on the FY2023-24 state budget, click on the resources below:
- You can watch a recording of the budget presentation by clicking here.
- You can download a copy of the Governor’s Budget Summary by clicking here.
- For a guide to the California state budget process published by the California Budget & Policy Center click here.
Momentum staff will be keeping a close eye on budget proceedings in Sacramento as the Governor has already sent warning signals that the January proposal is intentionally conservative with budget reductions, leaving room for more drastic modifications in the May 2023 revision.
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California DHCS Updates Public Health Emergency Continuous Coverage Unwinding Operational Plan
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On January 13, the California Department of Health Care Services (DHCS) updated the Medi-Cal COVID-19 Public Health Emergency (PHE) and Continuous Coverage Unwinding Operational Plan.
As a result of accepting enhanced Federal Medicaid funding during the COVID-19 PHE, the state had to agree to cease Medicaid eligibility redeterminations and assume eligibility for new recipients for the duration of the PHE. Those mandates will expire soon, and DHCS can begin reinstituting redetermination proceedings.
The updated operational plan incorporates guidance released from the Centers for Medicare & Medicaid Services (CMS) that the continuous coverage requirement from the PHE will end as of April 1, 2023. A goal of the plan is to inform the public about DHCS’ approach to return Medi-Cal to a normal state of operations. The plan also includes additional resources, including information about the DHCS Coverage Ambassadors campaign and links to CMS guidance documents.
On January 11, the U.S. Department of Health and Human Services (HHS) Secretary, Xavier Becerra, renewed the federal COVID-19 Public Health Emergency (PHE) for a full 90-day extension through April 11. Shortly thereafter, the Biden Administration announced its intention to allow the PHE to expire on May 11, 2023.
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Year End Federal Appropriations Bill Includes Funding for Cerebral Palsy Research
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On December 29, 2022, H.R. 2617, the Consolidated Appropriation Act of 2023 was signed into law and included funding for Cerebral Palsy research at the Centers for Disease Control and Prevention (CDC) and a directive to the National Institutes of Health (NIH) to prioritize and invest in research on Cerebral Palsy (CP).
As a result of H.R.2617, $2 million was appropriated to the CDC to reestablish CP surveillance research at two Autism Developmental Disabilities Monitoring Network (ADDM) sites. The CDC appropriation also included an increase of $1 million to continue existing activities that improve physical activity and fund health promotion for people with mobility disabilities.
Appropriations language for the NIH included a directive to prioritize CP research. Language in the bill “encourages NIH to continue to prioritize and invest in research on CP and to focus on basic and translational discoveries, as well as implementation, observational, and clinical studies aimed at early detection and intervention, comparative effectiveness, and functional outcomes. The agreement encourages NIH to support greater investment in research focused on the areas in need of growth, as outlined in the Strategic Plan on Cerebral Palsy Research, including research on lifespan issues to address the needs of transition-age youth and adults with CP, and research to support the development and delivery of new and improved screening tools, treatments, and interventions.”
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Better Care Better Jobs Act Reintroduced in Congress to Expand Access to Long-Term Care, Enabling People with Disabilities to Receive Quality Community-Based Services
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On January 26, U.S. Senator Bob Casey (D-PA), Chairman of the U.S. Senate Special Committee on Aging, and Congresswoman Debbie Dingell (D-MI-6) introduced legislation to expand access to home and community-based services for people with disabilities and older adults.
The bill would increase pay and improve benefits for the direct support professionals (DSPs) who provide critical community-based services. The Better Care Better Jobs Act would enhance Medicaid funding for home care, helping many of the over 650,000 people on waiting lists nationally by allowing them to receive support in the setting of their choice, stay active in their communities, and live independently.
“We have a caregiving crisis in this country that has been worsened by the Coronavirus pandemic. More than 50% of Americans 50 or older serve as a caregiver, and family caregivers need relief. Better Care Better Jobs moves us closer toward ensuring that no one must wait to get the care they deserve, and no care worker has to live below the poverty line to provide this care.” said Congresswoman Dingell.
Provisions of the Better Care Better Jobs Act include:
- Enhancement of Medicaid funding for Home and Community-Based Services (HCBS) by enacting a permanent 10 percentage point increase in the federal Medicaid match for delivering HCBS as well as additional funding for administrative activities associated with improvement efforts.
- Strengthening and expanding the HCBS workforce by addressing HCBS payment rates to promote recruitment and retention of direct care workers; regularly updating HCBS payment rates with public input; passing rate increases through to direct care workers to increase wages, and updating and developing training opportunities for this workforce as well as family caregivers.
- Make the Money Follows the Person Rebalancing Demonstration permanent.
- Encourage innovative models that benefit direct care workers and care recipients by providing additional incentives to help states build HCBS workforce programs that register DSPs and help connect them to people with disabilities seeking services.
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Administration Announces FY2024 Federal Budget Release Delayed to March
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The Biden Administration has announced that its FY2024 Federal Budget request would be delayed until at least March. This announcement marks the third straight year that the administration will be late in releasing a budget request despite a 1974 law that requires the President to submit a budget by the first Monday in February. The federal fiscal year begins on October 1, 2023.
This delay will ensure another late start to the Congressional appropriations process which is particularly concerning to disability advocates this year. Newly-elected House Speaker Kevin McCarthy (CA-20) is committed to releasing an appropriations bill that reduces federal spending to FY2022 levels which would require an 8 percent reduction in discretionary spending. If, as expected, defense spending is exempt from these cuts, discretionary spending would need to be cut by 18 percent.
Given the split control of Congress, the FY2024 budget battle promises to be drawn out and contentious which creates significant challenges to disability advocates working for passage of the Better Care Better Jobs Act and other federal investments to address the direct support professional (DSP) workforce crisis and investments in Home and Community-Based Services (HCBS) to shorten waiting lists for services.
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Employment Trends for People with Disabilities Outpace Trends for People Without Disabilities in 2022
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Statistics released by the U.S. Bureau of Labor Statistics (BLS) indicate that employment numbers for people with disabilities exceeded pre-COVID numbers in contrast to people without disabilities who have yet to reach pre-pandemic levels.
While the increase in employment numbers exceeded those for people without disabilities, it is important to remember that the total percentage of people with disabilities still lags far behind people without disabilities. While the overall gap remains significant, the positive trends are very encouraging.
The average monthly employment-to-population ratio for people with disabilities (ages 16-64) increased from 31.3 percent in 2021 to 34.8 percent in 2022. This was higher than the 29.1 percent increase recorded in 2020 (during the height of the pandemic) and the 30.9 percent increase recorded in 2019 (prior to the pandemic).
In contrast, for people without disabilities (ages 16-64), the employment-to-population ratio increased from 72.5 percent in 2021 to 74.4 percent in 2022, which was higher than the 70.0 percent recorded in 2020 but not above the 74.6 percent increase in 2019. The employment-to-population ratio, a key indicator, reflects the percentage of people who are working relative to the total population (the number of people working divided by the number of people in the total population multiplied by 100).
Kessler Foundation and the University of New Hampshire (UNH) Institute on Disability have issued National Trends in Disability Employment (nTIDE), a monthly, custom report on employment data for Americans with disabilities.
Stakeholders who are interested in disability employment statistics are encouraged to attend monthly Lunch and Learn first Friday jobs reports via zoom. On the first Friday of every month, corresponding with the Bureau of Labor Statistics jobs report, the nTIDE project offers a live broadcast via Zoom Webinar to share numbers and the latest news about disability employment. For more information and to register for upcoming webinars, click here.
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