CPEHN Applauds Major Investments in Health4ALL but More to Do for Racial Justice 

Sacramento, CA – The California Pan-Ethnic Health Network (CPEHN) released the following statement in response to Governor Newsom’s proposed $286.4 billion budget (FY 2022-2023). The statement can be attributed to Kiran Savage-Sangwan, the executive director: 

“Three years into a global pandemic and we continue to see the ongoing impacts of systemic racism, the disproportionate impact of COVID-19 case rates and deaths among communities of color, and the consequences of our crumbling public health infrastructure.  

“California continues to make investments towards addressing the symptoms of racial and economic inequity, without resourcing and funding communities to address the root causes. The Administration funds healthcare, for when people get sick and go to the hospital, but does not address what makes them sick. The places people live, work, and play are riddled with the impacts of redlining, segregation, and centuries of divestment and exclusion. 

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

“We are overjoyed the Governor has included closing the Medi-Cal gap for undocumented immigrants ages 27 to 49. California will be the first in the nation to cover Medi-Cal for everyone who calls it home, regardless of their immigration status. Once the legislature approves this initiative, this community will have access to health care, including oral and behavioral health and In-Home Supportive Services. This is thanks to the tireless work of advocates, spanning more than a decade, who fought to end racist exclusions to health care access. We look forward to working with the Administration to finish the job of getting to universal healthcare by closing remaining coverage gaps. 

“We are also excited to see a historic investment in the Community Health Worker/Promotoras (CHW/Ps) workforce. CHW/Ps are trusted community partners, who provide culturally and linguistically competent care. We look forward to seeing more details of the Administration’s proposal and opportunities for public input into how these critical dollars are spent.  

“But we must not stop there. California must dedicate ongoing funding for Medi-Cal outreach and enrollment by trusted community health navigators in order to retain the anticipated influx of individuals who will be up for renewal once the public health emergency ends, as well as those newly eligible for coverage. California must partner with culturally and linguistically competent community health navigators who have strong relationships with the people who need this information the most, and do outreach in Spanish, Mixteco, and more languages.  

“We urge the Governor to declare racism as a public health crisis, something that we and our coalition have been waiting nearly two years for. A declaration must be followed by resources, investments, and accountability. Across state programs and policies, resources should be targeted to the communities and grassroots organizations that bear the cumulative burden of centuries of underinvestment and divestment due to structural racism. 

“While CPEHN certainly appreciates the recently announced investments in public health, these one-time investments, earmarked strictly for testing, vaccinations, and related outreach and education, are not enough. We need ongoing, flexible, and permanent solutions, not stop gaps and piecemeal measures. Additionally, while investments to state and local infrastructure are important, community-based organizations must be funded directly through the Health Equity and Racial Justice Fund as a critical component to a comprehensive public health system that will meet the needs of California’s diverse population. 

“We look forward to working with the Administration and Legislature to enact these meaningful health equity and racial justice proposals, and to ensure funding directly to community-based organizations, clinics, and tribal organizations makes its way into the budget, tied to community engagement to make sure their voices and needs are incorporated.” 

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Governor’s Budget Includes Major Investments in Health4ALL, but More to Do for Racial Justice  

On Monday, January 10th, Governor Gavin Newsom released his $286.4 billion FY 2022-2023 proposed budget. The Governor’s spending plan includes significant investments in health care and workforce diversity, including a proposal to expand access to Medi-Cal for undocumented adults aged 26-49 years for an estimated 700,000 individuals and $350 million in one-time funds for recruitment and training of up to 25,000 culturally and ethnically diverse Community Health Worker/Promotoras (CHWs/Ps) by 2025. With the Governor’s proposed Medi-Cal expansion, California becomes the first in the nation to provide full-scope Medi-Cal to all Medi-Cal eligible Californians, regardless of immigration status. CPEHN looks forward to working with the Administration on this step towards universal healthcare by closing remaining coverage gaps in Medi-Cal, and to providing input on the Governor’s new investment in growing the CHW/P workforce.  

The budget also includes significant investments in public health, mental and oral health, homelessness, and climate change. While these investments are critical, the budget misses an important opportunity to address both health equity and racial justice together. With yet another budget surplus, this time projected at $45.7 billion, the Governor’s budget fails to pair a $300 million investment in public health infrastructure, earmarked strictly for testing, vaccinations, and related outreach and education, with ongoing, flexible funds to enhance local partnerships with racially and ethnically diverse community-based organizations through the California Health Equity and Racial Justice Fund. Additionally, the budget fails to provide funds for marketing and outreach, as well as navigation assistance for individuals who will be up for renewal once the public health emergency ends as well as adult seniors newly eligible for Medi-Cal as early as May 2022. 

To view the full budget proposal click here.  

Highlights of the FY 2022-23 Final State Budget Proposal:   

Total Budget: $286.4 billion  

Total Spending Health & Human Services: $217.5 billion ($64.7 billion General Fund and $152.7 billion other funds) 

Budgetary Reserves/Rainy Day Fund: $34.6 billion total, $20.9 billion Rainy Day Fund 

Medi-Cal:  $123.8 billion ($26.8 billion General Fund) in 2021-22 and $132.7 billion ($34.9 billion General Fund) in 2022-23 

Budget Highlights  

• Expands Medi-Cal Coverage to all Adults, Regardless of Immigration Status ($819.3 million in 2023-24 and $2.3 billion annually): The Governor’s budget expands access to full-scope Medi-Cal to all income-eligible adults aged 26-49, making California the first state in the nation to provide Health4All for an estimated 700,000 Californians. Beginning no sooner than January 1, 2024, Medi-Cal will be available to all income-eligible Californians, inclusive of oral and mental health and In-Home Supportive Services. 
• Includes an investment in developing the Community Health Worker (CHW) Workforce ($350 million one-time funding): Funds will be used to recruit, train, and certify 25,000 new community health workers by 2025 to meet the goal of a more ethnically and culturally inclusive workforce in partnership with the Department of Health Care Access and Information and the Department of Health Care Services, with specialty certifications in areas that include climate health, homelessness, and dementia. 
• Includes Financial Incentives for Medi-Cal Providers to Strengthen Prevention and Improve Health Equity ($400 million one-time funding): The Governor’s budget includes funding for provider payments to reward Medi-Cal providers for advancing equity and improving quality in children’s preventive, maternity, and integrated behavioral health care. 
• Includes funds to create the Office of Community Partnerships and Strategic Communications ($65M ongoing):  The budget includes funding to formalize and leverage the infrastructure and work of the Census 2020 and COVID-19 public awareness and community engagement campaigns. The Office will be established within OPR and will manage the state’s highest priority public awareness and community outreach campaigns. In managing these select efforts, the office will develop and execute the public awareness and outreach strategy, working in partnership with the respective state agencies who will serve as subject matter experts. The Office will work with local community-based organizations (CBOs) and other partners statewide to engage Californians experiencing the greatest health and social inequities with culturally competent and relevant information to improve the quality of their lives and livelihoods. 
• Fails to Include Funds for Navigation Assistance in Medi-Cal ($30 million ongoing): The Governor’s budget misses a critical opportunity to provide ongoing funding for Medi-Cal outreach and enrollment by trusted community health navigators. This is critical to retain the anticipated influx of individuals who will be up for renewal once the public health emergency ends as well as those newly eligible in Medi-Cal. California must partner with community health navigators who have strong relationships with the people who need this information the most to provide culturally and linguistically competent outreach in Spanish, Mixteco, and more languages. 
• Fails to include an investment in community-based organizations as part of California’s public health infrastructure: We applaud the state for investing in public infrastructure, however more needs to be done. Despite extensive advocacy from CPEHN and health and racial equity advocates in the last year, the proposed ongoing 300 million general fund in the proposed 2022-23 state budget fails to include direct investments in non-governmental, community-based organizations who are critical parts of California’s public health system and in particular filled the gaps for underserved communities during the COVID-19 pandemic. 
• Fails to Address Racism as a Public Health Crisis: Governor Newsom’s proposed 2022-23 state budget fails to acknowledge that racism is a public health crisis, nor does it commit actions or dollars towards tackling institutionalized racism within the state government. 

Medi-Cal  

The budget projects Medi-Cal expenditures of $34.9 billion General Fund in 2022-23, an increase of $8 billion General Fund compared with the revised 2021-22 expenditures due to the loss of enhanced FMAP, other COVID-19 related impacts, funding shifts and second year funding for the Behavioral Health Continuum Infrastructure Program and the Children and Youth Behavioral Health Initiative, funding for housing supports for those with behavioral health needs, and state-only claiming adjustments. Additionally, the Governor’s budget projects an average monthly caseload of 14.2 million in 2022-23, and includes $10 billion total funds ($2.8 billion General Fund) in 2022-23 for caseload attributable to the COVID-19 Pandemic. Caseload is projected to peak at 15.2 million in July 2022, driven by the assumed federal continuous coverage requirement related to the COVID-19 Public Health Emergency. 

Expands Medi-Cal Coverage to all Adults, Regardless of Immigration Status ($819.3 million in 2023-24 and $2.3 billion annually): The Governor’s budget expands access to full-scope Medi-Cal to all income-eligible adults aged 26-49, making California the first state in the nation to provide Health4All for an estimated 700,000 Californians. Beginning no sooner than January 1, 2024, Medi-Cal will be available to all income-eligible Californians, inclusive of oral and mental health and In-Home Supportive Services. 

Equity and Practice Transformation Payments: (one-time funds of $400 million total funds ($200 million General Fund)): The Department proposes to make equity and practice transformation payments to qualifying Medi-Cal providers, to close critical health equity gaps; address gaps in preventive, maternity, and behavioral health care measures; and address gaps in care arising out of the COVID-19 Public Health Emergency (PHE). Such payments are intended to promote patient-centered models of care in pediatric, primary care, obstetrics and gynecology, and behavioral health settings and to align with the goals of the Medi-Cal Comprehensive Quality and Equity Strategy. CPEHN has been advocating for many years for the state to tie health care payments in Medi-Cal to concrete, year-over-year goals for the reduction of health disparities. While this is a promising first step, we must continue to strengthen requirements on plans and providers for the collection of comprehensive, granular demographic data including for smaller subpopulations in order to ensure more equitable care for all. 

Invests in the state’s recently approved Medi-Cal waiver, California Advancing and Innovating Medi-Cal (Cal-AIM) ($1.2 billion in 2021-22, $2.8 billion in 2022-23, $2.4 billion in 2023-24, and $1.6 billion in 2024-25). The Governor’s spending plan includes funds for implementation of the state’s Medi-Cal 1115 waiver, Cal-AIM. Funds in 2022-23 are to be spent on mandatory enrollment into managed care of beneficiaries eligible for both Medi-Cal and Medicare; the requirement that all managed care plans cover long-term care; the provision of a targeted set of Medicaid services to eligible justice-involved populations prior to release; and the Providing Access and Transforming Health (PATH) initiative to further the successful implementation of CalAIM. PATH includes the following programs and initiatives: 

• Justice Package ($50 million in 2022-23, $561 million total funds over five years): CalAIM justice-involved initiatives support justice-involved individuals by providing key services pre-release, enrolling them in Medi-Cal coverage, and connecting them with behavioral health, social services, and other providers that can support their re-entry. California statute mandates that all counties implement pre-release application processes in county jails and youth correctional facilities no sooner than January 1, 2023. Funding is included for county and corrections capacity building and coordination activities and is also included to support services and administrative costs associated with these initiatives beginning in January 2023. Additionally, the Department is proposing trailer bill to extend the duration of suspension of Medicaid benefits when an individual is incarcerated in order to increase the likelihood that coverage is maintained. 
• Providing Access and Transforming Health (PATH) ($1.3 billion total over 5 years). PATH provides funding to community-based organizations, counties, and other local providers to support capacity building as they begin to implement and scale Enhanced Care Management and Community Supports, in particular increasing resources available to populations and communities that have been historically under-resourced and under-served. In addition, PATH will support justice-involved adults and youth by sustaining the pre-release and post-release services (see above). The proposed budget reflects an expanded scope of activities through PATH as part of the Department’s 1115 waiver renewal, subject to adjustment due to late changes in the final waiver package, finalized at the end of December 2021. 

Invests in additional COVID-19 Impacts ($3.1 billion total funds ($2.9 billion General Fund savings) in 2021-22 and $1.1 billion total funds ($498.6 million General Fund savings) in 2022-23 for COVID-19 impacts (excluding caseload), such as enhanced FMAP savings, COVID-19 testing in schools, and federal waiver flexibilities.  

Includes funds for implementation of Medi-Cal for Older Adults Regardless of Immigration Status ($54 million ($43.1 million General Fund) in 2021-22 and $660.9 million ($567.1 million General Fund) in 2022-23): The Budget includes funds for the full year cost of expanding full-scope Medi-Cal to older adults age 50 and older regardless of immigration status effective May 1, 2022 (inclusive of IHSS costs). This policy change was included in the 2021 Budget Act. The Governor’s budget fails to include funds for marketing and outreach to undocumented senior adults to ensure they are aware of this new benefit. CPEHN and state advocates will continue to urge the Administration to include funds for this purpose. 

Includes funds for elimination of Medi-Cal Asset Limits for Older and Disabled Adults ($200.7 million ($93.4 million General Fund) in 2022-23): The budget includes funds to phase in the elimination of the Medi-Cal asset limit no sooner than January 1, 2022 (inclusive of IHSS costs). The asset limit will be fully eliminated no sooner than January 1, 2024 with an annual cost of $434.7 million ($201.3 million General Fund) ongoing. This policy change was included in the 2021 Budget Act. 

Extends Adverse Childhood Experiences (ACES) Provider Training ($135.1 million ($67.6 million Mental Health Services Fund and federal funds)) over a three-year period.  

County Eligibility Redeterminations Funding ($73 million total funds ($36.5 million General Fund) in each of 2021-22 and 2022-23): The budget includes funds for counties to resume annual redeterminations of Medi-Cal beneficiaries.  

Includes funds for Indian Health Program Grant Restoration (one-time $12 million General Fund to restore grant funding for Tribal Health Programs): The budget includes funds for Indian Health Program grants, which provide health care services to American Indian populations, both on tribal land and in urban areas, and operate in designated Health Professional Shortage Areas. This funding will promote the retention of the health care workforce that serves these programs and decrease the health disparities experienced by American Indians.  

Includes funds for the Reduction of Medi-Cal Premiums ($53.2 million ($18.9 million General Fund) in 2022-23 and $89 million ($31 million General Fund) annually): The Administration proposes to reduce the financial burden of paying for health care coverage for approximately 500,000 Medi-Cal enrollees who pay monthly premiums for coverage. The Budget includes funds to reduce premiums for beneficiaries, including pregnant women, children, and disabled working adults, whose income is marginally above the threshold for no cost Medi-Cal.  

Sunsets the Child Health and Disability Prevention Program: The Administration proposes to sunset the Child Health and Disability Prevention Program (CHDP) effective July 1, 2023 to advance CalAIM’s goal of streamlining the Medi-Cal program. As part of this proposal, DHCS will implement the Children’s Presumptive Eligibility Program to replace the CHDP Gateway to allow applicable Medi-Cal providers to enroll children into Medi-Cal through the presumptive eligibility process. 

Transitions Certain Proposition 56 Payments to Ongoing General Fund Support ($176 million): Proposition 56 revenues have declined over time and are insufficient to support current Proposition 56 payments beginning in FY 2022-23. The budget proposes to fully transition the following payments, valued at $147 million, to ongoing rate increases supported by the General Fund, beginning in FY 2022-23:  

• Adverse Childhood Experiences Screenings  
• AIDS Waiver  
• Community-Based Adult Services  
• Developmental Screenings  
• Freestanding Pediatric Subacute  
• Home Health Services o Intermediate Care Facilities for the Developmentally Disabled  
• Non-emergency Medical Transportation (by converting the existing Proposition 56 supplemental payment to an ongoing rate increase, costs budgeted with other Proposition 56 changes) 
• Pediatric Day Health Care  

In addition, the budget includes an increase of $29 million from the General Fund to fully fund remaining Proposition 56 payments at their current level in FY 2022-23. 

Medi-Cal Mental Health 

The Administration has made numerous investments in behavioral health, including investments to expand services for children and youth, improve behavioral health facilities, and ensure timely access to behavioral health services for Medi-Cal consumers, regardless of where they begin care. Sadly, access to mental health care continues to be extremely challenging for Medi-Cal consumers. While these investments are a good start, the data shows Medi-Cal consumers continue to face other serious, systemic barriers to accessing timely, and culturally and linguistically appropriate mental health care.  if California is to be truly successful in addressing Medi-Cal consumers’ mental health needs across the lifespan, the Administration should direct resources and policy change towards improving consumer outreach and education in Medi-Cal health plans, the most common entry point for care for the majority of Californians. 

Includes a proposal to develop a plan to coordinate crisis response programs: A series of new state and federal resources aimed at reducing the impact of untreated behavioral health conditions on emergency departments, psychiatric facilities, and the criminal justice system have recently been introduced. This includes funds for a new Medi-Cal mobile crisis response services benefit and implementation of a 9-8-8 behavioral health crisis hotline (see details below). CPEHN and partners have advocated for CalHHS to implement these programs in a cohesive and coordinated fashion, with a clear commitment to advancing racial equity by building upon the promise of the Crisis Act and shifting funding to non-law enforcement response models. In response, the administration has indicated they plan to develop a plan to coordinate these various new state and federal programs aimed at addressing crisis in the January proposal:  

• Funds for a new Medi-Cal mobile crisis response services benefit ($108 million total funds, $16 million General Fund). Starting as soon as January 1, 2023, California will add a new Medi-Cal benefit to ensure all Medi-Cal consumers can have access to mobile crisis services for a qualifying mental health and/or substance use disorder-related crisis 24 hours a day, 7 days a week. The benefit will be implemented through county behavioral health delivery systems by multidisciplinary mobile crisis teams in the community. CPEHN and partners have advocated for this new benefit to not fund law enforcement, a common practice, and instead fund proven community-based models that center racial equity. The American Rescue Plan Act of 2021 has authorized 85 percent federal matching funds for this new benefit. Trailer Bill language is forthcoming. 
• Implementation of the 9‑8‑8 Behavioral Crisis Hotline ($7.5 million, $6 million ongoing). The budget includes general and ongoing funds for the California Governor’s Office of Emergency Services to advance implementation of the 9-8-8 call system, which aims to provide a person experiencing a behavioral health crisis access to a trained counselor by July 2022, an alternative to 911 for people seeking help during a mental health crisis. Though the proposal includes some funds for equipment to ensure existing crisis hotlines have the resources to support the anticipated increase in calls, adequate design, workforce, and funding are ongoing concerns for many local mental health providers.  

Precision Medicine and Depression Research in Behavioral Health Settings ($10 million one-time funding). The budget includes one-time General Fund for a competitive grant program to support precision medicine-based approaches to preventing, diagnosing, and treating depression. Clear evidence links the impact of systemic racism on medical research and interventions, particularly in the area of behavioral health. CPEHN urges the Administration to release more details about this proposal and clarify how these funds will not perpetuate racial disparities in behavioral health.  

Continued implementation of the behavioral health crisis care continuum ($2.4 billion): The administration will continue implementation of previous investments in behavioral, including investments to expand services for children and youth, improve behavioral health facilities, and ensure timely access to behavioral health services for Medi-Cal consumers, regardless of where they begin care. 

Opioid Response ($96 million 2022-23 and $61 million ongoing). The current opioid epidemic is one of the largest drug epidemics in U.S. history, and the increasing availability of synthetic opioids and psychostimulants has resulted in a disproportionate share of deaths occurring in communities of color and low-income communities. The administration has included funds for a number of programs to combat the epidemic, including:  

• Medication Assessment Treatment Expansion Program ($96 million)  
• Public Awareness Campaign Targeted Towards Youth Opioid Education awareness and fentanyl risk education ($50 million)  
• Improving the state’s ability to collect and analyze data on opioid overdose trends ($5 million)  
• provider training on opioid treatment ($26 million) for the Department of Health Care Access 
• Information, and distributing naloxone to homeless service providers ($5 million) for the Department of Health Care Services. 

Housing and Supports for Individuals with High-Risk Behavioral Health Needs. The Governor’s January Budget includes funding to support individuals with the greatest risk of homelessness, including individuals with serious behavioral health needs and individuals leaving incarceration.The budget includes: 

• $1.5 billion General Fund for behavioral health bridge housing  
• $571 million in prevention and community-based services to reduce the flow of new incoming referrals to incompetent to stand trial, and to treat the nearly 1,700 individuals currently found Incompetent to Stand Trial (IST) on felony charges and waiting in jail, and 
• Expansion of pre-release and post release services for incarcerated individual, which includes requirement counties to process Medi-Cal applications for incarcerated individual’s pre-release, to access need health and behavioral health services. Additionally, the governor’s budget includes plans to develop a broader strategy for preventing institutionalization and incarceration through community-based care.  
• A new multi-disciplinary mobile crisis services benefit to Medi-Cal. 

Investments in Workforce, including dedicated funds to expand stipends and scholarships for social workers ($210 million) and, trainings for psychiatric residents $120 million) and an investment in recruiting, training, and certifying 25,000 new community health workers. 

Oral Health 

Adult Californians enrolled in Medi-Cal continue to lack access to equitable access to critical oral health. The Governor’s budget proposes to expand access to custom crowns. While pre-fabricated crowns are considered a covered benefit under Medi-Cal, they are meant to be temporary, and they are by no means customizable. Adding this benefit will create parity for Medi-Cal patients.  

The Governor’s proposal also expands Medi-Cal coverage to all Californians, regardless of immigration status, would ensure that many Californians will have access to oral health coverage for the first time ever (see above). Some of the benefits this newly eligible population will have access to are full and partial dentures, root canals, deep cleanings, and hopefully, custom crowns.  

Medi-Cal Dental Policy Evidence-Based Practices ($37 million total funds, $13 million General Fund): The Department of Health Care Services proposes to update coverage requirements in Medi-Cal to include evidence-based dental practices. This will mean that instead of stainless-steel crowns, laboratory-processed crowns for posterior teeth will be available for adult Medi-Cal beneficiaries. Laboratory-processed crowns are custom made for a tooth, and therefore prevent further degradation of the tooth, making them an improved option for Medi-Cal beneficiaries, compared to stainless-steel crowns. 

Proposition 56 Provider Payments ($176 million General Fund): A portion of Proposition 56 revenue is distributed to the Department of Health Care Services to increase the level of payment for health care, services, and treatment provided to Medi-Cal beneficiaries, including dental services. As tobacco use declines, revenue collected through Proposition 56’s cigarette tax continues to decline. For this reason, the Governor’s Budget includes $176 million to support Medi-Cal supplemental payments funded by Proposition 56, as Proposition 56 revenue declines. 

State-Only Claiming Adjustment ($1.5 billion General Fund): The Governor’s Budget includes $728.3 million General Fund in 2021-22 and $1.5 billion General Fund in 2022-23 for retroactive and ongoing dental, pharmacy, managed care, and behavioral health costs associated with state-only populations. 

Dental Managed Care: The Administration plans to extend dental managed care contracts and reprocure new contracts no sooner than January 1, 2024. 

Incarcerated Patient Medical Care ($3.8 billion General Fund): The Governor’s Budget proposes $3.8 billion for health care programs that provide incarcerated individuals with access to medical care. Dental care services are also included in this scope of care and services. 

Federal Approval of Cal-AIM Dental Initiatives: To follow through on their commitment to improving the accessibility of Medi-Cal dental services and improving oral health outcomes for Medi-Cal members statewide, the Department of Health Care Services through CalAIM submitted a State Plan Amendment to CMS for expanded pay-for-performance payments and two new benefits. The State Plan Amendment was approved by CMS on December 15, 2021, authorizing the following initiatives, effective January 1, 2022: 

• Expanded pay-for-performance payments:  
• Preventative pay-for-performance: This offers a performance payment for each paid preventative service. The goal is to increase statewide utilization of preventative services for all Medi-Cal members. 
• Continuity of care pay-for-performance: This offers a flat rate performance payment paid annually to offices that maintain dental continuity of care. The goal is to establish a dental home for all Medi-Cal members, so patients return to the same dental office for continuity of care and improved health/oral health outcomes. 
• Caries Risk Assessment: This new benefit assesses and manages caries risk and emphasizes preventative services in place of more invasive and costly procedures for children aged 0-6. 
• Silver Diamine Fluoride: This new benefit provides an option for caries arresting treatment when restorative caries treatment may not be adequate. This benefit is reimbursable for children aged 0-6 and individuals with underlying conditions for whom nonrestorative caries treatment may be adequate. 

Public Health & Prevention 

Invests in Public Health Infrastructure ($300 million ongoing): Governor Newsom’s proposed 2022-23 state budget includes $300 million in funding to strengthen the state’s public health infrastructure, substantiating a promise from the 2021-22 California state budget. Of the total,100 million will be allocated to the California Department of Public Health (CDPH) for key investments including, establishment of an Office of Policy and Planning, strengthening emergency preparedness capacity, supporting workforce expansion, enhancing communication and public education, directing efforts towards population health management, and improving organizational equity efforts and quality measurements overall. The remaining 200 million will be allocated to California’s 61 local health jurisdictions (LHJs), following an allocation formula that takes into account race/ethnicity and poverty indices. These additional local assistances are directed to expand staffing, improve data collection and integration, and expand community partnerships at LHJs. These decisions were made following the recommendations from the 2021 “Future of Public Health Work Group” to assess gaps in the state’s public health infrastructure.  

Fails to include an investment in community-based organizations as part of California’s public health infrastructure: We applaud the state for investing in public infrastructure, however more needs to be done. Despite extensive advocacy from CPEHN, health and racial equity advocates in the last year, the proposed ongoing 300 million general fund in the proposed 2022-23 state budget fails to include direct investments in non-governmental, community-based organizations who are critical parts of California’s public health system and in particular filled the gaps for underserved communities during the COVID-19 pandemic. 

Fails to Address Racism as a Public Health Crisis: Governor Newsom’s proposed 2022-23 state budget fails to acknowledge that racism is a public health crisis, nor does it commit actions to tackle institutionalized racism within the state government. 

COVID-19 Public Health Responses: The 2022-23 budget proposal provides an overview of approximately $5 billion that California and state and local public health departments received from the Centers for Disease Control and Prevention since the onset of the pandemic. These federal funds have contributed to enhanced departmental capacity and staffing expansion, but are temporary in nature.  

Given recent variants and case surges, Governor Newsom’s proposed 2022-23 state budget seeks early action by the Legislature to allocate $1.43 billion in the current budget year to continue efforts in vaccination, expanding testing and supporting hospital surge staffing. The Administration estimates in the budget proposal that the state’s pandemic response costs through various departments have grown to $3.2 billion, or $1.43 billion above the level authorized in the 2021 Budget Act which authorized $1.75 billion to COVID-19 response activities. The Governor’s budget proposal projects expenditures at approximately $1.25 billion for budget year 2022-23. (From 2019-20 through 2022-23, direct emergency response costs due to the pandemic are estimated to be $13.9 billion.) Estimates for key public health strategies are as follows.  

• Vaccination: The budget proposes an additional $399 million in 2021-22 and $182 million in 2022-23 for vaccine distribution and administration. 
• Testing: The Budget proposes an additional $214 million in 2021-22 to maintain and expand testing operations and $362 million for continued testing efforts in 2022-23. 
• Hospital Surge: Given the demand for medical surge staff and vaccine administrators, the Budget proposes an augmentation of $478 million for surge staffing in 2021-22 and $124 million in the budget year 2022-23. 

The budget proposal also urges the Legislature to extend COVID-19 Supplemental Paid Sick Leave beyond September 30, 2021 (Senate Bill 95 of 2021) through additional legislative actions.  

The budget proposal specifically directs $74 million General Fund to CDPH to support continued COVID-19 Pandemic response and humanitarian efforts for newly arrived migrants and local border communities. This is following the efforts since 2021 to provide health and social relief for the migration and border communities due to the pandemic. 

Climate Change Resilience Programs ($385 million): Governor Newsom’s proposed 2022-23 state budget includes three initiatives to strengthen the state’s climate resilience through the California Department of Public Health (CDPH). These proposed initiatives include $10 million ongoing General Fund to establish a disease surveillance program, $25 million one-time General Fund Local Health Jurisdictions to develop regional Climate and Health Resilience Plans, and $350 million one-time General Fund to recruit, train, and certify 25,000 new community health workers by 2025 in areas such as climate health, homelessness, and dementia to meet the goal of a more ethnically and culturally inclusive workforce by 2025.  

Federal Relief to California for Pandemic Response ($657 billion): The Governor’s proposed budget provides a summary of the total $657 billion federal aid California has received since March 2020 through six enacted federal legislations. Most recently, the American Rescue Plan Act of 2021 provided California with $27 billion flexible aid (i.e. the State and Local Fiscal Recovery Fund), of which $11.2 billion will be used to offset California’s General Fund revenue losses.  

Supporting Community-Based Organizations through Non-Profit Hospital Community Benefit Fund: Governor Newsom’s proposed 2022-23 state budget proposed to require non-profit hospitals across the state to use 25 percent of their community benefit dollars to invest in local community-based organizations to address the social determinants of health.  

Other Health Programs 

Office of Health Care Affordability ($30 million): The new office will be established in Department of Health Care Access and Information and aims to increase transparency on cost and quality, develop cost targets for the health care industry, enforce compliance through financial penalties, and improve market oversight of transactions that may adversely impact market competition, prices, quality, access, and the total cost of care.The Budget reappropriates funding for the Office that was originally included in the 2021 Budget Act and proposes statutory changes for its establishment.  

Enhancing Covered California Subsidies ($333.4 million): The Governor’s budget proposes to tap into $333.4 million deposited into a reserve fund as part of the FY 2021-22 state budget (AB 128, AB 133) to be used for future affordability programs. Covered California has developed a report (as required by AB 133) “Bringing Coverage within Reach: Promoting California Marketplace Affordability and Improving Access to Care in 2023 and Beyond,” which provides options to reduce out-of-pocket expenses for consumers which continue to rise at unsustainable levels. The Administration will work with the Legislature, Covered California, and stakeholders, including CPEHN on options to further improve affordability and access to health care coverage, while considering the role that potential federal legislation may play in determining the ongoing level of federal subsidies available through Covered California.  

Reducing the Cost of Insulin: A potential partnership with a contract manufacturer of insulin could position the state to find drug affordability solutions as it lays the groundwork for future collaborations on other high-priority drugs, securing more consistent and reliable supply chains, and advancing a Healthy California for All where cost is not a barrier to essential medicines.  

Reproductive Health 

• Increasing Flexibilities— To increase flexibility for Medi-Cal providers to provide clinically appropriate medication abortion services, the Department of Health Care Services (DHCS) will modify its existing billing requirements to remove requirements for in-person follow up visits and ultrasounds, if not clinically indicated. 
• Family Planning, Access, Care and Treatment (PACT) HPV Vaccine Coverage ($8 million, $4.6 million General Fund, in 2022-23 and ongoing) – to add the human papillomavirus vaccine as a covered benefit under the Family PACT program, effective July 1, 2022. 
• Clinical Infrastructure (One-time funding of $20 million General Fund within the Department of Health Care Access and Information) Provides scholarships and loan repayments to a variety of health care provider types that commit to providing reproductive health care services.  
• Capital Infrastructure (One-time funding of $20 million in grant funding to the Department of Health Care Access and Information) Assists reproductive health care facilities in securing their physical and information technology infrastructure and to enhance facility security.  
• Zeroing out Covered California Premiums ($20 million): The Budget includes $20 million General Fund in 2022-23 for Covered California to support the One-Dollar Premium Subsidy program which subsidizes the cost of Covered California consumers for health plans due to federal policy concerning abortion coverage. 

Additional Funds for Department of State Hospitals ($2.6 billion, $2.4 billion General Fund, in 2022-23). The Department of State Hospitals (DSH) administers the state mental health hospital system, the Forensic Conditional Release Program, the Sex Offender Commitment Program, and the evaluation and treatment of judicially and civilly committed patients. This patient population is expected to reach 8,064 by the end of 2022-23.  

• Incompetent to Stand Trial (IST) Solutions Workgroup—The Budget includes statutory language authorizing the Department of Finance to augment DSH’s budget by an additional $350 million General Fund, building on the $175 million already available in 2022-23 authorized by the 2021 Budget Act for the purposes of implementing solutions identified by the Incompetent to Stand Trial (IST) Workgroup to address the IST patient waitlist. 
• Electronic Health Records (EHR) Phase 3—The Budget includes $2.4 million General Fund in 2022-23, $19.8 million General Fund in 2023-24, $20.8 million General Fund in 2024-25 and $8.2 million General Fund in 2025-26 and ongoing to prepare for and support operation of the enterprise Continuum EHR project. 
• COVID-19 Impacts—The Budget includes $64.6 million General Fund in 2022-23 related to direct response costs to continue responding to and mitigating the impacts of the COVID-19 Pandemic 

Funds Department of Health Care Access and Information (HCAI) ($310.5 million General Fund in 2022-23). HCAI collects data and disseminates information about California’s healthcare infrastructure and publishes information about healthcare outcomes; promotes an improved healthcare workforce with loan and scholarship programs; monitors the construction, renovation, and seismic safety of hospitals and skilled nursing facilities; and provides loan insurance to assist the capital needs of California’s non-profit healthcare facilities.  

Specifically, there will be adjustments around: 

• Care Economy: Workforce for a Healthy California for All ($1 billion over three years): to strengthen and expand the state’s health and human services workforce 
• Clinical Infrastructure: Reproductive Health Care ($20 million): to provide scholarship and loan repayments to a variety of health care provider types that commit to providing reproductive health care services. 
• Capital Infrastructure: Reproductive Health Care ($20 million): to assist reproductive health care facilities in securing their physical and information technology infrastructure.  
• Office of Health Care Affordability ($30 million): to lower health care costs, improve quality and address health equity. 
• Community Benefit Funding for Community-Based Organizations (CBOs): to require non-profit hospitals to direct 25% of their hospital community benefit dollars to CBOs with HCAI enforcement authority. 

Specific Immigrant Programs Food4All ($35.2 million increasing to $113.4 million in 2025-26): The Governor’s Proposed Budget provides funds for planning purposes to expand the California Food Assistance Program to Californians ages 55 and above, regardless of immigration status.  

Immigration Legal Services (43.6 million ongoing): The proposed budget includes ongoing funding for Immigration Services Funding which assists applicants seeking Deferred Action for Childhood Arrivals (DACA), naturalization, affirmative immigration remedies, provides legal training and technical assistance, education and outreach activities and services to assist individuals with removal defense.  

Immigrant Workforce: The Governor’s Proposed Budget includes allocated funds for the Labor and Workforce Development Agency (LWDA) and Governor’s Office of Business and Economic Development (Go-Biz), to invest in innovative practices that will increase immigrants’ participation in the workforce to help close critical gaps in the state’s economy. These include:  

• Integrated Education and Training ($30M one-time funds)for the Employment Development Department’s Workforce Services Branch. These funds would expand English Language Learner pilot programs and combine English language instruction with vocational skills training.  
• Workforce Literacy ($20M one-time funds) for the Employment Training Panel to expand workplace literacy training, digital skills, and technical skills training for incumbent workers in an effort to provide pathways for higher-wage jobs.  
• Grants for Local Government ($8.7M one-time funds) to create competitive grants for local governments to build trust with immigrant residents and help immigrant community members navigate state and local services.  
• Immigrant-Focused Position ($150,000 ongoing funds) for one position at Go-Biz to support statewide immigrant integration collaboration with existing similar positions across state government.  
• Business Quick Start and Navigational Guides ($600,000 in 2022-23 and $200,000 annually thereafter), to develop navigational guides regarding professional licensing for immigrants, provide additional translations for these resources, and expand online resources.  

Migration and Border Communities ($74 million one-time funds): The Governor’s Proposed Budget includes funds, for the Department of Public Health, to provide continued COVID-19 pandemic support and humanitarian response efforts. The funds would support sheltering, testing, vaccines, and support services for newly arrived migrants.  

Human Services 

Support for Food Banks: The budget proposal also includes an investment of $50M one-time funds to support the CalFood program and food banks throughout the state as they work to mitigate food insecurity along low-income communities. 

Community Benefit Funding for Community-Based Organizations (CBOs): The Governor’s Proposed Budget proposes to make statutory changes that would direct 25% of non-profit hospital community benefit dollars to community-based organizations. Currently, nonprofit hospitals are required to create Community Benefit Plans that demonstrate how the institution has identified and worked to address community needs. The Administration would require nonprofit hospitals to include information in the Benefit Plans on work done in collaboration with community-based organizations to address the social determinants of health. The oversight for these statutory changes and enforcement would fall on the Department of Health Care Access and Information (HCAI).  

Supplemental Security Income/State Supplementary Payment (SSI/SSP) Investments: The Governor’s Proposed Budget aims to begin to restore SSI/SSP payments to pre-Great Recession levels by taking steps to close the gap. The budget includes a $3.1B investment in 2022-23 to support caseload management within the Department of Health Care Services and a cost-of-living adjustment for monthly payments. Beginning January 1, 2024 there would be an investment of $296M in 2023-24 and $593M ongoing thereafter to fully restore benefits. These changes would also apply to the state-funded Cash Assistance Program for Immigrants (CAPI) program which provides benefits to individuals who are ineligible for SSI/SSP due solely to their immigration status. 

Helpline for California Parents and Youth: The Governor’s Proposed Budget includes an allocation of $4.7M one-time funds to continue the Helpline for California Parents and Youth within the Department of Social Services. These funds would be used over a period of three years to support the continuation of the hotline, which serves as a resource for children, families, and seniors to receive guidance on safety net services via phone or online. 

Care Economy Investments: The Governor’s Proposed Budget includes a $1.7B investment, over a period of three years, to bolster efforts that will expand the Care Economy workforce to recruit, train, and hire an ethnically and culturally diverse workforce that has improved diversity and health equity outcomes. The California Health and Human Services Agency (CalHHS) and the Labor and Workforce Development Agency (LWDA) will work in collaboration to oversee and implement various components of the proposed package. The investments noted here are specific to immigrant and non-English speaking communities, and include:  

• Community Health Workers: $350M to DHCS and HCAI to recruit, train, and certify 25,000 new Community Health Workers by 2025. These workers will also have specialty certifications in areas such as climate health, homelessness, and dementia.  
• English Language Learners Health Careers: $130M one-time Proposition 98 funds to support healthcare-focused pathways and vocational opportunities for English language learned, at all levels of  proficiency, to increase language and cultural diversity in the field.  
• Multilingual Health Initiatives: $60M to expand scholarship and loan repayment programs in health care and social work for multilingual applicants. These funds would also support efforts to increase language and cultural competencies throughout the entire health workforce.  
• Indian Health Program Grant Restoration: $12M one-time for Tribal Health Programs. The funds will assist with the retention of programs that provide these services to Native communities and work towards decreasing health disparities experienced by Native Americans.  

Public Safety 

CPEHN understands that incarceration and policing are key health issues affecting BIPOC communities 
everyday. For instance, at least 33% of people in California’s state prisons are diagnosed with mental health needs (CURB) and the state’s carceral system has often been the last resort for many to receive care. Although there is significant funding for rehabilitation services for incarcerated peoples, we 
also call for increased funding for preventative systems of care that ensures communities can receive support outside of the justice system. Additionally, there must be increased support for formerly incarcerated people to continue to receive care even after release and re-entering their communities. We will continue to monitor the intersection of health and public safety throughout this budget cycle.  

The Governor’s Budget includes total funding of $14.2 billion for the California Department of Corrections and Rehabilitation in 2022-23. 

COVID-19 Response: The state is allocating a $424.7 million General Fund for CDCR to respond and mitigate COVID-19 in state prisons. This funding is designated for COVID-19 testing, the use of masks and PPEs, and cleaning and sanitation services. 

Rehabilitation and Re-entry 

• Returning Home Well Program: Provides emergency transitional housing services to individuals who would have been at risk of being unhoused at the time of their release. The budget includes a $10.6 million General Fund annually for three years to continue the program.  
• Ongoing Education: The Budget includes $5 million General Fund to permanently fund Bachelor’s Degree Programs in collaboration with the California State University system. These programs will be available to students after they complete their community college programs. 
• Tattoo Removal Services: The Budget includes $567,000 General Fund in 2022-23 and $1.1 million through 2025-26 to provide tattoo removal services to incarcerated persons. 
• California Correctional Health Care Services (CCHCS): The state will allocate $3.9 million from the General Fund in 2022-23 and $4.6 million ongoing to provide administrative support for important rehabilitative services. 

Incarcerated Patient Medical Care and Mental Health Services 

• The budget includes $3.8 billion General Fund in 2022-23 for health care programs, which provide incarcerated individuals with access to mental health, medical, and dental care services that are consistent with the standards and scope of care appropriate within a custodial environment. 
• Integrated Substance Use Disorder Treatment Program: ISUDT was designed as a whole person care delivery model and to provide treatments for incarcerated individuals with substance use disorders. The Budget includes $126.6 million General Fund in 2022-23, and $162.5 million ongoing, to expand the Program. 
• CalAIM: The Budget includes $10.4 million ongoing to implement California Advancing and Innovating Medi-Cal (CalAIM) services and supports for justice-involved individuals (details above). 

Juvenile Justice: Counties will be responsible for serving all justice-involved youth. In 2020-21, to facilitate this realignment, the Board of State and Community Corrections (BSCC) allocated $9.6 million in one-time funds for the Regional Youth Programs and Facilities Grant Program as authorized by SB 823. The Budget includes $100 million one-time General Fund for grants to be administered by the BSCC to support improvements to county-operated juvenile facilities, with a focus on trauma-informed care, restorative justice, and rehabilitative programming. 

Bolstering Local Public Safety 

• The Budget includes a total of $356 million General Fund over three years, including $132 million in 2022-23, to bolster local law enforcement efforts responding to respond to organized retail theft and other crimes and support affected small businesses 
• $85 million annually through 2024-25 in competitive grants for local law enforcement to combat organized retail crime.  
• $10 million annually through 2024-25 for competitive grants to local District Attorneys to create retail theft prosecution teams. 
• $6 million in 2022-23 to provide a total of $15 million annually for CHP to create an Organized Retail Theft Taskforce. 
• $20 million one-time for grants to small businesses that have been the victim of retail theft 
• The Budget includes $25 million one-time General Fund to establish a competitive grant program to support local gun buyback programs.  

Proposition 47 Savings—In November 2014, voters passed Proposition 47, which requires misdemeanor rather than felony sentencing for certain property and drug crimes and permits incarcerated persons previously sentenced for these reclassified crimes to petition for resentencing. Proposition 47 established a fund to invest savings from reduced prison utilization to prevention and support community programs. The Department of Finance estimates net General Fund savings of $147.3 million in 2022-23.  

• These funds will be allocated according to the formula specified in the initiative, which requires 65 percent be allocated for grants to public agencies to support various recidivism reduction programs (such as mental health and substance use treatment services), 25 percent for grants to support truancy and dropout prevention programs, and 10 percent for grants for victims’ services. 

Department of Justice: The Budget includes total funding of approximately $1.2 billion, including $433 million General Fund, to support DOJ. 

• Police Officer Use of Force—$2.3 million General Fund in 2022-23, and $1.6 million ongoing, to investigate officer-involved shootings that result in the death of an unarmed civilian 
• Reproductive Health Care Services—$879,000 General Fund in 2022-23 and $671,000 ongoing to implement new data reporting requirements, prepare an annual report that details anti-reproductive healthcare rights violations and criminal offenses, and provide legal guidance to state and local entities  

The Commission on Peace Officer Standards and Training (POST) has a long history of establishing selection and training standards. 

• Implementation of SB 2—The Budget includes $22.7 million General Fund in 2022-23, and $20.6 million ongoing, for POST to support implementation of SB 2. SB 2 authorized POST to suspend, revoke, or cancel any peace officer certifications under specified conditions.  

Housing, Homelessness, Anti-poverty 

State Excess Sites Development—$100 million one-time General Fund ($25 million in 2022-23, and $75 million in 2023-24) to expand affordable housing development and adaptive reuse opportunities on state excess land sites. This will leverage state land as an asset to expedite housing opportunities by offering low-cost, long-term ground leases in exchange for affordable and mixed-income housing. 

Mobile home Park Rehabilitation and Resident Ownership Program—$100 million one-time General Fund ($25 million in 2022-23, and $75 million in 2023-24) for HCD’s Mobile home Park Rehabilitation and Resident Ownership Program. These funds will finance the preservation and development of affordable mobile home parks, assisting one of the communities disproportionately and negatively impacted by the state’s affordability and climate challenges. 

Encampment Resolution Grants: Building on the $50 million of Encampment Resolution Grants to local jurisdictions that will be awarded in Spring 2022, the Budget includes an additional $500 million one-time General Fund to deploy a substantially expanded program for jurisdictions to invest in short- and long-term rehousing strategies for people experiencing homelessness in encampments around the state. 

Transitional Housing for the formerly incarcerated: The Budget includes $10.6 million General Fund annually for three years to continue the Returning Home Well Program, which provides transitional housing services to individuals who would otherwise be at risk of being unhoused at the time of their release. This program, initiated during the COVID-19 Pandemic, has served nearly 5,300 individuals to date. For more information, see the Criminal Justice Chapter. 

Homeless Housing and Assistance Program: Local governments are required to submit local homeless action plans to Cal-ICH as a condition of receiving funding through the Homeless Housing and Assistance Program. This $2 billion one-time General Fund, multi-year, flexible grant program is available to counties, large cities, and Continuums of Care. Cal-ICH will work with local grantees on their accountability plans so that local governments begin taking immediate steps towards implementation. The California Interagency Council on Homelessness (Cal-ICH), formerly named the Homeless Coordinating and Financing Council 

Housing and Homelessness, overall resources: The Budget reflects the Administration’s commitment to equitably build more affordable housing for Californians and expand access to housing for vulnerable populations, including individuals with complex behavioral health conditions and people living in unsheltered settings. In total, the Budget includes $9 billion for housing resources and $8 billion for homelessness resources in 2022-23, as detailed below. 

The Young Child Tax Credit: Established in 2019, provides a $1,000 refundable tax credit to low-income earners with a child age 5 or younger. The Budget expands this tax credit to families that file returns without income, allowing more families to benefit, and proposes to index the credit to inflation, which will prevent the erosion of its value. 

Transportation/Climate ChangeCreating a green school bus fleet: $1.5 billion one-time Proposition 98 General Fund, available over three years, to support school transportation programs, with a focus on greening school bus fleets. Specifically, grants of at least $500,000 would be available with priority for local educational agencies with high concentrations of low-income students, youth in foster care, and English language learners, as well as small and rural local educational agencies. For $500,000, a local educational agency will be able to acquire an electric school bus, construct the bus’s charging station, and support other local school bus transportation needs. These investments will result in ongoing savings to transportation programs that could be used to support other aspects of school transportation programs. 

Decarbonizing California’s most polluted sectors: An additional $6.1 billion ($3.5 billion General Fund, $1.5 billion Proposition 98, $676 million Greenhouse Gas Reduction Fund, and $383 million Federal Funds) one-time over five years, with a focus on communities that are most impacted, bringing the total investment to $10 billion over six years to decarbonize California’s most polluting sector and improve public health. The Budget proposes targeted investments in disadvantaged and low-income communities, including tribal communities, to increase access to the benefits of clean transportation and more than doubles the money targeted for heavy-duty market acceleration.  

Low-Income Zero-Emission Vehicles and Infrastructure: $256 million for low-income consumer purchases, and $900 million to expand affordable and convenient ZEV infrastructure access in low-income neighborhoods. These investments will focus on planning and deploying a range of charging options to support communities, including grid-friendly high-power fast chargers and at-home charging.  

Zero-Emission Mobility: $419 million to support sustainable community-based transportation equity projects that increase access to zero-emission mobility in low-income communities. This includes supporting clean mobility options, sustainable transportation and equity projects, and plans that have already been developed by communities that address mobility. These locally driven projects continue to be a direct response to critical mobility needs identified by community-based organizations  

High-Speed Rail and Transit Safety Improvements—$4.2 billion Proposition 1A bond funds for High-Speed Rail, $3.25 billion General Fund for statewide, regional and local transit and rail projects, and $500 million General Fund for high-priority rail safety improvements.  

Climate Adaption Projects—$400 million General Fund for climate adaptation projects that support climate resiliency and reduce infrastructure risk.  

High-Speed Rail in the Central Valley: $4.2 billion to complete electrified high-speed rail construction in the Central Valley, perform advance work for service between Merced and Bakersfield, and complete advance planning and project design for the entire project. This is in addition to the funds available for this program in Cap and Trade.  

Active Transportation and Projects to Connect Communities: $750 million to transform the state’s active transportation networks, improve equity, and support carbon-free transportation options, including: $500 million for Active Transportation Program projects, which encourage increased use of active modes of transportation such as walking and biking, and increase the safety and mobility of non-motorized users.  

Workforce Development and Training  for Climate Change: $35 million General Fund for the UC to create regional workforce development and training hubs focused on climate change; $30 million General Fund over two years to the CCC to train, develop, and certify forestry professionals; and $60 million General Fund over three years for the California Workforce Development Board’s Low Carbon Economy Workforce grant program to support workforce development programs that align with strategies in the state’s Climate Change Scoping Plan. 

Drought Response: additional $750 million General Fund to address immediate drought response needs, including $250 million set aside as a contingency. These investments will expand support for critical drinking water emergencies and mitigate drought damage to fish and wildlife, and the investments will also support small farmers and ranchers and water systems facing a loss of water supply. 

Climate Initiatives: An increase of $185 million one-time General Fund to support three complementary climate initiatives, including $100 million for climate action research seed and matching grants available to researchers from the UC system and other institutions, $50 million for regional climate innovation incubators, and $35 million to establish climate workforce development and training hubs.  

Climate and Health Resilience Planning: $25 million one-time General Fund for a grant program to bolster the actions of local health jurisdictions and develop regional Climate and Health Resilience Plans.  

Climate, Health and Disease Monitoring—$10 million ongoing General Fund to establish a monitoring program to track emerging or intensified climate-sensitive health impacts and diseases.  

Community Air Monitoring—$30 million one-time Greenhouse Gas Reduction Fund to deploy local, real-time pollution monitoring, including climate, air and toxic emissions, in disadvantaged communities across the state.  

Community Resilience Centers Program: $25 million to support vulnerable residents experiencing extreme heat, wildfires, power outages, flooding, and other emergency situations brought about by the climate crisis.  

Low-Income Weatherization Program: $25 million to accelerate energy efficient upgrades in low-income households through, for example, accelerated deployment of air conditioning heat pumps and low global warming potential refrigerants in communities particularly vulnerable to heat.  

Transformative Climate Communities Program: $165 million to support catalytic projects that serve as a model for equitable, community-driven infrastructure investments in the most disadvantaged communities of California.  

Regional Climate Collaboratives and Resilience: $135 million to provide direct investment in communities through capacity building grants, tribal, local and regional adaptation planning, and implementation of resilience projects.  

California Climate Action Corps: $4.7 million ongoing to empower Californians to take climate action through service positions, volunteer opportunities, or individual action.  

Community Air Protection Program (AB 617): $240 million to support the Community Air Protection Program, which reduces emissions in communities with disproportionate exposure to air pollution through targeted air monitoring and community emissions reduction programs. This funding will provide grants to community-based organizations, implementation funding for local air districts, and incentives for cleaner vehicles and equipment.  

Expanding Monitoring in Disadvantaged Communities: $30 million to deploy local and real-time pollution monitoring, including climate, air, and toxic emissions, in disadvantaged communities across the state.   

Establishing Office of Racial Equity at the Air Resources Board: $1.8 million Air Pollution Control Fund ongoing and four positions to establish the new Office of Racial Equity (Office) at the Air Resources Board. The Office will help coordinate, integrate, and implement racial equity into policy development, with an initial focus on research, incentive programs, regulations, air quality planning, and climate change. The Office will help develop trainings for staff to engage communities and advance racial equity. 

Advancing Racial Equity and Environmental Justice in OEHHA’s Scientific Activities: $1.3 million ongoing for the Office of Environmental Health Hazard Assessment (OEHHA) to advance racial equity and environmental justice through science, data, and research including: $565,000 ongoing General Fund and two positions to create a new racial equity and environmental justice program. The program would formulate strategies, policies, and technical assessments to advance racial equity in OEHHA’s scientific activities, including quantitative risk-assessment methods.  

Strengthening CalEnviroScreen: $370,000 ongoing funding from multiple fund sources and two positions to support the tracking of changes in community pollution burden using information from the CalEnviroScreen mapping tool. CalEnviroScreen assigns cumulative scores to communities based on indicators such as environmental pollution exposure, health, and socioeconomic vulnerability. Analyzing changes over time can provide information on the effectiveness of the state’s programs in addressing environmental justice.  

Biomonitoring in Community Air Protection Program (AB 617) Communities: $350,000 ongoing Greenhouse Gas Reduction Fund for targeted biomonitoring studies in communities disproportionately impacted by air pollution. Contract funding will allow OEHHA to serve these diverse communities by applying biomonitoring to directly measure air pollution exposures in community members over time, increase understanding of the potential health risks they face, and support the design of effective strategies to reduce exposures.  

Climate Action Plan for Transportation Infrastructure (CAPTI): Additional nearly $15 billion for transportation programs and projects that align with climate goals, advance public health and equity, and competitively position the state to pursue significant federal investment through the Infrastructure Investment and Jobs Act (IIJA) and other federal funding programs by leveraging funding from state and local sources. 

Education 

K-12 education: $119 billion K-12 per-pupil funding totals $15,261 Proposition 98 General Fund—its highest level ever—and $20,855 per pupil when accounting for all funding sources. 

Enrichment, Arts and Music Instruction: Additional $3.4 billion Proposition 98 General Fund ongoing to support access to expanded-day, full-year instruction and enrichment for all elementary school students, with a focus on local educational agencies with the highest concentrations of low-income students, English language learners, and youth in foster care. Linked to this expansion is an additional $937 million Proposition 98 General Fund to support integrating arts and music into enrichment programs. 

State Pre-School supporting students with disabilities and dual-language learners. $309 million so that the State Preschool Program better supports students with disabilities and dual language learners. These funds will support new requirements for State Preschool providers to: (1) serve at least 10 percent students with disabilities, and (2) provide additional supportive services for dual language learners. Additionally, all students participating in State Preschool will maintain continuous eligibility for 24 months (increased from 12 months) once eligibility is confirmed, children with an individualized education program will be categorically eligible to participate in State Preschool, and State Preschool providers that have served all eligible three- and four-year-olds in their service will be allowed to serve two-year-old children.  

Inclusive Early Education Expansion Program: $500 million one-time Proposition 98 General Fund to support the Inclusive Early Education Expansion Program, which funds infrastructure necessary to support general education and special education students in inclusive classrooms.  

STEM Pathway Programs: $1.5 billion one-time Proposition 98 General Fund over four years to support the development of pathway programs focused on technology (including computer science, green technology, and engineering), health care, education (including early education), and climate-related fields. These programs are predicated on developing local partnerships that bring together school systems, higher education institutions, employers, and other relevant community stakeholders.  

High school student support, dual enrollment and career preparation: $500 million one-time Proposition 98 General Fund, also available over four years, to strengthen and expand student access and participation in dual enrollment opportunities that are also coupled with student advising and support services. These investments will be complemented by $45 million in higher education funding for curricular pathways software and public-private partnerships for STEM, education, and health care career preparation. 

Part-Time Faculty Health Insurance: An increase of $200 million ongoing Proposition 98 General Fund to augment the Part-Time Faculty Health Insurance Program to expand healthcare coverage provided to part-time faculty by community college districts.  

Healthcare Vocational Education: An increase of $130 million one-time Proposition 98 General Fund, of which $30 million is for 2022-23, $50 million is for 2023-24, and $50 million is for 2024-25, to support healthcare-focused vocational pathways for English language learners across all levels of English proficiency, through the Adult Education Program.  

Graduate Medical Education: A decrease of $582,000 ongoing General Fund to adjust the Proposition 56 revenue offset amount for a statewide grant program and maintain $40 million ongoing for graduate medical residency slots.  

Integrated Education and Training: $30 million to the Employment Development Department’s Workforce Services Branch to expand the English Language Learner pilots in the Integrated Education and Training programs to 15 sites across the state. These programs will combine contextualized English language instruction with vocational skills training for in-demand occupations.  

Workforce Literacy: $20 million for the Employment Training Panel to expand workplace literacy training in contextualized English, digital skills, and technical skills training for incumbent workers. This will enable employers to build skilled workforces and increase employee retention and provide pathways to higher wages and better jobs for immigrants.  

California Youth Leadership Program Language Justice Pathway: $10 million to expand earn-and-learn community change career pathways for community college students through the California Youth Leadership Corps, a new statewide partnership between the Labor Agency, the Community Learning Partnership, selected California community colleges, local nonprofit organizations, and community partners.