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2021-22 state budget proposal funds COVID-19 recovery, maintains oral health care investments

CDA would take part in pilot program to address COVID-19-related health care needs, create jobs

January 12, 2021 1012

Quick Summary:

Gov. Newsom proposes to use a $15 billion budget surplus on immediate COVID-19 relief for individuals and small businesses. The proposal also supports continuing the supplemental rate increases for Medi-Cal Dental providers and reintroduces CalAIM with an investment of $227 million per year.

In addition to funding California’s COVID-19 recovery and vaccination efforts and proposing several billion dollars to tackle homelessness, help schools reopen and reduce high-severity wildfires, the state budget proposal released Jan. 8 supports continued improvements in oral health care delivery and access to dental services, including the continuation of supplemental rate increases for Medi-Cal Dental providers. 

Despite the challenges wrought by the COVID-19 pandemic over the last 10 months, the governor’s office reported Friday that the state is operating with a $15 billion surplus. Gov. Gavin Newsom proposes to use that surplus on more immediate COVID-19 relief. He urges legislators to not wait until June to pass relief legislation in a final budget but to instead take quick action on the following items to assist individuals, families and businesses hit hardest by the pandemic:

  • $575 million in additional COVID-19 relief grants for small businesses disproportionately impacted by the pandemic 
  • $70 million in targeted relief for small businesses
  • $600 stimulus payments to eligible low-income workers
  • $2 billion to support the safe reopening of school campuses, prioritizing the earliest grades, plus additional funding for extended learning opportunities and summer programs

Over $370 million is slated for COVID-19 community vaccine distribution and would not need to wait for legislative action because the money is pulled from the public health emergency fund. 

CDA would partner with RDAs to address COVID-19 health care needs

Job creation is the impetus for a one-time investment of $4 million to expand training for allied health care professionals to address COVID-19-related health care needs. As part of this, CDA would partner with registered dental assistants in a pilot program that also includes respiratory technicians and medical assistants with the aim of creating 350 new jobs.

The budget proposal allocates a total of $25 million in one-time funding toward apprenticeships in construction, health care, forestry and agriculture and IT.

Supplemental rate increases for Medi-Cal Dental providers would continue

Gov. Newsom’s proposed budget extends by one year ― until July 2022 ― the Proposition 56 supplemental rate increases for Medi-Cal Dental providers. Those supplemental rates equal an increase of at least 40% and, in some cases, bring the provider rates to 80% of the average commercial payment. The rates apply to hundreds of dental codes.

The CalHealthCares program, which offers student loan repayments and practice relocation grants of up to $300,000 to dentists and physicians who commit to providing care for Medi-Cal beneficiaries, also remains funded under the budget proposal.

The supplemental rates and CalHealthCares program have so far been funded by revenues from Proposition 56, as state voters intended when they passed the tobacco-tax measure in 2016, but CDA has had to push for continued funding annually during the budget process. 

Proposition 56 funds have led to a steady increase of over 1,600 newly enrolled Medi-Cal dental providers since 2017, after decades of declining participation. 
CDA President Judee Tippett-Whyte, DDS, in a statement Friday said, “CDA applauds Gov. Newsom for his investments to promote greater health equity through workforce development, oral health care improvements and vaccine distribution.” 

CalAIM: Implementing Medi-Cal reforms

Broader reforms to the Medi-Cal Dental program through a Department of Health Care Services’ initiative known as CalAIM (California Advancing and Innovating Medi-Cal) were shelved in 2020 due to the pandemic, but the current budget proposal reintroduces the initiative.

The proposal is intended to reduce the program’s complexity and improve outcomes through payment and delivery reforms. It would also implement the successes of the Dental Transformation Initiative, making them a permanent part of the Medi-Cal Dental program, including pay-for-performance incentives for preventive services, continuity of care and caries risk assessments.

CalAIM also proposes to add silver diamine fluoride as a statewide Medi-Cal benefit. CDA has been advocating to fund the use of SDF, an effective, noninvasive and low-cost tool for treating dental decay, for several years, including through legislation introduced in 2019 that ultimately did not pass.

The state is proposing an investment of $227 million per year in all the new dental benefits.

“CalAIM will target and coordinate care for vulnerable populations with complex health needs that currently drive high costs,” the governor’s news release states.

Updates to program details and spending are expected in the coming months and again in the governor’s May Revision. The governor and the Legislature will negotiate and finalize the state budget as mandated by June 2021. CDA is working closely with the administration and legislators on budget issues of concern to members and to the state’s broader recovery and will keep members informed of developments, including the availability of new grants and economic relief.