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Gov. Gavin Newsom on Jan. 10 released a state budget proposal that pulls from a projected surplus of $45.7 billion to mitigate the impact of COVID-19, which is ravaging the state and straining the health care system, as well as to combat the climate crisis, confront homelessness and cost of living and improve safety on community streets.
The proposed budget includes $217.5 billion in state and federal funds for all health and human services programs in 2022-23 and includes new investments in pandemic response. The administration is asking the Legislature to take early action by allocating $1.4 billion toward efforts to slow community transmission of the COVID-19 virus and save lives. The funds will accelerate vaccine distribution, expand testing and support hospital surge staffing.
Details on proposed spending in these five key areas are available in the governor’s budget summary.
Several investments are specific to dentistry, and several Medi-Cal investments demonstrate the governor’s continued commitment to make the program more sustainable and improve access to care.
Workforce development would receive a one-time investment of $1.7 billion over three years with additional funding for the High Road Training Partnerships. As an initiative of the California Workforce Development Board, HRTP provides training and advancement opportunities in careers that include dental assisting.
The new investment builds upon the existing funding for initiatives such as Smile Crew of California, which CDA launched in October 2020. These funds are available via grants to train and expand the dental workforce in California. Funding in 2022-23 will support collaborations and training programs among community-based organizations, local workforce boards, educational institutions and employers to build partnerships and pathways into health care jobs.
Funding will also support health care-focused vocational pathways for English-language learners to increase language and cultural diversity in health care settings and will expand scholarships and loan repayment for multilingual applicants.
The Health Workforce Education and Training Council is tasked with researching health care workforce shortages and guiding strategies for building a diverse, culturally competent health care workforce. CDA is pleased that Dr. Nader Nadershahi, dean of the University of the Pacific, Arthur A. Dugoni School of Dentistry, was appointed by the governor to this council.
CDA will be engaging with policymakers to ensure the needs of the dental workforce, including staffing shortages that are exacerbated by the surge in omicron infections, are included in these workforce opportunities.
“CDA is listening to members and understands that staffing shortages are near the top of their list of concerns right now,” said CDA President Ariane Terlet, DDS. “We’re pleased to see that funding in the budget proposal recognizes the pandemic challenges dentists and other health care providers are facing, and CDA will be advocating to ensure these new workforce training funds are made available to enhance dental office staffing.”
California is poised to become the first state in the U.S. to pass universal health care coverage. The budget proposal makes health care coverage available to all income-eligible Californians through full-scope Medi-Cal benefits for individuals ages 26-49, regardless of their immigration status.
The Medi-Cal expansion builds on previous years’ expansions to children, adolescents and older adults and would begin as early as January 2024. The General Fund will pay for the annual cost of $2.2 billion.
The proposal backfills and sustains the supplemental 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.
Revenues from Proposition 56, the CDA-supported tobacco tax measure that voters passed at the polls in 2016, continue to decline as the rate of tobacco usage declines. CDA and other organizations that supported Proposition 56 consider the decline good news, as the goal of the initiative was to improve the health of Californians by reducing the negative impact of tobacco use.
Still, the supplemental rates were made permanent in last year’s budget, bringing much-needed stability for Medi-Cal providers. The budget proposal supports the Proposition 56 supplemental rates with $176M in General Fund monies.
Dr. Terlet said the Medi-Cal Dental program is much different today than it was a decade ago or even five years ago.
“It’s almost unrecognizable,” Terlet said. “No longer is it a barely functioning program with slashed rates and benefits; there is a robust benefit with increased provider rates, innovative payment models and a growing provider network. These improvements are a direct result of CDA’s multi-year advocacy campaign. We applaud the state’s commitment to sustaining these improvements, and CDA will continue advocating to make Medi-Cal even better for patients and dentists.”
Laboratory-processed crowns for posterior teeth should be available soon for adult Medi-Cal beneficiaries. Currently, only stainless-steel crowns are covered, except in limited circumstances. The new coverage requirement is expected to come through trailer bill language that updates Medi-Cal to include evidence-based dental practices consistent with the American Association of Pediatric Dentists and the American Dental Association.
This proposal fills one of the biggest remaining coverage gaps in the Medi-Cal Dental program; however, the state must implement appropriate treatment criteria and a sufficient provider rate to make the benefit real. CDA is working to understand the details of this proposed benefit and will continue to stress the importance for the state to pay a sustainable rate that covers the cost of the beneficiary’s care. The budget includes $37 million in total funds ($13 million from the General Fund) to implement the change.
CDA will keep members informed through the newsroom about any changes for dentistry as budget negotiations continue.