The proposed 2022-23 state budget focuses on COVID-19, and other major threats to California

Gavin Newsom released a state budget proposal on January 10 that draws from a projected $45.7 billion surplus to mitigate the impact of COVID-19, which is devastating the state and straining the health care system, as well as to combat the climate crisis, address homelessness and the cost of living and improve safety on community streets.

The proposed budget includes $217.5 billion in federal and state funds for all health and human services programs in 2022-23 and includes new investments in the pandemic response. The administration is asking the legislature to take early action by allocating $1.4 billion to efforts to slow the transmission of the COVID-19 virus into the community and save lives. The money will speed up vaccine distribution, expand testing and support an increase in hospital staff.

Details of proposed spending in these five key areas are available in the Governor’s Budget Summary.

The proposed budget provides good news for dental providers, and for access to oral health

Many of the investments are for dentistry, and many of the Medi-Cal investments demonstrate the portfolio’s continued commitment to making the program more sustainable and improving access to care.

The Community Development Authority is working to ensure that the shortage of dental staff in workforce training is addressed

Workforce development will receive a one-time investment of $1.7 billion over three years with additional funding for Highway Training Partnerships. As an initiative of the California Workforce Development Council, HRTP provides opportunities for training and career advancement that include dental assistantship.

The new investment builds on existing funding for initiatives such as the Smile Crew of California, launched by the CDA in October 2020. These funds are available via grants to train and expand California’s dental workforce. Funding in 2022-23 will support collaboration and training programs between community organizations, local workforce boards, educational institutions, and employers to build partnerships and pathways in healthcare functions.

Funding will also support healthcare-focused career paths for English language learners to increase linguistic and cultural diversity in healthcare settings and will expand scholarships and loan repayments for multilingual applicants.

The Health Workforce Education and Training Council is tasked with researching healthcare workforce shortages and directing strategies for building a culturally diverse and competent healthcare workforce. CDA is pleased that Dr. Nader Nader Shahi, Dean of University of the Pacific, Arthur A. Dogoni School of Dentistry, has been appointed by the Governor of this Board.

CDA will work with policymakers to ensure that dental workforce needs, including staff shortages exacerbated by the significant increase in omicron infections, are included in these workforce opportunities.

“CDA is listening to members and understanding that staffing shortages are near the top of their list of concerns right now,” said CDA President Ariane Turlett, DDS. “We are pleased to see that the funding in the budget proposal recognizes the epidemiological challenges faced by dentists and other healthcare providers, and will call on the CDA to ensure this new workforce training funds are available to boost employment in dental offices.”

Medi-Cal expanded to include all income-eligible California residents

California is preparing to become the first state in the United States to grant universal health care coverage. The budget proposal enables Medicare coverage for all income-eligible Californians through comprehensive Medi-Cal benefits for individuals ages 26 to 49, regardless of their immigration status.

Medi-Cal’s expansion builds on previous years’ expansions for children, teens, and seniors and will begin in January 2024. The General Fund will pay the $2.2 billion annual cost.

Medi-Cal supplemental dental prices will continue

The proposed offer fills and maintains supplement increases for Medi-Cal dental providers. These supplemental rates equate to at least a 40% increase and, in some cases, provider rates as high as 80% of the average commercial payment. Prices apply to hundreds of dental codes.

Revenue from Proposition 56, the CDA-backed tobacco tax measure that voters approved in polls in 2016, continues to decline as tobacco use declines. The CDA and other organizations that supported Proposition 56 consider the reduction to be good news, as the goal of the initiative was to improve the health of Californians by reducing the negative impact of tobacco use.

However, supplement rates became permanent in last year’s budget, bringing much-needed stability to Medi-Cal providers. The budget proposal supports the supplemental rates of Proposition 56 with $176 million in general account funds.

Medi-Cal Dental becomes a ‘robust benefit as provider rates increase’

Dr. Turlett said Medi-Cal dental program is much different today than it was a decade ago or even five years ago.

“Almost unrecognizable,” Terlett said. “It is no longer a program that is barely operating with reduced rates and benefits; there is strong 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 continuing these improvements, and CDA will continue to advocate for Medi-Cal Better for patients and dentists.”

Laboratory prepared crowns are available to adult Medi-Cal Dental program beneficiaries

Lab-treated crowns for posterior teeth should soon be available to adult Medi-Cal beneficiaries. Currently, only stainless steel crowns are covered, except in limited circumstances. The new coverage requirements are expected to come through trailer billing language that is updating 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 largest remaining coverage gaps in Medi-Cal Dental; However, the state must implement appropriate treatment standards and a sufficient provider rate to make the benefit real. The CDA is working to understand the details of this proposed feature and will continue to stress the importance of the country paying 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.

The CDA will keep members informed through the newsroom of any dental changes while budget negotiations continue.

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