surgical fire

in the patient’s airway.

Surgical fires were among the 10 most common sentinel events reported by hospitals to the Joint Commission in 2021. * grant program focused on supporting access to family planning and related services, system transformation, capacity, and sustainability of California’s safety net. This funding builds on the 2022 Budget Act investments for reproductive health services and continues California’s progress to provide comprehensive family planning and related services as California grapples with the effects of recent federal actions.

If a sentinel event happens and a ProAssurance insured is involved, they have direct access to medical liability claims specialists and risk management consultants with experience navigating these types of malpractice claims.

We’ve seen the worst you can imagine and have the expertise to help reduce risk and ensure a vigorous defense from day one. The principle of fair treatment guides every action we take in defense of our physicians and healthcare providers.

• Emergency Response and SMARTER Plan

Implementation - The Budget reflects $176.6 million General Fund in 2023-24 to continue the state’s efforts to protect the public’s health against COVID-19, consistent with the Administration’s SMARTER Plan, and maintain significant information technology systems, including the California COVID Reporting System for laboratory data management and CalCONNECT for case and outbreak investigation.

• Opioid and Fentanyl Response - The Budget includes an additional $93 million in Opioid Settlement Funds over four years beginning in 2023-24 to support youth- and fentanyl-focused investments for the Department of Health Care Services and for the Department of Public Health as follows: o $79 million for the Naloxone Distribution Project to increase distribution to first responders, law enforcement, communitybased organizations, and county agencies. o $10 million for fentanyl program grants to increase local efforts in education, testing, recovery, and support services. o $4 million to support innovative approaches to make fentanyl test strips and naloxone more widely available.

• Federal Public Health Emergency Extension

- The Budget assumes a two-quarter extension of the federal Public Health Emergency through mid-April 2023 and enhanced federal funding through the end of the 2022-23 fiscal year.

Budget Shortfall:

The Governor’s Budget forecasts that General Fund revenues will be $29.5 billion below the 2022 Budget Act projections, and California now faces an estimated budget gap of $22.5 billion in the 2023-24 fiscal year. The Governor’s Budget does not propose to draw from the State’s reserve accounts to close the budget gap. Rather, to close the budget gap, the State will be focusing on one-time and near-term spending instead of costly long-term obligations; tying or “triggering” a handful of new ongoing programs to sufficient revenue availability in 2024-25 ($3.9 billion); implementing funding delays ($7.4 billion), reductions and “pullbacks” ($5.7 billion), and fund shifts ($4.3 billion); and limited revenue generation and borrowing ($1.2 billion). If, however, economic and revenue conditions deteriorate in the spring, then the Administration may propose withdrawals from reserve accounts, as well as additional program reductions. Some of proposed solutions to the budget shortfall include:

• Managed Care Organization Tax - The Budget proposes the renewal of the Managed Care Organization (MCO) Tax effective January 1, 2024, through December 31, 2026, to help maintain MediCal program funding for the Medi-Cal expansion to all income eligible individuals and minimize the need for reductions to the program. The Administration will explore opportunities over the next few months to increase the MCO Tax to provide support for the Medi-Cal program.

• Partial Public Health Workforce Reductions

- The Budget reduces funding for various public health workforce training and development programs by $49.8 million General Fund over four years to help address the budgetary problem.

• Workforce Funding Delays - The Budget defers $68 million in 2022-23 and $329.4 million in 2023-24 for certain HCAI healthcare workforce programs, including for nursing initiatives, community health worker, and social workers. These programs remain fully funded, but these funds will be appropriated later than initially anticipated—$198.7 million in both 2024-25 and 2025-26.

• Behavioral Health Continuum Infrastructure Program Delays - The Budget delays the last round of behavioral health continuum capacity funding of $480.7 million General Fund appropriated in the 2022 Budget Act for 2022-23 to $240.4 million in 2024-25 and $240.3 million in 2025-26. A total of $1.2 billion has been awarded to date, and the Budget maintains $480 million General Fund for crisis and behavioral health continuum grant funding to be awarded in 2022-23.

• Covered California Subsidy Transfers - Last year, the Budget provided a contingency in case federal subsidies were not extended for Health Care Marketplaces, including Covered California. Federal subsidies were extended until 2025, so the contingency was placed in the Health Care Affordability Reserve Fund (HCARF) to ensure that state-only premium subsidies are available again in the future when they are most needed. Due to declining General Fund revenues, the Budget transfers the available HCARF balance of $333.4 million to the General Fund. These funds will be returned after federal subsidies end, which is scheduled in 2025-26.

The final Budget Bill must be passed by midnight on June 15, 2023. From now till then, CAFP will work with legislative offices and allies to support the Governor’s proposals to expand and improve health care in California and to maintain the General Fund expenditure allocated to the Song-Brown program for primary care graduate medical education (GME) programs.

CAFP’s Key Contacts receive these updates through the weekly Legislative Update. To receive information on what’s happening in Sacramento, sign-up to be a Key Contact https://www.tfaforms.com/379954.

Editor's note: The budget was passed on June 27.