In error, CA double funded transgender health account

  • by Matthew S. Bajko, Assistant Editor
  • Friday January 13, 2023
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According to state officials, the Transgender Wellness and Equity Fund was double funded last year, and lawmakers are expected to put $13 million back into the state's general fund. Photo: California Assembly
According to state officials, the Transgender Wellness and Equity Fund was double funded last year, and lawmakers are expected to put $13 million back into the state's general fund. Photo: California Assembly

Buried within the bills California legislators filed this month after Governor Gavin Newsom released his budget proposal for the 2023-2024 fiscal year is a line seeking to claw back $13 million from the state's Transgender Wellness and Equity Fund. Created in 2020, it was only until last year that state leaders had allocated money toward it.

In the budget bills is one paragraph instructing the state controller to take back two different amounts specified in the Budget Act of 2022 — $2,728,000 and $10,272,000 — from the Transgender Wellness and Equity Fund and deposit the money back into the General Fund. No explanation is given for why.

In response to a question from the Bay Area Reporter, the Legislative Analyst's Office explained that the trans fund was mistakenly given $26 million last year. Thus, the governor's office is aiming to correct the error this year, as the special fund was only to have been allocated $13 million.

"This language is a technical fix to the 22-23 Budget Act. The funds were double counted in the 22-23 Budget Act and the language you cited in the current year's budget returns the funds that were added via appropriation. The original $13 million is still available for use," wrote William Owens, a fiscal and policy analyst for the California Legislature, in an emailed reply to the B.A.R.

Assemblymember Phil Ting (D-San Francisco), as chair of his chamber's budget committee, introduced the 2023 Budget Act as Assembly Bill 221. East Bay state Senator Nancy Skinner (D-Berkeley) filed a verbatim bill in her chamber as chair of its budget committee.

A spokesperson for Ting explained that the state constitution requires each budget chair to introduce the governor's budget bill immediately, which they did Friday, January 10, after Newsom released his proposal. It is the starting point for negotiations on the budget, which must be approved by the Legislature by June 15, as the new fiscal year starts on July 1.

Neither Newsom's press office nor the governor's Department of Finance responded to the B.A.R.'s inquiry regarding the budget request to reverse the funding for the trans wellness fund. With the governor projecting a $22 billion budget deficit this year, it is highly unlikely the extra $13 million awarded to the trans fund won't be clawed back as part of this year's budget.

The B.A.R. reached out to several LGBTQ groups and the offices of state lawmakers that had advocated around the special fund's creation and fiscal allocation, including the initial author of the bill that set it up, Assemblymember Miguel Santiago (D-Los Angeles), regarding the language about the funding for it in this year's budget bills. None have yet to respond.

As the B.A.R. has previously reported, Newsom signed the legislation creating the special fund three years ago with a pledge to later allocate funding for it. With the state flush in cash last year, Newsom and state legislators allocated the $13 million to the trans fund.

The Office of Health Equity within the California Department of Public Health is tasked with administering the fund and awarding the fiscal grants to organizations providing trans-inclusive health care. The state agency told the B.A.R. it is working out plans for the disbursement of the money.

"CDPH is continuing with plans to distribute this funding as intended by the legislature, stakeholders and the governor," it stated in a January 17 emailed reply. "CDPH's Office of Health Equity has been — and will continue to — work with stakeholders to implement this first-of-its-kind initiative to address significant health disparities experienced by Transgender, Gender Non-Conforming and Intersex Californians."

The trans fund was the impetus for new policies being enacted in the Golden State this year and next due to Senate Bill 923, authored by gay state Senator Scott Wiener (D-San Francisco) and signed into law by Newsom last year. It requires California medical professionals who interact with transgender, gender-nonconforming, and intersex patients to receive cultural competency training, as well as requires health providers to create searchable online directories of their gender-affirming services.

Known as the TGI Inclusive Care Act, it took effect on January 1 but has staggered deadlines for the impacted state departments and medical providers to meet. For instance, the California Health and Human Services Agency has until March 1 to convene a working group that will help craft the new curriculum for health care providers with TGI patients.

The state agency has until September 1, 2024, to develop and implement quality standards for treating TGI patients. Meanwhile, the deadline for when health insurers and health plans have to require all of their staff in direct contact with patients to complete the cultural competency training is March 1, 2025 at the latest.

That is also the deadline for when health plans need to have rolled out their searchable databases for their gender-affirming services. The hope, however, is that the law's provisions will be enacted prior to those dates.

Updated, 1/17/23: This article has been updated with comments from CDPH.

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