Senate Budget and Fiscal Review Subcommittee No. 3 Hears Governor’s Oral Health, Home Visiting, and Black Infant Health Proposals

On Thursday, the Senate Budget and Fiscal Review Subcommittee No. 3 on Health and Human Services began hearing proposals under three state departments. Under the Emergency Medical Services Authority (EMSA), department leaders detailed proposals for additional staffing in response to various measures passed last year. The Office of Statewide Health Planning and Development (OSHPD) did the same, with much attention around the request for $50 million General Fund authority for mental health workforce development through loan repayment and scholarship programs.

The Department of Public Health (CDPH) section of the hearing began with a State of the State’s Public Health overview by Dr. Karen Smith, State Health Officer and CDPH Director, similar to that provided in   earlier this week. Subcommittee Chair Dr. Richard Pan during this time highlighted the importance of local health departments and capacity needs, foreshadowing next Wednesday’s Senate Health Committee informational hearing on California’s public health infrastructure. The subcommittee delved into a slate of items proposed in the Governor’s budget proposal; discussion on several key items of interest are noted below:

Oral Health Program. CDPH provided updates on the status on the work identified in the State’s Oral Health Plan and noted declines in Proposition 56 funds to the Oral Health Program. Dr. Kumar, CDPH’s State Dental Director indicated that despite declines in revenues, that the Local Oral Health Program (LOHP) would be made whole. He further discussed his urging to local health jurisdictions to think about alternative revenue streams in the long-term to make this work sustainable. He indicated that to account for the decline in revenue, the state could explore adjusting the frequency of reporting and surveys. CHEAC expressed appreciation for the State’s commitment to ensuring LOHP funding would not be harmed.

California Home Visiting Program Expansion (CHVP). CDPH representatives briefly touched on the Governor’s proposal to provide $23 million ongoing General Fund to expand participation in current and new sites for CHVP and their approach to incorporating new evidence-based models. CDPH indicated that the money would not be enough to fund all counties and that the department would solicit input from local health departments on evidence-based models currently used, but that the exploration would begin with evidence-based models at the federal level. CHEAC indicated our support for the additional funding and expressed our interest in engaging further.

Black Infant Health Program Expansion. CDPH provided an overview of the Governor’s proposal to provide $7.5 million General Fund to expand the Black Infant Health Program. The department indicated their plans to expand the number of sites, build a statewide awareness campaign and collect and analyze data to inform progress made in addressing black infant mortality. CDPH also indicated their interest in developing comprehensive and robust strategies to improve recruitment and retention in the program and their discussions with local MCAH directors. CHEAC expressed our support for investments to address African American infant mortality and strongly urged consideration for additional models beyond what is currently used within the Black Infant Health Program. CHEAC highlighted successes in other county strategies and underscored our interest in engaging further.

Women, Infant, and Children (WIC) Local Assistance Estimate. CDPH discussed declines in available funding due to caseload/participation declines. The department noted that California served roughly 65 percent of those eligible to participate in WIC, which is better than the national participation rate of 54 percent – based on 2016 data. CDPH highlighted their work to increase program participation including using data and research to better match WIC and CalFresh eligible participants, increasing benefits through providing tele-breastfeeding support, providing electronic recertifications, and the launch of the WIC electronic benefit transfer (EBT) for Napa and Solano scheduled for May 2019. Senator Pan showed interest in the State’s multi-agency approach to looking at data and asked for an update to be provided in the future.

Maternal, Child, and Adolescent Health Medi-Cal Oversight Activities. Representatives from CDPH discussed their request for five additional positions to perform oversight responsibilities for Title XIX Medicaid reimbursement to local health jurisdictions. CDPH referenced addition enforcement additional requirements for documentation and These positions would be funded with General Fund and local reimbursements. While CHEAC does not have a position on this request, CHEAC did take the opportunity to highlight that recent changes to Title XIX also impacts the workload at the local level and that additional training and technical assistance from the State would be beneficial.

All items were held open.

Agenda and background materials can be found here.