Assembly Select Committee on Infectious Diseases Convenes Informational Hearing on HIV, HCV, and STDs

On Tuesday, the Assembly Select Committee on Infectious Diseases, chaired by Assembly Member Mike Gipson, convened an informational hearing focused on the HIV, HCV, and STD epidemics in California. The hearing featured three key panels, the first providing an overview of the diseases in California, the second highlighting challenges in addressing them, and the third offering key strategies to end the HIV, HCV, and STD epidemics in our state.

Dr. Marisa Ramos, Chief of the Office of AIDS at the California Department of Public Health (CDPH), provided the Committee with a brief overview and of recent funding streams provided in the 2019 Budget Act to address these issues. She also discussed ongoing challenges associated with the epidemics, including the nexus with homelessness and opioid use. Dr. Ramos highlighted the importance of linkages to care and integrating surveillance and monitoring activities in effectively addressing the widespread epidemics.

Dr. Karen Mark, Medical Director with the Department of Health Care Services (DHCS), discussed DHCS’ recently proposed Medi-Cal Healthier California for All (CalAIM) proposal and its role in addressing the HIV, HCV, and STD epidemics. The initiative aims to address beneficiaries’ social determinants of health and provide intensive services for critical populations. Dr. Mark also discussed DHCS’ ongoing collaborations with CDPH, particularly around coverage of medications without prior authorization, availability of PrEP and PEP medications, and expansion of Hepatitis C programs regardless of disease stage.

Heidi Bauer with the Department of Corrections and Rehabilitation (CDCR) further discussed CDCR’s infectious disease screening and treatment programs operated by the Department to inmates. Bauer discussed the vulnerability of inmates upon their entry into CDCR facilities, the importance of ensuring successful community transition and linkages to care, and CDCR partnerships with local health departments and other state agencies in ensuring connections and referrals to care through Whole Person Care (WPC).

The second panel featured local and community-based perspectives of the challenges in addressing HIV, HCV, and STD epidemics. Panelists included representatives from the Gender Health Center, TruEvolution, Fresno Barrios Unidos, TransLatin@ Coalition, and the Kern County Public Health Services Department. The panelists discussed their entities’ roles in providing services, coordinating care, and responding to the HIV, HCV, and STD epidemics, as well as resource and staffing challenges and limitations in delivering such services. Kimberly Hernandez with Kern County Public Health discussed local rates of syphilis and congenital syphilis and role of the health department in conducting surveillance and monitoring, screening and testing, and linkage to care services among individuals who are infected and/or exposed to the communicable diseases. Ms. Hernandez further discussed the factors exacerbating the increase in STDs, including homelessness and poverty.

The last panel of the hearing included representatives from the California HIV/AIDS Policy Research Centers, the Transitions Clinic Network, the Los Angeles County Department of Public Health, Family Health Centers of San Diego, and Essential Access Health. Representatives of the panel examined key strategies to end the HIV, HCV, and STD epidemics throughout the state, including the need for intensive services for individuals exiting incarceration, well-coordinated linkages and transitions to care for vulnerable populations, expanded screening and testing activities, and adequate resources for staffing. Mario Pérez with the Los Angeles Department of Public Health Division of HIV and STD Programs further highlighted the health department’s role in responding to the epidemics and its close work with community-based organizations in reaching specific populations. Mr. Pérez discussed the need for state policy to routinize screening and testing and navigator staff to ensure access to treatment services. Mr. Pérez, among other panelists, urged the Legislature to bolster public health capacity and infrastructure to adequately address, respond, and prevent epidemics such as the HIV, HCV, and STD epidemics experienced statewide.

Members of the Select Committee inquired about the startling rates of infectious diseases, factors exacerbating disease conditions, barriers experienced by individuals, local agencies, and community-based organizations in addressing the epidemics, and strategies available to the Legislature and state to end the epidemics. Public comment featured a number of local governments, public health, and community-based entities discussing the need to broaden approaches to addressing the epidemics to consider social needs and cooccurring conditions, increasing investments in public health and health services, and expanding screening, navigation, and treatment services.

A video recording of the hearing is available here.