April 13, 2018 Edition

April Proving to be an Extremely Busy Month in Sacramento

This week, the California Legislature continued its flurry of activities with two weeks remaining before the April 27 deadline for policy committees to hear and report all fiscal bills introduced in their house of origin. Lawmakers have been extremely busy amending measures and presenting bills at policy committee hearings, and a significant number of bills continue to be set for hearings. Below, we highlight actions taken this week on bills of interest to CHEAC Members.

For a full update on bills, please refer to this week’s edition of the CHEAC Weekly Bill Chart.

Environmental Health

AB 1964 (Maienschein) as amended on April 3, 2018 – Oppose Unless Amended

CHEAC, along with CSAC, UCC, RCRC, and HOAC, remains opposed unless amended to AB 1964 authored by Assembly Member Brian Maienschein.  AB 1964 expands the definition of organized resident camps to now include day camps for children.  Our county coalition has asked that local enforcement agency oversight for the newly created category of day camps be limited to health and sanitation.  There are other aspects of day camp oversight that pertain to child welfare and safety that lie outside of county health department expertise.

The bill is scheduled for hearing before the Assembly Health Committee next week on Tuesday, April 17. CHEAC, along with our county partners, will be testifying in opposition to the bill.

AB 2892 (Quirk) as introduced on February 16, 2018 – Support

AB 2892 by Assembly Member Bill Quirk was heard in the Assembly Environmental Safety and Toxic Materials Committee earlier this week.  This measure establishes the California Mosquito Surveillance and Research Program within CDPH to maintain an interactive mosquito website for the management and dissemination of mosquito-borne virus and surveillance control data. AB 2892 passed out of the committee on a unanimous vote and moves on to the Assembly Appropriations Committee.

Drug and Alcohol Services

AB 2328 (Nazarian) as amended on March 23, 2018 – Support

AB 2328, authored by Assembly Member Adrin Nazarian and sponsored by the County Behavioral Health Directors Association (CBHDA), would establish the Youth Substance Use Disorder Treatment and Recovery Program Act. The measure would direct the Department of Health Care Services (DHCS), in collaboration with counties and substance use disorder services providers, to establish a comprehensive continuum of substance use disorder (SUD) services for California youth under age 21. AB 2328 also directs DHCS to seek funding from Medi-Cal, federal financial participation, and cannabis tax revenues dedicated to youth education, prevention and early intervention.

The measure was heard in the Assembly Health Committee on Tuesday, where Assembly Member Bigelow encouraged the author and sponsors to think through how the proposal would be funded. Interestingly, Assembly Member Waldron referenced arguments from CHEAC’s letter of support that highlighted treatment as a cost-effective way to reduce harm from SUDs while saving money elsewhere in the health care and criminal justice systems and the lack of investment in comprehensive SUD services for youth.

The committee unanimously passed AB 2328, which now moves to the Assembly Appropriations Committee.

AB 2487 (McCarty) as introduced on February 14, 2018 – Support

On Tuesday, AB 2487 by Assembly Member Kevin McCarty was heard in the Assembly Business and Professions Committee. The measure would require every applicant for a physician’s and surgeon’s certificate from the Medical Board to complete a course on the treatment and management of opiate-dependent patients and eight hours of instruction in buprenorphine treatment. It would also require every physician and surgeon to complete the buprenorphine treatment course through mandatory continuing education if they are not currently authorized to prescribe buprenorphine.

CHEAC was supportive of the measure as it would expand the knowledge base of new and practicing physicians about treating individuals with opioid-related substance use disorders, alongside the County Behavioral Health Directors Association and others. However, the measure was met with opposition from the California Medical Association, who cited the requirement as “unnecessary and burdensome” and noted there are a significant number of physicians that would not need this specific training for their practice.

During the discussion on the measure, Assembly Member Baker expressed concern with the proportion of continuing education hours spent solely focusing on buprenorphine as opposed to other topics that may be more relevant for the provider’s work. Assembly Member Eggman, who is a strong advocate for safe injection cites, was not keen on mandated provider trainings and as such encouraged Assembly Member McCarty to narrow the bill’s requirements. In a similar manner, Assembly Member Arambula expressed his discomfort with the mandated requirements on providers. He also indicated his desire to see the bill narrowed and suggested the language reflect a recommendation for continuing education come from the medical board itself as an evidence based practice.

The bill passed with nine ‘Yes’ votes, two ‘No’ votes and five abstentions and now moves to the Assembly Appropriations Committee.

AB 2760 (Wood)  as amended on April 3, 2018 – Support

AB 2760 by Assembly Member Jim Wood, was heard this week in the Assembly Business and Professions Committee. The measure would require prescribers to prescribe naloxone to their patients when they have a high opioid dosage amount, when they are also prescribed concurrently with benzodiazepine, or when the patient presents an increased risk for overdose. The bill also requires prescribers to provide education to patients and households on overdose prevention and the use of naloxone.

During the hearing Assembly Member Wood referenced the recent Surgeon General’s Advisory on Naloxone and Opioid Overdose, which urged more Americans to learn how to effectively use naloxone. The advisory noted that “knowing how to use naloxone and keeping it within reach can save lives.”

CHEAC supports AB 2760, which was passed with 14 ‘Yes’ votes, one ‘No’ vote and one member not voting. The measure will be heard next in the Assembly Health Committee.

Chronic Disease Prevention & Wellness Promotion

AB 1871 (Bonta) as amended on March 14, 2018 – Support

AB 1871 by Assembly Member Rob Bonta was advanced from the Assembly Education Committee to the Assembly Appropriations Committee this week with five ‘Yes’ votes, one ‘No’ vote, and one member not voting. The measure would require all California public charter schools to provide needy pupils with one nutritionally adequate free or reduced-price meal per school day. Since 1975, low-income students at traditional public schools in California have been guaranteed at least one meal each school day, but students attending public charter schools have not been guaranteed this same right. CHEAC supports this measure to ensure California’s low-income students have access to nutritious meals.

Injury Prevention

AB 1798 (Chu) as amended on March 14, 2018 – Support

AB 1798 by Assembly Member Steven Chu this week was advanced from the Assembly Education Committee to the Assembly Appropriations Committee with six ‘Yes’ votes and one member not voting. The measure requires all school buses operating in California to be equipped with a passenger restraint system by July 2035. CHEAC supports the measure to prevent injury and death among California children and improve safety of school transportation methods.

Maternal, Child & Adolescent Health

AB 2289 (Weber) as introduced on February 13, 2018 – Support

Assembly Member Shirley Weber’s AB 2289 requires school districts to allow six weeks of parental leave to parenting pupils who give or expect to give birth, eight weeks of parental leave for C-section or birth with complications, and four weeks of parental leave to a parenting pupil not giving birth. The measure also requires school districts to provide up to four excused absences to a parenting pupil per school year to care for a sick child without documentation from a health care provider. This week, AB 2289 was unanimously advanced from the Assembly Education Committee to the Assembly Appropriations Committee. The measure is supported by a number of MCAH-, healthcare-, and education-related advocacy organizations.

Kaiser Permanente Announces New Firearm Injury Prevention Initiative

This week, Kaiser Permanente announced the formation of the Kaiser Permanente Task Force on Firearm Injury Prevention and a $2 million investment in research to prevent injuries and death caused by firearms. In 2016, firearm-related injuries caused over 30,000 deaths in the United States, and Kaiser Permanente treated more than 11,000 victims of gunshot wounds in 2016 and 2017.

Pointing to the growing rates of firearm-related injuries and death, whether by suicide, homicide, or accident, Kaiser Permanente outlined its commitment to injury prevention and the health and wellbeing of the communities it serves. Under this new initiative, Kaiser Permanente plans to collaborate with key stakeholders to share research findings and disseminate best practices through wide-ranging networks, including webinars, white papers, and peer-reviewed publications.

The full Kaiser Permanente announcement is available here.

Prevention Institute Publishes Brief on Health Inequities

With support from the Robert Wood Johnson Foundation (RWJF), the Prevention Institute released a brief titled, “Countering the Production of Health Inequities through Systems and Sectors.” The brief examines a series of determinants of health, their connections to health and safety, and inequities in health and wellbeing outcomes. To better understand the origination of health inequities and determine how to best address them, the brief recommends a three-pronged approach through:

  • Single sector action;
  • Multi-sector action; and
  • A system to ensure a continued and deliberate focus on achieving health equity

The brief outlines a number of systems and strategies available to addressing and ameliorating health inequities, including built environment design improvements, violence prevention, economic opportunity initiatives, and housing availability. Local-based examples are highlighted in the report, and a call to action is made to reverse inequities and disparities and build health equity. The full Prevention Institute brief is available here.

Childhood Poisoning Report Shows Increases in Exposures of Addictive Substances to Children

The National Center on Addiction and Substance Abuse (CASA) recently published a report on childhood poisoning and prevention efforts. The report finds that in 2016 alone, over 30,500 reports were made to poison control centers regarding the exposure of addictive substances to young children. Exposure rates of nicotine, alcohol, cannabis, and opioids among children have increased over the past decade and many of these children experience serious consequences from these events. Notable findings include:

  • Exposures to cannabis increased by 148 percent over a seven-year period
  • Exposures to prescription opioids increased 93 percent each year over a nine-year period
  • Poison control center reports regarding e-cigarettes increased more than 1,400 percent over a three-year period
  • The number of young children exposed to alcohol has increased every year since 2012

The report details a set of recommendations and conclusions for public health practitioners, health care providers, parents and caregivers, policymakers, and researchers to ensure children are protected from toxic substance exposure, substance use, and addiction. The full report is available here.