April 17, 2020 Edition

Newsom, Trump Outline Frameworks for Reopening Society After COVID-19

This week, Governor Gavin Newsom and President Donald Trump both outlined frameworks and guidelines for reopening normal operations of daily life in California and the U.S.

Newsom Administration Identifies Six Criteria for Modifying Stay-at-Home Order

On Tuesday, Governor Gavin Newsom unveiled a series of indicators and considerations that will guide California’s actions for when and how to modify the statewide stay-at-home order amid the ongoing COVID-19 pandemic. During Tuesday’s noon press conference, Governor Newsom discussed the unsustainable nature of the current arrangement, particularly its impact on the state’s economy, individual and family household budgets, and the deferral of certain health services. Newsom reiterated the importance of remaining grounded in science and data and not politics in determining necessary modifications to public health orders.

Until immunity is built, the Administration outlined its overarching priorities to:

  • Ensure the ability to care for the sick in hospitals
  • Prevent infection in people who are at high risk for severe disease
  • Build capacity to protect the health and wellbeing of the public
  • Reduce social, emotional, and economic disruptions

To this end, the Administration identified six indicators and associated questions for modifying California’s stay-at-home order, including:

  • The ability to monitor and protect our communities through testing, contact tracing, isolating, and supporting individuals who are positive or exposed
  • The ability to prevent infection in people who are at risk for more severe COVID-19
  • The ability of the hospital and health systems to handle surges
  • The ability to develop therapeutics to meet demand
  • The ability for businesses, schools, and childcare facilities to support physical distancing
  • The ability to determine when to reinstitute certain measures, including stay-at-home orders, if necessary

While the Administration did not provide a specific timeline for modifying or lifting its order, Governor Newsom indicated a conversation regarding the order may be able to occur in two weeks if California has realized a decrease in hospitalizations and ICU admissions, adequate provision of personal protective equipment (PPE), and the development of infrastructure and workforce for contact tracing/tracking. Furthermore, Newsom indicated Californians will need to make modifications to daily routines and spaces, including reduced capacities in restaurants, businesses, and classrooms.

CSAC, in responding to the Newsom Administration’s framework, expressed the importance of local governments in determining when and how to return the state to normalcy and highlighted ongoing resource needs of local health departments. CSAC noted, “County public health departments are the front-line responders to COVID-19 and need immediate funding to maintain operations, hire communicable disease investigators, and handle the lasting ramifications of this pandemic. … Local public health departments are experts in communicable disease testing, tracing and isolation and should remain the lead role for tracking COVID-19 recovery data as they have the experience and appropriate training to follow the law, guidelines, and accreditation requirements.”

The full announcement from the Newsom Administration is available here.

Trump Administration Details Phased, State-Based Approach to Reopening

On Thursday, President Donald Trump unveiled guidelines for a phased approach to reopening major components of U.S. society. In an 18-page document, the Trump Administration suggests three phases for states to reopen with progressively relaxed levels of social distancing at each phase. For jurisdictions to advance through the phases, a 14-day period of a “downward trajectory” of cases would need to be realized. The overall framework detailed by the Trump Administration stresses the use of up-to-date data, mitigation of resurgence risk, protection of vulnerable individuals, and ability for activities to be implementable on a statewide or county-by-county basis at governors’ discretion. Furthermore, President Trump, in a call with U.S. governors on Thursday, indicated that governors will be in charge of determining when and how to lift restrictions on stay-at-home and social distancing orders.

The Trump Administration’s full guidelines are available here.

Newsom Assembles Task Force on Business and Jobs Recovery

Today, Governor Gavin Newsom announced the formation of a state Task Force on Business and Jobs Recovery to chart a path forward on recovery in the wake of the COVID-19 pandemic. The task force will be co-chaired by Governor Newsom’s Chief of Staff Ann Leary and philanthropist, environmentalist, and businessman Tom Steyer. Steyer was also appointed Chief Advisor to the Governor on Business and Jobs Recovery.

The task force consists of nearly 90 members and features executives and leaders in California business, labor, health, academia, and community entities. Among the members on the task force are Lieutenant Governor Eleni Kounalakis, Senate President pro Tempore Toni Atkins, Assembly Speaker Anthony Rendon, Senate Minority Leader Shannon Grove, Assembly Minority Leader Marie Waldron, former Federal Reserve Chair Janet Yellen, CHHS Secretary Dr. Mark Ghaly, Newsom Administration Cabinet Secretary Ana Matosantos, Department of Finance (DOF) Director Keely Bosler, and The California Endowment President and CEO Bob Ross. Honorary task force members include the four past living governors Jerry Brown, Arnold Schwarzenegger, Gray Davis, and Pete Wilson.

The task force will work on developing actions that government and businesses can take to help Californians recover as fast as safely possible form the COVID-19-induced recession and will meet twice a month throughout 2020 to develop options that would work for all Californians, with a particular focus on those hardest hit by the pandemic. The ideas that will be shaped by the task force will include short, medium, and long-term solutions and will build upon the work of other groups including the Governor’s Council of Economic Advisors and the Commission on the Future of Work.

The full announcement from the Governor’s Office is available here.

This Week’s Newsom Executive Orders Include Juvenile Justice, EDD Call Center, Food Sector Sick Leave, Others

Governor Gavin Newsom this week issued a series of executive orders related to COVID-19. Below, these orders are detailed:

Juvenile Justice Discharge and Reentry

Governor Newsom issued Executive Order N-49-20 calling for all Division of Juvenile Justice (DJJ) discharge and reentry hearings to be held via videoconference to minimize participants’ exposure to COVID-19. The order also shortens notification timeframes from 60 days to 30 days before holding a discharge hearing and allows for reentry consideration hearings to occur at the DJJ facility where youth are housed instead of transferring youth to a county jail.

EDD Call Center Hours

Executive Order N-50-20 was issued by Governor Newsom and directs the Economic Development Department (EDD) to launch a new call center on Monday that will operate seven days a week from 8:00 am to 8:00 pm. The Unemployment Insurance Branch will also be upstaffed with 1,340 employees, including 740 EDD employees and 600 employees from across state government. The order also directs EDD to expedite access to the Work Share program to avert layoffs.

Food Sector Sick Leave

Executive Order N-51-20 was issued by Governor Newsom on Thursday to provide California workers in the food and agriculture sectors impacted by the COVID-19 pandemic with two weeks of paid sick leave, filling a gap left by federal relief that provided similar paid leave benefits for employers with fewer than 500 workers. The order also provides health and safety standards to increase worker and customer protection by permitting workers at food facilities to wash their hands every 30 minutes, or as needed, to increase proper sanitation measures.

COVID-19 Response Efforts

Governor Newsom issued Executive Order N-52-20 also on Thursday covering a variety of issues in response to the COVID-19 pandemic, including adjusting admissions requirements for the California State University system and providing flexibility for 60 days on background checks for critical infrastructure sectors. Specifically, the CSU system will be able to waive hearing requirements to be able to make adjustments to admissions criteria for students applying this coming fall to enter as freshmen in the fall of 2021.

The order also allows the Department of Justice (DJJ) to develop procedures to perform name-based background checks to protect health and safety and avoid delays in processing employment for critical sectors, such as health care services and care and support for vulnerable populations. The order allows federal stimulus checks to flow directly to custodial parents owed back child support payments and will additionally allow for commercially licensed food trucks to temporarily operate in roadside rest areas for a period of 60 days to ensure essential infrastructure workers have access to food. CalTrans will be charged with developing and implementing a process to administer the temporary permits.

Senate Convenes First COVID-19 Budget Oversight Hearing

On Thursday afternoon, the Senate Budget & Fiscal Review Special Subcommittee on COVID-19 Response held its first oversight hearing to review the Newsom Administration’s use of $1 billion in state emergency funds, the use of the Disaster Response-Emergency Operations Account, and federal funding for COVID-19 response activities. After a lengthy delay due to technical issues with the Senate’s video server and with the majority of subcommittee members participating remotely, the subcommittee’s hearing began with opening remarks from Chair Senator Holly Mitchell and Vice Chair Senator Jim Nielsen. Senator Mitchell discussed the gravity of the current situation, the role of the Legislature in exercising oversight of Administration’s expenditures in responding to COVID-19, and the likelihood of difficult fiscal times ahead.

The hearing’s first panel featured Legislative Analyst Gabe Petek who presented an overview of the current economic status and forecasted economic experience as a result of COVID-19. The LAO has determined that the state has entered a recession and the economy’s recovery will likely depend on the trajectory of the virus itself. Petek discussed the role of the federal government in responding to COVID-19, including its ability to run budget deficits, appropriations made to state and local governments, and the likelihood of the need for further federal action around financial supports. Furthermore, Petek indicated California likely faces a challenging fiscal outlook with the state experiencing a situation in which General Fund expenses outpace revenues. Given the modified tax deadlines and difficulty in determining revenue estimates, the LAO recommends the Legislature adopt a cautious “baseline” budget in June that maintains existing service levels.

The next panel featured representatives from the Department of Finance (DOF), California Health and Human Services (CHHS) Agency, and the California Office of Emergency Services (Cal OES). DOF’s Vivek Viswanathan discussed the Administration’s planning and forecasting for a recession scenario, including enacting a balanced budget, paying off the “wall of debt,” and significantly investing in the state’s reserves. DOF expressed appreciation for the Legislature’s rapid action in approving up to $1 billion to support COVID-19 response activities and further indicated it expects California will incur $7 billion in direct COVID-19 expenses, as well as increased caseload expenses with Medi-Cal and other safety net programs. Given the fluid nature of the current situation, DOF indicated it had limited information to share with the Legislature regarding contracts entered into for COVID-19 supplies and resources, expenditure planning, and May Revision estimates.

DOF further indicated the Newsom Administration has committed $769 million of the $1 billion made available by the Legislature on a variety of areas, including hospital and laboratory preparedness, personal protective equipment, homelessness sheltering and services, childcare services, and direct financial assistance. DOF also discussed its $1.3 billion transfer to the Disaster Response-Emergency Operations Account to support procurement of personal protective equipment and critical medical supplies in response to COVID-19.

The last panel of the hearing featured Chris Hoene of the California Budget and Policy Center who discussed economic implications of COVID-19 on Californians, particularly those who are vulnerable, low-income, undocumented, and persons of color. Hoene identified a series of key gaps in recent federal actions that provided economic, financial, and workplace supports to citizens and Californians working in certain sectors. Hoene recommended future economic aid provided in response to COVID-19 prioritize local governments, children, families, and low-income Californians who have been disproportionately impacted by the ongoing pandemic.

Following the three panel presentations, subcommittee members had the opportunity to ask questions of the presenters. Senator Holly Mitchell began by questioning the DOF around the collection status of revenues, anticipated expenses to be incurred in responding to COVID-19, and processes governing the use of the state’s rainy day fund, as well as questioning the LAO around the use of other budgetary reserves that have been established in recent years. Other subcommittee members queried panelists around the new supply chain for personal protective equipment, unemployment insurance claims and projections, federal COVID-19 legislation and appropriations, homelessness services, stay-at-home orders, safety net program availability, and state budget processes. Notably, Senator Richard Pan posed a series of questions around adequately resourcing local health departments to conduct contact tracing and tracking, statewide testing capacities, distribution of personal protective equipment, and health care worker protections.

Public comment included representatives from local government, health and public health, education, businesses, and others. CHEAC Executive Director Michelle Gibbons during public comment highlighted the critical work of local health departments during the COVID-19 pandemic and urged the Legislature and Administration to dedicate significant resources to bolster local health department capacity and the public health infrastructure.

As a reminder, the Assembly will convene its budget subcommittee on COVID-19 oversight on Monday, April 20 and Monday, April 27 at 10:00 am. A recording of the Senate subcommittee hearing can be found here. The full subcommittee hearing agenda is available here.

Senate Creates Special Committee on Pandemic Emergency Response

On Wednesday, Senate President pro Tempore Toni Atkins announced the creation of the Senate Special Committee on Pandemic Emergency Response, a bipartisan committee of eleven senators to review the state’s response to the COVID-19 pandemic. The committee will explore what has gone well and what could be improved regarding the state’s planning and response activities, as well as make findings are recommendations for future pandemic preparedness.

The special committee will be chaired by Senator Lena Gonzalez, vice chaired by Senator Patricia Bates, and will include Senators Andreas Borgeas, Anna Caballero, Bill Dodd, Hannah-Beth Jackson, Brian Jones, Mike McGuire, Richard Pan, Thomas Umberg, and Scott Wiener. At the time of publication, the special committee’s first hearing date has not yet been set.

The full announcement from Senate President pro Tempore Toni Atkins is available here.

Newsom Administration Announces Additional COVID-19 Emergency Fund Expenditures

This week, the Newsom Administration announced the expenditure of additional COVID-19 emergency response funds that were approved by the Legislature last month. Below, we highlight these expenditures:

$42m Investment for Foster Youth and Families

On Monday, Governor Gavin Newsom announced $42 million in new investments to protect and support younger Californians who are at heightened risk for abuse and mistreatment due to COVID-19. The new investments, totaling $42 million ($40.6 million in State General Fund and $1.4 million in federal funds), are allocated over a number of different social services programs and supports and will support foster youth over the next three months. The investments include:

  • Family Support: $27,842,000 will provide a $200/month supplement to families in the Emergency Response and Family Maintenance Programs.
  • Social Worker Outreach: $6,896,552 to support social worker overtime and additional outreach by county social workers to foster families at higher risk of COVID-19 (e.g. caregivers over 60 years old).
  • Family Resource Centers: $3,000,000 to provide direct support and services to foster families through family resource centers, including material items, assistance with isolation needs, parenting resources, and staff time to link families to other state and federal supports (e.g. food, housing, etc.).
  • Helpline Expansions: $250,000 to support 2-1-1 and Parents Anonymous to offer immediate assistance to families in crisis who are seeking assistance.
  • Foster Youth Age Extension: $1,846,165 to extend foster care payments and eligibility for those aging out of the foster system.
  • Resource Family Support: $1,728,655 to support resource families impact by COVID-19 through higher monthly reimbursement rates to cover extra costs associated with supporting children with more complex needs.
  • Caregiver Approval Timeframes: $166,000 to allow caregivers to continue to be paid beyond 365 days while awaiting Resource Family Approval.
  • Access to Technology: $313,128 to purchase 2,000 laptops and 500 cell phones for foster youth to stay connected with their families and resources and participate in educational opportunities during COVID-19.

Additional information is available from Governor Newsom’s website here.

$125m Investment for Disaster Relief Fund

Governor Newsom on Wednesday announced the creation of the Disaster Relief Fund which will provide disaster relief assistance for working Californians. The fund is a statewide public-private partnership and will provide support to undocumented immigrants impacted by COVID-19 who are otherwise ineligible for unemployment insurance benefits and disaster relief, including the federal CARES Act, due to their immigration status.

Under the fund, California will provide $75 million and philanthropic partners have committed to raising an additional $50 million. The $50 million for direct financial assistance is expected to be raised by Grantmakers Concerned with Immigrants and Refugees (GCIR), a network of foundations focused on immigration issues. Initial investments of $5.5 million has been raised from the Emerson Collective, Blue Shield of California Foundation, The California Endowment, The James Irvine Foundation, Chan Zuckerberg Initiative, and an anonymous donor, among others.

Approximately 150,000 undocumented adult Californians are expected to receive a one-time cash benefit of $500 per adult with a cap of $1,000 per household to deal with the specific needs arising from the COVID-19 pandemic. Individuals will be able to apply for support beginning next month, and funds will be dispersed through a community-based model of regional nonprofits with expertise and experience serving undocumented communities. Additionally, California has developed a COVID-19 guide for immigrant Californians available here.

More information is available from the Governor’s website here.

DOF Issues COVID-19 Interim Fiscal Update

The Department of Finance (DOF) late last week issued a letter to Senate and Assembly Budget and Appropriations committee chairs providing an interim update on the state’s fiscal condition amid the ongoing COVID-19 pandemic. In its letter, DOF discusses economic forecasts and revenue projections, expenditures, federal stimulus measures, and cash flow.

DOF provides an overview of anticipated economic impacts to the state, including cascading and downstream impacts of the massive public health response. Notably, DOF indicates California is expected to incur $7 billion in direct expenses responding to the COVID-19 emergency; the bulk of expenses are likely to be reimbursed by the federal government. 

Further, DOF indicates it will provide an on-time May Revision budget which will reflect a “workload budget” for the state. The full DOF letter is available here.

DHCS Delays CalAIM Implementation, Will Seek Extension of Section 1115 and 1915b Waivers

The Department of Health Care Services (DHCS) on Wednesday announced via email it is postponing its California Advancing and Innovating Medi-Cal (CalAIM) proposal implementation timelines in order to allow for the continued response to COVID-19. DHCS further indicated it plans to engage stakeholders and the federal government in both an extension of the existing Section 1115 Waiver and the Section 1915b Specialty Mental Health Waiver.

DHCS still plans to continue seeking approval of CalAIM proposals but at a later, unannounced date. Below are some of the immediate changes to CalAIM implementation activities given Wednesday’s announcement:

  • Summary of CalAIM Changes: DHCS is delaying the release of “redlined” version of CalAIM proposals that reflect changes informed by the CalAIM Workgroup process and stakeholder feedback. Proposals are likely to be finalized later this summer.
  • CalAIM Regional Meetings and Technical Assistance: In-person regional meetings on CalAIM Enhanced Care Management (ECM) and In Lieu-of Services (ILOS) implementation have been postponed until further notice. DHCS is also delaying the launch of the CalAIM Targeted Technical Assistance teams; future dates will be forthcoming.
  • ECM/ILOS Transition Plans: Given changes to the overall CalAIM timeline, DHCS has determined that the ECM/ILOS transition plans will no longer be due to DHCS on July 1, 2020. A new deadline will be determined and communicated in the near future.
  • Medi-Cal Section 1115 Waiver Public Hearings: Public hearings for the Section 1115 Waiver renewal and consolidated Section 1915b hearing are currently scheduled for May 18 and May 27. These dates are subject to change based on the ongoing COVID-19 situation and discussions with the Centers for Medicare & Medicaid Services (CMS).
  • Foster Care Workgroup: DHCS and the California Department of Social Services (CDSS) have jointly determined to launch the Foster Care Model of Care Workgroup on June 26 instead of April 21. Group membership is expected to be announced by May 15.

DHCS Seeks Additional Section 1135 Waiver Flexibilities

Late last week, the Department of Health Care Services (DHCS) requested from the Centers for Medicare and Medicaid Services (CMS) additional Section 1135 Waiver flexibilities amid the ongoing COVID-19 pandemic. Recall last month, DHCS requested from CMS and was approved for flexibilities in key areas, including prior authorization eligibility, telehealth, service authorizations, administrative timelines, and rate setting methodologies.

The latest waiver flexibility request from DHCS seeks Medicare blanket waivers for Medicaid-only providers, service authorization and utilization control waivers, managed care health assessment and quality assessment/performance improvement activities, telehealth/telephonic/virtual visit waivers, and clarification of previous DHCS requests. The request further seeks a retroactive effective date of March 1, 2020.

The full DHCS letter is available here.

DHCS Issues April 2020 Stakeholder Communication Update

The Department of Health Care Services (DHCS) recently issued its bimonthly update of important events and actions at the Department. The April 2020 Stakeholder Update includes information on COVID-19-related activities, various program updates, and upcoming stakeholder meetings and webinars.

The April 2020 update is available here.

LAO Issues Report on State Budget Effects of Recent COVID-19 Federal Actions

This week, the Legislative Analyst’s Office (LAO) published a post detailing impacts on California’s state budget in light of COVID-19 and new federal resources that may assist in addressing state budget issues as a result of responding to the pandemic. The LAO examines sources of a potential budget problem where the state’s anticipated General Fund revenues are less than the General Fund costs to maintain state services. The state will likely be facing a budget problem upon the Governor’s release of his May Revision, as a result of three major COVID-19-related sources:

  • Higher Direct Costs to Respond to the Public Health Emergency: The state has already incurred significant costs in responding to the COVID-19 emergency. Examples of these expenses include leasing medical centers to expand the state’s hospital and laboratory capacity, purchasing and refurbishing of medical supplies, and providing testing and treatment services to COVID-19 patients.
  • Higher Indirect Costs as a Result of Changes in the Economy: The state will incur higher indirect costs from changes in the state’s economic circumstances resulting from the COVID-19 emergency. As unemployment rises and incomes fall, more residents will qualify for means-tested programs, including food assistance. In previous recessions, these types of costs have risen by low billions of dollars.
  • Lower Revenues as a Result of Changes in the Economy: The largest budgetary impact of the COVID-19 emergency is likely to arise as a result of lower revenues. The length and severity of the public health emergency will drive the severity of the economic disruption and the ensuing revenue implications.

The LAO examines a series of recent federal legislative actions that has directed funding to states, local governments, and other entities to respond to the COVID-19 emergency. These federal legislative actions include the Coronavirus Preparedness and Response Act, the Families First Coronavirus Response Act (FFCRA), and the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The LAO provides a detailed analysis of these funding sources and its impact on state and local budgets, as well as on key areas such as health care, unemployment, and education.

Ultimately, the LAO determines the various recent actions by the federal government will mitigate some of the adverse budgetary impacts caused by COVID-19. However, only a small portion of the federal funding allocated to date—additional Medi-Cal funding—will assist the state with the most significant source of budgetary strain that is likely to result from COVID-19: lower revenues. According to the LAO, additional federal action to support the economic and revenue consequences of this emergency could be warranted.

The full LAO post is available here.

FEMA Issues Disaster Financial Management Guide for Local Jurisdictions

Yesterday, the Federal Emergency Management Agency (FEMA) issued the “Disaster Financial Management Guide” to support jurisdictions in establishing and implementing sound disaster financial management practices. The guide takes an all-hazards approach and addresses a broad range of issues and contains concepts, principles, and resources applicable to the COVID-19 pandemic response.

The guide identifies capabilities and activities necessary to prepare and successfully implement disaster financial management while maintain fiscal responsibility throughout response and recovery operations. This includes considerations and practices necessary to track, calculate, and justify costs of an emergency; support local reimbursement reconciliation; avoid de-obligation of grant funding; and effectively fund and implement recovery projects and priorities. The principles, concepts, and resources contained in the guide can support jurisdictions in identifying the resources needed to support their community, increase efficiency of recovery efforts, and reduce the likelihood of audits and financial penalties for the jurisdiction.

A brief fact sheet on the guide and the COVID-19 pandemic is available here, and the full FEMA guide is available here.

Trump Administration Halts Funding to World Health Organization

This week, President Donald Trump directed his administration to place a hold on all funding to the World Health Organization (WHO). Each year, the U.S. Government provides approximately $400 million to $500 million to WHO to support its international health planning, coordination, and response activities. The Trump Administration contends that the WHO mismanaged the handling of the COVID-19 pandemic, including not acting expeditiously enough when receiving reports of human-to-human COVID-19 transmission and opposing travel restrictions established by the Trump Administration.

In announcing its decision to halt WHO funding, the Trump Administration calls for structural reforms to the organization, including increased transparency and data sharing, International Health Regulation accountability, and increased access to medicines. The full announcement from the Trump Administration is available here.

TFAH Report Examines Chronic Underfunding of Public Health and Emergency Preparedness Systems

The Trust for America’s Health (TFAH) recently released its report, The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations, 2020. The report examines federal, state, and local public health funding trends, finding a continuing pattern of underfunding vital public health and emergency preparedness programs. As such, TFAH determines that the lack of funding has made the nation vulnerable to health security risks, including the novel coronavirus pandemic.

While the United States spends an estimated $3.6 trillion annually on health, less than three percent of that funding is directed toward public health and prevention. Public health spending as a proportion of total health spending has been decreasing since 2000 and fall in inflation-adjusted terms since the Great Recession. TFAH finds that health departments across the country are battling 21st century health threats with 20th century resources.

TFAH details funding levels of the U.S. Centers for Disease Control and Prevention (CDC) for Fiscal Year 2020 which increased in certain areas including one-time investments in capital facilities, public health data modernization, and global health security. Modest investments were also made in suicide prevention and gun violence research; however, despite these modest increases, the CDC’s program level budget remains just above its level in FY 2008 when adjusting for inflation. Furthermore, the Prevention and Public Health Fund (PPHF), which was originally designed to expand and sustain the nation’s investment in public health and prevention, remains at half of where it should have been funded in 2020 due to the reappropriation of funds to other spending programs.

The report goes on to examine other federal public health-related investments, emergency preparedness programs and activities, and core capabilities of a robust public health system. Notably, the report discusses the public health workforce, finding that the workforce has shrunk by approximately 56,000 positions over the past decade primarily due to funding issues. In assessing the overall investment pattern into public health, TFAH notes, “An unfortunate pattern has emerged: as a nation, we pay attention to public health investment when there’s a crisis, often borrowing from existing public health budgets (money typically meant to address chronic illness) to pay for the emergency response before falling back into a pattern of underinvesting in public health.” The continued trend of using resources from other public health programs to pay for public health emergencies has left the overall public health infrastructure on weak footing.

TFAH outlines a series of 28 recommendations for policy action within four priority areas. Those four areas are:

  • Increased funding to strengthen the public health infrastructure and workforce, including modernizing the system’s data and surveillance capacities.
  • Safeguarding and improving Americans’ health by investing in chronic disease prevention and the prevention of substance misuse and suicide.
  • Improving emergency preparedness, including preparation for weather-related events and infectious disease outbreaks.
  • Addressing the social determinants of health and advancing health equity.

The full TFAH report is available here.

Budget & Policy Center Publishes Issue Brief on Health Coverage During and After COVID-19

This week, the California Budget & Policy Center published an issue brief around health coverage during and beyond the COVID-19 pandemic. The report discusses recent short-term actions by policymakers to mitigate serious health threats caused by COVID-19, including extending coverage for COVID-19 testing and treatment through Medi-Cal.

While these actions have provided temporary access to a narrow set of health services, the report further analyzes the longstanding issue of health insurance coverage gaps, particularly among high-risk populations. Seniors, especially those who are undocumented, could significantly benefit from having access to preventive health services and routine care that promote overall health over the long term. The report lastly outlines actions available to state lawmakers to expand Medi-Cal eligibility to include California’s seniors who are undocumented.

The full California Budget & Policy Center issue brief is available here.