April 2, 2021 Edition
On Monday, the California State Legislature will return to Sacramento from its week-long spring recess. Lawmakers face an extremely busy month ahead as they work through policy committee hearings, facing deadlines in late April and early May to advance to the floor bills introduced in their house of origin.
Recall, the Legislature is operating in a slightly different fashion given the ongoing COVID-19 pandemic. Legislators have set aside budget hearings and actions until the release of the Governor’s May Revise Budget in early May while they consider legislative and policy matters.
Below, we highlight several bills of interest to CHEAC Members. Our full CHEAC Weekly Bill Chart is available here.
Public Health Infrastructure
AB 240 (Rodriguez) as introduced January 13, 2021 – SPONSOR
AB 240 by Assembly Member Freddie Rodriguez will be heard in the Assembly Health Committee on Tuesday, April 6. CHEAC, HOAC, and SEIU California were joined by UCC and RCRC in sponsoring the measure this week. The measure would require the California Department of Public Health (CDPH) to contract with an appropriate and qualified entity to conduct an evaluation of the adequacy of the local health department infrastructure and to make recommendations for future staffing, workforce, and resource needs.
Communicable Disease Control
SB 742 (Pan) as amended March 4, 2021 – SUPPORT
Senator Richard Pan’s SB 742 would prohibit a person from engaging in physical obstruction, intimidation, or picketing within 300 feet a targeted vaccination site during the site’s operational hours. The measure additionally specifies violation penalties and includes an urgency clause to “ensure public peace and safety during the process of distributing vaccinations” during the COVID-19 pandemic. The measure will be heard in the Senate Health Committee on April 20.
Health Equity
AB 1407 (Burke) as amended March 18, 2021 – SUPPORT
AB 1407 by Assembly Member Autumn Burke would require specified nursing schools and programs to include in its curriculum coursework on implicit bias. The measure would also require new nurse licensees to complete direct participation in an implicit bias course and would require hospitals to implement an evidence-based implicit bias program as part of its program that hires and trains new nursing program graduates. CHEAC is proud to support AB 1407 as a way to potentially reduce health and health care disparities among Californians of racial, ethnic, or cultural minorities. AB 1407 will be heard in the Assembly Business and Professions Committee on Tuesday, April 6.
Today, the California Department of Public Health (CDPH) announced updates to the state’s Blueprint for a Safer Economy framework allowing additional activities to resume with modifications to reduce risk. According to CDPH, increasing vaccination rates and a near-record low statewide COVID-19 test positivity rate is allowing the state to make additional modifications to the reopening framework.
Today’s updates take effect on April 15 and include the following:
- Gatherings: In the Red Tier, outdoor gatherings of up to 25 people are allowed. The gathering size increases to 50 people in the Orange Tier and 100 people in the Yellow Tier. In the Purple Tier, only outdoor gatherings limited to three households are allowed. Indoor gatherings are strongly discouraged in all tiers but are allowed with modifications and capacity limits in the Red, Orange, and Yellow tiers.
- Private Events and Meetings: In all tiers, modifications to private events such as receptions or conferences are required to reduce COVID-19 risks. This includes pre-purchased tickets or a defined guest list and assigned seating.
- In the Purple Tier, these activities are only allowed outdoors and capacity is limited to 25 people. If all guests are tested or show proof of full vaccination, capacity increases to up to 100 people.
- In the Red Tier, outdoor gatherings are limited to 50 people and capacity increases to 200 if all guests are tested or show proof of full vaccination. In this tier, indoor activities are allowed if all guests are tested or show proof of full vaccination; capacity is limited to 100 people.
- In the Orange Tier, outdoor gatherings are limited to 100 people and capacity increases to 300 if all guests are tested or show proof of full vaccination. In this tier, indoor activities are allowed if all guests are tested or show full proof of vaccination; capacity is limited to 150 people.
- In the Yellow Tier, outdoor gatherings are limited to 200 people and capacity increases to 400 if all guests are tested or show proof of full vaccination. In this tier, indoor activities are allowed if all guests are tested and show full proof of vaccination; capacity is limited to 200 people.
- Indoor Live Events or Performances: In the Purple Tier, these activities are not allowed. In the Red, Orange, and Yellow tiers, these activities are allowed with capacity limits and modifications including physical distancing, advance ticket purchases, designated areas for eating and drinking, and attendance limited to in-state visitors.
- Venues with a capacity of up to 1,500 people: In the Red Tier, capacity is limited to 10 percent or 100 people and capacity increases to 25 percent if all guests are tested or show proof of full vaccination. In the Orange Tier, capacity is limited to 15 percent or 200 people and capacity increases to 35 percent if all guests are tested or show proof of full vaccination. In the Yellow Tier, capacity is limited to 25 percent or 300 people and capacity increases to 50 percent if all guests are tested or show proof of full vaccination.
- Venues with a capacity of 1,501 and above: In the Red Tier, testing or proof of vaccination is required and capacity is limited to 20 percent. In the Orange Tier, capacity is limited to 10 percent or 2,000 people and capacity increases to 35 percent if all guests are tested or show proof of full vaccination. In the Yellow Tier, capacity is limited to 10 percent or 2,000 people and capacity increases to 50 percent if all guests are tested or show proof of full vaccination.
CDPH indicates the state will continue to update the Blueprint for a Safer Economy periodically based on science and vaccination progress. An updated sector chart detailing allowable activities by tier assignment is available here. CDPH additionally notes local health departments may implement policies that are more restrictive than the state.
Additional information is available here.
On Thursday, as eligibility for COVID-19 vaccines expanded to residents ages 50 and older, Governor Gavin Newsom toured a COVID-19 community vaccination site in Los Angeles County and received his Johnson & Johnson COVID-19 vaccine administered by California Health and Human Services Agency Secretary Dr. Mark Ghaly. The Governor was joined by various state, community, local leaders, including Government Operations Agency Secretary Yolanda Richardson and Los Angeles County Supervisor Holly Mitchell, in touring the site and receiving the vaccine.
The Governor reminded residents of the expanded eligibility that became effective on Thursday and highlighted the upcoming expansion to residents ages 16 and older that becomes effective on April 15. A press statement from the Governor’s Office is available here.
Today, California State Auditor Elaine Howle issued an audit report on California’s management and use of federal COVID-19 funding allocated to the California Department of Public Health (CDPH). Recall, Auditor Howle in August 2020 designated the state’s management of federal COVID-19 funds a high-risk issue given the substantial amount of funds received and the risk of mismanagement of the funds.
The report released today focuses on the state’s use of approximately $467 million earmarked for the implementation and enhancement of programs related to the CDC Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC) Cooperative Agreement. The federal government provided $555 million to California from March 2020 to mid-December 2020 for state-level COVID-19 response efforts. Of this total amount, CDPH allocated $88 million to nonprofit partner Heluna Health. CDPH was then responsible for using the remaining $467 million to expand the state’s ability to test individuals for COVID-19 and to conduct case investigations and contact tracing among residents potentially exposed to COVID-19.
Under the state audit, it was found that the state’s testing of individuals for COVID-19 met or exceeded CDPH’s initial targets but statewide contact tracing has lagged well behind original plans. In early 2020, CDPH estimated statewide contact tracing would require more than 31,000 staff from local health departments. CDPH planned to assist LHDs in reaching the number of required contact tracers by temporarily reassigning 10,000 state employees to LHDs. In January 2021, however, the State Auditor determined that only about 12,100 contact tracing staff were employed statewide, including both staff hired or redirected by LHDs and staff reassigned by state agencies. According to Auditor Howle, this workforce was inadequate to meet the sharp year-end increase in COVID-19 cases realized statewide.
Further, the State Auditor reviewed state management of ELC COVID-19 funds that were allocated to 58 LHDs. CDPH allocated $286 million of its $467 million ELC balance to LHDs, and the State Auditor determined CDPH’s oversight of these funds has been insufficient. Namely, CDPH, as of mid-February, had not approved all ELC work and spending plans submitted by LHDs and quarterly fund reporting procedures were not entirely finalized at the time of the State Auditor’s report. As a result, the State Auditor determined that gaps in reporting and reviews have left untracked more than $40 million in ELC COVID-19 funds provided to LHDs.
Last, the State Auditor additionally reviewed CDPH’s oversight of the development of new information technology (IT) systems to track COVID-19 data. In establishing new IT systems and procedures, the Auditor determined CDPH did not retain an independent verification and validation consultant to perform key, early error identification steps. CDPH additionally did not prioritize oversight of the IT system, according to the Auditor, resulting in potential errors in data and IT functionality.
Auditor Howle identified a series of recommended actions for CDPH as a result of her office’s findings. CDPH is recommended to:
- Better leverage contact tracing as a tool to limit the spread of COVID-19 by reevaluating its contact tracing plan and update it to incorporate staffing efficiencies and create and implement a plan in partnership with LHDs to hire, train, and retain the number of contact tracing staff it determines necessary to limit the spread of COVID-19
- Ensure it has all necessary planning information in place related to funding allocations made to LHDs by reviewing and approving all initial ELC workplans by April 15, 2021
- Ensure it is performing necessary oversight and providing LHDs with guidance on improving their ELC COVID-19 activities by putting into place procedures to ensure that CDPH receives all required quarterly updates from LHDs
- Ensure the state has accurate COVID-19 data by directing its IT consultant to monitor system performance and data validation efforts, among other IT management considerations
CDPH concurred with the State Auditor’s recommendations and identified ways it plans to implement improvements. The full State Auditor’s report is available here.
This week, the Biden-Harris Administration announced continued expansions of its COVID-19 vaccine efforts. As a result of these expansions, the federal government anticipates by April 19 90 percent of adults in the U.S. will be eligible for a vaccine and 90 percent will have a vaccination site within five miles of where they live. Below, we highlight these activities:
- Federal Retail Pharmacy Program: The Biden-Harris Administration will expand the Federal Retail Pharmacy Program from 17,000 sites to nearly 40,000 within the next three weeks.
- Vaccines for Vulnerable and At-Risk Individuals: The U.S. Department of Health and Human Services (HHS) will award nearly $100 million in funding to Aging and Disability Networks in every state and territory to help increase vaccinations among older adults and people with disabilities. The funding is anticipated to provide assistance with scheduling vaccine appointments, transportation to vaccine sites, direct support services needed to attend vaccine appointments, connection to in-home vaccination options, and education about the importance of receiving the vaccine to older adults and people with disabilities.
- Mass Community Vaccination Sites: The Biden-Harris Administration will also be launching a dozen new federally run vaccination sites across the country. The Administration notes equity and access are prioritized in the design of these federal community vaccination sites with reserved slots for disadvantaged groups and communities.
Additional information is available here.
Governor Gavin Newsom on Tuesday announced emergency action to increase the state’s firefighting capacity ahead of an anticipated difficult wildfire year. Using Emergency Fund authorization, the Governor approved $80.74 million for 1,399 additional firefighters with the California Department of Forestry and Fire Protection (CAL FIRE) to bolster fuels management and wildfire response efforts. Under the investment, a surge of seasonal firefighters, Conservation Corps crews, and air operations personnel will be made available.
Additional information on the surge is available here.