April 23, 2021 Edition
The California State Senate and Assembly this week continued with its steady pace of policy committee hearings as the Legislature approaches upcoming deadlines for measures to be advanced in the legislative process. Next Friday, April 30 is the last day for policy committees to meet and report to appropriations committees bills with fiscal implications introduced in their house of origin. The following week, on May 7, is the last day for policy committees to meet and report to the floor bills without fiscal implications introduced in their house of origin. May 14 is the last day for policy committees to meet prior to June 7.
Following these deadlines, the Legislature is anticipated to shift its focus in earnest again to the state budget. Budget committees and subcommittees will soon begin meeting again to review updated proposed investments set forth by the Governor’s May Revise, which is anticipated to be released by mid-May.
Notably this week, the Assembly swore in Assembly Member Dr. Akilah Weber, who represents the 79th Assembly District in San Diego County. Assembly Member Weber recently won a special election to fill the seat of her mother, Shirley Weber, who is now the California Secretary of State. Assembly Member Akilah Weber was previously elected to the La Mesa City Council and is an obstetrician/gynecologist and assistant clinical professor by training.
Below, we highlight a number of legislative bills of interest to CHEAC Members. For a full update, the latest edition of the CHEAC Weekly Bill Chart is available here.
Communicable Disease Control
AB 789 (Low) as amended February 5, 2021 – SUPPORT
Assembly Member Evan Low’s AB 789 would require patients receiving primary care services in an outpatient setting to be offered a Hepatitis B or Hepatitis C screening test if their insurance covers the costs. Follow-up care would be provided, or patients would be referred to a health care provider if the screening test is positive for Hepatitis B or Hepatitis C. AB 789 was advanced out of the Assembly Health Committee on consent and now moves on to the Assembly Appropriations Committee.
SB 306 (Pan) as amended March 24, 2021 – SUPPORT
The measure, authored by Senator Richard Pan, was heard in the Senate Business, Professions, and Economic Development Committee this week. SB 306 would allow pharmacist to provide expedited partner treatment (EPT) for STDs. Health care service plans and insurers would be required to provide coverage for at home test kits. Requires pregnancies in the third trimester an additional blood test for syphilis. HIV counselors to perform specified STD tests and requires HIV counselor to provide appropriate counseling and referrals before performing tests. Requires reimbursements in the Family PACT program, subject to appropriation and draw down of FFP, for STD services to the uninsured, income eligible patients, or patients without healthcare coverage with confidentiality concerns who are not at risk for pregnancy or do not need contraceptive services. SB 306 was advanced out of the Senate Business, Professions, and Economic Development Committee on a 10-3 vote with one member not voting and now moves on to the Senate Appropriations Committee.
SB 742 (Pan) as amended March 4, 2021 – SUPPORT
Senator Richard Pan’s SB 742 was heard this week in the Senate Public Safety Committee. This measure would prohibit a person from engaging in physical obstruction, intimidation, or picketing targeted at a vaccination site during vaccination site operating hours, as well as one hour prior and one hour after. Violations would result in a fine not exceeding $1,000, imprisonment in county jail not exceeding 6 months, or both. SB 742 was passed out of committee on a unanimous 5-0 vote and now moves on to Senate Appropriations and will be heard on Monday, May 3, 2021.
Maternal, Child, and Adolescent Health Services (MCAH)
AB 1046 (Rubio) as introduced February 18, 2021 – SUPPORT
AB 1046, authored by Assembly Member Blanca Rubio, would require the California Health and Human Services (CHHS) Agency to consult with stakeholders to improve state and counties’ abilities to draw down Medi-Cal funding for evidence based maternal-infant and early childhood home visiting encounters. Developers of the California Home Visiting and CalWORKs Home Visiting programs, LHD divisions, human services, and behavioral services, as well as specified stakeholders, would be consulted. AB 1046 has been placed on the Assembly Appropriations Suspense File.
AB 541 (Berman) as amended March 2, 2021 – SUPPORT
AB 541, by Assembly Member Marc Berman, was heard in the Assembly Appropriations Committee this week. The measure would require disorder recovery and treatment facilities licensed under the Department of Health Care Services (DHCS) to evaluate each new patient or client for tobacco use. If tobacco use disorder is identified, the facility/program would be required to provide specified information and offer treatment or referral for tobacco use disorder treatment. AB 541 was placed on the Assembly Appropriations Suspense File where it will be acted upon at a later date.
AB 751 (Irwin) as introduced February 16, 2021 – SUPPORT
This measure, authored by Assembly Member Jacqui Irwin, was heard in the Assembly Health Committee this week. AB 751 would remove the sunset date provisions allowing local registrars to accept electronic requests sworn under penalty of perjury, that the requester of a marriage, birth, or death certificate is an authorized person. Additionally, this measure would authorize officials to accept an electronic request from applicants using a process that authentically identifies applicants using National Institute of Standards and Technology Digital Identity Guidelines and other requirements. AB 751 was unanimously passed out of the Assembly Health Committee with a 15-0 vote and moves on to Assembly Appropriations Committee.
Assembly Member Rob Bonta on Thursday was confirmed as California’s next Attorney General by the California State Senate and Assembly. Recall, Governor Gavin Newsom last month nominated Bonta to succeed Xavier Becerra, who is now the Secretary of the U.S. Health and Human Services.
Bonta was confirmed to his new position on a 29-6 vote in the Senate with three Republicans not voting and a 62-0 vote in the Assembly with Republicans not voting. He becomes the first Filipino American to serve as California Attorney General, and he will face reelection to his new role in November 2022. A special election will be held to fill the Assembly vacancy created by Bonta’s confirmation; just recently, Bonta’s wife, Mia Bonta, announced her candidacy for the seat.
Governor Newsom late this afternoon administered the oath of office to now-Attorney General Rob Bonta.
Today, the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) lifted their recommended temporary pause on the administration of the single-dose Johnson & Johnson COVID-19 vaccine.
The move follows today’s vote by the CDC Advisory Committee on Immunization Practices (ACIP) to recommend the resumption of Johnson and Johnson COVID-19 vaccines. The ACIP concluded the benefits of the vaccine outweigh risks from rare blood clots linked with the vaccine on a 10-4 vote with one member not voting.
Recall, the CDC and FDA on April 13 issued a recommendation to pause administration of the single-dose COVID-19 vaccine amid reports of thrombosis with thrombocytopenia syndrome (TTS) among individuals who recently received the vaccine. The CDC has received reports of 15 cases of TTS, all among women, with 13 of the cases among women under age 50. Three deaths have occurred.
CDC Director Rochelle Walensky has signed off on ACIP’s recommendation to resume vaccinations with a warning for women under age 50 acknowledging the risk of TTS. The FDA has issued an amended emergency use authorization (EUA) for the Johnson & Johnson vaccine and will update the label with an accompanying warning for the vaccine. The CDC and FDA are anticipated to make available communication and education materials on the vaccine, including infographics and patient fact sheets.
Additional information on the modified recommendations for the Johnson & Johnson vaccine from the CDC, as well as the California Department of Public Health (CDPH), is anticipated over the coming days. The presentation slides from today’s CDC ACIP meeting are available here. A joint statement by the CDC and FDA is available here.
This week, President Joseph R. Biden, Jr. announced the U.S. has reached its updated goal of administering 200 million COVID-19 vaccines within his Administration’s first 100 days. Recall, the goal was doubled after 100 million COVID-19 vaccine doses were administered by day 58 of the Biden-Harris Administration.
To encourage the continued administration of COVID-19 vaccines, President Biden called on every U.S. employer to provide full pay to employees for any time off needed to receive a vaccine and for any time it takes to recover from the after-effects of vaccination. As part of this announcement, the Administration plans to offer:
- Small- and Medium-Sized Business Tax Credit: A paid leave tax credit has been made available through the recently enacted American Rescue Plan to offset the cost for businesses and nonprofits with fewer than 500 employees for up to 80 hours between April 1 and September 30, 2021. This tax credit will allow employers to provide paid leave for employers to receive a COVID-19 vaccination and for any time employees may need to recover from vaccination at no cost to the employer. The IRS this week issued a fact sheet providing information to employers on how to claim the paid sick leave credit.
The Biden-Harris Administration is also calling on all employers to use their unique resources to provide information on how people can get vaccinated and why people should receive a COVID-19 vaccine.
Additional information on the President’s announcement is available here.
U.S. Health and Human Services Secretary Xavier Becerra recently renewed the country’s declaration of a public health emergency due to the ongoing COVID-19 pandemic. The renewal became effective on April 21 and is renewed for 90 days until July 20, 2021.
The renewed declaration is available here.
This week, the California Legislative Analyst’s Office (LAO) published a report detailing the state’s constitutional spending limit, also known as the Gann Limit, and its implications for the state’s budget for the upcoming and future fiscal years.
By way of background, voters in 1979 passed Proposition 4, establishing a constitutional appropriations limit on the state and most types of local governments. The appropriations limits, which were amended by Proposition 111 in 1990, are intended to keep real, inflation adjusted per-person government spending under 1978-79 levels. If the state realizes revenue collections above the Gann Limit over two consecutive years, the state constitution requires the state to split the excess revenues between taxpayer rebates and additional spending on schools.
At the time of the Governor’s January Budget proposal, the Department of Finance (DOF) expects the state to collect revenues in excess of the limit in some years between 2018-19 and 2021-22. Specifically, initial estimates indicate the state has excess revenues of approximately $100 million between 2018-19 and 2019-20 and approximately $500 million between 2019-20- and 2020-21. DOF is anticipated to update its revenue collection estimates at the time of the May Revision, at which point the state’s appropriations limits is anticipated to come into play.
In light of higher than anticipated revenue collections since January, the LAO anticipates the state appropriations limits will become an even more significant issue in the state budget over the coming years. Based on projections conducted by the LAO, the state is anticipated under the vast majority of likely outcomes to have to reduce taxes or issue refunds to taxpayers and make additional payments to schools to satisfy Gann Limit requirements. Further, without significant budget changes, the state likely does not have the capacity for new services or program expansions.
According to the LAO, the Gann Limit has emerged as a significant budgetary issue due to growth in personal income tax revenues which have exceeded the state’s appropriations limits growth rate. The state’s tax rate structure combined with faster income growth among high-income earners are the primary reasons why income tax revenues have exceeded the limits’ growth rate. Secondly, constitutionally required school spending has increased faster than school limits, requiring the state to absorb appropriations above school limits and leaving less room for the state to carry out investments without running into the Gann Limit.
The LAO sets forth a series of policy options available to the Legislature in addressing the Gann Limit. These alternatives include:
- Issuing Tax Refunds and Allocating Excess Revenues to Schools
- Increasing Spending on Excluded Purposes (e.g., subventions to local governments, debt service, federal and court mandates, capital outlay projects, emergency spending)
- Reduce Proceeds of Taxes and Spending
- Make Statutory Changes to the Gann Limit (e.g., shifting room under school district limits to the state, redefining local government subventions)
- Go to the Voters (e.g., request temporary increase in Gann Limit, request change to school and community college limits, request change in when reserves are counted toward the limit, request more fundamental changes)
The LAO notes that few of the above options, in isolation, are likely to be sufficient to keep the state from exceeding the Gann Limit over the coming years. The LAO recommends the Legislature form a strategy for short- and long-term options in responding to the Gann Limit and its potential sweeping implications for the state budget.
Additional information is anticipated with the release of the Governor’s May Revise budget by mid-May. The full LAO report is available here.
On Wednesday, Governor Gavin Newsom visited the Russian River watershed in Sonoma and Mendocino counties where water reservoirs are at record lows to announce a series of immediate actions to bolster the state’s drought resilience and prepare for widespread drought-related impacts.
Among other actions, Governor Newsom directed state agencies to work with regional and local governments to identify watersheds, communities, public water systems, and ecosystems that may require coordinated state-and-local actions to address drought impacts and protect residents. The Governor additionally proclaimed a regional drought emergency for Sonoma and Mendocino counties, further mobilizing state resources to address historically dry conditions in the Russian River watershed.
Additional information is available here. The Governor’s regional emergency proclamation is available here.
Today, Governor Gavin Newsom directed the California Department of Conservation’s Geologic Energy Management (CalGEM) Division to initiate regulatory action to end the issuance of new permits for hydraulic fracturing, or fracking, in the state by January 2024. The Governor additionally requested the California Air Resources Board (CARB) to analyze strategies to phase out oil extraction within the state by no later than 2045.
Under the directive, CalGEM will immediately initiate rulemaking processes to cease the issuance of new fracking permits by 2024. Relatedly, CARB will evaluate how to phase out oil extraction through the Climate Change Scoping Plan, which serves as the state’s comprehensive, multi-year regulatory and programmatic plan to achieve required reductions in greenhouse gas emissions.
Additional information on the Governor’s actions is available here.
Relatedly, President Joseph R. Biden, Jr. this week announced a new target for the United States to achieve up to a 52 percent reduction from 2005 levels in economy-wide net greenhouse gas emissions by 2030. Following the announcement, Governor Newsom issued a statement applauding the President’s reduction target and highlighting various strategies being implemented by California in reducing overall greenhouse gas emissions.
The CDPH Healthy Aging Initiative will host a webinar on Wednesday, May 12, at 10:00 am to share information about California’s current efforts around Alzheimer’s disease and related dementias. The webinar will feature California’s Alzheimer’s Disease Centers, recent Alzheimer’s disease and related dementias research, and the California Healthy Brain Initiative and state and local public health partners to address dementia.
Additional information and registration are available here.