April 5, 2019 Edition

One Week Remains Before Legislature’s Spring Recess

This week, the California Legislature maintained a swift pace of committee hearings, bill negotiations, and amendments. The Legislature will begin its 10-day Spring Recess upon the adjournment of session next Thursday, April 11. Upon their return on April 22, legislators will have limited time to move bills along the legislative process before meeting deadlines. All policy committees must hear and report all fiscal measures in their house of origin by Friday, April 26. One week later, all non-fiscal bills must be heard and reported by policy committees in their house of origin.

Given the upcoming recess and bill deadlines, the next several weeks in Sacramento are expected to be particularly busy. Below, we highlight activities on several bills of interest to CHEAC Members. Our full CHEAC Weekly Bill Chart is available here.

Drug & Alcohol Services

AB 1031 (Nazarian) as amended March 25, 2019 – SUPPORT

Assembly Member Adrin Nazarian’s AB 1031 would establish the Youth Substance Use Disorder Treatment and Recovery Program Act and direct DHCS, in collaboration with counties and SUD service providers, to establish regulations governing community-based nonresidential and residential treatment and recovery programs for those under 21 years of age. AB 1031 was heard in the Assembly Health Committee on Tuesday and unanimously advanced to the Assembly Appropriations Committee.

Emergency Medical Services (EMS)

AB 1544 (Gipson) as introduced on February 22, 2019 – OPPOSE UNLESS AMENDED

AB 1544 by Assembly Member Mike Gipson would enact the Community Paramedicine or Triage to Alternate Destination Act to allow local emergency medical services agencies (LEMSAs) to develop local community paramedicine programs including short-term post discharge follow-up, case management services to frequent EMS service users, and alternate transport of patients to behavioral health facilities or sobering centers. The measure also requires LEMSAs to use or establish local emergency medical care committees (EMCCs) and establishes the Community Paramedicine Medical Oversight Committee to advise the EMS authority on and to approve minimum medical protocols for all community paramedicine programs. The bill requires a LEMSA to provide a right of first refusal to every public agency that is located within its jurisdiction to provide community paramedicine program specialties prior to offering to private EMS providers. The measure is up for hearing in the Assembly Health Committee next Tuesday. CSAC, RCRC, UCC, CHEAC, EMSAAC, and EMDAC are all in oppose unless amended positions.

SB 438 (Hertzberg) as amended March 25, 2019 – OPPOSE

SB 438 by Senator Robert Hertzberg was a recently amended measure to restrict the use of non-governmental-operated public safety answering points (PSAPs), including 9-1-1 EMS dispatching centers. The measure would circumvent existing oversight activities of local emergency medical service agency (LEMSA) medical directors to ensure the appropriate deployment and use of EMS resources. SB 438 is up for hearing next Wednesday in the Senate Governance & Finance Committee. CSAC, RCRC, UCC, CHEAC, EMSAAC, and EMDAC are all opposed to the measure.  

Health Coverage/Health Care Reform

AB 715 (Wood) as corrected March 21, 2019 SUPPORT

Assembly Member Jim Wood’s AB 715 would increase income eligibility for the Medi-Cal Aged and Disabled Program up to 138 percent of the federal poverty level (FPL) by disregarding specified countable income over 100 percent FPL and up to 138 percent FPL. The measure was unanimously advanced on Tuesday from the Assembly Health Committee to the Assembly Appropriations Committee.

AB 1088 (Wood) as introduced February 21, 2019 SUPPORT

AB 1088 by Assembly Member Jim Wood would extend Medi-Cal eligibility without a share of cost for seniors or disabled individuals who would otherwise be eligible if not for the state buy-in of their Medicare Part B premiums. The measure was unanimously advanced on Tuesday by the Assembly Health Committee to the Assembly Appropriations Committee.

SB 207 (Hurtado) as amended March 20, 2019 – SUPPORT

Senator Melissa Hurtado’s SB 207 would require asthma preventive services to be included as a Medi-Cal covered benefit. The measure would also require DHCS to approve accrediting bodies with expertise in asthma to review and approve training curricula for asthma preventive services. The measure was advanced from the Senate Health Committee to the Senate Appropriations Committee on an 8-0 vote with one member not voting.

CSAC, Other Local Jurisdictions File Amicus Brief in Attempt to Protect ACA

This week, the California State Association of Counties (CSAC) and 35 cities and counties throughout the country filed an amicus brief in the U.S. Court of Appeals for the Fifth Circuit for the case State of Texas v. United States, which may determine the future of the Affordable Care Act (ACA).

Recall, in December 2018, Texas Federal District Court Judge Reed O’Connor struck down the ACA on the grounds that the individual health insurance mandate was unconstitutional and the remaining ACA provisions could not stand without the individual mandate. California, along with other states, swiftly filed a motion, ultimately resulting in Judge O’Connor issuing a stay on his order, allowing the ACA to stand while litigation moves forward. Last week, the Trump Administration reversed course and formally requested the federal court to strike down the ACA in its entirety.

The amicus brief filed by CSAC and other local jurisdictions explains the critical importance of the ACA in reducing local government indigent health care costs and enabling local governments to provide better care and services. The brief further describes how unwinding the ACA would lead to catastrophic health care costs, chaos, and disruption for residents, jurisdictions, and the entire health system.

Judge O’Connor’s ruling invalidating the entire ACA remains on a temporary hold while the matter is considered by the U.S. Court of Appeals for the Fifth Circuit in New Orleans. Further developments on the case are expected over the coming months.

California Surgeon General Embarks on Statewide Listening Tour

On Tuesday, California Surgeon General Nadine Burke Harris launched a statewide listening tour to raise awareness about the connections between adverse childhood experiences (ACEs), toxic stress, and serious health conditions. In her first appearance at the Fruit Ridge Community Collaborative in Sacramento, Burke Harris discussed her priorities as California’s first state surgeon general, including raising awareness and educating residents about ACEs, such as emotional abuse or domestic violence, and its nexus with major chronic health conditions, such as asthma, diabetes, and heart disease.

Burke Harris engaged with community leaders, including those from First 5 Sacramento, educators, service providers, and residents, to discuss the community’s health-related priorities and challenges and to underscore the importance of early interventions in improving health and wellbeing outcomes. To better learn about and listen to the unique challenges facing communities in various regions throughout the state, the surgeon general’s listening tour will include stops in Alameda, Butte, Fresno, Kern, Los Angeles, Orange, and San Diego counties.

The listening tour, according to Burke Harris, will bring together stakeholders, residents, and community leaders to determine strategies for addressing root causes of serious health conditions and health disparities, as well as how the Office of the Surgeon General can support communities in prevention and treatment activities. The press release from the California Health and Human Services Agency (CHHS) is available here.

CDPH, EMSA Release 2019 Statewide Medical & Health Exercise Materials

This week, the California Department of Public Health (CDPH) and the California Emergency Medical Services Authority (EMSA) released resources and materials for the 2019 Statewide Medical and Health Exercise Program. The materials include templates for this year’s exercise, slated to occur November 18-22, and feature discipline-specified objectives, scenarios, situation manuals, and other important materials. The resources, as well as other information on the exercise, are available here.

CDC Releases New “Tips From Former Smokers” Media, Resources for Public Health Professionals

The U.S. Centers for Disease Control and Prevention (CDC) recently launched a new round of media materials from the Tips From Former Smokers, offering a powerful and compelling view into the health consequences of tobacco use. The new media materials include advertisements on national network and cable television, in magazines, and online. The advertisements feature new stories about the impact of smoking on Tips participants and their loved ones and detail smoking-related conditions such as asthma, chronic obstructive pulmonary disease, cancer, heart disease, and more.

The advertisement series began airing on Monday and will run through early October. As part of the campaign, free resources for public health professionals are available to assist in education and awareness about the dangers of cigarette smoking. New materials are available from the Tips download center and include video, audio, print, and digital mediums. Additional information on the CDC Tips From Former Smokers campaign is available here.

NACCHO Solicits Applications for 2019-20 Subject Matter Advisory Workgroups

The National Association of County and City Health Officials (NACCHO) invites local health department leaders and staff to apply to its advisory workgroups to assist in informing and guiding NACCHO programming and projects. The advisory groups are utilized as a primary and recognized vehicle for identifying opportunities and challenges facing LHDs throughout the country, as well as the field of public health. NACCHO has a variety of workgroups spanning a wide array of public health subject matters, including community health, public health preparedness, environmental health, and public health infrastructure.

Applications to participate in NACCHO workgroups are due April 22. Descriptions of the workgroups are available here and applications may be accessed here.

ChangeLab Solutions Publishes Blueprint on Health Equity

ChangeLab Solutions recently released “A Blueprint for Changemakers: Achieving Health Equity Through Law & Policy,” a technical guidance document that provides an overview of a novel approach to reducing health inequities. Through legal and policy strategies for policymakers, public health practitioners, and community members, the blueprint is intended to support jurisdictions in dismantling systemic barriers to health, collaboratively establishing policies and laws that benefit children and families, and promoting health equity.

The report details five fundamental drivers of health inequity, which include:

  1. Structural Discrimination
  2. Income Inequality and Poverty
  3. Disparities in Opportunity
  4. Disparities in Political Power
  5. Governance That Limits Meaningful Participation

Through a variety of community-driven principles, the report discusses how local jurisdictions can ensure that laws and policies lead to equitable outcomes in health and wellbeing among residents. Those principles include, among other activities, using place-based strategies, improving access to healthcare, and promoting early childhood development.

The full ChangeLab Solutions blueprint is available here.