April 7, 2017 Edition

Legislature Approves Transportation Funding before Departing for Spring Recess

Transportation has consumed the Legislature and Governor’s focus this week as the Legislature passed SB 1 (Beall) and ACA 5 (Frazier) yesterday evening. The bills are headed to the Governor for signature and would increase transportation funding by $5.2 billion per year for the next decade.

Meanwhile, a few bills of interest were heard in policy committee hearings this week and are noted below. The Legislature departed for Spring Recess and will return to Sacramento on Monday, April 17. This week’s bill chart is available here.

Jail Medical

SB 222 (Hernandez) as introduced on 2/2/17 – Support

SB 222 by Senator Hernandez was heard in the Senate Health Committee this week. The measure would increase the length of time an incarcerated Medi-Cal beneficiary’s coverage can be suspended from one year to the length of the beneficiary’s incarceration. The measure, sponsored by CWDA and Californians for Safety and Justice, passed with 7 ‘aye’ votes, 1 ‘no’ vote, and 1 abstention and will be heard next in the Senate Public Safety Committee.

Health Equity

AB 210 (Santiago) as introduced on 1/23/17 – Support

The Assembly Human Services Committee heard AB 210 by Assembly Member Santiago, which would allow counties to establish multidisciplinary teams to facilitate expedited identification, assessment, and linkage of individuals experiencing homelessness to housing and supportive services. The measure, sponsored by Los Angeles County, passed unanimously and now moves to the Assembly Privacy and Consumer Protection Committee.

Communicable Disease Control

AB 511 (Arambula) as amended on 3/27/17 – Support

AB 511, by Assembly Member Arambula, was heard in Assembly Health Committee this week. This measure would update existing statute that requires certain individuals, including those who work with children, to have a tuberculosis test to instead receive a tuberculosis risk assessment. The measure, sponsored by HOAC, passed  with 9 ‘aye’ votes and 6 abstentions. AB 511 now moves to the Assembly Appropriations Committee.

Administration Releases Cannabis Trailer Bill

On Tuesday evening, the Brown Administration released proposed cannabis trailer bill language (TBL). The proposed language seeks to address differences between the Adult Use Marijuana Act (AUMA) and the Medical Cannabis Regulation and Safety Act (MCRSA), specifically on differences in the respective licensing structures.

Of particular interest to local health departments is the language the Administration included to delete the state medical cannabis identification card program (MMIC). As a result, the language makes it permissive for counties to operate their own identification card programs; however, it is not required. A brief summary is included on page 6. The bulk of the language begins on page 13.

We anticipate the Administration will release their draft medical cannabis regulations for public comment by the end of the month. Additional updates will be provided.

Repeal and Replacement Efforts Still Under Discussion

House Republicans continue to strategize on ways to revive the American Health Care Act (AHCA) which came to a sudden halt two weeks ago due to a lack of votes. This week, Republicans participated in two all-day sessions with Administration officials in hopes of finding a pathway forward. One amendment did emerge this week to create a ‘Federal Invisible Risk Sharing Program’, which would appropriate $15 billion per year beginning in January 1, 2018, until 2026. The funding would provide payments to insurers for eligible individuals to lower premiums. The amendment lacked details on how the program would be carried out and instead delegates that task to the Centers for Medicare and Medicaid Services to complete within 60 days of enactment. However, the amendment doesn’t seem to address the adverse impacts of the AHCA, including the millions of individuals that would lose coverage.

No action was taken prior to the start of their spring recess.

Proposed Current Year PHEP Cuts

Recently, the Trump Administration released more detail on the proposed cuts offered in their recent Skinny Budget release. The above linked chart presents a variety of Federal Fiscal Year 2017 “reduction options.” Included in these recommendations, is a proposed current year cut to the Public Health Emergency Preparedness (PHEP) grants of $49 million (page 10) with the justification indicating “There is overlap across HHS preparedness programs (PHEP and HPP) and the Federal Government has provided more than $18 billion to States since 2002 to improve preparedness capacity.

As we understand it, these proposed cuts, if enacted, are unlikely to impact your FY 2017/18 funding (as it’s funded out of the previous federal fiscal year); however, these cuts are of tremendous concern. NACCHO is encouraging local health departments to contact their members of Congress to reinforce the importance of robust funding for PHEP. You can find more information on NACCHO’s Take Action webpage.

Registration Open for CDPH Prevention in the 21st Century (P21) Conference

The California Department of Public Health (CDPH) invites you to register for the Advancing Prevention in the 21st Century: Commitment to Action (P21) 2.0 Conference which will be held on May 16-17, 2017 in Sacramento. The conference will convene statewide partners from public and private sectors to advance strategies to improve equity in health and wellbeing outlined in the California Wellness Plan, which aims to reduce the burden of chronic disease conditions among Californians. Registration is $100 and is due by Monday, May 1, 2017. For more information and to register, please visit the conference website.

PPIC Releases Report on Funding of the Medi-Cal Program

The Public Policy Institute of California (PPIC) recently released a report detailing Medi-Cal financing and its impact on the state budget. According to the report, state spending on Medi-Cal has outpaced growth in state revenues, and Medi-Cal currently accounts for 15 percent of total General Fund expenditures. The PPIC report explores additional revenue-generating options including establishing a tax on snack foods, which Assembly Member Cristina Garcia is aiming to do with AB 274. Other options explored include expanding taxes on products such as tobacco, alcohol, and cannabis, adding medical provider fees and taxes, and revisiting the state-local fiscal relationship. The full report is available here.