August 20, 2021 Edition

Legislature Returns to Sacramento, Suspense File Hearings Next Week

This week, the California State Senate and Assembly returned to Sacramento from their month-long summer recess. Fiscal committees face a deadline next week to meet and report bills to their respective floors, and both the Senate and Assembly Appropriations Committees are set to hold suspense file hearings on measures on Thursday, August 26. During these hearings, remaining bills in play will either be held on suspense (rendering measures dead for the year) or advanced from the committee to the floor (often with amendments).

Following the actions by the fiscal committees next week, the Legislature will have two weeks of floor session only during which no committees may meet for any purpose. Lawmakers are set to adjourn for interim recess on September 10, just four days before the Gubernatorial Recall Election.

In other legislative news this week, Assembly Speaker Anthony Rendon on Monday distributed a memo to all Assembly employees requiring vaccination against COVID-19 by September 1. Medical and religious exemptions are available to employees, and violations of the requirement may result in termination, per Speaker Rendon.

Below, we highlight a measure of interest to CHEAC Members. For a full update, the latest edition of the CHEAC Weekly Bill Chart is available here.

Tobacco Control

AB 541 (Berman) as amended April 12, 2021 – SUPPORT

Assembly Member Marc Berman’s AB 541 was granted final legislative approval this week when the Assembly voted 77-0 (with two members not voting) to concur in the Senate’s amendments to the measure. AB 541 would require alcoholism and substance use disorder recovery and treatment facilities licensed by the Department of Health Care Services (DHCS) to assess each patient and client for tobacco use at the time of initial intake. If tobacco use disorder is identified, the facility or program is required to provide specified information, including an offer or referral for tobacco use disorder treatment. AB 541 now heads to the desk of Governor Gavin Newsom.

California Takes Steps to Support Health System During Increase in COVID-19 Hospitalizations

In response to increasing COVID-19 hospitalizations statewide and the presence of the COVID-19 delta variant, the State of California this week took steps to ensure health care facilities throughout the state remain adequately staffed and continue to deliver critical patient care.

California Department of Public Health (CDPH) Director and State Public Health Officer Dr. Tomás Aragón issued a public health order requiring hospitals statewide to accept transfer patients from facilities with limited ICU capacity when clinically appropriate. Under the order, hospitals must notify the Medical and Health Operational Area Coordinator (MHOAC), local public health officer, and the CDPH Licensing and Certification district office when specified conditions exist, including having reduced capacity. The order took effect on Thursday this week.

In addition to CDPH’s public health order, Governor Gavin Newsom issued Executive Order N-12-21 extending various provisions implemented to expand California’s health care workforce during the COVID-19 pandemic, including allowing health care workers from out of state to provide services in California and enabling certain medical personnel and emergency medical technicians to continue supporting the state’s COVID-19 response. The order additionally provides health facilities flexibility to plan and adapt their space to accommodate increases in patient loads.

Additional information from the Governor’s Office is available here. Additional information from CDPH is available here.

CDPH Orders COVID-19 Vaccine or Testing Requirements for Correctional Health Care

On Thursday, California Department of Public Health (CDPH) and State Public Health Officer Dr. Tomás Aragón issued a state public health officer order requiring all paid and unpaid personnel providing health care services to inmates, prisoners, and detainees to receive the COVID-19 vaccine or submit to regular testing if exempt from the vaccine requirement.

The order took effect yesterday and requires all applicable personnel to be in compliance with the order by October 14, 2021.

The full order is available here.

CDPH Strengthens Vaccine Verification Requirements for Large Events

This week, the California Department of Public Health (CDPH) announced modifications to its “Beyond the Blueprint” COVID-19 guidance for large events to strengthen COVID-19 precautions for large events. Beginning September 20, proof of COVID-19 vaccination or a negative COVID-19 test within 72 hours prior to the event will be required for indoor gatherings with 1,000 or more attendees. Currently, vaccine verification or pre-entry negative testing is only required for indoor events with 5,000 or more attendees.

In addition to reducing the attendee threshold, CDPH will remove self-attestation as an acceptable method of verifying a person’s vaccination status. These changes will remain in effect until November 1, 2021.

Additional information from CDPH is available here.

Western States Sign off on Third COVID-19 Vaccine Dose for Immunocompromised

Following a move by the U.S. Food and Drug Administration (FDA) last week to allow for the administration of an additional Pfizer-BioNTech or Moderna COVID-19 vaccine dose to certain immunocompromised individuals, the Western States Scientific Safety Review Workgroup convened and concurred with the FDA move, paving the way for third doses to be administered to certain individuals in California and other western states.

The Western States group reviewed evidence presented to the U.S. Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) and ultimately supported the FDA and CDC’s decision to ensure protection of vulnerable individuals, particularly as the COVID-19 delta variant continues to spread.

Additional information from the Western States group is available here. A statement about the Western States’ approval from CDPH Director and State Public Health Officer Dr. Tomás Aragón is available here.

CA Medical Board Warns Physicians Against Inappropriate Mask Exemptions

On Thursday, the Medical Board of California (MBC) notified all physician licensees and the public that a physician who grants a mask or other exemption without conducting an appropriate prior examination and without finding a legitimate medical reason supporting such an exemption within the standard of care may be subject to disciplinary action by the State of California.

The move by the MBC comes as K-12 schools statewide begin the new school year and state school guidance requires masking, regardless of vaccination status, with limited exemptions. The MBC encourages Californians to file a complaint with the Board if they feel that a physician is granting mask exemptions inappropriately.

Additional information from the MBC is available here. A statement on the notification from the California Medical Association (CMA) is available here.

As Federal Unemployment Benefits Near Expiry, California Promotes Available State Benefits

With federal supplemental unemployment benefits set to expire next month, a host of California state departments and agencies are joining together to encourage eligible individuals to apply for critical public benefit programs that offer free or low-cost health coverage, provide money to pay for food, and pay rent and utilities.

The California Department of Health Care Services (DHCS), Covered California, the Department of Managed Health Care (DMHC), the Employment Development Department (EDD), the Department of Housing and Community Development (DHCD), and the California Department of Social Services (CDSS), among others, are working together to proactively continue assisting state residents.

The state intends to utilize funding provided through the American Rescue Plan Act and the “California Comeback” and state budget to deliver expanded state-based benefits, including assistance for health coverage, CalWORKs, CalFresh, and rent and utility assistance.

Additional information from the State of California is available here.

HHS Plans for COVID-19 Booster Shots this Fall

This week, public health and medical experts with the U.S. Department of Health and Human Services (HHS) announced the ongoing development of a plan to begin offering COVID-19 booster shots to vaccinated Americans beginning on September 20. The move comes as recent data suggests protection against SARS-CoV-2 infection from the Pfizer-BioNTech and Moderna COVID-19 vaccines begins to decrease over time and a booster dose will be needed to maximize vaccine-induced protection.

Under the plan, federal officials anticipate recommending booster doses eight months after an individual’s second COVID-19 dose. The U.S. Food and Drug Administration (FDA), as well as the U.S. Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP), will conduct an independent evaluation and determination of the safety and effectiveness of a third dose.

The full joint statement from HHS federal officials is available here.

CMS to Require Staff Vaccinations Among Nursing Homes Nationwide

This week, the U.S. Centers for Medicare and Medicaid Services (CMS), in collaboration with the U.S. Centers for Disease Control and Prevention (CDC), announced the development of an emergency regulation requiring staff vaccinations against COVID-19 within the country’s more than 15,000 Medicare and Medicaid-participating nursing facilities.

According to CMS, the new requirement is intended to protect the health and safety of nursing home residents and staff by ensuring that all staff receive the COVID-19 vaccine. While CMS undertakes emergency rulemaking procedures, the agency encourages nursing home residents and staff to receive their vaccine.

Additional information from CMS is available here.

Biden Extends Federal Reimbursement for COVID-19 Response

On Tuesday, President Joseph R. Biden, Jr. directed his Administration to extend 100 percent federal reimbursement to states for eligible COVID-19 emergency response costs, including emergency medical care, non-congregate sheltering, and vaccination operations, through December 31, 2021. Tuesday’s action extends the order President Biden issued upon taking office directing the Federal Emergency Management Agency (FEMA) to fully reimburse states for COVID-19 response costs from January 2020 to September 30, 2021.

For California, this extension includes full reimbursement for state and local government operations of Project Roomkey through the end of the year. According to the Governor’s Office, the program has sheltered more than 42,000 people experiencing homelessness since the beginning of the COVID-19 pandemic.

Additional information from the White House is available here. A statement from the Office of Governor Gavin Newsom on the extension of Project Roomkey is available here.

USDA Announces Historic Increase in SNAP Benefits

The U.S. Department of Agriculture (USDA) this week unveiled its re-evaluation of the Thrifty Food Plan, the lowest cost food plan option offered to low-income Americans by the USDA. By way of background, the cost of the June Thrifty Food Plan serves as the basis for the maximum Supplemental Nutrition Assistance Program (SNAP) benefit amount that becomes effective in the following federal fiscal year beginning on October 1.

The USDA conducted a data-driven review of the Thrifty Food Plan based on four key factors as specified in the 2018 Farm Bill passed by Congress: current food prices, typical foods consumed by Americans, dietary guidance, and nutrient values of foods. The reevaluation, the first conducted since the plan’s introduction in 1975, concluded that the cost of a nutritious, practical, and cost-effective diet is 21 percent higher than the current Thrifty Food Plan.

As a result of this adjustment, the average SNAP benefit, excluding additional pandemic-related funds, will increase by $36.24 per person, per month, or $1.19 per day, for Fiscal Year 2022 beginning on October 1, 2021. The adjustment is anticipated to assist the more than 42 million Americans who utilize the benefits each month.

Following the announcement, California Health and Human Services Secretary Dr. Mark Ghaly and California Department of Social Services Director Kim Johnson issued a statement applauding the Biden-Harris Administration for the adjustment and highlighted the impacts to Californians participating in CalFresh.

The full USDA announcement is available here. The Thrifty Food Plan re-evaluation report is available here.

CDC Establishes New Disease Forecasting Center

This week, the U.S. Centers for Disease Control and Prevention (CDC) announced the creation of a new center designed to advance the use of forecasting and outbreak analytics in public health decision making. According to the CDC, once established, the Center for Forecasting and Outbreak Analytics will bring together next-generation public health data, expert disease modelers, public health emergency responders, and high-quality communications experts to meet the needs of decision makers.

The new center will accelerate access to and use of data for public health decision-makers who need information to mitigate the effects of disease threats, such as social and economic disruption. The center will also prioritize equity and accessibility while serving as a hub for innovation and research on disease modeling.

The center will be started with funding from the American Rescue Plan Act and will focus on the following three key functions:

  • Predict: Undertake modeling and forecasting; enhance the ability to determine foundational data sources needed; support research and innovation in outbreak analytics and science for real-time action; and establish appropriate forecasting horizons.
  • Connect: Expand broad capability for data sharing and integration; maximize interoperability with data standards and utilize open-source software and application programming interface capabilities with existing and new data streams from the public health ecosystem and beyond.
  • Inform: Translate and communicate forecasts; connect with key decision-makers across sectors including government, business, and nonprofits, along with individuals with strong intergovernmental affairs and communication capacity for action.

Additional information from CDC on the new center is available here.

Ghaly Appoints CHHS Data Exchange Framework Stakeholder Advisory Group

California Health and Human Services (CHHS) Agency Secretary Dr. Mark Ghaly today announced the appointment of members to the state’s Health and Human Services Data Exchange Framework Stakeholder Advisory Group. The group will partner with CHHS and the state’s new Center for Data Insights and Innovation to develop the state’s framework for a single data sharing agreement and common set of policies and procedures that will govern the exchange of health information among health care entities and government agencies beginning in June 2024.

The new initiative was included as part of the FY 2021-22 State Budget Health Omnibus Trailer Bill (AB 133) that was signed into law by Governor Gavin Newsom on July 27, 2021. The legislation authorizes CHHS to establish a data exchange framework to improve how health information is shared across the health and social services systems. Pursuant to AB 133, the framework must be finalized by July 1, 2022, and providers are required to participate in the exchange beginning January 31, 2024.

The Stakeholder Advisory Group will be chaired by CHHS Secretary Dr. Mark Ghaly, and its first meeting will be held on August 31 from 9:30 am to 12:00 pm. Members include numerous public health, health, clinical, and health plan representatives, among others. Notably, CHEAC President and Alameda County Health Services Agency Director Colleen Chawla, as well as CCLHO President and Napa County Health Officer Dr. Karen Relucio, were named to the group.

Additional information on the initiative and the stakeholder group is available here.

Bonta Joins Attorneys General Urging FDA to Restrict Tobacco Products

On Wednesday, California Attorney General Rob Bonta joined a bipartisan coalition of 31 state attorneys general in urging the U.S. Food and Drug Administration (FDA) to take action to protect public health and address youth tobacco use by more effectively regulating electronic cigarettes and other emerging tobacco products. Specifically, the coalition of attorneys general are calling on the FDA to utilize its regulatory authority to eliminate access to all youth-appealing flavors (including menthol), limit nicotine levels, and restrict marketing activities.

An announcement from the Office of the Attorney General is available here. A copy of the letter is available here.

2021-22 Community Reinvestment Grant Solicitation and Application Released

Earlier this week, the Governor’s Office of Business and Economic Development (GO-Biz) released the solicitation for the next round of the California Community Reinvestment Grants (CalCRG). As a recap, these funds from Proposition 64 (Adult Use of Marijuana Act) are directed to local health departments and community-based organizations to provide grants to support activities such as job placement, system navigation services, and linkages to medical care, for communities disproportionately affected by past federal and state drug policies.

A total of $38.4 million is available for FY 2021-22, and awardees will have three years (May 2022-April 2025) to expend funds. 2021-22 CalCRG program priorities include proposals from organizations led by individuals directly impacted by the WoD, organizations that serve formerly incarcerated individuals, and organizations placing individuals in jobs with Preference Points allocated to proposals that match current CalCRG program priorities.

Phase One applications are due to GO-Biz on Monday, September 29, 2021. Applicants that pass through the Phase One process will be invited to participate in the Phase Two application process, anticipated to be released on December 13, 2021. More information on the grant solicitation can be found here, and Fiscal Year 2020-21 Awardees can be found here

Dodson Appointed to Lead New DHCS Office

On Wednesday, Governor Gavin Newsom named Anastasia Dodson as the Deputy Director of the Office of Medicare Innovation and Integration at the California Department of Health Care Services (DHCS). Recall, this new office was created as part of the FY 2021-22 State Budget and will be tasked with providing focused leadership and expertise to lead innovative models for Medicare beneficiaries in California, including Medicare-only beneficiaries and individuals dually eligible for Medicare and Medi-Cal.

Ms. Dodson has served as the Associate Director of Policy at DHCS since 2013. She was a Principal Program Budget Analyst at the California Department of Finance (DOF), a Management and Policy Consultant with Harbage Consulting from 2011to 2012, and a Senior Policy Analyst for the County Welfare Directors Association of California from 2007 to 2011. Ms. Dodson also has held positions with local governments in the Bay Area.

Additional information on Dodson’s appointment is available here.

California Issues Guidance on Mandated Reporting Requirements and ACEs Screening

This week, a joint letter was published by the California Department of Social Services (CDSS), the California Department of Health Care Services (DHCS), and the Office of the California Surgeon General providing clarifying guidance to clinicians, local governments, and other stakeholders on the responsibilities of health care clinical teams conducting screenings for adverse childhood experiences (ACEs) in the context of the state’s mandated reporting requirements.

The full guidance letter is available here.

State Secures Federal Assistance for Multiple Wildfires

As a result of numerous large wildfires throughout the state, the Office of Governor Gavin Newsom announced this week that the state has secured fire management assistance grants (FMAGs) from the Federal Emergency Management Agency (FEMA) to support continued response activities.

FMAGs were secured this week for the Monument Fire in Trinity County, the Dixie Fire in Lassen County, and the Caldor Fire in El Dorado County. The Governor also proclaimed a state of emergency this week in El Dorado County due to the Caldor Fire.

Additional information is available here and available here.