August 23, 2019 Edition
As a friendly
reminder, registration for the 2019 CHEAC Annual Meeting will close in just
over one week on September 1. This year’s annual meeting will be held from
October 9 – October 11 at the Westin Pasadena and will provide local health
department professionals representing a wide variety of disciplines throughout
California with networking and learning opportunities.
We are pleased
to once again offer expanded keynote sessions with guest speakers and a myriad
of workshops intended to stimulate best practice sharing and discussions around
shared issues in the field. Stay tuned for forthcoming announcements on key
department leadership and staff are strongly encouraged to register by
September 1. More information on this year’s CHEAC Annual Meeting, including
registration and room reservations, is available here.
The California Legislature
this week continued a steady pace of bill negotiations, committee hearings, and
floor deliberations as it nears the end of the first year of the 2019-20
Legislative Session. Senate and Assembly Appropriations Committees face a
deadline next Friday, August 30 to hear and report all measures to their
respective house floors.
As such, both the Senate and
Assembly Appropriations Committees will hold suspense file hearings next Friday
where hundreds of measures will either be advanced in the legislative process
or held on suspense to potentially be taken up again next year. After next Friday, August 30,
the California Legislature will enter two weeks of floor sessions before
adjourning for the year on September 13.
Below, we highlight several
items of interest to CHEAC Members. For a full update, the CHEAC Weekly Bill
Chart is available here.
SB 159 (Wiener) as
amended August 12, 2019 – SUPPORT
Senator Scott Wiener’s SB 159
was set for hearing in the Assembly Appropriations Committee on Wednesday. The
measure would allow pharmacists to furnish at least a 30-day supply and up to a
60-day supply of PrEP and PEP to patients without a physician’s prescription if
the pharmacist has completed specified training and screens the patient,
provides counseling to the patient, documents services provided, and notifies
the patient’s primary care provider. Health plans would also be prohibited from
placing any prior authorization or step therapy requirements on antiretroviral
medications, including PrEP and PEP. Senator Wiener waived presentation on SB
159 and the measure was placed on the suspense file where it will be acted upon
SR 58 (Pan) as
introduced August 19, 2019 – SUPPORT
Senator Richard Pan this week
introduced SR 58, recognizing August 2019 as National Immunization Awareness
Month in California and urging Californians, state and local public health
agencies, and healthcare practitioners to promote appropriate programs and
initiatives to raise public awareness of the importance of vaccinations. Given
recent outbreaks and increased numbers of cases of vaccine-preventable
diseases, including measles in influenza, throughout the state, CHEAC is
supporting Senator Pan’s resolution.
& Alcohol Services
SB 445 (Portantino) as
amended June 11, 2019 – SUPPORT
SB 445 by Senator Anthony
Portantino would require the Department of Health Care Services (DHCS) to
convene an expert panel and adopt regulations based on the panel’s
recommendations to establish youth substance use disorder (SUD) treatment,
early intervention, and prevention quality standards for California youth. The
measure would also require each county to designate a single public agency as
the entity responsible for administering youth SUD treatment services within
the county and requires that agency to comply with standards adopted by DHCS.
SB 445 was set for hearing in the Assembly Appropriations Committee on
Wednesday. Senator Portantino waived presentation on the measure which was
placed on the suspense file where it will be acted upon next Friday.
AB 1639 (Gray) as
amended August 21, 2019 – WATCH
AB 1639 by Assembly Member
Adam Gray was heard in the Assembly Health Committee on Tuesday. The measure would
set forth stricter requirements and penalties related to tobacco products.
Persons under 21 years old would be prohibited from entering a tobacco store,
and retailers would be required to use age verification software or devices.
CDPH would also be required to conduct random, onsite sting operations of at
least 20 percent of the total number of licensed tobacco retailers in
California and conduct follow-up sting operations on retailers who are found to
be in violation of selling tobacco products to underage purchasers.
Further, the measure would
strengthen penalties against specified retailers and individuals who furnish,
purchase, or possess tobacco products. Civil penalty amounts on retailers would
be increased and suspension or revocation of a retail license would be required
upon specified underage sale violations. The measure would also prohibit
various advertising, promoting, or packaging of electronic cigarette products
in a manner that is attractive to or intended to encourage use by those under
21 years old, among other conditions.
The measure initially
proposed to penalize youth who purchase or possess tobacco through a financial
penalty of not more than $100, suspension of driving privileges, and mandatory
drug or tobacco education or counseling and community service. However, these
provisions were removed from the bill when the measure was advanced out of the
Assembly Governmental Organization Committee last month.
The measure originally sought
to temporarily ban flavored tobacco products, but exempted mint, menthol, and
tobacco flavors, and potentially preempted local jurisdictions from banning
these flavors as well, which garnered opposition from key advocates such as the
American Cancer Society Cancer Action Network, the American Heart Association,
the American Lung Association, and Tobacco-Free Kids Action Fund. During this
week’s Assembly Health Committee hearing, Assembly Member Gray agreed to
amendments that removed these provisions and no longer addresses flavored
tobacco, a key issue to be addressed at a later time. Additional amendments
taken in the committee strengthened use of age verification software and
devices, clarified the definition of an electronic cigarette, and removed
specified reporting requirements.
In presenting the bill,
Assembly Member Gray indicated that his measure was the product of months of
negotiations among several authors of tobacco control-related measures and,
while the measure is not perfect, it should still be advanced to address the
increasing epidemic of electronic cigarette use among children and youth.
Assembly Health Committee
Chair Jim Wood expressed his disappointment in how other tobacco control
measures were negotiated and handled by the Assembly Governmental Organization Committee
(of which Gray chairs), including AB 739 (McCarty) which sought to restrict all
sales of flavored tobacco products. Wood underscored the urgent need for action
around flavored tobacco products and requested that he be included in future
negotiations on measures over which the Assembly Health Committee has
jurisdiction. AB 1639 was unanimously advanced as amended on a 15-0 vote. The
measure will next be heard on Wednesday in the Assembly Appropriations
SB 538 (Rubio) as
amended August 13, 2019 – SUPPORT
SB 538 by Senator Susan Rubio
would require electronic cigarette manufacturers to submit to CDPH a written
physical description and photograph of each electronic cigarette sold in
California. CDPH would be required to post the written product descriptions and
photographs online and conduct a public outreach campaign on the online listing
availability. SB 538 was heard in the Assembly Health Committee on Tuesday and
was unanimously advanced to the Assembly Appropriations Committee on a 15-0
vote. The measure will also be heard in the Assembly Appropriations Committee
Newsom, joined by the Governor’s Office of Emergency Services (CalOES) and
California Volunteers, on Tuesday officially launched Listos (Ready)
California, the new statewide emergency preparedness campaign aimed at
building resiliency in vulnerable communities at high risk for wildfire and
other disasters. The campaign is an effort to boost disaster preparedness by
engage a statewide network of community-based organizations, Community
Emergency Response Teams (CERT), Listos, AmeriCorps NCCC, veterinary
organizations, Fire Safe Councils, and management teams.
As part of the official
launch of the campaign, Newsom announced awardees of $50 million in grants provided
earlier this year through urgency legislation (AB 72) by the Legislature. California
Volunteers awarded $30 million in grants to expand various disaster volunteer
programs, deliver culturally and linguistically relevant emergency preparedness
curriculum, and launch a statewide public outreach campaign. CalOES awarded $20
million to CBOs in 24 counties to provide emergency preparedness education and
support communities in their development of new, uniquely tailored disaster
on Tuesday, Karen Baker, former California Chief Service Officer, was appointed
as the new Senior Advisor for Disaster Volunteering and Preparedness at CalOES.
Additional information on Governor Newsom’s announcement is available here. The new Listos California
website is available here.
Governor Gavin Newsom announced the appointment of John Connolly as the
California Health and Human Services Agency (CHHS) Deputy Secretary of
Behavioral Health. Connolly has been the director of the Substance Abuse
Prevention and Control Division at the Los Angeles County Department of Public
Health (LACDPH) since 2018. He has also served as acting deputy director of the
division from 2017 to 2018 and deputy director for policy, strategic planning,
and communications from 2015 to 2017. Connolly previously was deputy director
of the Insured the Uninsured Project (ITUP) from 2012-2015, a lecturer at the
University of Southern California Keck School of Medicine, and a senior policy
analyst for the Kaiser Commission on Medicaid and the Uninsured at the Kaiser
Family Foundation. The statement announcing Connolly’s appointment is available here.
changes to rules governing the federal Title X family planning program, Planned
Parenthood this week announced its nationwide exit from the program. Recall, the Trump
Administration in March set forth a final rule that prohibits Title X from referring
patients to certain reproductive health services and further specifies that
clinics that refer patients to other facilities for abortion services would no
longer qualify for Title X funds to provide low-income women with comprehensive
family planning and preventive health services.
Parenthood served about 40 percent of the country’s four million Title X
recipients. A handful of Title X providers in other states, including Maine,
Colorado, and New York, have already exited the program, while some states plan
to stay in the Title X program but not utilize any federal funds while legal
challenges continue. Recent guidance from the U.S. Department of Health and
Human Services (HHS), however, informed grantees that they would need to exit
the program if they were unable to demonstrate “good-faith efforts” to comply
with the new regulations.
challenges from California, nearly a dozen other states, and Planned Parenthood
continue to move forward after the Ninth U.S. Circuit Court of Appeals in June invalidated nationwide injunctions previously put into place by lower
court judges in several states. With the invalidation of the injunctions, the
Trump Administration was cleared to begin enforcing its new rules governing the
program. Arguments in the Ninth Circuit Court of Appeals are set for late
September while another lawsuit was just recently appealed to the First Circuit
Court of Appeals in Boston. The broader impact of the Trump Administration’s
Title X regulations and results of pending legal challenges remain to be seen.
U.S. Centers for Disease Control and Prevention (CDC) released a series of
resources on Alzheimer’s disease and related dementias, targeted at a variety
of audiences, including public health practitioners, local health departments,
and communities. The CDC’s Alzheimer’s Disease and Healthy Aging Program has
made the following resources available:
public health- and aging-related information from the CDC is available
This week, the
U.S. Food and Drug Administration (FDA) announced a report examining“The Real Cost” campaign and its impact on youth
tobacco use. “The Real Cost” campaign launched in 2014 to educate at-risk teens
about the harmful effect of cigarette smoking and other tobacco products. In a
new study published in the American Journal of Preventive Medicine, the FDA
reports that the campaign has prevented up to 587,000 youth nationwide from
initiating smoking between February 2014 and November 2016, half of whom might
have gone on to become established smoking.
It is further
estimated that by preventing hundreds of thousands of youth from becoming
established adult tobacco users, “The Real Cost” campaign will save more than
$53 billion for youth, their families, and the U.S. by reducing smoking-related
costs such as early loss of life, costly medical care, lost wages, lower
productivity, and increased disability. According to the FDA, the campaign to
educate the more than 10 million at-risk teens about the harmful effects of
cigarette smoking saved $180 for every dollar of the nearly $250 million
invested in the campaign.
information on the recent study, as well as the FDA’s tobacco prevention and
control efforts, is available here.
The California Health Care Foundation (CHCF) recently published a resource document providing an overview of California’s county-based health plans. The document details where county-organized health plans currently operate and how their enrollment and finances have changed between 2012 and 2018. According to CHCF, enrollment in county-organized plans increased 103 percent between 2012 to 2018 and revenue increased 223 percent between 2012 and 2018. The CHCF report includes a variety of charts and graphs detailing statewide and plan-specific figures of interest. The resource document is available here.