August 23, 2019 Edition

Just Over One Week Remains to Register for 2019 CHEAC Annual Meeting

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 speakers!

Local health 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.

Fiscal Committees Face Deadline Next Week, Suspense File Hearings Set for August 30

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.

Communicable Disease Control

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 next Friday.

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.

Drug & 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.

Tobacco Control

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 Committee.

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 next Wednesday.

Newsom Launches New Emergency Preparedness Campaign, Announces $50m in Grants

Governor Gavin 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 preparedness approaches.

Additionally, 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.

Connolly Appointed CHHS Deputy Secretary for Behavioral Health

On Tuesday, 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.

Planned Parenthood Announces Withdrawal from Title X Program

Citing recent 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.

Planned 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.

Legal 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.

CDC Publishes Series of Alzheimer’s Disease and Healthy Aging Resources

Recently, the 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:

Additional public health- and aging-related information from the CDC is available here.

FDA Report on “The Real Cost” Tobacco Campaign Shows Successes in Youth Smoking Prevention, Public Health Cost Savings

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.

Additional information on the recent study, as well as the FDA’s tobacco prevention and control efforts, is available here.

CHCF Publishes 2019 Overview of County-Organized Health Plans

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.