August 30, 2019 Edition

CHEAC Closed Monday, September 2

The CHEAC Office will be closed on Monday, September 2 in observance of Labor Day. We will resume normal operations on Tuesday, September 3.

2019 CHEAC Annual Meeting Registration Closes on September 1

Registration for the 2019 CHEAC Annual Meeting will close this Sunday, 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!

More information on this year’s CHEAC Annual Meeting, including registration, is available here.

PHAB Awards Riverside County National Accreditation Status

We are pleased to announce that the Riverside County Public Health Department was awarded accreditation status by the Public Health Accreditation Board (PHAB) this week. Riverside County becomes the 16th local health department awarded PHAB recognition in California, in addition to the California Department of Public Health (CDPH).

Please join us in congratulating all of the hard work of our colleagues in Riverside County. Additional information on PHAB is available here.

Legislature Holds Suspense File Hearings, Enters Final Two Weeks of Session

Today, the Senate and Assembly Appropriations Committees held unusually long suspense file hearings, meeting today’s deadline for fiscal committees to hear and report all bills to the floor. During the hearings, hundreds of bills were either advanced or held for the remainder of the year.

In the Assembly Appropriations Committee, Chair Lorena Gonzalez opted to hear first Senator Richard Pan’s SB 276 related to medical immunizations exemptions, acknowledging the crowd of opposition in attendance. Following the announcement that the bill was passed, the opposition began standing on chairs and chanting, which caused the chair to recess the committee. However, when the committee reconvened, the chanting and protests continued throughout the course of the committee’s business, even during multiple brief committee recesses.

Looking ahead, the Legislature will hold two weeks of floor sessions only beginning on Tuesday, and no committees other than conference committees of Rules Committees may meet for any purpose. Next Friday, September 6 is the deadline for legislators to amend bills on the floor, and the first year of the 2019-20 Legislative Session is set to conclude on Friday, September 13. The next two weeks will be a very busy time for legislators, bill sponsors, and the Newsom Administration as parties work to finalize negotiations and advance measures to the Governor’s desk. Several high-profile issues remain outstanding, including housing, labor relations, and education.

Below, we highlight suspense file results of particular interest to CHEAC Members. The latest edition of the CHEAC Weekly Bill Chart is available here.

Access to Health Services

AB 769 (Smith) –SUPPORT – HELD ON SUSPENSE

Expands Medi-Cal reimbursement eligibility to include licensed professional clinical counselors (LPCCs) in federally qualified health centers (FQHCs) and rural health clinics (RHCs).

AB 1494 (Aguiar-Curry) – SUPPORT – DO PASS AS AMENDED

Specifies Medi-Cal reimbursement shall be made available for telehealth, telephonic, or off-site services when delivered by an enrolled community clinic, including a city or county clinic exempt from licensure, or FFS Medi-Cal provider during or up to 90 days after expiration of a state of emergency, as deemed appropriate by DHCS.

SB 66 (Atkins) – SUPPORT – DO PASS

Authorizes Medi-Cal reimbursement for a maximum of two visits on the same day at a single FQHC or RHC location if: 1) after the first visit, the patient suffers illness/injury requiring additional diagnosis/treatment; or 2) the patient has a medical visit and a mental health visit or dental visit.

Cannabis – Medical/Adult Use

AB 228 (Aguiar-Curry) – WATCH – HELD ON SUSPENSE

Adds statutory language declaring a food, beverage, or cosmetic is not adulterated if it includes industrial hemp products, including cannabidiol (CBD), extracts, or derivates from industrial hemp. Prohibits restrictions on sale of products containing industrial hemp, CBD, extracts, or derivatives from industrial hemp. Authorizes MAUCRSA licensee to manufacture, distribute, or sell products that contain industrial hemp. Requires warning label on food, beverage, or cosmetic containing industrial hemp. Requires manufacturers to comply with Sherman Food, Drug, and Cosmetic law. Prohibits untrue or misleading health-related statements on labeling, advertising, or marketing of industrial hemp products.

Chronic Disease Prevention & Wellness Promotion

AB 388 (Limón) – SUPPORT – HELD ON SUSPENSE

Requires the California Department of Public Health (CDPH) to implement action agenda items from the U.S. Centers for Disease Control and Prevention (CDC) Healthy Brain Initiative. Requires CDPH, upon appropriation by the Legislature, to award one-time competitive grants to up to eight local health jurisdictions for local planning and preparation activities consistent with the CDC Healthy Brain Initiative Action Agenda.

Communicable Disease Control

SB 159 (Wiener) – SUPPORT – DO PASS AS AMENDED

Allows 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 under specified circumstances. Prohibits health plans from placing any prior authorization or step therapy requirements on antiretroviral medications including PrEP and PEP.

SB 276 (Pan) – SUPPORT – DO PASS

Requires physicians/surgeons to utilize a CDPH-developed statewide standardized electronic medical exemption certification form when issuing an immunization exemption for medical reasons. Specifies required information to be included on the form, including a certification that the physician/surgeon has physically examined the child, a description of the medical basis for the exemption, and authorization for CDPH to contact the issuing physician/surgeon and for the release of records related to the exemption to CDPH, the Medical Board of California, and the Osteopathic Medical Board of California. Prohibits physicians/surgeons from charging a fee for filling out a medical exemption form or for an examination related to the renewal of a temporary exemption. Requires CDPH to create a standardize system to monitor immunization levels in schools and monitor patterns of unusually high exemption form submissions by a physician/surgeon or medical practice. Requires CDPH to review at least annually immunization reports from all schools to identify schools with an immunization rate of less than 95 percent, from physicians/surgeons who have submitted five or more medical exemptions in a calendar year, and schools that do not provide vaccination rate reports to CDPH. Allows CDPH, upon the discretion of a clinically trained immunization staff, to accept a medical exemption that is based on other contraindications or precautions. Authorizes CDPH clinically trained immunization program staff that is a physician/surgeon or registered nurse to review any exemption in the state database as necessary to protect public health. Sets forth an appeal process for denied or revoked medical exemptions. Requires California Health and Human Services Secretary to establish an independent expert review panel to review exemption appeals.

Drug & Alcohol Services

AB 1031 (Nazarian) – SUPPORT – HELD ON SUSPENSE

Establishes the Youth Substance Use Disorder Treatment and Recovery Program Act. Directs the Department of Health Care Services (DHCS), in collaboration with counties and substance use disorder (SUD) services providers, to establish regulations regarding community-based nonresidential and residential treatment and recovery programs for youth under 21 years of age.

SB 445 (Portantino) – SUPPORT – DO PASS

Requires DHCS to convene an expert panel and adopt regulations based on the expert panel’s recommendations to establish youth SUD treatment, early intervention, and prevention quality standards for California youth. Requires each county to designate a single public agency as the responsibility entity for administering youth SUD treatment services within the county and requires the agency to comply with the standards adopted by DHCS.

Emergency Medical Services (EMS)

AB 1544 (Gipson) – OPPOSE UNLESS AMENDED – DO PASS AS AMENDED

Allows LEMSAs to develop local community paramedicine programs for specified services and alternate transport of patients to behavioral health facilities and sobering centers. Requires LEMSAs, if the county elects to establish a paramedicine or alternate transport program, to use or establish a local emergency medical care committee (EMCC) and prescribes the BOS to include specific EMCC members. Establishes the Community Paramedicine Medical Oversight Committee to advise EMSA on and to approve minimum medical protocols for all community paramedicine programs. Requires LEMSA to provide right of first refusal to every public agency located within its jurisdiction to provide community paramedicine program specialties prior to offering private EMS providers. Adds two members to the Commission on Emergency Medical Services.

Environmental Health

AB 836 (Wicks) – WATCH – DO PASS AS AMENDED

Establishes a grant program to provide funding, upon appropriation by the Legislature, to retrofit ventilation systems at various facilities (e.g. schools, community centers, senior centers, libraries) to create a network of clean air centers in order to mitigate adverse public health impacts due to wildfire and other smoke events.

AB 1500 (Carrillo) – SUPPORT – HELD ON SUSPENSE

Authorizes local health officer (LHO), in consultation with other local and state agencies, to issue an order to a responsible party of a hazardous waste release to suspend or discontinue operations, conduct specified environmental testing, and/or assist exposed individuals. Expands authority of unified program agency (UPA) to suspend, revoke, or withhold unified program facility permit under specified circumstances in which public health, safety, or the environment is imminently and substantially endangered.

Health Coverage/Health Care Reform

AB 50 (Kalra) – SUPPORT – HELD ON SUSPENSE

Requires DHCS to submit to the U.S. Centers for Medicare and Medicaid Services (CMS) an amendment request for the Assisted Living Waiver (ALW) program, including a request to increase slots from 5,744 to 18,500 and to start a process to expand the program on a regional basis beyond the existing 15 participating counties.

AB 848 (Gray) – SUPPORT – DO PASS AS AMENDED

Adds continuous glucose monitors and related supplies to the schedule of Medi-Cal benefits for diabetes mellitus treatment when medically necessary, subject to utilization controls.

AB 1004 (McCarty) – SUPPORT – DO PASS AS AMENDED

Requires screening services under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Program to include developmental screening services for individuals zero to three years of age. Requires Medi-Cal managed care plans (MCMC) to put in place mechanisms to ensure timely and consistent developmental screenings for children.

AB 1088 (Wood) – SUPPORT – DO PASS AS AMENDED

Extends eligibility without a share of cost for individuals who would otherwise be eligible if not for the state buy-in of their Medicare Part B premiums.

SB 29 (Durazo) – SUPPORT – DO PASS AS AMENDED

Expands full-scope Medi-Cal to undocumented adults 65 years of age and older with incomes at or below 138 percent of the federal poverty level (FPL).

Injury Prevention

AB 166 (Gabriel) – SUPPORT – DO PASS AS AMENDED

Requires DHCS to establish a violence intervention pilot program at a minimum of eight hospital-based or hospital-linked sites, including at least one site in Alameda, Contra Costa, Los Angeles, Monterey, Sacramento, San Francisco, Santa Clara, and Ventura counties targeted at reducing injury recidivism among Medi-Cal beneficiaries who have been violently injured. Requires violence preventive services to be offered to an eligible Medi-Cal beneficiary by a qualified violence prevention professional for a minimum of three months and a maximum of 12 months. Services shall include targeted case management and care coordination, home and community visitation, and peer support services.

AB 656 (E. Garcia) – WATCH – TWO YEAR BILL

Establishes the Office of Healthy and Safe Communities (OHSC) under the direction of the California Department of Public Health to develop, implement, and monitor a comprehensive statewide violence prevention strategy.

SB 58 (Wiener) – WATCH – DO PASS AS AMENDED

Requires Department of Alcoholic Beverage Control (ABC) to conduct a pilot program for additional hour license permits to allow specified bars/nightclubs to remain open until 4:00 am in the cities of Cathedral City, Coachella, Fresno, Long Beach, Los Angeles, Oakland, Palm Springs, Sacramento, San Francisco, and West Hollywood. Sets forth requirements of local governing boards and cities wishing to pursue additional hour license permits.

Jail & Community Corrections Services

AB 45 (Stone) – WATCH – DO PASS

Prohibits sheriff or other correctional facility administrators from charging fees for inmate-initiated medical visits or for durable medical equipment (DME) or medical supplies.

SB 42 (Skinner) – WATCH – DO PASS AS AMENDED

Requires county sheriff to make release standards, processes, and schedules available to a person booked into a county jail. Requires release standards to include specified rights, including the right for assistance in entering a SUD program, assistance in arranging for transportation to rehabilitation or a hospital free of charge, the option to stay in jail for up to 16 additional hours to be discharged during daytime, and a three days’ supply of medication that was being provided to the person while incarcerated upon release of a stay of 30 days or longer. Establishes the Late-Night Release Prevention Task Force.

Maternal, Child, & Adolescent Health

SB 464 (Mitchell) – SUPPORT – DO PASS AS AMENDED

Requires specified health facilities providing perinatal care to implement an evidence-based implicit bias program for all healthcare providers involved in perinatal care within those facilities. Requires initial course and refresher course at least every two years thereafter. Requires hospitals to provide patients with information on filing a discrimination complaint. Requires death certificates to indicate whether decedent was pregnant within 42 days of death or within 43 to 365 days of death. Requires CDPH to track and publish specified maternal morbidity and mortality data.

Tobacco Control

AB 1718 (Levine) and SB 8 (Glazer) – SUPPORT – DO PASS

Both ban smoking and disposal of all cigar and cigarette waste at all state coastal beaches or in state parks.

Vector Control

AB 320 (Quirk) – SUPPORT – DO PASS

Establishes the California Mosquito Surveillance and Research Program and requires the development of an interactive website for the management and dissemination of mosquito-borne virus and surveillance control data.

MCO Tax Budget Trailer Bill Now in Print

A budget trailer bill to extend the managed care organization provider tax (MCO tax) is now in print (AB 115). Recall, during budget convenings, the Legislature expressed significant concerns with the Administration not pursing a renewal of the MCO tax, which expired in July of this year. The previous MCO tax offset state General Fund spending on Medi-Cal by over $1 billion per year by leveraging federal dollars for Medi-Cal.  The Department of Health Care Services (DHCS) had previously cited the change in federal administration, upcoming waiver renewal negotiations, and only two other state MCO tax approvals as considerations for not pursing renewal of the tax. However, after further negotiation, an agreement was reached to pursue an MCO tax while delaying the inclusion of those revenues in the budget until federal approvals were secured.

The bill proposes to renew the MCO tax for three and a half years from July 1, 2019, to December 31, 2022, and identify two goals similar to the MCO tax in 2016: 1) generate an equivalent amount of nonfederal funds for Medi-Cal as generated by the previous tax; and 2) comply with federal Medicaid requirements. There are some key differences in the construct of the tax, with the enrollee tiers and associated taxes differing from the previous MCO tax structure. The bill, unlike the prior MCO tax, provides conditions in which the tax would cease to be operative: 1) If the director of DHCS, in consultation with the Department of Finance, determines that the taxes have not met the stated intent; and 2) if a determination is made by the courts or the federal Centers for Medicare and Medicaid Services (CMS) that the tax cannot be implemented.  

With only two weeks of session remaining, the MCO tax is likely to be an end-of-session item to watch. CHEAC will provide updates as deliberations on the bill progress. 

Newsom Scraps Plans for Statewide Homeless Czar, Will Instead Rely on Homelessness Commission

This week, Governor Gavin Newsom announced he was abandoning his plans to appoint a cabinet-level secretary dedicated to homelessness. In speaking with the press, Newsom instead indicated his Administration’s intent to rely on the already-established Commission on Homelessness and Supportive Housing led by Sacramento Mayor Darrell Steinberg and Los Angeles County Supervisor Mark Ridley-Thomas. Newsom initially announced the creation of the commission in February during his first state of the state address.

At the time, Newsom signaled he still planned to appoint a “homeless czar” to his cabinet to advise him on homelessness issues throughout the state. Several executive branch departments have also been tasked with addressing homelessness, and earlier this month, the Newsom Administration announced the newly created position of deputy secretary of homelessness within the Business, Consumer Services, and Housing Agency, which reports to the Governor’s Office.

Oklahoma Judge Rules Against Johnson & Johnson, Orders $572m Payment to State

On Monday, Cleveland County, Oklahoma, District Court Judge Thad Balkman ruled that Johnson & Johnson subsidiary Janssen Pharmaceuticals sparked the state’s opioid crisis by deceptively marketing opioid products, ordering the company to pay the State of Oklahoma $572 million. The amount ordered by the judge fell well short of the $17.5 billion initially sought by Oklahoma to pay for addiction treatment, drug courts, and other opioid-related harm services needed over the next 20 years to address damages caused by the epidemic.

Still, the landmark case was the first court ruling holding a pharmaceutical company responsible for one of the worst drug epidemics in U.S. history. After a seven-week civil trial, Judge Balkman determined in his ruling that Johnson & Johnson had promulgated “false, misleading, and dangerous marketing campaigns” that “caused exponentially increasing rates of addiction, overdose deaths, and neonatal abstinence syndrome in Oklahoma.” Between 2015 and 2018, 18 million opioid prescriptions were issued in the state with a population of 3.9 million. Since 2000, approximately 6,000 Oklahomans have died from opioid overdoses.

In his ruling, Judge Balkman indicated the $572 million judgement could pay for only one year’s worth of services needed to combat the opioid epidemic after determining the state did not present sufficient evidence of the amount of time and costs necessary beyond year one to abate the state’s opioid crisis.

Immediately following the ruling, Johnson & Johnson representatives announced their intent to appeal, stating that, “Janssen did not cause the opioid crisis in Oklahoma, and neither the facts nor the law support this outcome.” Despite its share of opioid sales in the state being only 1 percent of the market, Johnson & Johnson sales staff between 2000 and 2011 made nearly 150,000 visits to physicians in Oklahoma, focusing primarily on high-volume prescribers. The company also supplied most of the nation’s opioid material to other drug manufacturers, refined by Johnson & Johnson from poppy the company developed and grew in Tasmania. During the civil trial, Johnson & Johnson argued blame for the epidemic could not be placed squarely on one company with modest sales and whose drugs were approved and regulated by state and federal entities.

However, Judge Balkman indicated he was persuaded by Oklahoma’s legal theory in that Johnson & Johnson created a “public nuisance” by substantially contributing to an ongoing public health crisis. While the judgement amount fell short, Oklahoma officials lauded the broader sum of funding ordered payable to the state by opioid manufacturers. Recall, earlier this year Perdue Pharma and Teva Pharmaceuticals settled with the State of Oklahoma and agreed to pay $270 million and $85 million, respectively, for their roles in the state’s opioid crisis.

The Oklahoma case was closely monitored by opioid manufacturers, distributors, and retailers as they face more than 2,000 similar lawsuits brought by state and local governments throughout the country. Settlement negotiations may quicken between pharmaceutical industry defendants and two large plaintiffs groups following the Oklahoma ruling. One group of plaintiffs is representing thousands of counties and cities, which is set to be argued through a consolidated case in an Ohio federal court, and another group of plaintiffs is a coalition of states. The consolidated Ohio case against 22 opioid manufacturers and distributors is anticipated to begin in October. A number of states have also filed separate lawsuits against pharmaceutical companies, including California.

It remains to be seen how outstanding legal challenges will play out throughout the country, particularly given the potential for clashes between states and local government plaintiffs. Many local government plaintiffs have been pushing for the consolidated Ohio case to include a “negotiating class” of thousands of additional local governments. According to these local entities, this arrangement would allow them to more effectively distribute any settlement funds at the local level. Many state attorneys general, however, are opposed to the local government negotiating class arrangement, even going so far as to file amicus briefs with the Ohio court arguing against it.

Given the Oklahoma ruling, as well as the mounting legal challenges against the industry, a number of pharmaceutical companies, including Perdue Pharma, Johnson & Johnson, Endo International, and Allergan, are reportedly aiming to cut deals with plaintiffs through global settlements with both state and local governments in the near future. Reports suggest that Perdue Pharma, for instance, may settle in a deal involving $12 billion in payments to state and local governments and a bankruptcy process that would involve the Sackler family conceding ownership of the company. While concrete details are yet to emerge, court proceedings and potential settlements with state and local governments – which may reach amounts and mimic provisions similar to those of the 1998 Master Tobacco Settlement – are expected to unfold over the coming weeks and months.

CDC Issues Nationwide Health Alert Related to E-Cigarette Products

This morning, the U.S. Centers for Disease Control and Prevention (CDC) issued a nationwide health advisory related to the multistate outbreak of severe pulmonary injury associated with use of electronic cigarette products (devices, liquids, refill pods, and cartridges) containing nicotine or cannabis. The CDC advisory details outbreak background and recommendations for clinicians, public health officials, and the American public. As of August 27, 215 possible cases of vaping-associated pulmonary injury have been reported from 25 states, including California.

While a lack of evidence currently exists pointing to a single product or device that has caused the respiratory injuries, the CDC has advised individuals concerned about their health to cease using electronic cigarette products and to consult a healthcare provider with assistance in quitting use of the products. Further, the CDC indicates that regardless of the ongoing investigation into the multistate outbreak, electronic cigarette products should not be used by youth, young adults, pregnant women, or adults who do not currently use tobacco products. For individuals who use electronic cigarette products, the CDC advises individuals to monitor themselves for potential symptoms (e.g. cough, shortness of breath, chest pain) and promptly seek medical attention if concerns exist.

Also, this morning, CDC Director Robert Redfield and Acting U.S. Food and Drug Administration (FDA) Commissioner Ned Sharpless released a statement detailing federal and state collaboration to investigate the ongoing electronic cigarette-associated cases nationwide. The CDC and FDA continue to work expeditiously to investigate cases and assist states in their related activities. Further, the CDC and FDA warn Americans that they should not purchase electronic cigarette products off the street and should not modify electronic cigarette products or add any substances to these products that are not intended by the manufacturer. The federal agencies reiterated their commitment to determining the cause of the cases and communicating findings and updates to the American public in the coming days and weeks.

U.S. Surgeon General Issues Warning on Cannabis Youth Among Youth, Pregnant Women

On Thursday, U.S. Surgeon General Jerome Adams issued a national health advisory, warning that consuming cannabis is particularly dangerous to pregnant women, developing babies, and teenagers. Surgeon General Adams, during a news conference, expressed concern that many Americans are unaware of the health hazards posed by professionally grown cannabis crops, describing today’s cannabis as far more potent than it was in previous decades. Adams indicated THC levels in cannabis produced today have a range of 12 percent to 25 percent, much higher than four percent 20 years ago.

U.S. Health and Human Services Secretary Alex Azar joined Adams in warning the American public about the potential dangers of cannabis by declaring, “This is a dangerous drug. No amount of marijuana use during pregnancy or adolescence is safe.” According to the Surgeon General’s warning, cannabis is the most commonly used illicit drug in the U.S. and its potentially harmful effects include memory and motor impairments, as well as anxiety, agitation, paranoia, and psychosis is newer and more potent strains. Adams also warns of risks of physical dependence, addiction, and other negative consequences associated with exposure to high concentrations of THC and the younger age of initiation.

The warning details actions available to state and local governments, public health professionals, clinicians, educators, and parents and expecting parents. Specifically, the advisory calls for science-based messaging campaigns and targeted prevention programming to clearly communicate and amplify risks of cannabis use. Relatedly, HHS Secretary Azar on Thursday indicated President Donald Trump donated $100,000 from his salary to pay for a digital campaign to make the American public aware of the hazards of cannabis use.

The full U.S. Surgeon General advisory is available here.

CDC Warns Nationwide Measles Elimination Status at Risk

U.S. Centers for Disease Control and Prevention (CDC) National Center for Immunization and Respiratory Diseases Director Dr. Nancy Messonnier this week indicated there is a “reasonable chance” the United States will lose its measles elimination status in October 2019, largely caused by ongoing measles outbreaks in New York. Recall, the World Health Organization (WHO) declared in 2000 that the U.S. had eliminated measles, representing one of the most significant public health achievements in the country’s history.

According to the WHO, for a country to have its elimination status rescinded, measles must have been spreading continuously for one year. Two outbreaks began in New York City and Rockland County, New York, in September 2018, with more than 900 combined cases reported in those locations. The two outbreaks have largely occurred among children in ultra-Orthodox Jewish communities in which parents have refused to vaccinate their children.

Additional information and a detailed statement on the country’s elimination status are expected from the CDC in the coming days.

Public Charge Final Rule Summary from County Associations Now Available

The California State Association of Counties (CSAC), CHEAC, California Association of Public Hospitals and Health Systems (CAPH), County Behavioral Health Directors Association (CBHDA), and the County Welfare Directors Association (CWDA) released this week a summary document of the final public charge rule that was published in the Federal Register earlier this month.

Recall, the Trump Administration rule, set to take effect on October 15, will require individuals applying for or seeking adjustment to an immigration status or visa to establish that they are not likely at any time to become a public charge. An expanded public charge test will weigh a variety of factors, including whether an immigrant is receiving one or more specified public benefits, including non-emergency Medicaid, Temporary Assistance for Needy Families (TANF), housing subsidies, and Supplemental Nutrition Assistance Program (SNAP) benefits, among others.

The county association summary document provides local agencies critical information in understanding how the final public charge rule will change longstanding policy and details tips and important points of which to be aware, especially for those agencies working with immigrant families. The summary document is available here. Additional immigration-related resources and information is available on the CHEAC website here.

New Study Finds California Latinos Left Behind in ACA Coverage and Access Gains

A new study by the UCLA Center for Health Policy Research recently found that Latinos in California continue to fall behind other racial and ethnic groups in coverage and access to healthcare despite significant health insurance coverage gains provided under the Affordable Care Act (ACA). According to the center, Latinos in California are less likely to have health insurance due to a lack of employer-provided coverage and barriers such as citizenship restrictions on access. In turn, Latinos experience less access to health services, ultimately resulting in poorer health outcomes.

Using 2015 and 2016 California Health Interview Survey data, the study determined that 13.7 percent of Latinos in California remain uninsured. Although Latinos have one of the highest rates of enrollment in Medi-Cal at 44.9 percent, 21.6 percent of uninsured Latinos are eligible to enroll in Medi-Cal but are not currently enrolled. Only 31.6 percent of Latinos reported being insured through an employer, the lowest job-based coverage rate out of all racial and ethnic groups. Additionally, 139,000 Latino children up to 18 years of age, of 76 percent, are eligible to enroll in Medi-Cal but are not currently enrolled.

Additional findings of the study include:

• Uninsured rates are higher among Latinos with fair or poor health. Those who are not citizens or permanent residents are more likely to be uninsured than U.S.-born Latinos (44.7 percent versus 16.5 percent).
• Uninsured rates were higher for Latinos who came to the U.S. less than 10 years ago and those with low English proficiency.
• Cost is an important factor in Latinos accessing health care. A lack of money resulted in delays in seeking medical care or the inability to fill a prescription.

Researchers further point to the need to expand Medi-Cal access to noncitizens to substantially reduce the uninsured rate between Latinos and other Californians. Additional efforts around reducing healthcare cost and expanding access to subsidies to purchase coverage is another important tool in reducing the Latino uninsured rate.

The full health policy brief is available here.

CDPH to Hold Homicide Prevention Webinar on September 19

The California Department of Public Health (CDPH) Violence Prevention Initiative (VPI) will hold a Community of Practice webinar on Thursday, September 19 from 1:00 pm to 2:30 pm on “Homicide Prevention – Part I: Using Data to Drive Violence Prevention Program Planning.” The webinar will feature available data sources on homicide rates and mechanisms as well as a local level example from the Los Angeles County Department of Public Health on how data can be used to guide violence prevention program planning and development. Registration for the webinar is available here.

DHCS to Hold Informational Webinars on Medi-Cal Dental Member Support Services

The Department of Health Care Services (DHCS) will host two informational webinars on Medi-Cal dental member support services in September. The same webinar will be held on both dates and will include information on Medi-Cal dental services care coordination, case management, complaint processes, language assistance, personal health information requests, and the use of authorized representatives. Registration is not required, and individuals may participate in the webinar by clicking on the links below the day of the webinar:

September 9, 2019, 1:00 pm-3:00 pm: Available here

September 18, 2019, 1:00 pm-3:00 pm:Available here

For questions or additional information, please contact dental@dhcs.ca.gov.

LACDPH to Host Webinar on Health Equity Implications of Cannabis Regulation

The Los Angeles County Department of Public Health (LACDPH) Center for Health Impact Evaluation will host a live webinar on the “Health Equity Implications of Cannabis Regulation in Los Angeles County” on Thursday, September 12 from 10:00 am to 11:30 am.

LACDPH recently completed the health impact assessment at the request of the Los Angeles County Board of Supervisors and examined the potential health impacts of policy and regulatory decisions related to 1) cannabis business locations and density; 2) cannabis business practices; 3) cannabis regulatory enforcement; and 4) cannabis taxation. The assessment details a series of health equity-informed recommendations for cities and counties, local government agency and departmental leaders, and community advocates.

Local health department executives and staff are encouraged to join the webinar. Registration for the webinar is available here.

Public Health Advocates to Hold Trauma Conference November 20-21

Public Health Advocates will host its fall conference “Rooted in Community: Moving from Trauma to Healing” on November 20 and 21 at the Hyatt Regency Long Beach. The conference will include topics such as critical lessons in equity, the role of social support in individual and community healing, redesigning organizational culture, trauma-informed education, and climate change. A keynote presentation will be provided best-selling author and scholar Michael Eric Dyson. Additional information, including registration is available here.