December 10, 2021 Edition
This week, leaders of the California State Senate and Assembly outlined key priorities for investments in the 2022-23 State Budget. Both houses’ priority documents come ahead of the Governor’s January Budget, which is expected to be released by January 10, 2022. Below, we provide an overview of both the Senate and Assembly budget priorities.
Of particular note to CHEAC Members, both the Senate and Assembly priorities include nods to rebuilding and strengthening the state’s public health infrastructure.
Senate Calls for More Equitable Economy
Senate President pro Tempore Toni Atkins and Senate Budget & Fiscal Review Committee Chair Nancy Skinner on Wednesday released the Senate’s broad overview of key values that will guide the majority as the body crafts its budget plan for the next fiscal year.
The Senate details the following primary values:
- Sustain progress by building upon historic reserves to protect ongoing programs from future temporary downturns, paying down state debts and retirement liabilities, utilizing one-time funds for one-time or short-term purposes, and maintaining existing expenditure priorities that promote equity.
- Strengthen equity while meeting Gann Limit requirements by maximizing infrastructure investments (including in education), building on enacted targeted tax relief programs, adjusting budget approaches to ensure ongoing commitments can be made to core programs (e.g., health, safety net), and considering reforms to modernize the Gann Limit while respecting its original intent.
- Build a more equitable economy by supporting California workers, assisting families and those in need, improving public health, health, and mental health, addressing housing challenges, boosting 21st century infrastructure efforts, and sustaining California through climate and environmental activities.
The Senate, through its values blueprint, applauds the decade of responsible budgeting by the majority and points to the opportunity to make transformative investments with the historic projected surplus. The full Senate document is available here.
Assembly Aims to Deliver Prosperity to More Californians
Assembly Budget Committee Chair Phil Ting on Thursday similarly outlined budget priorities on behalf of Assembly Democrats, unveiling his 2022-23 Budget Blueprint entitled “Delivering Prosperity & Strengthening the Future.” Ting, in his blueprint, details numerous significant investments made in 2021 across multiple subject areas and calls for the state to ensure bold investments are accomplished in the 2022 budget.
The Assembly aims to:
- Deliver prosperity with 2021 programs including through investments in public health infrastructure, CalAIM and Children and Youth Behavioral Health Initiative, early childhood services and education, homelessness and affordable housing, emergency preparedness and climate change, and broadband access.
- Strengthen the future with new targeted investments including through major infrastructure investments (e.g., transportation, education, and housing), workforce development activities, access to health and human services, and resources for violence and suicide prevention.
The full Assembly budget document is available here.
Upon the Legislature’s return to Sacramento next month, lawmakers will receive the Governor’s January Budget proposal and begin its months-long budget hearing process. The Senate and Assembly, in early 2022, are expected to issue more detailed budget priorities. As budget activities begin in earnest in the new year, CHEAC will continue to keep Members apprised of relevant developments, including investments in public health infrastructure.
Amid redistricting activities and numerous announcements from lawmakers seeking other political offices, Assembly Speaker Anthony Rendon recently announced a series of changes to committee chairpersons.
Last month, Speaker Rendon removed Assembly Member Evan Low as the chair and member of the Committee on Business and Professions. Low, who has served as chair for the past five years, was reportedly not offered an explanation for change. Rendon, in Low’s place, appointed Assembly Member Marc Berman as the committee chair.
Also, this week, Rendon appointed Assembly Member Miguel Santiago as the chair of the Committee on Governmental Organization after chair Assembly Member Jim Frazier announced his resignation from the Assembly at the end of the year. Assembly Member Sharon Quirk-Silva was appointed as the chair of the Committee on Communications and Conveyance, succeeding Santiago. Assembly Member Buffy Wicks was appointed as chair of the Committee on Housing and Community Development, replacing David Chiu who has since become San Francisco’s City Attorney.
Last, Rendon appointed Assembly Member Christopher Ward as Assistant Majority Leader, replacing Assembly Member Ed Chau, who Governor Newsom recently appointed as a judge for Los Angeles County.
As redistricting maps are soon finalized and the 2022 election day nears, more candidacy and office-change announcements are all but certain.
The California Department of Public Health (CDPH) continues to urge Californians to receive the influenza (flu) vaccine to protect your health and the health of others, particularly with the holiday season underway and people visiting family and friends. For Californians who still have not received the COVID-19 vaccine or are due for their booster, the flu vaccine and COVID-19 vaccine can be administered in the same sitting.
Influenza is increasing around the country, according to CDPH, especially among young adults and children. CDPH recommends the annual flu vaccination for everyone six months of age and older and getting vaccinated against the flu is especially important for people at high-risk of severe disease and hospitalization.
Additional information from CDPH is available here.
Following a formal request from Pfizer-BioNTech last week, the U.S. Food and Drug Administration (FDA) on Thursday amended the emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 Vaccine to authorize the use of a single booster dose for administration to individuals 16 and 17 years of age at least six months after completion of primary vaccination.
The FDA took its steps without the convening its Vaccines and Related Biological Products Advisory Committee (VRBPAC) after the agency reviewed data supporting effectiveness, including an evaluation of the benefits and risks of administering a booster dose among this population. The FDA determined the booster request dose not raise questions that would benefit from an additional discussion by VRBPAC members.
Following the FDA’s actions, U.S. Centers for Disease Control and Prevention (CDC) Director Dr. Rochelle Walensky strengthened its booster recommendations and encouraged everyone 16 and older to receive a COVID-19 booster dose. Walensky, in updating the agency’s booster recommendations, did not convene the CDC’s Advisory Committee on Immunization Practices (ACIP).
U.S. Health and Human Services Secretary Xavier Becerra, following the updated guidance, issued a statement encouraging all eligible Americans to receive a booster dose.
The Western States Scientific Safety Review Workgroup similarly assessed the available data on booster doses among 16- and 17-year olds, ultimately issuing a recommendation to expand eligibility for boosters among the age group in California.
Additional information from the FDA is available here and from the CDC is available here.
This week, the U.S. Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for AstraZeneca’s Evusheld for the pre-exposure prophylaxis of COVID-19 in certain adults and pediatric individuals ages 12 and older. The monoclonal antibody (MAB) product is authorized for those individuals who are not currently infected with the SARS-CoV-2 virus and who have not recently been exposed to an individual infected with SARS-CoV-2.
Individuals must also have either:
- A moderate to severely compromised immune system due to a medical condition or due to taking immunosuppressive medications or treatments and may not mount an adequate immune response to COVID-19 vaccination; OR
- A history of severe adverse reactions to a COVID-19 vaccine and/or component of those vaccines.
One dose of Evusheld, administered as two separate consecutive intramuscular injections, may be effective for pre-exposure prevention of COVID-19 for six months. The product is not authorized for post-exposure prevention of COVID-19, and the product is not a substitute for vaccination in individuals for whom COVID-19 vaccination is recommended.
During a randomized, double-blind, placebo-controlled clinical trial, Evusheld recipients realized a 77 percent reduced risk of developing COVID-19 compared to those who received a placebo. Additional analyses determined the reduction in risk for Evusheld was maintained through six months.
Additional information from the FDA is available here.
This week, U.S. Surgeon General Dr. Vivek Murthy issued a new Surgeon General’s Advisory calling attention to the urgent need to address the nation’s youth mental health crisis. The advisory outlines the pandemic’s unprecedented impacts on the mental health of youth and families in the U.S., as well as mental health challenges that existed prior to the pandemic.
The Surgeon General’s advisory calls for a swift and coordinated response to the issue. Before the COVID-19 pandemic, mental health challenges were the leading cause of disability and poor life outcomes in young people with up to 1 in 5 children ages 3 to 17 in the U.S. having a mental, emotional, developmental, and behavioral disorder. Suicidal behaviors among high school students have also risen during the past decade, and early estimates show more than 6,600 suicide deaths occurred among youth ages 10-24 in 2020.
The Surgeon General further discusses the pandemic’s impacts on the lives of children and adolescents, including changes to in-person schooling, in-person social opportunities with peers and mentors, access to health and social services, food, housing, and the health of their caregivers. Topline recommendations of the Surgeon General’s advisory include:
- Recognize the mental health is an essential part of overall health.
- Empower youth and their families to recognize, manage, and learn from difficult emotions.
- Ensure that every child has access to high-quality, affordable, and culturally competent mental health care.
- Support the mental health of children and youth in educational, community, and childcare settings, and expand and support the early childhood and education workforce.
- Address the economic and social barriers that contribute to poor mental health for young people, families, and caregivers.
- Increase timely data collection and research to identify and respond to youth mental health needs more rapidly. This includes more research on the relationship between technology and youth mental health, and technology companies should be more transparent with data and algorithmic processes to enable this research.
Additional information on the Surgeon General’s advisory is available here.
On Tuesday, Vice President Kamala Harris, on behalf of the Biden-Harris Administration, marked its first-ever White House Maternal Health Day of Action, issuing a call to action to public and private sectors to help improve health outcomes for parents and infants in the U.S.
As part of the call of action, the Administration announced a set of new commitments to support safe pregnancies and childbirth and reduce complications and mortality in the year following birth. The Administration announced the following:
- Build Back Better Investments – The Build Back Better Act, passed by the U.S. House of Representatives, includes $3 billion in investments in maternal health, including funding for growing and diversifying the perinatal workforce, improving data collection and maternal health risk monitoring, and addressing the social factors contributing to poor maternal health outcomes. The Act would also require all states to provide continuous Medicaid coverage for 12 months postpartum and spark innovations by allowing state to establish maternal health homes.
- Encourage States to Expand Postpartum Coverage – The Centers for Medicare & Medicaid Services (CMS) released new guidance to help states provide 12 months of continuous postpartum coverage, up from the current 60 days. The Administration provided a pathway for states to expand this coverage through the American Rescue Plan Act (ARPA), which will be made available in April 2022. California, as part of the 2021 Budget Act, will expand Medi-Cal postpartum coverage for one year, contingent upon necessary federal approvals.
- Report on the Impact of Postpartum Coverage – The U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary of Planning and Evaluation (ASPE) is releasing a new report demonstrating the dramatic impact of state extensions of Medicaid postpartum coverage to 12 months. According to the Administration, if every state adopted an extension, the number of Americans receiving full coverage for one year postpartum would roughly double, extending coverage to an estimated 720,000 people.
- Create a New Hospital Designation – CMS is also planning to propose the establishment of a “Birthing-Friendly” hospital designation which would be the first HHS designation specifically focused on maternity care. The designation is intended to be awarded to hospitals participating in a collaborative program aimed at improving maternal outcomes and implement patient safety practices.
Additional information from the White House is available here. Additional information from the HHS is available here.
The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), awarded approximately $82 million in American Rescue Plan Act (ARPA) emergency home visiting funds to 56 states, jurisdictions, and nonprofit organizations to support children and families impacted by the COVID-19 pandemic. The funding builds upon an initial investment of $40 million in ARPA funds earlier this year. California, as part of this week’s allocation, is set to receive an additional $5.6 million.
Funds, dedicated to the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program, are anticipated to help families in communities where it is particularly difficult to access quality health care. Home visiting services provide support to families through pregnancy education, parenting skill-building, and related activities.
Additional information about the funding is available here.
The Substance Abuse and Mental Health Services Administration (SAMHSA) announced it has launched a first-ever SAMHSA Harm Reduction Grant Program with up to $30 million anticipated to be awarded nationwide. The funding, authorized by the American Rescue Plan Act (ARPA), aims to increase access to a range of community harm reduction service providers as they work to prevent overdose deaths and reduce health risks associated with drug use. SAMHSA is accepting grant applications from state, local, tribal, and territorial governments, tribal organizations, non-profit community-based organizations, and primary and behavioral health organizations.
The funding announcement comes as overdose deaths have exceeded 100,000 over a 12-month period for the first time. The U.S. Department of Health and Human Services (HHS) earlier this fall issued a renewed overdose prevention strategy that seeks to reduce harms and control the spread of infectious diseases.
SAMHSA will distribute $10 million per year over the next three years. Grant recipients must use the funding to support harm reduction services, including but not limited to the provision of sterile syringes, safe sex kits, prevention education about synthetic opioids or other substances, overdose prevention kits, peer worker engagement, medical services, case management, and referral to treatment.
Additional information about the harm reduction funding opportunity is available here.
The U.S. Centers for Disease Control and Prevention (CDC) this week announced it has awarded $22 million to nearly 30 organizations globally to combat antimicrobial resistance (AR) and other health care threats through the establishment of two new networks – the Global Action in Healthcare Network (GAIHN) and the Global AR Laboratory & Response Network (Global AR Lab & response Network).
These networks, paired with additional short-term research projects, are anticipated to span more than 50 countries worldwide and build programs focused on preventing infections in health care through proven infection control, build laboratory capacity to detect AR organisms in healthcare, the community, and the environment, and develop new and innovative ways to detect and respond to threats like AR and COVID-19 more rapidly.
The work builds upon successful U.S. efforts launched through CDC’s AR Solutions Initiative since 2016 and will complement ongoing, effective global work underway by CDC and public health partners worldwide.
Additional information is available here.
This week, the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Housing and Urban Development (HUD) announced the expansion of a partnership established earlier this year to improve access to affordable, accessible housing, and the critical services that make community living possible. HHS and HUD announced the launch of a national Housing and Services Resource Center (HSRC) as the hub of the coordinated federal effort.
The Housing and Services Resource Center will implement a federally coordinated approach to providing resources, program guidance, training, and technical assistance to public housing authorities and housing providers; state Medicaid, disability, aging, and behavioral health agencies; the aging and disability networks; homeless services organizations and networks; health care systems and providers; and tribal organizations. The Center aims to facilitate state and local partnerships between housing and service systems and assist communities in leveraging new housing and services resources available through the American Rescue Plan Act (ARPA) and other future acts.
According to HHS, the HSRC site brings together a wide variety of federal resources and guidance on both housing and services that support community living, including Medicaid-funded home- and community-based services, behavioral health supports, vouchers, and other housing programs. The site also provides information about the organizations in the respective networks and examples of successful partnerships and strategies for more effectively and efficiently connecting people to affordable, accessible housing, and the services provided in the home or community. HHS and HUD will be offering webinars, developing, and disseminating new technical assistance resources, facilitate peer-to-peer learning, and launch a learning collaborative.
Additional information from HHS is available here.
The California Department of Public Health (CDPH) Injury and Violence Prevention Branch (IVPB) recently issued a new report entitled, “Opportunities to Empower and Support Girls and Women in California: An Environmental Scan of Leadership Opportunities and Economic Supports to Prevent Sexual Violence, Intimate Partner Violence, and Teen Dating Violence.”
The report represents an initial exploration of the ways leadership opportunities and economic supports and serve as primary prevention strategies for girls and women to prevent violence.
The full CDPH IVPB report is available here.