December 11, 2020 Edition

Lawmakers Convene in Sacramento to Formally Begin the 2021-22 Legislative Session

On Monday, both houses of the California Legislature met to convene the 2021-2022 legislative session. These sessions are ceremonial in nature and begin with swearing in newly elected members and legislative officers into their positions. Usually, these affairs include members and their families on the floor of the respective houses with much fanfare. Given the ongoing COVID-19 crisis, however, this year the houses met in different circumstances.

The Senate convened on the floor of their house, but physically distanced, members wearing masks, and with the minimum number of staff in attendance. California’s Lieutenant Governor, and President of the Senate, Eleni Kounalakis presided over the floor ceremonies. Newly appointed State Supreme Court Justice Martin J. Jenkins conducted the swearing-in ceremony for senators, and two additional senators were sworn-in remotely by state judges from their districts. Three senators were unable to attend and will be sworn in at a later date. Of note, the Senate is now governed by an all-female team led by President pro Tempore Toni Atkins, Secretary of the Senate Erica Contreras, Senate Sergeant-at-Arms Katrina Rodriguez, and Senate Counsel Kara Jenkins.

Senator Atkins tied her opening remarks to Pearl Harbor Day and recognized the sacrifices made by the greatest generation who served during World War II. She then said Californians should meet the current tough times with the same courage, sacrifice, and determination that the silent generation did in the 1940s. Senator Atkins outlined her legislative priorities next year and those will include a comprehensive housing package, emergency preparedness and wildfire response, addressing systemic racism, broadband access, and how to improve Employment Development Department systems providing unemployment insurance.

The Assembly convened its organizational session at the Golden 1 Center in Downtown Sacramento, a venue near the State Capitol with adequate space to accommodate Assembly Members in a physically distanced fashion. Like the Senate, the Assembly session featured the pomp-and-circumstance of swearing in of elected members and legislative officers. Monday’s event was the first time either legislative house met outside of the Capitol chambers since 1981 when the building was being restored.

Assembly Member Anthony Rendon was reelected as Speaker of the Assembly, and Assembly Member Kevin Mullin was named Assembly Speaker pro Tempore. Assembly Member Eloise Gómez Reyes was named the Assembly Majority Leader, and Assembly Member Marie Waldron was named the Republican Leader. During remarks, Speaker Rendon reflected on the collective accomplishments of the Assembly during his time as Speaker and laid out his priorities for the upcoming legislative session. The priorities identified by Rendon included COVID-19 response and relief efforts, police decertification, broadband expansion, addressing housing and homelessness, climate change and environmental justice, and addressing economic inequities.

With the official opening of the legislative session, bill introductions have begun; however, legislative activities will not begin in earnest until they return on Monday, January 4, 2021. CHEAC will continue keeping members apprised of legislative activities of interest to public health and local health departments into the new year.

Assembly Outlines 2021-22 Budget Priorities

On Thursday, Assembly Budget Committee Chair Phil Ting released the 2021-22 Budget Blueprint, Preserve | Respond | Protect | Recover, identifying key budgetary priorities for the upcoming fiscal year. Assembly Member Ting indicated the state is anticipated to be able to reverse some budget cuts implemented as a result of the ongoing COVID-19 pandemic, largely due to a projected $26 billion budget surplus in 2021-22. Recall, however, budget deficits are projected in subsequent years.

In his report, Ting calls for the restoration of funding in key priority areas to assist Californians struggling amidst the COVID-19 pandemic while developing approaches to stimulate the economy and grow budgetary reserves for future downturns. Highlights of the report include:

  • Preserve – Restore state services, prepare for future downturns
    • Repay school and community college deferrals
    • Restore one-time funding cuts to UC, CSU, Courts, Housing, Child Support
    • Undo program suspension cuts to critical health and human services programs
    • Retain reserve funding for future shortfalls
  • Respond – Provide essential state response to COVID-19
    • Reinvest in public health infrastructure to respond to COVID-19
    • Safely reopen K-12 schools and target funding to prevent learning loss
    • Protect vulnerable seniors in SNFs from COVID-19 outbreaks
    • Ensure greater transparency and oversight of federal and state disaster-related funding
    • Mitigate the impact of COVID-19 in state prisons and commit to a long-term infrastructure investment and closure plan
    • Increase workplace safety enforcement
  • Protect – Help Californians most impacted by the crisis
    • Help Californians most impacted by the pandemic and use an equity lens to evaluate solutions
    • Implement TK-for-all four-year-old children beginning in 2021 and increase rates for all early childhood education providers
    • Appropriate funding for wildfire prevention and mitigation activities
    • Streamline program rules to reduce barriers to entry and retain current families in Medi-Cal, CalWORKs, CalFresh, IHSS, and other major programs
    • Provide ongoing homeless prevention state funding
    • Expand current housing support and assistance programs
  • Recover – Targeted stimulus to help Californians rebuild the economy
    • Provide coordinated and streamlined assistance to small businesses and nonprofits
    • Create a state program to prevent evictions and support mom-and-pop landlords
    • Modernize the Employment Development Department and eliminate the unemployment insurance backlog
    • Create a climate crisis investment plan to guide the expenditure of the Greenhouse Gas Reduction Fund revenue
    • Develop an infrastructure strategy to stimulate the economy

The full Assembly Budget Blueprint is available here. A press release from the office of Assembly Member Phil Ting is available here.

Aragón Named CDPH Director and State Health Officer

Early this week, Governor Gavin Newsom announced the appointment of several top officials to health-related posts, including the California Department of Public Health (CDPH), the Office of Statewide Health Planning and Development, and the Department of Managed Health Care (DMHC).

Notably, Tómas Aragón was named the Director and State Public Health Officer of CDPH. Aragón has served as the Health Officer of the City and County of San Francisco and the Director of the Population Health Division for the San Francisco Department of Public Health since 2011. Aragón has additionally served as volunteer faculty at the University of California, Berkeley School of Public Health since 2004. Aragón is anticipated to begin in his new role in January.

Elizabeth Landsberg was appointed the Director of OSHPD. Landsberg was the Deputy Director of the Help Center for the California Department of Managed Health Care since 2016 and the Director of Policy Advocacy for the Western Center on Law and Poverty from 2006 to 2016. Landsberg additionally served in other roles, including legal roles, earlier in her career.

Mary Watanabe was named the Director of DMHC where she has served as the Acting Director since 2020 and as Acting Deputy Director since 2019. Watanabe was previously the Deputy Director for Health Policy and Stakeholder Relations for DMHC from 2015 to 2019 and the Deputy Director of the Sales Division for Covered California from 2013 to 2015.

The full appointment announcement is available here.

FDA Anticipated to Issue EUA for Pfizer COVID-19 Vaccine

The U.S. Food and Drug Administration (FDA) is widely anticipated to issue its first emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 vaccine at any point in the coming days. Yesterday, during a day-long meeting, the FDA Vaccines and Related Biological Products Advisory Committee (VRBPAC) deliberated the safety and efficacy of the vaccine candidate, ultimately recommending the FDA issue an EUA approval for the vaccine among individuals 16 years of age or older on a 17-4 vote, with one abstention.

The FDA today indicated it will accept the recommendation of the VRBPAC and rapidly work to finalize and issue an EUA for the vaccine candidate. The FDA has notified the U.S. Centers for Disease Control and Prevention (CDC) and Operation Warp Speed to begin preparations for executing plans for timely vaccine distribution nationwide. The first doses are likely to reach patients within approximately one day of being authorized.

Amid an unprecedented surge in COVID-19 cases and hospitalizations in California and the U.S., the first U.S. approval of a COVID-19 vaccine is anticipated to be welcome news. Additional vaccine candidates, including Moderna’s mRNA vaccine, are likely to be approved over the coming weeks and months.

President-Elect Biden Rolls Out Health Team, Becerra Nominated HHS Secretary

On Monday, President-Elect Joe Biden and Vice President-Elect Kamala Harris announced their selections to lead their health and human services team, including response efforts to the ongoing COVID-19 pandemic. The following were named to posts in the incoming federal administration:

  • Xavier Becerra, Secretary of Health and Human Services – California Attorney General Xavier Becerra was appointed Secretary of Health and Human Services. The Biden-Harris Transition pointed to Becerra’s work on the Affordable Care Act (ACA) during his time as a member of Congress, as well as his defense of the ACA in the Supreme Court during his time as Attorney General. If confirmed, Becerra would be the first Latino to lead the Department of Health and Human Services.
  • Dr. Vivek Murthy, Surgeon General – Vivek Murthy is anticipated to reprise his role as Surgeon General in the incoming administration. Murthy served as Surgeon General during the Obama-Biden Administration and held the rank of Vice Admiral of the Public Health Service Commissioned Corps. Additionally, Murthy has served as the co-chair of the Biden-Harris COVID-19 Advisory Board.
  • Dr. Rochelle Walensky, Director of the Centers for Disease Control and Prevention (CDC) – Rochelle Walensky currently serves as the Chief of the Division of Infectious Diseases at the Massachusetts General Hospital and a Professor of Medicine at the Harvard Medical School. Walensky previously conducted extensive research on HIV/AIDS, as well as vaccine delivery and strategies to reach underserved communities.
  • Dr. Marcella Nunez-Smith, COVID-19 Equity Task Force Chair – Nunez-Smith is the founding director of the Yale University Equity Research and Innovation Center and an Associate Professor of Medicine and Epidemiology at the Yale School of Medicine. Nunez-Smith additionally served as the co-chair of the Biden-Harris COVID-19 Advisory Board.
  • Dr. Anthony Fauci, Chief Medical Adviser on COVID-19 to the President – Anthony Fauci, an expert on infectious diseases and adviser to six U.S. presidents, will serve as the Chief Medical Adviser to President-Elect Biden. The incoming administration anticipates Fauci to play a key role in the continued response to the ongoing COVID-19 pandemic.
  • Jeff Zients, Coordinator of the COVID-19 Response and Counselor to the President – Jeff Zients previously served as the Director of the National Economic Council, Acting Director and Deputy Director of the Office of Management and Budget, and the inaugural Chief Performance Officer of the United States. Zients successfully led complex national initiatives, including the website surge.

During Monday’s announcement, President-Elect Biden outlined a three-point plan to address the COVID-19 pandemic within his Administration’s first 100 days. The Biden-Harris Administration intends to distribute 100 million COVID-19 vaccines, require face coverings where possible (e.g., federal buildings, interstate travel), and reopen most schools with additional funding support from Congress within the Administration’s first 100 days.

An overview of the Biden-Harris health team is available here.

Newsom Launches CA Notify Statewide

On Monday, Governor Gavin Newsom announced the statewide expansion of CA Notify, the state’s digital tool to assist in reducing the transmission of COVID-19. Starting yesterday, December 10, California residents can opt-in to receive COVID-19 notifications informing them if they have been exposed to someone who has tested positive for COVID-19. CA Notify was developed in partnership with Apple and Google and piloted by the University of California, San Diego and the University of California, San Francisco.

The CA Notify service uses Bluetooth technology to exchange random codes between phones without revealing the user’s identity or location. If a CA Notify user tests positive for COVID-19, they will receive a verification code to enter into the platform, if they choose. Any other CA Notify users who have been within six feed for 15 minutes or more of the COVID-19 positive individual will get an anonymous notification of possible exposure. The state anticipates that CA Notify will accelerate how quickly people get notified of a possible COVID-19 exposure, giving people information needed to make responsible decisions around quarantine and testing.

The full announcement from the Governor’s Office is available here.

CDPH Publishes Guidance for LHDs on COVID-19 Workplace Outbreak Reporting Requirements

The California Department of Public Health (CDPH) this week issued guidance to local health departments (LHDs) detailing COVID-19 workplace outbreak reporting requirements mandated by AB 685 (Chapter 84, Statutes of 2020). Under the new law set to take effect on January 1, 2021, employers must notify employees who may have been exposed to COVID-19 and to report workplace outbreaks to the local health department. CDPH is required to publicly report information on workplace outbreaks by industry, and the requirements apply to all public and private employers in California, except health facilities.

The guidance from CDPH is available here.

CDPH Issues Health Alert for COVID-19 Impacts on Individuals with Chronic Conditions

Today, the California Department of Public Health (CDPH) issued a health alert, highlighting the disproportionate impact of COVID-19 on individuals with chronic health conditions. According to national surveillance data, COVID-19 can lead to severe outcomes in adults with underlying chronic health conditions such as cardiovascular disease, diabetes, and chronic lung disease.

Local health departments are advised to increase public messaging about the importance of routine care and promote participation in lifestyle programs such as chronic disease self-management. Clinicians are advised to encourage patients with chronic conditions to keep their medical appointments, maintain preventive health services, refill their prescriptions, manage their blood sugar, blood pressure, and weight, and quit smoking. Health systems and hospitals are advised to encourage patients with chronic conditions to participate in self-management classes and establish referrals to outpatient management with primary care clinics and/or community-based providers.

The full CDPH health alert is available here.

CA Surgeon General Releases Report on ACEs, Toxic Stress, and Health

This week, California Surgeon General Dr. Nadine Burke-Harris issued Roadmap for Resilience: The California Surgeon General’s Report on Adverse Childhood Experiences, Toxic Stress, and Health. The report is the first produced by the Office of the California Surgeon General and serves as a blueprint for how communities, states, and nations can recognize and effectively address adverse childhood experiences (ACEs) and toxic stress as a root cause to some of the most harmful, persistent, and expensive societal and health challenges.

The report identifies clear cross-sector and equitable response solutions, models, and best practices to be replicated or tailored to serve community needs. The comprehensive resource aims to bring together insights from global experts across sectors, specialties, and disciplines to promote science-based approaches to primary, secondary, and tertiary prevention strategies for ACEs and toxic stress. Further, the report specifies a sector-specific and cross-sector roadmap for addressing ACEs and toxic stress at the state level, prioritizing prevention, early detection, evidence-based interventions and equity in outcomes, highlighting the need for enhanced coordination across health care, public health social services, early childhood, education, and justice sectors.

The full report is available here. A press release on the report is available here.

State Issues Title V Report and Application

The California Department of Health Care Services (DHCS) recently announced California’s Title V 2019 Annual Report and 2021 Application is now available on the Health Resources and Services Administration (HRSA) website. The state’s application and annual report are accessible here. The state action plan table is available here.