February 4, 2022 Edition

CHEAC Publishes Latest #WeArePublicHealth Newsletter

CHEAC is proud to publish our latest edition of the #WeArePublicHealth Newsletter showcasing the work and activities carried out by California’s local health departments (LHDs). The January edition highlights significant proposed investments into public health workforce and infrastructure, COVID-19 pandemic response, and a recent poll finding support for state and local public health.

The latest #WeArePublicHealth Newsletter is available here.

Legislature Meets Two-Year Bill Deadline, Single-Payer Proposal Fails

On Monday, the California State Senate and Assembly met the deadline for two-year bills introduced in their house of origin last year to be advanced to the next house. Several high-profile measures awaited action on Monday, including bills related to health care and environmental health.

Of note, AB 1400 by Assembly Member Ash Kalra failed Monday’s two-year bill deadline after Kalra opted not to bring up the bill for a vote on the Assembly Floor. Recall, the measure would have created a comprehensive, universal single-payer health care coverage and health care cost control system in California. The measure garnered significant interest among advocates, the media, and progressive lawmakers. However, after it became clear that Kalra did not have enough votes for the measure to advance out of the Assembly, Karla did not act on the measure.

Kalra released a statement about his decision toward the end of Monday’s Assembly Floor Session, indicating, “Especially with four Democratic vacancies in the Assembly, the votes were not there today, but we will not give up.” Assembly Speaker Anthony Rendon similarly issued a statement expressing disappointment that the author did not bring up the bill for a vote on the Assembly Floor and indicating that he would have voted “yes” on the measure.

Kalra’s move to not bring up the bill for a vote followed a commitment from the California Democratic Party’s Progressive Caucus last week to pull endorsements of lawmakers that voted “no” or did not support single-payer health care; despite the bill’s failure, the caucus maintains its commitment to pull endorsements of candidates opposed to single-payer. Relatedly, the California Nurses Association (CNA), sponsors of AB 1400, denounced the decision not to hold a vote, indicating that “Nurses are outraged that the California Assembly … gave up on patients across the state” by not voting on the measure. Ultimately, AB 1400 realized the same fate as previous attempts to establish a universal, single-payer system in California.

In other news this week, Assembly Member Autumn Burke of Los Angeles County announced her resignation from the Assembly, effective immediately. Burke cited the importance to “have the flexibility and ability to spend more time with” her family in her letter announcing her resignation.

Looking ahead on the legislative front, lawmakers have until February 18 to introduce new bills.

Below, we highlight a bill of interest to CHEAC Members. For a full update, the latest edition of the CHEAC Weekly Bill Chart is available here.

Environmental Health

AB 257 (Holden) as amended January 27, 2022 – OPPOSE UNLESS AMENDED

AB 257 by Assembly Member Chris Holden was advanced from the Assembly Floor on Monday on a 41-21 vote with 14 members not voting. AB 257 is a two-year bill and faced Monday’s deadline to remain in play for the second half of the 2021-22 Legislative Session. Recall, the measure would establish the Fast-Food Sector Council to set forth sector-wide minimum standards on wages, working hours, and working conditions adequate to ensure and maintain health, safety, and welfare of fast-food workers. The measure would require the council to conduct a full review of the adequacy of minimum standards at least once every three years and authorize specified local governments to establish a Local Fast Food Sector Council to provide direction to and coordinate with local enforcement agencies.

Recall, last week, CHEAC joined CAEHA, HOAC, and CSAC in an “oppose unless amended” position on the measure as local environmental health programs are not responsible for enforcement or oversight of labor or working conditions. During debate on AB 257 on the Assembly Floor on Monday, Assembly Member Holden acknowledged concerns with the measure, including those related to local environmental health programs, and expressed a commitment to working with stakeholders on potential amendments to the bill.

AB 257 advanced to the Senate where it awaits referral to committees. CHEAC will continue working closely with our county colleague associations on the measure.

Budget Committees Assess Early Action Package, HHS Subcommittees Begin Work

The California State Senate and Assembly continue to ramp up their budget-related activities with the majority of budget subcommittees beginning hearings on proposed investments this week and next.

On Thursday, the Senate Budget & Fiscal Review Committee convened a hearing to consider and advance a series of measures included in the early budget action package. The full committee considered several budget clean-up measures and augmentations to the 2021 Budget Act, including funding to support the continued response to the COVID-19 pandemic.

Among the measures assessed by the Senate Budget & Fiscal Review Committee was AB 147 (Ting) which proposes to transfer a total of $1.9 billion from the General Fund to the California Emergency Relief Fund to support increased COVID-19 testing capacity, enhance and expand vaccination programs, bolster the health care delivery system, support frontline workers, and address the state’s latest COVID-19 surge fueled by the Omicron variant. Funding is anticipated to be allocated to the California Department of Public Health (CDPH; $1.6 billion), the California Department of Corrections and Rehabilitation (CDCR; $205.5 million), and the Office of Emergency Services (OES; $100 million).

The committee also considered budget measures to provide COVID-19 supplemental paid sick leave (AB 84), COVID-19 economic relief (AB 87), human services (AB 139), and state bargaining units (AB 142). The Senate Budget & Fiscal Review Committee voted and approved all budget measures heard on Thursday; the measures now move to the full Senate for consideration. The agenda from the Senate Budget & Fiscal Review Committee is available here.

The Assembly Budget Committee is set to convene a similar hearing on Monday morning to consider and advance measures included in the early budget action package. The Legislature is anticipated to vote on the measures included in the early budget action package as soon as next week.

In addition to the movement on early budget action items, budget subcommittees are in the process of scaling up their activities for the spring. The Senate Budget Subcommittee No. 3 on Health & Human Services convened its first hearing for the year on Thursday afternoon to review a series of investment proposals under the authority of the California Health and Human Services Agency (CalHHS), the Emergency Medical Services Authority (EMSA), the Department of Health Care Access and Information (HCAI), the Department of Managed Health Care (DMHC), the Mental Health Services Oversight and Accountability Commission (MHSOAC), and Covered California.

The subcommittee received a series of implementation updates of initiatives approved in the 2021 Budget Act, including the Children and Youth Behavioral Health Initiative and ACEs and Toxic Stress Awareness Campaign. The bulk of the subcommittee’s agenda items were informational only and no votes were taken during the subcommittee hearing.

The Assembly Budget Subcommittee No. 1 on Health and Human Services will convene on Monday to consider health care affordability-related investments.

As subcommittees begin their work in earnest over the coming weeks and months, CHEAC will continue to keep members apprised of budget-related activities of most interest to California local health departments.

Legislature Convenes Joint Hearing on Extreme Heat Emergency

The California Joint Legislative Committee on Emergency Management on Thursday convened an informational hearing to assess the state’s extreme heat emergency. Senator Henry Stern, chair of the joint committee, opened the hearing by highlighting concerning trends in extreme heat and wildfires in the state of California, largely exacerbated by impacts of climate change. Assembly Member Freddie Rodriguez similarly provided opening remarks and identified the series of human health-related impacts of extreme heat.

The hearing featured an update from the Newsom Administration on California’s Extreme Heat Action Plan from officials in the California Natural Resources Agency and Governor’s Office of Planning and Research (OPR). The second panel of the hearing explored the human costs of extreme heat, including the disproportionate impacts of extreme weather conditions on vulnerable populations. Representatives from various advocacy and community-based entities, including Climate Resolve and the Lawrence Berkeley National Laboratory, discussed the various health and mental health impacts of extreme heat on Californians.

The hearing’s third panel featured a focus on extreme heat prevention and response and included representatives from local government and advocacy organizations. The final panel of the hearing included state officials responsible for response to extreme heat emergencies, including the California Department of Public Health (CDPH) and the California Department of Industrial Relations (DIR). CDPH Deputy Director of the Office of Health Equity Dr. Rohan Radhakrishna highlighted the impacts of extreme heat on state residents, the role of CDPH in responding to such emergencies, and proposed investments related to climate health.

The full hearing agenda is available here. Background materials are available here. A video recording of the hearing is available here.

FDA Approves Moderna COVID-19 Vaccine, Prepares to Consider Pfizer COVID-19 Vaccine EUA for Young Children

The U.S. Food and Drug Administration (FDA) on Monday granted approval to a second COVID-19 vaccine. The Moderna COVID-19 vaccine received FDA approval, and the approved vaccine will be marketed as “Spikevax” for the prevention of COVID-19 in individuals 18 years of age and older.

According to the FDA, Spikevax meets the FDA’s rigorous standards for safety, effectiveness, and manufacturing quality required for approval. The Moderna COVID-19 vaccine has been available under an emergency use authorization (EUA) for individuals 18 years of age and older since December 18, 2020.

Following the agency’s approval, California Health and Human Services Agency (CalHHS) Secretary Dr. Mark Ghaly and California Department of Public Health (CDPH) Director and State Public Health Officer Dr. Tomás Aragón issued a joint statement applauding the agency’s approval and urging residents to receive a COVID-19 vaccine.

In related news, the FDA announced it has set a meeting of its Vaccines and Related Biological Products Advisory Committee (VRBPAC) on February 15 to discuss the EUA request of the Pfizer-BioNTech COVID-19 vaccine for use in children six months through four years of age.

Recall, the FDA authorized the Pfizer-BioNTech COVID-19 vaccine for use in children ages five through 11 in October 2021 and recently authorized use of a single booster dose in individuals 12 through 15 years of age and older.

Burke-Harris, Richardson Resign from Newsom Administration Posts

This week, two notable departures from the Newsom Administration were announced. Below, we highlight these announcements:

Burke-Harris to Step Down as California Surgeon General

Dr. Nadine Burke-Harris, California’s first Surgeon General, announced on Tuesday she is resigning her position. Burke-Harris began her role as the state’s inaugural Surgeon General in February 2019. Her last day in her position will be February 11.

In a statement issued by the Office of Governor Gavin Newsom, Newsom applauded Harris’ “expertise and leadership in championing equity, mental health, and early childhood development.” The Newsom Administration has not yet announced a successor for the position. Dr. Devika Bhushan, Chief Health Officer in the Office of the California Surgeon General, will fill the role on an acting basis upon Burke-Harris’ departure this month.

A full statement from Dr. Nadine Burke-Harris is available here.

Richardson to Depart Government Operations Agency

Government Operations (GovOps) Agency Secretary Yolanda Richardson also announced on Thursday that she would be stepping down from her role in the Newsom Administration. Secretary Richardson will depart GovOps on March 2 to assume the role of Chief Executive Officer (CEO) of the San Francisco Health Plan.

Richardson served as GovOps Secretary for two years and within days of beginning her role was tasked with overseeing the state’s COVID-19 vaccine distribution agreement with Blue Shield of California, serving as a third-party administrator (TPA). Richardson promoted the COVID-19 vaccine in her role, visiting disproportionately impacted communities statewide as part of the state’s “Get Out the Vaccine” campaign.

Newsom Names Members to Physical Fitness and Mental Well-Being Advisory Council

Governor Gavin Newsom this week named 16 members to the Governor’s Advisory on Physical Fitness and Mental Well-Being. The Council is tasked with exploring strategies to promote health and wellness among Californians of all ages and is led by First Partner Jennifer Siebel Newsom and Pro Football Hall of Fame Inductee Ronnie Lott.

The Council includes representatives from health and wellness organizations, youth sports programs, education, the entertainment and fitness industry, and other experts on physical and mental health.

According to the Governor’s Office, the Council’s activities may include providing guidance on the development of physical activity and wellness goals for Californians of all ages, increasing awareness among all age groups about the benefits of physical activity, sports, nutrition, and mental wellness, encouraging intergenerational physical fitness activities, promoting equitable access to outdoor and physical activities for underserved communities, and facilitating collaboration among federal, state, and local agencies and other sectors.

The full announcement is available here.

CDC Offers New Materials for Providers Supporting Pregnant and Postpartum Patients

The U.S. Centers for Disease Control and Prevention (CDC) this week released a new webpage and suite of materials for health care professionals as part of the “Hear Her” campaign which aims to reduce pregnancy-related deaths. Over 700 women die every year due to pregnancy-related complications, and two in three deaths are preventable. According to the CDC, health care professionals play a critical role in eliminating preventable maternal mortality, and the new website contains specific information for obstetric providers, pediatric staff, and other health care providers.

The CDC notes obstetric professionals have an opportunity to provide important education to pregnant and postpartum patients about recognizing urgent maternal warning signs. Pediatricians and other pediatric staff can be an important connection to care for postpartum people. Emergency department staff, EMTs/paramedics, urgent care staff, primary care providers, and mental health professionals also have an important role to play in asking about recent pregnancy status and recognizing the signs and symptoms of pregnancy-related complications.

The CDC’s campaign materials include posters, palm cards, shareable graphics, and sample social media content in English and Spanish. Other clinical resources and tools are offered.

Additional information is available here.

CDC Report Highlights HIV Disparities in U.S.

This week, the U.S. Centers for Disease Control and Prevention (CDC) released a report finding that despite overall progress in reducing HIV transmission in the United States, HIV continues to impact some groups more than others due to “longstanding and ingrained barriers.” Black and African American people account for a higher proportion of new HIV infections compared to other races and ethnicities. Black people accounted for 13 percent of the U.S. population but 40 percent of people with HIV in 2019, according to the CDC.

The CDC points to racism, longstanding systemic inequities, social and economic marginalization, residential segregation, unequal reach of HIV prevention and treatment, and higher levels of HIV in some communities among the factors that have contributed to troubling and persistent racial and ethnic disparities in HIV.

The report further determined that 52 percent of Black adults with diagnosed HIV resided in areas in the country with higher Social Vulnerability Index (SVI) scores – often residentially segregated communities comprised predominately of Black people. The report underscores the continuing, urgent need to address social determinants that contribute to disparities and better deliver HIV prevention and care to people who need it most.

Additional information, including the full CDC report, is available here.

Becerra Forms HHS Human Trafficking Prevention Task Force

U.S. Health and Human Services (HHS) Secretary Xavier Becerra announced this week the formation of the HHS Task Force to Prevention Human Trafficking. The Task Force will facilitate implementation of priority actions detailed in the Biden-Harris Administration’s National Action Plan to Combat Human Trafficking, as well as strengthen HHS’ human trafficking prevention and intervention efforts with a focus on partnerships, equity, and open data.

According to HHS, the Task Force will work to scale innovative models to prevent human trafficking, particularly in high-need areas of housing, mental health and substance use, and economic mobility. The Task Force will also integrate an equity lens into new public awareness strategies to better reach populations at disproportionate risk of human trafficking. Finally, the Task Force will partner with the research and business communities to analyze data on human trafficking and prevent human trafficking in health care supply chains.

Additional information is available here.

USDA Issues Final Rule on Transitional School Nutrition Standards

Today, the U.S. Department of Agriculture (USDA) announced updates to school nutrition standards providing a path forward for schools to transition from current pandemic operations toward more nutritious school meals. Specifically, the USDA issued transitional standards that will begin in school year 2022-23 and run through school year 2023-24.

In 2022, USDA will continue to prioritize supporting schools as they navigate COVID-19 pandemic-related challenges and related operational issues while ensuring children have access to healthy school meals. USDA is also planning for the future by engaging with school meal stakeholders to establish long-term nutrition standards beginning in school year 2024-25.

Recall, the USDA previously updated school nutrition standards in 2012. According to the USDA, schools have been largely successful in implementing standards which have had a proven, positive impact on student diets. However, due to specific implementation delays and pandemic-related constraints, some schools may not be prepared to fully meet standards for milk, whole grains, and sodium. The USDA, through its final rule on transitional standards, provides schools clarity on standards for the coming years and allows a graduate transition from pandemic-related operations to normal program operations.

The new final rule specifically establishes the following requirements for school year 2022-23:

  • Milk: Schools and childcare providers serving participants ages six and older may offered flavored low-fat milk in addition to nonfat flavored milk and nonfat or low-fat unflavored milk
  • Whole Grains: At least 80 percent of grains served in school lunch and breakfast each week must be whole grain-rich
  • Sodium: The weekly sodium limit for school lunch and breakfast will remain at the current level in school year 2022-23. For school lunch only, a 10 percent decrease in the limit will take effect for school year 2023-24. This approach aligns with the U.S. Food and Drug Administration’s (FDA) voluntary sodium reduction targets for processed, packaged, and prepared foods in the U.S.

All other nutrition standards, including fruit and vegetables standards, will remain the same as the 2012 standards.

Following issuance of the final rule, the FDA issued a statement applauding the USDA standards as an approach that “supports ongoing whole-of-government efforts to improve nutrition, reduce chronic disease, and help create a healthier food supply for all.”

USDA intends to issue a proposed rule later this year that moves toward updating nutrition standards for the long term. USDA is required to update school nutrition standards based on recommendations from the latest Dietary Guidelines for Americans. USDA anticipates finalizing its rule in time for schools to plan for the 2024-25 school year.

Additional information is available here.

“Staffing Up” Public Health Workforce Webinar Set for Feb. 10

The de Beaumont Foundation and the Public Health National Center for Innovations (PHNCI) at the Public Health Accreditation Board (PHAB) will host a webinar on Thursday, February 10 at 10:00 am, entitled “Staffing Up: Strengthening the Public Health Workforce for the Next Generation.”

The webinar will showcase first-of-its-kind research-based estimation of the number of public health workers needed in state and local health departments. Presenters will discuss a new national initiative “Staffing Up” which determined workforce levels needed to deliver comprehensive public health services to the nation, including how health departments can use this work to advocate for additional staffing.

Additional information, including registration, is available here.

UCLA Report Finds Persistent Disparities in Health Coverage and Health Care Access

A new study released by the University of California, Los Angeles (UCLA) Center for Health Policy Research (CHPR) found that after a decade of the Affordable Care Act (ACA), coverage and health care access disparities persist among Californians. In 2020, more than 2.5 million California children, adolescents, and adults (ages 0-64) did not have health insurance coverage.

The UCLA CHPR report, The State of Health Insurance in California: Findings from the 2019 and 2020 California Health Interview Surveys, assessed insurance rates after a decade of the enactment of ACA. The study found that young adults ages 19-25 still have the lowest rates of employment-based insurance (51.7 percent compared to 61-66 percent for other age groups), even after the ACA enabled them to stay on their parents’ coverage until age 26. Among women ages 19-64, only 43.1 percent of Latina women and 55.6 percent of Black women had employment-based coverage in 2020, compared to 72 percent of white women.

The California Health Interview Survey (CHIS) has been querying residents about health insurance topics since 2001. The latest report from UCLA is the 10th installment of the group’s in-depth look at health insurance coverage in California.

The full report is available here.

CDPH Publishes Climate Change & Health Equity Update

The California Department of Public Health (CDPH) Climate Change & Health Equity Section (CCHES) recently published its monthly newsletter for February 2022. The newsletter details CCHES program updates, climate-related state government updates, upcoming meetings and webinars, and climate and health equity resources.

The February 2022 Newsletter is available here.