February 5, 2021 Edition
On Wednesday, Governor Gavin Newsom announced a new partnership with the Biden-Harris Administration to launch a pilot project to establish two COVID-19 community vaccination sites in Alameda and Los Angeles counties. The pilot sites will be based at the Oakland-Alameda Coliseum and the California State University, Los Angeles and are part of the federal administration’s broader effort to establish 100 vaccination sites nationwide within the administration’s first 100 days.
The sites will be operated by the Federal Emergency Management Agency (FEMA) and the California Governor’s Office of Emergency Services (Cal OES). FEMA will provide resources and federal staffing support to establish the new community vaccination centers, as well as operational support. Site preparations at the two locations are underway and the sites are anticipated to be opened to eligible members of the public beginning February 16. Registration for vaccination appointments at these two sites will be available through the state’s MyTurn.ca.gov system.
A press announcement from the Governor’s Office is available here.
This week, the Biden-Harris Administration announced a series of actions intended to increase COVID-19 vaccine administration nationwide, as well as support other key COVID-19 response activities. This week’s activities include:
- Increased Vaccine Supply: The Biden-Harris Administration indicated overall, weekly vaccine supply to states, tribes, and territories will be 10.5 million doses nationwide beginning this week. The Administration has committed to maintaining 10.5 million doses as the minimum supply level for the next three weeks.
- Federal Retail Pharmacy Program: Beginning February 11, eligible populations will be able to access COVID-19 vaccine at select retail pharmacy settings as part of the newly formed Federal Retail Pharmacy Program for COVID-19 Vaccination. The program consists of partnerships with 21 national pharmacy entities and networks of independent pharmacies representing over 40,000 locations throughout the country. In the first phase of the program, select retail pharmacies, identified by CDC and states, will receive limited vaccine supply to vaccinate priority groups at no cost.
- Expanded FEMA Reimbursements: Building upon a previous Biden-Harris announcement providing full reimbursement to states for use of National Guard personnel in COVID-19 vaccine efforts, President Joseph R. Biden announced the federal government will retroactively fully reimburse states for FEMA-eligible activities that began as of January 20, 2020. At the direction of the president, FEMA expanded activities eligible for reimbursement for work conducted between January 21, 2021, and September 30, 2021, to include the safe reopening and operation of schools, childcare facilities, health facilities, non-congregate shelters, domestic violence shelters, and transit systems. An announcement from the Newsom Administration applauding the expanded reimbursement is available here.
The full announcement from the Biden-Harris Administration is available here.
This afternoon, the Senate Budget & Fiscal Review Subcommittee No. 3 on Health & Human Services convened its first hearing of the year to review the Newsom Administration’s proposed investments in a number of areas under the jurisdiction of the California Health and Human Services (CHHS) Agency. In addition to CHHS items, the subcommittee heard proposed investments under the Emergency Medical Services Authority (EMSA), Office of Statewide Health Planning and Development (OSHPD), the Department of Managed Health Care (DMHC), the Mental Health Services Oversight and Accountability Commission (MHSOAC), and the California Health Benefit Exchange (Covered California).
The subcommittee received presentations from agency and department representatives, as well as the Department of Finance (DOF) and the Legislative Analyst’s Office (LAO). Subcommittee members, Senators Susan Talamantes Eggman, Richard Pan, and Melissa Melendez, had the opportunity to raise questions related to the Administration’s proposed investments and all items were held open for action at a later date. The Senate Sub. 3 hearing agenda is available here.
The Assembly Budget Subcommittee No. 1 on Health and Human Services will convene its first hearing on Monday, February 8 to review the Administration’s proposed investments in the areas of the California Department of Public Health (CDPH), EMSA, and OSHPD.
This week, the Department of Finance (DOF) issued a letter to legislative leaders notifying them of a Fiscal Year 2020-21 budget adjustment to support continued COVID-19 pandemic response activities by local health departments statewide. The DOF notification specifies that 70 percent, or $1.2 billion, of the federal Epidemiology and Laboratory Capacity (ELC) Enhancing Detection funds received by the state will be allocated local health departments.
Recall, the ELC Enhancing Detection funds were provided by the Coronavirus Response and Relief Supplemental Appropriations Act of 2021 (P.L. 116-260) that was passed by Congress and signed into law late last year. These funds will provide local health departments additional resources to mitigate the spread of COVID-19 and reduce the number of hospitalizations related to COVID-19. The funds will be used to advance six strategies identified through the ELC program.
The full DOF letter is available here.
This afternoon, CDPH Director and State Public Health Officer Dr. Tomás Aragón revoked the state’s Hospital Surge Order which was issued on January 5, 2021, amid the urgent statewide crisis related to ICU capacity caused by the COVID-19 pandemic. The order was intended to spread the COVID-19 burden across hospitals and ensure all patients received a high quality of care to prevent loss of life.
CDPH lifted the hospital surge order due to declining COVID-19 cases, hospitalizations, test positivity, and transmission rates statewide. As community transmission decreased, the burden on the hospital system has also decreased with lower hospital admissions, lower levels of patients boarded in the emergency department, and shorter ambulance patient offload times.
The full revocation of the state’s hospital surge order is available here.
CDPH Director and State Public Health Officer Dr. Tomás Aragón on Wednesday issued a letter to all COVID-19 vaccine providers statewide clarifying vaccine guidance and urging providers to distribute doses as quickly as possible. The letter directs providers to manage vaccine inventory normally and report shots administered and inventory daily. CDPH additionally indicates the state will begin to manage and approve future orders based on vaccines distributed.
The full CDPH letter to COVID-19 vaccine providers is available here.
The California Department of Public Health (CDPH), as part of its efforts to simplify and streamline the vaccine management process, has announced its recently launched CalVax Provider system will now become myCAvax. According to the Newsom Administration, the name change will reduce confusion with other systems and will have a similar look to California’s vaccine scheduling system MyTurn.
An FAQ document related to the name change is available here.
This afternoon, the California Legislative Analyst’s Office (LAO) issued a report describing how COVID-19 spending is reflected in the California Department of Public Health’s (CDPH) budget. The LAO report provides information on CDPH’s COVID-19 spending, as well as funding that has flowed through CDPH’s budget to California’s 61 local health departments to support local response to the COVID-19 pandemic.
The LAO provides an overview of FY 2020-21 activities related to COVID-19 response and indicates the Governor’s FY 2021-22 Budget Proposal did not include a specific plan or strategy within CDPH for COVID-19-related spending. The LAO raises a series of questions around how the Newsom Administration plans to fund and manage vaccination efforts at the state and local levels, how to fund and manage expanded testing efforts such as testing for K-12 teachers and students, and how to spend potential future federal funds. In its report, the LAO indicates augmentations to CDPH’s budget primarily concern state COVID-19 testing activities, including for the continued operation of the state’s Valencia Branch Laboratory (VBL).
Further, the LAO’s report provides a framework for evaluating midyear and budget-year proposals and actions related to COVID-19 within CDPH’s budget and offers key public health issues for legislative consideration during the COVID-19 recovery process. Among the considerations raised by the LAO is the state’s overall public health infrastructure needs, as well as the need for an after-action report to the COVID-19 pandemic detailing the challenges and lessons learned by public health during the public health emergency. Notably, the LAO acknowledges CHEAC’s sponsored bill AB 240 (Rodriguez) to assess the local public health infrastructure.
The full LAO report is available here.
This week, the Center at Sierra Health Foundation, in partnership with the California Department of Social Services (CDSS) and the Labor and Workforce Development Agency (LWDA), today announced awarding more than $17.3 million in grants to 110 community-based organizations (CBOs) statewide to support community engagement, provide public health education, and encourage COVID-19 vaccination. Organizations received awards ranging from $50,000 to $300,000 for regional or statewide outreach efforts to be conducted over six months (February through July 2021).
Funds will be used to support outreach to disproportionately impacted populations, including workers in the hardest hit sectors, and will prioritize interactive engagement designed to connect individuals with information and resources related to the safety of the COVID-19 vaccine, public health guidance, workplace protections, and other state resources, including the public safety net, in multiple languages.
A full press announcement is available here.
On Thursday, Johnson & Johnson’s pharmaceutical division Janssen Biotech, Inc. requested from the U.S. Food and Drug Administration (FDA) an emergency use authorization (EUA) for its single-dose COVID-19 vaccine. According to Johnson & Johnson, the COVID-19 vaccine has a 72 percent efficacy rate in the U.S., but only a 57 percent efficacy rate in South Africa, raising concerns about the role of COVID-19 variants in continued transmission.
Following Johnson & Johnson’s EUA request, the FDA scheduled a meeting for its Vaccines and Related Biological Products Advisory Committee (VRBPAC) to review safety and efficacy data for February 26, 2021. VRBPAC will be ultimately tasked with recommending to the FDA whether Johnson & Johnson’s EUA should be approved. If the FDA does approve the EUA, Johnson & Johnson is expected to begin shipping its one-dose vaccine as early as March.
An announcement from the FDA is available here.
This week, the White House announced the purchase of 8.5 million rapid at-home COVID-19 tests that can be taken without a prescription. Recall, the U.S. Food and Drug Administration (FDA) issued an EUA to Ellume in December 2020 for its at-home rapid COVID-19 test.
The Biden-Harris Administration this week indicated it reached a $231.8 million agreement with Ellume to quickly scale up its production and create a manufacturing facility within the U.S. The expansion of the at-home COVID-19 tests is anticipated to provide for 640,000 tests per day by December 2021 to support domestic COVID-19 testing.
A full press announcement on the production expansion is available here.
This week, the California Department of Health Care Services (DHCS) released instructions for counties interested in changing Medi-Cal Managed Care (MCMC) models. In 2021, DHCS will begin a statewide procurement process for commercial MCMC plans. Multiple counties have expressed interest in transitioning to a MCMC model that includes a local plan. If a county transitions to a model that includes a local plan, DHCS may remove that county from the commercial plan procurement (for a single local plan model) or reduce the number of commercial plans procured in the county (for a Two-Plan Model).
DHCS, in its letter, provides instructions for a county and managed care plan letter of intent to transition models that is due March 31, 2021. The DHCS guidance provides information on required data and materials to be included as part of the letter of intent process. Of particular note, failure to submit a complete letter of intent will preclude a county from shifting to a local plan model by January 2024.
Additional information and details are available here.
The California Department of Health Care Services (DHCS) released its telehealth policy recommendations consisting of broad-based telehealth policy changes that would remain permanent fixtures following the eventual termination of the COVID-19 public health emergency. At a high-level, DHCS is seeking to modify or expand the use of synchronous telehealth, asynchronous telehealth, telephonic/audio-only, other virtual communication, and to add remote patient monitoring to create greater alignment and standardization across delivery systems.
DHCS’ proposal advances a series of policy recommendations effective July 1, 2021 (or in accordance with receipt of all necessary federal approvals), including:
- Allowing specified federally qualified health center (FQHC) and rural health clinic (RHC) providers to establish a new patient, located within its federal designated service area, through synchronous telehealth
- Make permanent the removal of site limitations on FQHCs and RHCs, for example, allowing them to provide services to beneficiaries in the beneficiary’s home
- Expanding synchronous and asynchronous telehealth services to 1915(c) waivers, the Targeted Case Management (TCM) Program and the Local Education Agency (LEA) Medi-Cal Billing Option Program (BOP), and add synchronous telehealth and telephone services to Drug Medi-Cal
- Providing that the TCM Program and the LEA BOP will follow traditional certified public expenditure cost-based reimbursement methodology when rendering services via applicable telehealth modalities
Through its recommended telehealth policy changes, DHCS intends to incorporate some but not all of the temporary COVID-19 public health emergency telehealth flexibilities. The full DHCS policy recommendations document is available here.
The California Department of Health Care Services (DHCS) recently issued its bimonthly update of important events and actions at DHCS. In its February 2021 update, DHCS provides various information and updates related to California Advancing and Innovating Medi-Cal (CalAIM), the COVID-19 public health emergency, and multiple programs, including the Adverse Childhood Experiences (ACEs) screenings program, Medi-Cal Rx, and the medication assisted treatment (MAT) expansion project.
The full DHCS update is available here.
The Prevention Institute will be hosting a peer learning forum on trauma-informed approaches during catastrophic events, including the COVID-19 pandemic. The learning forum will be held on February 17 from 11:00 am to 12:30 pm and will feature representatives from local governments, academia, and community-based organizations.
The objectives of the webinar include:
- Describe key features of a trauma-informed system and its importance for preventing trauma and suicide during the COVID-19 pandemic
- Use the Adverse Community Experiences and Resilience Framework to think about community-level recovery and systems change that supports wellbeing in the long-term
- Explore how agencies and organizations are integrating internal- and external-facing trauma-informed practices
- Discuss opportunities to overcome challenges and apply this information in other communities
Additional information and registration for the peer learning forum are available here.