February 8, 2019 Edition

CHEAC Hosts Successful State Legislative Member Education Day

On Wednesday, CHEAC hosted its first State Legislative Member Education Day in Sacramento. The event was held as part of the CHEAC Strategic Plan Priority Area #1: Policy and Advocacy which seeks to equip CHEAC Members for advocacy and educate legislators about the role and value of local health departments and agencies. Training was provided to participants on how to engage with legislators, educate them about public health issues in their jurisdiction, and discuss local public health resource needs.

14 CHEAC Member jurisdictions participated, representing small, medium, and large counties, as well as strong geographical representation throughout the state. CHEAC Members completed over 35 visits to legislators and/or their staff in the State Capitol, including those that chair or are members of key legislative committees. CHEAC extends our gratitude to those CHEAC Members that participated and looks forward to continuing to promote local health departments and their critical role in their jurisdictions.

Covered California Releases Report on Affordability and Coverage Options

Covered California late last week released an extensive report entitled, “Options to Improve Affordability in California’s Individual Health Insurance Mandate,” which details policy options to lawmakers on ways to enhance the Affordable Care Act (ACA), lower costs for consumers, and improve coverage options. The report was prepared with the input of leading economists and stakeholders and released pursuant to a 2018-19 budget trailer bill (AB 1810, Chapter 34, Statutes of 2018). The budget trailer bill required Covered California to detail in a report options to improve affordability for low- and middle-income consumers.

The report broadly covers two approaches with each approach containing different options for implementation. The first approach focuses on comprehensive market-wide affordability enhancements through enhancing and extending premium and cost-sharing supports. Various policy options are detailed under the first approach, including lowering and extending Affordable Care Act (ACA) contribution caps, instating an individual mandate penalty, and establishing a reinsurance program. The report’s second approach focuses on targeted affordability enhancement efforts through a variety of mechanisms, including enhanced premium subsidies and expanded cost-sharing reductions for specified income levels.

Covered California estimates that, depending on the approach and policy options selected, more than 750,000 Californians could gain coverage compared to anticipated enrollment in 2021 without the adoption of the report’s recommendations. The report’s approaches and increase in enrollment would also potentially allow consumers to save thousands of dollars in health care costs. The full Covered California report is available here.

LAO Publishes Analysis of Governor’s Individual Health Insurance Market Affordability Proposals

On Thursday, the California Legislative Analyst’s Office (LAO) released an analysis of Governor Gavin Newsom’s FY 2019-20 budget proposals related to individual health insurance market affordability. Citing ongoing legislative and public interest and concern related to healthcare costs, access, and affordability of individual market coverage, the LAO explores two key policy proposals by the Newsom Administration: 1) the creation of a state individual mandate with an associated financial penalty, and 2) the use of revenues from the state individual mandate penalty to provide state subsidies to reduce the cost of individual market coverage.

The LAO report details the current landscape of health insurance affordability and coverage options in California, as well as recent federal activities that have impacted the Affordable Care Act (ACA). The report also analyzes proposals laid out in the statutorily-mandated Covered California report and its recommended approaches and policy options available to the Legislature for improving affordability and increasing enrollment in the individual market.

In assessing Governor Newsom’s proposals, the LAO determines that the state-level individual mandate may be one of the most effective policy options to increase enrollment in the individual market and reduce the cost of premiums in the individual market. The LAO, however, discusses potential trade-offs of enacting a state individual mandate, including that revenues from the mandate would come at the expense of individuals who choose to pay its associated penalty instead of obtaining coverage.

Other policy options available to the Legislature are explored in the LAO report, including premium assistance and other cost-sharing reduction arrangements. The LAO provides commentary on potential implementation issues of the individual mandate and state subsidies, but ultimately recommends that the Newsom Administration’s individual mandate proposal warrants serious consideration in conjunction with other policy proposals that have been laid out related to individual market affordability. The full LAO report is available here.

California Future Health Workforce Commission Issues Final Report

The California Future Health Workforce Commission this week released its final report, detailing a series of recommendations to create and sustain the health workforce needed to meet current and future demands throughout the state. The Commission assesses the current state of California’s health workforce, finding a looming crisis in which provider shortages, workforce mismatches, and an increasingly growing, aging, and diverse population poses a threat to the wellbeing of the state.

The Commission’s final report includes a set of 27 detailed recommendations within three key strategies that will be necessary for: 1) increasing opportunities for all Californians to advance in the health professions, 2) aligning and expanding education and training, and 3) strengthening the capacity, retention, and effectiveness of health workers. The report also recommends establishing a statewide infrastructure, starting in 2019, to implement the recommendations in partnership with stakeholders, to monitor progress, and adjust as needs and resources change.

With an eye toward 2030, the Commission highlights 10 priority recommendations for immediate action and implementation. Among those actions are:

  • Expand and scale pipeline programs to recruit and prepare students from underrepresented and low-income backgrounds for health careers
  • Expand the number of primary care physician and psychiatry residency positions
  • Maximize the role of nurse practitioners as part of the care team to help fill gaps in primary care
  • Establish and scale a universal home care worker family of jobs with career ladders and associated training
  • Scale the engagement of community health workers, promotores, and peer providers through certification, training, and reimbursement

The California Future Health Workforce Commission was created in 2017 by a group of health philanthropies and is co-chaired by University of California President Janet Napolitano and Dignity Health President and CEO Lloyd Dean. The full report is available here.

CDPH Solicits Nominations for the 2019 Myers Award for Excellence in Public Health

The California Department of Public Health (CDPH) is currently soliciting nominations for the 2019 Beverlee A. Myers Award for Excellence in Public Health. This award recognizes the contributions of public health and health care services professionals in improving the health status of everyone who calls California home and the millions who visit the state every year.

The Beverlee A. Myers award is presented annually to an individual not currently working at CDPH who has exhibited outstanding leadership and accomplishments in public health in California. Nominations are due to CPDH by Friday, March 1, 2019 at 5:00 pm. The award recipient will be recognized at a special awards ceremony in Sacramento on Thursday, April 4 as part of National Public Health Week.

Additional information on the award and the nomination process is available here.

CDPH to Hold Oral Health Webinar Featuring Two LHDs on February 27

The California Department of Public Health (CDPH) Office of Oral Health will host a webinar on Wednesday, February 27 from 10:30 am-11:30 am featuring the oral health programs of the Tuolumne County Public Health Department and the Santa Clara County Public Health Department. Both counties have developed useful, concise, data-driven evaluation plans that will help their programs determine successes, areas for improvement, and populations reached.

The webinar will cover:

  • How and when the counties started their evaluation planning activities;
  • How the counties engaged stakeholders throughout the evaluation planning process;
  • The steps the counties took to develop evaluation questions, performance measures, and evaluation methods;
  • How the counties developed their oral health program logic models; and
  • Challenges and barriers to evaluation planning

Attendees will have the opportunity to ask questions of the presenters. CDPH encourages all oral health program team members to join the webinar and anticipates that the webinar will be particularly helpful to counties that are just starting or have begun evaluation planning activities. Registration for the webinar is available here.

CDC, AAP Release Oral Health Toolkit Aimed at Pregnant Women and Young Children

The U.S. Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) recently released Project Tiny Teeth, an oral health toolkit for medical and dental providers who care for pregnant women and young children. These materials are intended to help raise awareness about the importance of oral health as part of prenatal care and support clinicians in talking with pregnant women about their oral health and begin planning for the future oral health of their child.

The Tiny Teeth toolkit, which includes brochures, posters, infographics, and videos, is available here. The CDC also released a Pregnancy and Oral Health feature available here.

CDC Announces New Opioid Overdose Prevention Grant Opportunity

The U.S. Centers for Disease Control and Prevention (CDC) recently announced a new grant opportunity for local health departments to address the ongoing nationwide opioid epidemic. The grant opportunity “Overdose Data to Action” integrates the work of three previous CDC funding opportunities: Prescription Drug Overdose Prevention for States, the Data Driven Prevention Initiative, and the Enhanced State Surveillance of Opioid-Involved Morbidity and Mortality.

This three-year funding opportunity will focus on increasing comprehensives and timeliness of surveillance data, building state and local capacity for public health programs determined to be promising based on research evidence, making prescription drug monitoring programs (PDMPs) easier to use and access, and working with health systems, insurers, and communities to improve opioid prescribing. More information on the funding opportunity is available here.