January 10, 2020 Edition
This morning in
a nearly three-hour press conference, Governor Gavin Newsom unveiled his FY
2020-21 budget proposal.
a summary of the Governor’s 2020-21 budget proposal available
here. Additional budget resources will be posted on our CHEAC Budget Page
throughout the year.
Over the coming
weeks, the Legislature will begin hearing proposed budget items and stakeholder
proposals, and CHEAC will continue to keep its members apprised of budget-related
Legislature reconvened the second year of their two-year session on Monday with
relatively brief floor sessions. Both Senate President Pro Tempore Toni Atkins
and Assembly Speaker Anthony Rendon warmly welcomed their members back to their
respective chambers. Pro Tem Atkins acknowledged 2020 would be a very busy year
with the Senate first tackling the mountain of two-year bills that need to be
dispensed with this month. She also outlined three major issues of concern for
the Senate this year including addressing the homelessness crisis, preparing
California to respond to wildfires and to review processes for power safety
shutoff events, and finally ensuring the 2020 Census, California Primary, and
General Election proceed accordingly. Speaker Rendon, in his remarks, referenced
the work ahead this year and welcomed two new Assembly staffers – Chief Clerk
of the Assembly, Sue Parker and Chief Sergeant at Arms Alisa Buckley. Both were
officially sworn into their new roles during Thursday’s floor session.
This month, both
houses will have to contend with more than 1,100 legislative proposals that
were introduced in 2019 and made into two-year bills. The deadline to move
these bills through their house of origin is January 31. One of the hottest
topics to be discussed this month includes Senator Scott Wiener’s SB 50, which makes significant changes to
local zoning laws allowing for more high-density housing near mass transit
hubs. SB 50 has been highly contentious, particularly among local governments,
and was shelved by the Senate Appropriations Committee last year. Senator
Wiener has made some changes to the bill to address concerns, but it remains to
be seen if it has garnered enough support yet to make it out of the Senate.
hot topic this year to include some fixes to Assembly Member Lorena Gonzalez’s
AB 5 from last year, which added limitations to the way independent contractors
(such as Uber or Door Dash) are employed. Assembly Member Gonzalez has received
heavy criticism from various freelance workers impacted by the law (which went
into effect January 1st), but has been vocal in her desire to
address concerns in clean-up legislation.
proposal was unveiled in the Assembly this week to create a California-specific
Green New Deal modeled upon the national plan proposed by New York
Congresswoman Alexandria Ocasio-Cortez. AB 1839, authored by Assembly Members Rob Bonta,
David Chiu, Ash Kalra, Eloise Gomez Reyes, Shirley Weber, and eight additional
Democratic co-authors, is still in spot-bill form, but would seek to reduce
homelessness, further cut greenhouse gas emissions, and improve living
standards in California’s poor communities over the next 10 years. Assembly
Member Bonta indicated that details would be fleshed out during the legislative
process and acknowledged the bill would be “expensive but necessary.”
There are a few
key changes in the memberships of both houses since last Fall worth noting. On the
Senate side, Senator Jeff Stone resigned late last Fall to join the Trump
Administration in the US Department of Labor; his seat remains vacant until his
replacement is elected during the March primary/special election. In the
Assembly, the chamber welcomed new member Megan Dahle, who replaced her husband,
Senator Brian Dahle, in a special election held in November 2019.
With 2020 also
being an election year, all seats in the Assembly will be up during the March
primary and November general election compared to only the odd seats in the
Senate. As a final aside, term limits will hit six Senators this year (Jim
Beall, Cathleen Galgiani, Jerry Hill, Hannah-Beth Jackson, Bill Monning, and Mike
Morrell). In the Assembly, no member is termed out this year; however, eight
members have declared their candidacies for various other offices or official
retirements (Susan Eggman, Kansen Chu, Jay Obernolte, Monique Limon, Christy
Smith, Ian Calderon, Melissa Melendez, and Todd Gloria).
Please see our CHEAC Weekly Bill Chart for specific information on bills of
interest to CHEAC.
AB 315 (C. Garcia) –
AB 315, a
two-year bill, places restrictions on the use of revenues derived from local
agencies by local government associations (such as CHEAC) for lobbying the
Legislature or Congress or for educational activities. The measure would add
new reporting requirements on local government associations. The bill was originally
set to be heard in the Assembly Local Government Committee next week; however, has
since been pulled. Assembly Member Garcia has since indicated her intent to
introduce legislation to allow the State Auditor to conduct audits on local
government associations receiving taxpayer dollars.
SB 793 (Hill) – SUPPORT
Hill introduced on Monday a revitalized effort to ban sales of all flavored
tobacco products statewide, including mint and menthol tobacco products. Recall,
Senator Hill carried a similar measure last year (SB 38) which sought to ban
all flavored tobacco products; however, Senator Hill ultimately shelved the
measure on the Senate Inactive File after receiving hostile amendments which
would have exempted certain tobacco products. SB 793 is proposed to go farther
than the recently finalized federal rule by the U.S. Food and Drug
Administration (FDA) which will prohibit certain flavored cartridge-based
electronic cigarettes (except tobacco or menthol flavors).
In rolling out SB 793 this week, Senator Hill unveiled 29 coauthors from both the
Senate and Assembly representing both the Democratic and Republican parties. Lieutenant
Governor Eleni Kounalakis also joined in support of measure, which is sponsored
by the American Cancer Society Cancer Action Network, American Heart
Association, American Lung Association, the Campaign for Tobacco-Free Kids, and
Common Sense. CHEAC continues to work closely with the sponsorship coalition in
support of the measure to reduce access to all flavored tobacco products and
protect Californians from lifelong tobacco-related illnesses and death. We
strongly encourage local health departments to support SB 793 and express their
support via social media.
On Wednesday, Governor Gavin Newsom issued a press release announcing his Executive Order N-23-20 to reduce street homelessness, reduce barriers for homeless individuals to access health care and other services, and increase housing options for those experiencing homelessness. The executive order, effective immediately, requires:
state agencies named in the Executive Order to develop metrics for state
agencies and local partners by February 28, 2020 to assess the use of state
resources below and the impact.
Department of Finance to establish a new fund, the California Access to Housing
and Services Fund, within the Department of Social Services (DSS) to receive
future state appropriations, as well as donations from philanthropy and the
private sector, for affordable housing, rental and operating subsidies and
stabilizing board and care homes.
agencies to conduct the following actions by January 31, 2020, for the purpose
of identifying property that can be used by local partners for providing
shelter for homeless individuals on a short-term basis:
Department of General Services (DGS) to identify properties from the inventory
of excess state land and state facilities;
Department of Transportation (Caltrans) to develop and share a model lease
template to allow counties and cities to use Caltrans property adjacent to
highways or state roads;
Office of Statewide Health Planning and Development to work with local jurisdictions,
tribal communities and private entities to assess vacant and decommissioned
hospitals and health care facilities; and
Department of Food and Agriculture, in consultation with the DGS, the
Department of Housing and Community Development, DSS, and the Office of
Emergency Services, to conduct an initial assessment of fairgrounds in or near
jurisdictions where a shelter crisis is in effect.
to supply 100 travel trailers from state fleet and the Emergency Medical
Services Authority to supply complementary modular tent structures to provide
temporary emergency housing and health and social services across the state immediately
through September 30, 2020.
multi-agency strike team with the Business, Consumer Services and Housing
Agency, Government Operations Agency, Health and Human Services Agency, Labor
and Workforce Development Agency, and the Transportation Agency, to provide
technical assistance and targeted direct support to counties, cities and public
transit agencies looking to get homeless individuals indoors and connect them
to health and social services.
In addition to
the Executive Order, Governor Newsom previewed elements of his 2020-21 budget
proposal, including providing seed funding for the California Access to Housing
and Services fund created by the Executive Order and funding for the
Administration’s Medi-Cal transformation proposals, now called Medi-Cal
Healthier California for all (formerly known as CalAIM). Additional budget
details can be found in the CHEAC Budget Memo.
release can be viewed here.
Department of Health Care Services (DHCS) on Wednesday announced that is has
renamed the multi-year reform initiative aimed at improving the health outcomes
and quality of life for California’s population in Medi-Cal. Recall, DHCS
released its formal proposal to incorporate several state innovations that have
been successfully tested through California’s federal 1115 waivers at the end
of October 2019, referred to as “California Advancing and Innovating Medi-Cal”
effort to transform the Medi-Cal delivery system, program, and payment
structure will now be known as “Medi-Cal Healthier California for All.”
According to DHCS, the change reflects the initiative’s alignment with Governor
Gavin Newsom’s platform to build a “California for All,” as well as the long
history and public familiarity with the Medi-Cal name.
references to the initiative on DHCS’ website have been updated to reflect the
new name and existing bookmarks and webpages that include the old terminology
will be automatically redirected to the updated pages. Additional information
on the initiative is available here.
The California Department of Health Care Services (DHCS) recently posted an informational chart with managed care model type definitions and requirements. The purpose of the chart is to aid counties, plans, and other stakeholders in understanding the different managed care model types and the associated requirements. The informational chart can be found on DHCS’ website here.
California State Auditor Elaine Howle released a report entitled, “Childhood
Lead Levels: Millions of Children in Medi-Cal Have Not Received Required
Testing for Lead Poisoning.” The audit was conducted on the Department of
Health Care Services (DHCS) and the California Department of Public Health
(CDPH) and found that from fiscal years 2009-10 through 2017-18, more than 1.4
million of the 2.9 million one- and two-year old children enrolled in Medi-Cal
did not receive any of the required lead level tests and another 740,000
children missed one of the two tests.
generally requires that children enrolled in Medi-Cal receive tests for
elevated lead levels at the ages of one and two years. According to DHCS’ data,
the rate of eligible children receiving all required tests was less than 27
percent. Many of these children, according to the State Auditor’s office, live
in areas of the state with high occurrences of elevated lead levels. The
Auditor determined that DHCS has not effectively overseen Medi-Cal managed care
plans to ensure that children are receiving the required lead tests.
DHCS has only
recently begun developing a performance standard for measuring whether managed
care plans are ensuring that children receive such tests. While DHCS is
developing an incentive program to increase payments to healthcare providers
for each lead test they report administering, the State Auditor is concerned by
how long it may take these programs to influence lead testing rates. The State Auditor
further concluded that DHCS could take more immediate action to increase the
number of children receiving the tests, such as requiring health plans to
identify children who have not received lead tests and reminding their
healthcare providers of the need to provide the tests.
CDPH, which is charged with the prevention and management of lead poisoning
cases, the State Auditor determined that it has failed to focus on addressing
lead hazards before children are exposed to them and has failed to meet
legislative requirements concerning lead poisoning. State law requires CDPH to
identify geographic areas at high risk for childhood lead exposure and publish
an analysis of such areas each year beginning in March 2019; CDPH had not done
so as of October 2019. It also failed to meet a statutory requirement to post
on its website a list of certain census tracts in which children have tested
positive for specified lead levels. The State Auditor conducted a similar
analysis and found that from fiscal years 2013-14 through 2017-18, half of
children with elevated lead levels were located in just 15 percent of the
state’s census tracts.
State Auditor found that CDPH’s efforts do not appear to align with preventing
future instances of lead poisoning in geographic areas in which children are at
the greatest risk, given that CDPH contracts with childhood lead poisoning
prevention programs at local agencies and only requires local programs to
monitor abatement in homes of children who already have lead poisoning. The
State Auditor also determined that CDPH could not demonstrate the effectiveness
of local prevention program outreach activities in reducing lead exposure in
high-risk areas. Also included in the State Auditor’s report is an examination
of the CDPH Childhood Lead Poisoning Prevention Program, which was found to
allocate funding to local prevention programs based on a funding formula that
uses outdated information on the number of children with lead poisoning in each
jurisdiction, leading to significant differences in the services that local
programs have been able to provide.
Auditor detailed a series of recommendations for the Legislature, DHCS, and
state law to require laboratories to report contact information and unique identifiers
with children’s lead test results.
its effort to adopt a performance standard for lead tests and ensure that this
standard is specifically designed to monitor its success in meeting the State’s
requirements for lead testing of one- and two-year old children.
into its contracts with managed care plans a requirement that plans identify
each month all children without records of required lead tests and remind the
responsible healthcare providers of the need to test those children.
complete and publicize an analysis of high-risk areas throughout the state.
require local prevention programs to demonstrate the effectiveness of their
outreach or analyze the cost-effectiveness of approaches such as proactive
abatement and require the local prevention programs to replace or augment their
outreach to the extent resources allow.
meeting legislative requirements, including updating the factors healthcare
providers use to determine whether children are at risk of lead exposure.
its allocation formula to take into account the most recent data for the number
of children with lead poisoning in each jurisdiction.
responding to the Auditor’s report, agreed with the recommendations and has
prepared corrective action plans to implement them. CDPH also agreed or
partially agreed with the Auditor’s findings. The State Auditor found that both
DHCS and CDPH’s approaches for implementing certain recommendations do not
fully address the related findings and concerns.
The full State
Auditor report is available here.