The CHEAC Office will be closed on Monday, January 20, 2020, in observance of the Martin Luther King, Jr. holiday. We will resume normal operations on Tuesday, January 21.
January 17, 2020 Edition
Today, Governor Newsom announced Jacey Cooper’s appointment as State Medicaid Director and Chief Deputy Director of Health Care Programs at the Department of Health Care Services (DHCS). Since 2016, Ms. Cooper served as Assistant Deputy Director of Health Care Delivery Systems at DHCS since 2016. She also served Vice President at Meridian Healthcare Partners and in various roles within Kern Medical Center from 2010 to 2016.
The Governor also announced several reappointments at DHCS including Anastasia Dodson as Associate Director of Policy, Lindy Harrington as Deputy Director of Health Care Financing, and Erika Sperbeck as Chief Deputy Director of Policy and Program Support.
The official announcement can be viewed here.
On Monday, Governor Gavin Newsom’s Council of Regional Homeless Advisors, led by Sacramento Mayor Darrell Steinberg and Los Angeles County Supervisor Mark Ridley-Thomas, revealed their recommendations for reducing street homelessness, breaking down barriers keeping individuals experiencing homelessness from accessing mental health and substance use services, and findings ways to reduce the cost and boost the supply of housing options throughout the state of California. At the beginning of the 2020 legislative session, the council set forth a series of interim recommendations to guide specific budget and policy actions to address the state’s ongoing issues related to homelessness.
The council’s recommendations include:
- Creating an enforceable, results-based accountability mandate to end homelessness;
- Adopting a comprehensive crisis response strategy; and
- Creating a single point of authority for homelessness in state government.
The council’s interim recommendations were released as Governor Newsom embarked on a weeklong tour of meeting with individuals receiving homeless services throughout the state with stops in Nevada County, the Inland Empire, Los Angeles County, the Central Valley, and the Bay Area. During his tour, Newsom indicated that he would “lean in the direction” of the council’s recommendations to deploy a legal obligation to supply sufficient services and housing to individuals experiencing homelessness. Newsom further remarked, “I broadly have been encouraging this debate about obligations. There’s a distinction between rights and obligations. … The question is how you do it. This is not black and white. This is tough stuff.”
While the council’s recommendations do not provide specific details on how these actions would be implemented and enforced, the issue of homelessness is widely expected to dominate policy and budgetary matters this year in Sacramento.
The council’s letter to Governor Newsom is available here.
This week the Legislature convened a myriad of policy committees in each house to consider bills introduced last year (two-year bills). The deadline to pass all two-year bills is January 31st. While most policy committees met this week, their agendas were relatively short.
The Senate Education Committee heard SB 673, authored by Senator Mike Morrell, to amend the California Healthy Youth Act to require active parental consent (“opt-in”) with a signature for sexual health and HIV prevention education in grades lower than 7, to specifically require local educational agencies to make written and audio visual materials available for inspection before the date of instruction on the local educational agency’s Internet website, and to require those material to be translated. Despite a large contingent of advocacy groups and private citizens supporting the bill, SB 673 failed on a 2-5 vote.
Our CHEAC Weekly Bill Chart is available here.
Health Coverage/Health Care Reform
SB 175 (Pan) – SUPPORT
Senator Pan’s recently amended SB 175, which codifies in California statute the Affordable Care Act (ACA) prohibition on health insurance lifetime or annual limits, was heard in the Senate Health Committee on Wednesday. The bill ensures that despite threats to the Affordable Care Act at the federal level, California would continue to prohibit health insurers from instituting annual or lifetime limits on insurance benefits. CHEAC joined various health advocates in supporting the bill that was passed out of the committee on a 7-0 vote. It now moves on to the Senate Appropriations Committee.
On Thursday, the California Department of Public Health (CDPH) released their highlights of the Governor’s 2020-21 January Budget, which includes greater detail on budget implications for programs within the department. CHEAC prepared a brief memo highlighting items of interest to local health departments; the memo is available here.
On Monday, the Legislative Analyst’s Office (LAO) published its report, “The 2020-21 Budget: Overview of the Governor’s Budget,” which details significant investments, examines the broader fiscal status of the state, and recommends considerations and actions to the Legislature. Recall, Governor Newsom proposed his $222.2 billion state budget on Friday of last week.
The LAO’s report examines the projected total reserves and discusses the importance of reserves in insulating various state programs from adverse effects of budget shortfalls. The Legislature over recent years, according to the LAO, has dedicated a sizeable number of available surpluses to building more discretionary reserves. The LAO indicates that the Governor’s proposed budget does not continue this practice and urges the Legislature to consider the overall budget structure, including a target level of reserves.
Further, the LAO determines that the Governor has a projected $5.9 billion surplus to allocate through the 2020-21 budget process. Of this total, the Governor proposes to allocate $2.5 billion to one-time spending, $1.6 billion to maintain the state’s discretionary reserve, and $1.4 billion to ongoing spending. The bulk of spending (one-time and ongoing) is proposed to be dedicated to human services, housing, and homelessness; natural resources, environment, and emergencies; criminal justice; education; and health. Simply put, the Governor’s budget, according to the LAO, includes a large array of proposals across many priorities with relatively small dollar amounts. The LAO recommends the Legislature consider whether to take this similar approach or to dedicate larger amounts to a smaller number of priorities.
While California continues to enjoy a healthy fiscal status, the LAO discusses looming uncertainty in coming years, particularly as it relates to broader economic performance and federal decisions around healthcare financing (e.g. managed care organization tax). These potential outcomes could make a significant impact on California’s budget status to the tune of billions of dollars. The LAO further discusses the Governor’s projections for state operating surpluses, finding that the Newsom Administration anticipates small operating surpluses in the out years of its forecast period. The Governor did not allocate the surplus to increasing discretionary years, and, as a result, the LAO encourages the Legislature to consider maintaining a positive operative balance in its multiyear budget plans.
Both the Assembly Budget Committee and the Senate Budget & Fiscal Review Committee will convene budget overview hearings on Wednesday and Thursday, respectively, next week where members will receive a high-level presentation of items included in the Governor’s January Budget. Budget subcommittees are then expected to begin their work over the coming weeks.
The LAO will continue to publish various budget-related reports and informational materials throughout the year as the Legislature begins its budget consideration process. The full LAO overview report is available here.
The U.S. Centers for Disease Control and Prevention (CDC) recently launched a new initiative, “Active People, Healthy Nation,” with a goal of helping 27 million Americans become more physically active by 2027. The initiative uses five steps to coordinate actions to achieve its goal through supporting physical activity initiatives at the national, state, and local levels, mobilizing partners to increase physical activities, sharing messages that promote active lifestyles, training leaders for action, and developing technologies, tools, and data.
The new initiative launches as new data and maps were made available by the CDC, finding that all states and territories have more than 15 percent of adults who were physically inactive with a per-state estimate that ranged from 17.3 percent to 47.7 percent. California’s rate was determined to be 20.4 percent. Notably, the new data shows wide disparities in physical activity access by race and ethnicity.
Additional information from the CDC is available here.