January 18, 2019 Edition

Senate Budget and Fiscal Review Committee Holds Budget Overview Hearing

On Thursday, the Senate Budget and Fiscal Review Committee convened their first hearing on Governor Newsom’s FY 2019-20 Proposed Budget. Opening the hearing, Committee Chair Holly Mitchell provided brief remarks regarding the Newsom Administration’s extensive investments in education and health and human services proposals, as well as its prudent approach to paying down state liabilities and debts and funding reserves.

Vivek Viswanathan, representing the Department of Finance (DOF), provided the Budget and Fiscal Review Committee an extensive overview of the governor’s budget proposal and its policy priorities. In his remarks, Viswanathan emphasized the Newsom Administration’s focus on building fiscal strength and resiliency while still proposing bold and ambitious state programs and initiatives. Among those referenced, Viswanathan discussed the Administration’s measured approach to phasing-in more significant proposals such as paid family leave, earned income tax credit, early childhood education, and CalWORKs investments. Carolyn Chu, the Acting California Legislative Analyst, provided a brief overview of the Newsom Administration’s current budget assessment, economic forecasts, and key spending proposals detailed in the Administration’s budget.

Senators inquired about various components of the governor’s proposed investments into education, health and human services, and disaster preparedness and response, among other topics. Notable questions asked of the panelists included the Administration’s interest in expanding Medi-Cal coverage to additional undocumented residents, the impacts of the Administration’s prescription drug purchasing proposal on the 340B Drug Pricing Program, and the upcoming expiration of the managed care organization (MCO) tax.

Committee Chair Holly Mitchell indicated issues raised by committee members will be discussed in greater detail as budget subcommittees convene beginning in February and March. The next full committee hearing will occur on January 31 and will focus on emergency preparedness and response issues, particularly in light of the recent wildfires throughout the state. The agenda from Thursday’s overview hearing is available here.

LAO, Legislative Budget Committees Release Overviews of Governor’s Proposed Budget

The California Legislative Analyst’s Office (LAO) on Monday released its overview of Governor Gavin Newsom’s FY 2019-20 Budget Proposal. The LAO report assesses the state’s current budget position, discusses the Governor Newsom’s budget priorities and spending proposals, and areas for consideration as the Legislature begins its budget deliberations.

As part of the assessment of the proposed budget, the LAO determines that the governor estimates that the state’s budget position is even better than what the LAO predicted in its November Fiscal Outlook Report. Largely as the result of lower-than-expected spending in health and human services programs, the Newsom Administration has approximately $20.6 billion in discretionary resources to allocate for FY 2019-20. Of that amount, nearly half of those resources are proposed to be dedicated to paying down state liabilities and budgetary debts. Approximately one-quarter of the $20.6 billion is slated for one-time or temporary programmatic spending. Ongoing costs are proposed at $3 billion, an amount the LAO indicates is significantly higher than recent state budgets have allocated. A recent economic growth scenario by the LAO found that $3 billion was approximately the level of ongoing spending that the budget could support, particularly in times of more difficult economic conditions.

The LAO overview goes on to detail proposed spending on state liabilities and debts, programmatic areas, and reserves. The LAO briefly discusses other policy plans outlined in the Newsom Administration’s proposed budget and provides commentary on major proposals related to education, health and human services, housing and homelessness, and disaster response and recovery. The full LAO report on the overview of Governor Newsom’s FY 2019-20 Proposed Budget is available here.

Also, late last week, the California Assembly Budget Committee and Senate Budget and Fiscal Review Committee released summaries of the governor’s proposed budget. These summaries are intended to provide an overview of the governor’s proposals to legislators and staff and will serve as the basis for budget committee hearings that will occur over the coming months. The Assembly overview is available here and the Senate overview is available here.

Joint Legislative Budget Committee Announces Selection of New Legislative Analyst

This week, the California Joint Legislative Budget Committee announced the selection of Gabriel Petek as the new Legislative Analyst. Petek begins on February 4 and succeeds Mac Taylor who retired in December after 10 years as the Legislative Analyst. Petek will join the Legislative Analyst’s Office (LAO) from S&P Global Ratings where he currently manages its San Francisco office and is the primary credit analyst for California. Previously, Petek was a budget analyst in the City of Boston’s Office of Budget Management. Petek will be the sixth Legislative Analyst since the LAO’s inception in 1941.

OAL Adopts Final Statewide Cannabis Regulations

On Wednesday, the California Bureau of Cannabis Control (BCC) announced that the Office of Administrative Law (OAL) approved statewide cannabis regulations. These regulations were submitted to the OAL last month by the BCC, the California Department of Public Health (CDPH), and the California Department of Food and Agriculture (CDFA). These regulations go into effect immediately and govern cannabis manufacturing, cultivation, and distribution, transportation, retail, and laboratories.

Summaries of the final regulations submitted by all three regulatory agencies and adopted by OAL can be found on CHEAC’s cannabis resource page.

In Unprecedented Step, FDA Issues Over-the-Counter Naloxone Labels

On Wednesday, the U.S. Food and Drug Administration (FDA) issued two model consumer-friendly drug facts labels (DFLs) for over-the-counter naloxone products. Currently, FDA-approved versions of naloxone require a prescription from a medical provider, posing a barrier to individuals who may be at risk of an opioid overdose. The FDA is currently engaged in activities to make naloxone more widely available, including having naloxone approved as an over-the-counter (OTC) product.

FDA-approved prescription naloxone products currently have instructions for use in product labeling, but they do not currently have consumer-friendly DFLs – a requirement for OTC products. As part of the application for an OTC drug product, pharmaceutical companies must develop a DFL and conduct studies to demonstrate that consumers can clearly understand how to use the product without supervision by a health care provider. Through stakeholder processes, FDA learned that the requirement to develop and test these DFLs are a barrier to the development of OTC naloxone products.

Citing these barriers and the urgent need to make naloxone more widely available in the face of the nationwide opioid epidemic, FDA Commissioner Scott Gottlieb in a statement indicated this is the first time the FDA has proactively developed and tested a DFL for a drug to support development of an OTC product. The move is expected to make it easier for pharmaceutical companies to enter the OTC market with naloxone products and increase access for consumers who may be at risk of opioid overdose.

The two consumer-friendly DFL models are now available for nasal spray naloxone products and for auto-injector naloxone products. The FDA continues to build on efforts to address the nationwide opioid epidemic, including activities to improve addiction prevention, enhance treatment and recovery services, and strengthen data and research. Additional information on the FDA’s action on OTC labels is available here.

HHS Releases National Health Security Strategy

The U.S. Department of Health and Human Services (HHS) Office of Assistant Secretary for Preparedness and Response (ASPR) recently released the National Health Security Strategy (NHSS) for 2019-2022. The strategy provides a vision to strengthen the country’s ability to prevent, detect, assess, prepare for, mitigate, respond to, and recover from various disasters and emergencies. The strategy details efforts to improve readiness, adapt to operational capabilities, and address evolving threats such as cyber warfare, emerging infectious diseases that could lead to a pandemic, and catastrophic natural and human-caused disasters.

The overarching objectives for the NHSS 2019-2022 include:

  • Preparing, mobilizing, and coordinating a whole-of-government approach to bring the full spectrum of federal medical and public health capabilities to support state, local, tribal, and territorial authorities in a public health emergency, disaster, or attack
  • Protecting the nation from the health effects of emerging and pandemic infectious diseases and chemical, biological, radiological, and nuclear (CBRN) threats
  • Leveraging the capabilities of the private sector

The full NHSS for 2019-2022 is available here.

de Beaumont Foundation Publishes Public Health Workforce Survey Results

The de Beaumont Foundation this month released the 2017 results of the Public Health Workforce Interests and Needs Survey (PH WINS). PH WINS is a national survey of state and local public health agency employees that captures detailed demographics, workforce engagement, morale, training needs, and emerging concepts in public health. PH WINS also provides state-and city-specific data to agencies to help them understand strengths, gaps, and opportunities to improve skills, training, and employee engagement.

Key findings of the 2017 PH WINS Survey include:

  • Despite high levels of job satisfaction, a large proportion of workers are considering leaving their organization in the next year. Top reasons include dissatisfaction with pay, lack of opportunity for advancement, and workplace environment.
  • The majority of workers are satisfied with their jobs but are less satisfied with their organizations and pay.
  • Workers indicate a high level of engagement but do not believe that creativity and innovation are rewarded.
  • Top training needs among workers are budgeting and financial management, systems and strategic thinking, change management, and developing a vision for a healthy community.
  • The public health workforce is not demographically representative of the country in terms of gender or age.

Additional information is available here and the full 2017 PH WINS Survey is available here.