January 29, 2021 Edition
Throughout this week, numerous CHEAC Members met virtually with Senators, Assembly Members, and staff to highlight the role and value of local health departments in California. As part of the 2021 State Legislative Member Education Event, CHEAC had 26 members representing 17 local health departments, including a balance of large, medium, and small jurisdictions, conduct over 30 visits with legislator offices over three days this week. Notably, meetings included appointments with legislative leaders and staff of key committees, including budget committees.
CHEAC Members focused their discussions with legislators and their staff on numerous key issues to support local health departments, including CHEAC’s budget request for significant current fiscal year investments in COVID-19 testing, vaccination, and case investigation and contact tracing activities. CHEAC Members highlighted the urgent need for strengthening the public health infrastructure in California, including through an expanded public health workforce, and encouraged legislators to support CHEAC’s sponsored legislative bill and budget request related to a public health infrastructure study.
CHEAC extends our appreciation to those CHEAC Members that participated virtually amid COVID-19 response activities. We look forward to continuing to promote local health departments and their critical role in their jurisdictions to the Legislature.
Early this week, Governor Gavin Newsom, Senate President pro Tempore Toni Atkins, and Assembly Speaker Anthony Rendon announced an agreement to extend the eviction moratorium in the California through June 30, 2021. The state’s eviction moratorium, initially imposed amid the ongoing COVID-19 pandemic, was set to expire on January 31, 2021.
Both the Senate and the Assembly advanced to the Governor SB 89 and SB 91 on Thursday, providing an extension on the moratorium and making available up to $2.6 billion in financial assistance to income-qualified tenants and landlords. Governor Newsom, joined by pro Tempore Atkins and Speaker Rendon, signed the measures into law this morning.
On Thursday, the California Assembly Select Committee on Latina Inequities convened an informational hearing entitled, “Unseen Latinas: Economic and Health Impacts on Latinas During the COVID-19 Pandemic.” Thursday’s hearing was the select committee’s inaugural hearing and featured two panels of expert witnesses to discuss the economic and health implications of the ongoing COVID-19 public health emergency on the state’s Latina population.
In opening comments, Select Committee Chair Assembly Member Lorena Gonzalez discussed the status of Latinas in the state prior to the pandemic, including significant health disparities and pay gaps. Assembly Member Gonzalez touched on the experiences of Latinas during the pandemic and urged the select committee to take actions to address health and economic inequities exacerbated by the pandemic. The hearing’s panels featured all-Latina witnesses and included representatives from research and higher education, organized labor, and public health and health entities.
The hearing agenda is available here. A video recording of the hearing is available here.
Of particular note this week, Assembly Member Shirley Weber was confirmed to be California’s Secretary of State by the Senate on a 29-0 vote and the Assembly on a 70-0 vote. Recall, Governor Newsom nominated Weber for the position after appointing Alex Padilla to the U.S. Senate, filling the vacancy created by the election of Vice President Kamala Harris. Weber was sworn into her new role this afternoon and becomes the first African American to serve as the state’s elections chief.
Weber’s confirmation as Secretary of State now leaves a vacancy in the Assembly. Assembly Speaker Anthony Rendon announced the appointment of a handful of other Assembly Members to committee slots vacated by Ms. Weber. Assembly Member Cristina Garcia was named the Chair of the Assembly Budget Subcommittee No. 5 on Public Safety and was also placed on the Assembly Budget Subcommittee No. 6 on Budget Process, Oversight, and Program Evaluation and the Joint Legislative Budget Committee. Assembly Member Laura Friedman was named to the Assembly Budget Committee.
In related news, the Senate Rules Committee on Thursday advanced the appointment of Jacey Cooper as the State Medicaid Director and Chief Deputy Director for Health Care Programs at the California Department of Health Care Services (DHCS). Ms. Cooper received unanimous support from the committee, advancing on a 5-0 vote her confirmation for consideration by the full Senate.
This week, the Newsom Administration announced several sweeping changes related to COVID-19 vaccine allocation, distribution, and administration. The Administration framed the forthcoming changes as lessons learned from the state’s 10-day one-million vaccine doses challenge from earlier this month. Led by the Government Operations Agency (GovOps) and the California Health and Human Services Agency (CHHS), the Newsom Administration will be implementing the following changes:
- Vaccine Prioritization Eligibility – Beginning mid-February, the state will implement a statewide standard under which health care workers, individuals age 65+, education and childcare, emergency services, and food and agriculture workers will be eligible to schedule appointments to receive the vaccine. These are the groups identified in the state’s Phase 1B, Tier 1 framework.
Future groups, according to the state, will become eligible based on age. The statewide standard will move in unison across all 58 counties and is anticipated to allow the state to scale capacity while ensuring vaccine is delivered to disproportionately impacted communities.
- Information and Data – The state launched MyTurn.ca.gov, an online vaccination appointment and notification platform. Individuals will be able to sign up for a notification when they become eligible to make an appointment, schedule their vaccination appointment, and be reminded when it is time for the second COVID-19 dose. MyTurn.ca.gov was piloted in Los Angeles and San Diego counties this month. The MyTurn system will additionally automatically report vaccination information to state data systems, reducing data lags and providing real-time information on vaccine administration at local and statewide levels.
- Third-Party Administrator – The state announced it will establish the California COVID-19 Vaccination Network to be operated by a third-party administrator (TPA) to speed the equitable allocation and delivery of vaccines directly to providers. Reports indicated the TPA will be Blue Shield of California with support from Kaiser Permanente. The vaccine provider network is expected to include public health systems, pharmacies, health systems, public hospitals, community health centers, pop-up and mobile sites. Notably, according to the Administration, local public health systems will play a key role in the network as vaccine providers and by providing insights and knowledge to ensure the network reaches disproportionately impacted residents. Few details on the TPA are available, and the transition to the TPA network is anticipated to occur over the coming weeks.
The full announcement from the Newsom Administration is available here.
This week, Governor Gavin Newsom issued Executive Order N-02-21 to support state efforts in vaccinating as many Californians as possible against COVID-19. The order confirms existing law related to provider liability protections applies to health care professionals and providers participating in the state’s vaccine administration program. The order additionally extends liability protections to others, including pharmacy technicians, working under the supervision or instruction of providers.
The executive order additionally directs the Department of Consumer Affairs’ (DCA) disciplinary bodies to prioritize disciplinary proceedings and investigations against licensees who are alleged to have diverted COVID-19 vaccine supplies for financial gain.
On Monday, the California Department of Public Health (CDPH) announced the end of the state’s Regional Stay-at-Home Order, effectively lifting the order for all regions statewide, including the three regions that had still been under the order (Bay Area, San Joaquin Valley, and Southern California). Four-week ICU capacity projections for the three regions still under the order rose above 15 percent, the threshold allowing a region to exit the order. The Greater Sacramento Region exited the order on January 12 and the Northern California Region never entered the regional order.
With the statewide end of the Regional Stay-at-Home order, counties statewide returned to the guidance and framework of the Blueprint for a Safer Economy, including the color-coded tiers indicating which activities and businesses are allowed to reopen based on local case rates and test positivity. The majority of California counties remain in the strictest, widespread (purple) tier. The state has not established criteria for re-entering a Regional Stay-at-Home order.
Additionally, with the end of the Regional Stay-at-Home Order, the state’s Limited Stay-at-Home Order, which limited non-essential activities between 10:00 pm and 5:00 am, has also expired. The state’s Hospital Surge Order remains in effect.
A CDPH press statement on the Regional Stay-at-Home Order is available here.
Following a series of COVID-19-related announcements in their first week in office, including the issuance of the Administration’s 200-page National Strategy for the COVID-19 Response and Pandemic Preparedness, the Biden-Harris Administration rolled out additional actions to support the federal government’s response to the ongoing public health emergency.
The Biden-Harris Administration this week announced the following actions:
- Weekly Vaccine Supply Increase: The Administration announced it will increase the overall, weekly vaccine supply to states, tribes, and territories from 8.6 million doses to a minimum of 10 million doses. The Administration committed to maintaining 10 million doses as the minimum supply level for the next three weeks.
- Three-Week Look-Ahead: The Administration is additionally taking steps to provide states, tribes, and territories with a reliable, three-week supply look ahead. The Department of Health and Human Services (HHS) will provide allocation estimates for the upcoming three weeks as opposed to the one-week lookahead previously received by states, tribes, and territories.
- Additional 200 Million Doses: The Administration announced it will purchase 100 million additional doses each of the Pfizer and Moderna COVID-19 vaccines, increasing the total vaccine order for the U.S. from 400 million to 600 million. The additional doses are anticipated to be delivered this summer.
In addition to the above actions, President Biden reinstated COVID-19 travel restrictions on non-U.S. citizens who have been in countries heavily impacted by the pandemic, including Brazil, Ireland, the United Kingdom, and other European Union countries. The restrictions were additionally extended to travelers who have recently been to South Africa.
The directive issued by President Biden reverted an executive order issued by former President Donald Trump in his final days in office lifting the restrictions on travelers from other countries effective January 26. Biden’s order does not apply to a number of excluded travelers, including lawful permanent residents of the U.S.
Additional information on the Biden-Harris Administration’s COVID-19 actions is available here.
This week, President Joseph R. Biden, Jr. issued a series of executive actions related to a wide array of subject areas, including racial equity, health coverage, climate change, manufacturing, and more. Below, we highlight the executive actions of most interest to CHEAC Members:
Health Access and Coverage
The Biden-Harris Administration issued two actions related to health access and coverage, particularly amid the COVID-19 pandemic. The two actions include:
- Strengthening Medicaid and the ACA (Executive Order): Establishes a special enrollment period (SEP) for uninsured and underinsured Americans to gain health coverage through the federally facilitated marketplace between February 15 and May 15; directs specified agencies to review regulatory actions to determine if policies are inconsistent with the Administration’s policy of strengthening and protecting Medicaid and the Affordable Care Act (ACA); revokes certain ACA- and healthcare-related executive actions issued by the Trump Administration
- Following President Biden’s executive order, the U.S. Centers for Medicare and Medicaid Services announced the availability of a special enrollment period; Covered California, applauding the Biden Administration’s move, similarly announced a state-based special enrollment period through May 15
- Protecting Women’s Health (Memorandum): Rescinds the “Mexico City Policy” that bars U.S. federal funding to international agencies who provide counseling for or referral to abortion services; directs specified agencies to review regulatory changes to the Title X program to ensure access to comprehensive reproductive health services
President Biden issued four executive orders and memoranda seeking to advance racial equity in the United States, pointing to the need to end systemic racism and discrimination in the country’s economy, laws, and institutions that has disproportionately impacted Americans of color for generations. The four actions are detailed below:
- Redressing Discriminatory Housing Policies and Practices (Memorandum): Acknowledges the federal government’s historic involvement in discriminatory housing policies and practices, including the systemic underinvestment in communities of color; directs specified agencies to examine recent regulatory actions
- Strengthening Tribal Relationships (Memorandum): Directs specified agencies to undertake actions to strengthen tribal consultations and the relationship between the U.S. Government and tribal nations
- Condemning and Combating Racism Against AAPIs (Memorandum): Condemns racism, xenophobia, and intolerance against Asian Americans and Pacific Islanders (AAPIs), particularly amid the ongoing COVID-19 pandemic; directs specified agencies to issue guidance on advancing cultural competency, language access, and sensitivity toward AAPI populations in the federal government’s COVID-19 response; directs specified agencies to ensure agency actions do not contribute to racism, xenophobia, or intolerance against AAPIs
Climate Change and Science
The Biden Administration issued a series of sweeping actions related to climate change both domestically and internationally. The actions include:
- Tackling the Climate Crisis (Executive Order): Acknowledges climate change as a crisis and requires climate considerations to be an essential element in any U.S. foreign policy and national security; directs the Department of the Interior to pause new oil and natural gas leases on public lands; directs specified agencies to prepare a national intelligence estimate on security implications of the climate crisis; establishes the National Climate Task Force; commits to environmental justice for new, clean infrastructure projects; establishes development of an emissions reduction target; establishes the special envoy for climate on the National Security Council
- Scientific Integrity and Evidence-Based Policymaking (Memorandum): Directs the Office of Science and Technology Policy to ensure scientific integrity across all federal agencies; directs specified agencies to designate senior agency employees as chief science officers to ensure research programs are scientifically and technologically sound
The California Health Care Foundation (CHCF) yesterday released results of its 2021 CHCF California Health Policy Survey, an annual representative statewide survey of California residents that was conducted between November 2020 and January 2021. The poll includes Californians’ experiences of the health care system in the last year and the health policy agenda they want to set for state policymakers.
The number one health-related priority for Californians is making sure state and county health departments have the resources they need to control the spread of COVID-19, with 59 percent of respondents indicating the issue is “extremely important” and 26 percent indicating the issue is “very important.” Nearly three in four Californians (71 percent) indicate they will receive the COVID-19 vaccine once widely available. Large majorities of residents trust health care providers, federal health agencies, and public health departments to provide them accurate information about the vaccine.
The poll additionally found that about half of Californians acknowledge it is harder for black people (51 percent) and Latino/a people (49 percent) to get the health care they need compared to white people. Of those who believe it is harder, at least three of four think the federal government (86 percent), health insurance plans (82 percent), state government (78 percent), and individual health providers (75 percent) are doing too little to address racial and ethnic inequality in the health system. The CHCF poll additionally covered areas related to health care costs, homelessness, and other key issues.
The full CHCF poll is available here.
Late last week, the California Secretary of State’s Office announced a referendum seeking to overturn SB 793 (Hill) that would ban the sale of flavored tobacco products statewide. The law, which was signed into statute in late August 2020, was set to take effect at the beginning of this month. However, given that the referendum collected more than the required 623,212 signatures, the measure does not take effect until voters statewide have the opportunity to weigh in.
The referendum will be placed on the November 8, 2022, ballot, requiring a majority of voters to approve the 2020 state law before it can take effect. The referendum is sponsored by a coalition of retailers and tobacco industry representatives, including tobacco giant R.J. Reynolds and Philip Morris USA.
Additional information on the referendum is available here.
This week, the California Department of Health Care Services (DHCS) and the Office of the California Surgeon General (CA-OSG) awarded $30.8 million in ACEs Aware grant funds to 35 organizations across California. As part of its ACEs Aware Initiative, DHCS and CA-OSG provided funding to help build and strengthen robust networks of care to effectively respond to adverse childhood experiences (ACEs) and toxic stress with community-based health and social supports that meet the needs of children, adults, and families.
The newly awarded grants focus on planning and implementation activities. The state awarded $7.9 million in planning grants across 27 counties to assist in preparations of executing a robust screening, referral, and response process designed to address toxic stress. The state also awarded $22.9 million in implementation grants across eight counties to pilot the effectiveness of health care, social service providers, and community-based organizations working together to create a seamless screening, referral, and response process. Implementation grant funds will be available for up to 18 months.
Awardees include Glenn County (including Glenn County Health and Human Services) and Santa Cruz County Public Health. Other awardees feature key partnerships with several county health departments or agencies.
More information on the grant awards, including a listing of awardees, is available here.
This week, Children Now issued its 2020-21 California County Scorecard of Children’s Well-being, an interactive tool detailing data on how children are doing in each of California’s 58 counties. The tool tracks 39 key indicators of children’s well-being over time, by race/ethnicity, and relative to other counties from prenatal stages to the transition to adulthood.
According to Children Now, the current outlook is worrisome, particularly as California children increasingly experience stress, social isolation, disconnectedness, and serious mental health issues amid the ongoing COVID-19 pandemic. Children Now additionally points to learning loss and the lack of preventive health services as significant health threats to the youngest generation.
Children Now will be holding a webinar on the scorecard and will detail how to use its data to improve outcomes from children statewide. The webinar will be held on Wednesday, February 3 at 2:00 pm. Registration is available here.
The full Children Now county scorecard is available here.
The California Department of Aging (CDA) will hold a webinar as part of its “Ensuring Equity in Aging” series, entitled “Culturally Informed Policy and Programs for Black Elders.” The webinar will be held on Wednesday, February 3, 2021, from 10:00 am to 11:00 am. The webinar will cover a range of topics, including how historic and systemic discrimination and internal biases harm the wellbeing of black, indigenous, and people of color (BIPOC), LGBTQ, and disabled older adults. Speakers will address how stakeholders can work together to address inequities through culturally responsive policy, program, and service planning.
Additional information, including webinar registration, is available here.