January 8, 2021 Edition

Newsom Releases FY 2021-22 Budget Proposal

Today, Governor Gavin Newsom unveiled his proposed FY 2021-22 state budget ahead of the January 10 constitutional deadline. The $227.2 billion ($164.5 billion General Fund) spending plan includes sweeping investments in pandemic-related economic recovery efforts, individual economic supports, education funding, and wildfire preparedness, among other areas.

During a nearly two-hour press conference, Governor Newsom walked through the major components of his proposed budget, which will be considered by the California Legislature beginning next week. The Assembly Budget Committee is set to convene a budget overview hearing on Monday, and the Senate Budget & Fiscal Review Committee will hold its overview hearing next Thursday.

CHEAC Staff has published a memo summarizing key investments in areas of interest to CHEAC Members and local health departments. As the Legislature begins its budget deliberations over the coming weeks and months, CHEAC will continue to keep members apprised of relevant developments.

State Public Health Officer Issues Order on Hospital Surge

On Tuesday, California Department of Public Health (CDPH) Director and State Public Health Officer Dr. Tomás Aragón issued a state public health officer order to reduce pressure on strained hospital systems and redistribute the responsibility of medical care across the state so patients can continue to receive lifesaving care amid unprecedented COVID-19 cases and hospitalizations.

The public health order requires some non-essential and non-life-threatening surgeries to be delayed in counties with 10 percent or less of ICU capacity under the Regional Stay-at-Home Order where the regional ICU capacity is at zero percent. Examples of procedures that may be delayed include carpal tunnel release and non-urgent spine surgeries. Surgeries for patients who have serious and urgent medical conditions will continue.

The order additionally requires hospitals statewide to accept patient transfers from facilities that have implemented contingency or crisis care guidelines as long as those transfers can be done capably and safely.

The full order is available here. A CDPH press announcement is available here.

CDPH Issues Recommendations to LHDs and Providers on COVID-19 Vaccines

On Thursday, the California Department of Public Health (CDPH) issued vaccine recommendations to local health departments (LHDs) and providers focused on accelerating the pace of COVID-19 vaccine administration. The recommendations clarify the state’s vaccine prioritization process and authorize LHDs and providers to offer doses to lower priority groups when high-priority demand subsides or when doses are about to expire.

LHDs and providers are directed to immediately administer COVID-19 vaccines to individuals in all tiers of Phase 1a. In addition to frontline health care workers, this includes a wide range of professionals in health care settings, such as community health workers, public health field staff, primary care clinics, specialty clinics, laboratory workers, dental clinics, and pharmacy staff.

The full recommendations are available here. A CDPH press statement is available here.

Biden Administration Plans to Release All Available COVID-19 Vaccines

The incoming Biden Administration has announced that it plans to release nearly all available COVID-19 vaccine doses “to ensure the Americans who need it most get it as soon as possible” upon the administration’s inauguration on January 20. Currently, the Trump Administration has been holding back approximately half of its vaccine supply to ensure those already vaccinated receive the second booster dose.

The move by the incoming Biden Administration follows a letter sent to Health and Human Services Secretary Alex Azar by eight Democratic governors, including California Governor Gavin Newsom. The letter urges the Trump Administration to release all available COVID-19 vaccines to states as soon as possible.

HHS Renews COVID-19 Public Health Emergency

On Thursday, U.S. Department of Health and Human Services (HHS) Secretary Alex Azar extended the nationwide public health emergency due to the ongoing COVID-19 pandemic. The initial public health emergency declaration was made on January 27, 2020, and has been previously renewed three times. The full declaration is available here.

CDC Announces $22 Billion to Support Expanded COVID-19 Testing and Vaccine Distribution

This week, the U.S. Centers for Disease Control and Prevention (CDC) announced two upcoming actions to provide more than $22 billion in funding to states, localities, and territories to support the continued response to the ongoing COVID-19 pandemic. The funding was made available through the Coronavirus Response and Relief Supplemental Appropriations Act that was passed by Congress and signed into law late last month.

Funding will provide support for testing and vaccination-related activities to jurisdictions before January 19, 2021. Award recipients will include 64 jurisdictions, including all 50 states, the District of Columbia, five major cities, and U.S. territories/islands.

More than $19 billion will be allocated though the existing CDC Epidemiology and Laboratory Capacity (ELC) cooperative agreement. These funds will support testing, contact tracing, surveillance, containment, and mitigation activities. Over $3 billion will also be made available in an initial award to jurisdictions through the existing CDC Immunization and Vaccines for Children cooperative agreement. These awards will support a range of COVID-19 vaccine activities throughout the country.

Additional information on the new funding is available here.

CMS Approves One-Year Extension of Medi-Cal 2020 Waiver

Recently, the Department of Health Care Services (DHCS) received approval from the U.S. Centers for Medicare and Medicaid Services (CMS) for a one-year extension of California’s Section 1115 Medi-Cal 2020 demonstration waiver. Recall, DHCS requested an extension of the waiver in mid-2020 amid the ongoing COVID-19 pandemic. Notably, included in the approved extension is a one-year extension of Whole Person Care (WPC) Pilots.

DHCS and CMS are anticipated to continue working together on the terms and conditions of the extension period. The extension is now set to expire on December 31, 2021.

The full approval from CMS is available here.

Jimenez, Burke Harris Appointed to State First 5 Commission

This week, Governor Gavin Newsom announced two appointments to the First 5 California Children and Families Commission. CHEAC Secretary/Treasurer and Monterey County Health Department Director Elsa Jimenez was appointed to the commission as the commission’s public health representative. Jimenez has served in her current role in Monterey County since 2016 and has been with the county since 2001.

The Governor additionally appointed Dr. Nadine Burke Harris, California’s Surgeon General, as chair of the First 5 Commission. Burke Harris was named Surgeon General in 2019 and was previously the Founder and Chief Executive Officer of the Center for Youth Wellness from 2011 to 2019.

The full press announcement from the Governor’s Office is available here.

State Releases Master Plan for Aging

This week, the Newsom Administration released the California Master Plan for Aging, a comprehensive framework to prepare the state for significant demographic changes in the years ahead, including the growth of the 60-and-over population to 10.8 million people by 2030.

The Master Plan was initiated by an Executive Order issued by Governor Gavin Newsom in June 2019, directing the California Health and Human Services Secretary to develop a strategy for promoting the health and well-being of older Californians. The Master Plan outlines five major goals and 23 strategies for leaders in government, business, philanthropy, and community-based organizations to collaborate on creating age-friendly communities for all Californians. The Plan also sets a series of targets to track progress and provide accountability and will be powered by more than 100 initiatives that have already begun to be adopted by state agencies.

The five goals of the plan include:

  1. Housing for All Ages and Stages – Includes a target of establishing millions of new housing options to age well
  2. Health Reimagined – Includes a target of closing the equity gap in and increasing life expectancy
  3. Inclusion and Equity, Not Isolation – Includes a target to keep increasing life satisfaction with age
  4. Caregiving that Works – Includes a target goal of one million high-quality caregiving jobs
  5. Affordable Aging – Includes a target of closing the equity gap in and increasing elder economic sufficiency

Many of the initiatives included in the Plan are related to a wide array of policy areas, including housing, transportation, emergency preparedness, and broadband. The full Master Plan is available here. A press release on the plan is available here.

Auditor Issues Report on Proposition 56 Tobacco Tax Administration

California State Auditor Elaine Howle this week released an audit report entitled, “Proposition 56 Tobacco Tax: State Agencies’ Weak Administration Reduced Revenue by Millions of Dollars and Led to the Improper Use and Inadequate Disclosure of Funds.” Auditor Howle determined that the Department of Tax and Fee Administration (CDTFA) did not ensure the accuracy of the tax rate it imposed on certain tobacco products, resulting in $6.3 million in lost revenue during fiscal year 2018-19. Specifically, CDTFA only included premium-priced cigarettes in its calculation of the wholesale cost of cigarettes and it used an unsupported and higher-than-warranted wholesale markup rate on specified products.

The report also determined that a series of state agencies that received Proposition 56 funds have not consistently used them for the intended purposes, including grant awards for activities that did not comply with funding requirements. The Department of Health Care Services (DHCS), for instance, awarded tens of millions of dollars to repay student loans for physicians and dentists who provide services through Medi-Cal but did not sufficiently prioritize physicians and dentists located in areas that are underserved. Four of the six state agencies that receive Proposition 56 funding were also found to have failed to adequately disclose the amount of funds they received or how they used those funds.

The State Auditor outlines a series of recommendations for state agencies, including DHCS and the California Department of Public Health (CDPH). DHCS is recommended to ensure that it awards funds to applicants who address the need for providers in health professional shortage areas. DHCS and CDPH are also recommended to publish online specified information relative to Proposition 56 funding and expenditures.

The full State Auditor report is available here.

Children’s County Scorecard to be Released on January 26

Children Now is set to release the California County Scorecard of Children’s Well-Being on January 26. The report will include 39 data sets and will be broken out by race and ethnicity, where applicable. Children Now additionally will be offering scorecard technical assistance webinars and trainings following the release of the report.

Children Now will also be holding a kickoff webinar on February 3 from 2:00 pm to 3:00 pm, and additional information is expected to be forthcoming.