July 23, 2021 Edition
This week, during a statewide tour, Governor Gavin Newsom signed into law a series of budget trailer bills on several notable topics. These budget trailer bills provide the key funding and implementation details associated with investments included in the state’s FY 2021-22 Budget Act. Below, we highlight several of the actions from this week:
Governor Newsom on Monday in Sonoma County signed into law AB 140 which comprises the largest housing and homelessness investment in the state’s history. The package includes $10.3 billion for affordable housing development and $12 billion over two years to address homelessness throughout the state. Included in the homelessness funding is $5.8 billion to support 42,000 housing units through Homekey, as well as $2 billion in aid to local governments through the state’s Homeless Housing, Assistance, and Prevention grant program (HHAP). Additional information on the Administration’s housing and homelessness investments is available here.
On Tuesday in Tulare County, Governor Newsom visited a rural elementary school to sign into law SB 156 to provide a multi-year $6 billion investment in expanding access to broadband internet service. The significant investment includes $3.25 billion to build, operate, and maintain an open access, state-owned middle mile network, $2 billion to establish last-mile broadband connections, and $750 million for a loan loss reserve fund to secure financing for broadband infrastructure among local governments. Additional information on the state’s broadband activities is available here.
Natural Resources –
The Governor on Thursday toured the Folsom Lake Reservoir in Placer County with Federal Emergency Management Agency (FEMA) Administrator Deanna Criswell to assess the significant impacts of climate change. During the visit, Governor Newsom signed into law AB 148, the state’s budget trailer bill on natural resources. The measure expedites the response to severe drought conditions statewide, details guidelines for the state’s program to pay for past-due utility bills, increase oversight of the state’s critical infrastructure, and protect the environment from further climate threats. Additional information on the state’s natural resources activities is available here.
The Governor additionally signed budget legislation related to retail theft and the state’s film and television industry this week.
As a reminder, the California Legislature remains on its month-long summer recess. Legislators will return to Sacramento on August 16, at which point CHEAC will continue publication of the CHEAC Weekly Bill Chart.
The California Department of Public Health (CDPH) continues to promote COVID-19 vaccinations statewide amid increases in cases and hospitalizations, as well as increasing presence of COVID-19 virus variants. CDPH continues to focus on vaccinating the remaining population and maintaining vaccine accessibility through data-driven approaches that prioritize communities disproportionately impacted by the pandemic. Communication and outreach efforts have become more targeted, and CDPH notes ZIP codes with low rates of vaccination and communities experiencing outbreaks will drive efforts through public education, provider programs, and community events.
CDPH reported the state’s vaccination progress since launching the “Vax for the Win” incentive program as the state this week completed awarding all $50 incentive cash and grocery cards. According to CDPH, Vax for the Win helped improved vaccination rates in California’s hardest-hit communities and successfully reached Latino communities more than any other group.
To further support COVID-19 vaccine providers, CDPH has launched the $40 million CalVaxGrant program. The grant program will partially reimburse physician practices up to $55,000 to establish their offices as small, community-based vaccination sites. The funding can be used to offset expenses, including staffing, training, technology, infrastructure, supplies and equipment, and administrative overhead. Small practice providers with up to 200 physicians are eligible to apply. Additional information on the state’s grant program is available here.
CDPH also announced this week that partnerships with approximately 480 community-based organizations (CBOs) will be extended and expanded upon through the end of the calendar year to continue their critical work in connecting residents with vaccine information and providing direct appointment assistance.
Additional information from CDPH is available here.
This week, the State of California and Blue Shield of California announced a joint agreement for Blue Shield of California to transition out of its role as the state’s third-party administrator (TPA) for COVID-19 vaccine allocation and distribution activities. Recall, the Newsom Administration in January 2021 announced the selection of Blue Shield of California as the TPA, along with sweeping changes for COVID-19 vaccine allocation and distribution activities.
Blue Shield has now transitioned to an as-needed advisory role for the state, and the California Department of Public Health (CDPH) will resume day-to-day operations and oversight of California’s COVID-19 Vaccine Program. Minor programmatic implications are anticipated as part of the transition back to CDPH.
Additional information from Blue Shield of California is available here.
On Monday, the U.S. Government Accountability Office (GAO), the federal government’s watchdog agency, issued a nearly 500-page report on the federal government’s ongoing response to the COVID-19 pandemic. The GAO report outlines a series of recommendations intended to bring an end to the pandemic and strengthen national preparedness for future health emergencies.
The report emphasizes the importance of the federal government’s vaccination efforts as demographic disparities in vaccination rates persist and per-day vaccination rates decline. The GAO sets forth 15 recommendations, in addition to previously issued recommendations, related to testing and surveillance activities, relief funding for state and local agencies, and government agency communications. A section of the GAO report focuses on medical technologies, including laboratory testing and sequencing, domestic medical supply sources, and the Strategic National Stockpile (SNS).
The full GAO report is available here.
A bipartisan coalition of state attorneys general this week announced it has reached a national agreement for a $26 billion settlement with prescription drug manufacturers and distributors for their role in the opioid epidemic. The tentative agreement with the four companies, Johnson & Johnson, AmerisourceBergen, Cardinal Health, and McKesson, would establish the framework for significant nationwide investments in addiction treatment, prevention services, and other related expenses incurred in responding to the opioid epidemic. State negotiations were led by attorneys general of North Carolina and Tennessee, with involvement from California, Colorado, Connecticut, Delaware, Florida, Georgia, Louisiana, Massachusetts, New York, Ohio, Pennsylvania, and Texas.
In the case, Johnson & Johnson is accused of downplaying the addictive nature of opioid drugs to patients and providers, whereas the distributor companies are accused of not adequately tracking opioid prescription drug shipments, ostensibly flooding certain communities with opioid prescription drugs.
Under the agreement reached this week, the pharmaceutical companies would not acknowledge any wrongdoing in the epidemic. The three distributor companies (AmerisourceBergen, Cardinal Health, and McKesson) would make payments totaling $21 billion over 18 years. Johnson & Johnson would then pay $5 billion over nine years. One of the primary features of the agreement is that distributors would create a new system to track and report one another’s drug shipments. Johnson & Johnson would be prohibited from selling opioids for 10 years and would be subject to other related restrictions.
Total funding to be distributed will be determined by the overall degree of participation by litigating and non-litigating state and local governments. A formula has been developed to account for the number of opioid deaths, the number of residents with a substance use disorder, and the number of opioids prescribed. As part of the proposed settlement, California stands to receive a maximum of $2.34 billion if all California local governments join the agreement.
For the agreement to be finalized, however, states will have 30 days to review the agreement offers and structure, including how much funds each state would receive. Local governments will have 150 days to sign off on the agreement. It remains unclear how many states would need to agree to the settlement for the deal to be made final; if not enough states agree, the companies could retract the offer and continue litigation. The tentative settlement announced this week would resolve opioid-related claims of both states and local governments across the country.
Governor Gavin Newsom, following the announced agreement, issued a statement highlighting the impacts of the opioid epidemic on the state and acknowledging the opportunity to expand opioid prevention and treatment resources under the agreement framework. Additional information on the proposed settlement from California Attorney General Rob Bonta is available here.
The California Department of Health Care Services (DHCS) last month convened a webinar for providers and interested stakeholders to learn about the forthcoming policy changes associated with Medi-Cal Managed Care and the state’s sweeping California Advancing and Innovating Medi-Cal (CalAIM) Initiative. The webinar provided background on Medi-Cal, CalAIM components, Enhanced Care Management (ECM) and In Lieu of Services (ILOS), and opportunities for counties and providers to deliver health and social services to Medi-Cal beneficiaries.
A recording of the webinar is available here. Presentation materials from the webinar are available here.
This week, the U.S. Department of Health and Human Services (HHS), through the U.S. Centers for Medicare and Medicaid Services (CMS), issued an informational bulletin to states’ Medicaid and Children’s Health Insurance Program (CHIP) agencies reaffirming that the 2019 Public Charge Rule “Inadmissibility on Public Charge Grounds” is no longer in effect. CMS directs states to encourage eligible immigrant populations to access public benefits related to health and housing without fear of the final rule established by the Trump Administration.
Recall, the finalized public charge rule required individuals applying for or seeking adjustment to an immigration status or visa to establish that they were not likely at any time to rely on specified public benefits. Earlier this year, the Biden-Harris Administration announced it would abandon the rule and return to 1999 guidance on public charge inadmissibility which does not take into account use of specified public benefits, including Medicaid.
The full public charge informational bulletin from CMS is available here.
This week, the U.S. Centers for Disease Control and Prevention (CDC) issued a provisional report of life expectancy in the U.S., finding overall life expectancy dropped by more than a year and one half from 78.8 years of age in 2019 to 77.3 years of age in 2020. The decline in life expectancy is the greatest drop since World War II, and life expectancy is the lowest it has been since 2003.
According to the CDC, the decline in life expectancy is largely attributed to the COVID-19 pandemic and unintentional injuries. Racial and ethnic disparities in life expectancy declines were realized, with Hispanic Americans (3.0 years) and African Americans (2.9 years) realizing the greatest declines. White Americans experienced the smallest decline of 1.2 years.
The full CDC report is available here.
Between January 1, 2020, and September 30, 2020, the state’s ACEs Aware initiative reported new data details on the number of adverse childhood experience (ACE) screenings conducted by health care providers statewide. According to the released data, more than 17,100 providers have completed the training and are ACEs Aware-certified, including about 9,700 Medi-Cal Providers in California who are eligible to receive Medi-Cal payment for conducting ACE screenings. Medi-Cal providers conducted 315,000 ACEs screenings among approximately 264,000 unique Medi-Cal beneficiaries.
Trauma-informed networks of care supported by the state’s ACEs Aware initiative are bringing together health care providers, clinics, community-based organizations, and social services agencies to support children, adults, and families in effectively mitigating the impact of ACEs and toxic stress.
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