July 9, 2021 Edition
The California State Senate and Assembly this week continued with a steady pace of budget actions and policy matters. Legislators face a deadline of next Wednesday, July 14 for policy committees to hear and report bills in their opposite house, and the Legislature’s month-long summer recess is set to begin upon adjournment of session on Thursday, July 15.
In line with the unprecedented budget process this year, the Legislature acted on a handful of budget trailer bills and continue negotiations on a handful of other major investment areas. The Senate Budget & Fiscal Review Committee and the Assembly Budget Committee this week convened hearings to review education and higher education funding packages, as well as technical amendments to the 2021 Budget Act that was passed last week. These technical amendments include additional funding for wildfire prevention and response and county elections costs for administering the gubernatorial recall set for September 14. The Legislature has yet to act on the health budget trailer bill (AB 133/SB 133), among other subject areas. CHEAC will continue to keep Members apprised of relevant budget developments.
Also of news this week, the California State Capitol reinstated its mask mandate following reports of nine COVID-19 cases among Capitol employees, including four who are fully vaccinated. Lawmakers and staff in the Capitol, Legislative Office Building, and legislators’ district offices will be required to wear a mask regardless of vaccination status, and unvaccinated lawmakers and staff must be tested twice per week. It was only weeks ago that the Capitol began to allow fully vaccinated persons to remove their masks while working in their offices.
Below, we highlight several actions on legislative measures of interest to CHEAC Members. For a full update, the latest edition of the CHEAC Weekly Bill Chart is available here.
Public Health Infrastructure
AB 240 (Rodriguez) as amended June 21, 2021 – SPONSOR
AB 240 by Assembly Member Freddie Rodriguez, CHEAC’s sponsored measure, was heard in the Senate Appropriations Committee this week where it was referred to the Suspense File for action at a later date. The measure would require the California Department of Public Health (CDPH) to contract with an appropriate and qualified entity to conduct an evaluation of the adequacy of the local health department infrastructure and make recommendations for future staffing, workforce, and resource needs. CHEAC is joined by HOAC, SEIU California, UCC, RCRC, and Public Health Advocates.
Communicable Disease Control
SB 306 (Pan) as amended June 23, 2021 – SUPPORT
Senator Richard Pan’s SB 306 was heard this week in the Assembly Business and Professions Committee. This measure would expand access to various services addressing sexually transmitted diseases (STDs), including provisions allowing pharmacists to provide expedited partner treatment (EPT) for STDs, requiring private and public health insurance coverage to cover home STD kits, adding EPT treatment liability protections for health care providers when diagnosing and treating STDs, requiring specified health care professionals to provide syphilis screening and testing, allowing HIV counselors to perform rapid STD tests, and allowing Family PACT program reimbursements for STD-related services to uninsured individuals, income-eligible patients, or insured patients with confidentiality concerns. SB 306 was advanced from the Assembly Business and Profession Committee on a 16-2 vote with one member not voting and now heads to the Assembly Appropriations Committee.
AB 263 (Arambula) as amended April 15, 2021 – SUPPORT
AB 263, authored by Assembly Member Joaquin Arambula, was advanced out of Senate Judiciary Committee on an 11-0 vote. The measure would require all local and state public health orders and occupational safety and health measures to be complied by private detention facility operator. CHEAC is joined by HOAC is supporting the measure, which is now on the Senate Floor.
Today, the U.S. Centers for Disease Control and Prevention (CDC) issued updated guidance for COVID-19 prevention in K-12 schools nationwide. The long-anticipated guidance will inform education planning activities ahead of this coming fall, and the CDC’s updated guidance prioritizes returning students to in-person instruction.
Under the updated guidance, the CDC encourages a multi-layer strategy for preventing COVID-19 transmission in school settings. Per the CDC, masks should be worn indoors by all individuals ages two and older who are not fully vaccinated. The CDC also recommends schools maintain at least three feet of physical distance between students within classrooms, combined with indoor mask wearing by unvaccinated individuals, to reduce transmission risk. The updated guidance also provides information on screening testing, ventilation, handwashing and respiratory etiquette, and isolation and quarantine recommendations. The CDC also indicates localities should monitor community transmission, vaccination coverage, screening testing, and occurrence of outbreaks to guide decisions on the level of layered prevention strategies.
Shortly after the release of the CDC guidance, the California Department of Public Health (CDPH) issued a statement indicating California shares the CDC’s priority for in-person instruction for students, as well as the use of multiple mitigation strategies. CDPH acknowledges that requiring physical distancing of is not feasible for many of California’s school facilities due to space constraints. As such, CDPH will take a similar approach to the CDC by recommending multiple prevention strategies and layers, including continuing to require that masks be worn indoors in school settings regardless of vaccination status and making available testing resources at no costs to schools. CDPH is anticipated to release its updated school guidance in full on Monday, July 12.
The full CDC schools guidance is available here.
This week, COVID-19 vaccine manufacturer Pfizer and BioNTech released an update on the firms’ COVID-19 booster vaccine strategy, indicating continued booster trials have provided additional protection against the COVID-19 virus, particularly amid increased presence of virus variants. Pfizer and BioNTech point to recent studies regarding vaccine efficacy six- and 12-months post-vaccination and suggest a third dose may be needed to maintain protection against COVID-19. During media appearances this week, Pfizer representatives also indicated they intend to pursue an emergency use authorization (EUA) amendment request for the third booster shot of their vaccine.
Shortly after the companies’ announcement regarding booster vaccines, the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) issued a joint statement indicating vaccines used in the U.S. continue to be highly effective against COVID-19 and there is no need for a booster shot at this time. The CDC, FDA, and National Institutes of Health (NIH) continue a science-based process to consider whether or when a COVID-19 booster dose may be necessary. The federal government commits to keeping the American public informed of any further developments on COVID-19 vaccine booster shots.
The CDC and FDA statement regarding the vaccines’ efficacy underscores recent data released by the California Department of Public Health (CDPH) finding that out of over 20 million vaccinated Californians, only 0.003 percent (584 people) contracted COVID-19 and required hospitalization. CDPH similarly finds the vaccines are overwhelmingly safe and encourages all state residents to receive their vaccine.
California State Auditor Elaine Howle this week issued Report 2020-613 following the state’s high-risk audit of the California Department of Health Care Services’ (DHCS) management of federal funds that began last year. Recall, Auditor Howle last year identified the significant amount of funds to be received by state agencies and departments to be a “high-risk statewide issue,” authorizing her office to undertake specified actions to prevent adverse outcomes among state agencies and departments.
Given the significant influx of resources in the state’s Medi-Cal program as a result of the COVID-19 pandemic, Auditor Howle sought to assess DHCS’ administration and management of the Medi-Cal program. According to the State Auditor’s Office, DHCS “is not doing enough – not withstanding the [COVID-19] emergency – to resolve eligibility questions about Medi-Cal beneficiaries and avoid federal financial penalties” associated with beneficiaries that should not be enrolled in Medi-Cal.
While Auditor Howle identified many actions appropriately implemented by DHCS during the COVID-19 emergency, including communicating with stakeholders about applicable COVID-19-related Medi-Cal program changes, she expressed concerns that DHCS has halted its efforts to resolve hundreds of thousands of known Medi-Cal eligibility discrepancies that indicate some beneficiaries may no long meet Medi-Cal eligibility criteria. Many of the discrepancies identified by the State Auditor were issues highlighted in previous State Auditor reports and existed before the COVID-19 emergency. Over the past year, the number of Medi-Cal beneficiaries with questionable or undetermined eligibility has grown by 22 percent. Notably, the Auditor Howle indicates this eligibility issue has cost California tens of millions of dollars in federal reimbursements, and the risk that the state will have to pay future financial penalties to the federal government “continues to grow unabated.”
The State Auditor outlines the following recommendations for DHCS:
- To reduce inappropriate payments to health care providers and ensure that eligible individuals have access to care, DHCS should by August 2021:
- Begin monitoring instances of individuals identified as eligible for Medi-Cal in a county data system but not the state data system.
- Instruct counties to resume overdue processing of applications for beneficiaries awaiting final eligibility determinations.
- Expand planning efforts to address all high-risk eligibility discrepancies.
- Resume monitoring counties’ progress in resolving high-risk eligibility discrepancies.
- To ensure it is addressing weaknesses in counties’ processes for making eligibility redeterminations, DHCS should:
- Review data collected during the focus reviews it conducted in recent years to identify areas in which further county guidance is needed; by September 2021, DHCS should advise counties of improvements they must make to their redetermination process.
- Resume its focus reviews within four months of the end of the public health emergency.
In its response to the State Auditor report, DHCS agreed with all recommendations set forth by Auditor Howle. However, DHCS timelines for resolving issued flagged by the auditor are longer than recommended by the State Auditor’s Office, leading Auditor Howle to express concerns with the length of time DHCS plans to take to correct issues.
The full State Auditor report is available here.
Governor Gavin Newsom, speaking from San Luis Obispo County on Thursday, announced his Administration has added nine counties to the regional drought state of emergency and called on state residents to voluntarily reduce their water use by 15 percent compared to 2020 levels. Recall, Governor Newsom earlier this spring issued a regional drought emergency for 41 counties amid historically low water levels throughout the state.
This week’s addition of nine counties – Inyo, Marin, Mono, Monterey, San Luis Obispo, San Mateo, Santa Barbara, Santa Clara, and Santa Cruz – to the state’s emergency brings the total to 50 of the state’s 58 counties under the drought state of emergency. According to the Newsom Administration, the expansion of the emergency will enable state agencies to support drought response more quickly and effectively through actions such as expediting purchasing and contracting to complete projects that shore up water supplies.
Additional information from the Governor’s Office is available here.
This week, Governor Gavin Newsom launched a statewide day of action to highlight his Administration’s $1.1 billion initiative to revitalize California’s streets and public spaces through litter abatement and local beautification projects.
Entitled “Clean California,” the initiative is anticipated to expand existing state and local litter abatement efforts and generate an estimated 10,000 to 11,000 jobs over three years, including for people exiting homelessness, at-risk youth, veterans, those reentering communities from incarceration, local artists, and students. The statewide program will include potential projects in all 58 counties with nearly one-third of the funds being directly invested into local governments to clean and enhance local streets and public spaces.
California will award $296 million in matching grants for projects on local streets and roads, tribal lands, parks, and pathways and transit centers in underserved communities. The initiative additionally includes funding for a public education campaign to foster a sense of shared responsibility for litter prevention to protect the environment, public safety, and health.
More information is available here.
According to the U.S. Centers for Disease Control and Prevention’s (CDC) latest Annual Report to the Nation on the Status of Cancer, overall cancer death rates continue to decline in men and women for all racial and ethnic groups in the United States. During 2001 to 2018, declines in lung cancer death rates accelerated, and death rates for melanoma declined considerably in more recent years. However, the report finds that for several other major cancers, including prostate, colorectal, and female breast cancers, previous declining trends in death rates slowed or disappeared. Also, overall cancer incidence rates continue to increase among females, children, and adolescents and young adults.
In its report, the CDC finds a decrease in death rates for 11 of the 19 most common cancers among men, and for the 14 or the 20 most common cancers among women over the most recent period (2014-2018). Also of interest, overall cancer incidence rates were higher among men than women in every racial and ethnic group, except Asian/Pacific Islander populations. Overall cancer incidence rates were slightly lower among Black people than White people, but the overall cancer death rate was higher among Black people than White people.
Authors of the report indicate the findings could informed health care providers about the need to increase efforts related to cancer prevention, early detection, and treatment, and for the need for equitable implementation of effective cancer interventions, especially among under-resourced populations.
The report was collaboratively produced between the CDC, American Cancer Society (ACS), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACR).
Additional information is available here.
The California Department of Public Health (CDPH) will hold a webinar entitled, “Suicide in California – Data Trends in 2020, COVID Impact, and Prevention Strategies.” The webinar will be held on Wednesday, July 28 from 1:00 pm to 2:30pm. The webinar will cover data and more detailed information at how self-harm is experienced differently by age, race/ethnicity, and/or sex, as well as current CDPH violence prevention programs. Furthermore, speakers will address results from a study about violence Californians have experienced in the past year, including COVID-19 impacts, economic hardships, and health (including suicidality and gun purchases).
Please click here to register if interested.
The California Department of Public Health (CDPH) on August 6, 2021 from 11:00 am to 12:00 pm will host a webinar to highlight the recent campaign by the U.S. Centers for Disease Control and Prevention (CDC) to prevent injuries among older adults. CDC’s Still Going Strong campaign is targeted directly toward older adults and their caregivers. The campaign aims to educate about common risk factors for falls and motor vehicle crashes, as well as empower older adults and their caregivers to take simple steps to help older adults maintain independence and age without injury.
Registration and additional information are available here.