June 11, 2021 Edition

Budget Negotiations Continue, Legislature Prepares Budget Bill

In what has been a relatively quiet week in Sacramento on the budget front, closed-door negotiations remain ongoing between the Newsom Administration and legislative leaders on the state’s FY 2021-22 budget. Recall, last week, the California State Senate and Assembly announced agreement between the two houses on a unified legislative budget package, setting up the negotiation process with the Newsom Administration.

The Legislature, facing a June 15 constitutional deadline to pass a budget bill, has prepared AB 128 (Ting) and SB 128 (Skinner) which reflect the legislative budget framework agreed to by both houses. The measure was placed into print at 9:00 pm on Thursday, allowing the Legislature to take up the measures for a vote on Monday, June 14 in compliance with the state’s 72-hour in-print rule. Notably, the legislature’s budget bills include funding to cover local costs of the recall election against Governor Newsom which is estimated by the Department of Finance (DOF) to cost in upwards of $215 million.

While a deal between the Legislature and Newsom Administration remains elusive, the Legislature is prepared to pass a budget bill consistent with the constitutional deadline of June 15. It is possible that the Legislature will pass its version of the budget while negotiations continue with the Administration beyond the June 15 deadline. In many areas, specific funding and implementation details, including trailer bill language, are anticipated to be finalized over the coming months.

CHEAC continues to closely monitor budget developments as the Newsom Administration and legislative leaders continue to hammer out details. Any relevant updates, including on CHEAC’s sponsored request for public health infrastructure and workforce investments, will be shared with CHEAC Members.

Policy Committees Resume Hearings, CHEAC Measure to be Heard Next Week

Following the California Legislature’s floor only sessions and house of origin deadline last week, the Senate and Assembly this week resumed policy committee hearings to begin review of bills from the opposite house. Policy committees will have just over one month to meet and report bills, next facing a deadline of July 14 to advance bills along the legislative process. Looking ahead, the Legislature will take a one-month summer recess beginning July 16.

CHEAC’s sponsored measure, AB 240 (Rodriguez), will be heard next Wednesday in the Senate Health Committee. Recall, 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 in sponsoring the bill.

Below, we highlight several bills of interest to CHEAC Members. For a full update, the latest edition of the CHEAC Weekly Bill Chart is available here.

California Children’s Services

AB 382 (Kamlager) as amended April 29, 2021 – SUPPORT

AB 382 by Senator Sydney Kamlager would extend the termination of the Department of Health Care Services’ (DHCS) Whole Child Model (WCM) Stakeholder Advisory Group by two years to December 31, 2023. As a result of implementation delays of the WCM initiative, the state’s required evaluation of the initiative is not due to the Legislature until after July 2022. The extension of the advisory group will allow stakeholders, including CHEAC, to advise DHCS on the evaluation, improvements to the WCM initiative, and potential future expansion of WCM. CHEAC is supporting the measure which is sponsored by the California Children’s Hospital Association. AB 382 was advanced from the Senate Health Committee on consent this week and now heads to the Senate Appropriations Committee.

Drug & Alcohol Services

AB 381 (Davies) as amended March 25, 2021 – SUPPORT

Assembly Member Laura Davies’ AB 381 would require adult alcoholism or drug abuse recovery or treatment facilities to administer naloxone hydrochloride and have at least one staff member on premises who knows where facility naloxone hydrochloride is stored and has been trained on the administration of the drug. AB 381 was heard in the Senate Health Committee this week and advanced to the Senate Judiciary Committee on a 10-0 vote with one member not voting.

Health Coverage/Health Care Reform

AB 369 (Kamlager) as revised May 20, 2021 – SUPPORT

Senator Sydney Kamlager’s AB 369 would require the Department of Health Care Services (DHCS) to implement a program of presumptive eligibility for persons experiencing homelessness to the extent federal financial participation is available. The measure would authorize Medi-Cal providers to bill Medi-Cal for services rendered to persons experiencing homelessness off of the premises of a provider’s office, and a person experiencing homelessness would be authorized to receive primary care services and specialty care referrals from any Medi-Cal-enrolled provider. AB 369 will next be heard in the Senate Health Committee, and CHEAC is now supporting the measure.

Maternal, Child, and Adolescent Health Services

SB 65 (Skinner) as amended April 15, 2021 – SUPPORT IF AMENDED

SB 65 by Senator Nancy Skinner would implement a variety of maternal health-related activities and services, including extended Medi-Cal eligibility for postpartum individuals, doula services in Medi-Cal, economic supports for low-income pregnant persons, and nurse midwife training, among other items. Notably, SB 65 establishes the Maternal Morbidity Review Committee within the California Department of Public Health (CDPH) and sets forth additional requirements for jurisdictions related to infant death investigations and reporting. CHEAC has been engaged with the author’s office and sponsors of the measure to address a series of considerations identified by local health departments. This week, CHEAC took a “support if amended” position to ensure adequate funding is provided for local health departments in carrying out the fetal and infant mortality review processes. SB 65 will next be heard in the Assembly Health Committee on June 22.

Newsom Administration, CDPH Prepare to Retire the Blueprint for a Safer Economy

Ahead of the state’s June 15 retirement of the Blueprint for a Safer Economy, Governor Gavin Newsom and the California Department of Public Health (CDPH) took a series of actions to prepare for the state’s full reopening of the economy.

The Governor’s Office today established and timeline and process to continue winding down various provisions of the Governor’s 58 COVID-19-related executive orders, which suspended various statutes and regulations to assist the state and businesses continue operations during the pandemic. To ensure that impacted individuals and entities will have time to prepare for the upcoming changes, the Newsom Administration will sunset executive order provisions in phases, beginning later this month, in July, and in September.

Additionally, CDPH Director and State Public Health Officer Dr. Tomás Aragón today issued a new state public health officer order that goes into effect on June 15. The order replaces previous pandemic-related public health orders with limited requirements related to face coverings and mega events. The order also includes requirements for settings with children and youth pending an anticipated update to K-12 guidance from the U.S. Centers for Disease Control and Prevention.

Governor Newsom’s executive order terminating the state’s stay-at-home order and the Blueprint for a Safer Economy is available here. The Governor’s executive order rolling back other pandemic-related provisions is available here.

CDPH Issues Updated COVID-19 Masking and Testing Guidance

Ahead of the state’s anticipated June 15 retirement of the Blueprint for a Safer Economy, the California Department of Public Health (CDPH) this week issued updated COVID-19 guidance for the use of face coverings and testing requirements.

Masking Guidance

Under the updated face covering guidance which takes effect on June 15, masks are not required for fully vaccinated individuals, except in settings where masks are required for all persons, regardless of vaccination status, including on public transit and transportation facilities, indoors in K-12 schools and other youth settings, health care settings, correctional facilities, and homeless shelters, emergency shelters, and cooling centers.

Businesses, venue operators, and hosts are provided a series of options from CDPH in settings where masks are required only for unvaccinated individuals. These options include providing information to all individuals regarding vaccination requirements and allowing vaccinated individuals to self-attest to their vaccination status, implementing a vaccine verification process to determine whether individuals are required to wear a mask, or requiring all individuals to wear a mask. Notably, CDPH guidance specifies that no person can be preventing from wearing a mask as a condition of participation in an activity or entry into a business.

The updated masking guidance is available here.

Testing Guidance

On Monday, CDPH also issued updated testing guidance which relaxes many requirements for individuals to undergo regular COVID-19 screening testing. Under the updated guidance, fully vaccinated individuals do not need to undergo diagnostic screening testing in non-health care workplace settings, staff in long-term care facilities do not need to undergo diagnostic screening testing if 70 percent of staff and residents are fully vaccinated, and hospital staff do not need to undergo diagnostic screening testing if 70 percent of staff are fully vaccinated.

Generally, diagnostic testing should be considered for all individuals with symptoms or exposure to COVID-19, and health plans are required to pay for testing services pursuant to federal requirements. Local health jurisdictions have the ability to modify these guidelines to account for local conditions or patterns of transmission.

The updated testing guidance is available here.

Cal/OSHA Withdraws Recently Approved COVID-19 ETS, Will Reconsider Next Week

On Wednesday during a special meeting, the Cal/OSHA Occupational Safety and Health Standards Board (OSHSB) backtracked its revised COVID-19 emergency temporary standard (ETS), unanimously voting to rescind the rules adopted last week that would have relaxed many workplace preB cautions against COVID-19. Recall, the standards adopted by the board last week would have still required all employees to wear a mask in a workplace setting if unvaccinated persons were present in the same room. If all persons in the same room are vaccinated, however, masking would not be required.

OSHSB took the steps to rescind the revised ETS following a letter to OSHSB Board Members from CDPH Director and State Public Health Officer Dr. Tomás Aragón describing the state’s updated masking guidance which will take effect on June 15 and not require fully vaccinated persons to wear a mask except in certain settings advised by the U.S. Centers for Disease Control and Prevention (CDC).

With OSHSB’s Wednesday vote to rescind the previously adopted standards, the state will temporarily return to Cal/OSHA’s original November 2020 regulations requiring all employees to physically distance and be masked, regardless of vaccination status, among other requirements. OSHSB is set to reconvene for a meeting next Thursday, June 17 to review a revised ETS proposal from Cal/OSHA staff that better aligns with the state’s updated masking guidance. If approved during the June 17 meeting, the regulations will be sent to the Office of Administrative Law (OAL) for review and could take effect as soon as June 28.

Additional information on the Cal/OSHA developments is available here.

Newsom Conducts Second “Vax for the Win” Drawing

Governor Gavin Newsom today conducted the state’s second “$50,000 Fridays” drawing as part of the “Vax for the Win” incentive program to encourage California residents to receive the COVID-19 vaccine. 15 winners were randomly selected, each winning $50,000, for a total of $750,000 in cash prizes. Today’s winners are from the following counties: Monterey, Sacramento, Alameda, Los Angeles, San Francisco, Fresno, San Diego, San Mateo, Santa Clara, Riverside, Orange, and Kern.

The California Department of Public Health (CDPH) will notify winners of the random drawing over the next couple of days by telephone, text, email, or other contact information. All winners will have the option to accept their cash prize while remaining anonymous or decline the prize altogether.

On Tuesday, Governor Newsom will conduct the grand prize drawing of the incentive program, awarding 10 vaccinated residents $1.5 million each.

Additional information from the Governor’s Office is available here.

Biden-Harris Administration to Donate 500 Million COVID-19 Vaccines to Low-Income Nations

On Thursday, President Joseph R. Biden, Jr. announced the United States will purchase and donate 500 million Pfizer-BioNTech COVID-19 vaccines to 92 low- and lower middle-income countries and the African Union to support the global battle against the COVID-19 pandemic. The vaccines are anticipated to begin shipping in August 2021, and the U.S. will work through COVAX to deliver them. 200 million doses will be delivered by the end of this year and the remaining 300 million will be delivered in the first half of 2022.

Relatedly, the Biden-Harris Administration, in partnership with other G7 and guest countries, outlined a series of global health actions to address the COVID-19 pandemic. In addition to the donation of 500 million COVID-19 vaccines, the U.S. will be providing hundreds of millions of dollars in support of programs that provide assistance to counties and health systems prepare for vaccination efforts around the world, including in Latin America, Asia, and Africa. The U.S. is also assisting with personal protective equipment and emergency medical supplies, global vaccine supply expansions, surge capacity efforts.

The Administration also identified a handful of domestic actions to advance global health security to prevent future biological catastrophes, including by establishing disease surveillance and early warning systems, creating a global health security financing mechanism, and investing in global recovery from COVID-19.

Additional information on the Biden-Harris Administration’s actions are available here.

NASEM to Hold Multi-Part Webinar Series on COVID-19 and Vulnerable Populations

The National Academies of Sciences, Engineering, and Medicine (NASEM) will host a workshop series to exploring issues related to the COVID-19 pandemic and disaster preparedness for special populations on Thursday, June 17, Thursday, July 1, and Thursday, July 15 from 10:00 am to 11:00 am PT. This three-series webinar will discuss planning and response activities for home health workers providing services to individuals with disabilities, the needs of those living with disabilities and older adults, and preparedness considerations for disasters for vulnerable populations.

To register, please click here.

BCC Announces Changes to Cannabis Billboard Regulations

Late last year, the Superior Court of San Luis Obispo ruled that California’s Bureau of Cannabis Control (BCC) exceeded their authority in allowing cannabis advertising on billboards along California highways. The BCC had interpreted provisions of Proposition 64, which legalized cannabis in California, to ban cannabis billboards from being located within a 15-mile radius of the state border on an interstate highway or on a state highway that crossed the California border.

In February, the BCC filed an action with the Office of Administrative Law (OAL) to strike this provision from their regulations, and the OAL approved the petition for removal on May 19, 2021. The change to California’s cannabis billboard advertising provisions became effective that same day. This means that all billboards with cannabis advertising on any highway that crosses the state border (eg: I-5, I-80, or US-101) must be removed.

Updated state cannabis billboard regulations can be found here and the BCC’s justification for the change can be found here

CHCF Issues Report on Medi-Cal Managed Care Plan Procurement

The California Health Care Foundation (CHCF) earlier this month released a brief entitled, “Understand the Basics of Medi-Cal Managed Care Procurement,” detailing the basics of the state’s upcoming procurement process, the scope and goals of the 2021 procurement process, the timeline and specifics of each step of the procurement process, and opportunities for public stakeholders to provide input.

The California Department of Health Care Services (DHCS) has begun its process of re-contracting with all commercial managed care plans statewide to serve Medi-Cal beneficiaries. DHCS has issued a draft request for proposal (RFP) document associated with the procurement, and interested parties have until July 1, 2021, to provide input on the documents.

The full CHCF brief is available here.

ACEs Aware to Hold Webinar on Network of Care Roadmap

ACEs Aware, the state’s collaboration between the Office of the California Surgeon General and the Department of Health Care Services (DHCS), will be hosting a webinar entitled, “The Trauma-Informed Network of Care Roadmap: A Guide for Strengthening Community Relationships,” on Monday, June 28 from 12:00 pm to 1:00 pm. This webinar will discuss the purpose of the Network of Care Roadmap, guidance on key elements to support robust trauma-informed network of care and support the well-being of all, and how to share actionable steps and milestones for providers and community-based organizations to address health impacts of Adverse Childhood Experiences (ACEs) and toxic stress.

For registration information please click here.