June 14, 2019 Edition

Budget Conference Committee Strikes Deal, Legislature Passes 2019-20 Budget Act

This past week was filled with a flurry of activity aimed at reaching a budget agreement and passing the 2019-20 budget by the June 15 constitutional deadline.

Budget Conference Committee. On Sunday evening, the Budget Conference Committee completed their work to reconcile differences between the Senate and Assembly budget plans. CHEAC captured key actions taken by the Conference Committee this chart. Also, of interest, the Conference Committee deferred action on the renaming and refocusing of the Council on Health Care Delivery Systems approved in the 2018 Budget Act to the Healthy California for All Commission. Under the Governor’s proposal, the focus of the commission would be shifted to evaluating options to transition into a single-payer health care financing system. While originally approved by the Senate, the Assembly did not take action.

Legislature Passes the 2019 Budget Act. Yesterday, the Legislature passed the 2019-20 budget bill (AB 74), a $214.8 billion expenditure plan for the upcoming fiscal year. However, with the devil in the details, the Legislature did not act on any accompanying budget trailer bills. In fact, several trailer bills – such as the Health Omnibus trailer bill – are not yet in print. The Legislature will begin voting on trailer bills as early as next week, once bills meet the 72-hour in-print rule.

We are pleased that the final budget agreement includes several key public health investments, including $40 million one-time General Fund for infectious diseases, increased funding for the Black Infant Health Program and California Home Visiting Program, and funding to address STDs, HIV, and Hepatitis C. In addition, the budget agreement protects local health department funding at risk earlier in the budget year through the proposed increase to AB 85 diversions.

CHEAC provides a high-level summary of the final budget agreement in our CHEAC Budget Memo. As additional details become available through budget trailer bill actions, CHEAC will provide updates.

Legislature Continues Bill Hearings in Second House, Faces Busy Month Ahead

This week, the California Legislature held a number of policy committee hearings on bills in their second house. In what is shaping up to be a very busy month ahead, the Assembly and Senate continued setting bills for hearings in their policy committees ahead of the July 10 deadline for fiscal bills and July 12 deadline for non-fiscal bills.

Two new members were sworn into the California State Senate on Tuesday, bringing the Senate to its full 40-member capacity. Senator Lena Gonzalez (D-Long Beach) took the seat vacated by Ricardo Lara who was elected State Insurance Commissioner and Senator Brian Dahle (R-Bieber) took the seat vacated by Ted Gaines who was elected to the Board of Equalization. Gonzalez was previously a Long Beach City Councilmember, and Dahle was previously an Assembly Member since 2012 and a Lassen County Supervisor for 16 years prior to that time.

With the seating of the two new Senators, Senate President pro Tempore Toni Atkins yesterday announced several changes to Senate committee membership assignments. Of note:

  • Senator Maria Elena Durazo (D-Los Angeles) will fill a vacancy on the Senate Appropriations Committee (effective June 17)
  • Senator Lena Gonzalez will replace Senator Maria Elena Durazo on both the Senate Health Committee and Joint Legislative Audit Committee (effective June 17)
  • Senator Brian Dahle will replace Senator Mike Morrell (R-Rancho Cucamonga) and Senator Anna Caballero (D-Salinas) will replace Senator Maria Elena Durazo on the Senate Budget & Fiscal Review Committee (effective July 1)

Below, we highlight a few of this week’s actions of interest to CHEAC Members. For a full update, the CHEAC Weekly Update is available here.


AB 228 (Aguiar-Curry) as amended June 3, 2019 – WATCH

AB 228 by Assembly Member Cecilia Aguiar-Curry was heard in the Senate Health Committee on Wednesday. The measure would add statutory language declaring a food, beverage, or cosmetic is not adulterated if it includes industrial hemp products, including cannabidiol (CBD), extracts, or derivatives from industrial hemp. The definition of industrial hemp would be specified in statute to include a cosmetic, food, food additive, dietary supplement, or herb for human or animal consumption that contains no more than 0.3 percent tetrahydrocannabidiol (THC).

Further, MAUCRSA licensees would be authorized to manufacture, distribute, or sell products that contain industrial hemp, and any product containing industrial hemp would be required to bear a specified warning label. Wholesale food manufacturers that make any products containing industrial hemp must be able to demonstrate that the hemp comes from a state or country with an approved inspection or regulatory program, and the manufacturer must also be in compliance with existing Sherman Food, Drug, and Cosmetic Law. AB 228 was advanced to the Senate Business, Professions, and Economic Development Committee on an 8-0 vote with one member not voting.  

Communicable Disease Control

SB 276 (Pan) as amended May 17, 2019 – SUPPORT

Senator Richard Pan’s SB 276 would require physicians to submit a statewide standardized immunization medical exemption request form and require the state public health officer or designee to approve or deny the request upon determining sufficient medical evidence that the immunization is contraindicated utilizing guidance from the U.S. Centers for Disease Control and Prevention (CDC). The California Department of Public Health (CDPH) would be required to create and maintain a database of approved medical exemption requests and make available the database to local health officers. The state public health officer and local public health officers would be authorized to revoke a medical exemption if it is determined that the exemption is fraudulent or inconsistent with CDC guidelines. SB 276 has been set for hearing in the Assembly Health Committee next Thursday, June 20.

Health Coverage/Health Care Reform

AB 848 (Gray) as revised May 16, 2019 – SUPPORT

AB 848 by Assembly Member Adam Gray would add continuous glucose monitors and related supplies to the schedule of Medi-Cal benefits for diabetes mellitus treatment when medically necessary, subject to utilization controls. AB 848 was heard in the Senate Health Committee on Wednesday and advanced to the Senate Appropriations Committee on a unanimous 9-0 vote.

Newsom Issues Executive Order on Statewide Master Plan for Aging, Solicits Stakeholder Involvement for Advisory Committee

On Monday, Governor Gavin Newsom issued Executive Order N-14-19 calling for the development of a statewide Master Plan on Aging by October 1, 2020. Citing figures showing that California’s over-65 population is set to grow to 8.6 million by 2030, Governor Newsom indicates the Master Plan will serve as a blueprint to be used by state government, local communities, private organizations, and philanthropic entities to build environments that promote healthy aging.

The executive order directs the secretary of the California Health and Human Services Agency (CHHS) to convene a cabinet-level Workgroup for Aging to advise the secretary in the development and issuance of the Master Plan. Additionally, CHHS and other state-level partners will convene a Master Plan for Aging Stakeholder Advisory Committee, which will include a Research Subcommittee and a Long-Term Care Subcommittee. Subcommittees are expected to include older Californians, adults with disabilities, local government representatives, health care providers, health plans, employers, community-based organizations, foundations, academic researchers, and organized labor.

According to the Newsom Administration, this workgroup’s focus is expected to go beyond the health and human services area and into other areas such as transportation and housing. The Master Plan will explore issues beyond public programs and consider older Californians that do not utilize or have access to public programs and services the state administers.

On Wednesday, CHHS convened a stakeholder call to discuss the executive order and Administration’s efforts related to the Master Plan. Included in the discussion was the stakeholder advisory committee and the Administration’s intent to ensure the group is racially and culturally diverse and includes representatives from a wide array of jurisdictions. We encourage CHEAC Members interested in participating in the Master Plan for Aging Stakeholder Advisory Committee to send an email to admin@cheac.org by Friday, June 21. CHEAC will then forward information of interested parties for vetting by CHHS. 

2019 Advancing Health Equity Award Applications Now Available, Due August 4

The Committee for California’s Health (formerly the Health Equity Awards Planning Committee) recently announced its third cycle of the California Advancing Health Equity Awards and accompanying workshop. These awards are designed to honor innovative local health departments and uplift strategies that build power to advance health equity for all Californians.

All California local health departments are encouraged to apply. Applications are now open and are due no later than Sunday, August 4, 2019. An informational applicant webinar will be held on Monday, June 17 from 2:00 pm to 3:00 pm and will detail the award purpose, guidelines, and application process; webinar registration is available here.

An awards ceremony will be held on December 3, 2019, in Oakland, and a special invitation will be extended to California LHDs to join the accompanying Advancing Health Equity Workshop that will be held December 3 and 4.

TFAH Releases Issue Brief Detailing Alcohol, Drug, and Suicide Trends Among Millennial Generation

The Trust for America’s Health (TFAH) this week released an issue brief as part of its continuation of Pain in the Nation: The Drug, Alcohol, and Suicide Crises series. In 2017, more than 152,000 Americans died from alcohol- and drug-induced fatalities and suicide, the highest number ever recoded and more than twice as many as in 1999. While these deaths have affected all age groups and communities, the impact on individuals in their 20s and early 30s has been particularly pronounced, according to the latest TFAH report.

Notably, the number of drug deaths among young adults has increased by 400 percent during the last two decades, largely fueled by the ongoing opioid crisis. Drug deaths accounted for nearly seven deaths per 100,000 people nationally across all age groups in 1999. By 2017, that number increased to 22.7 deaths per 100,000 across all age groups. For young adults ages 18-34 in 2017, there were nearly 31 drug-overdose deaths per 100,000 people. Alcohol death rates for young adults increased 69 percent between 2007 and 2017, and suicide deaths for the same age group and same years increased 35 percent.

The TFAH report details the combination of challenges unique to the Millennial Generation, including the opioid crisis, skyrocketing costs of education and housing, and entering the workforce during the Great Recession. The report goes on to discuss the urgent need for evidence-based policies and programs, including a National Resilience Strategy, to help stem the national tidal wave of deaths of despair. The full TFAH report is available here.