June 14, 2019 Edition
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.
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.
Cannabis
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.
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.
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.
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.