June 25, 2021 Edition
The California State Senate and Assembly this week maintained a steady pace of policy committee hearings as legislators approach upcoming bill deadlines and its month-long summer recess, set to begin upon the Legislature’s adjournment on July 16.
Of note this week, Governor Gavin Newsom and legislative leaders today announced a three-party agreement on AB 832 (Chiu) which proposes to extend the state’s current eviction moratorium through September 30, 2021. Under the agreement, the state is anticipated to utilize the more than $5 billion in federal rental assistance to ensure tenants and vulnerable households remained housed. The agreement reached today expands rental assistance, increases reimbursement to 100 percent for past due rent and prospective payments for tenants and landlords, ensures rental assistance dollars remain in California, and uses the judicial process to ensure tenants and landlords have attempted to obtain rental assistance. The Legislature is anticipated to take up the bill for vote next week.
While agreement on a budget deal for the upcoming fiscal year remains elusive, the Governor and legislative leaders are reportedly hammering out final funding details with only days to spare. The California Legislature is anticipated to put into print its “Budget Bill Jr.” today that amends the year’s Budget Act and updates various appropriations for state programs and services pursuant to the anticipated agreement between the Assembly, Senate, and the Governor. CHEAC will continue to keep its Members apprised of relevant budget developments.
Below, we highlight several actions of interest to CHEAC Members. For a full update, the latest edition of the CHEAC Weekly Bill Chart is available here.
Access to Health Services
SB 316 (Eggman) as Introduced February 4, 2021 – SUPPORT
SB 316 by Senator Susan Talamantes Eggman was advanced from Assembly Health Committee to the Assembly Appropriations Committee on consent this week. This measure would authorize Medi-Cal reimbursement for a maximum of two visits on the same day at a single FQHC or RHC location if: 1) after the first visit the patient experiences an illness or injury requiring additional treatment and/or diagnosis 2) the patient has a medical, mental health, or dental visit.
Communicable Disease Control
SB 306 (Pan) as amended June 23, 2021 – SUPPORT
Senator Richard Pan’s SB 306 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 out of Assembly Health Committee on a 12-2 vote with one member not voting and now moves on to the Assembly Business and Professions Committee.
SB 744 (Glazer) as amended June 24, 2021 – OPPOSE UNLESS AMENDED
SB 744, authored by Senator Steve Glazer, would require the California Department of Public Health (CDPH), upon an appropriation by the Legislature, to create a program to provide for the expedited release, during a declared public health emergency, of specified health care data to researchers of specified institutions of higher education. The bill would also require any electronic tool used by a local health officer for reporting communicable disease cases to include the capacity to collect and report data on the type of housing where the patient resides, the number of people in the patient’s household, and occupation and workplace of the patient, and a relevant travel history based on the disease course. SB 744 was advanced from Assembly Health Committee on a 11-0 vote with four members not voting and now moves on to the Assembly Judiciary Committee.
Drug and Alcohol Services
AB 381 (Davies) as amended June 14, 2021 – SUPPORT
AB 381 by Assembly Member Laura Davies would require licensed adult alcoholism or drug abuse recovery or treatment facilities to administer naloxone hydrochloride or any opioid antagonist approved by the U.S. Food and Drug Administration (FDA) for treatment of an opioid overdose. AB 381 was advanced from the Senate Health Committee to the Senate Judiciary Committee on consent this week.
Health Coverage/Health Care Reform
SB 56 (Durazo) as amended June 14, 2021 – SUPPORT
Senator Maria Elena Durazo’s SB 56 was advanced this week out of the Assembly Health Committee to the Assembly Appropriations Committee on an 11-3 vote with one member not voting. SB 56 would expand Medi-Cal coverage to all undocumented adults 60 years of age and older with incomes at or below 138 percent FPL, effective July 2022, subject to appropriation by the Legislature.
Maternal, Child, and Adolescent Health Services
SB 65 (Skinner) as amended June 14, 2021 – SUPPORT IF AMENDED
SB 65, authored by Senator Nancy Skinner, would implement various 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. 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. SB 65 was heard in Assembly Health Committee this week and was passed with a 11-2 vote with two members not voting. The bill will now be heard next week in the Assembly Human Services Committee. CHEAC has taken a “support if amended” position to ensure adequate funding for local health departments in carrying out fetal and infant mortality review (FIMR) activities.
SB 395 (Caballero) as amended May 3, 2021 – SUPPORT
SB 395 by Senator Anna Caballero would impose a 12.5 percent tax on the retail sale of electronic cigarettes in California and allocate tax revenue to Proposition 99, Proposition 10, and Proposition 56 accounts. A portion of the revenues would also be allocated to the Health Careers Opportunity Grant Program. CHEAC is joined by CSAC in supporting this measure, which was passed this week by the Assembly Revenue & Taxation Committee on an 8-1 vote with two members not voting. The bill now moves to the Assembly Health Committee.
On Wednesday, the California Senate Rules Committee held a hearing to consider the Governor’s appointment of Dr. Tomás Aragón as the Director and State Public Health Officer of the California Department of Public Health (CDPH). During the hearing, Dr. Aragón discussed his background and qualifications for the position, areas of prioritization for CDPH, and his vision for and approach to improving the health of all state residents.
Committee members had the opportunity to ask questions of Dr. Aragón, which included topics such as public health infrastructure and funding, epidemiological surveillance capacities, engagement with local health departments (LHDs), sexually transmitted diseases (STDs), opioid misuse, COVID-19 response activities, and emergency preparedness. Senators applauded Dr. Aragón for stepping into the role amid the COVID-19 pandemic and spoke highly of his qualifications, professionalism, and collaborative approach.
The Senate Rules Committee unanimously advanced the appointment of Dr. Aragón as CDPH Director and State Public Health Officer on a 5-0 vote. The full Senate will consider confirming Dr. Aragón to his position in the coming weeks.
A video recording of the Senate Rules Committee hearing is available here.
On Thursday, U.S. Centers for Disease Control and Prevention (CDC) Director Dr. Rochelle Walensky issued an extension of the nationwide eviction moratorium, preventing the eviction of residential tenants who are unable to make rental payments. Recall, the CDC last fall issued the nationwide eviction moratorium as a way to keep people in their homes and out of congregate settings, such as homeless shelters, to prevent the spread of the COVID-19 virus.
The nationwide moratorium was initially set to expire on June 30, 2021. With Thursday’s 30-day extension, the moratorium will now last through July 31, 2021. According to the CDC, Thursday’s extension is intended to be the final extension of the eviction moratorium.
The full CDC order is available here.
A new report released by the U.S. Centers for Medicare & Medicaid Services (CMS) earlier this week unveiled a record high number of Americans enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) within the past year. Over 80 million Americans now have health insurance coverage through Medicaid and CHIP, and nearly 10 million residents enrolled in coverage between February 2020 and January 2021, representing a nearly 14 percent increase over the 12-month period.
Among the 50 states and the District of Columbia, a total of 80.5 million people were enrolled and receiving full benefits from Medicaid and CHIP programs by the end of January 2021. In the 50 states that reported total Medicaid child and CHIP enrollment data for January 2021, over 38.3 million children were enrolled in Medicaid and CHIP combined, approximately 50 percent of the total Medicaid and CHIP enrollment. According to the U.S. Health and Human Services (HHS), these latest figures underscore the essential role of Medicaid and CHIP in providing quality and necessary coverage for millions of vulnerable children and adults. Both programs serve as the largest single source of health coverage in the country.
The increase in total Medicaid and CHIP enrollment is largely attributed to the impact of the COVID-19 pandemic, and in particular, the enactment of the Families First Coronavirus Response Act (FFCRA). FFCRA provides states with a temporary 6.2 percent payment increase in Federal Medical Assistance Percentage (FMAP) funding.
Additional information, including the full report, is available here.
As a friendly reminder, the California Department of Health Care Services (DHCS) will host a webinar on Medi-Cal managed care and upcoming policy changes associated with the California Advancing and Innovating Medi-Cal (CalAIM) initiative on Tuesday, June 29 from 2:00 pm-3:00 pm. The webinar is intended for counties and providers and will feature an opportunity to learn the latest on Enhanced Care Management (ECM) and In Lieu of Services (ILOS) components of CalAIM. The June 29 webinar will be the first of a two-part webinar series. CHEAC strongly encourages local health departments to register and attend the upcoming webinar.
Additional information, including registration, is available here.
The California Department of Health Care Services (DHCS) will launch on July 1, 2021, the Hearing Aid Coverage for Children Program (HACCP). The FY 2020-21 State Budget included the proposal to create this new program that will cover hearing aids and related services for approximately 7,000 children under the age of 18 who have a household income of up to 600 percent of the federal poverty level (FPL) and who are not otherwise eligible for Medi-Cal. The benefit will be available to individuals whose health insurance does not cover hearing aids and services.
HACCP policies will reflect existing California Children’s Services (CCS) policies for coverage of hearing aids and hearing aid replacement, hearing aid supplies and accessories, hearing aid-related audiology services, and post-evaluation services. These services will be provided based upon a valid hearing aid prescription or a referral from an audiologist, otolaryngologist, or physician. HACCP will utilize enrolled Medi-Cal providers to offer program services.
The initial rollout of the program will use a paper application process, followed by the launch of an online application portal. Additional information on the HACCP is available here.
The National Association of Counties (NACo) will host a webinar on Tuesday, June 29 at 11:00 am PT on the eligible uses of Fiscal Recovery Funds for public health response activities. The webinar comes as counties determine how to invest their American Rescue Plan Act (ARPA) State and Local Fiscal Recovery Funds to support a broad range of public health needs across COVID-19 mitigation, medical expenses, behavioral health, and public health resources.
Additional information and webinar registration are available here.
ACEs Aware, the state’s initiative between the Office of California Surgeon General and the California Department of Health Care Services (DHCS), will host two upcoming webinars related to trauma-informed care and adverse childhood experiences (ACEs). Below, these webinars are detailed:
The Trauma-Informed Network of Care Roadmap: A Guide for Strengthening Community Relationships
ACEs Aware, on Monday, June 28 from 12:00 pm to 1:00 pm, will convene a webinar entitled, “The Trauma Informed Network of Care Roadmap: A Guide for Strengthening Community Relationships.” The webinar will discuss the purpose of the Network of Care Roadmap that health care providers, clinics, community-based organizations, and social services agencies can take to improve the systems to prevent, treat, and heal toxic stress.
For more information and registration please click here.
The Science of ACEs and Toxic Stress: Part II
ACEs Aware will reconvene on Wednesday, July 14 from 12:00 to 1:00 pm for the second part of “The Science of ACEs and Toxic Stress.” This webinar will feature Al Race, Deputy Director and Chief Knowledge Officer from the Center on the Developing Child at Harvard University for a discussion on the importance of childhood toxic stress and its impacts on long-term health outcomes.
For additional information and registration, please click here.
The Public Policy Institute of California (PPIC) this week issued a report detailing health coverage and care statuses of undocumented residents in California. The latest report updates data and findings from PPIC’s previous work on the subject and examines aspects of how children in mixed-status families engage with the health care system.
Considering changes in the federal and state contexts over the past five years, including the COVID-19 pandemic, PPIC finds that:
- Uninsured rates are high for low-income undocumented immigrants; uninsured rates for those older than age 50 are especially concerning given higher levels of health care needs.
- The health care safety net serving undocumented immigrants is uneven across geography, by age group, and in some cases by health needs.
- Undocumented immigrants and their families do not use more emergency department services than other immigrants; lack of connections to the health care delivery system is a greater concern.
- Children in families with at least one undocumented member are almost 11 percent less likely to have a usual source of care compared to children in other immigrant families, although they receive health care at similar rates.
PPIC identifies a series of outstanding questions, including how to improve access to health insurance coverage and medical care for undocumented immigrants and their families. Current legislation, such as AB 4 (Arambula) and SB 56 (Durazo), proposes further expansion to cover all low-income adults regardless of immigration status. According to PPIC, expanding affordable insurance options could begin to address coverage gaps experienced by undocumented Californians.
In addition to coverage expansions, PPIC recommends incentivizing all counties to serve undocumented immigrants in their programs for the medically indigent and increasing supports for safety net providers to improve equity in accessing medical care. Outreach to immigrant communities through community-based organizations and other trusted messengers could begin to alleviate some of the fear undocumented immigrants and their family members have around government programs.
The full PPIC report on health coverage among undocumented Californians is available here.
The UCLA Center for Health Policy Research (CHPR) recently released a policy brief detailing barriers to accessing oral health care in California, particularly among low-income residents who face financial and other barriers to access. The report, utilizing data from the 2018 and 2019 California Health Interview Survey (CHIS), identifies the following main findings:
- There are fewer dentists per capita in some parts of the state.
- About 79 percent of the state’s dentists do not provide care for low-income patients who rely on Medi-Cal.
- Only eight percent of the state’s dentists are Latino or Black, compared with 60 percent of the state’s low-income adult population overall.
- 39 percent of low-income California adults report that their oral health was “fair” or “poor,” and 41 percent reported not having visited the dentist within the past year.
The report’s authors also identify a looming shortage of dental providers with nearly a quarter of dentists over the age of 60 and nearing retirement age. UCLA researchers offer possible suggestions to address barriers to accessing oral health services, including expanding the roles of dental hygienists and dental therapists, encouraging dentists to use “mobile clinics” to bring oral health services to underserved areas, and offering at least some appointments through web-enabled devices for people who cannot immediately visit a dentist’s office.
Additional information on the UCLA policy brief is available here.