June 29, 2018 Edition

Early Bird Price for 2018 CHEAC Annual Meeting Expires in Two Weeks

2018 CHEAC Annual Meeting registration is open, and two weeks remain before the early bird registration price expires. CHEAC Members are encouraged to register and book a hotel room at the Hyatt Regency Sacramento as soon as possible. This year’s annual meeting will be held from October 17 – October 19 and will provide local health department professionals representing a wide variety of disciplines throughout California with networking and learning opportunities.

For attendees coming to Sacramento on Tuesday, October 16, rooms are still available at the Hyatt Regency. However, CHEAC has met its room block for Tuesday night and the discounted room rate is no longer available; rooms will be offered on Tuesday night at the Hyatt’s prevailing room rate (government rate also available when reserving by phone). Rooms are still available at CHEAC’s discounted rate for Wednesday and Thursday nights. Members are encouraged to stay at the Hyatt Regency as all conference programming will occur at this location.

If the Hyatt’s offered rate for the night of Tuesday, October 16 is an issue for jurisdictions, nearby hotels, including the Sterling Hotel, the Best Western Plus Sutter House, the Holiday Inn Express Sacramento Convention Center, and the Residence Inn by Marriott, are offering a discounted government rate for a Tuesday night stay.

More information on this year’s CHEAC Annual Meeting, including registration, is available here.

Governor Brown Signs the 2018-19 State Budget

On Wednesday, Governor Jerry Brown signed his final budget, the Budget Act of 2018 (SB 840), while highlighting his significant accomplishment of taking the state from a $27 billion deficit to one that continues to save for the next recession and includes significant investments for combating homelessness, protecting immigrants, and providing K-14 and higher education.

Governor Brown did not issue any vetoes in the Legislature’s budget package. As such, all budget items reported in the June 14, 2018, CHEAC Budget Memo were included in the signed budget.

Additional trailer bills were passed this week dealing with local government taxation on sugar-sweetened beverages (SSBs), Proposition 56 allocations, Medi-Cal, and No Place Like Home. CHEAC has highlighted Governor Brown’s signed budget and recent budget trailer bills in a memo available here.

Ballot Initiatives Influence State Budget and Policy, Budget Trailer Bill Bans Local Soda Taxes

The ability for local governments to impose taxes and fees on sodas and sugar-sweetened beverages was highly debated in the California State Legislature this week. Two trailer bills, SB 872 and AB 1838 were introduced to ban the ability for local jurisdictions to impose new taxes on groceries, which by definition includes sugar-sweetened beverages/sodas, until 2031. Taxes or fees on groceries in place prior to January 1, 2018, are grandfathered in and may be reauthorized.

The trailer bills were the result of a deal negotiated by labor and the California Business Roundtable to stop the “Tax Fairness, Transparency and Accountability Act of 2018” initiative. The initiative, if passed, would require two-thirds voter approval for a local tax or fee increase and a two-thirds vote by a local electorate to place a tax on the ballot. The passage of this initiative would inhibit the ability for local governments to impose taxes or fees given the two-thirds threshold and could have a significant impact on local revenues, both existing and new.

According to the high-level analysis from the Legislative Analyst’s Office, roughly half of the majority-vote taxes enacted since 2012 did not receive the two-thirds vote of the electorate as the initiative would require and could result in substantial local revenue reductions in the future. Given these considerations, CHEAC took a ‘concerns’ position on the trailer bills and highlighted our concerns with stifling the growing momentum behind sugar-sweetened beverage taxes before the budget committees of both houses.

During discussion in the budget committees and the floor, several members denounced the decision before them, recognizing the choice between public health and protecting local governments. Several members condemned the antics of Big Soda and their hostile approach of using the initiative process to push their agenda. Legislators implored their colleagues to take state-level action around soda taxes and warned that the soda industry may have won the battle, but they will not win the war.

The Legislature passed AB 1838 on Thursday sending it immediately to the Governor. Governor Brown signed AB 1838 and proponents subsequently withdrew the initiative just before the Secretary of State deadline for initiatives to qualify for the November ballot.

SB 872 was amended on Wednesday to remove the original language that bans local governments from imposing taxes or fees on groceries. The bill instead further clarifies the definition of cannabis, which continues to be excluded from the definition of groceries. The trailer bill is expected to be taken up by the Legislature on Monday.

Two other ballot initiatives were with withdrawn as the result of intense negotiations:

Lead-Paint Manufacturers. The Legislature announced a deal that results in lead-paint manufacturers withdrawing their initiative that would have eliminated their liability to clean up lead paint in old houses and instead require tax payers to bear the financial burden. In exchange, three Assembly members will be holding their bills this legislative session that seek to address lead-paint – AB 2073 (Chiu), AB 2803 (Limon) and AB 2136 (Bloom).

Consumer Privacy Rights. AB 375 (Chau) was passed and signed by Governor Brown on Thursday just before the ballot initiative deadline. A Bay Area real estate developer had initially proposed an expansive data privacy measure that would have qualified for the November ballot, but negotiations between proponents and technology industry representatives resulted in a withdrawn initiative. AB 375, now law, allows consumers the right to know what data companies possess about them and to stop the sharing and selling of their data. Consumers will also be able to sue over data breaches if the companies are inadequate in their efforts to protect data. The new law takes effect in 2020.

Legislature Reaches Fiscal Bill Deadline, One Week Remains before Summer Recess

Today is the deadline for the California Legislature policy committees to hear and report all fiscal bills, which resulted in a busy week of committee hearings and amendments to bills. Next Friday, July 6 is the deadline for policy committees to hear and report all non-fiscal bills and also the start of the Legislature’s month-long summer recess.

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

Chronic Disease Prevention and Wellness Promotion

AB 1335 (Bonta) as amended on June 20, 2018 – Support

Assembly Member Rob Bonta’s AB 1335 was heard in the Senate Health Committee this week. The measure would require the labels of sugar-sweetened beverages (SSBs) to bear the safety warning, “STATE OF CALIFORNIA SAFETY WARNING: Drinking beverages with added sugar(s) contributes to obesity, type 2 diabetes, and tooth-decay.” The safety warnings would also be required for vending machines, dispensing machines, and points of purchase for any sealed SSBs. In 2017, SB 300 (Monning) proposed the same requirements, but the bill did not receive a hearing its first policy committee. AB 1335 was advanced from the Senate Health Committee to the Senate Appropriations Committee on Wednesday.

SB 1192 (Monning) as amended on June 12, 2018 – Support

SB 1192 by Senator Bill Monning would require restaurants selling children’s meals to make the default beverage with that meal either water, sparkling water, or flavored water or unflavored milk or nondairy milk alternative. Customers would be able to receive a different drink upon request. The measure would also require the beverage listed or displayed on restaurant menus or advertisements for children’s meals to be one of the default beverages. SB 1192 was advanced from the Assembly Appropriations Committee to the Assembly Floor on Wednesday.

Communicable Disease Control

AB 2892 (Quirk) as amended on May 25, 2018 – Support

Assembly Member Bill Quirk’s AB 2892 was heard in the Senate Health Committee this week. The measure would establish the California Mosquito Surveillance and Research Program within the California Department of Public Health (CDPH) tasked with maintaining an interactive website for the management and dissemination of mosquito-borne virus and surveillance control data, providing confirmation of tests completed by local and state agencies, and working in collaboration with local mosquito abatement and vector control districts to conduct research. On Wednesday, AB 2892 was advanced to the Senate Appropriations Committee.

Drug and Alcohol Services

SB 275 (Portantino) as amended on June 28, 2018 – Support

SB 275 by Senator Anthony Portantino would require the Department of Health Care Services (DHCS) to convene an expert panel and adopt regulations based on the expert panel’s recommendations to establish youth substance use disorder (SUD) treatment, early intervention, and prevention quality standards for California youth. The measure would also require each county to designate a single public agency to be responsible for administering youth SUD treatment services within the county and require the agency to comply with the standards adopted by DHCS. SB 275 was advanced by the Assembly Health Committee to the Assembly Appropriations Committee on Tuesday.

Environmental Health

SB 212 (Jackson) as revised on June 27, 2018 – Support

Senator Hannah-Beth Jackson’s SB 212 was heard in the Assembly Environmental Safety and Toxic Materials Committee this week. SB 212 would establish a comprehensive statewide pharmaceutical and sharps waste stewardship program and require covered pharmaceutical manufacturers to participate in or establish and implement a stewardship program. Stewardship program operators would be required to submit to CalRecycle a stewardship plan that details participating manufacturers, handling, transportation, and disposal procedures, and collection system arrangements. The measure specifies the minimum number of collection sites in counties and requires covered pharmaceutical manufacturers to pay all administrative and operational costs of stewardship the stewardship program. SB 212 was advanced by the Assembly Environmental Safety and Toxic Materials Committee to the Assembly Appropriations Committee on Tuesday.

Health Coverage/Health Care Reform

AB 11 (McCarty) as amended on June 18, 2018 – Support

Assembly Member Kevin McCarty’s AB 11 was advanced by the Senate Health Committee to the Senate Appropriations Committee on Wednesday. AB 11 would require screening services under the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program to include developmental screening services for individuals zero to three years of age.

Tobacco Control

SB 835 (Glazer) as amended on March 20, 2018 – Support

SB 836 (Glazer) as amended on May 15, 2018 – Support

SB 835 and SB 836 by Senator Steven Glazer were heard in the Assembly Appropriations Committee this week. SB 835 would ban smoking and disposal of cigar and cigarette waste at all state parks, and SB 836 would ban the same at all coastal beaches. The measures were placed on the Assembly Appropriations suspense file where they will be considered at a later date.

Senate Passes Own Version of Farm Bill, Does Not Include Significant SNAP Modifications

On Thursday, the U.S. Senate passed its own version of the Farm Reauthorization Bill (S. 3042) on a bipartisan vote of 86-11. The Senate’s $867 billion Farm Bill does not include major modifications to nutrition title provisions that govern the Supplemental Nutrition Assistance Program (SNAP) and SNAP-Education (SNAP-Ed). Despite the fact that several senators filed amendments that would have modified SNAP, the amendments were ultimately not offered during debate on the Senate floor and a clean measure was passed. CHEAC and CWDA this week submitted a letter to California’s U.S. Senators opposing the filed amendments that would have weakened SNAP and urging their support of SNAP improvements included in S. 3042.

Recall last week, the U.S. House of Representatives passed its own sweeping Farm Bill (H.R. 2) on a razor-thin margin of 213-211 that included an overhaul of nutrition programs that would shift SNAP and SNAP-Ed funding from state and local agencies to state land grant universities. H.R. 2 would also modify SNAP work requirements and eligibility provisions.

Given that the Senate and House versions of the Farm Bill differ significantly, members of Congress must meet in conference committee to reconcile differences and determine a final version of the measure. Congress faces a deadline of September 30 to finalize and pass a reauthorization measure before the current Farm Bill expires on this date.

Plumas County Public Health to Hold Conference on Rural Opioid Epidemic

The Plumas County Public Health Agency invites local health department professionals and others engaged in rural opioid work to the Tools and Strategies for Rural Opioid Work Conference on August 28-29 in Quincy, CA. The two-day conference is free to attend and will highlight best practices used by harm reduction programs, nature and strengths of rural communities, and tools and strategies available to address the opioid epidemic.

Space is limited to 200 attendees. Registration and additional information is available here.

Public Health Toolkit for Addressing the Opioid Epidemic Now Available

The Massachusetts Health Officers Association (MHOA) recently released Essential Measures: A Local Public Health Toolkit for Addressing the Opioid Epidemic. The toolkit is intended to be used as a framework to plan from, initiate, expand upon, and collaborate on strategies available to LHDs to address the opioid epidemic. Notably, the toolkit’s framework encompasses the 10 Essential Services of Public Health and details best practices from communities that can easily be adapted in implemented in other jurisdictions. The full toolkit, available digitally and in a PDF format, is available here.

CDPH Releases End of Life Option Act Annual Report

The California Department of Public Health (CDPH) recently released the 2017 End of Life Option Act Annual Report. Recall, the End of Life Option Act became law in June 2016 and allows qualified individuals diagnosed with a terminal disease to obtain and self-administer aid-in-dying drugs. CDPH is required to report annually the number of prescriptions written and number of individuals who died using aid-in-dying drugs.

In 2017, 577 individuals received aid-in-dying drugs under the End of Life Option Act, and 374 people died following ingestion of the prescribed drugs. Of the 374 individuals, 90.4 percent were older than age 60, 95.2 percent were insured, and 83.4 percent were receiving hospice and/or palliative care. The full 2017 End of Life Option Act Annual Report is available here.

PPIC Releases Report on Emergency Department Utilization after ACA

The Public Policy Institute of California (PPIC) this week released a report examining health care coverage expansions under the Affordable Care Act (ACA) and their impact on the utilization of emergency department services. After controlling for factors such as patient age and health status, PPIC determined the odds of being a frequent emergency department user, defined as four or more annual emergency department visits, were significantly lower for Medi-Cal beneficiaries after the ACA. Among uninsured patients, the odds of frequent emergency department use declined event more.

However, the PPIC report found that, at the same time, there has been an overall increase in both the share and absolute number of emergency department patients who are frequent emergency department users, despite the lower odds of frequent emergency department use after the ACA. The largest predictors of frequent emergency department use—both before and after the ACA—were having a diagnosed mental health condition or substance use disorder. The PPIC findings suggest state efforts to better integrate physical and behavioral health services for Medi-Cal beneficiaries could help lower frequent emergency department visits. The full PPIC report is available here.