June 9, 2017 Edition
Last night, the Budget Conference Committee adjourned shortly after 11:00 pm, concluding their work to reconcile the Senate and Assembly versions of the 2017-18 Budget. The Legislature reached agreements to:
- Adopt the Governor’s revenue estimates with the exception of using the LAO’s property tax estimates;
- Increase funding for after-school programs;
- Restore adult dental and optical services under Medi-Cal;
- Expand the state’s earned income tax credit for low-income working families;
- Adopt a $387 million dam safety and emergency response package; and
- Reject Assembly’s $400 million Affordable Housing proposal.
A few outstanding issues remain, including Cap and Trade, the allocation of Proposition 56 – Tobacco Tax revenues and Cannabis trailer bill language (though not addressed in Conference).
The full budget committees are expected to hear trailer bill language on Tuesday, June 13. The deadline for a budget to be adopted by the Legislature is Thursday, June 15. Additional Budget Conference Committee highlights are provided below.
Proposition 56 – Tobacco Tax Revenues
As mentioned above, no agreement was reached on how to allocate the $1.3 billion in Prop. 56 revenues. Key differences between the Senate and Assembly’s investments Prop 56 revenues can be found here. The allocation of tobacco tax revenues is a point of contention with the Administration, who proposed to use these revenues to offset costs to the Medi-Cal program and particularly the increased state share of the expansion population. The Administration noted the need for fiscal prudence, continuing conversations and technical language issues that would need to be addressed.
Restoration of Optional Benefits
While the restoration of full adult dental benefits and optical benefits under Medi-Cal were discussed in the context of Proposition 56 allocations, the Conference Committee took bipartisan action to fund these restorations using General Fund. The Conference Committee approved $34.8 million in FY 2017-18 and $73 million ongoing for the restoration of adult dental benefits beginning in January 1, 2018. Additionally, the Conference Committee approved $12.5 million in FY 2020-21 and $26.3 million ongoing for the restoration of optical benefits.
Other key actions are noted in the table below:
After last week’s legislative deadline for bills to be passed out of their house of origin, policy committees in both houses met to resume hearings. Many bills are still awaiting policy committee assignments, and the next several weeks are shaping up to be quite busy as we move toward the next legislative deadline in July.
Below, we highlight bills of interest to CHEAC Members. This week’s full bill list is available here.
AB 175 (Chau) as amended on 5/30/17 – Support
The CHEAC Legislative Committee this week moved to support Assembly Member Ed Chau’s AB 175, which would require adult use cannabis manufacturers, prior to releasing cannabis-infused edible products, to receive product packaging and labeling approval from the California Department of Public Health (CDPH). This measure works to ensure compliance with CDPH cannabis regulations, including the requirements that packaging be child resistant and not attractive to children. AB 175 is assigned to the Senate Transportation & Housing Committee where it awaits a hearing date.
Local Health Department Administration
AB 1250 (Jones-Sawyer) as amended on 5/30/17 – Oppose
AB 1250, introduced by Assembly Member Reginald Jones-Sawyer, Sr., awaits committee assignment in the Senate. The measure specifies an extensive list of criteria that must be met when counties and cities contract out for personal services, including provisions related to cost savings, displacement of county and city employees, competitive bidding processes, and performance standards. Counties and cities would also be required to conduct an audit to determine cost savings through contracts, and would not be able to renew contracts prior to those audits. For contracts exceeding $100,000 annually, the measure imposes additional public disclosure requirements. Certain intergovernmental contracting is permitted and services such as public transit and public works are exempted.
This bill poses significant challenges related to local health department administration, as well as general local government operations. CHEAC has joined the California Association of Counties (CSAC) in opposing this bill.
Communicable Disease Control
AB 1279 (Salas) as amended on 5/30/17 – Watch
Assembly Member Rudy Salas’ AB 1279 is currently in the Senate awaiting policy committee assignment. The measure requires counties to find and report to CDPH every confirmed case of valley fever within their jurisdiction in a timely manner. CDPH is also required to post confirmed cases online, establish an enhanced monitoring system to track confirmed cases, conduct annual public outreach, and establish a workgroup consisting of five health officers from the counties with the highest incidences of valley fever. The Health Officers Association of California (HOAC) recently removed their opposition to the bill. It should be noted that the Budget Conference Committee did not approve funding for enhanced valley fever monitoring and education programs this week.
Senate Seeking to Gain Momentum to Overhaul the Affordable Care Act
Senate Majority Leader Mitch McConnell publicly shared his goal for the Senate to vote on the Senate’s version of the Affordable Health Care Act (AHCA) prior to the Senate leaving for recess before July 4. Despite initial vows to conduct public hearings and to move the measure more thoughtfully, the Senate Republicans are now proceeding to a different tune. The bill will not be thoroughly vetted through policy committees, but will instead, likely proceed directly to the floor for a vote as done by House Republicans.
Senate Republicans still have a daunting task ahead of them. Under reconciliation rules, the Senate’s bill must achieve the same federal savings as the AHCA passed by the house, $119 billion. The current savings scored for the AHCA is largely related to the elimination of the Medicaid expansion, which would cause 14 million people would be uninsured in 2018, growing to 23 million in 2026. Senate Republicans have suggested their bill would be more generous to consumers; however, in order to do this, tax increases would need to remain intact. Providing more generous benefits and providing tax relief would be nearly impossible to deliver.
Language has not yet been released; however, in order to meet the Senate Majority Leader’s deadline, language will need to be released soon to the CBO for a score.
CHEAC will continue to provide updates as things progress.
On a final note, CHEAC has signed on to another joint letter with CSAC, CAPH, CBHDA, CMSP, CWDA, and UCC, addressed to Senators Feinstein and Harris, expressing California’s counties’ opposition to the American Health Care Act (AHCA) and outlining our major concerns with the significant proposed changes to the Medicaid program as the Senate deliberates the AHCA.
The Centers for Disease Control and Prevention (CDC) released a new Diabetes State Burden Toolkit with state-specific data. The toolkit breaks the burden of diabetes down into three categories: health burden, economic burden, and mortality. Based on 2013 data, for example, the toolkit shows a cost of $19,410 per person aged 19-64 with diabetes in California.
The toolkit is available on the CDC website.
On Wednesday, June 21, the National Association of County and City Health Officials (NACCHO) will host a webinar on low-cost strategies for tobacco prevention. The webinar will take place from 11:00 am to 12:00 pm (PST) and will explore ways local health departments can integrate the Centers for Disease Control and Prevention’s (CDC) Tips from Former Smokers Campaign into clinical settings. There will be speakers from two local health departments to describe their efforts in working with providers to increase between patients and providers. The CDC and NACCHO will also present.
More information can be found here. To register, please click here.