March 18, 2022 Edition

CHEAC Invites Workshop Abstract Proposals for 2022 Annual Meeting

The CHEAC Annual Meeting provides networking and learning opportunities to local health department leadership and staff throughout California. This year’s theme is “Public Health Equity & Readiness Opportunity (HERO) – Achieving an Equitable and Resilient Workforce and Recovery,” and will once again include keynote sessions with guest speakers, as well as a myriad of workshops intended to stimulate best practice sharing and/or discussion around issues impacting public health.

CHEAC invites local health departments and key partners to submit workshop abstracts should you wish to host a workshop session.  Roughly 15 workshops will be hosted between 10:00 am and 4:00 pm on Wednesday, October 5 and Thursday, October 7.

Those interested in submitting an abstract can find more information on our website here. All abstract proposals are due to CHEAC via email by COB Friday, April 25, 2022.

Legislature Begins Shift to Policy Committee Hearings

The California State Senate and Assembly has largely shifted its focus toward policy committee hearings as new bills introduced in the second year of the 2021-22 legislative session begin to be set for hearings over the coming weeks. Senate and Assembly budget subcommittees are nearing the completion of their hearings prior to the release of the Governor’s May Revise Budget in mid-May.

In Sacramento this week, lawmakers swiftly acted on legislation to address an enrollment-related issue at University of California, Berkeley (UCB) as result of a recent court order that would have required UCB to significantly reduce admissions due to environmental- and development-related concerns. The Legislature advanced a bill ensuring that student enrollment at a college is not singled out as a project under the California Environmental Quality Act (CEQA). Governor Gavin Newsom signed the measure into law virtually immediately after its approval by the Legislature.

Also, this week, lawmakers continue to grapple with competing proposals to address the rising price of gasoline statewide. On Tuesday, Assembly Republicans attempted a vote on the Assembly Floor to hear a measure (AB 1638/Kiley) to suspend the state’s gasoline tax, a move that ultimately failed on an 18-40 vote. Then, on Thursday, a group of Assembly Democrats unveiled a proposal to provide relief from high gasoline prices. The group of Assembly Members are proposing the use $9 billion of the state’s budget surplus to provide a $400 rebate for taxpayers to cover the current 51.1 cent per gallon tax for one full year of weekly refills for a vehicle with a 15-gallon gasoline tank. The move by the Assembly Members comes after Governor Newsom, in his recent state of the state address, suggested the need for economic relief from rising gasoline prices.

Below, we highlight a CHEAC-tracked measure of interest. The CHEAC Legislative Committee, having completed its two daylong bill review meetings, will now be meeting on a weekly basis throughout the legislative session to review new proposals, assess recent amendments, and discuss positions on legislative bills of interest to local health departments. For a full update, the latest edition of the CHEAC Weekly Update is available here.

Public Health Emergency Preparedness

SCR 5 (Melendez) as amended February 2, 2021 – WATCH

Of note this week, the Senate Committee on Governmental Organization convened a hearing to consider SCR 5 by Republican Senator Melissa Melendez. SCR 5 would declare that the state of emergency proclaimed by Governor Newsom on March 4, 2020, due to the COVID-19 public health emergency is at an end, thereby terminating the emergency powers granted to the Governor consistent with the proclamation. During the Tuesday hearing, Senator Melendez indicated that California has been “under a state of emergency for more than 700 days,” and that, “it is time for the state to allow local governments to take the lead and address emergencies locally without the shotgun approach of a statewide emergency.”

SCR 5 garnered some support but was opposed by a number of notable groups, including the California Hospital Association, California Labor Federation, and the California Professional Firefighters, among others. Senators, during the hearing, expressed the need to keep in place the emergency proclamation to support the continued response to the COVID-19 pandemic. Senator Bill Dodd, chair of the committee, noted the Governor has begun to phase down a series of emergency orders put in place during the pandemic but keeping the emergency proclamation will allow the state to be prepared for future variants and surges.

Ultimately, SCR 5 failed to advance from the Governmental Organization Committee on an 4-8 vote with three members not voting. Senator Melendez was granted reconsideration, allowing her to bring back the measure for legislative consideration at a later date.

Drug & Alcohol Services

AB 1598 (Davies) as amended March 10, 2022 – SUPPORT

AB 1598 by Assembly Member Laura Davies would exclude testing equipment for fentanyl, ketamine, gamma hydroxybutyric acid, and any analog of fentanyl from the statutory definition of “drug paraphernalia.” AB 1598 this week was advanced from the Assembly on consent to the Senate where the bill now awaits referral to a policy committee.

Assembly Considers Health Care Workforce Proposals

On Monday, March 14, the Assembly Budget Subcommittee No. 1 on Health and Human Services heard the Governor’s health care workforce budget proposals under the Department of Health Care Access and Information (HCAI). Representatives from the HCAI, the Legislative Analyst’s Office, Vision y Compromiso, and CHEAC were invited to participate in the panel discussion. While proposals were focused on health care workforce, CHEAC Executive Director Michelle Gibbons highlighted California’s public health workforce challenges and the lack of investments focused on bolstering the public health workforce pipeline.

During the discussion, Assembly Member Arambula noted his sensitivity to the pipeline challenges public health departments face and the turnover and attrition that has occurred during the pandemic. He noted his interest in doing what we can to support recruitment into public health and his hope to engage with the Administration to figure out how to budget and resource for that. He specifically asked HCAI why public health was not included in the care economy workforce proposal. Elizabeth Landsberg, HCAI Director, noted that the focus of the department has historically been limited to the primary care, behavioral health, and dental workforce and that they currently do not have programs to support public health, such as programs for epidemiologist and microbiologists.

The Governor’s January budget would provide $296.5 million in FY 2023 and $370.5 million in FY 2023-24 and FY 2024-25 to HCAI to support the following initiatives in the Workforce for a Healthy California for All Program:

Community Health Workers. Support a new program to recruit, train, and certify 25,000 new community health workers by 2025.

Comprehensive Nursing Initiative. Increase the numbers of registered nurses, licensed vocational nurses, certified nursing assistants, certified nurse midwives, certified medical assistants, family nurse practitioners, and other health professions through the expansion of existing workforce programs.

Social Workers. Increase the number of social workers trained in California by supporting social work training programs and providing stipends and scholarships to create a new pipeline for diverse social workers.

Psychiatric Residents. Increase the number of behavioral health providers such as psychiatrists, psychiatric nurse practitioners, and psychologists through additional residency slots in from FY 2022-23 through FY 2024-25.

Multilingual Health Initiatives. Increase the linguistic and cultural competencies in the health workforce by expanding scholarship and loan repayment opportunities for multilingual applicants.

Opioid Response Initiatives. Support a three-year grant program for community-based substance use disorder providers focused on opioid treatment and establish a pilot project to provide vocational rehabilitation services for consumers with opioid use disorders and train the provider workforce to include employment services as part of participation in treatment.

No action was taken by the committees and items were held open. The full agenda for Monday’s hearing is available here. A video recording of the hearing is available here.

Newsom Names New Legislative Affairs Secretary

Governor Gavin Newsom on Monday announced a change in his legislative leadership in the Office of the Governor. Legislative Affairs Secretary Angie Wei, serving in her role since December 2020, will depart to serve as a member of the State Compensation Insurance Fund.

Governor Newsom, in Wei’s place, has appointed Christy Bouma. Bouma has served as President of Capitol Connection from 2008 to 2022 and Legislative Advocate from 2000 to 2008. Bouma has represented a range of clients during her time with Capitol Connection, including the California Professional Firefighters (CPF) and the California School Employees Association (CSEA).

Additional information is available here.

DOF Publishes March Finance Bulletin

The California Department of Finance (DOF) this week issued its March finance bulletin, providing a statewide economic update and detailing labor and revenue conditions. Notably, preliminary General Fund cash receipts for the first eight months of 2021-22 fiscal year were $17.534 billion above the 2022-23 Governor’s Budget forecast of $117.301 billion. Cash receipts for the month of February were $1.682 billion above the forecast of $7.946 billion.

According to DOF, $6.265 billion of the total additional revenue through eight months is due to higher-than-expected Pass-Through Entity (PTE) elective tax payments under the corporation tax. Personal income tax cash receipts to the General Fund for the first eight months of the fiscal year were $10.019 billion above the forecast of $81.162 billion. Lastly, sales and use tax cash receipts for the first eight months of the fiscal year were $1.299 billion above the forecast of $20.637 billion.

The full DOF March Finance Bulletin is available here.

LAO Releases Cost Analysis of Single-Payer Health Care Proposal

This week, the Legislative Analyst’s Office (LAO) made public its fiscal analysis on AB 1400 by Assembly Member Ash Kalra. Recall, the measure would have created a single-payer health care delivery system known as “CalCare.” A companion measure, ACA 11, would establish a financing mechanism for CalCare by imposing a excise tax, payroll tax, and personal income tax.

The Assembly Rules Committee requested the LAO to analyze financing and other considerations associated with CalCare, including a review of barriers relevant to the implementation, feasibility, and sustainability of CalCare. Of note, the LAO tags the CalCare proposal with a cost of $494 billion to $552 billion with cost growths around $20 billion to $30 billion annually.

Compared to statewide health care expenditures under the current and existing system, the LAO estimates that CalCare could reflect an increased cost of $9 billion (2 percent) to $67 billion (14 percent). Nearly all private health care expenditures would no longer be present under CalCare and generally be replaced with public expenditures on health care.

Of note, AB 1400 failed earlier this year after Assembly Member Kalra opted not to bring up the bill for a vote on the final day of Legislature’s two-year bill deadline. As such, the measure will not move forward for the remainder of the legislative session.

The full LAO analysis is available here.

Becerra Visits Butte County to Promote Pediatric COVID-19 Vaccination

On Monday, U.S. Health and Human Services Secretary Xavier Becerra visited Butte County to host a roundtable session focused on pediatric vaccinations against COVID-19. Secretary Becerra, during his visit, met with Butte County Public Health, Enloe Medical Center, and local pediatricians to discuss strategies for promoting sound data and facts on vaccines, vaccinating children and families, and ensuring the health and safety of Americans.

Secretary Becerra participated in a closed roundtable with local providers and professionals before hosting a media briefing. Becerra reiterated COVID-19’s impacts on the country, including the hospital and health care delivery system, and urged vigilance against the virus that remains present nationwide.

Additional photos and updates from Secretary Becerra’s Butte County visit are available here on Butte County Public Health’s Twitter Page.

Butte County Public Health Director Danette York hosts U.S. Department of Health and Human Services Secretary Xavier Becerra in Butte County on Monday, March 14.

White House Warns Congress of Lack of COVID-19 Response Funds

This week, the White House sent a letter to Congress reiterating the need for additional emergency COVID-19 response funds and outlining consequences of a lack of funding. According to the White House, if funds are not appropriated by Congress soon, the U.S. will be unequipped to handle a future pandemic surge.

Specifically, if immediate funding is not provided, the Biden-Harris Administration identifies the following consequences:

  • Inability to secure sufficient booster doses and variant-specific vaccines, if needed
  • Scaling back, then ending, the uninsured program that reimburses providers for testing, treating, and vaccinating uninsured individuals
  • Ending the purchase of monoclonal antibody treatments and scaling back allocations to state and territories
  • Stopping testing, vaccine, and treatment efforts, such as purchasing oral antiviral pills and maintaining domestic testing capacity
  • Scaling back planning purchases of preventive treatments for immunocompromised persons
  • Winding down some COVID-19 surveillance efforts, thereby reducing the ability to rapidly identify and assess emerging variants
  • Damage to global vaccination and COVID-19 treatment efforts

While U.S. House Speaker Nancy Pelosi has committed to passing legislation to provide additional COVID-19 response funds, it is not clear whether or when Congress will approve additional funds. The letter from the White House to Speaker Pelosi is available here.

Biden Announces Changes in White House COVID-19 Response Coordinator

This week, President Joseph R. Biden, Jr. announced a leadership change in his Administration’s COVID-19 response team. White House COVID-19 Response Coordinator Jeff Zients will be stepping down from his role after serving the Administration for the past 14 months. President Biden applauded the work and expertise of Zients, coordinating strategies and infrastructure to deliver vaccines, tests, treatments, and masks to hundreds of millions of Americans.

President Biden, in Zients’ place, has named Dr. Ashish Jha to serve as the next White House COVID-19 Response Coordinator. Jha is a widely recognized public health leader, currently the dean of the Brown University School of Public Health. Jha is anticipated to begin his role in April and will be tasked with executing the Biden-Harris Administration’s National COVID-19 Preparedness Plan and managing ongoing COVID-19 risks.

Additional information is available here.

Pfizer, Moderna Seek Authorization for Additional COVID-19 Vaccine Booster

This week, both Pfizer-BioNTech and Moderna each announced they have formally requested authorization from the U.S. Food and Drug Administration (FDA) for booster doses of their COVID-19 mRNA vaccines.

On Tuesday, Pfizer-BioNTech submitted a request to the FDA for an emergency use authorization (EUA) for an additional booster dose for adults 65 and older who have gotten a booster dose of any of the authorized or approved vaccines. According to the companies, the request comes as two data sets from Israel indicate an additional mRNA booster increases immunogenicity and decreases confirmed infections and severe illness.

On Thursday, Moderna then similarly submitted a request to the FDA to amend its EUA to allow for a fourth COVID-19 vaccine dose in adults 18 years of age or older who have received an initial booster of any of the authorized or approved COVID-19 vaccines. According to Moderna, the request to include adults ages 18 years of age and older was made to provide flexibility to the U.S. Centers for Disease Control and Prevention (CDC) and health care providers to determine the appropriate use of an additional booster dose, including for those at higher risk of COVID-19 due to age or comorbidities. Moderna’s request is based in part on recently published data generated in the U.S. and Israel following the emergence of Omicron.

The FDA is anticipated to convene its Vaccines and Related Biological Products Advisory Committee (VRBPAC) in April to review the requests and consider recommendations for booster doses in 2022. A specific meeting date has not yet been set.

CDPH Updates COVID-19 Guidance for Mega Events

Today, the California Department of Public Health announced a change to its COVID-19 guidance for mega events. Effective April 1, 2022, requirements for vaccine verification or proof of a negative test for indoor mega events will be lifted and move to a strong recommendation.

Additional information is available here.

CDPH Issues Fact Sheet on Federal Test-to-Treat Initiative

The California Department of Public Health (CDPH) recently issued a fact sheet on the federal government’s COVID-19 Test-to-Treat initiative. Recall, the U.S. Government unveiled the initiative to promote rapid access to free treatment for COVID-19. Beginning March 7, the U.S. Department of Health and Human Services (HHS) began distributing oral antivirals Paxlovid and Molnupiravir directly to federally qualified health centers, pharmacy-based clinics, and long-term care facilities.

Facilities not participating in the federal program which are able to offer Test-to-Treat services can be added to the new upcoming HHS Test-to-Treat locator. Local health jurisdictions will be responsible for vetting additional Test-to-Treat facilities in their jurisdictions.

Additional information is available here.

CDC Launches 2022 Mental Health Study for Public Health Workers

The U.S. Centers for Disease Control and Prevention (CDC) this week launched its 2022 State, Tribal, Local, and Territorial (STLT) Mental Health Survey to understand and address the mental health impacts and support needs of frontline public health workers.

The survey is an anonymous, self-administered, online questionnaire that covers questions addressing symptoms of anxiety, depression, post-traumatic stress disorder (PTSD), and suicidal ideation. The survey additionally assesses demographics, job categories, and work environments. The study additionally seeks information on organizational support and coping strategies throughout the pandemic.

The survey will remain open through March 25, 2022. Additional information is available here.

Johns Hopkins Researchers Publish Study on Harassment of Public Health Officials

A study led by researchers at the Johns Hopkins Bloomberg School of Public Health was released this week, identifying 1,499 unique reports of harassment across local health departments in the U.S. during the first 11 months of the pandemic from March 2020 to January 2021. The study additionally found that more than half of surveyed local health departments (57 percent) had been targets of harassment.

Moreover, the study found that across state and local health departments, 222 public health officials departed their positions during this time period, with more than one-third of those departures (36 percent) involving officials who had experienced some form of harassment. According to researchers, the study provides scope and context to departures of public health officials during the first phase of the pandemic, underscoring the importance of prioritizing worker safety and wellbeing in health departments and public health systems, especially in times of crisis.

Researchers utilized data from a survey of local public health departments conducted by the National Association of County and City Health Officials (NACCHO), as well as media reports and other accessible information about the departure of public health officials nationwide. Five common themes of health officials’ experiences during the pandemic emerged: a sense of being underappreciated, undersupported, villainized, caught up in politics, and disillusioned.

Authors of the study, published in the American Journal of Public Health, suggest that training public health officials on how to respond to political and societal conflict, improving professional support systems, providing employee support, making investments in long-term public health staffing and infrastructure, and establishing sound reporting systems for harassment incidents are key to reducing the threats against public health officials and ensuring support for officials when incidents do occur.

Additional information on the study is available here.

CalSHAPE Funding Available to Improve School Ventilation

This week, the California Schools Healthy Air, Plumbing, and Efficiency Program (CalSHAPE) announced a funding opportunity for local educational agencies to upgrade heating, air, and ventilation (HVAC) systems in public schools. In addition, the funding will also cover noncompliant plumbing fixtures and appliances that fail to meet water efficiency standards.

The CalSHAPE Ventilation will be accepting Funding Round Two applications starting on March 28, 2022, at 10:00am and will close on May 31, 2022, at 5:00pm. In Funding Round Two, grants are awarded only for projects at sites located in an “Underserved Community” as defined in Chapter 1, Section E of the guidelines.  Submissions must be completed via the CalSHAPE Online System.

More information can be found under the “Ventilation Program” on the CalSHAPE website available here.

CDC Finds Decreases in Adult Tobacco Use

The most recent findings from the U.S. Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report indicate decreases in the use of commercial tobacco products overall, combustible tobacco products, cigarettes, e-cigarettes, and two or more tobacco products among U.S. adults from 2019 to 2020. Despite these decreases, however, nearly one in five adults (an estimated 47.1 million) reported current tobacco product use in 2020, including 30.8 million who smoked cigarettes.

In assessing national tobacco product use among adults, the CDC analyzed data from the 2020 National Health Interview Survey. The survey assessed use of five tobacco products: cigarettes, cigars (cigars, cigarillos, or filtered little cigars), pipes (regular pipes, water pipes, hookah), e-cigarettes, and smokeless tobacco.

The study found that, in 2020, 19.0 percent of U.S. adults used at least one tobacco product, down from 20.8 percent in 2019. Cigarettes remained the most commonly used product (12.5 percent), followed by e-cigarettes (3.7 percent), cigars (3.5 percent), smokeless tobacco (2.3 percent), and pipes (1.1 percent). Notably, marked disparities in current tobacco use among U.S. adults persist.

Additional information is available here.

FDA to Host Public Workshop on Naloxone Access

The U.S. Food and Drug Administration (FDA) will host a virtual public workshop on Tuesday, March 29 from 9:30 am to 12:00 pm to discuss critical questions around access to naloxone. The workshop is a collaboration with the Reagan-Udall Foundation for the FDA.

The workshop will provide an in-depth discussion to review the current landscape of naloxone availability, address perceived barriers to naloxone access, and address questions posed by various groups on the subject. In addition, various stakeholders, including harm-reduction specialists, physicians, pharmacists, and regulators, will also share their experiences in addressing the availability of naloxone for opioid overdose.

Additional information, including registration, is available here.

HHS Announces Opioid Use Disorder Funding Opportunities

The U.S. Department of Health and Human Services (HHS), through the Substance Abuse and Mental Health Services Administration (SAMHSA), recently announced two new grant programs totaling $25.6 million to expand access to medication-assisted treatment for opioid use disorder and prevent the misuse of prescription drugs. The funding opportunities reflect priorities of the HHS Overdose Prevention Strategy and new efforts to strengthen the country’s mental health and crisis care systems.

The two grant programs are:

  • Strategic Prevention Framework for Prescription Drugs (SPF Rx) – Provides funds for state agencies, territories, and tribal entities that have completed a Strategic Prevention Framework State Incentive Grant plan or similar state plan to target prescription drug misuse. The grant program will raise awareness about the dangers of sharing medications, fake or counterfeit pills sold online, and overprescribing. The grant will fund a total of $3 million over five years for up to six grantees.
  • Medication-Assisted Treatment – Prescription Drug and Opioid Addiction (MAT-PDOA) – Provides resources to help expand and enhance access to Medications for Opioid Use Disorder (MOUD) and help increase the number of individuals with opioid use disorder (OUD) receiving MOUD and decrease illicit opioid use and prescription opioid misuse. The grant will fund a total of $22.6 million over five years for up to 30 grantees. No less than $11 million will be awarded to Native American tribes, tribal organizations, or consortia.

Additional information on the two funding opportunities is available here.

HHS Announces Funding Opportunities for Populations at Risk or Living with HIV/AIDS

The U.S. Department of Health and Human Services (HHS), through the Substance Abuse and Mental Health Services Administration (SAMHSA), announced three funding opportunities to strengthen mental health and substance use services for individuals at risk for or living with HIV/AIDS. The funding, totaling $43.7 million, is being deployed to help underserved communities and aligns with the Biden-Harris Administration’s National HIV/AIDS Strategy.

The funding programs include:

  • Substance Use Disorder Treatment for Racial/Ethnic Minority Populations at High Risk for HIV/AIDS – Provides funding to increase care for racial and ethnic minority individuals with cooccurring substance use and mental health challenges who are at risk for or are living with HIV/AIDS and receive HIV primary care and other services. The grant will fund up to $30.5 million over five years to up to 61 grantees.
  • Substance Abuse and HIV Prevention Navigator Program for Racial/Ethnic Minorities – Provides funding for training and education around the risks of substance use and HIV/AIDS, as well as the integration of a range of services for persons with HIV/AIDS. The program uses a navigation approach, including community health workers, neighborhood navigators, and peer support specialists, to expedite services for these populations. The grant will fund up to $4.5 million over five years to up to 18 grantees.
  • Minority AIDS Initiative Service Integration – Provides funding to reduce cooccurring epidemicsof HIV, Hepatitis, and mental health challenges through accessible, evidence-based, culturally appropriate treatment that is integrated with HIV primary care and prevention services. The grant will fund $8.7 million over four years up to 18 grantees.

Additional information on the funding opportunities is available here.

SAMHSA Launches 9-8-8 Website

This week, the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) launched a new website dedicated to the 9-8-8 suicide and crisis lifeline. The new website is designed to serve as a one-stop-shop for all 9-8-8 resources from SAMHSA.

The website hosts a 9-8-8 partner toolkit, key communications resources, frequently asked questions, and other information about 9-8-8 and its implementation efforts. The official 9-8-8 transition will occur on July 16, 2022.

The new website is available here.