March 2, 2018 Edition
The 2018 CHEAC Annual Meeting will be held on October 17 – October 19 in Sacramento and will provide local health department leadership and staff throughout the state with networking and learning opportunities.
This year’s conference theme is “Celebrating 30 Years of Improving the Health of All Californians” and will feature expanded workshops offered to attendees by collaborating with key partners to host innovating and exciting workshop sessions. Approximately 15 workshops will be hosted between 10:00 am and 4:00 pm on Wednesday, October 17 and Thursday, October 18.
Interested parties are invited to submit a workshop abstract proposal to CHEAC by COB on Friday, March 9. Additional information on workshop opportunities is available here.
In what is shaping up to be a busy spring ahead, activity within the California Legislature continues to ramp up as policy and budget committee hearings are being set for the coming weeks. Recall, last week, the CHEAC Legislative Committee met to review the first batch of new bills introduced by the Legislature this year. The Legislative Committee will be meeting once again next week to review the second batch of new bills and taking positions on measures that have a potential impact on public health and local health departments.
Our CHEAC Weekly Bill Chart, available here, now includes bills of interest that were identified by the Legislative Committee during our first in-person meeting last week. We will continue to regularly update CHEAC Members as Legislature moves forward with its busy agenda.
On Monday, the Assembly Budget Subcommittee No. 1 on Health and Human Services convened a hearing predominantly focused on issues related to the California Department of Public Health (CDPH). Susan Fanelli, CDPH Assistant Director, provided subcommittee members with a general overview of the department’s budget, highlighting their General Fund budget of $138 million. The budget reflects a one-percent ($10.4 million) General Fund reduction from the prior year for the department, which is largely attributed to one-time General Fund augmentations in 2016 for sexually transmitted disease control, naloxone kit distribution, Alzheimer’s disease early detection, hepatitis prevention efforts, and the Biomonitoring Program. She further provided highlighted key activities CDPH has been engaged in such as:
- Hepatitis A – Epidemiology and monitoring of the Hepatitis A outbreak, standing up command incident command centers, and the Governor’s emergency declaration which provided funding for the purchase of additional vaccinations.
- Influenza – Resistance testing, coordinating with medical health centers, ongoing communications with local health departments, and vaccine promotion.
- Zika – Tracking cases and outreach and close collaboration with Vector Control.
- Wildfires/Oroville Dam – Partnering with emergency medical services, activating emergency operation centers, initiating mapping, creating facility dashboards and providing supplies and technical assistance to local health departments.
- Cannabis – Implementing public education campaigns.
- Opioids – increasing access to naloxone kits and increasing public awareness through local opioid safety coalitions.
Gun Violence. The subcommittee was then provided updates on various programs under the purview of CDPH. Legislators did demonstrate a particular interest in school shooting data. However, CDPH indicated they do not have data on school shootings in particular, as firearm-related deaths are reported, but those are related to school shootings are not uniquely identified.
Lead. The hearing also had a brief discussion around lead testing and California’s lead accreditation and certification program. Legislators continued to inquire about the low rates of lead testing amongst children in Medi-Cal and questioned what agency is responsible for ensuring the rates improve.
For more information, hearing materials can be found here.
On Thursday, the White House hosted an Opioid Epidemic Summit to discuss efforts of the Trump Administration to address the nationwide opioid epidemic. The summit gathered a handful of Administration officials, including Health and Human Services Secretary Alex Azar and Attorney General Jeff Sessions, individuals who have been impacted by the opioid epidemic, and addiction- and recovery-related organizations.
President Trump briefly joined the summit, though he was not previously expected to participate. First Lady Melania Trump also addressed the nearly 200 individuals in attendance, indicating she is proud of what the Administration has accomplished, though there remains much work to be done. Panel discussions during the summit explored prevention, treatment and recovery services, as well as law enforcement and drug interdiction
Recall, the President’s Commission on Combating Drug Addiction and the Opioid Crisis released a report last November detailing nearly 60 recommendations to address the opioid epidemic. Most recommendations, however, have been unaddressed altogether, and only some are a work in progress.
While many advocates that attended Thursday’s summit reportedly remained skeptical of the Trump Administration’s approach and sense of urgency, the Administration continued to underscore its efforts to address opioid abuse through education and prevention outreach, treatment and recovery services, and law enforcement.
An overview of the summit is available from the White House here. An article detailing the Trump Administration’s approach to combatting the opioid epidemic is also available from the White House here.
The California Department of Public Health (CDPH) Prescription Drug Overdose Prevention (PDOP) Initiative has partnered with the Harm Reduction Coalition to provide a free, two-part webinar series on opioid overdoses and naloxone.
Part 1: Overdose Education and Naloxone Distribution (OEND)
Date: March 26, 2018
Time: 2:00 pm – 3:30 pm
Part 2: Implementing Naloxone Distribution Systems
Date: March 30, 2018
Time: 10:00 am – 11:30 am
Individuals are requested to register for the webinar(s) by Thursday, March 22. Additional information may be found here.
Regional full-day in-person naloxone trainings are also being scheduled for the coming months. There will be a training held in Santa Cruz on March 20, 2018, in San Diego in April (date TBD), and Fresno in May (date TBD). If you are interested in hosting a live regional naloxone training in your community, please contact CDPH at PDOP@cdph.ca.gov.
This week, the California Health Care Foundation (CHCF) launched a new resource to help county health executives and other local leaders in planning to meet the demand for medication-assisted treatment (MAT) and services for opioid-use disorders (OUD). CHCF worked in collaboration with the Urban Institute to create snapshots of each California county that show the prevalence of OUD and available treatment resources.
Assuming 20 percent of people with OUD seek treatment at any one time, researchers estimate the “treatment gap” in each county and suggest various strategies to meet the demand for services. The CHCF/Urban Institute data cards for each county are available for download here.
An informational webinar to provide an overview and guidance on use of the data card resource will be held on Thursday, March 15 from 11:30 am to 12:30 pm. Additional information and webinar registration are available here.
The Center on Budget and Policy Priorities recently published a report that highlights the importance of the Affordable Care Act’s (ACA) Medicaid expansion in increasing insurance coverage among individuals with opioid-use disorders (OUDs). The latest data available from the federal government rebut claims that Medicaid expansion contributed to or exacerbated the nationwide opioid crisis.
CBPP determined that Medicaid expansion increased coverage and access to treatment among populations with substance use disorders (SUDs) and dramatically reduced opioid-related hospitalizations. In states that expanded Medicaid, opioid-related hospitalizations in which the patient was uninsured fell from 13.4 percent in 2013 (just prior to expansion) to 2.9 percent two years later. The report indicates that many of these individuals experiencing OUDs gained coverage through Medicaid expansion. CBPP compares expansion vs. non-expansion states and determines that opioid-related hospitalizations have been growing at roughly the same rate in all states since expansion took effect.
The report finds that Medicaid expansion has been a critical tool in addressing the nationwide opioid crisis and showcases several state-based innovations that are underway, including those in California. The full CBPP report is available here.
This week, the Trust for America’s Health (TFAH) released an analysis detailing public health funding throughout the country, finding that spending on public health is insufficient and constitutes a crisis. The report examines funding levels at the federal, state, and local levels and provides recommendations to increase funds and improve the public’s health.
At the federal level, the analysis determines that the U.S. Centers for Disease Control and Prevention (CDC) budget, after adjusting for inflation, has been essentially flat for the past decade. 12 percent of the CDC’s budget consists of the Prevention and Public Health Fund (PPHF), and between FY 2013 and FY 2027, the PPHF will receive nearly $12 billion less than what was intended by law. Additionally, core emergency preparedness funding to state and local health departments has been cut by more than one-third since the program was established in 2002.
State spending on public health has been declining throughout the country, as well. While only 19 states and the District of Columbia maintained or increased their state public health budgets between FY 2015-2016 and FY 2016-2017, 31 states made cuts to their budgets. Further, state public health spending is lower in 2-16-2017 than it was in 2008-2009, given that some of the funding cuts that occurred during the Great Recession have not been fully restored and federal funding has been essentially flat.
At the local level, LHDs have lost over 55,000 staff due to layoffs or attrition since 2008. 25 percent of LHDs in the country also reported a lower FY 2016-2017 budget than the previous year, and fewer LHDs reported an increase in the current year’s budget as compared to previous years.
Pointing to specific public health and safety risks, including the recent California floods, wildfires, and debris flows, the TFAH report provides a series of recommendations to increase public health funding, improve preparedness and response readiness, and prevent illness and injury. Some of the key recommendations include:
- Preserving the Prevention and Public Health Fund (PPHF)
- Preparing for Public Health Emergencies and Pandemics
- Establishing a Standing Public Health Emergency Response Fund
- Building a National Resilience Strategy to Combat Deaths of Despair
- Preventing and Reducing Chronic Disease
Additional information on the TFAH report is available here. The full report is available here.
This week, the California State Association of Counties (CSAC) and the League of California Cities (League) Joint Homelessness Task Force released a report detailing the status of homelessness in California and tools and resources available to cities and counties to address the growing issue throughout the state.
Last year, CSAC and the League formed a joint task force to explore options to addressing homelessness in California and met several times over the course of the year. The task force heard from a wide variety of state and local leaders, nonprofit organization, and other stakeholder entities about the causes and solutions to the homelessness crisis. The report is intended to be a toolkit for local governments to help them identify programs, initiatives, partnerships, and funding sources to assist in reducing homelessness.
The CSAC-League Joint Homelessness Task Force Report is available here.
A webinar will be held on Wednesday, March 7 to discuss the report and highlight several innovative programs local governments are implementing to address homelessness. Additional webinar information and registration are available here. Two full-day workshops are also being planned on this topic, and dates and locations will be announced in the coming weeks.
The California Department of Public Health (CDPH) is soliciting nominations for the 2018 Beverlee A. Myers Award for Excellence in Public Health. This award recognizes the contribution of public health and health care services professionals in improving the status of all Californians and the millions who visit the state each year.
Nominations must be received by CDPH by Wednesday, March 7, 2018, at 5:00 pm. This year’s award recipient will be recognized at a special awards ceremony in Sacramento on Thursday, April 5, 2018, as part of National Public Health Week. Additional information is available here.
The County Services Medical Program (CMSP) is soliciting county representative nominations for the CMSP Planning and Benefits Committee. The Planning and Benefits Committee focuses on current CMSP policy and program issues and future directions for the program, particularly related to benefits design and coverage matters. The committee serves in an advisory capacity to the CMSP Governing Board.
Counties are limited to one county representative on each CMSP committee. Please view the CMSP letter, which details the committee and eligible counties, and nomination form here. Nominations are due to CSMP by Wednesday, March 7.
Healthy People 2020 recently announced that it will be holding a webinar to learn about progress made toward achieving the Healthy People 2020 Environmental Quality Leading Health Indicators on Thursday, March 22 from 9:00 am – 10:00 am. The webinar will specifically highlight the harmful effects of secondhand smoke exposure and showcase innovations in eliminating exposure to environmental tobacco smoke. Registration is available here.
The U.S. Centers for Disease Control and Prevention (CDC) Office on Smoking and Health recently published a new infographic and updated online information related to e-cigarettes. The material provides standard background information on the latest research, particularly in light of the recent National Academies of Sciences, Engineering, and Medicine (NASEM) comprehensive report on the Public Health Consequences of E-Cigarettes.
The CDC’s updated site is available here and the infographic is available here.
The Center for Sharing Public Health Services recently announced a small grant opportunity to organizations that wish to explore, plan, implement, or improve specific aspects of cross-jurisdictional sharing in public health. Grant awards will be funded up to $10,000 for a project period of up to eight months.
Additional information is available here. Submissions are due by Friday, March 30.