March 25, 2022 Edition
The CHEAC Annual Meeting provides networking and learning opportunities to local health department leadership and staff throughout California. This year’s conference will occur October 5-7 in Sonoma County with the theme of “Public Health Equity & Readiness Opportunity (HERO) – Achieving an Equitable and Resilient Workforce and Recovery.” The conference 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 6.
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 Monday, April 25, 2022.
This week, the California State Senate and Assembly maintained a steady schedule of policy committee hearings, considering new measures introduced this year. A handful of budget subcommittees will meet over the next week, but most have largely wrapped up their work until the Governor’s May Revise Budget release in mid-May.
On Thursday, Senate President pro Tempore Toni Atkins and Assembly Speaker Anthony Rendon issued a statement announcing a measure to extend through June 30, 2022, pandemic-related eviction protections for residents who are participating in rental assistance programs will receive quick action in both the Senate and Assembly. Under current law, state eviction protections are set to expire next week on Friday, April 1, just one day after the March 31 deadline for residents to apply for state rental relief. The measure maintains the March 31 application deadline but would protect residents from eviction action while the state processes relief applications. The measure also prohibits local governments from enacting their own eviction protections until July 1, at the earliest.
In other news this week, Governor Newsom signed into law SB 245 (Gonzalez) prohibiting health plans and insurers from imposing a copay, deductible, or other cost-sharing requirement or utilization management practice for abortion and abortion-related services. In signing the law, Governor Newsom reiterated California’s commitment to protecting reproductive health choices.
This week also brought more proposals related to addressing the high price of gasoline statewide. Governor Gavin Newsom unveiled an $11 billion proposal to provide $400 in direct payments per vehicle (up to two vehicles) to residents, $750 million in incentive grants to transit agencies to provide free transit for three months, $600 million to pause part of the diesel sales tax, and $523 million to pause the inflationary adjustment to gasoline tax rates. This proposal comes as a series of other proposals have been offered from legislators, including an attempt by Republican lawmakers to immediately suspend the gas tax and others by Democratic lawmakers to provide cash payments to specified residents. At this time, it remains unclear how the Legislature and Administration will work together to address the price of gasoline.
Below, we highlight several bills of interest to CHEAC Members. For a full update, the latest edition of the CHEAC Weekly Bill Chart is available here.
Built Environment & Climate Change
AB 2076 (L. Rivas) as amended March 23, 2022 – SUPPORT IN CONCEPT
Assembly Bill 2076 by Assembly Member Luz Rivas was heard on Monday in the Assembly Natural Resources Committee. AB 2076 sets forth a variety of actions related to extreme heat, including the Extreme Heat Hospitalization and Death Reporting System, the Extreme Heat and Community Resilience Program, a chief heat officer and heat advisory council, and updates to the state’s Extreme Heat Action Plan. This measure is sponsored by the Climate Resolve and was advanced to the Assembly Health Committee on a 10-0 vote with one member not voting.
Chronic Disease Prevention & Wellness Promotion
AB 1618 (Aguiar-Curry) as amended March 8, 2022 – SUPPORT IF AMENDED
AB 1618 authored by Assembly Member Aguiar-Curry was advanced from the Assembly Health Committee to the Assembly Appropriations Committee on Tuesday on consent on a 14-0 vote. AB 1618 requires the California Department of Public Health (CDPH) to establish an Office of the Healthy Brain Initiative and implement a grant program to support local initiatives consistent with the CDC’s Healthy Brain Initiative.
Communicable Disease Control
SB 1234 (Pan) as introduced February 17, 2022 – SUPPORT
Senator Richard Pan’s SB 1234 was heard in the Senate Health Committee on Wednesday. The measure would require reimbursement in the Family PACT program, subject to appropriation and draw down FFP, for STD-related services to the uninsured, income-eligible patients, or without healthcare coverage, or patients who obtain confidentiality concerns who are not at risk for pregnancy or do not need contraceptive services. SB 1234 was advanced from the Senate Health Committee to the Senate Appropriations Committee on a 9-0 vote with two Senators not voting.
Health Coverage/Health Care Reform
AB 1995 (Arambula) as amended March 24, 2022 – SUPPORT
AB 1995 would eliminate Medi-Cal premium and subscriber contributions for children, pregnant and postpartum women, and individuals with disabilities. This measure would also prohibit the department from imposing subscriber contributions for the purpose of coverage. AB 1995 was heard in the Assembly Health Committee on Tuesday and now moves to the Assembly Appropriations Committee after receiving a 12-0 vote with two members not voting.
On Monday, the Assembly Budget Subcommittee No. 1 on Health and Human Services heard various proposals under the California Department of Public Health (CDPH), including the Governor’s January Budget proposal to provide $300 million ongoing to state and local health departments. CDPH Director and State Public Health Officer Dr. Tomás Aragón and Chief Deputy Director Susan Fanelli presented the Newsom Administration’s proposal to provide $200 million to local health jurisdictions and $100 million to CDPH for critical state public health workforce and infrastructure.
The state’s portion of the $300 million investment is anticipated to support over 400 positions at the state level across workforce development, emergency preparedness and response, information technology and data science, communications and public education, community partnerships, and community health improvement efforts.
During the hearing, CHEAC Executive Director Michelle Gibbons emphasized the importance of the investments proposed by the Newsom Administration. Ms. Gibbons, during her remarks to the subcommittee, expressed CHEAC’s support for the Governor’s $300 million proposal to fund advancements in state and local public health challenges the public health workforce is experiencing, exacerbated by burnout, harassment of public health officials, and increased competition with other sectors.
Ms. Gibbons emphasized the importance of the investment to enable state and local health departments to begin to rebuild and expand the local public health workforce. Ms. Gibbons also called attention to the California Can’t Wait Coalition’s budget requests for one-time investments in critical public health training and workforce pipeline investments.
SEIU California member Julio Ramirez, a Public Health Microbiology Supervisor, brought attention to the importance of the work of public health professionals such as public health educators, disease investigators, microbiologists, and community health workers perform for California communities.
Mr. Ramirez explained that while effective efforts have been made to curtail the effects of COVID-19, the prior lack of funding for the public health infrastructure severely decreased California’s ability to combat other harmful diseases and organisms. He finished his testimony by emphasizing that the $300 million in funding proposed by the Newsom Administration for public health will assist in rebuilding the public health infrastructure and thereby increase public health professionals’ capacity to protect the health of Californians.
Following the panel’s comments, Assembly Budget Subcommittee No. 1 Chair Assembly Member Joaquin Arambula expressed the Legislature’s willingness to engage with CDPH and address the public health workforce pipeline needs. He also reiterated his interest in ensuring local jurisdictions do not supplant the funding, with CDPH highlighting metrics that are forthcoming and will hold locals accountable. Assembly Member Arambula also raised questions around the Legislative Analyst’s Office recommendation in evaluating the laboratory capacity in California. CDPH discussed work groups intended to explore this and committed to a detailed evaluation of the appropriate capacity in our state.
CHEAC supports additional items considered by the Assembly Budget Subcommittee No. 1 including the climate and health surveillance program, public health regional climate planning, the Alzheimer’s Healthy Brain Initiative, California Home Visiting Program expansion, and the Black Infant Health (BIH) program expansion.
No action was taken by the committee and items were held open. The full agenda for Monday’s hearing is available here. A video recording of the hearing is available here. (Please note, there were technical issues that affected the audio throughout the hearing so some portions of the testimonies and questions may not be audible.)
On Tuesday, California Department of Finance (DOF) Director Keely Martin Bosler announced she will soon step down from her role after the 2022 Budget Act is finalized this summer. Bosler has served as the DOF Director during Governor Gavin Newsom’s entire first term in office.
Bosler was first appointment DOF Director in August 2018 by then-Governor Jerry Brown. Newsom, in December 2018, reappointed Bosler as the Governor’s chief fiscal policy advisor. Bosler previously served as Cabinet Secretary for Governor Jerry Brown from 2016 to 2018 and DOF Chief Deputy Director from 2013 to 2016. She has extensive budget and fiscal experience, serving as staff director and consultant for the Senate Budget & Fiscal Review Committee, associate director for fiscal services for the California Department of Corrections and Rehabilitation (CDCR), and fiscal and policy analyst for the California Legislative Analyst’s Office (LAO).
Additional information is available here.
Today, state officials from the California Department of Public Health (CDPH) warned consumers not to eat specific brands of enoki and mixed mushrooms imported from China, Korea, and Taiwan after tests conducted by CDPH found Listeria monocytogenes. CDPH instructs consumers in possession of these specific types of packaged enoki and mixed mushrooms to immediately discard the products.
The affected packaged mushrooms were sold at retail stores in California during the first part of March 2022. Recent surveillance sampling of mushrooms at grocery stores by the CDPH Food and Drug Branch determined these mushrooms were contaminated. Eight of the 10 samples collected on March 2, 2022, tested positive for the bacterium.
CDPH notes voluntary recalls have been issued by multiple firms after the identification of Listeria monocytogenes. Symptoms of Listeria infection may include high fever, headaches, and neck stiffness. Infants, the elderly, and people with weakened immune systems are at highest risk for severe illness and death. Listeria infection in pregnant women may lead to miscarriage or stillbirth, premature delivery, or infection of the newborn. Consumers experiencing illness after consumption of these packaged products are instructed to consult their health care provider.
Additional information form CDPH is available here.
The California Department of Public Health (CDPH) is currently soliciting nominations for the 2021 and 2022 Beverlee A. Myers Award for Excellence in Public Health. This award recognizes the contributions of public health and health care services professionals in improving the health status of everyone who calls California home and the millions who visit the state every year.
The Beverlee A. Myers award is presented annually to an individual not currently working at CDPH who has exhibited outstanding leadership and accomplishments in public health in California. Nominations are due to CPDH by Thursday, March 31 at 5:00 pm. The award recipients for 2020, 2021, and 2022 will be recognized at the Public Health Week Virtual Awards Ceremony on Thursday, April 21, 2022.
Additional information on the award and the nomination process is available here.
This week, the U.S. Health Resources and Services Administration (HRSA) announced it has stopped accepting claims for COVID-19 testing and treatment for uninsured individuals due to a lack of sufficient funds. No claims submitted to HRSA for testing or treatment after March 22, 2022, will be processed for adjudication or treatment, according to the agency. HRSA also indicates the Uninsured Program will stop accepting claims for vaccination on April 5, 2022, due to lack of sufficient funds.
Previously, the U.S. Department of Health and Human Services (HHS) had reimbursed providers delivering these services to uninsured and underinsured individuals. The Biden-Harris Administration indicated the wind-down of the program is an early consequence of Congress failing to provide an additional $15 billion in COVID-19 emergency funding requested by the Administration.
In light of the federal action, the California Department of Health Care Services (DHCS) announced it will accept claims for individuals enrolled in the COVID-19 Uninsured Group Program. Individuals must apply for the program through a Medi-Cal qualified provider (QP). QPs include providers of the following programs: Presumptive Eligibility for Pregnant Women, Breast and Cervical Cancer Treatment Program, Hospital Presumptive Eligibility, and Child Health and Disability Prevention. Providers must submit applications via the COVID-19 Uninsured Group Application Portal to be able to submit COVID-19 testing, testing-related, and treatment claims to DHCS for claims processing.
The COVID-19 Uninsured Group Program is authorized under the Families First Coronavirus Response Act which was enacted by Congress in March 2020. The program will end the last day of the calendar month in which the federal COVID-19 public health emergency ends.
The U.S. Food and Drug Administration (FDA) announced it will convene a virtual meeting of the Vaccines and Related Biological Products Advisory Committee (VRBPAC) on Wednesday, April 6 to discuss considerations for future COVID-19 vaccine booster doses and the process for selecting specific strains of the SARS-CoV-2 virus for COVID-19 vaccines to address current and emerging variants.
Advisory committee members, as well as representatives from the U.S. Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH), will participate in the April 6 meeting. The meeting will assist the FDA in develop a general framework that will inform its regulatory decision-making on what might warrant updating COVID-19 vaccine composition to address specific variants and timing and populations for COVID-19 vaccine booster doses in the coming months.
The FDA notes that a vote is not planned for the meeting and there will not be any discussions on product-specific applications, including booster authorization requests from Pfizer and Moderna submitted to the FDA last week.
Additional information from the FDA is available here.
This week, Moderna announced it plans over the coming weeks to submit an emergency use authorization (EUA) request to the U.S. Food and Drug Administration (FDA) for a two-dose COVID-19 mRNA vaccine for children six months to six years old.
The vaccine for children is a quarter of the dose of Moderna’s adult COVID-19 vaccine and the two-dose regimen was found to generate similar protection against the virus as it did for adults. Real-life effectiveness was less robust during the omicron wave, but no children were found to develop severe disease. Reported side effects were similar in children as adults, with no one in the clinical trial developing severe side effects.
Additional information is available here.
The Federal Emergency Management Agency (FEMA) recently announced that additional disaster funding is available to all states, tribal nations, and territories with presidential major disaster and emergency declarations issued in 2020 and 2021.
President Joseph R. Biden, Jr. signed into law the 2022 Consolidated Appropriations Act (H.R. 2471) last week, granting a minimum 90 percent federal cost share for any emergency or major disaster declaration declared occurring or having an incident period between January 1, 2020, and December 31, 2021. The enacted law authorizes an increase to the standard 75 percent federal cost share to at least 90 percent for Public Assistance, the Hazard Mitigation Grant Program, and specified Individual Assistance programs authorized under disaster declarations.
The assistance authorized under H.R. 2471 is in addition to President Biden’s March 1 announcement extending full federal cost share to 100 percent for all eligible work under the COVID-19 emergency and major disaster declarations through July 1, 2022.
Additional information is available here.
On Monday, the U.S. Department of Health and Human Services (HHS) recognized the one-year anniversary of the Health Resources and Services Administration (HRSA) Health Center COVID-19 Vaccine Program which has provided COVID-19 vaccines directly to thousands of HRSA-supported health center sites nationwide. To date, health centers have administered more than 20 million vaccines in underserved communities across the country through the HRSA program and in partnership with states.
The HRSA Health Center COVID-19 Vaccine Program is supported by funding from the American Rescue Plan Act (ARPA), which provided $7.6 billion to health centers to prevent, mitigate, and respond to COVID-19.
Additional information is available here.
The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), this week announced more than $413 million in Provider Relief Fund (PRF) payments to more than 3,600 providers throughout the country. The latest round of funding is the fourth round, totaling nearly $12 billion that has been distributed to more than 82,000 providers in all 50 states, Washington, D.C., and five territories since November 2021.
This amount is in addition to HRSA’s distribution of American Rescue Plan Act (ARPA) rural payments totaling nearly $7.5 billion in funding to more than 44,000 providers across the country over the past four months. PRF payments received in the first half of 2022 can be used until June 30, 2023. Approximately 89 percent of fourth phase applications have been processed.
According to HRSA, PRF payments have played a key role in response to COVID-19, helping providers prevent, prepare for, and respond to the COVID-19 pandemic. Providers can use the payments to continue supporting patient care and respond to workforce challenges through recruitment and retention efforts.
Additional information is available here.
The U.S. Department of Health and Human Services (HHS) this week released, on the 12th anniversary of the Affordable Care Act (ACA), a new report highlighting the successes of the ACA and key health coverage gains made under the initiative. The “State of the ACA” report, published by the Centers for Medicare and Medicaid Services (CMS), indicates that the ACA remains in a strong position, providing coverage to millions of Americans.
The report further highlights initiatives undertaken by the Biden-Harris Administration to strengthen the ACA and expand coverage to more individuals, including through pandemic-related special enrollment periods (SEPs) and expanded tax credits to offset costs of coverage.
Additional information is available here.
This week, U.S. Health and Human Services (HHS) Secretary Xavier Becerra and U.S. Education Department (ED) Secretary Miguel Cardona launched a joint-department effort to expand school-based health services in an effort to ensure children have the health services and supports necessary to build resilience and thrive. Under the joint effort, HHS and ED will provide additional technical assistance, resources, and support to schools on federal funding available for school-based physical and behavioral health services.
As part of the effort, HHS and ED will host a webinar on Wednesday, March 30 at 12:00 pm PT to highlight successful models of health center service delivery in schools, as well as approaches, needs, and opportunities to support partnerships between schools and health centers.
Additional information is available here.
Effective Friday, April 1, 2022, the California Department of Health Care Services (DHCS) will extend the postpartum care coverage period for currently eligible and newly eligible pregnant individuals. The American Rescue Plan Act (ARPA) Postpartum Care Expansion (PCE) extends the coverage period from 60 days to 365 days for individuals eligible for pregnancy and postpartum care services in Medi-Cal and the Medi-Cal Access Program (MCAP).
ARPA PCE coverage includes the full breadth of medically necessary services during pregnancy and the extended postpartum period. Pregnant and postpartum individuals do not have to request PCE or provide any additional information. All Medi-Cal and MCAP-eligible individuals who report a pregnancy or are in their postpartum period are automatically eligible for ARPA PCE, regardless of immigration status or how the pregnancy ends.
All DHCS systems have been programmed and are prepared for April 1 implementation. For questions about the expansion, DHCS has established an inbox (pregnancy@dhcs.ca.gov).
This week, the U.S. Food and Drug Administration took a series of actions as part of its work to ensure any electronic nicotine delivery system (ENDS) products available on the market have demonstrated that marketing of the products is appropriate for the protection of public health.
The FDA authorized several tobacco-flavored ENDS products from Logic Technology Development, LLC, after concluding that the likely benefit for adult smokers who significantly reduce their cigarette use (or who switch completely and experience cigarette use cessation) outweighs risk to youth, provided that the company follows post-marketing requirements to reduce youth access and exposure to marketing. The FDA also issued marketing denial orders to Logic for multiple other ENDS products. Denied products currently on the market must be removed or the FDA may take enforcement action.
The FDA has taken action on approximately 99 percent of the nearly 6.7 million ENDS products submitted for premarket authorization, including issuing marketing denial orders for more than one million ENDS products. Of additional note, the FDA is close to making additional decisions on applications for popular ENDS products that account for a large part of the market. The continued marketing of these products, according to the FDA, has the potential to have a substantial public health impact, either positively or negatively, as they hold an overall large market share and are used by a significant amount of people.
Additional information from the FDA is available here.
The U.S. Centers for Disease Control and Prevention (CDC) on Thursday, in observance of World Tuberculosis (TB) Day, recognized a slate of public health professionals as 2022 CDC U.S. TB Elimination Champions. According to the CDC, the champions have adapted to the changing health care landscape and played an important role in ensuring equitable access to TB services.
Out of the eight TB champions recognized by the CDC, the following California local health department teams were acknowledged:
- Monterey County Public Health Department – TB Control Unit
- Solano County Public Health – TB Control Program
The Martin Luther King, Jr. Hospital Infection Prevention Team in Los Angeles County was also recognized.
Additional information on the 2022 CDC U.S. TB Elimination Champions is available here.
Preliminary data published this week from the U.S. Centers for Disease Control and Prevention (CDC) explore the effect of the COVID-19 pandemic on tuberculosis (TB) in the United States. Reported TB disease diagnoses decreased 20 percent in 2020 and remained 13 percent lower in 2021 than TB disease diagnoses made prior to the COVID-19 pandemic.
Before the COVID-19 pandemic, disease diagnoses typically declined between 1-2 percent each year. The 2020 and 2021 declines, according to the CDC, may be related to factors associated with the COVID-19 pandemic, including a true reduction in incidence as well as delayed or missed TB diagnoses.
For example, the CDC notes efforts to prevention COVID-19, including wearing masks and physically distancing, may have also reduced the spread of TB. Widespread disruptions to health care during the pandemic have also delayed TB diagnoses, and similarities in symptoms between COVID-19 and TB disease may have led to missed TB diagnoses.
Additional information, including the latest data, from the CDC is available here.
The California Healthy Places Index (HPI) will soon unveil a new version of its tool that can be used to explore and improve community conditions that influence health, well-being, and life expectancy. HPI 3.0, a product of the Public Health Alliance of Southern California (Alliance), will launch in early April, featuring more robust data and capabilities.
Other new features of the new version will include the ability to:
- Track indicator changes over time
- Conduct side-by-side map comparisons
- View data by ZIP codes and unincorporated areas
- Access policy recommendations tailored to the community needs
The Alliance will host a virtual launch webinar on Wednesday, April 6 at 10:00 am to feature the new and updated platform. Additional information, including registration, is available here.
The National Association of County and City Health Officials (NACCHO) recently announced an invitation to local health department leaders and staff to join NACCHO Subject Matter Expert (SME) Advisory Workgroups. The workgroups are a primary and recognized vehicle for identifying the opportunities and challenges facing local health departments and the field at large.
A listing of SME Advisory Workgroups is available here. The Workgroups will help inform and guide NACCHO’s strategic projects and activities. The application period for SME Workgroups will close on April 30, 2022. Additional information is available here.
The Public Policy Institute of California (PPIC) recently published a brief on California’s health care safety net. The brief highlights the various programs and providers that comprise the state’s health care safety net, primarily serving individuals with low incomes, no private insurance, and other special medical needs.
PPIC assesses the expansion of the health care safety net over recent years, including through Affordable Care Act (ACA) and undocumented immigrant coverage expansions. The brief further explores the impacts of the COVID-19 pandemic on the safety net, identifying declines in visits and service utilization throughout the pandemic. Lastly, PPIC highlights the critical role of county hospitals and primary care clinics in addressing equity gaps in coverage and care statewide.
The full PPIC brief is available here.
Governor Gavin Newsom issued a state of emergency this week for 16 counties impacted by severe weather in October 2021 that caused widespread damage to roads and other infrastructure. The counties include Amador, Butte, Contra Costa, Glenn, Humboldt, Lake, Marin, Mendocino, Monterey, Napa, Placer, Plumas, San Francisco, Solano, Sonoma, and Trinity.
The proclamation also directs Caltrans to request immediate federal assistance for highway repairs or reconstruction. Additional information is available here.