March 26, 2021 Edition
This week, the California State Senate and Assembly continued with a steady pace of policy and fiscal committee hearings. Following the adjournment of yesterday’s floor sessions, the Legislature began its week-long spring recess. Legislators are set to return to Sacramento on Monday, April 5, and, upon their return, will face a very busy month ahead.
Policy committee hearings will consume much of legislators’ time and attention throughout the month of April before the Legislature again shifts its focus to the budget corresponding with the release of the May Revise Budget by May 10.
The CHEAC Legislative Committee continues to review and identify recently amended bills of interest to local health departments and public health. Below, we highlight several of these measures. The latest edition of the CHEAC Weekly Bill Chart is available here.
Public Health Infrastructure
AB 240 (Rodriguez) as introduced January 13, 2021 – SPONSOR
CHEAC’s sponsored bill, AB 240 by Assembly Member Freddie Rodriguez, will be heard in the Assembly Health Committee on Tuesday, April 6. The measure would require the California Department of Public Health (CDPH) to contract with an appropriate and qualified entity to conduct an evaluation of the adequacy of the local health department infrastructure and to make recommendations for future staffing, workforce, and resource needs. CHEAC is joined by HOAC and SEIU California in sponsoring the measure.
Built Environment & Climate Change
AB 585 (L. Rivas) as amended March 17, 2021 – SUPPORT
Assembly Member Luz Rivas’ AB 585 was heard in the Assembly Natural Resources Committee on Wednesday. The measure establishes, upon appropriation by the Legislature, the Extreme Heat and Community Resilience Program within the Office of Planning and Research (OPR) to coordinate state efforts to address extreme heat, facilitate implementation of climate change projects statewide, and reduce public health risks by establishing community resilience centers. The measure is sponsored by Climate Resolve and was advanced to the Assembly Appropriations Committee on a 9-0 vote with two members not voting.
California Children’s Services (CCS)
AB 382 (Kamlager) as introduced February 2, 2021 – SUPPORT
AB 382 by Assembly Member (now Senator) Sydney Kamlager was advanced from the Assembly Health Committee to the Assembly Appropriations Committee on Tuesday on consent. The measure extends the termination of the DHCS Whole Child Model (WCM) Stakeholder Advisory Group by two years to December 31, 2023. The measure is sponsored by the California Children’s Hospital Association. CHEAC has a seat on the WCM Stakeholder Advisory Group and supports AB 382.
Chronic Disease Prevention & Wellness Promotion
SB 464 (Hurtado) as amended March 17, 2021 – SUPPORT
SB 464 by Senator Melissa Hurtado would modernize the California Food Assistance Program (CFAP) by recasting eligibility criteria to include noncitizens meeting all CalFresh eligibility criteria except for requirements related to immigration status beginning January 2023. The measure is sponsored by the California Immigrant Policy Center and is supported by CHEAC and the County Welfare Directors Association of California (CWDA). SB 464 was advanced from the Senate Human Services Committee to the Senate Appropriations Committee on Tuesday on a 4-1 vote.
AB 263 (Bonta) as revised March 24, 2021 – SUPPORT
AB 263 by Assembly Member Rob Bonta was heard by the Assembly Public Safety Committee on Tuesday. AB 263 would require a private detention facility operator to comply with and adhere to all local and state public health orders and occupational safety and health regulations. The bill is sponsored by the Immigrant Defense Advocates, NextGen, Physicians for Human Rights, and the California Collaborative for Immigrant Justice. CHEAC is joined by HOAC in supporting the measure which was unanimously advanced to the Assembly Floor on an 8-0 vote.
AB 1407 (Burke) as amended March 18, 2021 – SUPPORT
AB 1407 by Assembly Member Autumn Burke was recently significantly amended to require nursing schools and programs to include in their curriculum coursework on implicit bias. Nurse licensees within the first two years of holding their license would be required to complete one hour of direct participation in an implicit bias course and hospitals would be required to implement an evidence-based implicit bias program as part of its new nursing graduate training program. CHEAC is proud to support AB 1407.
SB 17 (Pan) as amended February 25, 2021 – SUPPORT
Senator Richard Pan’s SB 17 was heard in the Senate Governmental Organization Committee on Tuesday. SB 17 would establish a statewide Office of Racial Equity to be governed by a Racial Equity Advisory and Accountability Council to coordinate, analyze, develop, evaluate, and recommend strategies for advancing racial equity across state agencies, departments, and the office of the Governor. The Office would be required to develop a statewide Racial Equity Framework, and state agencies would be required to develop and implement a Racial Equity Action Plan that aligns with the statewide framework. CHEAC strongly supports SB 17 as it aligns with CHEAC’s statement on racism as a public health crisis, as well as the county leaders’ statement on racism as a public health crisis. SB 17 was advanced from the Senate Governmental Organization Committee to the Senate Judiciary Committee on a 9-3 vote with three Senators not voting.
Public Health Emergency Preparedness
AB 1202 (Cervantes) as amended March 22, 2021 – WATCH
AB 1202 by Assembly Member Sabrina Cervantes would require a county to ensure that local assistance centers are accessible to people with access and functional needs. Counties would be required to designate, prearrange, and procure space to aid in sheltering and transporting its homeless population during local and state emergencies and emergency evacuations. In its next update to its emergency plan, counties would also be required to integrate transportation and sheltering plans that include strategies for ensuring shelters and local assistance centers are accessible to homeless populations. Counties would also be required to enter into agreements with transportation agencies to transport its homeless populations to shelters and local assistance centers in the event of a local or state emergency. CHEAC took a “Watch” position on AB 1202 this week.
AB 1488 (Cervantes) as amended March 22, 2021 – WATCH
Assembly Member Sabrina Cervantes’ AB 1488 would require counties, upon its next update to its emergency plans, to work with Mutual Aid and Administrative Regions, the Emergency Medical Services Authority (EMSA), and the California Department of Public Health to coordinate interregional agreements for acquisition of medical equipment for access and functional needs populations. Subject to an appropriation by the Legislature, EMSA would also be required to contract with city and county local emergency medical services agencies to provide prearranged assistance to local jurisdictions in planning, organizing, implementing, and maintaining regional emergency medical equipment. CHEAC this week took a “Watch” position on this bill.
AB 541 (Berman) as amended March 2, 2021 – SUPPORT
Assembly Member Marc Berman’s AB 541 was advanced from the Assembly Health Committee to the Assembly Appropriations Committee on consent this week. AB 541 would require alcoholism and substance use disorder recovery and treatment facilities licensed by the Department of Health Care Services (DHCS) to assess each patient or client for tobacco use at the time of initial intake. If a tobacco use disorder is identified, a facility or program is required to provide specified information, including an offer for treatment or referral for tobacco use disorder treatment.
On Wednesday, Governor Gavin Newsom announced his selection of Assembly Member Rob Bonta as California’s next Attorney General. Bonta was named to the post following the recent confirmation of Xavier Becerra as the Secretary of the U.S. Department of Health and Human Services.
Bonta’s nomination must be confirmed by the California State Assembly and Senate within 90 days. In confirmed, Bonta will become the first Filipino American to serve as California Attorney General.
A full press announcement from the Governor’s Office is available here.
On Thursday, the Assembly Health Committee and the Assembly Budget Subcommittee No. 1 on Health and Human Services convened a joint informational hearing to continue its review of various components as part of the Newsom Administration’s ambitious California Advancing and Innovating Medi-Cal (CalAIM) proposal. Recall, the same committees have convened similar hearings over the past two weeks to explore behavioral health services, eligibility, in lieu of services (ILOS), and enhanced care management (ECM) services, among other components. Thursday’s joint informational hearing was likely the final informational hearing convened by the committees to review CalAIM proposals.
This week’s hearing featured nine panels and primarily focused on Medi-Cal managed care accreditation, rate-setting, dual eligible special needs plan (D-SNP) provisions, and county oversight components proposed under CalAIM. Representatives from the Department of Health Care Services (DHCS), including Director Will Lightbourne and State Medicaid Director Jacey Cooper, the Legislative Analyst’s Office (LAO), health plans, consumer groups, and labor organizations, among others testified on various components of CalAIM components.
CHEAC Executive Director Michelle Gibbons testified to the committees on the Administration’s proposal to increase DHCS oversight and monitoring of local California Children’s Services (CCS) and Child Health Disability Prevention (CHDP) Programs. Ms. Gibbons highlighted the crucial role of local health departments in administering these programs on behalf of the state, expressed the need for additional details on the proposed increased oversight and monitoring of the programs, and set forth recommendations for consideration by the legislative committees.
Thursday’s hearing agenda is available here. A background paper is available here. A video recording from Thursday’s hearing is available here.
This week, Governor Gavin Newsom announced that General Fund revenues are running approximately $14.3 billion above January’s revenue forecast, boosted by February receipts exceeding the month’s projections by nearly $4 billion. According to the Governor’s Office, nearly 60 percent of February’s gain is attributed to timing with lower refunds caused by later enactment of the $600 one-time Golden State Stimulus than initially anticipated, as well as fewer-than-expected state tax refunds due to a delayed federal start to the tax filing season.
As the Governor’s May Revise Budget release nears, additional details and updated projections are anticipated. More information from the Governor’s Office is available here.
The Newsom Administration on Thursday announced the state will begin expanding COVID-19 vaccine eligibility to additional populations in April amid increased vaccine supplies. Beginning April 1, individuals age 50 and over will be eligible to make an appointment. Beginning April 15, individuals age 16 and over will become eligible.
Based on current estimates, the Newsom Administration expects to be allocated approximately 2.5 million first and second doses per week in the first half of April, increasing to more than three million doses in the second half of April. Currently, California receives approximately 1.8 million doses per week. The Newsom Administration indicates the state has capacity to administer more than three million vaccines per week and anticipates having the capacity to administer four million vaccines weekly by the end of April.
In addition to expanded eligibility pursuant to the Biden-Harris Administration’s recent directive to make all adults eligible for a vaccine by May 1, the Newsom Administration indicated the state will update its vaccine allocation methodology. Over four weeks, beginning with the March 22 allocation, the state’s allocation methodology will shift from one based on the distribution of the 65 and older population and workers in specified occupations to one based on the distribution of the 16 and older population across California. This shift will be carried out in conjunction with completion of the shift to the state directly allocating vaccines to providers.
Additional information from the Governor’s Office is available here. A provider bulletin reflecting the upcoming changes is available here. Updated vaccine eligibility guidelines are available here.
Late last week, Governor Gavin Newsom signed SB 95 which extends access of up to 80 hours of COVID-19 supplemental paid sick leave for eligible employees, including those advised to quarantine or isolate and those caring for COVID-19-impacted family members. Under the legislation, supplemental sick leave is available through September 30, 2021, and is retroactive to sick leave taken beginning January 1, 2021. Small businesses employing 25 or fewer workers are exempt from the legislation, but may offer supplemental paid sick leave and, if eligible, receive a federal tax credit.
Additional information from the Governor’s Office is available here.
Within the past week, the California Department of Public Health (CDPH) updated a series of its COVID-19 guidance related to commencement ceremonies, amusement and theme parks, outdoor seated live events, in-person school instruction, youth recreational sports, and cohorts. Below, we highlight these updates:
- Outdoor Seated Live Events & Performances: CDPH today issued updated industry guidance for outdoor seated live events and performances, including ballparks, stadiums, and event venues, which are allowed to open beginning April 1 with significantly reduced capacity, fixed seating, mandatory masking, and other public health precautions. The updated guidance is available here.
- Amusement & Theme Park Guidance: Similarly, CDPH issued updated guidance for amusement and theme parks which are also allowed to open beginning April 1 with specified COVID-19 precautions. The updated guidance is available here.
- Commencement & Graduation Ceremonies: CDPH issued new guidance today for commencement and graduation ceremonies. The guidance provides recommendations to help students, teachers, families, and school administrators celebrate academic milestones while preventing the spread of COVID-19. Ceremonies must adhere to all California COVID-19 protocols for schools, travel, outdoor events, and lodging. The new guidance is available here.
- K-12 Schools Guidance: CDPH last Saturday updated its K-12 Schools Guidance to align with the latest science, as reflected by the recent guidance update from the U.S. Centers for Disease Control and Prevention (CDC). Under the updated guidance, CDPH strongly recommends distancing of at least three feet for students in classrooms. The updated guidance also renders all schools eligible to open if case rates are below 25 per 100,000 population. In all tiers, schools that have not yet opened must post their COVID-19 Safety Plan online five days before reopening. In the Purple tier, all schools must also submit their COVID-19 Safety Plan to their local health officer and the State Safe Schools Team concurrent with the online posting. The updated guidance is available here.
- Cohort Guidance: This week, CDPH additionally announced changes to its Cohort Guidance. The update now specifies that the cohort guidance applies to counties in the Purple tier only. This guidance is frequently referenced for operations at day camps, before- and after-school programs, and childcare centers.
This week, the Biden-Harris Administration announced it will invest nearly $10 billion to expand access to COVID-19 vaccines and better serve communities of color, rural areas, low-income populations, and other underserved communities. Below, significant components of the sizable investment are detailed:
- $6 Billion for Community Health Center Vaccines: The U.S. Department of Health and Human Services will invest more than $6 billion from the recently enacted American Rescue Plan into community health centers nationwide to expand COVID-19 vaccinations, testing, and treatment for vulnerable populations, deliver preventive and primary health services to people at higher risk for COVID-19, and expand health centers’ operations capacity during the pandemic and beyond. The Health Resources and Services Administration (HRSA) will provide funding starting in April to nearly 1,400 centers across the country. Additional information on the funding is available here.
- Expanded Eligibility: Community health centers participating in the federal Health Center COVID-19 Vaccine Program are now invited to expand eligibility to populations in the ACIP’s 1C eligibility tier, which includes frontline essential workers and all persons 16 years and older with high-risk medical conditions.
- $3 Billion to Strengthen Vaccine Confidence: HHS, through the Centers for Disease Control and Prevention (CDC), will invest $3 billion to support local efforts to increase vaccine uptake and equity. This funding will go directly to states, territories, and some large cities, enabling them to support local health departments and community-based organizations in launching new programs and initiatives intended to increase vaccine access, acceptance, and uptake. The awards will be made in early April and administered through CDC’s existing immunization cooperative agreement with 64 jurisdictions.
- Vaccines for Dialysis Patients: The Biden-Harris Administration announced a new partnership with dialysis clinics to provide COVID-19 vaccines to people receiving dialysis and health care personnel in outpatient dialysis clinics. Vaccines will be provided directly to dialysis treatment centers under this new partnership. A CDC press statement on this initiative is available here.
- $330 Million for Community Health Workers: HHS, through CDC, will provide $300 million to jurisdictions for community health worker services to support COVID-19 prevention and control, and an additional $32 million for training, technical assistance, and evaluation. This funding will be used to address disparities in access to COVID-19-related services and will help address factors that increase risk of severe COVID-19 illness. A CDC press statement on this initiative is available here.
Additional information from the Biden-Harris Administration is available here.
In addition to the above announcements, President Biden this week updated his Administration’s vaccination goal. Recall, the Biden Administration previously set a goal of administering 100 million COVID-19 vaccine doses within the Administration’s first 100 days. The Administration met that goal on its 58th day and has now set a goal of 200 million vaccines by the Administration’s first 100 days. The President’s announcement is available here.
This week, the U.S. Senate confirmed two officials nominated by the Biden-Harris Administration to top posts within the U.S. Department of Health and Human Services (HHS).
Dr. Vivek Murthy was confirmed on Tuesday as the U.S. Surgeon General on a 57-43 vote. This is Dr. Murthy’s second time serving as surgeon general after serving in the same role under the Obama and Trump Administrations. Dr. Rachel Levine was confirmed on Wednesday as the Assistant Secretary of Health (ASH) on a 52-48 vote. Dr. Levine became the first transgender person to be confirmed by the U.S. Senate and was previously the Secretary of the Pennsylvania Department of Health.
Relatedly, President Joseph R. Biden, Jr. this week nominated Dawn O’Connell as the next Assistant Secretary for Preparedness and Response (ASPR) within HHS. O’Connell is currently the Senior Counselor to the HHS Secretary for COVID-19. Previously, O’Connell served on the Biden Transition Team for health-related matters and was the director of the Coalition for Preparedness and Innovation’s (CEPI) U.S. Office. More information on her nomination is available here.
On Wednesday, Governor Newsom issued Executive Order N-85-20 extending price gouging protections for Butte, Los Angeles, Mendocino, Napa, Sonoma, and Ventura counties. These protections will remain in effect through December 31, 2021.
The California Department of Public Health, Injury and Violence Prevention Branch (CDPH/IVPB) and the California Department of Social Services, Office of Child Abuse Prevention (CDSS/OCAP)’s Essentials for Childhood (EfC) Initiative on Thursday, April 29, 2021, from 1:00 PM -2:30 PM will hold a webinar, titled, “Family Experiences During COVID-19 Pandemic Data Webinar.”
The webinar will feature representatives from the HOPE Project at Tufts Medical Center and the KidsData program at PRB for a discussion on the overview of the questionnaire, summarize California and national findings, share where to access California data and national messages, and offer highlights from the Healthy Outcomes Positive from Experience (HOPE) perspective.
Registration for the webinar is available here.
The Healthy Aging Initiative on Thursday, April 22 from 10:00 am to 11:15 am will convene a webinar as part of its Master Plan for Aging (MPA) and related Local Playbook. The webinar will feature representatives from the California Department of Aging (CDA) for a discussion on implementing MPA public health initiatives at the local level, an MPA Data Dashboard walk through, and questions regarding efforts within your specific community.
The webinar may be accessed here.