March 9, 2018 Edition
The CHEAC Legislative Committee is meeting in Sacramento today to review the second set of new bills introduced in 2018. Over 100 bills will be reviewed and assessed for their impact on public health and local health departments, and CHEAC’s official positions on measures will be determined by the committee.
Our CHEAC Weekly Bill Chart is available here. Please note that new bills being reviewed today will be included in next week’s bill chart. Stay tuned for information and updates on new bills introduced in 2018.
The Legislature continues to propose amendments to new measures and schedule policy committee hearings. Below, we highlight bill activity from this week:
Communicable Disease Control
AB 1992 (Chu) as introduced on 2/1/2018 – Watch
This week, AB 1992 by Assembly Member Kansen Chu was heard in the Assembly Human Services Committee. The measure seeks to extend the amount of time CalWORKs families have to comply with immunization verification requirements for children not yet enrolled in school from 45 days to six months before impacting the grant calculation to the household. In addition, the bill strives to ensure families have access to immunizations by requiring counties to provide transportation. If after six months, there is still no documentation on file, the head of household may be excluded from the grant calculation until documentation has been provided.
The Western Center on Law on Poverty, the sponsors of AB 1992, stated their intent is not to decrease immunization rates, but to simply allow additional time for compliance and to make immunizations more accessible and to incorporate better tracking.
The bill was passed by the Assembly Human Services Committee and now heads to the Assembly Appropriations committee.
Upcoming Bill Hearings
SB 835 (Glazer) as amended on 3/5/2018 – Support
SB 835 by Senator Glazer seeks to ban smoking and disposal of cigar and cigarette waste at all state parks and permits the Director of Parks and Recreation to exempt designated areas of state parks from smoking ban. The measure is set to be heard in the Senate Natural Resources and Water Committee on Tuesday, March 13.
SB 836 (Glazer) as amended on 3/5/2018 – Support
SB 836 by Senator Glazer seeks to ban smoking and disposal of cigar and cigarette waste at all state coastal beaches and permits the Director of Parks and to exempt designated areas of state coastal beach from the smoking ban. This measure is also set to be heard in the Senate Natural Resources and Water Committee on Tuesday, March 13.
As budget hearings continue to ramp up, this week the Assembly Budget Subcommittee No. 1 on Health and Human Services convened two hearings. Monday’s hearing focused on issues related to the Department of Health Care Services (DHCS) and the Department of Managed Health Care, while Thursday’s hearing focused on the Department of Rehabilitation and the Department of Developmental Services.
On Monday, DHCS Director Jennifer Kent provided members with an overview of the DHCS budget of roughly $104.5 billion for FY 2018-19. She highlighted key policy changes reflected in the Governor’s budget proposal, including the proposed 50 percent increase to home health rates for fee-for-service and waiver populations, utilizing Proposition 56 funds. In addition, she noted the proposed increase of $232 million in Proposition 56 funding to maintain supplemental payments negotiated in last year’s budget and provide supplemental payments to physician and dental providers.
Director Kent also reiterated the estimates included in the Governor’s budget for the Children’s Health Insurance Program (CHIP) was prior to the reauthorization by Congress. In light of this, the May Revision will update estimates to take into consideration the reauthorization at the enhanced federal match of 88 percent. During her comments, she also alluded to the proposed elimination of the 340B Program, which would be discussed further in an upcoming hearing.
Committee members demonstrated an interest in the Administration’s Proposition 55 calculation. Recall, in 2016 voters passed Proposition 55, which extended a tax on high-income earners in California. The proposition requires the Administration to perform a calculation to determine if additional funding is available for Medi-Cal. The Administration’s calculation did not result in additional funding for Medi-Cal. Members specifically questioned the Administration’s application of the additional $3.5 billion deposit into the Rainy Day fund. The topic will be revisited in a future hearing.
All items for the subcommittee hearing were left open. A complete agenda can be found here.
On Thursday, the Senate Budget Subcommittee No. 3 on Health and Human Services briefly revisited the IHSS MOE deal reached during the 2017-18 budget negotiations. Will Lightbourne, Director of the California Department of Social Services, provided a concise recap of events surrounding the new MOE provisions, including the Administration’s elimination of the Coordinated Care Initiative and termination of the previous county MOE.
The Legislative Analyst’s Office (LAO) did highlight the requirement for a two-year look back to evaluate the impacts of the IHSS MOE deal, however members of the Subcommittee did not have further questions at this time.
During public comment, CSAC thanked the Administration for their strong partnership and noted that while counties are managing the impact in the early years of the deal, that there is a need to revisit the MOE construct in the 2019-20 budget to ensure the delivery of IHSS and other critical services such as health and mental health. Our county associations submitted a joint coalition letter, which can be found here.
This week, the U.S. Centers for Disease Control and Prevention (CDC) reported that emergency department visits for opioid overdoses increased 30 percent in all parts of the United States from July 2016 to September 2017. Opioids include prescription pain medication, heroin, and illicitly manufactured fentanyl. The Midwest realized the highest increase in opioid overdoses with a 70 percent jump in overdoses, and the West realized the second highest increase with a 40 percent jump in overdoses. The nationwide increases occurred among both sexes and every age group of adults.
The latest data from the CDC shows that opioid overdoses continue to increase in cities and counties of all types, and the highest opioid overdose increase (54 percent) occurred in large cities. The CDC provides recommendations and roles for a variety of stakeholders, including health departments, healthcare providers, and state and federal governments. The CDC recommends that LHDs can:
- Alert communities to rapid increase in overdoses seen in emergency departments
- Increase naloxone distribution to first responders, families and friends, and other community members
- Increase availability of and access to treatment services, including medication-assisted treatment (MAT)
- Support programs to reduce harms which can occur when injecting opioids in combination with referral to treatment
The CDC urges coordination between LHDs, emergency departments, mental health and treatment providers, community-based organizations, and law enforcement to address and reduce opioid overdose and death. The full CDC Vital Signs report is available here.
Free CDC Continuing Education Webinar
On Tuesday, March 13 from 11:00 am to 12:30 pm, the CDC will also be offering a free continuing education (CE) webinar on how public health practitioners and health care providers can work together in coordinating a robust response to the opioid overdose epidemic. The webinar will feature Acting CDC Director Anne Schuchat, U.S. Surgeon General Jerome Adams, and other public health and medical professionals. Additional webinar information and registration is available here.
A recent report published in the journal Tobacco Control shows that after California’s 2016 increase in the minimum tobacco sales age from 18 years old to 21 years old, the percentage of California retailers selling tobacco to minors dropped from 10.3 percent to 5.7 percent. The rates are based on surveys in which minor decoys attempted to purchase tobacco from retailers.
The survey data indicated that nearly 99 percent of California tobacco retailers were aware of the new law that raised the age to purchase tobacco from 18 to 21, and nearly 61 percent of retailers supported the increase. While retailer compliance with the increased age limit varies geographically throughout the state, the data shows that high awareness and support for the new law likely contributed to a decrease in illegal tobacco sales to minors. The full Tobacco Control article is available here.
The National Association of Counties (NACo) has set April 18 as County Health Day—a day designed to feature the important work counties are doing to improve health. Throughout the day on April 18, NACo will post links and examples of county innovations and accomplishments, as well as health tools and resources available to other jurisdictions.
NACo invites counties across the country to join in County Health Day by posting on NACo’s Facebook page or Tweeting @NACoTweets using #CountyHealth with links to your county’s public health projects, resources, and innovations to improve the health and wellbeing of your community. @NACoTweets will be hosting a #CountyHealth Twitter Chat on April 18 beginning at 11:00 am PST to discuss how counties support healthy communities.