November 19, 2021 Edition

El Dorado County Awarded Accreditation Status by PHAB

We are pleased to announce that the El Dorado County Health and Human Services Agency – Public Health was recently awarded accreditation status by the Public Health Accreditation Board (PHAB) on November 16, 2021. El Dorado County becomes the 22nd local health department awarded PHAB recognition in California, in addition to the California Department of Public Health (CDPH).

Pleas join us in congratulating our colleagues in El Dorado County on their accomplishment. Additional information on the announcement is available here.

LAO Publishes 2022-23 Fiscal Outlook, Projects $31B Surplus

On Wednesday, the California Legislative Analyst’s Office (LAO) issued its annual publication, “The 2022-23 Budget: California’s Fiscal Outlook,” providing an assessment of the state’s budget condition and a preview of major decision points for the Legislature ahead of budget activities in the new year.

Perhaps most notably, despite the ongoing pandemic and associated economic impacts, revenues in California continue to grow at historic rates. The LAO estimates the state will have a $31 billion surplus to allocate in 2022-23. Given the rosy budget projections, the LAO notes that the State Appropriations Limit (SAL) will be a key issue and decision-point for the Legislature and Administration next year.

Recall, the SAL limits how the Legislature can appropriate revenues that exceed a specific threshold. Before allocating the projected surplus for discretionary purposes, the Legislature must first determine how much of the state’s revenues are subject to the SAL. The Legislature can then satisfy constitutional requirements imposed by SAL by lowering tax revenues, splitting excess revenues between education spending and taxpayer rebates, or appropriate more funds for purposes excluded from the SAL. Per the LAO, current estimates place the amount of revenues that will need to be allocated pursuant to SAL at roughly $14 billion for 2020-21 and 2021-22. For 2022-23, the state could realize an additional $12 billion in SAL requirements.

The LAO further notes that the operating surplus, the amount available to allocate on an ongoing basis, is lower than the total $31 billion surplus figure. There are a series of expenditures where costs may be lower than anticipated, including related to Medi-Cal and Pensions, leaving the state with a projected operating surplus of $3 billion to $8 billion to support new, ongoing spending.

The LAO rounds out its report with commentary on budget uncertainties, inflationary pressures, and budget choices and oversight for consideration by the Legislature. The LAO offers a series of recommendations for lawmakers, including taking action in early 2022 to address SAL requirements and keeping in mind administrative capacities of specified state agencies and departments for new spending.

Following the release of the LAO report, Assembly Speaker Anthony Rendon issued a statement reiterating the Legislature’s budgetary progress and indicating additional investments will be made to benefit all communities. Senate President pro Tempore Toni Atkins similarly issued a statement applauding the work of legislators and governors for strengthening the state’s overall fiscal condition and pointing to the LAO publication as valuable guidance as lawmakers take budget action in 2022.

The full LAO publication is available here.

Eligibility for COVID-19 Boosters Expanded to All Adults

Today, the U.S. Food and Drug Administration (FDA) amended the emergency use authorizations (EUAs) for the Moderna and Pfizer-BioNTech COVID-19 vaccines, authorizing the use of a single booster dose for all individuals 18 years of age and older after completion of the primary vaccination with any FDA-authorized or approved COVID-19 vaccine.

Prior to today’s announcement, a single Moderna or Pfizer-BioNTech COVID-19 booster vaccine was authorized for administration to individuals 65 years of age or older, individuals 18 through 64 years of age at high risk of severe COVID-19, and individuals 18 through 64 years of age with frequent institutional or occupational exposure to SARS-CoV-2. Today’s action expands the use of booster doses of both the Moderna and Pfizer-BioNTech vaccines to include individuals 18 years of age and older at least six months after the completion of the primary vaccine series of the Moderna and Pfizer-BioNTech vaccines or at least two months after completion of the primary vaccination with the Janssen COVID-19 vaccine.

Following the FDA’s amendments to the EUAs, the U.S. Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) considered updating its recommendations. That decision came this afternoon when the ACIP voted unanimously to recommend that the CDC expand eligibility for COVID-19 boosters. CDC Director Dr. Rochelle Walensky endorsed the ACIP recommendation, clearing the way for all adults ages 18 and older who received a Moderna or Pfizer-BioN-Tech vaccine at least six months after their second dose.

Recall, last week, the California Department of Public Health (CDPH) clarified expectations for the administration of booster doses, urging vaccine providers to not turn away a patient who is requesting a booster if the patient is 18 or over and has met the appropriate duration of time after their primary vaccination series.

Additional information from the FDA is available here.

Biden-Harris Administration to Procure 10m Courses of COVID-19 Oral Antiviral

This week, the Biden-Harris Administration announced it has secured 10 million treatment courses for Pfizer’s COVID-19 oral antiviral drug, pending an emergency use authorization (EUA) or approval from the U.S. Food and Drug Administration (FDA).

The investigational drug, Paxlovid, is under development to treat non-hospitalized, symptomatic adults diagnosed with COVID-19 who are at an increased risk of progressing to severe illness that could lead to hospitalization or death. Pfizer recently announced the results of a clinical trial which found that a treatment course of one dose every 12 hours for five days reduced the rate of hospitalization due to COVID-19 or death by nearly 90 percent of patients treated within three days of symptom onset. Similar results were found when treated within five days of symptom onset.

According to HHS, Paxlovid is a protease inhibitor designed to block an enzyme needed by the SARS-CoV-2 virus to replicate in human cells. Protease inhibitors are a class of drugs that prevent viruses from replicating within cells in the human body, rendering the virus unable to multiply and spread within the body. In laboratory studies, Paxlovid blocked SARS-CoV-2 replication, as well as other coronaviruses, indicating the potential for the drug to be tested in future clinical trials against other coronaviruses.

Through the purchase agreement announced this week, the U.S. government will receive 10 million treatment courses for $5.295 billion, with the first courses delivered by the end of 2021, pending EUA.

Additional information from HHS is available here.

CDC Reports Record High Overdose Deaths

The U.S. Centers for Disease Control and Prevention (CDC) National Center for Health Statistics (NCHS) this week released provisional figures finding that drug overdose deaths passed for the first time 100,000 during a 12-month period from April 2020-April 2021, representing an increase of nearly 30 percent from the previous year. In California, a nearly 48 percent increase was realized during the same 12-month period.

Overdose deaths slightly increased throughout 2019, though deaths have increased significantly since then. The CDC notes that financial, social, mental health, and other difficulties of the COVID-19 pandemic are likely to blame for the sharp increase in overdose deaths. Most of the overdose deaths were caused by synthetic opioids such as fentanyl.

Additional information and provisional figures are available here.

CDPH to Convene COVID-19 and Climate Crisis Webinar

The California Department of Public Health (CDPH) recently announced it will convene the Public Health Workgroup of the California Climate Action Team (CAT-PHWG) for a meeting on lessons learned from COVID-19 equity actions and how they can be leveraged to strengthen climate action planning and community resilience. The meeting will occur on Tuesday, November 30 from 10:00 am to 12:00 pm.

Additional information, including registration, is available here.

Newsom Announces First Broadband Expansion Projects

Governor Gavin Newsom on Wednesday announced the state has identified 18 projects to begin work on an “open-access middle-mile network” to provide missing infrastructure paths to establish expanded access to broadband internet. The announcement comes as part of the Newsom Administration’s $6 billion broadband investment to provide internet access to Californians.

The initial 18 projects are being carried out throughout the entire state, and the evaluation of project areas included consideration of public comments, prioritization of unserved or underserved areas, and inclusion of tribal communities, cities, and counties. State entities involved in the middle-mile initiative include the California Department of Technology, the California Public Utilities Commission, and CalTrans.

Additional information from the Governor’s Office is available here.

Newsom Takes Actions to Support Communities Impacted by Storms, Wildfires

Governor Gavin Newsom this week proclaimed a state of emergency to support counties across the state recover from storms experienced during January 2021, as well as an executive order extending consumer protections for communities impacted by wildfires last year.

Executive Order N-22-21 extends prohibitions on price gouging in counties impacted by wildfires, and the emergency proclamation supports repair of infrastructure damaged by winter storms.