October 16, 2020 Edition
Thursday marked the deadline for the federal government to approve flexible financial assistance to state and local governments amid the economic downturn ushered in by the ongoing COVID-19 pandemic. With Congressional leaders and the White House still not in agreement on a COVID-19 relief measure, budget cuts included in the 2020-21 state budget are here to stay, according to the California Department of Finance (DOF). In a letter to legislative leaders, DOF Director Keely Martin Bosler provided official notice that funding restorations would not occur as a result of the lack of federal action.
Recall, California’s final 2020-21 budget agreement included a series of funding restorations and funding actions if the state received an additional $14 billion of flexible federal funding by October 15, 2020. If the funding was received, numerous cuts would have been “triggered” off, restoring support to numerous state and local services, spanning health and human services, education, and housing. Most notably, an additional $250 million would have been dedicated to augment the budget’s $750 million General Fund “backfill” to offset counties’ loss of realignment sales tax funding, including for public health and indigent health services.
The House of Representatives passed earlier this month a revised $2.2 trillion relief measure that would have provided $436 billion in assistance for state, local, territorial, and tribal governments. However, the measure was deemed to carry too large of a price tag by Senate Republicans, and agreement has not been secured from the White House. While stimulus talks remain underway among Congressional leaders and the White House, it is unclear whether any significant aid will materialize at this time.
DOF will continue to “monitor and report on federal developments” on any potential federal funding that may be provided to the state. Additional details will communicated to CHEAC Members as information becomes available.
Earlier this week, the State of California was notified that the Trump Administration rejected the state’s major disaster declaration following a series of recent historic wildfires, including fires in Fresno, Los Angeles, Madera, San Bernardino, San Diego, and Siskiyou counties. According to press reports, the state learned of the Trump Administration’s decision on late Wednesday and no additional details on the reason for the denial were given.
However, it was reported today that President Donald Trump reversed the decision by the Federal Emergency Management Administration (FEMA) to deny California’s request. The presidential disaster declaration has been approved and federal financial assistance will be made available to support fire recovery efforts which include crisis counseling, housing and unemployment assistance, legal services, and response, recovery, and protective measures.
The full announcement from the Governor’s Office is available here.
Today, the California Department of Public Health (CDPH) posted employer guidance and frequently asked employer questions about AB 685 by Assembly Member Eloise Gómez Reyes that was signed into law last month. The measure requires employers to notify employees who may have been exposed to COVID-19 and to report workplace outbreaks to local health departments. CDPH is required to publicly report information on workplace outbreaks, and Cal/OSHA is authorized to enforce COVID-19 hazards as an imminent hazard to provide immediate protection for workers under the law.
CDPH details employer guidance on the new law, including CDPH definitions relative to the law’s provisions. CDPH also provides additional information on frequently asked questions (FAQs) raised by employers. The law is set to take effect on January 1, 2021. However, as CDPH indicates, several requirements included in the law, including employer notification to local health departments in the event of a workplace outbreak, are already required by CDPH COVID-19 guidance that is currently in place.
This week, an article was posted in the Journal of the American Medical Association (JAMA) on the cost of the ongoing COVID-19 pandemic. The article explores the various expenses incurred from the pandemic, including unemployment insurance claims, lost gross domestic product (GDP), premature death, long-term health impairment, and mental health impairment. In total, the article estimates the total cost of the pandemic to exceed $16 trillion, or approximately 90 percent of the annual GDP of the United States.
The article concludes that “policies that can materially reduce the spread of SARS-CoV-2 have enormous social value,” namely through widescale population testing, contact tracing, and isolation. Authors determine significant cost savings could be generated through such public health activities, finding that projected economic returns from test-and-trace strategies is approximately 30 times the cost.
The full article on the pandemic costs is available here.
Recently, tobacco company giants R.J. Reynolds Tobacco Company and Philip Morris USA sued the State of California in an attempt to block SB 793 from going into effect. SB 793 by Senator Jerry Hill would prohibit the sales of specified flavored tobacco products statewide. The measure was passed by the Legislature and signed into law almost immediately by Governor Gavin Newsom in late August.
Recall, the same tobacco company entities also filed a referendum to overturn the measure last month. Filers must collect over 623,000 signatures from California voters by November 30, 2020, to qualify the referendum for a future ballot, possibly in 2022. If enough signatures are collected, the measure would be placed on hold until voters weigh in.
In the recent lawsuit, tobacco company plaintiffs contend that the state’s ban on the sale of most flavored tobacco products is “an overbroad reaction to legitimate public health concerns about youth use of tobacco products,” claiming California’s action is “the most draconian ban on tobacco products of any state in the nation.” The plaintiffs further argue that the ban is unconstitutional on the grounds that federal law supersedes state law and that tobacco manufacturing is subject to “intensive regulation” by the federal government. Plaintiffs also suggest the ban unlawfully attempts to regulate out-of-state manufacturers, violating the Commerce Clause of the Constitution, and conclude that California “has no legitimate interest in enforcing its unconstitutional law.”
Tobacco company plaintiffs filed, in addition to their complaint, a request for a preliminary injunction to stop the law from taking effect on its scheduled date of January 1, 2021, while the courts tend to the case.
Additional information on the status of SB 793 is expected over the coming weeks and months and will continue to be communicated with CHEAC Members as it becomes available.
Today, Governor Gavin Newsom announced the fifth round of Homekey awards, the state’s program to assist local governments expand permanent, long-term housing for people experiencing or at risk of experiencing homelessness. Today’s awards total $30.7 million to three applicants for three projects comprising 210 units. Entities receiving funds today include the Yurok Tribe in Humboldt County, the City of San Luis Obispo, and the City of Los Angeles. To date, more than $627 million has been awarded to 45 applicants for 71 projects totaling 4,646 units.
In making today’s announcement, Newsom was joined by state, tribal, and local leaders to discuss Homekey’s impacts in rural communities throughout the state. Additional information from the Governor’s Office is available here.
This week, California Surgeon General Nadine Burke Harris announced that nearly 14,000 health care providers in California have completed the ACEs Aware initiative’s training program. The training, Becoming ACEs Aware in California, trains health care providers to screen patients for adverse childhood experiences (ACEs) and to recognize and respond to the symptoms of toxic stress.
According to a data report released by the Office of the California Surgeon General and the Department of Health Care Services (DHCS), of the nearly 14,000 providers trained, 8,300 are Medi-Cal providers who are eligible to receive payment for providing ACEs screenings. Other information included in the data report indicate high numbers of providers that planned to implement changes in their practice to address ACEs, as well as greater numbers of providers that planned to implement routine ACEs screenings for children and/or adults.
The Office of the Surgeon General and DHCS also launched the ACEs Aware Provider Directory that offers patients a way to find and connect with trained ACEs Aware providers throughout the state.
Additional information on the ACEs Aware initiative, as well as the latest data report, is available here.
According to a new national poll conducted for the de Beaumont Foundation, awareness and recognition of local health departments (LHDs) has risen significantly since the last election season, suggesting public health is a key issue for voters in the 2020 election. In the poll, conducted in July 2020, 73 percent of voters said public health departments play an important role in keeping people healthy, up from 56 percent in 2018. Further, after hearing a list of the types of services provided by health departments, six in 10 voters indicated they would be willing to pay more in state and local taxes to increase funding for LHDs.
The increased recognition for public health departments cuts across age, gender, race, political party, education, and income. Voters additionally indicated higher levels of support for public health emergency preparedness and response, and the most valued public health services among voters included controlling communicable diseases, supporting women and children’s health, reaching out to people that are at greatest risk of poor health outcomes, ensuring environmental health, and providing critical, unbiased information on how to respond and what to do in a crisis to protect yourself and those close to you. Additional information on the poll and its results is available here
This week, the National Association of County and City Health Officials (NACCHO) released a request for applications (RFA), “Piloting Self-Specimen Collection Outside of Clinical Settings Using a Telemedicine Model for Testing Gonorrhea and Chlamydia.” The opportunity is a program improvement and evaluation effort to identify replicable models and best practices for patient self-collection of specimens outside of clinic settings and testing of specimens for patients recommended by the U.S. Preventive Services Taskforce or U.S. Centers for Disease Control and Prevention (CDC) treatment guidelines. Funded sites could receive up to $300,000.
The deadline for applications is November 25, 2020. Additional information from NACCHO is available here.