October 30, 2020 Edition

State Opens New PerkinElmer COVID-19 Laboratory

Today, Governor Gavin Newsom announced the opening of the state’s new laboratory in Valencia in Los Angeles County to increase the state’s COVID-19 testing capacity and reduce test turnaround time. In partnership with PerkinElmer, the new $25 million lab will begin processing tests starting in November and will work toward full capacity of 150,000 tests per day by March 2021.

Under its contract with the State of California, PerkinElmer will be required to turn around PCR test results within 24-48 hours. The contract additionally includes provisions to enable PerkinElmer to adopt new test processing technologies as they become available. The per-test cost is anticipated to be $30.78 when the target of 150,000 tests per day is reached. To support the contract at the lowest cost to taxpayers, the state will additionally enter into a contract for third-party billing services to recoup costs from health insurance companies or other payers. California additionally worked with San Mateo County-based health technology company Color to create a user-friendly front-end interface for the state’s expanded testing program. Recall, the Newsom Administration announced the partnership with PerkinElmer in late August 2020.

The full press announcement from the Newsom Administration is available here.

Western States Join COVID-19 Vaccine Safety Workgroup

On Monday, Governor Gavin Newsom and California Health and Human Services Secretary Dr. Mark Ghaly announced that Washington, Oregon, and Nevada have joined California’s COVID-19 Safety Review Workgroup which will be tasked with independently reviewing the safety and efficacy of any vaccine approved by the U.S. Food and Drug Administration (FDA) for distribution. Recall, last week, Governor Newsom named California public health and medical experts to the workgroup.

The governors of Washington, Oregon, and Nevada will identify their own public health experts to join California’s workgroup to review any COVID-19 vaccines prior to distribution to any of the states’ residents. A full announcement from the Newsom Administration is available here.

CDPH Forms COVID-19 Vaccine Drafting Guidelines Workgroup

This week, the California Department of Public Health (CDPH) announced the COVID-19 Vaccine Drafting Guidelines Workgroup to advise the state on COVID-19 vaccine prioritization and allocation. Building on the state’s COVID-19 Scientific Safety Review Workgroup, the Drafting Guidelines Workgroup is comprised of immunization, geriatrics, ethics, epidemiology, health equity, and pharmacy practice experts. The group is tasked with developing California-specific guidance for prioritization and allocation of a COVID-19 vaccine which will be based on several national frameworks from the National Academies of Sciences, Engineering, and Medicine (NASEM), the Advisory Committee on Immunization Practices (ACIP), and the U.S. Centers for Disease Control and Prevention (CDC).

The Drafting Guidelines Workgroup is a component of the state’s initial COVID-19 vaccine distribution plan that was submitted to the CDC earlier this month. Members of the workgroup include:

  • Co-Chair Dr. Oliver Brooks, CMO, Watts Health Care Corporation
  • Co-Chair Dr. Robert Schechter, Chief, CDPH Immunization Branch
  • Dr. Ngoc-Phuong Luu, Health Officer, Yuba and Sutter Counties
  • Melissa Thun, Public Health Nurse Manager, San Diego County
  • Ann Walker, Immunization Program Coordinator, Kern County Department of Public Health
  • Dr. Claire Jarashow, Director, Vaccine Preventable Disease Control and Chief, Epidemiology and Data, Acute Communicable Disease, Los Angeles County Department of Public Health
  • Dr. Sergio Aguilar-Gaxiola, Professor of Clinical Internal Medicine and Founding Director of the Center for Reducing Health Disparities at UC Davis Health
  • Dr. Louise Aronson, Director, Age Self Care Program, UCSF and Clinical Lead, Senior Hub, San Francisco Department of Public Health COVID-19 Response
  • Dr. Randy Bergen, Immunization Lead, Kaiser Permanente Northern California
  • Dr. Arleen Brown, Professor of Medicine, UCLA and Chief of Internal Medicine and Health Services Research at Olive View-UCLA Medical Center
  • Susan Ducore, Immunization Coordinator, California Indian Health Service
  • Dr. Katherine Flores, UCSF Fresno Latino Center for Medical Education and Research
  • Dr. Jeff Goad, Department of Pharmacy Practice Chair, Chapman University
  • Dr. Bernard Lo, Director, UCSF Program in Medical Ethics and Emeritus and President, The Greenwall Foundation, New York
  • Dr. Jeff Silvers, Immunization Lead, Sutter Health
  • Dr. Mike Witte, CMO, California Primary Care Association

A Community Advisory Vaccine Committee will additionally provide input and feedback to the planning efforts and solve barriers of equitable vaccine implementation and decision-making.

A full press announcement from CDPH is available here.

CMS Issues Interim Final Rule on Future COVID-19 Vaccine

This week, the U.S. Centers for Medicare and Medicaid Services (CMS), along with the Departments of Labor and Treasury, issued an interim final rule with comment period (IFC) to remove administrative barriers to eliminate potential delays to patient access to a COVID-19 vaccine once available among Medicare and Medicaid beneficiaries, as well as those with employer-sponsored or other private health coverage.

Upon FDA approval of a COVID-19 vaccine, CMS is expected to announce coding and payment information through program memoranda. The IFC was taken to ensure that a COVID-19 vaccine authorized by FDA under an emergency use authorization (EUA) will be covered by Medicare and Medicaid. Without this action, a vaccine authorized under the EUA would not be treated the same way, creating cost sharing and reimbursement barriers to care. The IFC additionally implements a Congressional CARES Act requirement that private insurers cover vaccines authorized for emergency use as long as the COVID-19 public health emergency exists.  

The IFC additionally:

  • Creates flexibilities for states maintaining Medicaid enrollment during the COVID-19 public health emergency;
  • Establishes enhanced Medicare payments for new COVID-19 treatments;
  • Takes steps to ensure price transparency for COVID-19 tests;
  • Provides an extension of Performance Year 5 for the Comprehensive Care for Joint Replacement (CJR) model; and
  • Creates flexibility in the public notice requirements and post-award public participation requirements of a State Innovation Waiver under Section 1332 of the Patient Protection and Affordable Care Act during the COVID-19 public health emergency

Additional information on the interim final rule is available here.

DOF Extends Use of DREOA Funds to Respond to COVID-19

This week, the California Department of Finance (DOF) notified the Joint Legislative Budget Committee (JLBC) of a 120-day extension on the use of funds from the state’s Disaster Response-Emergency Operations Account (DREOA) to support response activities to the ongoing COVID-19 pandemic. In its letter, DOF indicated that, despite progress made under the state’s Blueprint for a Safer Economy framework, a potential upward trend in COVID-19 case rates, hospitalizations, and ICU admissions may be realized over the coming months. Additionally, with winter approaching, the state is likely to realize a seasonal effect that will contribute to a rise in cases.

According to DOF, extended use of the DREOA will support continued COVID-19 monitoring and response activities, including expanded testing, vaccine distribution, personal protective equipment (PPE) procurement, and surge capacity resource needs. Since March 2020, DOF has notified the Legislature of approximately $4.050 billion in expenditures from the DREOA, Control Section 36.00, Budget Bill Jr. transfers, and appropriations over the 2019-20 and 2020-21 fiscal years. To sustain the state’s response efforts, DOF anticipates needing additional funds. An interim cost update is expected to be provided in early November, and future transfers to DREOA will likely be needed in the near term to support testing services.

The full DOF notification is available here.

Legislature Holds COVID-19 Hearings on Schools, Skilled Nursing Facilities

This week, the California State Senate and Assembly convened separate oversight hearings to explore the COVID-19-related impacts on education and distance learning, as well as skilled nursing facilities (SNFs). Below, brief summaries of the hearings are provided.

Senate Joint Oversight Hearing on Distance Learning

On Monday, the Senate Education Committee and Senate Special Committee on Pandemic Emergency Response convened a joint oversight hearing on K-12 distance learning during the ongoing COVID-19 pandemic. The hearing featured two panels focused on access to distance learning and access to the internet and consisted of education officials and technology and telecommunications experts.

The oversight hearing explored distance only and in-person learning options, instruction and services to English language learners and special education students and impacts on student mental health. The hearing additionally focused on the digital divide, access to learning opportunities, and pandemic-related educational arrangements.

The Senate hearing agenda is available here. A background paper is available here and a video recording of the hearing is available here.

Assembly Oversight Hearing on School Reopening Process

The Assembly Budget Subcommittee No. 2 on Education Finance convened a hearing on Tuesday to explore the state’s role in the safe reopening of schools throughout California. The hearing focused primarily on how the 2020-21 State Budget provided resources to support the safe reopening of schools and how to anticipate the further role of state leadership and resources.

Tuesday’s hearing featured educational representatives, including school districts and the California Department of Education (CDE), the Legislative Analyst’s Office (LAO), and the Department of Finance (DOF). Acting State Public Health Officer Dr. Erica Pan participated in the hearing to provide background and an overview of the California Department of Public Health’s (CDPH) education guidance, engagement with education and labor representatives, and ongoing efforts to safely reopen schools throughout the state.

During the hearing, subcommittee members raised concerns around the clarity of guidance for COVID-19 testing among teachers, students, and staff, as well as the lack of uniformity of school reopenings among public and private schools. Another notable topic of discussion was financial supports for schools to adequately implement COVID-19 precautions, including personal protective equipment (PPE), testing, and physical distancing.  

The Assembly hearing agenda is available here. A video recording of the hearing is available here.

Assembly Informational Hearing on COVID-19 in Skilled Nursing Facilities

On Wednesday, the Assembly Budget Subcommittee No. 6 on Budget Process, Oversight, and Program Evaluation convened an informational hearing to receive updates on COVID-19 in skilled nursing facilities (SNFs) throughout the state. Wednesday’s hearing featured representatives from CDPH and DHCS, as well as the California Association of Long-Term Care Medicine, SEIU California, Ombudsman Services of Contra Costa, Solano, and Alameda, the University of California, San Francisco (UCSF), and the California Association of Health Facilities.

In opening remarks, Subcommittee Chair Assembly Member Phil Ting discussed the high number of COVID-19 infections and deaths among SNF residents and staff and the importance of protecting vulnerable populations in SNFs. Presentations from panelists focused on state regulatory enforcement and technical assistance activities, COVID-19 response efforts, SNF resident and staff needs, infection prevention protocols, and SNF management practices.

The Assembly hearing agenda is available here. A video recording of the hearing is available here.

Assembly Convenes Informational Hearing on Health Care Affordability

On Tuesday, the Assembly Health Committee, chaired by Assembly Member Jim Wood, convened a lengthy afternoon hearing to hear from a series of experts on health care affordability in California. Five panels covered topics such as health care spending in the state, health care cost drivers, the availability of health data in the state, health care industry consolidation, and options to control healthcare costs. The Assembly Health Committee provided a brief background paper on the issues addressed during the hearing. Members of the committee focused the majority of their questions on how to make health insurance more affordable as well as transparent for consumers.

The a video of the hearing can be viewed here. Presentations for most of the hearing speakers are listed below:

Health Care Spending

Health Care Cost Drivers

Availability of Cost, Price, and Spending Data in California

Health Care Industry Consolidation

Options for Controlling Costs

Newsom Announces Seventh and Final Round of Homekey Awards

On Thursday, Governor Gavin Newsom returned to a Yolo County hotel where he launched in April the state’s Project Roomkey initiative to announce the seventh and final round of awards to provide permanent supportive housing for individuals experiencing homelessness. The seventh round of awards total $129.6 million awarded to nine jurisdictions for 17 projects providing 982 units. Thursday’s awards included projects in Alameda, Los Angeles, Marin, and San Mateo counties, among others.

With this week’s announcement, nearly all available Homekey funding has been awarded. To date, more than $835.6 million has been awarded to 48 jurisdictions for 93 projects providing 6,055 units. The average per-unit cost to Homekey is $138,512 which is below the average cost in California to build new housing units.

The full announcement from the Governor’s Office is available here.

Newsom Issues Executive Order Related to COVID-19 Response

Governor Gavin Newsom on Wednesday issued Executive Order N-83-20 addressing a series of issues in response to the ongoing COVID-19 pandemic.

The order directs the Department of Transportation to develop and implement a process to issue and administer temporary encroachment permits allowing businesses located on state highways to expand their outdoor dining options onto sidewalks and parking lots. The order also allows those older than 70 years of age to renew their driver’s license by mail, allows the Director of the Department of Alcoholic Beverage Control (ABC) to suspend deadlines for renewing state licenses upon payment of annual fees through June 30, 2021, and extends provisions related to real estate license application and renewal fee deadlines and continuing education requirements for licensees.

CDPH, CDSS Issue ACEs Data Report

This week, the Essentials for Childhood Initiative (EfC), a project of the California Department of Public Health (CDPH) and California Department of Social Services (CDSS), published a report on adverse childhood experiences (ACEs) in California that provides an overview of data from 2011-2017 collected through the California Behavioral Risk Factor Surveillance System (BRFSS).

The report presents ACEs data from the 2011, 2013, 2015, and 2017 California BRFSS and finds that more than 60 percent of adult respondents that they had experienced at least one category of ACEs before age 18 and about 40 percent reported two or more categories of ACEs. Over a quarter of respondents reported facing three or more categories of ACEs, and about 16 percent experienced four or more categories of ACEs. The most commonly reported ACEs were emotional abuse (30.4 percent) and living with someone who abused substances (28.2 percent). The least common ACE reported was living with someone who was incarcerated (7.5 percent).

In California, 27 out of 58 counties (46.6 percent) were above the state average prevalence of four or more ACEs, and Humboldt, Trinity, Kings, and San Benito counties had the highest reported prevalence of ACEs between 2011 and 2017. Differences in the prevalence of ACEs among racial and ethnic groups were present with respondents who identified as multiracial, Hispanic, or Black reported the highest overall exposure to ACEs compared to White and “other” racial and ethnic groups. The data report additionally details ACEs by educational attainment, income, and healthcare coverage.

The full CDPH and CDSS report is available here.

NACCHO Solicits Model Practices and Innovative Practice Award Applications

The National Association of County and City Health Officials (NACCHO) has opened the application process for 2021 Model Practices and Innovative Practice Awards. Each year, NACCHO’s Model Practices Program nationally honors and recognizes outstanding local public health practices and shares them through the Model Practices Database. These practices are rigorously reviewed by a committee of peers, consisting of other local health department professionals, and selected from a competitive pool of applicants.

The Model Practices Program application is strongly recommended to LHDs if a practice demonstrates exemplary and replicable outcomes in response to an identified public health need and it reflects a strong local health department role, collaboration, innovation, sustainability, and a thorough evaluation.

This year, amid the COVID-19 pandemic, a new Innovative Practice Award application will run concurrently with the Model Practices Program application. The Innovative Practice Award was created to recognize outstanding practices that have been created or significantly adapted in response to COVID-19.

The Innovative Practice Award application is strongly recommended to LHDs if a practice was developed in response to the COVID-19 pandemic or if a practice was creatively adapted to meet the circumstances of the COVID-19 pandemic and the practice demonstrates remarkable innovation to address COVID-19 but does not yet exhibit the same rigorous program evaluation or long-term sustainability as a Model Practice.

The application period for the 2021 Model Practices Program and 2021 Innovative Practice Award will open November 2, 2020, and close December 31, 2020. NACCHO will hold an informational webinar on the opportunities on Thursday, November 5 at 11:00 am PT.