October 8, 2021 Edition
This week, after a one-year hiatus due to the ongoing COVID-19 pandemic, CHEAC hosted a successful 2021 Annual Meeting in a virtual format. Over 230 registrants representing nearly all of California’s 61 local health jurisdictions attended the conference, featuring multiple plenary and workshop sessions.
CHEAC extends sincere gratitude to those individuals who were able to attend this year’s conference, and we hope to be back in-person for next year’s conference.
Additional information about this year’s conference, including all presentation materials, are available here.
Governor Gavin Newsom this week acted on a series of high-profile legislative measures just prior to his looming Sunday deadline to sign or veto measures sent to his desk by the California Legislature.
As a reminder, CHEAC will issue a final bill chart following Sunday’s sign or veto deadline detailing the outcome of all CHEAC-tracked measures during the first year of the 2021-22 Legislative Session. Below, we highlight a handful of policy areas of interest to CHEAC Members and local health departments acted upon this week:
- COVID-19 Recovery – Today, Governor Newsom signed into law legislation aimed at supporting small businesses and establishments impacted by the COVID-19 pandemic. Measures allow restaurants to continue selling to-go alcoholic drinks and offering expanded outdoor dining opportunities. Other measures signed today broaden services various health professionals can provide to patients, including bills that authorize optometrists, dentists, and podiatrists to administer COVID-19 vaccinations and testing. Additional information is available here.
- Maternal and Infant Health – Governor Newsom on Monday signed into law SB 65 by Senator Nancy Skinner to address racial disparities in maternal and infant health statewide. The measure, known as the California Momnibus Act, aims to improve maternal and child health outcomes and strengthen services and supports to women and families. CHEAC worked closely with the author’s office and sponsors of SB 65 to ensure local health departments receive adequate resources to carry out activities related to fetal and infant mortality review processes at the local level. CHEAC was pleased to support SB 65. Additional information is available here.
- Early Care and Education – During a visit to an elementary school in Fresno County this week, Governor Newsom signed into law measures aimed at improving early care and education services for California children. Measures signed by the Governor aim to improve access to childcare for migrant agricultural workers and enhance reporting of dual language learner students in preschools. Additional information is available here.
- Older Adult Services – Governor Newsom also on Monday signed into law a suite of measures aimed at protecting older adults throughout the state. Measures signed by the Governor increase transparency of skilled nursing facility finances, improve access for seniors to receive annual cognitive health assessments, and expand access to videoconferencing for people living at residential care facilities for the elderly. Additional information is available here.
- Environmental Protections – Governor Newsom signed into law measures aimed at addressing plastic pollution and protecting residents from toxic chemicals, including those prohibiting the use of PFAS in products for children and disposable food products. Other measures strengthen labeling requirements for “compostable” products and prohibit food facilities from providing single-use food accessories and condiments unless specifically requested by consumers. Additional information is available here.
- Rural Areas – The Governor additionally highlighted a series of measures signed into law aimed at supporting rural areas of California, including a measure to establish the Farm to Community Food Hub Program to incentivize the creation of food hubs to help local and regional farms distribute goods to public institutions and nonprofit entities in nearby areas. Additional information is available here.
On Tuesday, the Assembly Health Committee convened an informational hearing to assess the licensing, inspections, and quality of care provided in skilled nursing facilities (SNFs) throughout California. The hearing featured three panels consisting of state officials, service providers, and facility representatives.
The first panel provided an overview of the licensing and inspection process of SNFs from California State Auditor Elaine Howle and the Legislative Analysts’ Office (LAO). The second panel explored quality of care challenges in SNFs and featured officials from the California Department of Public Health (CDPH) and representatives from older adult advocacy groups. Last, the third panel discussed potential solutions and stakeholder involvement in addressing quality of care concerns identified during the hearing.
During the hearing, numerous Assembly Health Committee members, including Chair Jim Wood, raised significant concerns with the state’s oversight of SNFs, particularly those with outstanding licensing issues. Members pressed CDPH on state regulatory activities with Mr. Wood at one point asking of CDPH, “Where is the proactive, patient-centered public safety approach here? … Because I don’t feel it right now. And yet here we are. Here we sit. … We have to wait for people to die.” CDPH representatives, responding to members’ questions, largely pointed to staffing challenges, high turnover rates, training matters, and significant pressures imposed by the COVID-19 pandemic.
The agenda from the hearing is available here. Additional background materials from the hearing are available here. A video recording of the hearing is available here.
The California Department of Health Care Services (DHCS) today announced a series of important changes to timelines relative to the Medi-Cal program and services. These include:
- Managed Care Plan (MCP) Procurement – DHCS is modifying the release date of the Medi-Cal MCP Request for Proposal (RFP) to February 2, 2022. DHCS had initially planned on releasing the RFP at the end of 2021. This modification will not affect the implementation date of January 1, 2024. According to DHCS, additional time is needed to address stakeholder comments and to avoid the winter holidays. Updates to the RFP schedule will be posted here.
- Community Health Worker (CHW) and Doula Benefits – DHCS is also delaying the launch date for new Medi-Cal benefits related to CHWs and doulas from January 1, 2022, to July 1, 2022. According to DHCS, the six-month delay is needed to work with stakeholders and health plans, review input, incorporate feedback into the State Plan Amendment, ensure system updates, and seek federal approval from the Centers for Medicare & Medicaid Services (CMS). CHW and doula services will be delivered by unlicensed practitioners, requiring DHCS to define the services, qualifications, and supervision required for practitioners. Additional information on the CHW benefit and doula benefit is available from DHCS.
On Thursday, Pfizer and BioNTech announced they have submitted a formal request to the U.S. Food and Drug Administration (FDA) for emergency use authorization (EUA) of its COVID-19 mRNA vaccine among children ages 5-11. Up to 28 million children nationwide could become eligible upon authorization.
Recall, Pfizer and BioNTech received full FDA approval for its COVID-19 vaccine for persons ages 16 and older. The FDA has granted an EUA for the vaccine for children ages 12-15. The formal request submitted this week follows data provided to the federal government last month indicating favorable effectiveness and safety among children 5-11.
The FDA Vaccines and Related Biological Products Advisory Committee has set a meeting for October 26 to review the firms’ EUA request. Additional information is anticipated later this month.
This week, the Biden-Harris Administration announced it would invest $1 billion to support the development and availability of at-home rapid tests for COVID-19. The Administration announced the infusion of funding will quadruple the number of at-home tests available for Americans by December.
The increase in tests is anticipated to help improve access to at-home testing for individuals who need tests for school and work or after a close contact with an infected person. The U.S. Food and Drug Administration (FDA) approved an emergency use authorization (EUA) for a new at-home rapid test from ACON Laboratories on Monday, and the Biden-Harris Administration has secured commitments from two other manufacturers to expand production of their tests.
In addition to the at-home testing options, the Biden-Harris Administration announced an expansion of the federal government’s free local pharmacy COVID-19 testing program. The Administration will be doubling the number of pharmacies to 20,000 to ensure free COVID-19 testing in communities throughout the country.
Additional information is available here.
A new study released this estimates that more than 140,000 children in the U.S. have lost a parent or grandparent caregiver to COVID-19 between April 1, 2020, and June 30, 2021. The study, published in the journal Pediatrics, indicates that the risk of primary caregiver loss was 1.1 to 4.5 times higher among children of racial and ethnic minorities compared to non-Hispanic white counterparts. The lead author of the study from the U.S. Centers from Disease Control and Prevention (CDC) further estimates that over the past three months, the number of children that has lost a primary caregiver has risen to over 175,000.
The highest burden of COVID-19-associated death of parents and caregivers was found to have occurred in Southern border states for Hispanic children, Southeastern states for Black children, and in states with tribal areas for American Indian and Alaska Native populations. Authors of the study note the increased risks of short-term trauma and lifelong adverse consequences of children due to the loss of a primary caregiver.
Additional information from the CDC is available here. The full study is available here.
This week, the U.S. Department of Health and Human Services (HHS) issued a final regulation governing the Title X Family Planning Program, effectively reversing restrictions on patient referrals to certain reproductive health services established by the Trump Administration in 2019.
Recall, the rules put into place by the Trump Administration barred Title X providers from referring patients to abortion services and specified that clinics referring patients to services would no longer qualify for Title X funds to provide low-income women with comprehensive family planning and reproductive health services. The Trump Administration, after winning several legal challenges, finalized the rule and began enforcement in 2019. Many reproductive health services providers, including Planned Parenthood, exited the Title X program following the finalized rules.
The Biden-Harris Administration unveiled its proposed rule earlier this year seeking to replace and reverse the restrictions on patient referrals and funding eligibility. This week, HHS finalized its proposed rule to realign the nation’s family planning program with nationally recognized standards of care and reaffirm the program’s commitment to quality and equity. The final rule is set to become effective on November 8, 2021.
In California, eight local health departments have served as Title X subgrantees, delivering reproductive health services to residents at 46 sites in those jurisdictions. LHDs that are not direct subgrantees work closely with community-based Title X providers to ensure access to essential health services.
Additional information on the finalized Biden-Harris Title X rule is available here.
The U.S. Department of Health and Human Services (HHS) this week announced awarding approximately $2.21 billion in Ryan White HIV/AIDS Program funding to local governments, states, and community-based organizations in fiscal year 2021. The funding, issued by the Health Resources and Services Administration (HRSA), supports a comprehensive system of HIV primary medical care, medication, and essential support services necessary to improving the health outcomes of nearly 560,000 Americans with HIV.
Funding was awarded under multiple parts of the Ryan White Program, including for the AIDS Drug Assistance Program (ADAP), Early Intervention Services (EIS), and other medical and support services. Multiple jurisdictions in California were awarded funds to support this critical work.
Additional information is available here.
The U.S. Department of Health and Human Services (HHS) this week, as part of President Joseph R. Biden, Jr.’s Executive Order 14008 related to climate change, released its Climate Adaptation and Resilience Plan to bolster resilience of its operations and assets from the accelerating impacts of climate change. With the release of its plan, HHS joins 20 other federal agencies in identifying agency-level climate-related actions.
The HHS plan identifies five priority actions that will be implemented through its mission, programs, operations, and management. These priorities include:
- Expand existing climate change-related public health and biomedical research activities
- Improve HHS responses to the climate crisis
- Develop climate-resilient grant policies at HHS
- Workplace optimization and effective space management for climate resilience
- Promote sustainable and climate resilient operations at HHS facilities
Additional information about the plan and policy statement is available here.
This week, the Office of Statewide Health Planning and Development (OSHPD) announced its official rebranding as the Department of Health Care Access and Information (DHCAI). The change comes as part of the enacted 2021 Budget Act, which recast OSHPD’s responsibilities and authorized additional departmental activities related to health workforce training and data.
Additional information, including its new website, is available here.
On Monday, Governor Gavin Newsom issued two executive orders to support the state’s ongoing response to the COVID-19 pandemic, as well as assist schools impacted by recent wildfires.
Executive Order N-17-21 extends flexibilities allowing the state to increase health care capacity to support ongoing testing and vaccination efforts against COVID-19. The same order rescinds provisions related to Board of Parole hearings conducted via videoconference.
Executive Order N-18-21 ensures continuity in education for displaced students and includes waivers related to class size, outdoor physical education, school district residency, and deadline extensions for specified local educational agencies.
Additional information from the Governor’s Office is available here.
This week, Governor Gavin Newsom announced the appointment of two officials to aging-related posts within the state government.
Kimberly McCoy Wade has been appointed the Senior Advisor on Aging, Disability, and Alzheimer’s within the Office of Governor Gavin Newsom. McCoy Wade served as the Director of the California Department of Aging since 2019 and was previously the CalFresh and Nutrition Branch Chief at the California Department of Social Services (CDSS) from 2015 to 2019. McCoy Wade’s new role does not require Senate confirmation.
Susan DeMarois has been appointed the Director of the California Department of Aging. DeMarois has served as the Director of Public Policy and Advocacy for the Alzheimer’s Association of California since 2013 and has held previous roles in aging-related advocacy organizations and health systems.
Additional information about the Governor’s aging-related appointments is available here.
Governor Newsom this week proclaimed a state of emergency in Orange County to support the emergency response to the oil spill off the coast of Huntington Beach that originated in federal waters. Latest reports estimate the spill released up to 140,000 gallons of oil into the Pacific Ocean, which has begun to arrive onshore over the past week.
At the Governor’s direction, California has deployed personnel from the Department of Fish and Wildlife and the Office of Emergency Services to assist in the response efforts and closely coordinate with the U.S. Coast Guard, local agencies, and other entities.
Governor Newsom traveled to Orange County on Tuesday to receive a briefing on the oil spill. Additional information, including the Governor’s proclamation, is available here.
The California Department of Public Health (CDPH) Office of Strategic Development and External Relations (Fusion Center) will host a webinar next Tuesday, October 12 from 11:00 am to 12:00 pm to explore 2020 increases in deaths in California.
The webinar will feature state-level analysis of excess mortality in the state in 2020, including assessment of impacts by race/ethnicity, age, and deaths due to conditions other than COVID-19 (e.g., drug overdose, homicide, Alzheimer’s, and heart disease). The analysis was produced using the California Community Burden of Disease (CCB) system as part of the State Health Assessment.
Additional information, including registration, is available here.