September 17, 2021 Edition
As a reminder, registration for the 2021 CHEAC Annual Meeting is now open! This year’s conference theme is “Revitalizing Public Health: Leveraging Lessons Learned from COVID-19.” The conference will be held in an entirely virtual format from October 6 through October 8 and will feature several plenary speakers, as well as multiple breakout sessions.
CHEAC welcomes local health department executives and staff to attend this year’s conference. For additional information and registration, please visit here.
CHEAC this week published its first edition of the #WeArePublicHealth newsletter. The newsletter highlights some of the many activities and services delivered by California’s 61 local health departments. Our first edition features the role of local health departments in COVID-19 pandemic response, school reopening efforts, and wildfire response activities, among others.
The first edition of the #WeArePublicHealth newsletter is available here.
On Tuesday, Governor Gavin Newsom handily defeated the effort to recall him from his gubernatorial post with over 60 percent of voters voting to reject the attempt to remove him from office. With his post retained, Governor Newsom shifted his focus to the state’s business, including acting on measures sent to his desk by the California Legislature.
Recall, the Legislature last Friday adjourned its first year of the 2021-22 Legislative Session. CHEAC, upon the adjournment of session, issued an End of Session Memo highlighting actions of interest to CHEAC Members and local health departments. As a reminder, measures sent to the Governor on or after the last day of the legislative session (September 10) must be acted upon by the Governor within 30 days; measures without affirmative action taken (signed into law or vetoed) automatically become law. A final bill chart will be issued following the October deadline for the Governor to act on measures.
Among measures signed into law by Governor Newsom this week were a set of housing and residential development bills. The measures, SB 8 (Skinner), SB 9 (Atkins), and SB 10 (Wiener), all seek to address aspects of the state’s challenging housing landscape. SB 8 extends provisions of the Housing Crisis Act of 2019 through 2030. SB 9 facilitates the process for homeowners to build a duplex or split their current single-family lot to expand housing options for residents of all income levels. SB 10 creates a voluntary process for local governments to access a streamlined zoning process for new multiunit housing near transit or urban infill areas.
Additional information on the Governor’s housing-related actions is available here. A listing of other measures signed into law this week is available here.
Today, the U.S. Food and Drug Administration (FDA) Vaccines and Related Biological Products Advisory Committee (VRBPAC) voted to recommend authorizing a booster shot for recipients of the Pfizer-BioNTech COVID-19 vaccine who are 65 years of age and older or are at high risk of severe COVID-19.
The recommendation for COVID-19 booster shots for older adults and high-risk groups followed a vote by the VRBPAC overwhelmingly recommending against a Pfizer-BioNTech booster dose for persons ages 16 and older. The committee engaged in lengthy discussions throughout the day, scrutinizing whether COVID-19 booster doses are needed to maintain protection against the virus and for whom. Many members of the VRBPAC raised concerns with the data provided by Pfizer and BioNTech about the need for booster shots for such a large swath of the country’s population.
While the FDA is not obligated to comply with the VRBPAC recommendation, the agency rarely departs from the guidance provided by the independent panel. Today’s vote complicates the Biden-Harris Administration’s announcement last month that it planned to make booster shots available to vaccinated Americans beginning on Monday, September 20. The announcement by the administration has been viewed as controversial, given the need for the FDA and CDC to adequately review data and decide about the safety and effectiveness of a third dose.
The FDA must decide whether to act upon the VRBPAC recommendation, which is expected over the coming days. The U.S. Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) is scheduled to meet next week to recommend how exactly the extra doses should be used. Previous public conversations among the group have suggested ACIP may be leaning toward offering booster shots to older adults and vulnerable populations.
Additional information about the FDA’s meeting held today is available here.
The California Department of Public Health (CDPH) this week announced a partnership with actor Tyler Perry to continue educating California residents about the safety and importance of COVID-19 vaccines. The partnership is part of the state’s “Let’s Get to ImmUnity” public education campaign designed to inform Californians about COVID-19 vaccines.
CDPH will distribute a series of videos created by Tyler Perry Studios throughout September, addressing various frequently asked questions about the safety and efficacy of the vaccines across various social media platforms. Topics will include how we know the vaccines are safe, what is mRNA, and more.
Additional information about the state’s partnership with Tyler Perry is available here.
This week, the Office of Governor Gavin Newsom announced the state reached a significant milestone as part of California’s COVID-19 Rent Relief Program for residents who have suffered financial hardship due to the COVID-19 pandemic. California has obligated more than $1 billion in funding in rent and utility assistance to assist over 74,000 additional households statewide. More than $526 million of the $1 billion in rental and utility assistance has already been distributed to 44,432 low-income California households experiencing financial hardship.
According to the Governor’s Office, more than 243,000 applications for assistance have been received, and more than $2.2 billion in rent and utility assistance is currently requested and is pending eligibility verification and fraud prevention screening.
In addition to providing 100 percent of back rent and prospective rent for eligible residents, AB 832 signed into law earlier this summer extends state-level eviction protections through the end of March 2022 for households at or below 80 percent of the area median income.
Additional information on the state’s COVID-19 rent and utility assistance program is available here.
California State Auditor Elaine Howle issued a report this week warning the state may be at risk of losing millions of unobligated federal funds intended for rent and utility assistance amid the COVID-19 pandemic. The report comes as part of the state’s high-risk audit program. Recall, in August 2020, the auditor designated the state’s management of federal COVID-19 funds as a high-risk issue with substantial risk of serious detriment to the state and its residents.
Under the report issued this week, the auditor focused on the Department of Housing and Community Development’s (DHCD) management of $1.8 billion for California’s program to provide rental assistance benefits to eligible households with residents at risk of eviction. California faces a crucial deadline of September 30, 2021, to obligate funds for their intended purpose issued in the program’s first funding round by the federal government. California received a total of $2.6 billion in the first round of funding with $1.5 billion to the state and $1.1 billion directly to 49 cities and counties statewide.
Auditor Howle, in her report, raises concerns with DHCD’s management of the funds including:
- DHCD did not properly utilize the definition of “obligated funds” in its most recent report to the U.S. Department of Treasury
- DHCD remains at risk of losing up to $337 million in unobligated funds if the amount of obligated funds is not increased by the September 30, 2021, deadline
- DHCD’s ability to reallocate funds has been slowed by changes to the state’s rent relief program
DHCD, in its response to Auditor Howle’s report, disagreed with the conclusion that funding is at risk after the September 30, 2021, deadline due to differences in interpretation of federal law.
The full auditor report is available here.
President Joseph R. Biden, Jr. this week visited California to survey damage from the smoldering Caldor Fire in Northern California, now the 15th largest and 16th most destructive wildfire in the state’s history. President Biden recently approved a Presidential Major Disaster Declaration in El Dorado County to assist state, tribal, and local governments with wildfire emergency response and recovery efforts.
During the President’s visit to California, President Biden and Governor Gavin Newsom traveled to the Governor’s Office of Emergency Services (Cal OES) Headquarters to receive a briefing on the Caldor Fire response led by Cal OES Director Mark Ghilarducci, CAL FIRE Director Thom Porter, and U.S. Forest Services Regional Forester Jennifer Eberlien. The President and Governor later surveyed damage from the Caldor Fire in an aerial tour of impacted areas in El Dorado County. The President then discussed how his administration is prioritizing mitigation activities relative to climate change and extreme weather events, including catastrophic wildfires.
Additional information about President Biden’s visit to California is available here. Remarks from the President are available here and available here.
This week, the California Department of Forestry and Fire Protection (CAL FIRE) announced it will direct nearly $138 million in funding for 105 local fire prevention projects to help protect communities across California from wildfires. The fire prevention grants enable local organizations such as fire safe councils to implement activities that address the risk of wildfire and reduce wildfire potential for communities. Funded activities include fuel reduction, wildfire planning, and fire prevention education.
Additional information, including the full list of funding recipients, is available here.
Today, the U.S. Centers for Disease Control and Prevention (CDC) announced a $2.1 billion investment to improve infection prevention and control activities across the U.S. public health and health care sectors. The investment, made possible through the American Rescue Plan Act (ARPA), seeks to strengthen and equip state, local, and territorial public health departments and other partner organizations with resources needed to better fight infections in U.S. health facilities, including COVID-19 and other known emerging infectious diseases.
Over the next three years, CDC will issue $1.25 billion of the total to 64 state, local, and territorial health departments to support this infection prevention and control work. Initial awards totaling $885 million will be made in October 2021 and will be used to support the following activities:
- State-based nursing home and long-term care strike teams – The funding from CDC, in partnership with the Centers for Medicare and Medicaid Services (CMS), will allow state and other jurisdictional health departments to staff, train, and deploy strike teams to assist skilled nursing facilities, nursing homes, and other long-term care facilities with known or suspected COVID-19 outbreaks. The strike teams will allow jurisdictions to provide surge capacity to facilities for clinical services, address staffing shortages at facilities, and strengthen infection prevention and control activities to prevent, detect, and contain outbreaks, including support for COVID-19 vaccine boosters.
- Strengthening state capacity to prevent, detect, and contain infectious disease threats across health care settings – CDC will allocate significant infection prevention and control assistance to public health departments to work with health facilities to improve the quality of care, strengthen interventions for the prevention and containment of infectious diseases to minimize the spread of infection in a variety of settings, identify, address, and monitor health-related disparities and health equity, and increase capacity to investigate outbreaks of health care- associated infections (HAI).
- Laboratory capacity for health care – Funds will also increase state and regional laboratory capacity to conduct surveillance for emerging pathogens to better identify patients infected with or carrying infectious disease threats, such as antibiotic resistant germs.
- Project Firstline – Funds will expand efforts to design and implement effective infection prevention and control training and education to frontline health care staff, leveraging a unique collaborative of health care, public health, and academic partners. Project Firstline seeks to meet various education needs of diverse health care workforce personnel, ensure personnel have the knowledge necessary to protect themselves and patients, and develop training and education that addresses disparities across health settings.
- National Health Care Safety Network (NHSN) – CDC will increase data and monitoring activities through the NHSN to determine where and when infections occur in health settings. Funds will support state efforts to improve NHSN data collection from health facilities, including state coordination, reporting expansions, and technical assistance provision.
- Antibiotic stewardship – Funds will additionally support state data analyses of antibiotic use and implement programs to improve antibiotic prescribing across communities, including addressing health disparities related to antibiotic use.
In addition to the amounts provided to state, local, and territorial health departments, $880 million in funding will be used over several years to support health care partners, academic institutions, and other nonprofit partners to develop new prevention interventions and capacities for infection prevention and control training, data collection, and technical assistance.
Additional information on the funding announcement from the CDC is available here.
The U.S. Department of Health and Human Services (HHS) today announced nearly $350 million in awards to states to support safe pregnancies and healthy babies. The funding will expand home visiting services to families most in need, increase access to doulas, address health disparities in infant deaths, and improve data reporting on maternal mortality. The Health Resources and Services Administration (HRSA) awarded these funds.
HRSA is investing in the following maternal and child health programs:
- Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program – The MIECHV program is awarding $342 million in funding to 56 states, jurisdictions, and nonprofit organizations. These funds will support communities in providing critical home visiting services, including pregnancy education, parenting skill-building, and referrals to other community-based supports. As part of this award, California is slated to receive an additional $19 million to support MIECHV programming.
- Health Start Initiative – The Healthy Start Initiative supports communities where the infant mortality rate is 1.5 times the national average. These projects work with women during pregnancy and after birth to help reduce infant death and severe maternal illness. Specific activities to be supported by the investment include:
- Community-Based Doulas – More than $3 million in supplemental funding has been awarded to 25 Healthy Start grantees to increase the availability of doulas. Funding will cover the costs of training, certifying, and compensating doulas.
- Infant Health Equity – More than $1.6 million in supplemental funding has been awarded to 21 Healthy Start grantees to help reduce disparities in infant mortality in regional areas with the highest number of non-Hispanic Black or non-Hispanic American Indian/Alaska Native infant deaths. Awardees will use the funding to create local action plans to address conditions affecting infant mortality disparities.
- State Systems Developmental Initiative (SSDI) – Approximately $600,000 in supplemental funding has been awarded to 10 grantees participating in the SSDI program. The funding will expand the capacity of states and jurisdictions to collect and report timely, high quality maternal health data to support health care quality improvement activities.
Additional information from HHS is available here.
This week, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), awarded over $48 million to 271 HRSA-supported health centers across 26 states to expand HIV prevention and treatment services, including preexposure prophylaxis (PrEP), outreach, and care coordination. California health centers are set to receive just shy of $9 million.
The investment is part of HHS’ Ending the HIV Epidemic in the U.S. (EHE) initiative which aims to reduce the number of new HIV infections in the U.S. by 90 percent by 2030. The funding will expand HIV prevention services that decrease the risk of HIV transmission in counties, territories, and states prioritized due to substantial HIV diagnosis. The latest awards will build upon FY 2020 HRSA Health Center Program EHE awards by funding additional health centers in EHE priority jurisdictions.
Awarded health centers will use the funding to conduct outreach and HIV testing, expand their workforce to increase access to and use of PrEP, and connect individuals who test positive for HIV to treatment. Awardees are encouraged to partner more closely with community organizations, such as HRSA’s Ryan White HIV/AIDS Program and health departments, to facilitate referrals for prevention and treatment services.
Additional information from HHS is available here.
This week, the Substance Abuse and Mental Health Services Administration (SAMHSA) awarded more than $123 million in funding through six grant programs to provide multifaceted support to communities and health care providers to combat the nation’s opioid overdose epidemic.
The funding will be allocated across the following grant programs:
- Medication Assisted Treatment for Prescription Drug and Opioid Addiction (MAT-PDOA) – This program expands and enhances communities’ access to medication-assisted treatment (MAT) services for people who have opioid use disorder (OUD). This five-year program seeks to increase the number of Americans receiving MAT and decrease their illicit opioid use and/or prescription misuse by their six-month follow-up visits. Awards totaling $71.3 million will be distributed to 127 grantees. Recipients of this funding include numerous health providers throughout the state of California.
- Tribal Opioid Response Grants (TOR) – This program addresses the opioid crisis in tribal communities by increasing access to culturally appropriate and evidence-based treatment, including MAT. Grant recipients will also address stimulant misuse and use disorders, including for substances such as cocaine and methamphetamine.
- Screening, Brief Intervention, and Referral to Treatment (SBIRT) – SBIRT guides clinicians in the practice of screening for substance use disorders (SUD), providing intervention services, and referring patients to other treatment settings. Funding awards total $10.6 million annually to 11 grantees.
- Strategic Prevention Framework for Prescription Drugs (SPF Rx) – This program provides funding to states, territories, and tribal entities to raise community awareness and bring prescription drug misuse prevention activities and education to schools, communities, parents, prescribers, and patients. The program seeks to raise awareness about the dangers of sharing medications and work with pharmaceutical and medical communities on the risk of overprescribing, particularly to young adults. Funding awards total $9.9 million annually to 21 grantees.
- First Responder-Comprehensive Addiction and Recovery Act Grants (FR-CARA) – This program encourages first responders and members of other key community sectors to administer a federally-approved device for the emergency reversal of a known or suspected opioid overdose. Grantees will train and provide resources to first responders and other community members at the state, tribal, and local governmental levels in safely implementing these lifesaving procedures. Funding awards total $8.2 million annually to 16 grantees, including the Contra Costa County Health Services.
- Providers Clinical Support System-Universities (PCSS-Universities) – This program trains health professionals to provide effective, evidence-based treatments to patients with OUD in primary care, psychiatric care, substance use disorder treatment, and pain management settings. The PCSS-Universities funding will expand or enhance access to MAT services at the community level by investing in the nation’s medical workforce educational system. Grant funds will provide education and training in MAT for students pursuing careers in the medical, physician assistant, and nurse practitioner fields.
Additional information about the multifaceted investment awards is available here.
The Public Health Accreditation Board (PHAB) recently launched the vetting of PHAB Standards & Measures: Version 2022. PHAB is encouraging public health personnel to weigh in on the proposed version of measures to reflect the changing landscape of public health practice and incorporate feedback from practitioners.
To share feedback, visit here to access the full draft of standards and measures, as well as instructions for completing the survey. Vetting is open until November 5, and PHAB will use input collected through this process to develop the final version of standards and measures for 2022. The final version is anticipated to be released early next year.
The Trust for America’s Health (TFAH) recently released its 18th annual State of Obesity: Better Policies for a Healthier America report, finding that social and economic factors linked to obesity were exacerbated by the COVID-19 pandemic.
TFAH reports that in 2020, 16 states had adult obesity rates at or above 35 percent, up from 12 states the previous year. As recently as 2012, no state had an adult obesity rate above 35 percent. Notably, California realized a significant increase in obesity rates between 2019 and 2020 with 30.3 percent of adults in California with obesity.
Authors of the report indicate that the COVID-19 pandemic changed eating habits, worsened levels of food insecurity, created barriers to physical activity, and heightened stress, on top of a decades-long pattern of increasing obesity in America. Obesity rates reported by TFAH vary considerably among states and regions of the U.S. TFAH points to systemic inequities and socioeconomic factors as playing a major contributing factor in higher rates of obesity among certain racial and ethnic populations.
To address the nation’s obesity levels, TFAH sets forth a series of recommendations focused on two principles: 1) the need for multi-sector, multi-disciplinary approaches, and 2) an intentional focus on population groups that experience a disproportionate risk for obesity. TFAH’s recommendations include:
- Increasing funding to CDC’s National Center for Chronic Disease Prevention and Health Promotion – TFAH argues this investment should include at least $125 million in FY 2022 for CDC’s Division of Nutrition, Physical Activity, and Obesity, and $102.5 million in FY 2022 for CDC’s Racial and Ethnic Approaches to Community Health to ensure sufficient and equitable funding for obesity prevention programming in all 50 states.
- Make healthy school meals free for all students – as a step to end child hunger and ensure access to healthy foods. TFAH urges policymakers to protect the recent expansion of the Supplemental Nutrition Assistance Program (SNAP) benefits and enhance access to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
- Close loopholes and eliminate business-cost deductions – related to advertising of unhealthy food and beverages to children.
- Increase the price of sugar-sweetened beverages through an excise tax – with tax revenues allocated to local efforts to reduce health and socioeconomic disparities and obesity prevention programs.
- Ensure that all residents have safe and convenient access to walking and biking trails and that all students have safe routes to walk or bike to school – State and local educational agencies are also urged to prioritize physical activity during the school day.
- Expand access to health insurance including through the extension of Medicaid – and by making marketplace coverage more affordable. Insurance plans should cover all U.S. Preventive Services Task Force “A” or “B” recommendations for obesity prevention programs with no-cost sharing for the patient.
The full TFAH report is available here. Additional data on obesity trends from the CDC is available here.
The University of California, Los Angeles (UCLA) Center for Health Policy Research will host a virtual symposium on Monday, October 4 and Tuesday, October 5 entitled, “Opening Doors for All: Improving Health in Housing and Homelessness.” The symposium will bring together public health leaders, community advocates, policymakers, and other thought leaders to identify past successes and lessons learned to encourage California to effectively invest in evidence-based solutions to create a healthier, more prosperous state for all residents.
From a lack of affordable housing and health, mental health, and substance use services, to unemployment, incarceration, structural racism, domestic violence, and more, symposium speakers and panelists will discuss many of the underlying economic and social factors contributing to homelessness in California. The symposium will additionally discuss what actions are available to stakeholders in understanding and effectively addressing underlying factors to improve the health and well-being of state residents experiencing housing instability and homelessness.
Additional information, including registration, on the symposium is available here.
The Essentials for Childhood (EfC) Initiative, a joint project of the California Department of Public Health (CDPH) and the California Department of Social Services (CDSS), recently published a new resource, “Connecting Families to Tax Credits to Improve Child Wellbeing in California: A Brief for California Local Health Departments and Children & Family Service Providers.”
The resource is intended to assist local health departments and children and family service providers in their efforts to educate about how the collection of the California Earned Income Tax Credit (CalEITC), California Young Child Tax Credit (YCTC), federal EITC, federal child tax credit, and other associated tax credits can improve the wellbeing of Californians. By educating Californians about the importance of filing taxes in order to receive associated tax credit benefits, the state aims to improve the lives of families and strengthen economic supports.
The full resource from EfC is available here.
The Bay Area Regional Health Inequities Initiative (BARHII), along with partners including the Public Health Advocates, will host multiple equity-focused webinar series over the coming weeks. These webinars include:
In the Room Where it Happens: Funding Equity Officer Positions for Emergency Management
This webinar will occur on Wednesday, September 22 from 10:00 am to 12:00 pm. The webinar will highlight the important role of equity officers in emergency management activities and will explore strategies to embed equity-focused leadership roles in local government, including through a new $32 million grant from the California Department of Public Health (CDPH) for equity infrastructure in local health departments.
Registration is available here.
Media Spokesperson Training: Leading Our Voices for Equity Investments
This two-part webinar will feature the Berkeley Media Studies Group (BMSG) to provide tools and guidance to local government staff and community organizations to communicate with the media in support of equity investments. Trainers will help participants speak confidently with reporters, frame the issue to connect their policy goal, and stay on message even when answering difficult questions.
The first session will be held on Tuesday, October 5 from 10:00 am to 12:00 pm, and the second session will be held on Wednesday, October 6 from 10:00 am to 12:00 pm. Participants are required to register for both sessions. Registration is available here.
The California Department of Public Health (CDPH) Injury and Violence Prevention Branch (IVPB) and the Prevention Institute will host a webinar on Wednesday, September 29 from 12:00 pm to 1:00 pm. The webinar is entitled, “Preventing Trauma and Suicide during Catastrophic Events and Beyond: Strategies for Preventing Suicide in California.”
The webinar will feature presenters from CDPH, the Prevention Institute, and the Center for Law and Social Policy (CLASP). Speakers will unveil a new toolkit on preventing trauma and suicide during catastrophic events, including the COVID-19 pandemic, wildfires, and other significant events.
Additional information, including registration, is available here.
ACEs Aware, California’s initiative between the Office of the California Surgeon General and the California Department of Health Care Services (DHCS), will host a special webinar highlighting the ACEs Screening How-To Guide and implementation lessons from clinics throughout the state. The webinar will occur on Wednesday, September 29 from 12:00 pm to 1:00 pm.
The webinar will discuss ways in which the how-to guide can assist clinics in implementing ACEs screening, highlight how several practices have implementing ACEs screening, and share actionable ideas for clinical teams to implement ACEs screening.
Additional information, including registration, is available here.
The California Department of Public Health (CDPH) Alzheimer’s Disease Program (ADP) will host a webinar on Wednesday, October 22 from 10:00 am to 11:00 am. The webinar will share information about California’s current activities around Alzheimer’s disease and related dementias, including highlights on California’s Alzheimer’s Disease Centers, recent research activities, and local efforts to address dementia.
Additional information, including registration, is available here.