September 25, 2020 Edition
This week, Governor Gavin Newsom issued Executive Order N-80-20 taking action on a series of items related to the COVID-19 pandemic. Notably, the order allows local health officers and other public health officials to participate in the Secretary of State’s Safe at Home Confidential Address Program. The order acknowledges the numerous threats and other harassment experienced by local public health officials, including threats and harassment targeted at their places of residence, which “threatens to chill the performance of their critical duties.”
CHEAC released the following statement in light of the Governor’s order to protect public health officials:
“Governor Newsom’s executive order recognizes that the work of local public health directors and public health officers is crucial to saving lives in California, and that we must be free to make decisions based on science and in the best interest of the public without facing threats and harassment.”
“We are grateful Governor Newsom has acted to protect public health officials and our families who have sacrificed dearly as we’ve worked around the clock for the last seven months with one goal in mind: saving lives.”
“While we are seeing positive trends in COVID-19 containment, we are fighting a relentless virus and the flue season around the corner calls for maintaining vigilance. We look forward to continued partnership with Governor Newsom and the administration to continue our progress so that California may reopen safely.”—Mimi Hall, CHEAC President and Santa Cruz County Health Services Agency Director
Newsom’s executive order also authorizes the California Department of Managed Health Care (DMHC) to gather information to assess the impacts of the pandemic on health care providers and health care service plans. The order also extends authorization for local governments to halt evictions for commercial renters impacted by the COVID-19 pandemic through March 31, 2021, and extends other provisions related to the California Environmental Quality Act (CEQA).
Today, Governor Gavin Newsom signed a handful of legislative measures to reform the state’s behavioral health care system, including reforms aimed at improving access to mental health and substance use disorder services and behavioral health services for individuals experiencing homelessness.
Most notably, Governor Newsom signed into law AB 1976 (Eggman) to expand court-ordered Assisted Outpatient Treatment (AOT), AB 2265 (Quirk-Silva) to authorize the use of specified Mental Health Services Act (MHSA) funds for the treatment of cooccurring mental health and substance use disorders, SB 803 (Beall) to support statewide standards for behavioral health peer support specialists and add the services as an option in Medi-Cal, and SB 855 (Wiener) to require commercial health plans and insurers to provide full coverage for the treatment of all mental health conditions and substance use disorders and establish standards for what constitutes medically necessary treatment and criteria for use of clinical guidelines.
Governor Newsom additionally signed a number of other behavioral health and homelessness-related measures, including AB 1544 (Gipson) related to community paramedicine or triage to alternate destinations, AB 2112 (Ramos) related to suicide prevention, AB 2553 (Ting) related to shelter crisis declarations, and SB 1065 (Hertzberg) related to CalWORKs homeless assistance.
The full announcement from the Office of the Governor is available here.
This week, the Newsom Administration marked Climate Week 2020 by announcing a series of new climate change-related initiatives. Below, we summarize some of the most notable actions:
Zero Emissions Vehicles by 2035
Among the actions, Governor Gavin Newsom issued Executive Order N-79-20 requiring the sales of all new passenger vehicles to be zero-emissions by 2035 and additional measures to eliminate emissions from the transportation sector. According to the Office of the Governor, the target would achieve more than a 35 percent reduction in greenhouse gas emissions and an 80 percent improvement in oxides of nitrogen emissions from cars statewide.
The order also sets deliverables for new health and safety regulations to protect workers and communities from the impacts of oil extraction. The Governor is asking the Legislature to end the issuance of new hydraulic fracking permits by 2024.
Additional information on the Governor’s order and related actions are available here.
Launch of Climate Action Corps
Additionally, Governor Gavin Newsom announced the launch of the California Climate Action Corps, a first-in-the-nation approach to empower California residents to take meaningful actions to protect their homes, health, and communities against the impacts of climate change. Applications for the Climate Action Corps Fellows Program have launched this week, and over 250 AmeriCorps fellows will deploy through 2021 to support local climate action projects in front-line and low-income communities throughout the state. Fellows will be placed with state and local government agencies, nonprofit organizations, and universities and colleges to focus on developing and implementing climate action projects with an emphasis on volunteerism and community engagement.
California Volunteers is also establishing a statewide online volunteer hub of climate-focused volunteer opportunities. Environmental and climate-focused organizations will be able to post service opportunities to be activated by local volunteers, allowing all California residents to become engaged in climate action activities. Additional information on the Climate Action Corps is available here and a statement from the Governor’s Office is available here.
The Department of Health Care Services (DHCS) has made available the 2018-2020 California Children’s Services (CCS) Title V Needs Assessment Final Report. Title V of the Social Security Act provides for programs to improve the health of all mothers and children, including children with special health care needs. As a condition of the Title V Maternal and Child Health (MCH) Block Grant Program, the Federal MCH Bureau requires each state agency to complete a needs assessment every five years.
The needs assessment was carried out by the University of California, San Francisco (UCSF) Family Health Outcomes Project (FHOP) and included a number of focus groups, surveys, and key informant interviews. Findings of the needs assessment include topics such as family engagement in the CCS program, medical home availability, maintenance of insurance coverage, early and regular health screenings, availability of community-based services, and transition to adult care.
Notably, the needs assessment includes an examination of CCS Program capacity at the county level, finding local capacity challenges that impact the abilities of counties to implement the CCS program. Challenges include recruitment and retention of skilled staff, including therapists in Medical Therapy Units (MTUs), processing of eligibility determinations, requests for authorizations for services and durable medical equipment, and completion of annual medical reviews in a timely fashion. Additionally, the implementation of the Whole Child Model (WCM) has required considerable resources at state and county levels, and many CCS Administrators reported unanticipated and underfunded workload after implementing WCM without enough staff.
Overall priorities that were identified through the needs assessment were to make systems of care easier to navigate for children and youth with special health care needs and their families and to enhance family engagement and resilience. The full needs assessment is available here.
This week, the Department of Health Care Services (DHCS) announced it is seeking stakeholder participation in a series of technical workgroups that will be convened to obtain input regarding the renewal of the Home and Community-Based Alternatives (HCBA) Waiver. The HCBA Waiver provides long-term, community-based services and supports to Medi-Cal-eligible beneficiaries in the community of their choice.
Workgroup members will provide critical feedback and make recommendations about the HCBA Waiver renewal, including identifying opportunities to expand what works well, address challenges, safeguard participant health and safety, reinforce participant choice, and improve access to waiver services.
Three technical workgroups will be held between October 2020 and January 2021. Workgroup recommendations will, as allowable, be incorporated into the 2022 HCBA Waiver application. If you wish to be considered for participation in the workgroup, individuals must submit the HCBA Waiver Renewal Technical Workgroup Statement of Interest form to HCBAlternatives@dhcs.ca.gov by 5:00 pm on October 2, 2020. Workgroup membership will be limited to ensure a productive discussion environment. Additional information on HCBA is available here.
This week, President Donald Trump signed an executive order declaring it a policy of the federal government to ensure that Americans with pre-existing conditions can obtain health insurance of their choice at affordable rates. The order directs specified federal agencies to “build upon existing actions to expand access to and options for affordable healthcare” and “build upon existing actions to ensure consumers have access to meaningful price and quality information prior to the delivery of care.”
The order additionally directs U.S. Department of Health and Human Services to take administrative action to prevent a patient from receiving a medical bill for “out-of-pocket expenses that the patient could not have reasonably foreseen” in the event Congress does not pass legislation on the matter by the year’s end. The order also directs specified agencies to maintain and build upon existing actions to “reduce waste, fraud, and abuse in the healthcare system.”
President Trump framed the order as an “America-First Healthcare Plan,” but health policy experts widely signaled the President’s order falls short on details and has minimal impact on existing legislation and regulations. Additionally, the order comes amid an upcoming legal challenge to the Affordable Care Act (ACA).
Recall, the Trump Administration in June filed a brief with the U.S. Supreme Court petitioning the court to strike down the ACA in its entirety, which, among other actions, prohibits health insurers from refusing insurance coverage due to pre-existing conditions. The Supreme Court is scheduled to hear oral arguments on the case, California v. Texas, on November 10, 2020.
The full executive order from the Trump Administration is available here.