September 27, 2019 Edition

Referenda Seeking to Reverse Immunization Medical Exemption Laws Cleared for Circulation

This week, California Secretary of State Alex Padilla cleared for circulation two referenda challenging California statute related to state oversight of medical exemptions for school immunization requirements enacted through Senator Richard Pan’s SB 276 and SB 714. Recall, the two measures were passed and signed into law earlier this month after a flurry of activities, including bill negotiations, numerous protests, and last-minute amendments from the Newsom Administration.

Proponents of the referenda must collect 623,212 signatures on both referenda by December 9, 2019, to qualify for the 2020 statewide ballot. Recall, a recent poll from the Public Policy Institute of California (PPIC) found that nearly three-fourths of Californians support requiring vaccinations. Additional information on the status of the referenda can be found on the California Secretary of State’s website here.

CDPH Issues Health Advisory Urging Californians to Refrain from Vaping

On Tuesday, the California Department of Public Health (CDPH) issued a statewide health advisory urging Californians to refrain from vaping, regardless of the substance or source. The health advisory follows the executive order issued by Governor Gavin Newsom, setting forth a series of actions related to health risks associated with vaping and increasing youth utilization.

CDPH, in coordination with other states, the U.S. Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), local health departments, and healthcare providers continue to investigate the matter. As of September 24, 2019, CDPH has received reports that 90 Californians with a history of vaping have been hospitalized for severe breathing problems and lung damage and two people have died.

CDPH’s full health advisory and related information are available here.

GO-Biz Awards First Round of California Community Reinvestment Grants (CalCRG)

Earlier this week, the Governor’s Office of Business and Economic Development (GO-Biz) announced the first round of awardees for the California Community Reinvestment Grants (CalCRG). Recall these grants are for the first cycle of funding (FY 18/19) awarded from the Proposition 64 (Adult Use of Marijuana) grants program intended to support activities for communities disproportionately impacted by the war on drugs. Both community based organizations and local health departments are eligible for this funding and eligible activities include job placement, mental health and substance use disorder treatment, system navigation services, legal services to address barriers to reentry, and linkages to medical care.

A total of $9.6 million has been awarded to 69 entities representing 23 counties or portions of counties statewide. Four local health departments in collaboration with other entities received funding awards as well as one solo local health department awardee. GO-Biz anticipates applications for the second round of CalCRG funding (~$20 million available) to be released in the spring of 2020.

NACCHO Issues Sign-on Opportunity Supporting Ban of Flavored E-Cigarettes

This week, the National Association of County & City Health Officials (NACCHO) released a sign-on opportunity for local health departments and officials to support the recently announced U.S. Food and Drug Administration (FDA) plan to remove non-tobacco flavored electronic cigarettes, including mint and menthol, from the market in an attempt to curb utilization of the products among youth. Recall, a recent flurry of activities at the federal level, including several states such as California, has occurred targeting such electronic cigarettes and vaping.

The most recent data from the U.S. Centers for Disease Control and Prevention (CDC) indicates a steady rise in use of flavored electronic cigarettes among youth, with 27.5 percent of high schoolers reporting that they recently vaped and that fruity and minty flavors were a popular reason to vape. NACCHO’s sign-on opportunity to indicate support of the impending ban and to encourage swift implementation by the U.S. Department of Health and Human Services is available here.

Report Released Detailing First-Ever National Recommendations for State Suicide Prevention Infrastructure

Recently, the Suicide Prevention Resource Center (SPRC) released the first-ever national recommendations for State Suicide Prevention Infrastructure, a collaborative effort among an advisory panel of experts and stakeholders. The guidelines detail essential infrastructure elements for advancing state suicide prevention efforts, including elements to assist policy leaders and officials assess the status of their current infrastructure and guide policymaking, funding, and administrative decisions accordingly.

The recommendations are organized into six essential elements with specific guidance in each area: 1) Authorize; 2) Lead; 3) Partner; 4) Examine; 5) Build; and 6) Guide. An overview of the report and its development is available here. SPRC’s full recommendations are available here.

NASEM Report Urges Consideration of Social Needs in Health Delivery to Improve Outcomes, Reduce Disparities

In a new report released by the National Academies of Sciences, Engineering, and Medicine (NASEM), finds five overarching goals and associated recommendations for health systems, government agencies, and related entities should implement to better integrate patients’ social needs into health care delivery. The report, Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation’s Health,examines the need to integrate social care with health care, largely finding that the move toward paying care providers based on health outcomes (rather than visits or services) and an increasing recognition that the social determinants of health have a profound impact on an individual’s physical and mental health have fueled the need to broaden the focus of health services.

The challenge in the U.S. is determining how social services – including home help for the elderly, rent subsidies, child allowances and credits, childcare support, job training, and disability benefits – are uniformly defined and financed in the health care space, according to the report. The report details a series of recommendations:

  • Better integrate social care into health care delivery. Health care organizations are recommended to, among other actions, make an organizational commitment to addressing health-related social needs, identify the most effective ways to assess and document social needs, and include social care providers as an integral part of health care teams.
  • Support and train an engaged, integrated care workforce. Currently, certain federal, state, and institutional barriers limit adequate payment of social care workers and their ability to work to the full extent of their education and training. Workforce development efforts should aim to create standards for the reimbursement of social care by public and private payers, test for knowledge of social determinants of health in licensure exams, and adopt curricula that prepare students of social work to use technology, data collection, and payment methods.
  • Develop an infrastructure for data sharing between health and social care. The report calls for a national vision and defined technology standards for integrating health care and social care data, similar to the standards underpinning the adoption of electronic health records.
  • Finance the integration of health care and social care. Specifically, the report calls on the U.S. Centers for Medicare and Medicaid Services (CMS) to define which aspects of social care Medicaid can cover, incentivize health organizations and managed care programs to collaborate with community-based health and social services, and coordinate the coverage benefits of dually eligible and high-need Medicare and Medicaid populations.

The report calls for more formalized and robust evaluations of the effectiveness of integrating social care needs into health care delivery to provide health officials and stakeholders with concrete examples of effective integration of social care and health care. The full report is available here.