Legislature Returns from Spring Recess, Meets Fiscal Bill Deadline

On Monday, the California Legislature returned from its Spring Recess to a busy week of committee hearings and bill negotiations. Today is the deadline for policy committees to hear and report all bills with a fiscal impact introduced in their house of origin. Next Friday is the deadline for policy committees to hear and report all remaining bills without a fiscal impact introduced in their house of origin.

There were a number of high-profile bill hearings this week spanning a wide array of issues, including vaccination exemptions, housing developments, charter schools, and law enforcement use-of-force. Committee hearings lasted multiple hours, often stretching well into the evening, as legislators worked to advance bills ahead of today’s fiscal bill deadline.

Notably this week, two additional measures attempting to limit sugar-sweetened beverage (SSB) consumption in California succumbed to increased scrutiny and skepticism by legislators and industry stakeholders. AB 138 by Assembly Member Richard Bloom was pulled from the agenda in the Assembly Revenue and Taxation Committee just prior to its scheduled hearing on Monday afternoon. AB 138 would impose a $0.02 fee per fluid ounce on SSBs and allocate revenues to a number of state agencies and departments for the purposes of promoting health equity, reducing health disparities, improving oral health, and preventing chronic disease conditions.

Reports indicated Assembly Member Autumn Burke, Chair of the Assembly Revenue and Taxation Committee, will remain opposed to AB 138 – or any future similar proposal – if the measure does not steer SSB fee revenues toward lowering the cost of bottled water in low-income and disadvantaged areas of the state. Burke voted in favor of AB 138 earlier this month in the Assembly Health Committee; however, the measure lost her support after reported amendments were not finalized prior to its hearing in the Assembly Revenue and Taxation Committee. While Bloom shelved the proposal for this year, he indicated his continued commitment to fighting “against well-funded and powerful special interests that profit at the expense of the public’s health and welfare.”

AB 765 by Assembly Member Buffy Wicks also experienced a similar fate on Tuesday just prior to its scheduled hearing in the Assembly Health Committee. The measure would require that only specified healthy beverages be made available in checkout aisles of retail stores. Wicks earlier this month rescheduled the measure’s hearing, attempting to work through enforcement provisions and other logistical considerations of the measure. Wicks, vowing to pursue the measure again next year, indicated in a statement, “The link between sugary drinks and obesity, diabetes, and heart disease is undeniable … I am committed to finding practical solutions, like increasing the healthy checkout options at checkout aisles, to promote the best interests of California’s health.”

The shelving of both AB 138 and AB 765 mark the second and third defeat of legislative efforts targeting SSB consumption in California. Recall, AB 766 (Chiu), which sought to prohibit large SSB fountain drinks, was withdrawn earlier this month. Two of the five measures proposed as part of the SSB package remain in play, however. AB 764 (Bonta), prohibiting SSB financial incentives, and SB 347 (Monning), requiring SSB warning labels, continue to make their way through the legislative process.

Below, we highlight several other items of interest to CHEAC Members. Our CHEAC Weekly Bill Chart is available here.

Communicable Disease Control

SB 276 (Pan) as amended April 9, 2019 – SUPPORT

SB 276 by Senator Richard Pan was heard in the Senate Health Committee on Wednesday, featuring hundreds of individuals in support and opposition and lasting over five hours. SB 276 would require physicians to submit a statewide standardized immunization medical exemption request form and require the state public health officer or designee to approve or deny the request upon determining sufficient medical evidence that the immunization is contraindicated utilizing guidance from the U.S. Centers for Disease Control and Prevention (CDC). The California Department of Public Health (CDPH) would be required to create and maintain a database of approved medical exemption requests and make available the database to local health officers. The state public health officer and local public health officers would also be authorized to revoke a medical exemption if it is determined that the exemption is fraudulent or inconsistent with applicable CDC guidelines.

In presenting his measure, Senator Pan raised significant concerns over some physicians issuing immunization exemptions under the guise of medical necessity. He claimed a small number of “unscrupulous” physicians are advertising and selling “fake medical exemptions,” thereby threatening the public’s health and safety. Senator Pan referenced the ongoing measles outbreaks both in California and throughout the country and urged the need to take proactive steps in shoring up vaccination rates in the state.

Alameda County Interim Health Officer Dr. Erica Pan testified in support of the measure on behalf of the Health Officers Association of California (HOAC), providing critical expertise on the public health considerations of immunization exemptions, community immunity, and the threat of communicable disease outbreaks among unvaccinated individuals and communities. Those in support of the measure largely consisted of public health and healthcare professionals and organizations.

Several medical professionals testified in opposition to the measure, citing concerns over the erosion of the doctor-patient relationship. Those in opposition to SB 276 largely consisted of individuals and parents concerned about the safety of vaccines and those who see the measure as an infringement upon their rights.

Robust debate amongst committee members and witnesses followed the lengthy public comment period and featured discussions on community immunity, vaccine contraindications, and implementation considerations of the measure. SB 276 was advanced out of the Senate Health Committee to the Senate Appropriations Committee on a party-line vote of 7-2.

Relatedly, HOAC this week released a report on community immunity by legislative district. Using publicly available data, HOAC found that there are 835 schools in California who have a kindergarten MMR immunization rate of less than 95 percent, with nearly 398,000 children attending these schools. This report is available here.

Environmental Health

AB 377 (E. Garcia) as revised April 24, 2019 – SUPPORT

AB 377 by Assembly Member Eduardo Garcia was heard in the Assembly Appropriations Committee on Wednesday. Recall, AB 377 is the clean-up measure to AB 626 (Chapter 470, Statutes of 2018) which established microenterprise home kitchen operations. The measure provides clarifying and technical amendments around jurisdictional opt-in procedures, local permitting and inspection activities, and exempted food safety and sanitation provisions. CHEAC remains concerned with the potential for increased risk to the public’s health and safety through the operation of microenterprise home kitchen operations; however, CHEAC supports AB 377 as the measure provides greater clarity of critical provisions enacted through AB 626. AB 377 was unanimously advanced from the Assembly Appropriations Committee to the Assembly Floor.

Health Coverage/Health Care Reform

SB 29 (Durazo) as amended March 11, 2019 – SUPPORT

SB 29 by Senator Maria Elena Durazo was scheduled in the Senate Appropriations Committee on Monday. The measure would expand full-scope Medi-Cal to all undocumented adults in California with incomes at or below 138 percent federal poverty level (FPL). Senator Durazo waived presentation and the measure was placed on the Senate Appropriations Suspense File.  

SB 175 (Pan) as amended on April 3, 2019 – SUPPORT

SB 175 by Senator Richard Pan was heard in the Senate Governance and Finance Committee on Wednesday. The measure would institute a state-level individual health insurance coverage mandate in California. SB 175 would also require Covered California to conduct specified outreach and enrollment efforts among Californians who do not maintain minimal health coverage. The measure was advanced to the Senate Appropriations Committee on a 4-2 vote with one member not voting.

Jail and Community Corrections Services

SB 433 (Monning) as amended on April 11, 2019 – SUPPORT IN CONCEPT

Senator Bill Monning’s SB 433 was heard in the Senate Human Services Committee on Monday. SB 433 would require the California Department of Social Services (CDSS), in collaboration with CDPH, to establish and oversee the Office of Youth Development and Diversion (OYDD) Grant Program, consisting of up to five three-year pilot programs to be administered by county health departments. Under the grant program, counties would be required to conduct a series of activities in partnership with community-based organizations and local governmental entities related to youth development and diversion programming and services. SB 433 was unanimously advanced from the Senate Human Services Committee to the Senate Appropriations Committee on a 6-0 vote.

Tobacco Control

AB 1718 (Levine) as introduced on February 22, 2019 – SUPPORT

AB 1718 by Assembly Member Marc Levine would prohibit the smoking and disposal of cigar or cigarette waste at all state coastal beaches or in state parks. The measure was scheduled for hearing in the Assembly Appropriations Committee on Wednesday; Assembly Member Levine waived presentation and the measure was placed on the Assembly Appropriations Suspense File.

SB 38 (Hill) as introduced on December 3, 2018 – SUPPORT

SB 38 by Senator Jerry Hill would prohibit tobacco retailers from selling any flavored tobacco products and sets forth enforcement and penalty provisions to be carried out by CDPH. The measure was scheduled for hearing in the Senate Appropriations Committee on Monday; Senator Hill waived presentation and the measure was placed on the Senate Appropriations Suspense File.