Newsom Inaugurated, Issues Series of Executive Orders Related to Health, Emergency Preparedness

On Monday, Gavin Newsom was sworn in as California’s 40th governor. On the steps of the State Capitol in Sacramento, Newsom in his expansive inaugural address underscored his commitment to Californians stating, “Our government will be progressive, principled, and always on the side of the people.” Newsom highlighted the need for a range of investments and action to strengthen California’s safety net and address persistent challenges, including affordability, housing, and homelessness. He discussed plans to improve lives of California families through an expansion of paid family leave, earned income tax credits, and early childhood development and care initiatives.

In a nod to the Brown Administration, Newsom stressed the importance of being “prudent stewards of taxpayer dollars” and planning for a potential future economic downturn. Newsom credited former Governor Jerry Brown for much of California’s progress and promised to serve as a uniting force to establish a “California for all.”

Following his inauguration, Newsom issued a series of executive orders related to health coverage, prescription drugs, and emergency preparedness and response. Below, we highlight these executive orders:

California Surgeon General

Governor Newsom issued Executive Order N-02-19 establishing a California Surgeon General to lead Californians in addressing root causes of serious health conditions, including adverse childhood experiences (ACEs) and the social determinants of health. Newsom pointed to a growing body of scientific evidence showing how upstream factors such as toxic stress eventually leads to chronic and acute health conditions amongst Californians. The executive order tasks the surgeon general with marshaling “the insights and energy of medical professionals, public health experts, public servants, and everyday Californians to solve our most pressing health challenges with surgical focus.”

The surgeon general is required to be a physician licensed to practice in California and a recognized thought-leader in addressing root causes of health disparities, among other qualifications. The position is required to be appointed by February 1, 2019.

Prescription Drug Purchasing

Governor Newsom issued Executive Order N-01-19 to address rising prices of prescription drugs. The executive order tasks the Department of Health Care Services (DHCS) and other departments with transitioning all pharmacy services for Medi-Cal managed care to a fee-for-service benefit by January 2021, reviewing purchasing initiatives through the California Pharmaceutical Collaborative, and taking steps to expand bulk pharmaceutical product purchasing. Newsom charts the path for private and public purchasers to negotiate prescription drug prices with pharmaceutical companies through this executive order.

Additional details related to Newsom’s pharmaceutical drug proposals are covered in his budget proposal released this week.

Letter to Federal Government Leaders

Governor Newsom sent a letter to President Donald Trump and Congressional leaders calling on the federal government to remove barriers that currently prevent states from designing and implementing solutions for affordable health care and expanded coverage. Newsom discusses in his letter opportunities around cost and coverage waivers, expanded tax subsidies, and cost containment efforts. The letter urges the federal government to lift current limitations that could allow California to develop a single-payer health system and establish universal coverage for all residents.

Natural Disaster Preparedness and Response

Governor Newsom issued Executive Order N-05-19 that tasks state agencies with a series of actions related to wildfire and natural disaster preparedness and response. The California Department of Fire and Forestry (Cal Fire), among other state agencies, is required to recommend to the governor administrative, regulatory, and policy changes necessary to prevent and mitigate wildfires with an emphasis on public health and safety. A report is required to be provided to the governor within 45 days that details personnel and resource deployment, resource procurement, and community assessment efforts. Assessment activities are required to detail high-hazard areas, socioeconomic factors, and vulnerable populations particularly at risk in natural disaster events.

Procurement Processes for Preparedness and Response Resources

Governor Newsome issued Executive Order N-04-19 that lays out streamlined and flexible procurement processes for emergency preparedness and response resources. State agencies are tasked with developing a new iterative procurement approaches, starting with innovative solutions to the state’s wildfire risks and forest health.