With One Week Remaining in Legislative Session, Lawmakers Meet Bill Amendment Deadline

Next week is the final week for the Legislature to act on bills prior to concluding their business for the Legislative year on September 13. Today marked a key deadline for the legislature, the last day to amend bills on the floor without a two-thirds vote to waive the rules. Next Tuesday, will be the last day to amend the bills entirely given the Constitutional requirement for bills to be in print for 72 hours before they can be voted on.

While we anticipate a flurry of activity next week, this past week proved to be quite eventful with a lot of activity around Senator Richard Pan’s SB 276 (additional details below). The Legislature worked through lengthy floor sessions this week with the Assembly meeting on Tuesday, Thursday and Friday, while the Senate convened daily. Between the two houses, the Senate has the bulk of measures yet to be acted upon compared to the Assembly. The Legislature will likely work well into the evenings next week in order to finish their business.

Several key issues are outstanding, including, but not limited to:

  • Gig EconomyAB 5 (Gonzalez) seeks to codify the California Supreme Court’s Dynamex ruling into state law and would classify independent contractors as employees. The measure has been met with strong opposition from Uber, Lyft, and other “gig economy” employers.
  • Rent CapsAB 1482 (Chiu) would limit yearly rent increases statewide to 5 percent plus inflation. It also provides further protections for tenants by requiring additional documentation of lease violations for evictions and relocation assistance should the landlord want to convert the building or make renovations.
  • Fair Pay to PlaySB 206 (Skinner) would allow college athletes in California to earn compensation as a result of the student’s celebrity without jeopardizing the student’s scholarship or eligibility. Public and private institutions have weighed in in opposition to the bill and the NCAA has threatened to ban California schools from postseason events should the measure pass. The bill has also garnered attention from professional athletes such as LeBron James, who took to twitter to express his support for the measure.
  • Budget Trailer Bills – A number of budget trailer bills on issues such as housing, social services, and the managed care organization tax, among others, also await action in the final week.

Below, we highlight several actions from this week on bills CHEAC is actively tracking. For a full update on bills, the CHEAC Weekly Bill Chart is available here.

Communicable Disease Control

SB 276 (Pan) as enrolled September 6, 2019 – SUPPORT

Much of the week was dominated by actions related to Senator Richard Pan’s SB 276. Below, we detail the events that transpired:

Assembly Floor. Coming off the heels of a tense Assembly Appropriations Committee hearing last Friday, the Assembly opted to take up SB 276 on Tuesday as the last item of business, without reference to file – meaning they heard the bill without notice. This move surprised several members, including Assembly Member Gonzalez, who presented the bill on behalf of Senator Pan. During the debate on the Assembly Floor, several members spoke in opposition and others spoke “not in support” of the measure. Members raised questions and concerns about why the bill is not limited to simply pursing the “bad actors”, the potential for backlogs at CDPH (likening it to the DMV) in reviewing exemptions, the potential chilling effect on doctors should the bill be enacted and risks of personal identifiable information being hackable. A number of Assembly Members rose in support of the measure and underscored the importance of community immunity and strengthening the medical exemption process. The Assembly passed the bill 47-17 immediately followed by protests in the Assembly viewing gallery.

Governor Weighs in. Minutes after the Assembly passed SB 276, the Governor’s Office issued a statement on Twitter alluding to additional “technical” amendments that they are seeking. A second tweet indicated the Governor would seek these changes in a concurrent bill. Later reports of these amendments revealed that they were not quite technical, but in fact rather substantive. The amendments seek to limit the state’s review of medical exemptions to those granted after January 2020 and strike the requirement for doctors to certify exemption requests under penalty of perjury.

Senate Floor. The Senate took up the bill the following day with members in opposition to the measure waging a similar debate. In addition, several opponents were gathered in the gallery and frequently interrupted the debate causing Senators to issue multiple warnings about their conduct. When asked why the amendments requested by the Governor were not included in SB 276, Senator Pan reiterated that the current version of the bill is what the Governor had previously agreed to sign. He further noted that any clean-up to the measure would be handled in a different vehicle. Those in support of the bill reiterated the importance of this bill in protecting the small percentage of people and children that actually require a medical exemption. The Senate passed the bill on a party line vote 28-8 with one member not voting. As of today, the bill has been enrolled and is headed to Governor Newsom for action. It is unclear whether the Governor will withhold action until the concurrent bill (detailed below) with his sought amendments reaches his desk.

Subsequent Bill. Today, SB 714 was gutted and amended to make the additional changes sought by the Newsom Administration. The measure will be carried by Senator Pan and would allow a child who has a medical exemption issued before January 2020 to be allowed to continue enrollment until the child enrolls in the next grade span, as specified, remove the requirement that the statewide form be signed under the penalty of perjury, modify which physicians and surgeons are eligible to issue a medical exemption, and modify information disclosure provisions.

SB 714, in its previous form, was set for hearing in the Assembly Health Committee in early July. However, the measure’s author at the time, Senator Tom Umberg, cancelled the bill’s hearing. While all details remain unclear at the time of this update, SB 714, in its new form, will have to receive rule waivers to be heard in the Assembly Health Committee next week. Additional details regarding the bill’s path forward are expected over the coming days.

Opposition. Opponents of the bill have now turned their focus to lobbying the Governor and Administration, protesting outside of the Governor’s Office this week. Opponents held signs and chanted “veto the bill, amendments aren’t enough.” In addition, a rally was held yesterday on the steps of the Capitol where opponents voiced their desire for United States Department of Justice to investigate doctors, county health officers, and any other licensed professionals associated with the measure.

Editorials. Several newspapers have weighed in with editorials questioning Governor Newsom’s stance on this measure. Links are provided below:

Access to Health Services

AB 1494 (Aguiar-Curry) as amended August 30, 2019 – SUPPORT

Assembly Member Cecilia Aguiar-Curry’s AB 1494 would make available Medi-Cal reimbursement for telehealth, telephonic, or off-site services when delivered by an enrolled community clinic, including a city or county clinic exempt from licensure, or a FFS Medi-Cal provider during or up to 90 days after the termination of a state of emergency, as deemed appropriate by the Department of Health Care Services. AB 1494 was unanimously passed by the Senate on Thursday and heads back to the Assembly for concurrence.

Emergency Medical Services

AB 1544 (Gipson) as amended August 30, 2019 – NEUTRAL

Assembly Member Mike Gipson’s AB 1544 would enact the Community Paramedicine or Triage to Alternate Destination Act to allow local emergency medical services agencies (LEMSAs) to develop local community paramedicine programs. The measure would also require LEMSAs, if the county elects to establish a community paramedicine or alternate transport program, to use or establish a local emergency medical care committee (EMCC) and prescribes the Board of Supervisors to include specific EMCC members. The measure would also establish the Community Paramedicine Medical Oversight Committee to advise EMSA on and to approve minimum medical protocols for all community paramedicine programs.

Amendments made during the Senate Appropriations Suspense File process clarified first right of refusal provisions by specifying that LEMSAs must provide the first right of refusal to every public agency providing advanced life support services within its jurisdiction to provide community paramedicine program specialties prior to offering the services to private EMS providers. Amendments also clarified provisions related to LEMSA authority and exclusive operating areas as specified in Health and Safety Code Sections 1797.201 and 1797.224. With these amendments, CHEAC, along with our county colleague associations CSAC, UCC, and RCRC, has removed opposition to the measure. AB 1544 is currently awaiting a vote on the Senate Floor.

SB 438 (Hertzberg) as amended July 11, 2019 – NEUTRAL

SB 438 by Senator Robert Hertzberg modifies statute related to EMS 9-1-1 dispatch services. Recent amendments allow local EMS agencies to continue private contractual arrangements but allows a public safety agency to operate medical dispatch for their own jurisdiction. In addition, the measure further clarifies that EMS medical dispatching, including call processing, falls within the medical control of the local EMS medical director. SB 438 was passed by the Assembly on Tuesday on a 68-4 vote with seven members not voting and concurred by the Senate on Wednesday on a 33-6 vote with one member not voting. SB 438 now heads to Governor Newsom for action.

Environmental Health

AB 377 (E. Garcia) as amended August 21, 2019 – SUPPORT

Assembly Member Eduardo Garcia’s AB 377 is the cleanup 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 kitchens; however, we support the measure to provide greater clarity on a number of critical provisions enacted through AB 626. AB 377 was passed by the Senate on Thursday on a 30-8 vote with two members not voting and now heads back to the Assembly for concurrence.

Health Coverage/Health Care Reform

AB 848 (Gray) as amended August 30, 2019 – SUPPORT

AB 848 by Assembly Member Adam Gray would add continuous glucose monitors and related supplies to the schedule of Medi-Cal benefits for diabetes mellitus treatment when medically necessary, subject to utilization controls. AB 848 was unanimously passed by the Senate on Wednesday and now heads back to the Assembly for concurrence.

AB 1004 (McCarty) as amended August 30, 2019 – SUPPORT

Assembly Member Kevin McCarty’s AB 1004 would require screening services under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Program to include developmental screening services for individuals zero to three years of age. Medi-Cal managed care plans would also be required to put in place mechanisms to ensure timely and consistent developmental screenings for children. AB 1004 was unanimously passed by the Senate on Thursday and now heads back to the Assembly for concurrence.

AB 1088 (Wood) as amended August 30, 2019 – SUPPORT

AB 1088 by Assembly Member Jim Wood would requires the Department of Health Care Services (DHCS) to seek a Medicaid state plan amendment or waiver to implement an income disregard to allow an aged, blind, or disabled individual who would otherwise be eligible if not for the state buy-in of their Medicare Part B premiums to maintain Medi-Cal coverage. AB 1088 was unanimously passed by the Senate on Thursday and now heads back to the Assembly for concurrence.

Health Equity

AB 241 (Kamlager-Dove) as amended August 28, 2019 – SUPPORT

AB 241 by Assembly Member Sydney Kamlager-Dove would require continuing education for physicians and surgeons, nurses, and physician assistants on understanding implicit biases and how biases may contribute to healthcare disparities. The measure was passed by the Senate on Tuesday on a vote of 34-0 with six members not voting. The Assembly concurred in the Senate’s amendments on Thursday on a vote of 68-4 with seven members not voting. The measure now heads to Governor Gavin Newsom for action.

Injury Prevention

AB 645 (Irwin) as enrolled September 3, 2019 – SUPPORT

Assembly Member Jacqui Irwin’s AB 645 would add to existing warning labels on firearms and signage at licensed firearm dealer premises language stating, “If you or someone you know is contemplating suicide, please call the National Suicide Prevention Lifeline,” with the phone number. The measure also would require the Department of Justice (DOJ) firearm safety certificate course and written acknowledgement to cover the topic of suicide prevention. AB 645 was passed by the Senate and Assembly last week and has been presented to Governor Newsom.

Maternal, Child, and Adolescent Health

AB 577 (Eggman) as amended August 14, 2019 – SUPPORT

Assembly Member Susan Talamantes Eggman’s AB 577 would require health plans and insurers to cover up to 12 months of services associated with the treatment of a maternal mental health condition by a terminated or nonparticipating provider. AB 577 was passed unanimously by the Senate on Tuesday and the Assembly concurred in the Senate’s amendments on Thursday on a 77-0 vote with two members not voting. The measure has now been sent to Governor Newsom.

Tobacco Control

AB 1639 (Gray) as amended August 21, 2019 – SUPPORT

AB 1639 by Assembly Member Adam Gray sets forth stricter requirements and penalties related to tobacco products. Specifically, persons under 21 years old would be prohibited from entering a tobacco store, and retailers would be required to use age verification software or devices for all purchasers. The California Department of Public Health (CDPH) would also be required to conduct random, onsite sting operations of at least 20 percent of the total number of licensed tobacco retailers in California and conduct follow-up sting operations on retailers who are found to be in violation of selling tobacco products to underage purchasers.

Further, the measure would strengthen penalties against specified retailers and individuals who furnish, purchase, or possess tobacco products. Civil penalty amounts on retailers would be increased and suspension or revocation of a retail license would be required upon specified underage sale violations. The measure would also prohibit various advertising, promoting, or packaging of electronic cigarette products in a manner that is attractive to or intended to encourage use by those under 21 years old, among other conditions.

Recall, this measure was a late gut and amend bill that previously faced contentious hearings in both the Assembly Governmental Organization Committee and the Assembly Health Committee. The most recent amendments to the measure remove specified financial and driving privilege penalties on youth, as well as remove a temporary ban on flavor tobacco products (except mint, menthol, and tobacco flavors). With these amendments, a coalition of health-related organizations, including the American Cancer Society Cancer Action Network, American Heart Association, American Lung Association, and the Tobacco-Free Kids Campaign, removed their opposition and are now supporting the measure. This week, the CHEAC Legislative Committee adopted a similar position in supporting the bill.

AB 1639 was passed by the Assembly on Tuesday on a 76-0 vote with three members not voting. The measure is now in the Senate Rules Committee where it awaits assignment to a committee for further action.

SB 39 (Hill) as enrolled September 5, 2019 – SUPPORT

Senator Jerry Hill’s SB 39 would require mail-order tobacco products to be packaged in a container with specified conspicuous labeling and require the signature of a person 21 years of age or older upon or before completing the delivery of mail-order tobacco products. The Assembly passed the measure on Tuesday on a 77-0 vote with two members not voting. SB 39 is now headed to Governor Newsom for action.