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February 8, 2019

Bill Introduction Deadline

With the new bill introduction deadline just two weeks away (February 22), several bills of interest have been introduced and there is much speculation about what issues may soon be introduced in legislation.  The health care ministry will see bills that address new community benefits plan reporting, expansion of Medi-Cal to adults regardless of immigration status, strengthening the various aspects of the Affordable Care Act in California, surprise/balance billing, additional oversight on hospital transactions by the Attorney General, access to affordable housing, addressing aspects of homelessness and other important determinants of health.  As the deadline nears, the Alliance will report on its advocacy agenda for 2019

February 8, 2019

Health Budget Subcommittees Hearing Schedules

The Assembly Budget Subcommittee No. 1 and Senate Budget Subcommittee No. 3, which cover health and human services issues, have released their preliminary hearing schedules.  See the links below for the hearings that will explore the Governor’s January Budget proposals that relate to the variety of health issues.  Note that votes will NOT be taken at these hearings.  A new round of hearings will take place after the May Revise is released.

Also included are some of the more interesting health care informational hearings that are set for the coming weeks, as well as a link so you can watch the Governor’s State of the State address set for next Tuesday.

Budget Subcommittee Schedules

  • • Assembly Budget Subcommittee No. 1 schedule of hearings linked here.
  • • Senate Budget Subcommittee No. 3 schedule of hearings linked here.

Governor’s State of the State Address | Tuesday, February 12 | 11:00am

Health-Related Informational Hearings | Thursday, February 14

• Joint Assembly Health, Senate Health, Assembly Budget Subcommittee No. 1 and Senate Budget Subcommittee No. 3: Health Insurance Affordability Assistance for Californians: Options & Funding:  1:30pm, Capitol Room 4202

• Senate Budget and Fiscal Review: Informational Hearing on Prescription Drug Affordability and Expanding Medi-Cal Coverage: 9:30am, Capitol Room 4203.

February 28, 2019

New Task Force Outlines the Way Forward for California’s Health Care Workforce

The California Future Health Workforce Commission was created in 2017 by a group of the state’s leading health philanthropies to address the looming health care workforce crisis – and to create a comprehensive action plan for building the health workforce California will need by 2030.

The Taskforce acknowledged that California’s health system is facing a crisis, which at its core is the simple fact that California does not have enough of the right types of health workers in the right places to meet the needs of its growing, aging, and increasingly diverse population.  The Commission focused on the need to increase the diversity of the state’s health workforce, enable the workforce to better address health disparities, and incorporate new and emerging technologies.

The Commission was co-chaired by Lloyd Dean, president and CEO of Dignity Health, and was noted as one of the state’s largest health systems and health employers; and Janet Napolitano, president of the University of California (UC), which operates the largest health sciences education and training system in the nation and is a major health provider.  The 24 commissioners included prominent health, policy, workforce development, and education leaders in the state.  They developed three key strategies, with more than two dozen specific recommendations.  The report provides a real roadmap for Legislators and other decisionmakers, by including timelines associated with each recommendation and a preliminary assessment of the cost to implement each item.

The three overall strategies include: 1) Increase opportunity for all Californians to advance in the health professions; 2) Align and expand education and training to prepare health workers to meet California’s health needs; and 3) Strengthen the capacity, effectiveness, well-being, and retention of the health workforce.

The Task Force hopes that Strategy 1 will result in an expanded, more qualified, and diverse pool of candidates from California communities with greater motivation, support, incentives, and opportunity to successfully pursue careers in primary care, behavioral health, and care for older adults and service in underserved communities.  Strategy 2 is expected to ensure that health professions training programs in California provide access to and graduate enough qualified, diverse candidates with the skills and experience to meet health and workforce needs in all communities.  Strategy 3 is aimed at providing incentives, training, tools, and innovations to increase the capacity and optimize the roles of the current and future health workforce within emerging health models.

Specific recommendations include: expanding the scope of nurse practitioners to “help fill in the gaps in primary care;” develop a psychiatric nurse practitioner program; work to eliminate provider burnout; expand medical school enrollment at public institutions; increase mental health training for primary care providers; and expand the number of residency position in the state.

You can access the full report here.

January 28, 2019

Assembly Key Rule Change

When the Assembly’s work and shifts even more power to the Committee chairs.  In previous years, when the Rules Committee referred a bill to a committee for hearing, the Committee was obligated to give that bill a hearing.  This year, the Assembly-adopted rules say that a Committee “may” set and hear legislation referred to them (as opposed to “shall” be heard).  This gives the Chairs the authority to shelve a bill without a hearing and without any reasons given.

Speaker Anthony Rendon has always led with a soft touch and given his Committee Chairs a great deal of autonomy to run their committees as they see fit and as it meets their political needs.  This is taking that stance to a new level.  One can imagine that Speaker Rendon would have loved to have this rule in place during the Single Payer debate, when the buck stopped with him to keep that bill from being heard.  In these new rules, the Speaker could have had the Chair of that Committee park the bill – and incur the ire and protests from the bill’s proponents.

We will have to see how this plays out this year, but Committee chairs and Committee fights will be even more critical this year than in years past.

January 28, 2019

California Democratic Party Grows

Late last week, Assemblymember Brian Maienschein (San Diego) announced he would be leaving the Republican Party for the Democratic Party.  In his statement regarding his re-registration, he said that “Donald Trump has led the Republican Party to the extreme on issues that divide our country… But his leadership is not the only reason for my change in party affiliation. I, too, have changed.”  As a Republican, Mr. Maienschein was known to buck his party on key issues and this decision did not come as a surprise to many of his colleagues.  Maienschien narrowly won re-election in November, defeating his Democratic challenger by a very slim margin of 50.2 percent to 49.8 percent.

The Assembly now has 61 Democratic members (76%).  And on a related note, the Senate currently has 28 Democratic members (70%), and it is expected to grow by one when the special election is held in June for the seat held by former Democratic Senator Ricardo Lara (now Insurance Commissioner).  As many observe, it’s a misnomer to say the Democrats in both houses have a “super majority” – it really is a “mega majority.”

January 28, 2019

California’s New Surgeon General

Following up on an Executive Order signed by Governor Newsom on his first day in office, the Governor has appointed Dr. Nadine Burke Harris as California’s first Surgeon General.

As Surgeon General, Dr. Burke Harris will urge policymakers at every level of government and leaders across the state to consider the social determinants of health, especially for children. Her work will focus on combating the root causes of serious health conditions — like adverse childhood experiences and toxic stress — and using the platform of Surgeon General to reach young families across the state.

Dr. Burke Harris is a pediatrician and is the founder and CEO of the Center for Youth Wellness (CYW), which aims to improve the health of children exposed to toxic stress and trauma known as adverse childhood experiences. She is also the leader of the Bay Area Research Consortium on Toxic Stress and Health, a partnership between the CYW and UCSF Benioff Children’s Hospital that furthers scientific screening and treatment of toxic stress.  When Governor Newsom was mayor of San Francisco, he appointed Burke Harris to the city’s Citizen Committee for Community Development.

The position does not require Senate confirmation, and she will be sworn in February 11th in Sacramento.

January 28, 2019

Poll on Public’s Healthcare Priorities

The California Health Care Foundation (CHCF) and Kaiser Family Foundation have just released a joint statewide poll conducted shortly after Governor Newsom was elected.  The goal was to assess the public’s views of health priorities as the Governor and Legislature got to work early in 2019.

In the poll, Californians rank making health care more affordable among their top overall priorities for the state’s Governor and Legislature, with 45% citing it as “extremely important,” just behind improving public education (48%) and ahead of affordable housing (40%).

Among health issues, Californian’s top priorities are ensuring people with mental health problems can get treatment (49% say it is “extremely important”), making sure all Californians have access to health coverage (45%), and reducing what people pay for their health care (41%).

Mental health access ranks in the top two health priorities for Democrats, Republicans, and Independents alike. Half of all Californians (52%) say their community does not have enough mental health providers to meet its needs.

For more analysis, you can read the “5 main takeaways” that CHCF concluded via the link here.

Janaury 11, 2019

Governor Newsom: Health Care Actions and Budget Proposal

On Monday, Gavin Newsom was sworn in as California Governor, and immediately took action signing two executive orders and issuing one letter regarding health care – see attached. He signed executive orders to create a state Surgeon General and facilitate state consolidation of the purchase of drugs. He sent a letter to President Trump and Congressional leaders and is reported to be working with Congressman Ro Khanna to develop a new Medicaid waiver to allow for more innovation in the program to help facilitate the state’s movement to a single payer health care system. And on Thursday, Governor Gavin Newsom presented his first state budget proposal for FY 2019-20. Attached is a brief budget overview and highlights of the global health proposals. More details will be forthcoming from our exploratory efforts in the days to come, as well as Budget Subcommittee hearings that are set to begin in the next few weeks.


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