Black Health Equity Advocacy Week

CBHN is proud to announce a major success in declaring May 1-5, 2023, and every first week of May thereafter, as Black Health Equity Advocacy Week in California. This comes after Assemblymember Akilah Weber, M.D., (D-San Diego), with the unanimous support of the California Legislative Black Caucus (CLBC), introduced ACR-53, a resolution that establishes the first of its kind, a statewide focus on the need to address the health disparities gap for Black Californians. The resolution also commends CBHN for its efforts to improve the health, well-being, and life expectancy of Black Californians.

View Press Release CBHN_ACR53Release_Draft for Dr Weber review_Approved

CBHN 2023 Budget and Legislative Priorities:

CBHN co-sponsor

AB 85 (Weber) Social Determinants of Health: Screening and Outreach: It would require health plans and insurers to pay for the screening for social determinants of health. This bill will ensure that healthcare teams have the resources to conduct SDOH screenings and to adapt their workflows in a way that doesn’t contribute to further burnout and allows them to discuss behaviors and social factors that influence patient health outcomes. Furthermore, this bill will increase efforts to bridge patients to community resources or government social services to address their SDOH needs by requiring health plans and insurers to provide access to community health workers. Finally, this bill will establish a workgroup to create a standardized model and procedures for connecting patients with community resources, to assess the need for a centralized list of accredited community providers, and to determine gaps in research and data to inform policies on system changes to address SDOH.

Significance: AB 85 is intended to close the gap between community-based organizations (CBOs) and providers to improve follow-ups after screening and collaboration efforts with community organizations to assist patients with their social needs.

AB 11 (Jackson) Affordable California Commission: It would create the Affordable California Commission to assess factors contributing to California’s rising cost of living.

Significance: For Black Californians, stagnant wages and the rise of inflation at 8.2% have made it difficult to afford the cost of food, housing, healthcare, and energy.  The bill would require the Commission to produce a report on its findings and recommendations to address the major causes of the rising cost of living and submit it to the Legislature by August 31, 2025.  This is an essential step in assessing the factors driving up California’s cost of living and determining tangible recommendations.

AB 41 (Holden) The Digital Equity in Video Franchising Act of 2023: It would rename the Digital Infrastructure and Video Competition Act of 2006 (DIVCA) to the Digital Equity in Video Franchising Act (DEVFA). AB 41 strengthens anti-discrimination statutes by establishing a state policy to require certain cable operators or video service providers to offer equal access to subscribers within the service areas. The bill defines equal access as “the equal opportunity to subscribe to an offered service that provides comparable capacities and other quality-of-service metrics in a given area for comparable terms and conditions.” The bill gives the Public Utilities Commission (PUC) the right to exercise its oversight authority as established by state and federal law.

Significance: According to the 2020 American Community Survey, only 83% of Black households in California have broadband, putting them at a significant disadvantage in getting their school work done or finding jobs.  AB 41 strengthens antidiscrimination provisions in the statutes and empowers CPU to enforce them.

AB 228 (Wilson) Infant Formula Stockpile: It would also establish the Infant Formula Advisory Committee to make recommendations for developing guidelines for the procurement, management, and distribution of infant formula and advise the development and implementation of the program. The bill would require the committee to provide an annual report to the Legislature with feedback regarding the program’s implementation and updates regarding policy changes and public comments.

Significance: The baby formula shortage impacted Black and many low-income mothers.  According to the Centers for Disease Control and Prevention, fewer than 74.1% of Black infants are breastfed, lower than all other groups. The same report attributed “unsupportive work policies and lack of parental leave” as significant factors for Black and low-income mothers to stop breastfeeding early. AB 228 would implement the 2022 FDA’s recommendation for each state to have a strategy to have a stockpile of infant formula to ensure California has safe and reliable infant formula in case of shortages.

AB 249 (Holden) School sites: Lead Testing: Conservation: It would require the community water system that serves a school site built before January 1, 2010, to test for lead in each school site’s portable water system by January 1, 2027.  If the lead level exceeds five parts per billion, the bill requires the community water system to report its finding to the local educational agency within two business days. Under this bill, the local educational agency informs the students’ parents or guardians of where elevated lead levels are found and shuts down all fountains and faucets at those vicinities.

Significance: The food and Drug Administration set the maximum contaminant level for lead in drinking water at zero since lead harms human health even if exposure is low.  Lead exposure is a major problem for school systems in urban and rural areas for lower-income students, and research has shown that Blacks and Hispanics are at more risk for lead exposure than other groups.   This bill would set the lead action level for drinking water for childcare centers and k-12 schools at five parts per billion, lessening the exposure of our children to lead in drinking water.

AB 425 (Alvarez) Medi-Cal: Pharmacogenomic Testing: The bill would define pharmacogenomic testing as laboratory genetic testing by a laboratory with specified licensing, accreditation, and certification, to identify how a person’s genetics may impact the efficacy, toxicity, and safety of medications. The bill would cover the benefit under Medi-Cal if a medication is being considered for use or is already being administered, and is approved for use, in treating a Medi-Cal beneficiary’s condition and is known to have a gene-drug or drug-drug-gene interaction that has been demonstrated to be clinically actionable if an enrolled Medi-Cal clinician or pharmacist orders the test.

Significance: The genetic variants impact how people metabolize medications, which in some cases can cause adverse reactions if the medication they take is incompatible with their genetic makeup.  This bill would establish Medi-Cal coverage of pharmacogenomic panel testing to reduce adverse drug events, improve clinical outcomes, and create more equitable access to better medication management.

AB 632 (Gipson) Health Care Coverage: Prostate Cancer Screening: This bill would prohibit a health care service plan or a health insurance policy issued, amended, renewed, or delivered on or after January 1, 2024, from applying a deductible, copayment, or coinsurance to coverage for prostate cancer screening services for an enrollee or insured who is 55 years of age or older or who is 40 years of age or older and is a high risk, as determined by the attending or treating health care provider.

Significance: The incidence of prostate cancer is almost 70 percent higher in African American men, who have a two-fold higher rate of prostate cancer mortality relative to men of other
race. African American men are diagnosed with the more aggressive disease by stage and
grade, at younger ages, and higher incidence compared to white men in settings of
equal access to treatment.  The clinical value of prostate cancer screening has been scientifically validated.  This bill would make early prostate cancer screening possible for many high-risk and underserved populations by eliminating deductibles, co-pays, and other out-of-pocket expenses.

SB 9 (Cortese) Raising the Age for Extended Foster Care Act of 2023: It would expand the dependency and transitional jurisdiction of the juvenile court to a nonminor who has not attained 22 years of age if the court makes a finding that the nonminor is experiencing homelessness or is at reasonable risk of homelessness if they are not under the jurisdiction of the juvenile court, among other requirements. The bill would also make these nonminors eligible for benefits under AFDC-FC, CalWORKs, Kin-GAP, and AAP.

Significance: According to the Anne E. Casey Foundation, most young individuals age out of foster care without marketable skills or resources and face barriers, including housing instability and homelessness, behavioral health issues, and involvement in the criminal justice system.  SB 9 would allow eligible foster youth to remain in the foster system until they reach 22, helping them maintain services and plan for a better transition.

SB 10 (Cortese) Pupil Health: Opioid Overdose Prevention and Treatment: It would require local education agencies to include opioid overdose prevention and treatment in the School Safety Plans, including synthetic opioids like fentanyl. It requires the California Department of Education to collaborate with California Health and Human Services Agency to develop and distribute an Opioid Antagonist Training and School Resource Guide to local education agencies on how to use opioid antagonists such as naloxone on school campuses.

Significance: According to the Centers for Disease Control and Prevention, fentanyl overdose deaths tripled among Black teens. This bill would expand overdose prevention and treatment to reduce overdose and fentanyl-related deaths among youth.

SB 90 (Wiener) Health Care Coverage: Insulin Affordability: It would prohibit a health care service plan contract or a disability insurance policy issued, amended, delivered, or renewed on or after January 1, 2024, from imposing a deductible on an insulin prescription drug or imposing a copayment of more than $35 for a 30-day supply of an insulin prescription drug, except as specified for a high deductible health plan. Because a willful violation of these provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program.

Significance: Around 4 million adults in California live with diabetes, and approximately 263,000 more Californians are diagnosed with type 1 diabetes yearly. According to the Department of Health and Human Services Office of Minority Health, 13.4% of Black men and 12.7% of Black women have been diagnosed with diabetes. Blacks are twice as likely to develop type 2 diabetes than white, and they are twice as likely as non-Hispanic whites to die from diabetes.  Californians with diabetes rely on daily doses of insulin for survival. Without access to insulin, patients can develop serious health complications, including cardiovascular disease, blindness, and kidney disease. According to the legislative findings, the average insulin price nearly tripled, resulting in one in four patients reporting insulin underuse. National law under the Inflation Reduction Act creates a $35 monthly cap on insulin, yet this legislation is limited to seniors and Medicare enrollees. SB 90 will extend this protection to patients with commercial insurance.

SB 238 (Wiener) Health Care Coverage, Independent Medical Review: requires health plan denial of care for mental health disorders for youth ages 0-21 to be automatically reviewed by an Independent Medical Review System (IMRs).

Significance: In 2019, 13 percent of California’s children 3 to 17 years of age reported having at least one mental, emotional, developmental, or behavioral health problem, and 8 percent of children have a serious emotional disturbance that limits participation in daily activity. Black and Latinx children were about 14% less likely than White youth to receive treatment for their depression.   According to the legislative finding, since 2017, the IMRs overturned 79 percent of healthcare service plan’s and disability insurers’ decisions to deny mental health care to youth. While the IMR process allows for greater oversight of health plans, it burdens the consumer to initiate and delay or prevent children and youth in California from accessing critical, timely mental health treatment. Language barriers, health literacy, and demanding jobs may prevent some parents from filing IMRs, furthering mental health access inequities. Under SB 238, health plans, not consumers, must submit those denials to the IMR process for claims to be reviewed automatically.

SB 694 (Eggman) Medi-Cal: self-measured blood pressure device and services: It would make self-measured blood pressure (SMBP) devices and SMBP services covered benefits under the Medi-Cal program for the treatment of high blood pressure.

Significance: In California, almost 30 percent of adults have been diagnosed with HBP, disproportionately impacting communities of color, particularly African American and American Indian communities.  HBP also has a significant impact on maternal health, and HBP can be managed. Improving hypertension diagnosis, treatment, and control is critical for improving the cardiovascular health of all Americans and reducing major cost drivers in the healthcare system. A key component to achieve this is SMBP monitoring, an evidence-based strategy recommended in national guidelines to improve blood pressure (BP) control for individuals with hypertension.   SB 694 will ensure Californians with Medi-Cal coverage can access SMBP devices and correlated services, providing clarity to healthcare providers, guaranteeing coverage for patients, and saving state resources.

SB 873 (Bradford) Prescription drugs: cost sharing:  This bill, by January 1, 2025, would require an enrollee’s or insured’s defined cost sharing for each prescription drug to be calculated at the point of sale based on a price that is reduced by an amount equal to 90% of all rebates received, or to be received, in connection with the dispensing or administration of the drug.

Significance: It would immediately help Californians afford their medications and improve health outcomes by requiring health insurance companies and their Pharmacy Benefit Managers (PBMs) to pass along at least 90% of negotiated rebates to patients at the pharmacy counter. Sharing rebates with patients at the point-of-sale will not only reduce out-of-pocket costs for patients, but it will also improve medication adherence rates – as demonstrated by UnitedHealth’s OptumRx practice of sharing rebates at the pharmacy counter, which enabled patients to save an average of $130 per eligible prescription and improved adherence rates between 4-16%.


CBHN Budget Priority 2023/24

SUPPORT Governor’s Budget Change Proposal  – 4260-079-BCP-2023-GB  DHCS Implementation of SB 987 – California Cancer Care Equity Act

Support for the Governor’s Budget Change Proposal (BCP), which requests three permanent and one limited-time position at the Department of Health Care Services (DHCS) to implement SB 987 (Chapter #608 , 2022) – the Cancer Care Equity Act.  The BCP requests new positions and limited-term expenditure authority to provide oversight and monitoring resulting from new statute which assures Medi-Cal patients with a complex cancer diagnosis can request a referral to an NCI (National Cancer Institute) Designated Comprehensive Cancer Center.

Support for Creating the Health Equity and Racial Justice Fund

Support for $50 million over two years in a one-time investment to fund a pilot investment to create the Health Equity and Racial Justice Fund.  The Health Equity and Racial Justice Fund will support projects proposed by nonprofit organizations, clinics, and tribal organizations that serve disproportionately impacted communities of color and low income to address the social determinants of physical health and behavioral health and reduce the unequal burden of the leading causes of death and illness, in children and adults, would be eligible.

Racial Equity Commission

Support for the creation of the Racial Equity Commission, Chapter 4.6 (commencing with Section 8303), within the Governor’s Office of Planning and Research.  The commission shall develop resources, best practices, and tools for advancing racial equity based on publicly available information and data.   The commission will prepare an annual report that summarizes feedback from public engagement with communities of color, provides data on racial inequities and disparities in the state, and recommends best practices on tools, methodologies, and opportunities to advance racial equity. The report will be submitted by December 1, 2025, and no later than April 1, 2026, and annually after that, to the Governor and the Legislature and shall be posted publicly on the internet website of the commission.

$11 million one-time appropriation request to the Department of Public Health for the integration of existing adult Sickle Cell Disease clinics into CalAIM 

Support for a one-time appropriation of $11 million in 2023/2024 fiscal year budget to ensure the integration of Networking California for Sickle Cell Care (NCSCC) into CalAIM. NCSCC’s 12 clinics provide the kind of comprehensive care management service that CalAIM supports. By targeting a special population with specific needs and providing reimbursement for Sickle Cell Disease services and associated costs, the clinics are already well-positioned to be integrated into existing reimbursement mechanisms.

The funds will provide adults with Sickle Cell Disease access to specialty care and care management; improve the quality of care delivered; support workforce expansion; conduct data capture and surveillance to monitor disease incidence, prevalence, outcomes, and cost-effectiveness of specialized care; and provide for administrative support for the centers. This support is intended to provide reimbursement for Sickle Cell Disease services and associated costs while the clinics are integrated into existing reimbursement mechanisms.

Request $14 million to fund the Local Equitable Access to Food (LEAF) Program: support of funding SB 907 (Pan) – the Local Equitable Access to Food (LEAF) Program, which expands Electronic Benefits Transfer (EBT) access at all certified farmers’ markets in California and also seeks to increase the number of farmers’ markets in low-income communities throughout our state. To meet the statutory requirements outlined in SB 907, we request $14 million in one-time funding to establish the LEAF grant program, which the Department of Food and Agriculture will develop along with the Department of Social Services. The grant funding could also be used to scale and improve EBT processes at existing farmers’ markets and establish EBT access at new certified markets in low-income communities.

CBHN 2022 Budget and Legislative Priorities:

SB 987 (Portantino D) California Cancer Care Equity Act: It would ensure that Medi-Cal enrollees who receive a complex cancer diagnosis have the choice to seek treatment at a National Cancer Institute (NCI) designated comprehensive cancer center, increasing the pool of Californians able to benefit from emerging therapies, clinical trials, and cancer doctors specializing in a particular type of cancer.  Complex cancer diagnoses covered in SB 987 include leukemia, multiple myeloma, certain lymphomas, pancreatic cancer, advanced stage lung cancer, advanced stage prostate cancer, advanced stage breast cancer, sarcomas, and liver and biliary cancer.

Significance: Cancer care is evolving at a pace that has resulted in dramatic changes to the diagnosis and treatment of patients. Delivering the best outcomes for specific complex cancer diagnoses increasingly relies on precision genetic and genomic testing to enable cancer subspecialists to develop personalized courses of care for a patient’s particular subtype of cancer.

Too many patients are being hurt by a one-size-fits-most system that often results in improper care and connects patients to care too late, shortening lives and ultimately increasing costs. Too many Californians realize that health insurance coverage does necessarily add up to access to the care they need. SB 987 is a critical step to improving cancer care equity in California.

 CBHN position: Co-sponsor.

SB 17 (Pan D) Racial Equity Advisory and Accountability Commission: It would establish the Racial Equity Commission consisting of 11 members until January 2030 to address systemic and institutional racism that has resulted in poorer health outcomes and disparities in Black, Indigenous, and people of color (BIPOC).  The bill would require the Commission to develop a statewide Racial Equity Framework that includes methodologies and tools to advance racial equity and address structural racism in California.  The bill would require the Commission to gather data on racial inequities and disparities and compile feedback from communities of color to prepare a report to be submitted to the Governor and the Legislature on and after December 1, 2025, and annually after that.    The bill would define racial equity as efforts to ensure race can no longer be used to predict life well-being, outcomes, and conditions for all groups.

Significance: Members of the Commission would be able to hold hearings and develop best practices and tools for advancing racial equity based on the data and publicly available information.  The Commission would publish annual reports on racial disparities in the state and make recommendations to reduce such disparities.   In consultation with private and public stakeholders, the Commission would develop a Racial Equity Framework for the state.

CBHN position: Support as part of the SB 17 coalition.

AB 1038 (Gipson D) California Health Equity Program:  It would, on July 1, 2022, establish the California Health Equity Program, a competitive grant program administered by the Office of Health Equity to community-based nonprofit organizations, community clinics, local health departments, and tribal organizations to take actions related to health equity. The bill would establish the California Health Equity Fund in the State Treasury and, upon appropriation by the Legislature, would make money in the fund available for the grant program. The bill would also establish the California Health Equity Fund Oversight and Accountability Committee, a 15-member committee with specified membership, to monitor the distribution, implementation, and impact of local and regional grants funded by the California Health Equity Fund and make reports about the status of the program and related recommendations to specified entities, among other duties.

Significance: COVID-19 has devastated the brown and Black communities.  This bill would have provided dedicated funding to empower CBOs to act in areas of housing and economic insecurities, and health inequality.

CBHN position: Co-sponsor


CBHN Budget Priorities: 

The California Health Equity and Racial Justice Fund is a budget request for $100 million to provide resources directly to CBOs to identify the most pressing health and racial justice issues in their communities and develop self-determined solutions to address them.  The goals of the Fund are to reduce health and social inequities that impact communities of color and other historically marginalized communities and to transform community conditions and institutional government systems to promote racial justice.  The Health Equity grants will support organizations to take action to reduce health inequities at the local level by addressing the social determinants of health that drive preventable diseases such as housing security, food security, healthy food systems, economic stability, community violence, and hate crime, health-promoting build environments, and environmental justice.

The Racial Justice grants will support innovative approaches to promote racial justice via systems and governance changes such as overcoming structural barriers to racial equity in how government activities are implemented, improving data systems and collection to ensure that demographic data recognizes all Californians, supporting racially equitable leadership and participation in sectors such as arts and culture, technology, and research.

An Oversight and Accountability Committee will be established to collaborate with the California Department of Public Health’s Office of Healthy Equity in guiding the distribution, implementation, and assessment of the impact of local and regional grants dispersed by the Fund.

Significance: It would establish dedicated funding to achieve health equity and racial justice in California.

Status: The Legislature included $75 million ongoing in their budget for 2022-23 to establish the Health Equity and Racial Justice Fund.  However, it was not included in the 2022-23 final budget.  CBHN and coalition members are actively working to advance the Fund in the next budget cycle.

CBHN position: co-sponsor.

Exemption of Continuous Glucose Monitoring (CGM) System: Exempts CGM from AB 97 (2011) provider cuts.

Significance: CGMs were added as a covered Medi-Cal benefit for adult patients with diabetes, and the budget eliminated the provider rate reductions implemented by AB 97.

Status: The May Revision includes CGM’s exemption from AB 97 provider cuts, and the Legislators also approved the Governor’s proposal.

CBHN position: Support. CBHN worked with a coalition to support the budget request.

$30 Million Budget Request – Continued Funding for Networking California for Sickle Cell Care:  It would include $30 million in the 2022 Budget Act allocated for the expansion of Networking California for Sickle Cell Care (“Network”). The sustained funding over the next three years will allow the state’s first and only network of specialized Sickle Cell Disease clinics to continue its success in expanding services and improving care for California adults living with Sickle Cell Disease.

Significance: The budget would cover the Network California for Sickle Cell Care (NCSCC) network clinics and community health workers at $10 million a year for the next three years and will provide needed funds until the NCSCC transitions to a disease management network within the state Department of Health Care Services. We met with the state healthcare leadership and those at the California Children’s Services and Genetically Handicapped Persons Program. These leaders have helped us shape the NCSCC into a robust disease management model, synergizing value via improved outcomes and quality of life on the path to sustainability.

Status: The 2022-23 budget included $30 million for the expansion of the network.

CBHN position: Support. CBHN worked with a coalition to push for this funding.


CBHN High-Priority Bills

AB 1666 (Bauer Kahan D) Abortion: Civil actions: It declares that it is contrary to the public policy of California for a law of another state that authorizes bringing a civil action against a person or entity that “receives or seeks an abortion, performs or induces an abortion, and knowingly engages in conduct that aids or abets the performance or inducement of an abortion.”

Significance: The law gives women across the United States the right to access abortion in California.

CBHN Position: support

AB 1797 (Weber, Akilah D) Immunization registry:  Current law authorizes health care providers and other agencies to disclose specified immunization information with local health departments and the State Department of Public Health and authorizes local health departments and the department to disclose that same information to each other and health care providers, schools, childcare facilities, family childcare homes, and county human services agencies, among others, as specified. This bill would require health care providers and other agencies, including schools, childcare facilities, family childcare homes, and county human services agencies, to disclose the specified immunization information. It would add the patient’s or client’s race and ethnicity to the list of information that shall or may be disclosed.

Significance: It would streamline schools’ ability to enter and verify students’ vaccine records.  It would also require data collection of students’ race and ethnic information.

CBHN Position: Support

AB 1878 (Wood D) California Health Benefit Exchange: affordability assistance: It would require the California Health Benefit Exchange’s (Covered California) affordability assistance to reduce cost-sharing, including copays, coinsurance, and maximum out-of-pocket costs, and to eliminate deductibles for all benefits. The bill would specify the actuarial value of cost-sharing assistance based on the income level of an enrollee. The Exchange would require to adopt standard benefit designs consistent with these specifications.

Significance: The bill would eliminate out-of-pocket costs for “Silver” plans offered through Covered California and lowered out-of-pocket costs for consumers with income over 400 percent of the federal poverty level.

CBHN position: Support

AB 2199 (Wicks D) Birthing Justice for California Families Pilot Project: This bill would establish a three-year grant pilot program, upon an appropriation by the legislature, that provides funding to community-based doula groups, local public health departments, and other organizations to provide complete spectrum doula care to members of communities with disproportionately high rates of adverse birth outcomes who do not qualify for Medi-Cal, and incarcerated birthing people.

Significance: Although California’s overall maternal mortality rate has declined by 65% since 2006, mortality and morbidity for Black and Indigenous/Native American birthing people and babies remain considerably higher than the State’s average. Research indicates that racism and implicit bias, among other inequities, are root causes of the disparities in birth outcomes faced by Black, Indigenous, and other birthing people of color. This bill recognizes that all birthing people deserve dignity in birthing and seeks to address the persistent adverse maternal and infant health outcomes in our state by expanding access to full-spectrum doula care to a broader group of birthing people, capturing birthing people in the gaps.

CBHN Position: Support

AB 2402 (Rubio): Medi-Cal Continuous Coverage for Young Children.  It would make a child under five years of age in the Medi-Cal program, the Medi-Cal Access for Infants Program (MCAIP), and the County Children’s Health Initiative Matching Program (CCHIP) continuously eligible for Medi-Cal, including without regard to income until the child reaches five years of age. It would prohibit a redetermination of Medi-Cal eligibility from being conducted before a child reaches five years of age unless specified conditions are met.

Significance: Under the current law, children under five years of age could be disenrolled from Medi-Cal for any technical errors, and this bill would give them continuous health coverage.

CBHN position: Support

AB 2680 (Arambula D) Medi-Cal: Community Health Navigator Program: It would require the Department of Health Care Services (DHCS) to create the Community Health Navigator (CHN) Program to make direct grants to qualified 501(C)(3) community-based organizations to conduct targeted outreach, enrollment, retention, utilization and access activities for individuals and families eligible for Medi-Cal. It also requires frequent communication between Covered California and Medi-Cal Navigators to provide seamless health care coverage outreach and enrollment support.

Significance: Medi-Cal is a very complex system to navigate, challenging many Californians when applying for Medi-Cal benefits.  The CHN program will address that problem by providing direct grants to community-based organizations to provide outreach, enrollment, retention, and utilization services to low-income Californians who want to receive Medi-Cal benefits.

CBHN Position: Support

AB 2697 (Aguiar-Curry D) Medi-Cal: community health worker services:  It would ensure that California can address the state’s growing health needs and disparities for communities of color by including community health workers (CHW) and promoters (CHW/P) preventive services under the Medi-Cal program. The bill would make CHW/P services available to all Medi-Cal beneficiaries individually or in a group setting. It would advance health equity by requiring CHW/P services to provide health education and navigation, including addressing barriers to health. CHWs and promoters have cultural, economic, and social affinities with the community they serve, making them ideal for delivering health education to the Black and brown communities.

Significance: It would ensure that communities across the state can access CHW/P services to receive health information in a socially and culturally sensitive manner. CHW/Ps are an equity-driven strategy that has been proven to assist Californians in connecting them to both healthcare and other social determinants of health resources central to their wellbeing.

CBHN position: Support

SB 57 (Wiener D) Controlled substances: overdose prevention program: It would allow specified jurisdictions to pilot and evaluate overdose prevention projects (OPP), subject to local hearings, local votes, a statutory sunset of five years, and a mandated independent evaluation of their effects on public health and public safety.  The bill would give the cities of San Francisco, Los Angeles, and Oakland, and the County of Los Angeles the ability to evaluate these promising programs better to address the high rate of fatal drug overdose, public drug use, connect people to substance use disorder treatment and housing and prevent the transmission of HIV and viral hepatitis.

Significance: It would establish overdose prevention programs to reduce health and safety problems associated with drug use, including public drug use, discarded syringes, HIV and hepatitis infections, and overdose deaths.

CBHN position: Support

SB 523 (Leyva D) Contraceptive Equity Act of 2022 would provide a comprehensive approach to ensuring greater contraceptive equity in California while saving health care costs and protecting workers from discrimination from anti-choice employers. The recent Supreme Court ruling overturning Roe v. Wade has made the need to expand equitable access to birth control and California’s leadership on this issue more urgent.

Significance: The recent Supreme Court decision eliminating the constitutional right to abortion care has made access to contraception paramount. The SCOTUS ruling also opened doors to future attacks on the right to use birth control. The Governor and State Legislature have stated their commitment to bolstering sexual and reproductive health care access in California. In addition, the FDA currently reviews an application to make birth control pills available over the counter. Now is the time to modernize and expand our contraceptive equity laws to reduce barriers to birth control, improve sexual and reproductive health outcomes, create more significant health equity, and ensure California becomes a true Reproductive Freedom State.

CBHN Position: Support

SB 1019 (Gonzalez D) Medi-Cal managed care plans: mental health benefits: It would require Medi-Cal Managed Care Plans (MCPs) to conduct annual outreach and provide culturally and linguistically relevant education and materials to members and primary care physicians on a plan beneficiary’s right to timely mental health services under their Medi-Cal plan, how to find a provider, and how to seek assistance with navigating mental health services.

Significance:  One in five Medi-Cal beneficiaries will encounter mental health symptoms in a year.  The ongoing global pandemic has only exacerbated the great need for mental health services.  Under this bill, Medi-Cal beneficiaries would be made aware of the available mental health services under MCPs.

CBHN position: Support

SB 1033 (Pan D) Health care coverage: It would require the Department of Managed Health Care (DMHC) to establish regulations consistent with the federal guidance and best practices for standardized demographic data collection to capture, among others, the unmet health-related social needs of the insured population and to hold health plans accountable if they fail to comply. SB 1033 would require health plans to assess the health-related social needs of the individuals they serve.

Significance: Collecting and reporting comprehensive granular demographic and health-related social needs data is crucial to identifying gaps in reducing disparities.

CBHN position: Support

SB 1083 (Skinner D) CalWorks: pregnancy and homeless assistance would expedite access to temporary housing assistance for pregnant people and people with families. It would increase the maximum number of days people can live in a temporary shelter to connect them to permanent housing before their temporary housing assistance expires. The bill would modify the criteria to determine whether a family is considered homeless to include any notice that could lead to eviction to ensure that low-income families facing eviction can receive benefits expeditiously and avoid becoming unsheltered.

Significance: SB 1083 is vital to prevent families from facing homelessness, maintain the continuum of care, and avert family separation. According to the California Interagency Financing
Council, about 26,000 families with children, are experiencing homelessness.

CBHN position: Support

CBHN opposed bill

SB 1338 (Umberg) Community Assistance, Recovery, and Empowerment (CARE) Court Program: Governor Newsom sponsors SB 1338.  It would establish the Community Assistance, Recovery, and Empowerment (CARE) Court Program authorizing a person 18 years or older with a severe mental illness or psychotic disorder to petition a civil court to create a CARE plan.  An individual can also be referred to CARE proceedings by the director of a hospital, a first responder, and a public guardian, among others.

The bill would require the court to appoint counsel for the respondent if needed.  The State Department of Health Care Services is required under this bill to offer training and resources for volunteer supporters on CARE Act proceedings. The idea of the bill is to connect a person with severe mental illness to a court-ordered CARE plan for up to 12 months—the bill allows an extension for an additional 12 months if needed.

Significance:  The CARE Court could lower the legal standard to order an individual to undergo medical treatment involuntarily.  This bill could violate Californians’ civil rights, particularly Blacks and other people of color.

CBHN position: Oppose; CBHN is working with a coalition to oppose the bill.

CBHN priority bills signed into law in 2021 include:

SB 65 (Skinner): California Monmnibus Act
This innovative and comprehensive law reimagines perinatal care to close the existing racial gaps in maternal and infant mortality and morbidity within California. This law advances equity in birthing outcomes by:

  • Codifying and expanding California’s Pregnancy-Associated Mortality Review Committee to investigate maternal mortality and morbidity with a mandate to look specifically at racial and socioeconomic disparities; queer, trans, and gender non-conforming birthing outcomes, and make recommendations for best practices to reduce maternal and infant mortality and morbidity;
  • Updating data collection and protocols for counties that participate in the Fetal and Infant Mortality Review Process;
  • Clarifying that pregnant people are exempt from CalWORKS welfare-to-work requirements; and
  • Building the midwifery workforce by establishing a fund for midwife training programs that meet the priorities of admitting underrepresented groups and those from underserved communities, or prioritize training and placement of graduates in California’s maternity care deserts.

Additionally, certain aspects of the California Momnibus Act that were included in the Budget Act of 2021 include:

  • Expanding eligibility for CalWORKs grants to pregnant people regardless of the requirement that they report which trimester their pregnancy is in and simplifying the verification process;
  • Increasing the pregnancy basic needs payment for pregnant WalWORKs recipients to $100 per month (from $47).
  • Adding doula care to eligible Medi-Cal Services;
  • Extending full scope Medi-Cal Services;
  • Extending full scope Medi-Cal to a birthing parent for 12 months postpartum; and
  • Including pregnant people as a priority for the state’s Guaranteed Income Pilot funded in the budget.

AB 342 (Gipson): Colorectal Cancer Screening & Testing
This law works to reduce the incidence or colorectal cancer and mortality rates by increasing preventative screening. This law eliminates out-of-pocket cost-sharing for a follow-up colonoscopy after a positive stool test, which will eliminate a significant barrier to colorectal cancer screening.

AB 118 (Kamlager): CRISES Act
This law establishes the Community Response Initiative to Strengthen Emergency Systems (CRISIS) Act pilot program, which will fundamentally improve emergency responses for vulnerable populations in California, by strengthening, expanding, and promoting community-based responses to emergencies.

AB 1407 (Burke): Implicit Bias Education: Registered Nurses
This law works to reduce the prevalence of implicit bias in healthcare settings by requiring an approved school of nursing, or an approved nursing program to include in its curriculum implicit bias coursework.

AB 789 (Gipson/Low): Hep C & B Screening
This law works to close the disparities in diagnosis and treatment of hepatitis B and C by making California the first state in the country to require health facilities to offer voluntary hepatitis B and C testing.

AB 1344 (Arambula/Skinner) Syringe Exchange Programs
This law protects syringe services programs from misuse of the California Environmental Quality Act and ensures that these programs can continue to provide lifesaving services for people who use drugs.

SB 306 (Pan/Wiener): Sexually Transmitted Diseases: Testing
This law will strengthen California’s public health infrastructure and provide greater testing and treatment for sexually transmitted infections (STI). This law will expand access to STI testing remotely at home and in the community, increase access to STI treatment for patients and their partners, and update state law to boost congenital syphilis screening in the face of alarming increases in maternal-child transmission.

SB 395 (Caballero): Electronic Cigarette Tax: Health Careers Opportunity Grant Program
This law establishes a 12.5% excise tax on electronic cigarettes and uses a portion of the revenue to fund a State Health Career Opportunity Program that will support programs to increase the number of underrepresented minorities recruited, supported, and trained as needed health professionals.

AB 490 (Gipson/Bonta): Law enforcement: Positional Asphyxia
This law prohibits law enforcement from using techniques or transport methods that involve a substantial risk of positional asphyxia, which can occur when a person being restrained cannot get enough oxygen.

SB 2 (Bradford/Atkins): Peace Officers: De-certification
This law aims to increase accountability for law enforcement officers that commit serious misconduct and illegally violate a person’s civil rights. This law creates a statewide decertification process to revoke the certification of a peace officer following the conviction of serious crimes or termination from employment due to misconduct. Additionally, this law will strengthen the Tom Bane Civil Rights Act to prevent law enforcement abuses and other civil rights violations.