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.