5 Things California: Nathan Fletcher, 50+ speakers, SB 977

Shelley Rouillard has been one of the steady hands in California state government when it comes to health policy. She led DMHC under both Gov. Brown and Gov. Newsom. She announced her departure from state service in the spring, but has now stepped down. Her steady leadership in an area that really warrants it has been good for a system facing intense cost and political pressure.

Shelley was also one of the first people to put wind in our sails at State of Reform, joining our first event agenda in 2015 and being available to help us in big ways and small. So, best of luck in the future, Shelley! We’ll try to rope you back in to State of Reform after some earned time away.





With help from Emily Boerger

1. Q&A: Supervisor Nathan Fletcher

Nathan Fletcher is the County Supervisor for San Diego’s 4th Supervisorial District. Fletcher was sworn into office in January 2019 and is the only Democrat on the Board of Supervisors. In this Q&A, Fletcher describes his experience as a county leader during COVID, behavioral health investments, addressing health inequities, and what gives him hope during this time.

Fletcher also discusses the data he’s watching to inform his decision-making. “One of the problems is that coronavirus is like a big heavy freight train and when it really starts moving, it’s moving. And you can put the brakes on but it’s going to take a considerable amount of time — it’s not going to stop instantly. So, when we put in place additional tightenings or restrictions, you’re not going to see the impact of those for several weeks. So, that’s a challenge.”

2. 5 Slides: Mental Health Access and the Safety Net

Next week on July 29th, from 12pm – 1pm, we will host our “5 Slides: Mental Health Access and the Safety Net” virtual conversation. The convening will feature Michelle Doty Cabrera, Executive Director of the County Behavioral Health Directors Association of California, Alex Briscoe, Principal of the California Children’s Trust, and David Bond, Director of Behavioral Health at Blue Shield of California Promise Health Plan.

This panel of experts will discuss the issue and importance of access to mental health services and the connection to the safety net that serves those in highest need in California. Learn more and register for the virtual event here.

3. Detailed Agenda coming Thursday

On Thursday we will release the Detailed Agenda for the 2020 Northern California State of Reform Virtual Health Policy Conference! That is a list of about 50 speakers lined up to be with you on August 18th at this year’s event. Ahead of that, I wanted to feature one of these panels in particular that we are excited to host. Joining us on our “Tele-health and COVID: Lessons for the Future” panel will be Asm. Cecilia Aguiar-Curry, Joel Gray, Executive Director of Anthem Blue Cross – CA Medicaid, and Terri Stratton, CEO of El Dorado Community Health Centers.

Tele-health is one of the key stories of this pandemic era. So, learning from what is working – and what is not – is a critical piece for the health system as we navigate this period. Be sure to check out the Topical Agenda to get a feel for the day and take a look at our Convening Panel to see some of the folks who helped put the agenda together. If you haven’t registered to be with us yet, we’d be honored to have you join us!


4. AG oversight bill to be heard in Assembly

California’s bill expanding the attorney general’s oversight of health care acquisitions and affiliations passed off the Senate floor at the end of June. The bill (SB 977) would broaden the type of health care transactions that require AG consent and approval, and would require the AG to deny requests unless the proposed transaction would result in a “substantial likelihood” of clinical integration, of increasing access to services to an underserved population, or both.

The bill would also permit the AG to deny consent if the transaction is likely to result in anticompetitive effects that outweigh the benefits of increased services and access. A list of organizations in support and opposition of the bill is available here. SB 977 is expected to be heard in the Assembly Health Committee at the end of this month.


5. COVID and nursing home infections

Seventy-six percent of frontline employees at California skilled nursing facilities say they have had diagnosed or suspected COVID-19 cases among staff at their facilities, according to a recent California Health Care Foundation poll. Sixty percent of those surveyed report cases among residents.

Data from the poll also reflects the disproportionate impact of COVID-19 on Black and Latino individuals. In facilities where the majority of residents are Black or Latino, 66% of survey respondents report COVID cases among residents. In other facilities, 50% of respondents report cases among residents. 93% of survey takers report being worried about contracting COVID while working