5 Things California: Budget preview, Pre-filed bills, New leadership

We feature a number of news bits out of Sacramento this week, as well as from our recent SoCal conference. But, perhaps the biggest news about California health care this week – at least outside of California – was the 60 Minutes story featuring the AG lawsuit against Sutter “for business practices that drove up health care prices for Californians.”

For California health policy geeks, this story might be old news. For folks in DC, this was something of an introduction to the new HHS Secretary-Designate Xavier Becerra. The AHA prioritized a response to this and it came up in conversations I’ve had with health care leaders in Florida, Virginia and Texas, just in the last few days.

This may be a unique confluence of health care costs, media amplification, and political winds that might foreshadow more of this conversation to come, as some of California’s leaders in 2020 become some of America’s leaders in 2021.





With help from Emily Boerger

1. Looking ahead to the budget tussle

Asm. Phil Ting, Chair of the Assembly Budget Committee, unveiled his 2021-22 Budget Blueprint last week, calling for investments in public health, targeted economic stimulus, and restored funding for housing and health & human services. Ahead of his budget release, Ting joined Asm. Joaquin Arambula and Jedd Hampton with the California Association of Health Plans for a discussion on the budget at the 2020 SoCal State of Reform Health Policy Conference.

During the panel discussion, Dr. Arambula said he will prioritize health equity and the social determinants of health while making budget decisions. “We cannot simply restore and recover our programs to their current state, as that current state was not meeting our needs,” he said. All three panelists agreed that the continued support of telehealth will also be critical. We offer a rundown of their remarks here.


2. Health bills teed up for 2021

Looking ahead to California’s 2021 legislative session, lawmakers across the state have already introduced over 200 bills covering a broad range of issues. Reporter Emily Boerger offers this roundup of health-related bills we’ll be watching come January.

The list includes AB 32, which would require DHCS to “indefinitely continue the telehealth flexibilities in place during the COVID-19 pandemic state of emergency,” and SB 17, which calls on California to declare racism a public health crisis. We also have our eye on legislation focused on youth behavioral health and this bill which looks to expand full-scope Medi-Cal benefits to all eligible individuals regardless of immigration status.

3. ICYMI: Morning keynote with Will Lightbourne

Will Lightbourne, Director at DHCS, offered an update on CalAIM and the Medi-Cal managed care re-procurement process during the Morning Keynote at State of Reform last week. He says enhanced care management, value-based payments, and measured progress on closing disparities in health outcomes will be emphasized in the RFP.

Lightbourne also noted that the key elements of CalAIM remain at the core of DHCS’s goals, but that he anticipates more of a phased in implementation of the initiative. The director says DHCS plans to release a draft RFP by spring 2021 and the finalized RFP by fall.


4. Surgeon General’s ACEs report

The Office of the CA Surgeon General released its “Roadmap for Resilience” report last week, focused on addressing Adverse Childhood Experiences (ACEs) and toxic stress. The report discusses strategies of prevention, early detection, and early intervention to reverse or prevent further harms caused by ACEs. The report also identifies which communities are most at risk for experiencing these stressors, and how to tailor the strategies to each community.

Recent data indicates 62% of California adults have experienced at least one ACE and 16.3% have experienced four or more ACEs. According to the report, a recent estimate revealed that ACEs cost California $112.5 billion annually, and over the next 10 years may cost over $1.2 trillion if their root causes are not adequately addressed.

5. Newsom announces new leadership

Last week, Gov. Newsom’s office announced new leadership at California’s health agencies. Tomás Aragón will take over as Director of the California Department of Public Health after having served as Health Officer for the City and County of San Francisco since 2011.

Mary Watanabe has been appointed Director of the California Department of Managed Health Care (DMHC), where she has served as Acting Director since 2020. Elizabeth Landsberg, who has been Deputy Director of the Help Center at DMHC since 2016, has been named the new Director of the Office of Statewide Health Planning and Development.