Q&A with Assemblymember Cecilia Aguiar-Curry on rural health care, COVID-19, and the 2021 session

Assemblymember Cecilia Aguiar-Curry represents California’s 4th Assembly District, which includes all or parts of Napa, Lake, Yolo, Sonoma, Colusa and Solano counties. Aguiar-Curry is on the Committee of Health.  She is also chair of the Local Government Committee. In this Q&A, Aguiar-Curry discusses rural health care, COVID-19, the 2021 session, and bridging the digital divide.

 

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Sydney Kurle: The Federal government recently passed a $900 billion stimulus package, however this package lacked specified funding for state and local governments. What are your thoughts or plans to help fund these governments that will most likely be experiencing a budget shortfall?

ASM. Cecilia Aguiar-Curry: “Well there’s a couple of things. First of all, I chair the local government committee for the state of California, and one of the things that I don’t want to have happen is to burden the cities and counties right now and add on any legislation that hinders them from going forward, because they’re really in a bind. 

I’m doing what we call an Assembly Constitutional Amendment [ACA-1], and the constitutional amendment I ran before and I’m running it again. And it’s so local governments can run bonds, and currently they have to be passed by two-thirds to get a bond passed. But I’m saying we want the threshold lowered to 55 percent. It’s still a majority, but the two-thirds is really hard for cities to get those passed… So when they could say to their constituents ‘we need new sewers’ or ‘we need new infrastructure for internet’ or whatever, and they can determine their own projects and not have the state determine what the projects are… And locals are more likely to pass a bond when it’s related to local projects… The local governments are really happy I’m running it again, my colleagues didn’t get it through the first time because they were nervous about it. And I said well you’re not taxing anyone, you’re just giving communities the ability to pass a bond at 55 percent rather than two-thirds.”

 

SK:  When I was reading about ACA-1, it talks about homelessness and making housing more affordable. Is that a main goal of the amendment?

CA-C: “It’s one of many. I used to be the mayor of a really small town, and you realize that all of this is a big jigsaw puzzle. When you’re going to do new affordable housing, you’ve got to make sure that you have sewer and water, you’ve got to make sure you have electrical. And that infrastructure costs money and ultimately some of the developers put that on the project itself. So this is a way to make sure costs are evenly distributed throughout the community so that we can continue to make sure that affordable housing can continue to be affordable.”

SK: With recent spikes in COVID-19 cases and hospitalizations, the stress on the health care system and workers has been immense in both cities and rural areas. How has your district’s response to the pandemic changed over time? How is it fairing?

CA-C: “So I have the rural part of California; I have five large counties. And a major issue is access. Lack of access to health care, education, internet, transportation are all major. So my past legislative health care experience before the pandemic was focused on issues with just getting access to health care and related services in the district. But my work on telehealth is the one that I’m working on the hardest, because it’s really helping reach out to the people in my district who can’t get to doctor’s appointments or get specialized help. 

So the emergency telehealth expansion has really helped with reducing times to be reimbursed for telehealth during the pandemic currently, and we’re going to expand that. We also expanded remote pharmacies in areas that don’t have pharmacies nearby, and that has been vital. We’re hoping that continues. I’ve also been working with my constituents on continuing access and affordable, personalized health care for all of my constituents. That’s probably the most gratifying and heartwarming thing that I’ve done is finding solutions for health care and access for everyone in the state. California is leading the way for access to health care in the country.”

SK:  It seems like compared to the rest of the country it’s easier to get health care in California?

CA-C: “In rural areas it’s hard because we can’t get doctors to stay in an area for a length of time. They have to really love living out in the middle of nowhere and not having the best accommodations. But it’s been very important for us to increase access, and with telehealth we’ve seen an incredible increase of people reaching out to doctors and mental health treatments have skyrocketed. People who would normally have a hard time getting to a mental health appointment can now pick up the phone or a zoom call and talk to their mental health provider. There are an incredible amount of people attending those calls which they hadn’t been before.”

SK: You recently introduced Assembly bill 14. Obviously you’ve talked about how lack of internet access is a rural issue, but it’s also a racial and class issue.  Why is bridging the digital divide so important to you?

CA-C: “I’ve worked on this project for 10 years, but trying to get internet to rural communities has been difficult. It’s also been difficult in urban areas because there are deserts in urban areas. So the solution is with AB-14, which is to bridge the digital divide. Everybody thinks that in California, everybody has the internet. But California is a big state, so now with COVID it’s really brought the issue to the surface. Obviously we need a fast and reliable internet infrastructure for distance learning, for working from home, for telehealth. I think we figured that 1 in 8 Californians still do not have internet, and communities of color face even higher numbers. So here we are, the state with a large tech capital, and neighbors of ours don’t have access to internet and they’re being left behind. 

Last year I did a bill, AB-570, which would have provided the necessary funding and safeguards for those communities. Unfortunately we couldn’t get the deal across the finish line, with the senate and the governor. But AB-14 is a partnership with the senate, and hopefully that will be helpful to get this bill across the finish line this year. The really important thing about AB-14, is how we’ll get the funding and the bonding capacity. And the bonding is the really important piece to this and it will pave the way for future investments in the infrastructure. The state could leverage that funding and use this bill to go after federal funds as well. Federal funds are available, but many states can’t go after it because they need to be able to bond or leverage money to get the money. There are hurdles, like permitting for local governments, but we’re working with them to get that done.”

SK: Partisanship has been a major issue these last four years, what are your hopes for passing bipartisan legislation in California?

CA-C: “I think that COVID has really made us sit down and try to work things out more. I’m of the belief that you have to collaborate with both sides of the aisle. You get a better policy, you get it done, and you have diverse ideas coming to the table. So things that I work on I generally try to have my colleagues on either side of the aisle come together and try to come up with a solution. Does it always work? No, but we end up with better policies. So I keep reminding myself that Sacramento isn’t Washington DC. We can still come together. Particularly with the pandemic, if we can’t come together now, I don’t know what to tell you.”

SK: Since the last time you spoke with us, a presidential election has happened, What do you hope the Biden administration will address in health care?

CA-C: “I think that it’s pretty obvious to me that he is really focused on making sure that health care is up at the top of his priorities. I’m pleased that he seems to have put together a really good team to work with state and local governments. But there also appears to be money in the pandemic relief bill for a partnership to create fast, reliable, and affordable internet access. And that’s only going to help us even more with the technology we need for telehealth. And I am hoping that we can help move that along. This is life-saving technology and I think the Biden administration realizes that. “

SK: What, in your opinion, is California’s biggest health care issue? I know we’ve talked about telehealth, but beyond that? 

CA-C: “You know I can say access, access, access, but it really is COVID. Until we get this taken care of, that’s going to be the number one thing to deal with. We’re not out of the woods. There is still a lot to do. I know that we’re opening up some things, and I don’t know that it’s the best right now. We just talked about opening up some schools in February, and I don’t want to rush to this because we have no idea what the new strain will do. But number one is we need to make sure that marginalized communities that have been struggling for affordable health care and hopefully we can get affordable health care. It’s just going to take time. 

The other one is mental health. We’ve got to make sure we don’t forget about the people that need this care, because it’s a human right. And it’s part of our duty as legislators to make health care equality a reality.”

SK: Lastly, and on a hopefully brighter note: What are your hopes for health care policy in California next year?

CA-C: “Oh man, I’m so excited! I’m going to be bringing up Assembly Bill 32, which will make permanent the telehealth care services established under AB-1494, which was a health emergency bill. We want to ensure that it’s a permanent part of health systems. So if you pick up the phone and call the doctor, the doctor gets paid just like you were going into the doctor’s office. And it helps keep our clinics afloat, because if they’re not getting funding from Medi-Cal and Medicaid, they’re going to die. 

I’ll also be working on mental health. I’ll reintroduce some legislation I tried to get through last year but I decided to hold it. This bill will make mental health consultations available through hospital systems to pediatricians so they can help children with mental health issues. Pediatricians are great but they also need some help with the mental health portion of it. I just think that every minute we can help with mental health treatment for a child, they are more likely to have a stable life. I’ll probably have two on mental health. And I have a lot of colleagues who are loving my telehealth bill, so we’ll probably see a lot of action on telehealth.”

This conversation has been edited for clarity and length.