Despite significant health equity progress, stakeholders say California needs to do more

In spite of California’s historic health equity investments this year, advocates say more must be done to address inequities in the state’s health care system. 

The FY 2021-2022 budget made significant expansions to Medi-Cal eligibility, covered community health workers through Medi-Cal, and allocated $24.6 million to health equity research and programs. But equity-focused leaders say the state needs to take more action — in particular, implement the proposed Health Equity and Racial Justice Fund.

 

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The California Pan-Ethnic Health Network (CPEHN) said in a statement following the passage of the budget:

“…we are deeply disappointed that the budget agreement does not reflect the urgency of the most pressing public health crisis of our time: racism. This budget misses the opportunity to invest $100 million in the Health Equity and Racial Justice Fund and to spur innovation and community investment to advance racial justice.” 

The initiative to include a $100 million Health Equity and Racial Justice fund in this year’s budget was supported by numerous stakeholders and the legislature. But after negotiations with Gov. Gavin Newsom’s office, the fund wasn’t included in the final budget.

This fund would have funded partnerships between community based organizations, tribal governments, local health departments, and communities of color to identify the most urgent problems among these communities and develop strategies to address them. This could include ensuring sustainable housing, economic stability, and education for underserved communities.

Lynn Silver, program director at the Public Health Institute, told State of Reform the community needs to continue pushing the state to enact the fund.

“It’s clear that stakeholders need  to continue to advocate strongly over the course of the coming months to make sure that the commitment is kept and investment in health equity actually happens.”

Both Newsom and the legislature, however, stated in June their intent to direct $300 million to community-led health equity initiatives in FY 2021-2022. 

PHI, CPEHN, and other community organizations like the California Black Women’s Health Project and the Latino Coalition for a Healthy California, support dedicating a portion of that committed money to establishing the fund next year.

Silver said:

“… Our broad coalition of stakeholders  will continue to advocate  strongly that at least a third of new funding for public health & health equity  go to create this ongoing Health Equity and Racial Justice Fund for community-led investments.”

Kiran Savage, executive director of PEHN, agreed.

“We are planning on holding the government and the legislature accountable to that commitment, and look forward to seeing that funded next year.”

Another yet-to-be-met demand from health equity advocates is for the state to declare racism a public health crisis. The governor has received continuous calls in the past years to do so. Sen. Richard Pan’s SB 17, which passed the Senate in June and now sits in the Assembly Appropriations Committee, would require the state to make the declaration. The bill would also create an Office of Racial Equity.

Savage, whose organization has been heavily involved in this effort, said:

“We have been asking the governor to declare racism to be a public health crisis via executive order, and then this bill does it [legislatively]. We are sort of agnostic on the approach, but we want it to happen, so I do think it’s important.”

Savage said she’s “not sure what comes next” for SB 17 since the budget is already finalized, meaning this office wouldn’t have any funding next year. Silver believes the initiative could still progress this year — even though it will lack funding until next year, establishing the fund and program  itself are important symbolic steps. She called it a “statement of principle.”

“We have talked and talked about health inequity, but done little to change how we invest resources to prevent disease and disparities before they happen. If we don’t change that now after COVID when will we?”