5 Things California: Comments on draft RFP, Detailed Agenda, State HIE timeline


Eli Kirshbaum


The modeling for COVID suggests that California is going to do relatively well against the Delta variant compared to other states. The early mask mandate in LA probably helped. At 42%, California has the highest proportion of residents in any state saying they are “always wearing a mask when leaving home.” California has the lowest rate of mobility of any state, measured by smart phone apps and indexed against Jan. 2020. And, because many Californians got COVID earlier in the pandemic and is coupled with a high rate of vaccinations, there is an estimated 78% of the entire state population with immunity to non-escape variants.

That all bodes well for the strategies we’ve all been hearing about for months: masks work, vaccinations work, and social distancing works. Who knew?





With help from Eli Kirshbaum

1. Stakeholders raise concerns about DHCS draft RFP

After reviewing DHCS’s Medi-Cal Managed Care draft RFP, stakeholders are voicing concerns about the document’s alleged incompleteness. In a recent webinar hosted by CHCF to summarize public comments on the draft RFP, stakeholders highlighted missing elements including details on CalAIM initiatives, enhanced care management, ILOS, and the new Children and Youth Behavioral Health Program.

Stakeholders worry DHCS won’t offer further opportunity for stakeholder review before the RFP is finalized at the end of 2021, with some calling on DHCS to reissue the RFP for review before finalization. “We think that it’s really important that DHCS have a transparent and collaborative process to review the draft contract in its entirety and not just the components that were shared with us in June,” said Linnea Koopmans, CEO of Local Health Plans of California.


2. Implementing a statewide HIE: easier said than done?

The timeline laid out in AB 133 gives California only a short amount of time to carry out the “significant lift” of developing a framework for its statewide HIE, says Mark Elson, Principal at Intrepid Ascent. The bill requires CHHSA to convene a stakeholder advisory group by next month to inform the recommendations it will make to the legislature in 2022. An HIE framework must be operative no later than July 1, 2022, with facilities such as general acute care hospitals needing to sign a statewide data sharing agreement by Jan. 31, 2023, and participate in statewide data sharing no later than Jan 31, 2024.

Another central challenge will be figuring out how the over 15 existing regional HIEs will factor into a statewide system. While organizations with their own HIEs support the equity-focused goals of the initiative, they’re concerned about how the infrastructure they’ve already invested in will be affected, says Karen Ostrowski at Intrepid Ascent. “It will take policymaking creativity to get the mix of carrots and sticks just right, but AB 133 gives California a chance to take a leap forward by focusing us on this task,” says Elson.


3. LA event moving to all virtual

Next week, we’ll release our Detailed Agenda for the 2021 Los Angeles State of Reform Health Policy Conference. We’ve got a very strong lineup of over 60 speakers that we are excited to bring together on September 23. If you haven’t already registered to be with us next month, you can do so here.

However, given the increase of the delta variant, and the reluctance among many of our community to return to an in person setting, we have decided to return to an all virtual event format for this September conference. We are, after all, a health care conference. And, many in our community are working hard to keep folks safe. Getting together in person while that’s such a focus doesn’t seem like quite the right fit. So, we’ll return to virtual. We’ll refund the registration difference for our in-person folks. And, we’ll still tee up some of the smartest folks in California health care for you on September 23rd.


4. California leads nation in nursing home staff COVID vaccinations

California has one of the highest rates of COVID vaccinations among nursing home staff in the country, according to the AARP’s Nursing Home COVID-19 Dashboard. The state ranks behind only Hawaii for nursing home staff vaccinations, with 79.5% of staff fully vaccinated as of July 18. With a nursing home resident vaccination rate of 81.4%, California lags considerably behind the highest-ranked states for this category. Vermont, for instance, has a 95% resident vaccination rate.

On Wednesday, President Biden announced US nursing home staff will need to be vaccinated in order to receive Medicare and Medicaid funding. According to AP News, this new federal mandate could become effective as early as next month.


5. Newsom’s vaccine mandates draw praise from some

California isn’t shying away from executive action concerning vaccines. Gov. Newsom’s announcement that all state health care workers will need to be fully vaccinated or regularly tested by Sept. 30 was met with praise from organizations like the California Hospital Association, which said the mandate is “an important step in the long battle we face against COVID-19.”

Newsom also recently mandated all school staff be either fully vaccinated or tested at least once a week, with all schools needing to comply by Oct. 15. Various school health leaders praised the announcement. Ron Tanimura, Director of Student Medical Services at the LA Unified School District, told State of Reform: “I believe Governor Newsom’s first-in-the-nation vaccine mandate is a positive step in our ever-increasing quest to ensure that our schools open with the highest level of safety measures in place.”