There’s a lot happening in the California health policy space right now—reprocurement, the news of the state granting Kaiser a no-bid Medi-Cal contract, waning public health mandates—all while the legislative session continues.
This week’s newsletter features a conversation with Sen. Wiener on his policy priorities, a look at some of the health bills making their way through the legislature, and a report revealing gaps in behavioral health treatment.
Have a great weekend!
State of Reform
1. Q&A: Sen. Wiener on access and affordability
As the legislative session continues, Sen. Scott Wiener’s top priorities include addressing substance use disorder, remedying behavioral health workforce shortages, and enforcing stricter health plan accountability. The Senate Housing Committee chair recently spoke with State of Reform about his health policy priorities in the legislature this year.
Wiener is sponsoring two bills that aim to improve access to care: the Medication Access Act and the Health Plan Accountability Act. The Medication Access Act would require health plans to cover prescription drug medications “through the duration of any appeals of a denial of insurance coverage” in order to ensure that individuals maintain access to critical medications and avoid any lapses in treatment. The Health Plan Accountability Act would allow DMHC to impose stricter penalties on health plans that deny coverage to a patient.
2. Health bills on the move
Tomorrow is the last day for bills to be introduced in the California Legislature. Notable initiatives this year include bills that would require hospitals to screen patients for suicide risk, provide community mental health services to veterans, and allow Californians to receive information on coverage options through their tax returns.
After amending the policy to address opponents’ concerns, Sen. Dave Cortese is continuing to advance a 2021 bill to secure workers’ compensation for hospital employees after it failed to gain enough support in the Senate last year. The bill—which passed its chamber of origin in January—would make cancer, infectious disease, respiratory illness, and other illnesses merit paid sick/injury leave for these frontline staff.
3. What They’re Watching: Paul Hegyi, San Diego County Medical Society
Paul Hegyi, CEO of the San Diego County Medical Society, says the county has been dealing with a backlog of patients who previously had their care deferred. Deferrals have caused patient conditions to worsen, consequently increasing the cost of caring for them.
The rising cost of health care, Hegyi says, was a problem prior to COVID-19 but has only gotten worse. “[The cost of health care] is untenable, and we realize that …” he says. “Health care is taking up more and more of gross domestic product, of the state budget, of personal budgets, and business budgets, and that’s unsustainable. And we need to be part of the solution to that.”
4. Many Californians with SUDs aren’t receiving treatment
A recent CHCF report found that of the 9% of Californians (2.9 million individuals) aged 12 and older that met the criteria for an SUD, only 10% received treatment in the last year. The report found that approximately 40% of HMO and PPO members with SUDs went to initial treatments within 14 days of diagnosis, but only 13% continued to receive care afterwards.
Most SUD patients who received care received outpatient treatment, while only 13% of these individuals received residential care and 1% received hospital inpatient care. The report also revealed that narcotic treatment programs, which CHCF says are “critical” for people who receive methadone treatment, are absent in 24 of the state’s counties.
5. CalHHS delays school mask mandate decision
While acknowledging the removal of California’s indoor mask mandate was the result of recent promising COVID case numbers, CalHHS Secretary Dr. Mark Ghaly said schools will take a couple more weeks to examine the data before removing their mask mandates. This will allow local communities to make informed decisions about their mask policies, taking into account community-specific considerations, he said.
“As we move forward, [we will be] basing our decision on the evidence and information that we have, and understanding that we will continue to prepare and continue to support schools to stay in person for all students,” he said. Ghaly noted there are many COVID-vulnerable students who need to attend school in person for meals and other important services, further complicating the decision around mask policy.