5 Things California: Health policy movement, Food insecurity, CalAIM LTC benefit


Eli Kirshbaum


I’m happy to announce that the registration page for our 2022 Los Angeles State of Reform Health Policy Conference is now live! You can register here to join us at the Los Angeles Marriott Burbank Airport on Sept. 22nd!

We’re holding our Convening Panel meeting for the event today, so stay tuned for the announcement of panel topics in a few weeks after we’ve consulted with our expert stakeholders and curated the agenda.

As always, thank you for your support!

Eli Kirshbaum
State of Reform      


1. Health policy movement to watch

Having passed the bill chamber crossover deadline on May 27th, lawmakers have progressed a multitude of bills in the last month. One of these is a contentious move to limit growing health sector consolidation in the state, a bill that numerous health systems say would place unjust restrictions on market practices. Another bill that recently passed its chamber of origin would grant the right to independent medical reviews for denied services to the around 4 million Med-Cal enrollees who currently aren’t enrolled in managed care or who are enrolled in MCPs that aren’t regulated by DMHC.

Legislation that would prohibit providers from disseminating COVID misinformation recently passed the Assembly with a vote of 53-20. It has significant opposition from free speech advocates who believe it’s unconstitutional to limit providers’ speech to their patients, even if they’re sharing potentially dangerous nonfactual claims about COVID. A bill to allow teenagers to consent to receive the COVID vaccine continues to advance despite opponents’ arguments that minors aren’t equipped to make good personal medical decisions.


2. Immigrants strongly impacted by food insecurity

According to a policy brief from the advocacy group Food4All, 45% of undocumented immigrants in California are impacted by food insecurity, and 500,000 of undocumented individuals aged 18 or older live in food-insecure households. Betzabel Estudillo, Senior Advocate at Nourish California, spoke to State of Reform about how the brief reveals that California’s immigrant population bears the brunt of food insecurity in the state.

While applauding Gov. Newsom’s expansion of the California Food Assistance Program to undocumented individuals 55 and older in his May Revise, Estudillo emphasized that work remains. CFAP benefits still don’t extend to certain populations, such as DACA recipients and certain visa holders, so Nourish California is working to include additional CFAP expansion in the state budget to help these food benefits reach more immigrants in need.


3. What They’re Watching: Asm. Mia Bonta

Asm. Mia Bonta (D – Alameda) is primarily focused on abortion policy, aiming to make California a “sanctuary” for those seeking abortions in light of abortion access restrictions throughout the country and a potential overturn of Roe v. Wade.

She has a bill in the 13-bill reproductive rights package being forwarded by the Legislative Women’s Caucus. Her legislation protects the medical privacy of out-of-state patients who come to California for abortions by preventing information about their care from being used against them in another state.



4. CalAIM LTC benefit could help patients avoid institutional placement

With CalAIM’s mandatory institutional long-term care benefit set to begin Jan. 1, 2023, experts are emphasizing the ways this carve-in can help divert long-term care patients away from nursing facilities and into lower levels of care. A recent report from the Center for Health Care Strategies outlined ways the new benefit diverts patients to living situations other than institutional care in a nursing facility, including communicating with hospital and nursing home discharge planners to establish discharge plans for patients prior to their admission.

Other recommendations include adding members’ preferences for post-acute care to their Health Risk Assessment before their hospitalization and supporting informal caregivers as alternative care providers. “[We are really] focusing on how community supports can intersect with the long-term care carve-in to promote diversions from and transitions out of nursing homes, and making sure that individuals have the most opportunity to live in the setting of their choice,” said Carrie Graham, PhD, Director of Long-Term Services and Supports at the CHCS.


5. Medi-Cal primary care utilization highest at FQHCs

FQHCs and related clinics, such as Look-Alikes and Rural Health Centers, accounted for 44% of all primary care visits provided to Medi-Cal members between 2017 and 2019, CHCF recently revealed. According to a CHCF report, which breaks down primary care utilization based on race/ethnicity, this data can help policymakers and other stakeholders gauge which underserved communities are receiving primary care at what locations and evaluate how Medicaid expenditures are impacting primary care use.

“Analysis of the utilization of health services (i.e., benefits) [provides] information about service demand, whether the population’s service needs are met, whether resources are allocated appropriately, the quality and effectiveness of those services, and the relative influence of various services on Medicaid spending,” reads the report. CHCF also says this data can provide a better picture of where people of color who don’t access FQHCs are receiving primary care.