5 Things California: CARE Court legislation, Feedback on CalAIM implementation, Nurse practitioners & abortion


Eli Kirshbaum


We are well underway with our agenda development for the upcoming 2022 Los Angeles State of Reform Health Policy Conference on Sept. 22nd! If you haven’t already done so, you can take a look at the Topical Agenda to see the conversations we have lined up. You can register here if you haven’t already—we’d be thrilled to see you there! We’re excited for a fantastic event.

This week’s newsletter features coverage of Gov. Newsom’s CARE Court proposal, insight from the Insure the Uninsured Project’s regional CalAIM workgroups, and an update on legislation that would allow nurse practitioners to provide abortion services.

Thanks for your support!

Eli Kirshbaum
State of Reform 


1. CARE Court legislation nears passage

Gov. Gavin Newsom’s CARE Court proposal is approaching passage in the legislature, having passed its second reading on the Assembly floor on Tuesday. The initiative would provide treatment and support services to individuals with complex behavioral health needs by requiring them—if they’re deemed applicable for the program—to complete a 12-month court-ordered recovery plan. Supporters say the program will help individuals transition out of homelessness and deter them from incarceration.

The bill’s mandatory aspect has led some advocacy organizations like the ACLU of California to oppose the bill. Kevin Baker, Director of Governmental Relations at ACLU California Action, said the bill doesn’t actually have specific provisions guaranteeing the provision of services and housing. “I don’t know of any policy expert that believes the way to fund and deliver health care services is by simply giving a bunch of new money to the courts and nothing for the providers,” he said.


2. 5 Slides: Lessons learned through CalAIM implementation

We’re thrilled to be hosting a valuable “5 Slides” conversation about stakeholders’ experience with the first phase of CalAIM rollout next week! Join us on Wednesday, August 24th for a conversation with Health Net leadership and two of the CBOs they’re partnering with for CalAIM on what they’ve experienced with rollout so far.

Martha Santana-Chin, Medi-Cal President for Health Net, Katherine Bailey, CEO of the San Diego Wellness Collaborative, and Robert Jones, Founder and CEO of Roots Food Group, will speak to their experience during the conversation. HMA’s Vern Smith, PhD, will be the moderator. If you haven’t registered already, we’d love to have you with us!


3. ITUP regional workgroups identify areas of improvement for CalAIM

Health plan and local health care delivery system stakeholders that participated in the Insure the Uninsured Project’s 2022 regional workgroup sessions say they’d like to see DHCS improve communications related to CalAIM implementation. Katie Heidorn, Executive Director of ITUP, told State of Reform that these sessions were valuable for gaining information from stakeholders about how the new collaboration between health plans and community-based organizations for the delivery of Community Supports has been going.

“We’re really bringing two systems much closer together, and we’re asking them to interact with each other in formal ways that we never have really before … I think it’s very important to the policy community as well as to the consumers to make sure that we are getting folks on the ground what they need so that they can actually make this successful,” Heidorn said. She also said counties are struggling with real-time corrections as they continue with implementation, especially counties that had no infrastructural foundation for this initiative beforehand.


4. California nurse practitioners could soon provide abortions

bill to allow California nurse practitioners to perform first trimester abortions without physician supervision is nearing passage. The bill would set the minimum standards for the nurse practitioner’s clinical training and mentoring period to 4,600 hours, which would be among the most “robust” in the country, according to CHCF. Jessica Dieseldorf, Senior Program Manager of Abortion Services at Planned Parenthood Mar Monte, told State of Reform that the bill could help increase access to reproductive health care across the state, especially for women fleeing from states with more stringent abortion restrictions.

SB 1375 is just one of the bills in the 13-bill package that the Legislative Women’s Caucus released in March to expand and protect access to abortion in California in response to the overturning of Roe v. Wade. The 10 other bills in the package that have not yet been signed by Gov. Newsom now await a third reading in one of the two chambers.


5. Kaiser mental health workers continue strike

Today marks the fourth consecutive day of strikes for Kaiser Permanente mental health providers, who have been picketing outside of Kaiser facilities in Fresno, Sacramento, San Francisco, and San Jose since Monday. The clinicians are protesting what they say are insufficient staffing levels that overburden mental health providers and hamper their ability to adequately meet the high patient demand for care.

Sarah Soroken, a Kaiser therapist in the Bay Area, told State of Reform that these protests are the employees’ last resort for getting their demands met after negotiations between Kaiser and union leaders failed to result in an agreement. We’ve negotiated at the bargaining table, reached out to all levels of Kaiser leadership, filed grievances with state regulatory agencies, and held press events to pass mental health parity legislation, but our patients are still being denied the medically necessary care that they need.”