NEWSLETTER
Volume 3, Issue 22 - June 2, 2023
CSAP Nominates Senator Eggman for APA's Patient Advocacy Award
This week, CSAP nominated Senator Susan Talamantes Eggman, Ph.D for the American Psychiatric Association’s (APA) Patient Advocacy Award.
Senator Eggman is a joint author of the CARE Act in California (SB 1338 – 2022), championed by Governor Gavin Newsom, which will serve as an upstream intervention for the most severely impaired Californians to prevent avoidable psychiatric hospitalizations and incarceration. She has also led the fight in California to secure billions of dollars in order to transform our state’s behavioral healthcare system. Her efforts have resulted in the passage of CSAP co-sponsored legislation in 2022 such as SB 1035, SB 1227, and SB 1238 (unfortunately this one was vetoed by Governor Newsom). This year, CSAP is working with Senator Eggman on the passage of SB 43, which would expand the definition of gravely disabled in California as well as allow hearsay evidence in conservancy proceedings. Senator Eggman is also authoring another CSAP co-sponsored bill, SB 363, which would create a real-time statewide registry of mental health and substance use disorder beds in California. Her passion and success on behalf of California’s patients, physicians, and their practices is reaching its zenith as she nears the end of an incredibly successful 12 years in office.
Negotiations regarding SB 43 have already begun in the Assembly. Will substance use disorders stay in the bill? Will the hearsay provisions stay in as well? How significantly might the bill be amended? More to follow next week. CSAP is working extensively with Senator Eggman and her staff to preserve as much as possible through this gauntlet. It will not be easy.
State and Federal Formulary News
Effective February 2023, the California Department of Public Health (CDPH) added the following antipsychotic injectables to the ADAP formulary: Aripiprazole (Abilify Maintena®), Aripiprazole (Aristada®), Olanzapine (Zyprexa Relprevv™), Paliperidone (Invega Sustenna®), Risperidone (Risperdal Consta®). The addition of these medications provides options to ensure that ADAP clients receive care consistent with current national guidelines to manage severe depression, schizophrenia, and schizoaffective disorder among people with HIV. Please see link to the CDPH management memo released for more information: ADAP MM 2023-02. More information on ADAP which helps ensure that people living with HIV in California, who are uninsured or under-insured, have access to medication can be found here (hyperlink to https://www.cdph.ca.gov/Programs/CID/DOA/Pages/OAadap.aspx).
Also, at the federal level, please be aware that Medicare is making plans to expand coverage of Alzheimer’s drugs.
Legislation - Enjoy "Halftime"
The Legislature had a couple of long days as they remained busy trying to pass legislation on their respective floors before the House of Origin deadline, which is today June 2, 2023. The House of Origin deadline is, in other words, the deadline by which any bill introduced this year must be off the floor in its own house. Bills that didn't meet the deadline can be considered next year (the second year of the 2023-24 legislative session). Very few bills in either house succumbed to this year's deadline.
This weekend is essentially "halftime" in the legislative schedule. Committees may resume hearing bills from the other house starting June 5, 2023.
Of note, especially for those of you with larger practices or oversight in the public mental health system - SB 525, Senator Maria Elena Durazo’s bill to create a health care minimum wage, cleared the Senate just barely. The bill has recently been amended to (1) revise the implementation timeline to increase the health care minimum wage to $21/hour in June 2024 and to $25/hour in June 2025; (2) revise the inflator to the lesser of 3.5 percent or CPI (instead of the greater of); and (3) revise the salary minimum for salaried employees from 200% to 150% of the health care minimum wage (from $104,000 to $78,000). So far, none of the contract or other provisions are being changed. Hospitals, clinics, counties, and other health care providers all still oppose the bill. Read more here.
Still a lot of bills moving! CSAP's Government Affairs Committee will consider many more positions at its next meeting on June 15. See a bill without a CSAP position that you would like considered, just email Paul Yoder at SYASL.
CARE Act
Upcoming CARE Act Training and Technical Assistance: Eligibility in Practice on June 14
Health Management Associates (HMA) will provide a training session on Wednesday, June 14, from 9 a.m. to 10 a.m., to cover CARE Act eligibility criteria, including a review of diagnoses, symptoms, functional impairment, and other criteria. The training will also cover the key points in the Community Assistance, Recovery, and Empowerment (CARE) Act process where eligibility is applied/reviewed (e.g., report, evaluation). This training is intended for all counties, counsel, judges, county providers, and other stakeholders that are participating in the CARE Act implementation. For more information, see here. For registration, see here.
MCO Tax
The Assembly Health Committee and the Assembly Budget Subcommittee on Health and Human Services held a joint informational hearing this week: Maximizing the Opportunity for Medi-Cal Managed Care Organization Tax Renewal. You can view hearing materials and SYASL staff notes from the hearing below.
Key take-aways as legislators mull over the Governor's proposal: (1) the provider-plan-labor panel was not comfortable with the proposed 8 to 10 year planned expenditure, and would prefer investments be more front loaded (over a period of 3.5 years); (2) hospitals need support now (Kaweah Delta in Tulare County was mentioned several times); (3) investments in community health workers and same day billing also are needed; 4) investments also are needed in specialty care and behavioral health; and, 5) more must be done to invest in the pipeline of graduate medical education and workforce.
Agenda
LAO Handout
DHCS MCO Tax Primer
SYASL Staff Notes
Children and Youth Behavioral Health Initiative
May Equity Working Group Meeting
Today, the California Health & Human Services Agency (CalHHS) held its Equity Working Group. You may view SYASL staff notes from the meeting here.
Upcoming Webinar
The California Health & Human Services Agency (CalHHS), in partnership with its departments, on June 9 from 2 p.m. to 4 p.m. PST will host a webinar on the Children and Youth Behavioral Health Initiative (CYBHI).
June’s webinar will (1) provide a closer look and discussion on the behavioral health services platform and e-consult being developed by the Department of Health Care Services (DHCS), (2) share updates on recent developments and the progress, work-to-date and upcoming next steps of the Initiative and its workstreams; (3) include a brief question-and-answer session to engage with CYBHI leaders and partners on their work. Register here.
Grants and Opportunities for Comment
For SYASL's latest compilation of draft behavioral health regulations and grant opportunities, see here.
San Francisco Launches New Street Crisis Team
The City of San Francisco has announced the launch of a new pilot program that will serve as an alternative to law enforcement response for non-emergency calls involving people experiencing homelessness in need of a higher level of care. The new Homeless Engagement Assistance Response Team (HEART) is a community-based team made up of Urban Alchemy practitioners. Read more here.
Worth a Read
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