California Legislative Updates
Assemblymember Mark Stone of California's 29th Assembly District and Senator Bill Monning of the Senate District, joined this meeting to provide insight into the state budget cycle and give updates on statewide ballot propositions.
The state of California has surpluses that are more than most states’ general funds budgets which have been allotted to increased funding for various programs and reimbursements. Unfortunately, these funds could not be expanded to cover Medi-Cal for undocumented immigrants nor to moderate income Californians. The Assembly District was however able to expand the earning income tax credit to lower age eligibility and reach more young families to assist their sustainability. This year, a number of bills focused on maternal health, mental health, prenatal and postpartum care for mothers struggling with mental health issues, and other social services to support young families in underserved communities. At the last HIP Council meeting, members discussed the partnership of the Human Services Department and the Health Services Agency on the Thrive by Three initiative which closely aligns with these health focuses to ultimately alleviate challenges faced by families in underserved communities.
Although the uncertainty of the future of the Affordable Care Act (ACA) is a major concern, the programs in place will continue to move forward due to the extensive funds in various reserve accounts. For the counties, $50 million included in the budget were allocated to help the Department of Healthcare Services provide funding for intense outreach, treatment, and related assistance for homeless people in need of mental health services.
An update of health-related statewide ballot proposition numbers includes: Propositions 1, 6, and 63. Proposition 1 – the Housing Programs and Veterans' Loans Bond- would authorize $4 billion in general obligation bonds for housing-related programs for veterans. Proposition 6 - the Voter Approval for Future Gas and Vehicle Taxes and 2017 Tax Repeal Initiative - would repeal the gas and diesel tax increases and vehicle fees that were enacted in 2017 and require voter approval for fuel tax and vehicle fee increases in the future. Although this proposition is not directly linked to health, it has indirect consequences such as road safety and job creation. An initiative called “No Place Like Home” under Proposition 63 - the Mental Health Services Act - will provide $2 billion to the construction and rehabilitation of permanent supportive housing for homeless individuals suffering from mental illness.
Senator Bill Monning authored SB 1192 -the California Healthy-by-Default Kids’ Meal Drinks bill-which would set water or milk as the default beverage for children’s combo meals instead of sugary drinks. The California Medical Association and Dental Association are also exploring placing a statewide ballot measure in 2020 to create a statewide tax on sugar sweetened beverages.
Heath Means Everything
Theresa Fay-Bustillos, Chief Program Director of the Blue Shield of California Foundation, presented on the new strategic vision of the Blue Shield of California. The focus of this strategic plan is to work within the systems of health and domestic violence. It is important to improve these systems and make them more receptive to vulnerable populations, low income Californians, and others. The Foundation’s strategy areas are: breaking the cycle of domestic violence, collaborating with and helpingthe community, designing the future of health, and enabling investments. The driving goal of this bold vision is to make California the healthiest state in the country, and to have the lowest rate of domestic violence by leveraging the power of community and collaboration to generate change.
A root cause analysis performed on breaking the cycle of domestic violence (DV) yielded valuable results. The top two factors which lead to the creation of perpetrators regardless of gender are DV exposure and child abuse. If no healing interventions are made, these children may exhibit intimate partner violence (IPV) later on between the ages of 12 to 17. Young adults ages 18 to 25 exhibit the highest prevalence of DV for first-time experiences of IPV for both genders. This issue is highly complex in that perpetrators can be victims, and victims can be previous perpetrators. Data shows that of women experiencing IPV, 71.1% experience it before the age of 25, and 58.2% men experience it before 25. While the risk factor for men and women is about the same, the impact of DV on women is much more severe and can lead to depression and self-harming activities. Children born into DV situations are also at a high risk of experiencing violence within their home, known as the Domestic Violence Pipeline. The Blue Shield Foundation Board has approved a two-generation approach by shifting the focus from adult women to children and adolescents, to interrupt this vicious cycle by involving the family as well as the individual.
The next strategy to reach the driving goal is collaborating with healthy communities. Collaboration generally starts around service delivery within partnerships which can be expanded to the next level of integrative collaboration. This collaborative work will be used to address the domestic violence pipeline and explore possible preventative interventions.
The Blue Shield Foundation wants to design the future of heath in the context of prevention. However, because of the delayed return on investment as a result of prevention, new payment and financing models have to be put in place which are currently being constructed.
Oral Health Access Santa Cruz County
Laura Marcus, Chief Executive Officer, and Dr. Sepi Taghvaei, Chief Dental Officer, of Dientes Community Dental presented on the 2018 Oral Health Access Report Card. Dientes commissioned the first Oral Health Needs Assessment of Santa Cruz County in 2016 which showed the tremendous need for oral health service access. The Oral Health Access Steering Committee developed a strategic plan to expand access and focus on prevention for children.
The first goal to carry out this plan is the “First Tooth, First Birthday” campaign which educates parents with young children on the importance of their child’s dental care.
As part of the first phase of this educational outreach campaign, Dientes partnered with the Central California Alliance for Health (CCAH) to send out informational newsletters to 106,000 Medical patients and over 2,000 medical providers. The second phase of this campaign is currently underway which utilizes radio ads and geofencing to spread information more efficiently.
The second goal is to promote kindergarten oral health visits by reinstating mandatory dental visits during the school year. 35,000 kindergarteners received Santa Cruz County dental care forms in an effort to bring them into a dental office at Salud Para La Gente or Dientes Community Dental.
The third goal is to expand capacity within the county. Because the current standard of care allows medical staff to apply fluoride varnish, 64 medical staff members were trained to perform this application at well child visits which is a significant move towards oral decay prevention.
The funds from Proposition 56 have greatly supported the efforts of increasing capacity, spreading educational outreach, and implementing preventative measures to carry out the strategic plan envisioned by Dientes. For further questions or information, contact firstname.lastname@example.org.