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Legislative Homestretch: Where We Stand

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Lawmakers returned from their summer break this week to finish out the legislative session, which ends in four short (or long, depending on how you see it) weeks. By Sept. 13, bills need to be voted on and sent to the Governor, who then has 30 days to act on them.

As we enter the homestretch, here’s where we stand on some of this year’s top priorities:

On Immigration Status, Caregivers Don’t Care

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Among the many tragedies born of the mass shooting in El Paso, Texas, which killed 22 and injured another two dozen, was the news that some victims might not have sought care at hospitals because of their immigration status.

This fear was so widespread that the West Texas wing of U.S. Customs and Border Protection tweeted: “We are not conducting enforcement operations at area hospitals, the family reunification center or shelters.”

Tragedy in Gilroy

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“My son had his whole life to live and he was only six. That’s all I can say.” – Alberto Romero, father of Gilroy shooting victim Stephen Romero

“I have no words to describe this pain I’m feeling…We just want Keyla to be remembered as someone that is beautiful…She really cared a lot about other people. She loved animals. She had big dreams and aspirations and her life was cut short.” – Katiuska Pimentel Vargas, aunt of 13-year-old Gilroy shooting victim Keyla Salazar

Elevate, Educate, Innovate to Improve Behavioral Health Care

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Last month, Tom Insel, MD, Gov. Newsom’s new special advisor on mental health care, shared with the Behavioral Health Action coalition some early ideas to change the trajectory of behavioral health care delivery in California. That Dr. Insel recognized coalition members as important to the process of transforming behavioral health is testament to the group’s hard and excellent work over the past year.

CHA co-founded Behavioral Health Action in 2018 with the National Alliance for Mental Illness, California, as an alliance of more than 50 organizations from health care, education, labor, law enforcement, local government, and business. Our first-of-its-kind coalition is focused on eliminating stigma and engaging lawmakers to develop solutions to the behavioral health challenges that so many Californians experience — for example:

More than 6 million Californians suffer from a mental illness.
Only one in three gets the help they need.
The number of adolescents suffering from depressive illnesses statewide continues to outpace the national rate.
Half of us will care for someone living with a mental health issue at some point in our lives.

The statistics are daunting, so the coalition hit the ground running last year with its mission to elevate the prominence of behavioral health so it gets the attention it needs, educate decision makers, and innovate the way we treat and support Californians in need — which includes getting the right care, in the right setting, at the right time.

In October, we held a one-on-one conversation with then-candidate Newsom, who pledged his commitment to turn California into a leader in improving the lives of people experiencing behavioral health challenges. When Dr. Insel spoke to the coalition last month, he continued to advance that conversation, explaining his view that we need both a shared understanding of the current problems and shared goals for tackling them.

Behavioral Health Action is working on just such a shared vision — an updated statewide model for behavioral health that will serve as a roadmap for the administration to use. As the model progresses, we’ll keep you updated.

In the meantime, we continue our work on many fronts: educating lawmakers about the importance of change, advocating for a budget that ensures everyone can get care when they need it, and strengthening our ties with the administration through a common sense of purpose.

CARMELA

Rate Setting, Front and Center

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Surprise billing continues to garner attention from both federal and state lawmakers — and it’s a vitally important conversation. Patients should not be caught off guard by unexpected bills for out-of-network emergency care. Hospitals have said all along that when patients need emergency care, we support protecting them from surprise bills by limiting their out-of-network cost sharing to no more than the amount for in-network patients.

Setting a Course for Seismic Policy

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Last week, this message highlighted that hospitals and their staff would be available to all who might need them while the rest of us took a break for the long holiday weekend. And, of course, that’s exactly what happened when two major earthquakes struck the town of Ridgecrest in the span of just two days.

A Shining Example of National Ideals

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While much of the nation prepares this week for the July 4 summer holiday, hospitals and their dedicated employees will continue their 24/7 work to care for any and all who need them, at any moment.

In California, the Independence Day weekend isn’t just a beginning-of-summer holiday — it also marks a few days of heightened risk at the start of a perilous fire season. One thing Californians have learned over the past several years of wildfires: hospitals and the people who work in them are ready, willing, and able to do what’s needed when disaster strikes.

Yes, there are the hospital emergency operations plans; the standards, regulations, and statutes; the staff training and education; and everything else hospitals do in case of an emergency. But there are also the people who dedicate themselves to their communities and their neighbors in need, no matter the strained circumstances or personal difficulty. 

Area Wage Index Battle Presses On

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In a little more than a month, the Centers for Medicare & Medicaid Services (CMS) will issue a final rule of significant importance for California’s hospitals: a decision that could alter the way Medicare adjusts hospital payments for geographic differences in labor costs (known as the Area Wage Index).

Their proposal? Take money from hospitals in California with high wages to give to hospitals in states with lower wages. CMS suggests this is an effort to address longstanding inequities in the wage index and to help rural hospitals.  

In a Sea of Legislation, Here’s Some to Watch For

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California’s nine-month legislative session will take its summer recess in mid-July and rev back up in mid-August for what will be a frenetic final four weeks to send bills to the Governor’s desk. CHA has been tracking hundreds of health care-related bills, and actively working on dozens on behalf of hospitals and health systems.

A Bullish Budget

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On Thursday, the Legislature approved the first budget under this new Governor — a nearly $214 billion spending plan that makes significant investments in the new Governor’s top priorities, including health care (we anticipate the trailer bill related to health care will be approved later in the month).

One of the key takeaways from Newsom’s first budget negotiation effort is that he is clearly disposed to use the budget — his most powerful tool as Governor — in a proactive and impactful way to advance his health care goals.