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HomeMy WebLinkAboutBOARD STANDING COMMITTEES - 03092020 - Legislation Cte Agenda Pkt            LEGISLATION COMMITTEE March 9, 2020 *NOTE CHANGE*1:30 P.M. 651 Pine Street, Room 101, Martinez Supervisor Karen Mitchoff, Chair Supervisor Diane Burgis, Vice Chair Agenda Items: Items may be taken out of order based on the business of the day and preference of the Committee              1.Introductions   2.Public comment on any item under the jurisdiction of the Committee and not on this agenda (speakers may be limited to three minutes).   3. RECEIVE and APPROVE the Record of Action for the February 10, 2020 meeting of the Legislation Committee, with any necessary corrections.   4. RECEIVE the report on the State Budget and State Legislation of interest and provide direction to staff and advocates, as needed.   5. DIRECT staff on the contractor procurement process for the federal advocacy contract beginning July 1, 2020.   6. CONSIDER recommending to the Board of Supervisors a position of "Support" on H.R. 5823, the "State and Local Cybersecurity Improvement Act," as recommended by the Chief Assistant County Administrator, Tim Ewell.   7. CONSIDER the recommendations of the Contra Costa County Mental Health Commission related to the Mental Health Services Act (MHSA) funds and the Institutions for Mental Disease (IMD) federal policy, and provide direction to staff.   8.The next meeting is currently scheduled for April 6, 2020 at 11:00 a.m. (Note time change.)   9.Adjourn   The Legislation Committee will provide reasonable accommodations for persons with disabilities planning to attend Legislation Committee meetings. Contact the staff person listed below at least 72 hours before the meeting. Any disclosable public records related to an open session item on a regular meeting agenda and Page 1 of 78 distributed by the County to a majority of members of the Legislation Committee less than 96 hours prior to that meeting are available for public inspection at 651 Pine Street, 10th floor, during normal business hours. Public comment may be submitted via electronic mail on agenda items at least one full work day prior to the published meeting time. For Additional Information Contact: Lara DeLaney, Committee Staff Phone (925) 335-1097 lara.delaney@cao.cccounty.us Page 2 of 78 LEGISLATION COMMITTEE 3. Meeting Date:03/09/2020   Subject:Record of Action for Legislation Committee Meeting Submitted For: LEGISLATION COMMITTEE,  Department:County Administrator Referral No.: 2020-06   Referral Name: Record of Action  Presenter: L. DeLaney Contact: L. DeLaney, 925-335-1097 Referral History: County Ordinance (Better Government Ordinance 95-6, Article 25-205, [d]) requires that each County Body keep a record of its meetings. Though the record need not be verbatim, it must accurately reflect the agenda and the decisions made in the meeting. Referral Update: Attached is the Draft Record of Action. (Attachment A) Any handouts or printed copies of testimony distributed at the meeting will also be attached to this meeting record.  Recommendation(s)/Next Step(s): RECEIVE and APPROVE the Record of Action. Attachments Attachment A: Draft Record of Action Page 3 of 78 D R A F T LEGISLATION COMMITTEE RECORD OF ACTION FOR February 10, 2020   Supervisor Karen Mitchoff, Chair Supervisor Diane Burgis, Vice Chair    Present: Karen Mitchoff, Chair      Diane Burgis, Vice Chair    Staff Present:Lara DeLaney, Sr. Deputy County Administrator; Erika Jenssen, Deputy Director, Contra Costa Health Services  Attendees:Alvaro Fuentes; Mariana Moore; Dr. William Walker; Mary Ann Buggs; Roxanne Carrillo-Garza; Rebecca Rosen; James Gross, Michelle Rubalcava; Paul Schlesinger of Alcalde & Fay                   1.Introductions    Chair Mitchoff convened the meeting. Vice Chair Burgis and attendees present introduced themselves. The County's state and federal legislative advocates were on the conference line.   2.Public comment on any item under the jurisdiction of the Committee and not on this agenda (speakers may be limited to three minutes).    No public comment was offered.   3.RECEIVE and APPROVE the Record of Action.      The Record of Action was approved as presented.    AYE: Chair Karen Mitchoff   Vice Chair Diane Burgis  4.RECEIVE the report on the Contra Costa CARES program and funding proposal. CONSIDER recommending that the Board of Supervisors support the proposal at its February 25, 2020 meeting and AMEND the adopted 2020 State Legislative Platform to include the state budget appropriation request as an additional component of the advocacy work program for 2020.    Attachment A Page 4 of 78    Dr. William Walker, legislative consultant to Contra Costa Health Services, provided a report to the Committee about the Contra Costa CARES program. Attendees of the meeting provided comment, supporting an amendment to the County's adopted 2020 State Platform to add a state budget request for the Contra Costa CARES program. The Committee directed staff to send this item to the Board of Supervisors with a recommendation to support at the next possible meeting.    AYE: Chair Karen Mitchoff   Vice Chair Diane Burgis  5.RECEIVE the report on the State Budget and Legislation of interest and provide direction to staff, as needed.        The Committee received the report on the State Budget and key state legislative issues from the County's state legislative advocates, Jim Gross and Michelle Rubalcava from Nielsen Merksamer. They covered the Governor's focus on housing and ending homelessness. Supervisor Burgis emphasized the need to tie additional housing needs with transportation and jobs, as East County in particular looks to job development.    AYE: Chair Karen Mitchoff   Vice Chair Diane Burgis  6.RECEIVE the report on federal legislation of interest to the County and provide direction to staff as needed.        The County's federal legislative advocate, Paul Schlesinger, was on the conference line with his associates Perrin Badini and Anne Cullather, and provided the federal update. He also discussed the appropriation request forms that our congressional delegation was issuing and our need to prioritize our federal program appropriation needs. The Committee indicated that programs that provided for health services, housing assistance, and food assistance should be prioritized.    AYE: Chair Karen Mitchoff   Vice Chair Diane Burgis  7.The next meeting is currently scheduled for March 9, 2020 at 1:30 p.m. (*Note time change)    Chair Mitchoff adjourned the meeting at 1:35 p.m.   8.Adjourn   Attachment A Page 5 of 78 Attachment A Page 6 of 78 LEGISLATION COMMITTEE 4. Meeting Date:03/09/2020   Subject:State Budget and Legislation of Interest to Contra Costa County Submitted For: LEGISLATION COMMITTEE,  Department:County Administrator Referral No.: 2020-09   Referral Name: State Budget and Legislative Update  Presenter: L. DeLaney and Nielsen Merksamer Team Contact: L. DeLaney, 925-335-1097 Referral History: The Legislation Committee regularly receives updates from staff and the County's legislative advocates on State Budget and legislation of interest to the County. Referral Update: Coronavirus On March 4, 2020, Governor Gavin Newsom announced a declaration of a state of emergency to make additional resources available to address the global COVID-19 outbreak. Joined by Health and Human Services Agency Secretary Dr. Mark Ghaly, Director of the Department of Public Health and State Public Health Officer Dr. Sonia Angell, and Director of the Office of Emergency Services Mark Ghilarducci, the Governor noted the proclamation comes after the number of positive California cases has increased and the tragic first official COVID-19 death earlier in the day. “The State of California is deploying every level of government to help identify cases and slow the spread of this coronavirus,” said Governor Newsom. “This emergency proclamation will help the state further prepare our communities and our health care system in the event it spreads more broadly.” As of the writing of this report: 53 Californians are confirmed as having coronavirus. 9,400 people in 49 counties are being monitored. Attorney General Xavier Becerra warned against price gouging on products such as hand sanitizer that could be used to fend off coronavirus. The cost of COVID-19 tests will be covered by health insurance and Medi-Cal, Newsom announced. On the Federal side, the Senate cleared an $8.3 billion emergency funding bill to combat the coronavirus on a 96-1 vote on March 5, sending the measure for the President's signature. The bill, H.R. 6074 will provide almost $6.5 billion to the Department of Health and Human Services, nearly $1.3 billion to the State Department, and $20 billion to the Small Business Administration. Contra Costa Health Services provides up-to-date information about coronavirus at its website: http://cchealth.org/coronavirus. See Attachment A for more information. March 3, 2020 Primary Election In other important state news, the March 3, 2020 primary election ("Super Tuesday") was conducted in California. The latest statewide election results include:  Bernie Sanders: 1.57 million votes, 33.8%. Joe Biden: 784,341, 25.1% Proposition 13 school bond, 44.6% for it and 55.4% against. Outstanding votes: millions. (Contra Costa County had 112,000 ballots remaining as of March 4, 2020.) From Politico's Jeremy B. White: "Super Tuesday polls have long since closed, but a coming wave of uncounted ballots is poised to reshape California results from the presidential contest through legislative races. America’s most populous state has sought to augment turnout by dramatically expanding the number of mail ballots to more than 16 million, allowing Election Day voter registration and accepting ballots that arrive up to three days after Election Day. That means that there are likely millions of votes left to be tallied. While history suggests the late-arriving ballots will skew left, the fact that many Democratic primary voters may have waited to vote until the last possible moment in a fluid presidential primary injects extra uncertainty." At the local level, transportation measures all failed at the ballot across the Bay Area region, with Contra Costa's Measure J failing to muster even a majority let alone the 66.7% required to pass. For more information on this subject: https://www.eastbaytimes.com/2020/03/05/transportation-taxes-flopped-on-super-tuesday-is-that-bad-news-for-the-bay-areas-mega-measure/ Page 7 of 78 https://www.eastbaytimes.com/2020/03/05/transportation-taxes-flopped-on-super-tuesday-is-that-bad-news-for-the-bay-areas-mega-measure/ The fate of Contra Costa County's elected representatives after March 3 also remains uncertain for several. Though County District II Supervisor Candace Andersen (uncontested) and County District III Supervisor Diane Burgis succeeded in their e-election bids, District V Supervisor Federal Glover is awaiting final results to learn whether he won outright in the Primary or heads to a General Election run-off in November. At the State level, Senate District 3 representative, Bill Dodd, was uncontested. Senate District 7 incumbent Steve Glazer appears to be heading to the November General Election against Republican challenger Julie Mobley. Senate District 9 incumbent Nancy Skinner was uncontested in her re-election bid. On the Assembly side, District 11 representative Jim Frazier was also uncontested for his re-election bid. District 14 representative Tim Grayson prevailed in his re-election, as did District 15 representative Buffy Wicks, and District 16's Rebecca Bauer-Kahan. On the Federal level, Contra Costa County's congressional delegation of Representatives Mark DeSaulnier, Jerry McNerney, Eric Swalwell, and Mike Thompson, all succeeded in their re-election efforts. All Contra Costa County election results are available at: https://www.cocovote.us/election-results-march-3-2020/ Homelessness Regarding the critical issue of the fight against homelessness, a press release on March 4 announced "a historic funding request to combat homelessness throughout California." AB 3300 is intended to provide an appropriation to "dramatically reduce homelessness." The press release indicates that Assembly Member Bonta, Assembly Member Wicks and other Northern California leaders will be hosting a press conference to announce AB 3300 at 10:00 a.m. on Friday, March 6, 2020. Senate and Assembly Examine Role of Local Development Impact Fees on Housing Crisis On February 26, 2020, the Senate Governance and Finance Committee, Senate Housing Committee, Assembly Local Government Committee, and Assembly Housing and Community Development Committee convened for a joint informational hearing to examine local development impact fees and the role they play in housing development and affordability. Titled “The Price of Civilization: Benefits and Costs of Impact Fees on Housing in California,” the hearing featured nearly three hours of testimony from local and regional government agencies, housing developers, and legal and housing finance experts. While the committee members and panelists agreed that the rise of and the reliance on development impact fees are a direct result of Proposition 13 and the subsequent decline in property tax revenue that previously supported overall community development, infrastructure, and local government services, the members wrestled with what role fees should continue to play in light of the affordable housing and homelessness crisis. There are a few legislators that believe – even while recognizing the value the infrastructure and other benefits local fees provide – that more housing would be developed and housing prices would come down if local fees were capped or eliminated. Of the legislators with this perspective, some believe those fees should be back-filled by the state in order to continue to provide local infrastructure improvements to support development. Others were unconvinced that capping or eliminating fees would actually result in more housing or more affordable housing. Local agencies are doing proactive, innovative things to help reduce the impact fees have on development ranging from: Regional uniform fee programs that help eliminate the “first-in” problem. Assessing fees by square feet rather than unit, which can be a disincentive to build smaller units, and Deferral programs to help reduce borrower costs for developers. Riverside County testified that development has flourished in their region, not despite fees, but because the fees provided the infrastructure necessary to accommodate growth in an orderly fashion. The “soft costs” of development that include design costs, process costs, financing, and fees can range from 20% to 30% of a project’s cost. With land costs ranging from 5% to 15% of a project’s costs, that means the single largest cost of housing is labor and materials or “hard costs” and these are much more difficult to influence yet could reduce the cost of housing much more substantially if addressed. Panelists had a number of recommendations for the committee members to contemplate, including: Conducting a feasibility analysis for specified (although not yet defined) housing projects to determine whether a locality’s fees impact the viability of a project that could then allow the agency to better assess the trade-offs of fees on a specific project; Reducing fees in areas where the housing market is sluggish but growth is desired; back-filling any lost revenue or somehow providing predictable state funding for local infrastructure; and Better aligning state resources (such as cap-and-trade grants, the infill infrastructure grant program, etc.) with the allocation of regional housing needs.  While the hearing was robust and meaningful, questions remained unanswered. Would capping or eliminating fees translate into costs savings for renters and homeowners? What guarantees can the Legislature offer should it mandate reduced fees on local governments so that prices would come down? With at least 10 bills on local fees having been introduced, there will be more opportunity to ask these questions in the coming months of the legislative session. CalAIM Updates The Administration announced last week that the Administration’s proposal to restructure the Medi-Cal program will once again be referred to as CalAIM. The restructure proposal was unveiled in October and dubbed California Advancing and Innovating Medi-Cal (CalAIM). In January, the Governor renamed it Medi-Cal Healthier California for All. On February 25, the Administration announced that the name for the program redesign is officially back to CalAIM. The Department of Health Care Services (DHCS) wrapped up the stakeholder meetings on CalAIM at the end of February. Various parts of their CalAIM will require approvals through a 1915b waiver, an 1115 waiver, state plan amendments, and plan contracts (and presumably Page 8 of 78 their CalAIM will require approvals through a 1915b waiver, an 1115 waiver, state plan amendments, and plan contracts (and presumably legislation); DHCS staff will be developing a “cheat sheet” regarding which CalAIM component requires which type(s) of approval. DHCS anticipates posting final revised proposals that reflect stakeholder engagement at the end of March or early April. There will be a 30-day public comment period in May. DHCS plans to submit the elements of CalAIM requiring federal approvals (the 1115 waiver and 1915b waiver) to CMS in June of this year. The following provides additional updates about various elements of the CalAIM proposal: Enhanced Care Management (ECM). DHCS will offer a phased approach to give plans without Whole Person Care and Health Homes Programs experience additional time to prepare for the transition to enhanced care management. The implementation date for plans in counties with Whole Person Care pilots and/or Health Homes Programs is January 1, 2021; plans in counties without WPC or HHP will have until July 1, 2021 to implement but may implement earlier. Additionally, at the February 26 Senate informational hearing, DHCS also was very clear that their ECM proposal will require high-touch case management “outside four walls, in the community.” Dr. Brad Gilbert acknowledged that each of populations that the enhanced care management benefit will target will require different work, perhaps with different partners. He noted, in particular, community entities and counties. Dr. Gilbert also commented that he is not expecting managed care plans to build ECM models out themselves, but to partner with CBOs, counties, public hospital systems, as well as providers in the community. It’s worth noting that Senator Pan also expressed some concerns with rate setting for new services, as well as how complicated the proposal is, and the time required to build out services. Population Health Management. DHCS has determined that managed care plans should have additional time to design and implement their Population Health Management Strategies, delaying the effective date to January 1, 2022.  Technical Assistance. DHCS has scheduled a series of CalAIM Regional Meetings to provide technical assistance to health plans, counties, and community-based organizations as they prepare to implement the enhanced care management benefit and in lieu of services. Health plans, lead entities for WPC, county behavioral health agencies, county public health agencies, and Tribal Health Programs will be invited to attend the meeting in their region. DHCS will be sending formal invitations to these meetings, which are not open to the public. Updated Dual Eligible Special Needs Plans (D-SNP) Policy Proposal . The CalAIM webpage has been updated, based upon stakeholder feedback, with a revised memo entitled, Expanding Access to Integrated Care for Dual Eligible Californians. This memo outlines the Department’s transition plan for dual eligibles and the Coordinated Care Initiative.  The LAO released a comprehensive analysis of CalAIM late last week, which generally urged caution – suggesting that the Legislature consider slowing down the timeline. While Newsom's plan has great promise, it carries financial risk and great uncertainty — particularly regarding whether Medi-Cal managed care plans are prepared for the changes. The LAO acknowledged that certain changes reliant on federal waivers may need to start next year but said "some elements of the proposal could be postponed or implemented in phases." The LAO also raised concerns about cost increases in Medi-Cal and suggested that California could face "significantly higher costs" in future years than the Newsom administration has projected. However, the LAO noted that CalAIM could simplify administration of the $104 billion program and improve mental health and substance abuse services across California. Attachment B is the Master List of Bills of Interest to the County, as of March 5, 2020. Recommendation(s)/Next Step(s): RECEIVE the report and provide direction, as needed. Attachments Attachment A Attachment B Page 9 of 78 Attachment A Page 10 of 78 Attachment A Page 11 of 78 1 2020 Master List of Bills of Interest To Contra Costa County March 5, 2020 AB 22 AUTHOR: Burke [D] TITLE: Housing: Children and Families FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 12/03/2018 LAST AMEND: 01/16/2020 DISPOSITION: Failed LOCATION: ASSEMBLY SUMMARY: Declares that it is the policy of the state that every child and family has the right to safe, decent, and affordable housing. Requires the policy to consider homelessness prevention, emergency accommodations, and permanent housing. Requires all relevant state agencies and departments to consider that policy when establishing policies, regulations, and grant criteria pertinent to advancing the components of Housing First. STATUS: 02/03/2020 In ASSEMBLY. Died pursuant to Art. IV, Sec. 10(c) of the Constitution. AB 46 AUTHOR: Carrillo [D] TITLE: Individuals With Mental Illness: Change of Term FISCAL COMMITTEE: no URGENCY CLAUSE: no INTRODUCED: 12/03/2018 ENACTED: 06/26/2019 DISPOSITION: Enacted LOCATION: Chaptered CHAPTER: 2019-09 SUMMARY: States the intent of the Legislature to enact legislation to replace derogatory terms with more culturally sensitive terms when referring to individuals with mental illness. STATUS: 06/26/2019 Signed by GOVERNOR. 06/26/2019 Chaptered by Secretary of State. Chapter No. 2019-09 AB 563 AUTHOR: Quirk-Silva [D] TITLE: Mental Health: Funding FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 02/13/2019 LAST AMEND: 04/22/2019 DISPOSITION: Failed LOCATION: ASSEMBLY SUMMARY: Appropriates a certain amount from the General Fund to the State Department of Health Care Services to distribute to the North Orange Co unty Public Safety Task Force for the development of a two year pilot program. Requires 1/2 of the moneys to be distributed on a specified date, and 1/2 to be distributed on a specified date, and would require the moneys to be used to provide a range of programs, services, and activities designed to assist individuals and families experiencing mental health crises. STATUS: 02/03/2020 In ASSEMBLY. Died pursuant to Art. IV, Sec. 10(c) of the Constitution. Attachment B Page 12 of 78 2 AB 732 AUTHOR: Bonta [D] TITLE: County Jails: Prisons: Incarcerated Pregnant Persons FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 02/19/2019 LAST AMEND: 01/23/2020 DISPOSITION: Pending LOCATION: SENATE SUMMARY: Requires an incarcerated person in a county jail or the state prison who is identified as possibly pregnant or capable of becoming pregnant during an intake health examination, or at any time during incarceration, to be offered a test upon intake or reques t. Provides an incarcerated person in a local detention facility with the right to summon a physician, nurse practitioner, certified nurse midwife, or physician assistant. Provides for the use of menstrual hygiene products. STATUS: 01/27/2020 In ASSEMBLY. Read second time. To third reading. 01/27/2020 In ASSEMBLY. Assembly Rule 63 suspended. 01/27/2020 In ASSEMBLY. Read third time. Passed ASSEMBLY. *****To SENATE. (63-0) Commentary: Watch AB 953 AUTHOR: Ting [D] TITLE: Land Use: Accessory Dwelling Units FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 02/21/2019 LAST AMEND: 01/06/2020 DISPOSITION: Pending LOCATION: SENATE SUMMARY: Deems a permit application for the creation of an accessory dwelling unit or junior accessory dwelling unit approved if the local agency has not acted upon the completed application within 60 days. Requires ministerial approval of an application for a building permit within a residential or mixed-use zone to create one accessory dwelling unit and one junior accessory dwelling unit per lot with a proposed or existing single-family dwelling if certain requirements are met. STATUS: 01/30/2020 In ASSEMBLY. Read third time. Passed ASSEMBLY. *****To SENATE. (76-0) Commentary: Send to DCD AB 1121 AUTHOR: Bauer-Kahan [D] TITLE: Firearms: Prohibited Persons FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 02/21/2019 LAST AMEND: 03/19/2019 DISPOSITION: Failed LOCATION: ASSEMBLY SUMMARY: Prohibits a person who is granted this pretrial diversion based on a mental health disorder from owning or possessing a firearm, or other dangerous or deadly weapon. STATUS: 02/03/2020 In ASSEMBLY. Died pursuant to Art. IV, Sec. 10(c) of the Constitution. 02/03/2020 From Committee: Filed with the Chief Clerk pursuant to Joint Rule 56. Attachment B Page 13 of 78 3 AB 1126 AUTHOR: O'Donnell [D] TITLE: Mental Health Services Oversight and Accountability FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 02/21/2019 LAST AMEND: 04/01/2019 DISPOSITION: Failed LOCATION: ASSEMBLY SUMMARY: Requires the Mental Health Services Oversight and Accountability Commission to establish technical assistance centers and clearinghouses to support counties in addressing mental health issues of statewide concern, with a focus on school mental health and reducing unemploy ment and criminal justice involvement due to untreated mental health issues. Requires the Commission to develop transparency and accountability strategies. STATUS: 02/03/2020 In ASSEMBLY. Died pursuant to Art. IV, Sec. 10(c) of the Constitution. AB 1182 AUTHOR: Carrillo [D] TITLE: Post-Release Supervision Of Offenders FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 02/21/2019 LAST AMEND: 04/22/2019 DISPOSITION: Failed LOCATION: ASSEMBLY SUMMARY: Requires persons who have been scored as low or moderate risk to be released if they have been on parole for a certain number of days and have not committed any new offenses. STATUS: 02/03/2020 In ASSEMBLY. Died pursuant to Art. IV, Sec. 10(c) of the Constitution. AB 1216 AUTHOR: Bauer-Kahan [D] TITLE: Solid Waste: Illegal Dumping FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 02/21/2019 LAST AMEND: 03/26/2019 DISPOSITION: Failed LOCATION: ASSEMBLY SUMMARY: Authorizes the counties of Alameda and Contra Costa to establish a pilot program to em ploy 2 law enforcement officers, one from each county, solely for the purpose of enforcing dumping laws in those counties. STATUS: 02/03/2020 In ASSEMBLY. Died pursuant to Art. IV, Sec. 10(c) of the Constitution. AB 1275 AUTHOR: Santiago [D] TITLE: Mental Health Services: County Pilot Program FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 02/21/2019 LAST AMEND: 05/16/2019 DISPOSITION: Pending FILE: A-51 LOCATION: Senate Inactive File Attachment B Page 14 of 78 4 SUMMARY: Requires the State Department of Health Care Services to establish a 3-year pilot project to include the County of Los Angeles and up to 9 additional counties in which each participating county would be required to establish an outreach team, comprised of county employees, to provide outreach services to individuals with a history of mental illness or substance use disorders who are unable to provide for urgently needed medical care and who are homeless or at risk of experiencing homelessness. STATUS: 09/14/2019 In SENATE. From third reading. To Inactive File. AB 1405 AUTHOR: Gloria [D] TITLE: Permanent Supportive Housing for Parolees FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 02/22/2019 LAST AMEND: 04/29/2019 DISPOSITION: Failed LOCATION: ASSEMBLY SUMMARY: Requires the Department of Corrections and Reh abilitation to enter into contracts with contractors who provide short-term housing to parolees through an adult day reporting center or through the department's Specialized Treatment for Optimized Programming to provide permanent housing for individuals exiting prison who are at risk of homelessness and to parolees experiencing homelessness. STATUS: 02/03/2020 In ASSEMBLY. Died pursuant to Art. IV, Sec. 10(c) of the Constitution. AB 1450 AUTHOR: Lackey [R] TITLE: Child Abuse Central Index FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 02/22/2019 LAST AMEND: 01/06/2020 DISPOSITION: Pending LOCATION: SENATE SUMMARY: Authorizes a police or sheriff's department to which a report of suspected child abuse or severe neglect is made on or after January 1, 2021, or that is investigating an open case for which a report of suspected child abuse or severe neglect was made on or before January 1, 2021, to forward to the Department of Justice a report in writing of its investigation of known or suspected child abuse or severe neglect that is determined to be substantiated. STATUS: 01/27/2020 In ASSEMBLY. Read third time. Passed ASSEMBLY. *****To SENATE. (74-0) Commentary: Send by AL AB 1525 AUTHOR: Jones-Sawyer [D] TITLE: Cannabis: Financial Institutions FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 02/22/2019 LAST AMEND: 01/16/2020 DISPOSITION: Pending LOCATION: SENATE SUMMARY: Attachment B Page 15 of 78 5 Provides that an entity, that receives deposits, extends credit, conducts fund transfers, transports cash or financial instruments on behalf of a financial institution, or provides other financial services, including public accounting, for a person licensed to engage in commercial cannabis activity does not commit a crime under any state law. STATUS: 01/27/2020 In ASSEMBLY. Read third time. Passed ASSEMBLY. *****To SENATE. (68-1) Commentary: CSAC supports AB 1844 AUTHOR: Chu [D] TITLE: Paid Sick Leave: Behavioral Health Conditions FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 01/06/2020 DISPOSITION: Pending LOCATION: Assembly Labor and Employment Committee SUMMARY: Relates to prescribed sick leave. Expands purposes to also include diagnosis, care, or treatment of an existing behavioral health condition of, or preventive care for, an employee or an employee's family member. STATUS: 01/17/2020 To ASSEMBLY Committee on LABOR AND EMPLOYMENT. Commentary: Sent by AL AB 1853 AUTHOR: Frazier [D] TITLE: Health Care: Medical Goods: Reuse and Redistribution FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 01/07/2020 DISPOSITION: Pending COMMITTEE: Assembly Aging and Long-Term Care Committee HEARING: 03/31/2020 3:00 pm SUMMARY: Requires the Department of Aging, upon appro priation by the Legislature, to establish a comprehensive 3-year pilot program in the Counties of Contra Costa, Napa, and Solano to facilitate the reuse and redistribution of durable medical equipment and other home health supplies. Requires the department to contract in each county with a local nonprofit agency to oversee the program. STATUS: 01/30/2020 To ASSEMBLY Committees on AGING & LONG TERM CARE and HEALTH. Commentary: Sent by Andrew Langley AB 1907 AUTHOR: Santiago [D] TITLE: California Environmental Quality Act: Shelters FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 01/08/2020 DISPOSITION: Pending LOCATION: Assembly Natural Resources Committee SUMMARY: Exempts from environmental review under the California Environ mental Quality Act certain activities approved by or carried out by a public agency in furtherance of providing emergency shelters, supportive housing, or affordable housing. Requires a lead agency that determines to carry Attachment B Page 16 of 78 6 out or approve an activity that is within this CEQA exemption to file a notice of exemption. STATUS: 01/30/2020 To ASSEMBLY Committees on NATURAL RESOURCES and HOUSING AND COMMUNITY DEVELOPMENT. Commentary: https://www.latimes.com/california/story/2020-01-08/affordable-housing-homeless-shelter-bill-bypas s-environmental-law-ceqa AB 1908 AUTHOR: Chen [R] TITLE: Transportation: Homeless Encampment and Litter Program FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 01/08/2020 DISPOSITION: Pending LOCATION: Assembly Transportation Committee SUMMARY: Requires the Department of Transportation, within its maintenance program, to establish a Homeless Encampment and Litter Program to provide timely abatement and cleanup of homeless encampments on Department property and expedited and coordinated access to housing and supportive services. Requires the Department to coordinate with homeless service provider agencies and to establish homeless adult and family multidisciplinary personnel teams. STATUS: 02/27/2020 To ASSEMBLY Committees on TRANSPORTATION and HUMAN SERVICES. Commentary: Send to PW & Deidra AB 1910 AUTHOR: Bauer-Kahan [D] TITLE: Firearms: Prohibited Persons FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 01/08/2020 DISPOSITION: Pending LOCATION: Assembly Public Safety Committee SUMMARY: Prohibits a person who is granted pretrial diversion from criminal prosecution for certain offenses, based on a mental health disorder, from owning or possessing a firearm. STATUS: 01/17/2020 To ASSEMBLY Committee on PUBLIC SAFETY. AB 1920 AUTHOR: Boerner Horvath [D] TITLE: Climate Change: Climate Adaptation Center FISCAL COMMITTEE: no URGENCY CLAUSE: no INTRODUCED: 01/13/2020 DISPOSITION: Pending LOCATION: ASSEMBLY SUMMARY: Declares the intent of the Legislature to enact subsequent legislation that would establish the Climate Adaptation Center and Regional Support Network to provide technical support and information to local governments on adapting to climate change impacts, including, but not limited to, sea level rise. STATUS: 01/13/2020 INTRODUCED. AB 1921 AUTHOR: Diep [R] TITLE: Unlawful Entry of a Vehicle Attachment B Page 17 of 78 7 FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 01/13/2020 DISPOSITION: Pending LOCATION: Assembly Public Safety Committee SUMMARY: Makes forcibly entering a vehicle with the intent to commit a theft therein a crime punishable by imprisonment in a county jail. STATUS: 01/23/2020 To ASSEMBLY Committee on PUBLIC SAFETY. Commentary: Send by AL AB 1924 AUTHOR: Grayson [D] TITLE: Housing Development: Fees FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 01/14/2020 DISPOSITION: Pending LOCATION: Assembly Local Government Committee SUMMARY: Requires that a fee levied or imposed on a housing development project by a local agency be proportionate to the square footage of the proposed unit or units. STATUS: 01/23/2020 To ASSEMBLY Committees on LOCAL GOVERNMENT and HOUSING AND COMMUNITY DEVELOPMENT. Commentary: Send to DCD AB 1938 AUTHOR: Eggman [D] TITLE: Mental Health Services Act: Inpatient Treatment Funding FISCAL COMMITTEE: no URGENCY CLAUSE: no INTRODUCED: 01/16/2020 DISPOSITION: Pending LOCATION: Assembly Health Committee SUMMARY: Specifies, to the extent Mental Health Services Act funds are otherwise available for use, that those funds may be used to provide inpatient treatment, including involuntary treatment of a patient who is a danger to self or others or gravely disabled, in specified settings, including an acute psychiatric hospital, an institution for mental disease, and a mental health rehabilitation center. STATUS: 01/23/2020 To ASSEMBLY Committee on HEALTH. Commentary: Watch AB 1946 AUTHOR: Santiago [D] TITLE: Mental Health Services: Involuntary Detention FISCAL COMMITTEE: no URGENCY CLAUSE: no INTRODUCED: 01/17/2020 DISPOSITION: Pending LOCATION: ASSEMBLY SUMMARY: States the intent of the Legislature to enact legislation to reform the Lanterman -Petris-Short Act, including expanding the definition of gravely disabled to add a condition in which a person is unable Attachment B Page 18 of 78 8 to provide for their own medical treatment as a result of a mental health disorder, and emphasizing the necessity to create policies that prioritize living safely in communities. STATUS: 01/17/2020 INTRODUCED. Commentary: Watch AB 1948 AUTHOR: Bonta [D] TITLE: Taxation: Cannabis FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 01/17/2020 DISPOSITION: Pending COMMITTEE: Assembly Revenue and Taxation Committee HEARING: 03/09/2020 2:30 pm SUMMARY: Reduces the excise tax rate on the purchase of cannabis and cannabis products from 15% to 11% on and after the operative date of this bill until July 1, 2023, at which time the excise tax rate would revert back to 15%. Suspends the imposition of the cultivation tax on and after the operative date of this bill until July 1, 2023. STATUS: 01/30/2020 To ASSEMBLY Committees on REVENUE AND TAXATION and BUSINESS AND PROFESSIONS. Commentary: Watch AB 1950 AUTHOR: Kamlager-Dove [D] TITLE: Probation: Length of Terms FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 01/17/2020 DISPOSITION: Pending LOCATION: Assembly Public Safety Committee SUMMARY: Restricts the period of probation for a misdemeanor. STATUS: 01/30/2020 To ASSEMBLY Committee on PUBLIC SAFETY. Commentary: Watch AB 1954 AUTHOR: Cooley [D] TITLE: Foster Care: Relative and Sibling Placement FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 01/17/2020 DISPOSITION: Pending COMMITTEE: Assembly Human Services Committee HEARING: 03/24/2020 1:30 pm SUMMARY: Extends the definition of relative, for purposes of disposition of a child who is a dependent of the juvenile court due to abuse or neglect, to include caregivers of minor siblings who are in a permanent plan of adoption, legal guardianship, or placement w ith a fit and willing relative. Deletes the provision prohibiting the consideration and investigation of a relative placement from being a cause for continuance of the dispositional hearing. STATUS: 02/06/2020 To ASSEMBLY Committees on HUMAN SERVICES and JUDICIARY. Attachment B Page 19 of 78 9 AB 1979 AUTHOR: Friedman [D] TITLE: Foster Youth: Housing FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 01/23/2020 DISPOSITION: Pending COMMITTEE: Assembly Human Services Committee HEARING: 03/10/2020 1:15 pm SUMMARY: Requires a county placement agency to examine its ability to meet the emergency housing needs of nonminor dependents. Includes a transitional living setting approved by a county to support youth who are entering or reentering foster care or transitioning between placements, excluding a runaway and homeless youth shelter or adult homeless shelter, within the definition of a supervised independent living setting. STATUS: 02/06/2020 To ASSEMBLY Committee on HUMAN SERVICES. Commentary: Watch AB 2063 AUTHOR: Mullin [D] TITLE: Property Taxation: Welfare Exemption: Housing FISCAL COMMITTEE: yes URGENCY CLAUSE: yes INTRODUCED: 02/04/2020 DISPOSITION: Pending COMMITTEE: Assembly Revenue and Taxation Committee HEARING: 03/09/2020 2:30 pm SUMMARY: Decreases the percentage of occupants that are lower income household s required to qualify for the property tax exemption. Increases the total exemption amount allowed to a taxpayer. STATUS: 02/14/2020 To ASSEMBLY Committee on REVENUE AND TAXATION. AB 2064 AUTHOR: Patterson [R] TITLE: Emergency Preparedness: Access and Functional Needs FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 02/04/2020 LAST AMEND: 03/04/2020 DISPOSITION: Pending LOCATION: Assembly Governmental Organization Committee SUMMARY: Requires the Office of Emergency Services, in the next update of the State Emergency Plan, to include best practices for local governments and nongovernmental entities to use to mobilize and evacuate people with access and functional needs. Requires the Office to develop and update annually a guidance document for local governments regarding the lessons learned about emergency and natural disaster preparedness. STATUS: 03/04/2020 From ASSEMBLY Committee on GOVERNMENTAL ORGANIZATION with author's amendments. 03/04/2020 In ASSEMBLY. Read second time and amended. Re-referred to Committee on GOVERNMENTAL ORGANIZATION. AB 2266 AUTHOR: Quirk-Silva [D] TITLE: Mental Health Services Act: Use of Funds FISCAL COMMITTEE: yes Attachment B Page 20 of 78 10 URGENCY CLAUSE: no INTRODUCED: 02/14/2020 DISPOSITION: Pending LOCATION: Assembly Health Committee SUMMARY: Requires the Department of Health Care Services to establish a pilot program in up to 10 counties and authorizes funding from the Mental Health Services Act (MHSA) to be used by participating counties to treat a person with co-occurring mental health and substance abuse disorders when the person would be eligible for treatment of the mental health disorder pursuant to the MHSA. STATUS: 02/24/2020 To ASSEMBLY Committee on HEALTH. Commentary: Mr. Twa on CSAC Working Group. Send updates. AB 2289 AUTHOR: Nazarian [D] TITLE: Mental Health Services Fund FISCAL COMMITTEE: no URGENCY CLAUSE: no INTRODUCED: 02/14/2020 DISPOSITION: Pending LOCATION: ASSEMBLY SUMMARY: Makes technical, nonsubstantive changes relating to the Mental Health Services Fund. STATUS: 02/14/2020 INTRODUCED. Commentary: Mr. Twa on CSAC Working Group. Send updates. AB 2387 AUTHOR: Grayson [D] TITLE: In Home Supportive Services: Needs Assessment FISCAL COMMITTEE: no URGENCY CLAUSE: no INTRODUCED: 02/18/2020 DISPOSITION: Pending LOCATION: Assembly Human Services Committee SUMMARY: Relates to in home supportive services assessments. Authorizes counties to perform a needs assessment by telephone if certain conditions are met, including that the recipient has had at least one in person assessment since the initial program intake and the recipient has not changed their residence since the previous assessment. STATUS: 02/24/2020 To ASSEMBLY Committee on HUMAN SERVICES. Commentary: Our sponsored bill BOS: Support ACR 98 AUTHOR: Wicks [D] TITLE: Mental Health and Substance Use Treatment FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 06/04/2019 DISPOSITION: Pending LOCATION: Senate Health Committee SUMMARY: Urges specified state departments and the Attorney General to use their authority to ensure that health care service plans and health insurers subject to their authority comply with the federal Paul Attachment B Page 21 of 78 11 Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act. STATUS: 09/05/2019 Re-referred to SENATE Committee on HEALTH. Commentary: CSAC supports SB 45 AUTHOR: Allen [D] TITLE: Wildfire Prevention, Drinking Water, Drought, and Flood FISCAL COMMITTEE: yes URGENCY CLAUSE: yes INTRODUCED: 12/03/2018 LAST AMEND: 01/23/2020 DISPOSITION: Pending LOCATION: ASSEMBLY SUMMARY: Enacts the Wildfire Prevention, Safe Drinking Water, Drought Preparation, and Flood Protection Bond Act, which, if approved by the voters, would authorize the issuance of bonds to the State General Obligation Bond Law to finance projects for a wildfire preventio n, safe drinking water, drought preparation, and flood protection program. STATUS: 01/29/2020 In SENATE. Read third time, urgency clause adopted. Passed SENATE. *****To ASSEMBLY. (29-6) SB 50 AUTHOR: Wiener [D] TITLE: Planning and Zoning: Housing Development FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 12/03/2018 LAST AMEND: 01/06/2020 DISPOSITION: Failed LOCATION: SENATE SUMMARY: Requires a local agency to notify the development proponent in writing if the local agency determines that the development conflicts with any of the requirements provided for streamlined ministerial approval within 60 days of the submission of the development to the local agency. Authorizes a development proponent of a neighborhood multifamily project located on an eligible parcel to submit an application for a streamlined, ministerial approval proc ess that is not subject to a conditional use permit. STATUS: 01/30/2020 In SENATE. Read third time. Failed to pass SENATE. (18 -15) SB 54 AUTHOR: Allen [D] TITLE: Solid Waste: Packaging and Products FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 12/11/2018 LAST AMEND: 09/10/2019 DISPOSITION: Pending FILE: A-20 LOCATION: Assembly Inactive File SUMMARY: Amends the Alcoholic Beverage Control Act. Authorizes the Department of Alcoholic Beverage Control to suspend or revoke the certificate of compliance of an out of state vendor that fails to comply with the provisions of the State Circular Economy and Pollution Reduction Act. STATUS: 01/23/2020 In ASSEMBLY. From third reading. To Inactive File. Attachment B Page 22 of 78 12 SB 353 AUTHOR: Skinner [D] TITLE: Criminal Record Data Sharing and Research FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 02/19/2019 DISPOSITION: Failed LOCATION: SENATE SUMMARY: Specifies criminal court records, as defined, as part of criminal offender record information to be provided to the public agency or bona fide research body. STATUS: 02/03/2020 In SENATE. Returned to Secretary of Senate pursuant to Joint Rule 56. SB 596 AUTHOR: Stern [D] TITLE: In Home Supportive Services FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 02/21/2019 LAST AMEND: 01/23/2020 DISPOSITION: Pending LOCATION: ASSEMBLY SUMMARY: Requires a county human services agency to use existing materials to inform each applicant for benefits under the In Home Supportive Services program that the applicant may be eligible to receive that higher energy allowance and any advanced notifications that may be provided by a public utility, when the public utility plans to deenergize portions of the electrical distribution system or in an emergency. STATUS: 01/29/2020 In SENATE. Read third time. Passed SENATE. *****To ASSEMBLY. (38-0) Commentary: Watch SB 640 AUTHOR: Moorlach [R] TITLE: Mental Health Services: Gravely Disabled Persons FISCAL COMMITTEE: no URGENCY CLAUSE: no INTRODUCED: 02/22/2019 LAST AMEND: 01/06/2020 DISPOSITION: Failed LOCATION: SENATE SUMMARY: Authorizes a county to instead use a definition of gravely disabled for these purposes that would read, in part, a condition in which a person, as a result of a mental health disorder, is incapable of making informed decisions about, or providing for, the person's own basic personal needs for food, clothing, or shelter without significant supervision and assistance from another person and, as a result of being incapable of making these informed decisions, the person is at risk of substantial bodily harm. STATUS: 02/03/2020 In SENATE. Returned to Secretary of Senate pursuant to Joint Rule 56. SB 753 AUTHOR: Stern [D] TITLE: Public Social Services: Emergency Notification FISCAL COMMITTEE: yes URGENCY CLAUSE: no Attachment B Page 23 of 78 13 INTRODUCED: 02/22/2019 LAST AMEND: 01/15/2020 DISPOSITION: Pending LOCATION: ASSEMBLY SUMMARY: Permits elderly or disabled clients telephone numbers and email addresses to be disclosed. Specifically identifies a public safety power shut off as a public safety emergency. Requires a county social services agency that intends to disclose such information to notify elderly or disabled individuals receiving services of that fact and give the individual the option to opt out of having that information disclosed. STATUS: 01/27/2020 In SENATE. Read third time. Passed SENATE. *****To ASSEMBLY. (39-0) Commentary: EHSD recommends support, as amended. SB 773 AUTHOR: Skinner [D] TITLE: Land Use: Accessory Dwelling Units FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 02/22/2019 LAST AMEND: 01/06/2020 DISPOSITION: Pending LOCATION: ASSEMBLY SUMMARY: Deems a permit application for the creation of an accessory dwelling unit or junior accessory dwelling unit approved if the local agency has not acted upon the completed application within 60 days. STATUS: 01/27/2020 In SENATE. Read third time. Passed SENATE. *****To ASSEMBLY. (39-0) Commentary: Send by AL SB 776 AUTHOR: Skinner [D] TITLE: College Admissions: Criminal History Inquiry FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 02/22/2019 LAST AMEND: 01/06/2020 DISPOSITION: Pending LOCATION: ASSEMBLY SUMMARY: Prohibits a postsecondary educational institution in this state from inquiring about a prospective student's criminal history on an initial application fo rm or at any time during the admissions process before the institution's final decision relative to the prospective student's application for admission. STATUS: 01/27/2020 In SENATE. Read third time. Passed SENATE. *****To ASSEMBLY. (30-6) Commentary: watch SB 793 AUTHOR: Hill [D] TITLE: Flavored Tobacco Products FISCAL COMMITTEE: yes URGENCY CLAUSE: no Attachment B Page 24 of 78 14 INTRODUCED: 01/06/2020 DISPOSITION: Pending LOCATION: Senate Health Committee SUMMARY: Prohibits a tobacco retailer from selling, offering for sale, or possessing with the intent to sell or offer for sale, a flavored tobacco products. Makes a violation punishable as an infraction with specified penalties. STATUS: 01/15/2020 To SENATE Committee on HEALTH. Commentary: Dan Peddycord preparing an LOS. Consistent with 2019 Platform, #94. SB 852 AUTHOR: Pan [D] TITLE: Health Care: Prescription Drugs FISCAL COMMITTEE: no URGENCY CLAUSE: no INTRODUCED: 01/13/2020 DISPOSITION: Pending LOCATION: Senate Rules Committee SUMMARY: States the intent of the Legislature to introduce legislation to require the state to manufacture generic prescription drugs for the purposes of controlling prescription drug costs. STATUS: 01/31/2020 To SENATE Committee on RULES. Commentary: Watch SB 855 AUTHOR: Wiener [D] TITLE: Health Coverage: Mental Health or Substance Abuse FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 01/14/2020 DISPOSITION: Pending LOCATION: Senate Health Committee SUMMARY: Requires a health care service plan contract or health insurance policy that provides hospital, medical, or surgical coverage to provide coverage for the diagnosis and medically necessary treatment of mental health and substance use disorders under the sam e terms and conditions applied to other medical conditions. Authorizes certain individuals or entities to pursue a civil action against a health care service plan or health insurer for a violation of these provisions. STATUS: 01/31/2020 To SENATE Committees on HEALTH and JUDICIARY. Commentary: https://www.sfchronicle.com/business/article/California-bills-would-make-insurers-cover-more-1497 5239.php SB 889 AUTHOR: Skinner [D] TITLE: Juveniles FISCAL COMMITTEE: no URGENCY CLAUSE: no INTRODUCED: 01/24/2020 DISPOSITION: Pending LOCATION: Senate Rules Committee SUMMARY: States legislative intent to raise the age limit on the state's youth justice system. Attachment B Page 25 of 78 15 STATUS: 02/06/2020 To SENATE Committee on RULES. Commentary: Watch SB 946 AUTHOR: Pan [D] TITLE: Local Flood Protection Planning Act: Flood Plans FISCAL COMMITTEE: no URGENCY CLAUSE: no INTRODUCED: 02/10/2020 DISPOSITION: Pending COMMITTEE: Senate Natural Resources and Water Committee HEARING: 03/24/2020 9:30 am SUMMARY: Requires a local plan of flood protection to also include an identification of current and future weirs, bypasses, and other appurtenances. STATUS: 02/20/2020 To SENATE Committee on NATURAL RESOURCES AND WATER. Commentary: Steve Cruz sent SB 1349 AUTHOR: Glazer [D] TITLE: State Responsibility Area Fire Prevention Fees FISCAL COMMITTEE: yes URGENCY CLAUSE: no INTRODUCED: 02/21/2020 DISPOSITION: Pending LOCATION: SENATE SUMMARY: Changes the reference in the fire prevention fee provisions from the State Board of Equalization to the California Department of Tax and Fee Administration or the Office of Tax Appeals as appropriate. STATUS: 02/21/2020 INTRODUCED. Copyright (c) 2020 State Net. All rights reserved. Attachment B Page 26 of 78 LEGISLATION COMMITTEE 5. Meeting Date:03/09/2020   Subject:Federal Legislative Advocacy Services FY 2020-21 Submitted For: LEGISLATION COMMITTEE,  Department:County Administrator Referral No.: 2020-07   Referral Name: Federal Legislative Advocacy Services  Presenter: L. DeLaney Contact: L. DeLaney, 925-335-1097 Referral History: Alcalde & Fay, minority-controlled/employee-owned firm, is the County’s current federal representative. Paul Schlesinger, the County’s point person at Alcalde & Fay, has established the County’s presence in Washington, D.C. and developed excellent relationships with staff of our congressional delegation. The result has been a positive “return on investment” for the County for its appropriation and authorization requests. In August 2018, pursuant to its contract solicitation policies, the Legislation Committee directed staff to undertake a procurement process early in 2019 for the state and federal advocacy services for the period FY 2019/20 through FY 2021/22. CAO staff issued a Request for Qualifications on March 27, 2019 for the federal legislative advocacy services, to which three firms responded, including the incumbent firm.  A County Selection Committee of five interviewed the firms, evaluated, rated and ranked the proposals, and recommended to the Legislation Committee on May 13, 2019 that the contract be awarded to a firm for which the Legislation Committee did not achieve consensus on the recommendation, and the recommendation was forwarded to the Board of Supervisors for consideration without Committee endorsement.  The Board of Supervisors considered the matter on June 11, 2019 and rejected the recommendation from the County Selection Committee, acting instead to extend the current contract with Alcalde & Fay through June 30, 2020. The Board of Supervisors further directed the Legislation Committee to develop performance measurements to be incorporated into a new or amended contract upon Board approval. The County Administrator's Office was directed to seek the input of County departments to prioritize federal legislative initiatives and inform the development of performance metrics for federal legislative advocacy.  Referral Update: As the Alcalde & Fay federal advocacy services contract termination date of June 30, 2020 draws Page 27 of 78 As the Alcalde & Fay federal advocacy services contract termination date of June 30, 2020 draws nearer, staff requests direction from the Legislation Committee on the process for developing a contract for service for the period beginning July 1, 2020.  The contractor solicitation (Request for Qualifications) undertaken in 2019 anticipated a contract award for a three-year period, with two single year options to renew to the successful responder.  The contract with Alcalde & Fay provides for a monthly retainer of $8,458, plus expenses. The Service Plan for the contract is provided as Attachment A.  Alcalde & Fay continues to provide valuable information and advocacy efforts on behalf of Contra Costa County's federal legislative agenda. They routinely provide the County with relevant federal news and information, Federal Register entries, a weekly Grant Alert for Local Governments, appropriations requests support, consultation on advocacy and community engagement efforts, federal legislation summaries and fact sheets, Administration Budget Summaries, draft legislation support letters, notices of funding opportunities, and advocacy aligned with our adopted Federal Platform. Recommendation(s)/Next Step(s): DIRECT staff on the process for procuring federal advocacy services for the period beginning July 1, 2020. Attachments Attachment A: Service Plan Page 28 of 78 Attachment A Page 29 of 78 Attachment A Page 30 of 78 LEGISLATION COMMITTEE 6. Meeting Date:03/09/2020   Subject:H.R. 5823 State and Local Cybersecurity Improvement Act Submitted For: LEGISLATION COMMITTEE,  Department:County Administrator Referral No.: 2020-05   Referral Name: H.R. 5823 Cybersecurity Improvement Act  Presenter: Paul Schlesinger Contact: L. DeLaney, 925-335-1097 Referral History: The Legislation Committee is the body that reviews and makes recommendations to the Board of Supervisors on state and federal bills of interest to Contra Costa County for which adopted policy is not established. The 2020 Adopted Federal Legislative Platform does not contain policy regarding cybersecurity though it is a critical concern to all County departments.  Referral Update: The County's federal advocates from Alcade & Fay provided the following report:  H.R. 5823 , the State and Local Cybersecurity Improvement Act, was introduced by Congressman Cedric Richmond (D-LA-2) on February 10 th, 2020. Congressman Richmond chairs the Homeland Security Subcommittee on Cybersecurity, Infrastructure Protection, and Innovation. Congressman Richmond was joined by a bipartisan group of fourteen original cosponsors, including the ranking Republicans on the full Committee and Subcommittee. There are no California Representatives currently co-sponsoring the legislation. Immediately after its introduction, on February 12, it was marked up and ordered reported from Committee.  The bill, if enacted, will establish a grant program at the Department of Homeland Security for States to address cybersecurity risks and cybersecurity threats to state and local information systems. According to the press release, the specific features of the legislation are: Establishes a $400 million DHS grant program that incentivizes States to increase their own cybersecurity funding. Requires DHS’s Cybersecurity and Infrastructure Security Agency (CISA) develop a strategy to improve the cybersecurity of State, local, tribal, and territorial governments. Requires State, local, tribal, and territorial governments develop comprehensive Cybersecurity Plans to guide use of grant dollars. Establishes a State and Local Cybersecurity Resiliency Committee so State, local, tribal, and territorial governments can advise CISA on their cybersecurity needs.” In the press release, Committee Chairman Bennie Thompson (D-MS-2), an original co-sponsor, Page 31 of 78 said, “For too long, our State and local governments have had to fend for themselves as foreign adversaries and cyber criminals have targeted their networks. The State and Local Cybersecurity Improvement Act will provide long overdue resources and support to State, local, Tribal, and territorial governments across the country whose cyber defenses are outmatched by sophisticated adversaries.” Attachment A is a fact sheet on the bill, provided by the House Committee on Homeland Security. Recommendation(s)/Next Step(s): CONSIDER recommending to the Board of Supervisors a position of "Support" on H.R. 5823, the "State and Local Cybersecurity Improvement Act" and directing staff to send the item to the Board at the next available opportunity for their consideration on Consent. Attachments Attachment A: Fact Sheet HR 5823 Page 32 of 78 As prepared by the Committee on Homeland Security Majority Staff The “State and Local Cybersecurity Improvement Act” As Introduced by Rep. Richmond (D-LA), Rep. Katko (R-NY), Rep. Kilmer (D-WA), Rep. McCaul (R-TX), Rep. Ruppersberger (D-MD), Chairman Thompson (D-MS), and Ranking Member Rogers (R-AL) The State and Local Cybersecurity Improvement Act would authorize a new Department of Homeland Security (DHS) grant program to address cybersecurity vulnerabilities on State and local government networks. State and local governments are rich targets for cyber adversaries and the frequency of attacks is accelerating. In 2019, ransomware attacks crippled State and local agencies in Louisiana, the City of Baltimore, MD, 23 towns in Texas, a school district in Syracuse, and many other communities scattered across the country. Cities from Albany to Atlanta have been impacted– to the tune of nearly $20 million, in some cases. The Federal government needs to redouble its efforts at partnering with State and local governments to build robust cybersecurity defenses. The State and Local Cybersecurity Improvement Act will improve the ability of State and local governments to detect and defend against cyber-attacks by authorizing dedicated resources and support. The State and Local Cybersecurity Improvement Act: • Establishes a $400 million DHS grant program with a graduating cost-share that incentivizes States to increase funding for cybersecurity in their budgets; • Requires the Cybersecurity and Infrastructure Security Agency (CISA) to develop a Strategy to Improve the Cybersecurity of State, Local, Tribal, and Territorial Governments to, among other things, identify Federal resources that could be made available to State and local governments for cybersecurity purposes and set baseline objectives for State and local cybersecurity efforts; • Requires State, Tribal, and territorial governments to develop comprehensive Cybersecurity Plans to guide use of grant dollars; Attachment A Page 33 of 78 As prepared by the Committee on Homeland Security Majority Staff • Establishes a State and Local Cybersecurity Resiliency Committee comprised of representatives from State, local, Tribal, and territorial governments to advise and provide situational awareness to CISA regarding the cybersecurity needs of State, local, Tribal, and territorial governments; and • Requires CISA to assess the feasibility of implementing a short-term rotational program for the detail of approved State, local, Tribal, and territorial government employees in cyber workforce positions at CISA. Today, State and local governments are not in the position to defend their networks against the cyberattacks from sophisticated foreign adversaries or cyber criminals. Stretched State and local budgets have not adequately funded cybersecurity. Despite the potential national security consequences of a cyberattack against a State or local government, the Federal government has been slow to act. Passage of the State and Local Cybersecurity Improvement Act is an important first step toward defending State and local networks. The State and Local Cybersecurity Improvement Act requires both the Federal government and its State, Tribal, and territorial partners to develop strategies to bolster State and local cybersecurity capabilities and provides funding to ensure those strategies are implemented. Investing in cybersecurity before a cyberattack saves money, protects important data housed on State and local networks, and ensures State and local governments can continue to provide the important services Americans rely on. Attachment A Page 34 of 78 LEGISLATION COMMITTEE 7. Meeting Date:03/09/2020   Subject:Recommendations from the Contra Costa County Mental Health Commission Submitted For: LEGISLATION COMMITTEE,  Department:County Administrator Referral No.: 2020-08   Referral Name: MHC Recommendations  Presenter: L. DeLaney Contact: L. DeLaney, 925-335-1097 Referral History: During the Contra Costa County Mental Health Commission meeting on February 5, 2020, two motions were passed for the Contra Costa County Board of Supervisors' Legislation Committee's consideration at its March meeting. Referral Update: The first motion relates to the use of Mental Health Services Act (MHSA) funds: "We, the Contra Costa County Mental Health Commission, urge Contra Costa County Board of Supervisors and Behavioral Health Director to support our position regarding Mental Health Services Act (MHSA) programs and funding. We do not want the MHSA to be repurposed in any way from the original intent, purposes and funding requirements that were approved by Californians in 2004. Per the original intent services are to be consumer driven, family focused, based in the community, culturally and linguistically competent, and integrated with other appropriate health and social services. In addition, we want to emphasize that the requirement remain for the County’s MHSA Three Year Program and Expenditure Plan and Annual Updates be developed with the active participation of local stakeholders in a community program planning process, and approved by the Contra Costa County Board of Supervisors." Attachment A includes the MHSA Three Year Program and Expenditure Plan for FY 2020-23, Outline of Draft Plan, prepared by CC Health Services, the "MHSA Three Year Program and Expenditure Plan" prepared by the Contra Costa Behavioral Health Division, and a copy of an article from POLITICO Pro related to the Governor's plans to revamp MHSA. The CSAC Board of Directors is interested in what changes to MHSA that could be made by the Governor and Legislature that would not trigger a ballot measure. Merely clarifying the language would only require a majority vote of the Legislature. Furthering the intent of MHSa would require a 2/3 vote of the Legislature (e.g., expanding the definition of Substance Abuse Disorder treatment), and substantial change (such as changing the percent of fund balance allowed to be retained) would require a ballot measure. CSAC expects their Working Group (of which the Page 35 of 78 County Administrator David Twa is a member) to be close to a final document for the CSAC Board to consider at an upcoming meeting. The second motion relates to the Institutions for Mental Diseases (IMD) waiver: "We, Contra Costa County Mental Health Commission, ask Contra Costa County Board of Supervisors to support permanent repeal of the Institute of Mental Diseases (IMD) Medi-Cal reimbursement exclusion as requested by the National Association of Attorney’s General (NAAG) letter to federal congressional leadership." (Attachment B ) Since Medicaid’s inception in 1965, federal policy has barred using federal Medicaid funds for care provided to most patients in mental health and substance use disorder residential and inpatient treatment facilities larger than 16 beds — known as “institutions for mental disease” (IMD). This federal policy is known as the IMD exclusion. In 2018, federal policy changed to allow states to seek a waiver of this rule if certain requirements are met. California’s Department of Health Care Services plans to assess stakeholder interest in pursuing such a waiver, which could offer an opportunity to free up local funds to invest in other community services and supports that many communities say are sorely lacking. Such a waiver would require that communities develop and demonstrate a robust continuum of care so that patients could be “stepped down” to community-based care as their condition improves. Recommendation(s)/Next Step(s): CONSIDER the recommendations of the Contra Costa County Mental Health Commission and direct staff, as needed. Attachments Attachment A Attachment B Page 36 of 78 Mental Health Services Act (MHSA) Three Year Program and Expenditure Plan for FY 2020-23 OUTLINE OF DRAFT PLAN 3/1/20 1Version #2 Attachment A Page 37 of 78 FY 20-23 Plan Summary •The Three Year Plan proposes to set aside approximately $67.8 million for fiscal years 2020-23 to fund 85 programs and plan elements. This proposes an additional $13 million in budget authority authorized by the Board of Supervisors in June 2019. •The $13 million increase is requested to fund prioritized service needs determined by our Community Program Planning Process, to include significant additional dollars for supportive housing for persons with serious mental illness, and projected annual increases in the cost of doing business. •This continues the Board approved strategy to spend down the County’s MHSA unspent fund balance in order to prevent reversion to the State. •It is anticipated that current total budget spending authority will not need to be reduced in order to fully fund MHSA programs and plan elements for the three year period. 3/1/20Version #2 2 Attachment A Page 38 of 78 Plan Outline Summary •Executive Summary •Table of Contents •Vision •Community Program Planning Process •The Plan •The Budget •Evaluating the Plan •Acknowledgements •Appendices o Mental Health Service Maps o Program and Plan Element Profiles o Glossary o Certifications, Funding Summaries o Public Comment and Hearing o Board Resolution 3/1/20Version #1 3 Attachment A Page 39 of 78 Executive Summary •Provides an overview of MHSA, MHSA values, statutory and regulatory requirements •Highlights program updates and changes to the current Three Year Plan, to include the Community Program Planning Process •Summarizes the overall budget increase, focus on supportive housing, and strategy to spend down the County’s MHSA unspent fund balance o Approximately 41% of budget authority is now dedicated to assisting individuals get and keep housing that is integrated in the community •Outlines where performance indicators and program outcomes are located in the plan 3/1/20Version #2 4 Attachment A Page 40 of 78 Vision We intend to utilize MHSA funding to assist Contra Costa Behavioral Health Services in addressing three key areas: •Improve access to community mental health and substance use disorder care that is culturally and linguistically responsive to the diverse communities that we serve. •Partner with clients and their families to determine and provide the level and type of care needed, and coordinate for other needed resources. •Work with our health, behavioral health and community partners as a team to provide multiple services coordinated to a successful resolution. We need to continually challenge ourselves to improve our response to individuals and their families who need us the most, and may have the most difficult time accessing care. 3/1/20Version #2 5 Attachment A Page 41 of 78 Needs Assessment Provides a quantitative assessment of behavioral health needs that complement the Community Program Planning Process. •The County is proportionally serving all three regions. Asian/Pacific Islanders and children ages 0-5 are slightly underrepresented on our caseloads -all service rates exceed statewide averages. •Expenditure data indicate significant services available at all levels of care, with an oversubscription of funds paying for locked facilities. •Workforce analysis indicate a shortage of psychiatry time and clinicians who speak languages other than English. 3/1/2019Version #2 6 Attachment A Page 42 of 78 Community Program Planning Process •Describes the process •Describes the Consolidated Planning and Advisory Workgroup and ongoing stakeholder participation •Describes and summarizes results of the recently completed Community Program Planning Process and community forums for FY 2020-21 •Links prioritized needs to MHSA funded programs, projects and plan elements contained in the Three Year Plan 3/1/20Version #2 7 Attachment A Page 43 of 78 Community Program Planning Process Prioritized Service Needs FY 20-21: FY 19 -20: 1.More housing and homeless services 1. 2.More support for family members and loved ones of consumers 3. 3.Support for peer and family partner providers 11. 4.Outreach to the underserved –provide care in my community, 2. 5.Improved response to crisis and trauma 4. 6.Connecting with the right service providers in your community 5. 7.Better coordination of care 6. 8.Children and youth in-patient and residential beds 9. 9.Intervening early in psychosis 8. 10.Getting to and from services 7. 11.Serve those who need it the most 10. 12.Care for homebound frail and elderly 13. 13.Increased psychiatry time 12. 14.Assistance with meaningful activity 14. 3/1/20Version #2 8 Attachment A Page 44 of 78 The Plan •Community Services and Supports (CSS) •Prevention and Early Intervention (PEI) •Innovation (INN) •Workforce Education and Training (WET) •Capital Facilities and Technology (CF/TN) Each component leads with a short description of the component and categories within the component, and then lists and describes each program or plan element, cost allocated, and number to be served. 3/1/2019Version #2 9 Attachment A Page 45 of 78 Community Services and Supports $47.6 million to fund programs and plan elements that provide services to approximately 2,000 individuals -children who are seriously emotionally disturbed, transition age youth (TAY), adults and older adults who are seriously mentally ill. •Full Service Partnerships (FSPs) ($31m): o 9 FSP Programs serving all age groups and all county regions – NEW ACT to fidelity with flexible supportive housing funds o Assisted Outpatient Treatment o FSP support staff at all children and adult clinics o 3 Wellness and Recovery Centers o Hope House (transitional residential center) o MHSA funded housing services (temporary, supported and permanent) - NEW –more funding for augmented board & care and housing supports •General System Development ($16.6m): o Children’s Wraparound and EPSDT expansion o Older Adult Program o Clinic support Staff –NEW –MH Specialists as case managers -adult o Clinic staff at PES, CCRMC, Miller Wellness Center, Concord Health Center o Administrative support and quality assurance staff 3/1/2019Version #2 10 Attachment A Page 46 of 78 Prevention and Early Intervention (1) $10.6 million to fund 25 MHSA programs that provide prevention and early intervention services to approximately 33,000 individuals. All are designed to prevent mental illness from becoming severe and debilitating, and 1) creates access and linkage to mental health services, 2) reduces stigma and discrimination, and 3) provides outreach and engagement to underserved populations. All programs are in the following 7 categories: 1.Seven programs provide Outreach for Increasing Recognition of Early Signs of Mental Illness ($2m) NEW –adding Early Childhood Mental Health Program 2.Five programs provide Prevention Services that reduce risk factors and increase protective factors ($1.8m) 3/1/20Version #2 11 Attachment A Page 47 of 78 Prevention and Early Intervention (2) 3. The First Hope program provides Early Intervention Services for youth at risk of or who are experiencing early onset of psychosis or a first episode ($3m) 4. Three programs provide Access and Linkage to Mental Health Services ($.75m) 5. Six programs Improve Timely Access to Mental Health Services for Underserved Populations ($1.7m) 6. The Office for Consumer Empowerment (OCE) provides leadership and staff support that addresses efforts to Reduce Stigma and Discrimination ($.35m) 7. Contra Costa Crisis Center and County staff address Suicide Prevention ($.8m) NEW –increased funding for county wide suicide prevention education and training •Administration and Evaluation ($.2m) 3/1/20Version #2 12 Attachment A Page 48 of 78 Innovation $2.8 million in FY 2020-21 to fund new or different patterns of service that contribute to informing the mental health system of care as to best or promising practices that can be subsequently added or incorporated into the system. o Coaching to Wellness. ($.2m) Adding peer wellness coaches to the adult clinics o Partners in Aging . ($.2m) Support for frail, homebound older adults o Overcoming Transportation Barriers . ($.1m) Assisting consumers overcome transportation barriers to accessing services o CORE ($1.4m) Multi-disciplinary intensive care treatment team to serve youth with mental health and substance use disorders o CBSST ($.5) Bringing cognitive behavioral social skills training to clients living in augmented board and care facilities o Administration and Project Evaluation (.4m) 3/1/20Version #2 13 Attachment A Page 49 of 78 Workforce Education and Training $3 million annually from Contra Costa’s MHSA unspent funds to recruit, support and retain a diverse, qualified paid and volunteer workforce. The five WET categories are: 1.Workforce Staffing Support. ($1.4m) Funds the county operated senior peer counseling program, NAMI’s family volunteer support network, and WET administrative staff 2.Training and Technical Assistance. ($.4 m) Funds Mental Health First Aid, Crisis Intervention Training, NAMI Basics/Faith Net/de Familia a Familia and various county and contract staff trainings 3.Mental Health Career Pathway Programs. ($.4m) Funds the college accredited SPIRIT course where approximately 50+ individuals yearly are trained as peer providers and family partners 4.Internship Programs. ($.5m) Provides approximately 75 graduate level clinical intern placements in county and contract operated community mental health programs to increase workforce diversity NEW –more funding to recruit interns with multiple language proficiencies 5.Financial Incentive Programs. ($.3m) Establishes a locally administered loan repayment program to address workforce shortages and support upward mobility of community support workers/peer/family specialists 3/1/20Version #2 14 Attachment A Page 50 of 78 Capital Facilities and Information Technology This component enables counties to utilize MHSA funds on a one -time basis for major infrastructure costs necessary to implement mental health services and supports, and to generally improve support to the County’s behavioral health system. For FY 20-21: •Capital Facilities o NEW -$3.2m to renovate two county owned buildings at the Oak Grove site for supportive housing and FSP services to transition age youth o NEW -$.3m to re-purpose two county owned buildings at Sherman Drive site for Short Term Residential Program for high acuity children ages 8-15 •Information Technology o NEW -$.5m to build data management capacity into the County’s electronic health record and ShareCare systems for better behavioral health decision-making and communication with stakeholders 3/1/20Version #2 15 Attachment A Page 51 of 78 The Budget •Provides estimated available funds, revenues, expenditures and projected fund balances by component for Fiscal Years 20-23 •Projected revenues include state MHSA Trust Fund distribution and interest earned •The County currently maintains a prudent reserve of $7.5 million to ensure that services do not have to be significantly reduced in years in which revenues are below the average of previous years. It is projected that an additional $4.4 million can be transferred to the Prudent Reserve during the Three Year Plan •A collective increase in budget authority for 20-23 proposes an increase in the cost of doing business, and is subject to Board of Supervisor approval •It is projected that the requested budget enables the County to fund all proposed programs while maintaining sufficient funding reserves 3/1/20Version #2 16 Attachment A Page 52 of 78 Evaluating the Plan •Describes a program and fiscal review process with written report to determine whether MHSA funded programs: o Meet the letter and intent of MHSA o Support the needs, priorities and strategies identified in the community program planning process o Meet agreed upon outcomes and objectives o Are cost effective •Includes a quarterly MHSA financial report to enable ongoing fiscal accountability. 3/1/20Version #2 17 Attachment A Page 53 of 78 Acknowledgements A thank you to individuals who shared their stories, provided input, and who are working to make the system better. 3/1/20Version #2 18 Attachment A Page 54 of 78 Appendix A -Mental Health Service Maps Provides six one page pictorials of all Contra Costa Mental Health’s services broken down by the following: •East County adult, older adult and transitional age youth •East County Children’s •Central County adult, older adult and transitional age youth •Central County Children’s •West County adult, older adult and transitional age youth •West County Children’s 3/1/20Version #2 19 Attachment A Page 55 of 78 Appendix B -Program Profiles Provides a profile of each MHSA funded program according to the following outline: •Organization contact information •Brief organization description •Title(s) and brief description(s) of MHSA funded program o Total MHSA funds allocated o FY 18-19 outcomes •Contains an alphabetized Program Profile Table of Contents 3/1/20Version #2 20 Attachment A Page 56 of 78 Appendix C -Glossary Provides an alphabetical listing and definition of terms and acronyms used in the document. 3/1/20Version #2 21 Attachment A Page 57 of 78 Appendix D –Certifications Appendix E -Funding Summaries •County Behavioral/Mental Health Director Certification •County Fiscal Accountability Certification •MHSOAC required funding summaries 3/1/20Version #2 22 Attachment A Page 58 of 78 Appendix F -Public Comment, Hearing Appendix G –Board Resolution •Will include evidence of Public Comment period and Hearing, and summary of public comments. •Mental Health Commission’s review of draft plan and recommendations. •Contra Costa Behavioral Health Service’s response to public comments and Mental Health Commission recommendations. •Board of Supervisor Resolution 3/1/20Version #2 23 Attachment A Page 59 of 78 Timeline •MAR -DRAFT Three Year Plan shared with CPAW/MHC for input, posted for 30 day comment period •APR -Mental Health Commission (MHC) hosts Public Hearing on Three Year Plan •MAY –Public Comment, Hearing and MHC recommendations addressed -Three Year Plan submitted to County Administrator for inclusion on Board of Supervisors’ (BOS) agenda •JUN –BOS considers Three Year Plan 3/1/20Version #2 24 Attachment A Page 60 of 78 Your Input Is Most Welcome! Point of Contact: Warren Hayes MHSA Program Chief 1220 Morello Avenue, Suite 100 925-957-2616 warren.hayes@cchealth.org 3/1/20 25Version #1 Attachment A Page 61 of 78 Attachment APage 62 of 78 Attachment APage 63 of 78 Attachment APage 64 of 78 Attachment APage 65 of 78 Attachment APage 66 of 78 Attachment APage 67 of 78 Attachment APage 68 of 78 Attachment A Page 69 of 78 Attachment A Page 70 of 78 Attachment A Page 71 of 78 Attachment A Page 72 of 78 August 5, 2019 The Honorable Nancy Pelosi The Honorable Kevin McCarthy Speaker of the House Minority Leader U.S. House of Representatives U.S. House of Representatives H-232, The Capitol H-204, The Capitol Washington, DC 20515 Washington, DC 20515 The Honorable Mitch McConnell The Honorable Charles Schumer Majority Leader Minority Leader U.S. Senate U.S. Senate S-230, The Capitol S-221, The Capitol Washington, DC 20510 Washington, DC 20510 Dear Speaker Pelosi, Minority Leader McCarthy, Majority Leader McConnell, and Minority Leader Schumer, The undersigned attorneys general share your concern about the impact of the opioid epidemic on our country. As President Trump has recognized in the National Drug Control Strategy he released earlier this year, the opioid crisis has resulted in more American deaths in just two years than in the course of the entire Vietnam War. In 2017, there were more than 70,200 drug overdose deaths in the United States. More than 47,500 of these deaths involved an opioid, and more than half of these deaths involved a synthetic opioid such as illicit fentanyl or one of its analogues. The impact of the epidemic has been so pervasive and so severe that life expectancy in the United States has declined for three years in a row for the first time since the influenza pandemic of 1918. The epidemic has contributed to a rise in Hepatitis C and heart valve infections (endocarditis), a rise in the number and rate of hospitalizations associated with drug withdrawal in newborns, and other significant and costly health impacts. This loss of life and these major health consequences are matched by significant and continuing costs imposed on our criminal justice and social service systems. And the economic cost of the opioid crisis exceeded $500 billion in 2015 – equal to 2.8 percent of the U.S. Gross Domestic Product (GDP) that year – according to the White House Council of Economic Advisers. We all understand that effective treatment is key to saving lives and helping to stop this epidemic. In particular, research shows that Medication-Assisted Treatment (MAT) – the use of medications, in combination with counseling and behavioral therapies – is a highly effective approach to the treatment of opioid use disorders. 1850 M Street, NW Twelfth Floor Washington, DC 20036 Phone: (202) 326-6000 http://www.naag.org/ Attachment B Page 73 of 78 Unfortunately, there are three significant barriers to treating opioid use disorder that we cannot change at the state level and that must be tackled at the federal level. We share these barriers below in the hope that we can work together to remove them and allow more providers to offer treatment for opioid use disorder and other substance use disorders. 1. Replace the cumbersome, out-of-date, privacy rules contained in 42 CFR Part 2 with the effective and more familiar privacy rules contained in the Health Insurance Portability and Accountability Act (HIPAA). 42 CFR Part 2 sets forth strict requirements for the use and disclosure of patients’ substance use disorder treatment records. The complexities of complying with 42 CFR Part 2 often prevent general practice providers from even attempting to treat patients with substance use disorders through the use of medication-assisted treatment (MAT), because – while providers are familiar with how to comply with the privacy requirements of HIPAA – they may be intimidated by the requirements of 42 CFR Part 2. This regulatory scheme also sets up a strange situation in which office-based MAT providers do not have to follow the specialized requirements of 42 CFR Part 2 unless they advertise to the public that they provide MAT. So, in an era when we are trying to promote access to MAT, we are encouraging office-based MAT providers to keep secret the fact that they provide this life- saving service so they can avoid the cumbersome 42 CFR Part 2 rules. These privacy rules were created more than 40 years ago in a time of intense stigma surrounding substance use disorder treatment. They were created to assure patients that they would not face adverse legal or civil consequences when seeking treatment by protecting confidentiality of substance use disorder patient records. Unfortunately, they now serve to perpetuate that stigma, as the principle underlying these rules is that substance use disorder treatment is shameful and records of it should be withheld from other treatment providers in ways that we do not withhold records of treatment of other chronic diseases. While maintaining confidentiality is imperative to encouraging individuals to seek and obtain treatment, the inability to share records among providers can burden coordination of care, potentially resulting in harm to the patient. To be effective in fighting the opioid epidemic, we must treat substance use disorder as the chronic disease that it is—and that means aligning the rules regarding disclosure of substance use disorder treatment records with the protections against unwanted disclosure of patient records already contained in HIPAA, particularly as it relates to disclosure of substance abuse treatment information to authorized providers. In seeking needed changes in 42 CFR Part 2, we are joined by Democratic and Republican lawmakers in both houses of Congress. In the House, the Overdose Prevention and Patient Safety Act (OPPS Act) (H.R. 2062) was introduced by Reps. Markwayne Mullin (R-OK) and Earl Blumenauer (D-OR); and in the Senate, the Protecting Jessica Grubb’s Legacy Act (Legacy Act) (S. 1012) was introduced by Sens. Joe Manchin (D-WV) and Shelley Moore Capito (R- WV). Both bills will align Part 2 with HIPAA for the purposes of health care treatment, and both are supported by the Partnership to Amend 42 CFR Part 2, a growing coalition of more than Attachment B Page 74 of 78 40 national health care organizations that includes the American Hospital Association, the American Psychiatric Association, and the American Society of Addiction Medicine. 2. Pass H.R. 2482, the Mainstreaming Addiction Treatment (MAT) Act, and eliminate unnecessary burdens on buprenorphine prescribing imposed by the Drug Addiction Treatment Act of 2000 (DATA 2000). DATA 2000 was a step forward in substance use disorder treatment because it allowed the treatment of opioid use disorder in an office-based setting. However, it created a cumbersome bureaucratic system whereby providers who wish to prescribe buprenorphine in an office-based setting must prove to the Substance Abuse and Mental Health Services Administration (SAMHSA) that they have taken special trainings and then apply to the Drug Enforcement Administration (DEA) for a special DEA “X” number to indicate when buprenorphine is being prescribed to treat substance use disorder. This is the only drug on the market for which prescribers have to prove they have received specialized training in order to prescribe the drug. This requirement was put in place well before the rapid rise in opioid use disorder and opioid overdose deaths that have become a national crisis. Just as opioid use disorder and opioid overdose deaths have risen dramatically in recent years, so the need for MAT with buprenorphine has risen just as dramatically. Because the need for MAT is far out-pacing the availability of such treatment, it is time to reconsider the DATA 2000 regulatory framework and other barriers that stand in the way of expanded use of buprenorphine to treat opioid use disorder and help prevent opioid overdose deaths. The fact is that, as a partial agonist, buprenorphine is a safer drug than opioid agonists such as oxycodone and fentanyl that are readily prescribed without any requirements for training or specialized DEA numbers. So, doctors need not prove any special training to prescribe more addictive opioid pain killers but must follow complicated bureaucratic steps to prescribe a less addictive opioid (buprenorphine) for substance use disorder treatment. Buprenorphine should not be singled out from all other drugs because it is a treatment for substance use disorder. Providers should be trained to prescribe buprenorphine the same way they are trained to prescribe other drugs – in medical schools, nurse practitioner schools, medical residencies, and continuing medical education. The stigma-based policy is endangering lives by suppressing access to treatment and should be changed. In our effort to eliminate this antiquated policy that restricts a healthcare provider’s ability to prescribe buprenorphine, we are joined by a coalition of 22 states, led by the New York State Department of Health, seeking exactly this change. H.R. 2482, the Mainstreaming Addiction Treatment (MAT) Act, would address this issue by eliminating the redundant and outdated requirement that practitioners apply for a separate waiver through the DEA to prescribe buprenorphine for the treatment of substance use disorder. We urge Congress to pass – and President Trump to sign – the MAT Act or similar legislation as expeditiously as possible. Attachment B Page 75 of 78 3. Fully repeal the Medicaid Institutions for Mental Diseases (IMD) exclusion. The Institutions for Mental Diseases (IMD) exclusion generally prohibits state Medicaid programs from receiving federal reimbursement for adults between 21 and 65 receiving mental health or substance use disorder treatment in a residential treatment facility with more than 16 beds. This arcane federal policy, while well intentioned at its inception to encourage treatment in community-based settings, has proven to detrimentally limit states’ ability to provide the full continuum of clinically appropriate care for Medicaid enrollees with a substance use disorder. We join the National Governor’s Association and a wide range of health care and public health groups in calling on the Administration to continue working with states to expedite approval of IMD waivers, while also recognizing the need for a permanent, statutory solution to resolve this issue for all states. The recently-enacted Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) Act took a step in the right direction, but it did not go far enough. The SUPPORT Act partly eliminates the IMD exclusion for a five-year period by allowing states to cover IMD services to people with at least one substance use disorder for up to 30 days over a 12-month period under certain circumstances. Congress needs to go further, by fully repealing the IMD exclusion. We applaud the federal government for its recent constructive steps to address the opioid epidemic through both legislative and executive action, but we all know that there is more work to be done. By making the changes recommended, Congress would make effective treatment for opioid use disorders more widely and readily available so that we can save more lives and help turn the tide on this crisis. Thank you for your consideration. Sincerely, Josh Stein Mike Hunter North Carolina Attorney General Oklahoma Attorney General Kevin G. Clarkson Leslie Rutledge Alaska Attorney General Arkansas Attorney General Xavier Becerra Phil Weiser California Attorney General Colorado Attorney General Attachment B Page 76 of 78 William Tong Kathleen Jennings Connecticut Attorney General Delaware Attorney General Karl A. Racine Ashley Moody District of Columbia Attorney General Florida Attorney General Clare E. Connors Lawrence Wasden Hawaii Attorney General Idaho Attorney General Kwame Raoul Tom Miller Illinois Attorney General Iowa Attorney General Jeff Landry Aaron M. Frey Louisiana Attorney General Maine Attorney General Maura Healey Dana Nessel Massachusetts Attorney General Michigan Attorney General Keith Ellison Jim Hood Minnesota Attorney General Mississippi Attorney General Tim Fox Douglas Peterson Montana Attorney General Nebraska Attorney General Aaron D. Ford Gordon MacDonald Nevada Attorney General New Hampshire Attorney General Attachment B Page 77 of 78 Hector Balderas Letitia James New Mexico Attorney General New York Attorney General Wayne Stenehjem Dave Yost North Dakota Attorney General Ohio Attorney General Ellen F. Rosenblum Josh Shapiro Oregon Attorney General Pennsylvania Attorney General Peter F. Neronha Jason R. Ravnsborg Rhode Island Attorney General South Dakota Attorney General Herbert H. Slatery III Sean Reyes Tennessee Attorney General Utah Attorney General T.J. Donovan Mark R. Herring Vermont Attorney General Virginia Attorney General Robert W. Ferguson Patrick Morrisey Washington Attorney General West Virginia Attorney General Joshua L. Kaul Wisconsin Attorney General Attachment B Page 78 of 78