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:
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53 Californians are confirmed as having coronavirus.
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9,400 people in 49 counties are being monitored.
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Attorney General Xavier Becerra warned against price gouging on products such as hand sanitizer that could be used to fend off coronavirus.
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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:
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Bernie Sanders: 1.57 million votes, 33.8%.
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Joe Biden: 784,341, 25.1%
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Proposition 13 school bond, 44.6% for it and 55.4% against.
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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/
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:
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Regional uniform fee programs that help eliminate the “first-in” problem.
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Assessing fees by square feet rather than unit, which can be a disincentive to build smaller units, and
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Deferral programs to help reduce borrower costs for developers.
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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.
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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.
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Panelists had a number of recommendations for the committee members to contemplate, including:
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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;
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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
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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 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:
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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.
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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.
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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.
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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. |