A New Administration With A Focus On Health Care

January 2019 marks the beginning of Governor Gavin Newsom’s Administration and the first time California has had a self-proclaimed “health care Governor.” As leaders in the health care community, this marks a historic opportunity for California’s community health centers, not only because of the Administration’s focus on health care, but also because of the comprehensive and holistic understanding of how health, economics, and social factors all contribute to the health and wellbeing of a community.  The new Governor readily and passionately speaks about the impact of social determinants of health on a person’s life, the need to screen both children and adults for adverse childhood experiences (ACEs), and the importance of committing resources to children, their families and their communities early on and consistently.  His January budget and early policy proposals reflect these values. Health centers are not only well positioned for this change in state leadership, but are critical and necessary partners for California’s ultimate success.

CaliforniaHealth+ Advocates (Advocates) is strongly encouraged by the Administration’s clear commitment to universal health care, demonstrated by the expansion of coverage to undocumented adults ages 19 through 25 and expanding coverage subsidies for families up to 600 percent of the Federal Poverty Level.  While strongly committed to the people of California, the Administration also acknowledges the practical realities of providing access to all, a reality that is exacerbated by the state’s current health care workforce crisis. The budget rightly commits $33 million annually to the Song-Brown workforce residency funding to ensure we close the gap and meet the needs.

Perhaps the boldest initiative of his tenure so far is the Executive Order (EO), N-01-19, which creates a single-purchaser system for prescription drugs in California. The goal of the EO is to lower the price of drugs for the state of California and possibly privately insure Californians as well. Advocates commends his willingness to take on challenging policy issues. However, we are gravely concerned that the pharmacy benefit is slated to be carved out of the Medi-Cal managed care benefit, and instead administered by the state as a fee-for-service program.  In addition to harming the integration of care and the medication oversight provided by the plans and providers, the proposal also eliminates the 340B Drug Discount Program in Medi-Cal managed care in 2021. Advocates’ is working diligently with health centers, hospitals and plan partners to educate the Administration on the importance of keeping pharmacy in Medi-Cal managed care and how 340B savings play an essential role in the larger health care delivery system and how it can be leveraged to meet the Administration’s broader health goals.

Key Voices in the Administration

Soon after Gavin Newsom was elected as Governor he chose the following individuals to fill key posts within his administration:

  • Ana Matosantos as Cabinet Secretary: Ms. Matosantos was most recently the budget and policy consultant for the Public Policy Institute of California

  • Richard Figueroa as Deputy Cabinet Secretary: Mr. Figueroa was Director of Prevention for The California Endowment, the nation’s largest state-specific health care foundation. 

  • Tam Ma as Deputy Legislative Secretary: Ms. Ma was assistant secretary of the Office of Program and Fiscal Affairs at the California Health and Human Services Agency.

  • Dr. Nadine Burke Harris as Surgeon General: Dr. Burke Harris, a pediatrician, is the founder and former CEO of Center for Youth Wellness (CYW).

  • Dr. Mark Ghaly as Secretary of the California Health and Human Services Agency: Dr. Ghaly, a pediatrician, previously served as director of health and social impact for Los Angeles County.   

Advocates has made it a top priority to build and strengthen relationships with the aforementioned individuals and share our desire to partner in reforming and strengthening the health care delivery system in California. 

In December of 2018, Cabinet Secretary Ana Matosantos, at the invitation of our CEO Carmela Castellano-Garcia, met with the California Primary Care Association (CPCA) and Advocates leadership and board to share the priorities of then incoming Governor Newsom. This meeting was also an opportunity for our health center leaders to educate Ms. Matosantos on our 2019 legislative and budget priorities, the important role health centers play in California and offer solutions on how to address the issues that are important to not only our patients and health centers, but the Governor as well.

In May 2019, at the personal invitation of Jim Mangia, CEO of St. John’s Well Child & Family Center, President and CEO of CaliforniaHealth+ Advocates, Carmela Castellano-Garcia, joined Governor Newsom during a tour of St. John’s Well Child & Family Center, where she had a promising conversation with the Governor about the 340B program. Their conversation was an important first step in educating the Administration about the importance of 340B. Shortly after, Carmela, along with Andie Martinez Patterson, Vice President of Government Affairs for Advocates, Dr. Anitha Mulangi, Kevin L. Mattson, CEO of San Ysidro Health, Louise McCarthy, CEO of the Community Clinic Association of Los Angeles County , Richard A. Veloz, CEO of South Central Family Health Center, Jane Garcia, CEO of La Clínica De La Raza, met with Dr. Mark Ghaly, secretary for the California Health and Human Services Agency (CHHS), to also discuss the Governor’s proposed pharmacy transition and the impact it would have on the 340B program. Both Governor Newsom and Secretary Ghaly acknowledged the impact to health centers and both reassured meeting participants that they see health centers as partners and aim to ensure no undue harm is done through their larger proposals. 

Additionally, this past April, we were honored to have Deputy Cabinet Secretary, Richard Figueroa, as the keynote speaker at our annual Day at the Capitol (DAC) event where he discussed the Governor’s vision for health care. He also touched on the Governor’s executive order on pharmacy and acknowledged that the Administration was hearing loud and clear from the health centers that there is grave concern about the proposal, more specifically, they understand we are concerned about the negative impact the order would have on the 340B program.  He ensured attendees that he and the Governor’s Administration are open to feedback on the proposal. The following day, Mr. Figeroa continued the dialogue, along with Deputy Legislative Secretary Tam Ma, at the CPCA board meeting.  Many CaliforniaHealth+ DAC attendees were present in the board meeting to hear the continued discussion about how health centers can support and participate in the Governor’s health care vision.

Advocates will continue to build relationships Governor’s Administration, including with California’s Surgeon General, Dr. Nadine Burke Harris, who we hope to meet with in the coming months.