January 2022 Update
(As of Jan. 25, 2022)
February 18, 2022 is the deadline for Legislative members to introduce new bills. For that reason, there is not much to report at the moment. This is an even year, which means this is the second year of the Legislature’s two-year session. Two notable bills introduced in 2021 are moving again.
Senator Wiener’s overdose prevention program (“safe injection site”) proposal was heard in the Assembly Health Committee and moved to the Assembly Public Safety Committee. The bill (SB 57) has been amended to include a study to evaluate the pilot programs.
The workforce development bill for the substance use disorder treatment industry (AB 666) is being considered by the Senate Appropriations Committee and has been amended to authorize the newly established Department of Health Care Access and Information to implement the SUD workforce development program.
See below for details.
Bill: SB 57 (Wiener, D-San Francisco) - Overdose prevention program
Description: The bill would allow for the establishment of pilot “overdose prevention programs” (OPPs) in Los Angeles, San Francisco and Oakland. Specifically, SB 57 would allow approved entities to operate programs that provide “hygienic space supervised by trained staff where people who can use drugs can consume pre-obtained drugs, sterile consumption supplies, access or referrals to substance use disorder treatment” and staff trained to use an opioid antagonist such as naloxone to clients experiencing an overdose. The bill would also exempt staff from civil, criminal and professional liability for services provided at the sites.
This proposal was introduced in 2021 and passed the Senate but did not make it out of the Assembly. In January 2022 it was heard by the Senate Health Committee and amended to include a provision requiring local jurisdictions who chose to participate in the Program to select (and provide funding for) an independent entity to conduct a peer reviewed study to examine outcomes and community impact. The study must be submitted to the Legislature by Jan. 15, 2027.
Status: Heard in the Assembly Health Committee, amended, and referred to the Assembly Committee on Public Safety January 18, 2022.
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Bill: AB 666 (Quirk-Silva, D-Fullerton) - Substance Use Disorder Treatment Workforce Development
Description: Would require the Department of Health Care Services to develop a substance use disorder (SUD) workforce needs assessment report that evaluates the current state of the SUD workforce, determines barriers to entry, and assesses the state’s systems for regulating and supporting the SUD workforce. It also permits the Department of Health Care Access and Information, subject to an appropriation from the Legislature for these purposes, to implement an SUD workforce development program. As originally introduced in 2021, the bill would have funded the program with $9 million from the state’s $573 million settlement with McKinsey & Company over the consulting firm’s role in the opioid crisis.
The bill was introduced in 2021, passed the Assembly, but was held in the Senate. In January 2022, the bill was amended to, among other things, authorize the Department of Health Care Access and Information to implement the SUD workforce development program.
Status: Currently with Senate Appropriations Committee.
The Fiscal Year 2022-23 State Budget
One key piece of legislation every year is the State Budget. How the state spends the revenue it takes in is a clear reflection of public policy priorities. Constitutional deadlines require the governor to submit a proposal in January for the next fiscal year, followed by a revised version in May. The work then falls on the Legislature to finalize the next fiscal year’s budget by the end of June, which marks the end of the current fiscal year.
Governor Newsom released his January proposal for the fiscal year 2022-23 budget earlier this month. Several sections of the proposed budget include funding for substance use disorder treatment and prevention:
Medi-Cal Community-Based Mobile Crisis Services – The American Rescue Plan Act of 2021 authorizes federal matching funds for a Medicaid mobile crisis response services benefit. Under the current budget proposal, the state’s Department of Health Care Services will add multi-disciplinary mobile response services for crises related to mental health and substance use disorders as a new Medi-Cal benefit, as soon as January 1, 2023, to help reduce the impact of untreated behavioral health conditions on emergency departments and psychiatric facilities. Over the five-year period authorized by the Act, total costs of this new benefit are projected to be $1.4 billion ($335 million from the General Fund). According to the budget summary, “this benefit builds on the $205 million and other funds the 2021 Budget Act provided to counties for infrastructure development in preparation for the implementation of the mobile crisis benefit.”
Integrated Substance Use Disorder Treatment Program (prison MAT and cognitive therapy) – The 2019 Budget Act included resources for Department of Corrections and Correctional Health Care Services to implement the Integrated Substance Use Disorder Treatment (ISUDT) Program. This program was designed to provide an interconnected series of treatments and interventions to help incarcerated individuals with substance use disorders. Since the ISUDT Program was implemented in January 2020, nearly 14,000 patients have been provided access to medication-assisted treatment (MAT) and approximately 5,700 patients received cognitive behavioral interventions. The proposed 2022-23 budget includes $126.6 million General Fund dollars in 2022-23, and $162.5 million ongoing, to expand the ISUDT Program and enhance the Department’s ability to treat individuals with substance use disorders.
Proposition 47 Savings — In November 2014, voters passed Proposition 47, which requires misdemeanor rather than felony sentencing for certain property and drug crimes and permits incarcerated persons previously sentenced for these reclassified crimes to petition for resentencing. Proposition 47 established a fund to invest savings from reduced prison utilization to prevention and support community programs. The Department of Finance estimates net General Fund savings of $147.3 million in 2022-23. These funds will be allocated according to the formula specified in the initiative, which requires 65 percent be allocated for grants to public agencies to support various recidivism reduction programs (such as mental health and substance use treatment services).
Expanding the Care Economy Workforce – The proposed 2022-23 budget includes a one-time $1.7 billion investment over three years in care economy workforce development—across both the Labor and Workforce Development Agency (Labor Agency) and California Health and Human Services Agency (CalHHS)—that will create more innovative and accessible opportunities to recruit, train, hire, and advance an ethnically and culturally inclusive health and human services workforce, with improved diversity, wages, and health equity outcomes. Targeting opioid treatment, $26 million to train providers to build out the substance use disorder (SUD) workforce with a focus on opioid treatment. Funding will be used to increase the number of licensed clinicians, including providers focused on addiction. Funding will also provide supportive employment services to people with SUD issues to transition them into ongoing employment.
Updated Allocation of the Cannabis Tax Fund – Proposition 64 specifies the allocation of resources in the Cannabis Tax Fund, which are continuously appropriated. The first priority is for regulatory and administrative activities, with remaining funds allocated to youth education, prevention, early intervention, and treatment; environmental protection; and public safety-related activities. The proposed 2022-23 budget projects 60 percent of these remaining funds ($356.9 million) will go to education, prevention, and treatment of youth substance use disorders and school retention.