Monday Rx | April 22, 2019 | Are You Ready for Legislative Advocacy Day?
What You Need to Know About Legislative Advocacy Day
It’s the 45th Annual Legislative Advocacy Day (week) when the medical societies and CMA convene in Sacramento to talk policy and to share opposition or support for legislation that impacts physicians and their ability to care for patients. We will hear from California Governor Gavin Newsom, CMA President and former LACMA president Dr. David Aizuss, CMA CEO Dustin Corcoran, and CMA chief lobbyist Janus Norman.
So, what’s on the agenda?
Assembly Bill 764 (Bonta) Prohibiting Manufacturer Discounts and Coupons of Soda
As a key driver of grocery shopping behavior, price promotions have been criticized for encouraging excessive consumption and unhealthy food habits. In recent years, increasing attention has been given to the role that the marketing of high-calorie, low-nutrient foods and beverages plays on the development of obesity, especially childhood obesity. According to the Centers for Disease Control and Prevention, more than one-third of U.S. adults are obese, and approximately 12.5 million children and adolescents ages two to 19 years are obese. Research indicates a tripling in the youth obesity rate over the past three decades. Overweight youth face increased the risk for many serious detrimental health conditions that do not commonly occur during childhood, including high cholesterol and type 2 diabetes.
Obese children and teenagers also remain at greater risk of developing serious chronic diseases including type 2 diabetes, heart disease, high blood pressure, cancer and other serious health conditions including asthma, sleep apnea, and psychological effects such as decreased self-esteem.
Research has found promotional bias towards unhealthy foods, particularly sugar-sweetened beverages, fatty and sugary food items, and salty and fatty snacks. Specifically, buy-one-get-one deals are heavily skewed toward less healthy products. Focus groups of Latino mothers have revealed that the most significant barrier to establishing healthy eating habits for their children is an economic constraint.
AB 764 would prohibit soda companies from offering promotional and marketing incentives, including manufacturers coupons, to subsidize the lower retail costs of sugary sweetened beverages. This solution would directly prohibit the soda companies’ ability to offer promotional and marketing incentives and directly impact the industry’s ability to influence price reductions on sugar-sweetened beverages in underperforming communities, or communities where soda purchasing is decreasing.
Senate Bill 276 (Pan) The Child Safety and Disease Prevention Act
In 2015, California’s legislature passed SB 277 (Pan), a CMA sponsored bill, which removed the personal belief exemption for children attending public school or daycare. Despite the success of SB 277 in increasing the overall immunization rate of kindergarten students, California has since experienced a dramatic increase in the number of medical exemptions. Since the passage of SB 277, the rate of medical exemptions has more than tripled (from 0.2% in 2015-16 to 0.7% in 2017-18). Senate Bill 276 reshapes California’s process to require state-level public health approval of all medical exemptions. The proposed legislation will include four strategies to strengthen oversight of the medical exemption process:
- Medical exemptions will only be granted by the California State Health Officer and their designees; physicians will no longer have the authority to grant medical exemptions by a date set in the bill. Instead, physicians will submit information to the Department of Public Health on the patient’s behalf requesting a vaccine exemption. The Department will grant exemptions when vaccination is contraindicated per CDC guidelines.
- To apply for an exemption, physicians must include the reason for the exemption and certify that they have examined the patient. The physician will be required to provide their name and license number on the application.
- The Department of Public Health will create and maintain a database of medical exemptions, and parents will be required to send a copy of existing medical exemptions to the department by a date to be set if those exemptions are to remain valid for school enrollment. The Department will make the data available to the county health departments, the Department of Education and the Medical Board of California.
- The State Health Officer and County Health Officers will have the authority to revoke medical exemptions granted by licensed physicians if they are found to be fraudulent or inconsistent with contraindications to vaccination per CDC guidelines.
AB 1038 Update
Last week, Dr. Sion Roy, LACMA president-elect, myself and Henry Rogers, LACMA’s government relations consultant met with Assemblyman Al Muratsuchi (D-66th District) to discuss AB 1038 that would require a California licensed physician to report to the Office of Statewide Health Planning and Development (OSHPD) for each contract they maintain with a payor and their negotiated rates. Our intention was to communicate our opposition to the bill. Yet, prior to our arrival, the bill was pulled from the committee and will no longer be discussed.
Chief Executive Officer
Los Angeles County Medical Association
“If it matters to our LACMA members, it matters to me.”
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