2021-2022 Legislative Priorities
1. Behavioral and Mental Health
AB 58 (Salas) Pupil Health: Suicide Prevention Policies and Training
Description: Requires that local education agencies (LEAs) update their suicide prevention training materials and encourages LEAs to provide suicide awareness and prevention training to teachers annually beginning with the 2024-25 school year.
Status: Two-year bill. Passed Senate Ed on 6/8, Referred to Sen Appropriations suspense file on 6/20.
AB 552 (Quirk-Silva) Integrated School-Based Behavioral Health Partnership Program
Description: Authorizes community behavioral health programs and local education agencies to establish partnership programs to provide prevention, early intervention, and access to behavioral health services for pupils with serious emotional disturbances or substance use disorders.
Status: Two-year bill. Passed Sen Ed on 6/1, passed Sen Health on 6/16, set for Sen Appropriations hearing on 8/1.
AB 748 (Carillo) Pupil Mental Health: Mental Health Assistance Posters
Description: Would require each school-site in a school district, county office, of education, or charter school serving students grades 6-12 to create a poster that identifies approaches and shares resources regarding mental health.
Status: Two-year bill. Passed Sen Ed on 6/1, passed Sen Judiciary 6/14, Sen Appropriations placed on suspense file 6/27.
AB 1969 (Gipson) Pupil Health: Peer-to-Peer Mental Health Program
Description: Would provide funding to community-based organizations to support peer-to-peer mental health programs within schools. Trainings would emphasize trauma informed care practices and would be specifically geared towards schools without other mental health services. Status: Introduced in the Assembly 2/10, referred to committees on health and education. Currently in Assembly Education, hearing date pending.
SB 387 (Portantino) Pupil Health: School Employee and Pupil Training: Youth Mental and Behavioral Health
Description: Would require local education agencies to ensure that 75 percent of its classified employees who have direct contact with pupils at school have received specific youth behavioral health training.
Status: Two-year bill. In Asm Ed, hearing date pending (6/29 hearing postponed by committee).
SB 1019 (Gonzalez) Medi-Cal Managed Care Plans: Mental Health Benefits
Description: Would require a Medi-Cal managed care plan to conduct annual outreach and education to its enrollees regarding the mental health benefits that are covered by the plan, and to also develop annual outreach and education to inform primary care physicians regarding those mental health benefits.
Status: Passed Senate floor vote 5/26. Passed Asm Health 6/21, referred to Asm Appropriations hearing date pending.
2. Health Equity
AB 408 (Quirk-Silva, Rivas) Homeless Children and Youths: Reporting
Description: Requires local education agencies to establish homeless education program policies, requires homeless education liaisons to offer training to specified school staff, and requires the California Department of Education to develop a risk-based monitoring plan for homeless education requirements. This bill arose from a 2019 state audit that found some education sites do not follow best practices to identify students experiencing homelessness.
Status: Two-year bill. Passed Sen Ed on 5/4, in Sen Appropriations hearing set for 8/1.
AB 558 (Nazarian) School Meals: Child Nutrition Act of 2022
Description: Creates an additional per-meal reimbursement for local education agencies (LEAs) that elect to increase their meal offerings to accommodate student dietary restrictions including plant-based food and beverages, vegetarian food, and religious dietary restrictions. Also requires the CA department of education to develop guidance for LEAs serving K-6th grade children on how to serve eligible non-school aged children breakfast or a morning snack at an LEA site.
Status: Two-year bill. Passed Sen Ed 6/27, Sen Appropriations set for 8/1.
AB 1001 (Garcia) Environment: Mitigation Measures for Air and Water Quality Impacts: Environmental Justice
Description: Amends the CA Environmental Quality Act (CEQA) to 1. Require mitigation to compensate for adverse air or water quality impacts in a disadvantaged community to mitigate those impacts directly in the affected community and 2. Require all public agencies implementing CEQA to give consideration to the principles of environmental justice by ensuring the fair treatment and meaningful involvement of people of all races, cultures, incomes, and national origins.
Status: Two-year bill. In Sen Environmental Quality hearing set for 6/15, hearing cancelled at the request of author.
AB 1930 (Arambula) : Medi-Cal Comprehensive Perinatal Services
Description: Would promote maternal and infant health as well as help prevent ACEs by ensuring Medi-Cal provides social needs assessments and related services throughout the additional 10 months postpartum eligibility period launching April 1, 2022 under the American Rescue Plan Act of 2021.
Status: Passed Asm Health on 4/27, referred to Asm appropriations.
AB 2402 (Rubio) Medi-Cal: Continuous Eligibility
Description: Would ensure that children under the age of 5 qualify for continuous enrollment in Medi-Cal by removing the requirement for providing income information at the end of 12 months.
Status: Passed Sen Health hearing 6/15, Sen Appropriations referred to suspense file on 6/27.
SB 234 (Weiner) Transition Aged Youth Housing Program
Description: This bill creates the Transition Aged Youth Housing Program to create housing for youth under 26 years of age who have been removed from their homes, are experiencing homelessness unaccompanied by a parent or legal guardian, or are under the jurisdiction of a dependency court.
Status: Two-year bill. Passed Asm Committee on Housing & Community Development 6/15, passed Asm Human Services 6/29, referred to Asm Appropriations hearing date pending.
SB 532 (Caballero) Pupil instruction: High School Coursework and Graduation
Description: Expands and strengthens the rights for foster youth, homeless youth, former juvenile court school students, children from military families, and migratory children to be exempt from local graduation requirements if certain conditions are met (must have moved high schools after the second year). It requires local education agencies (LEAs) to provide these students the option to remain in school for a fifth year of high school to complete coursework requirements to ensure that these vulnerable populations have the chance to obtain a high school diploma.
Status: Two-year bill. Passed Asm Ed 6/21, in Asm Appropriations hearing date pending.
SB 1016 (Portantino) Special Education: Eligibility: Fetal Alcohol Spectrum Disorder
Description: Would require that Fetal Alcohol Spectrum Disorder (FASD) be included under the “other health impairment” definition for Individual Education Plans to expand eligibility for pupils to receive special education and related services.
Status: Passed Asm Ed 6/29, in Asm Appropriations hearing date pending.
3. Immigrant Youth Health
AB 1777 (Aguiar-Curry) Migrant Education: Average Daily Attendance
Description: This bill aims to improve the education for migrant children within CA, which has the highest number of migrant pupils within the US (1 out of 3 migrant children who live in the US reside in CA). Achievement gaps experienced by migrant children are attributed in part due to lost instructional time when traveling with parents. This bill would provide additional funding to local education agencies to provide migrant children specific educational services for children in pre-K through 8th grades.
Status: Passed Sen Ed 6/29, in Sen Appropriations hearing date pending.
COVID-19 Vaccine Bills
AB 1797 (Weber) Immunization Registry
Description: Would authorize children aged 12 years and older to consent to receive the COVID-19 vaccine without parental or guardian consent.
Status: Passed Sen Health 6/23, in Sen Ed hearing set for 6/30.
SB 866 (Wiener, Pan) Minors: Vaccine Consent
Description: Would allow schools to access vaccine databases to more easily track the vaccination status of their students.
Status: In Asm pending floor vote.
SB 871 (Pan) Public Health: Immunization
Description: Would add the COVID-19 vaccine to the list of required vaccinations for children to enter into public schools. This bill is currently broad, with edits and specifications to come when heard in committees.
The Quorum: Monthly Policy Updates
June 2022: The Formula Shortage Crisis
It’s been over three months since Abbott Nutrition issued a voluntary recall of powder formula manufactured at a plant in Michigan, spearheading the infant formula shortage crisis. But it wasn’t only this recall that led to the ongoing shortage – pandemic related supply chain issues and long-standing market concentration among four formula companies serve as the basis for the problem. About a month ago the average out-of-stock rate nationwide was about 40%, and for the week ending on May 28, that rate had surged to 73.6%.1 The ongoing shortage has been particularly impactful for lower-income families who rely on the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), which provides services to more than 1.7 million infants. The crisis has also underscored glaring disparities in breastfeeding rates. Some women cannot breastfeed for a myriad of reasons, however, other women who may desire to breastfeed their infant face structural barriers such as inadequate peripartum lactation support, limited access to supplies such as breast pumps, and work environments lacking time and private space to pump. This month’s Quorum will review inequities in breastfeeding rates and ongoing federal and local level policies aimed at addressing the ongoing formula shortage crisis.
The AAP recommends exclusive breastfeeding until around 6 months and continued breastfeeding until at least 12 months. However, according to CDC data, while 83.9% of infants are initially breast fed, only 56.7% are still breastfed at 6 months and 35% are breastfed at 1 year.2 Moreover, breastfeeding disparities exist among minority and socioeconomically marginalized families. Fewer non-Hispanic Black infants (75.5%) are ever breastfed compared with Asian infants (92.4%), non-Hispanic White infants (85.3%), and Hispanic infants (85%).2 Infants eligible for WIC are also less likely to be ever breastfed (76.9%) than infants eligible, but not receiving WIC (83.3%), and infants ineligible for WIC (91.6%).2
Within Los Angeles County (LAC), significant disparities in lactation support, breast feeding rates, and infant health outcomes exist. Among LAC Service Planning Areas (SPAs), 68.6% of infants in the West SPA are exclusively breastfed at 3 months as compared to 33.3% and 28.8% in the less affluent Antelope Valley and South SPAs, respectively.3Moreover, the Antelope Valley and South SPAs have the highest infant mortality rates in LAC, the fewest lactation support resources, and the highest number of households with annual incomes between $12,813 and $41,400.3
There have been numerous federal-level policy initiatives to address the ongoing formula shortage crisis. In May, the Biden Administration invoked the Defense Production Act, which required suppliers to make infant formula over other goods. The administration also launched Operation Fly Formula, which directed the Department of Health and Human Services (HHS) and US Department of Agriculture (USDA) to expedite infant formula imports from Switzerland. Simultaneously, the FDA lifted import rules to allow for a greater influx of foreign-made formula.4 And on May 21st, President Biden signed H.R. 7791, the Access to Baby Formula Act of 2022, a bill that allows WIC participants to buy any brand of formula with their vouchers, not just the brand that their local WIC office has a contract with (typically each local WIC agency contracts with a single formula manufacturer). Of note, Democrats in the US House of Representatives tried to give $28 million in emergency assistance to the Food and Drug Administration via H.R. 7790 to enhance safety inspections and prevent fraudulent products from getting into stores – but the bill failed as GOP members refused to give the FDA more money (90% of House Republicans voted against the bill).
Within California, the California Department of Public Health’s WIC program has expanded the list of formula brands eligible for purchase with WIC benefits – as of June 2nd, WIC participants can choose from more than 130 different formula brands.5 On June 8th, Governor Newsom signed an executive order banning excess price hikes on baby formula. Under the order, retailers are not allowed to sell formula at a price that is greater than 10% of the price charged by the seller as of February 17th.6 And within Los Angeles, LAC and the LAC Department of Child and Family Services (DCFS) purchased $750,000 and $500,000 of infant formula, respectively, to be distributed to families in need.7
1. Breslow, J. As the baby formula crisis worsens, it’s also magnifying disparities in the US. NPR. 6 June 2022. https://www.npr.org/2022/06/02/1102479185/baby-formula-shortage-disparities
2. Centers for Disease Control and Prevention. Breastfeeding: Key Facts. https://www.cdc.gov/breastfeeding/data/facts.html
3. Breastfeed LA. Taking action to reduce infant feeding inequities in Los Angeles County: Our collective responsibility. May 2019.
4. Fact Sheet: President Biden announces new actions to address infant formula shortage. The White House. https://www.whitehouse.gov/briefing-room/statements-releases/2022/05/18/fact-sheet-president-biden-announces-new-actions-to-address-infant-formula-shortage/
5. State continues to add formula choices for WIC families. Office of Governor Gavin Newsom. https://www.gov.ca.gov/2022/06/02/state-continues-to-add-formula-choices-for-wic-families/
6. Newsom executive order bans price gouging of baby formula amid shortage. CBS Bay Area. https://www.cbsnews.com/sanfrancisco/news/baby-formula-shortage-gov-gavin-newsom-executive-order-bans-price-gouging/
7. Esquivel, P. LA County buys $750,000 worth of baby formula to distribute to families as shortage persists. LA Times. 28 May 2022. https://www.latimes.com/california/story/2022-05-28/county-will-soon-start-distributing-baby-formula-at-food-distribution-sites-and-through-outreach-programs
The Quorum is a monthly policy spotlight. For any inquiries, please email Chapter 2 legislative and policy analyst, Karinne Van Groningen, at KVanGroningen@mednet.ucla.edu.
Previous Legislative Spotlights:
Get Involved with Advocacy
Pediatricians can play a unique role in facilitating policy change. We know first-hand what it takes to care for vulnerable populations and by educating the public, conducting research, and assisting in the interpretation of medical research – our potential impact on driving policy change is immeasurable.
Advocacy doesn’t just happen in Sacramento. We all have a role to play and it is our responsibility to speak up on behalf of the children in our Chapter.
Are you interested in joining the advocacy committee, writing letters, and/or speaking at public forums? If so, contact the chapter legislative and advocacy analyst below:
Karinne Van Groningen, MD, MPH
AAP-CA2 State Government Affairs (SGA) Committee Representatives and Staff:
Susan Wu, MD, FAAP (SGA)
Marti Baum, MD, FAAP (SGA)