California State Legislature October 13 Was the Last Day for the Governor to Sign Or Veto Any Bills That Were on His Desk

TO: AHS Board of Trustees

FROM: Terry Lightfoot, Director of Public Affairs and Community Engagement

DATE: October 18, 2019

SUBJECT: Public Affairs and Community Engagement Report: Government Relations – Policy and Legislative Updates, Community Engagement Activities, Print / Broadcast / Online Media Coverage, and Social Media Coverage

Government Relations – Policy and Legislative Updates

California State Legislature October 13 was the last day for the Governor to sign or veto any bills that were on his desk. Unless otherwise specified, bills that are signed by the Governor will take effect on January 1st, 2020. Here are some key bills that Alameda Health System has been monitoring:

Signed by the Governor:

SB 227 (Levy) Nurse Staffing Ratio Penalties (signed on 10/12) – This bill requires periodic inspections of hospitals by the Department of Public Health to include reviews of compliance with nurse staffing ratios. It also establishes administrative penalties for nurse staffing ratio violations of $15,000 for a first violation, and $30,000 for each subsequent violation. Recent amendments to the bill include allowing State department inspectors to exercise discretions when hospitals do not meet the ratio while encountering “unpredictable” and “uncontrollable” circumstances.

AB 962 (Burke) Supplier Diversity Reporting (signed on 10/12) – This bill takes effect on July 1, 2021. It requires hospitals with operating expenses of $50 million or more ($25 million or more if part of a hospital system) to annually submit a report to the Office of Statewide Health Planning and Development (OSHPD) on their minority; women; lesbian, gay, bisexual, transgender (LGBT); and disabled veteran business procurement efforts. Civil penalties will be imposed on hospitals that do not submit a report.

AB 577 (Eggman) Medi-Cal: maternal mental health (signed on 10/12) – This bill requires health plans and health insurers to extend continuity of care for pregnant women to up to 12 months from the end of pregnancy or from the diagnosis of a maternal mental health condition, whichever occurs later.

AB 414 (Bonta) Healthcare coverage: minimum essential coverage (signed on 10/12) – Following amendments, this bill will direct Franchise Tax Board to report to the Legislature information resulting from California’s minimum essential health coverage requirement and individual shared responsibility penalty.

SB 464 (Mitchell) California Dignity in Pregnancy and Childbirth Act (signed on 10/7) – this will require hospitals to implement an implicit bias program for all health care providers involved in the perinatal care of patients within their facilities. It also requires these healthcare providers to complete an initial basic training and a refresher course every two years thereafter. Hospitals are required to provide each patient, upon admission, information on how to file a discrimination complaint with California Department of Public Health or the Medical Board of California if the patient feels being discriminated against.

AB 678 (Flora) Medi-Cal: podiatric services (signed on 10/2) - This bill prohibits the requirement of prior authorization for podiatric services.

AB 1514 (Patterson) Deaf and Disabled Telecommunications Program (Signed on 9/12) – This will allow nurse practitioners to certify the needs of an individual who has been diagnosed as being deaf or hard of hearing to participate in the California Deaf and Disabled Telecommunications Program (DDTP) program (which provides telecommunications device).

AB 5 (Gonzalez) – Independent Contractor (Signed on 9/18) – This bill will codify the decision of the California Supreme Court in Dynamex Operations West, Inc. v. Superior Court of Los Angeles (2018) that presumes a worker is an employee unless the hiring entity satisfies a three- factor test. There are exemptions for specific health care professionals including doctors, podiatrists, dentists and psychologists. However, it will prohibit independent contractor status for almost all other health care professionals such as nurse practitioners, physical therapists, certified nurse anesthetists, and others.

Vetoed by the Governor:

AB 848 (Gray) Medi-Cal: covered benefits (vetoed)- This bill would have required Medi-Cal to provide coverage for continuous glucose monitors and related supplies required for use with those monitors for the treatment of diabetes mellitus when medically necessary.

SB 154 (Pan) Medi-Cal: Restorative dental services (vetoed) - This bill would have authorized Denti-Cal reimbursement to Denti-Cal providers for using silver diamine fluoride (SDF) as a caries arresting agent.

Community Engagement Activities: October – November 2019 Date/Time Activity Location Summary 10/05/2019 Dublin Senior Info Fair Dublin Senior Center AHS will provided information about 10 am – 1 pm 7600 Amador Valley services, programs, and our commitment to Blvd., Dublin serving all in Alameda County. 10/18/2019 San Leandro Senior Health San Leandro Senior San Leandro Hospital staff will offer tips on 10 am - 2 pm and Resource Fair Center living a healthy and purposeful life in 13909 E. 14th Street addition to providing health screenings and San Leandro education. 10/19/2019 Alameda Hospital Alameda Hospital Free flu shots, bike helmets, health 9 am – 12 pm Community Health Fair 2070 Clinton Avenue screenings and activities will be offered at

Alameda this 27th Annual Health Fair that brings together organizations and businesses that promote health and community wellness. 10/23/2019 Oakland Unified School Oakland High School OUSD will hold a computer giveaway for 2 pm – 3 pm District / 1023 MacArthur Blvd. high school students enrolled in their health TechExchange/AHS Oakland pathways programs. This event provides an Computer Giveaway opportunity to acknowledge AHS’ donation of computer monitors provided to TechExchange who supports schools and organizations throughout Alameda County. 10/30/2019 MCH Tour – Asian Health Highland Hospital Providers from Asian Health Services will 4 pm Services 1411 E. 31st Street meet with MCH leaders/staff and tour the Oakland Highland Hospital Family Birthing Center. 11 – 12/2019 Alameda County AHS Facilities AHS will hold a virtual food drive for Community Food Bank ACCFB during the holiday season. ACCFB Virtual Food Drive distributes millions of healthy meals every year, and is committed to ending hunger and poverty in our communities. 11/2/2019 Alameda Hospital Grandview Pavilion The Alameda Hospital Foundation’s annual 6:30 pm Foundation Fall Gala 300 Island Drive fall gala, “A Moonlight Luau”, will honor Alameda Dr. William S. Lowery, 2019 recipient of the Kate Creedon Award. 11/2/2019 Unity Council’s Dia de Los Fruitvale Neighborhood AHS physicians, Spanish speaking patient 10 am – 5 pm Muertos Festival Oakland advisory council, eligibility and PACE will participate in this annual event that celebrates the diversity of the community. Health screenings will be provided. 11/13/2019 AHS Acute Rehabilitation San Leandro Hospital Elected officials, community stakeholders, 5 pm – 7 pm Unit Open House 13855 E 14th St. AHS/AHSF leadership and the BOT are San Leandro invited to attend this celebration that will feature a ribbon cutting for the new acute rehabilitation unit at San Leandro Hospital. Highlighted sections reflect additions and changes since previous report

Print, Broadcast and Online Media Coverage Highlights: September 13, 2019 – October 15, 2019 Media Outlet: Topic: Headline: Summary: Link: KRON 4 Strike East Bay Nurses San Leandro and Alameda https://www.kron4.com/news/ Go on Strike Hospital nurses hit the picket bay-area/east-bay-nurses-to- lines for a one day strike. hit-the-picket-lines/

East Bay Times Strike Nurses Strike at Registered nurses at https://www.eastbaytimes.co Three Bay Area Alameda Hospital and San m/2019/09/21/photos-nurses- Hospitals Leandro Hospitals go on strike-at-three-bay-area- strike. hospitals/ Modern DSH Cuts Hospitals Hope AHS CEO Delvecchio https://www.modernhealthcar Healthcare DSH Cut Delay Finley explains how planned e.com/providers/hospitals- Leads to Long- DSH cuts would have hope-dsh-cut-delay-leads- Term Solutions limited the system’s ability long-term-solutions to provide care to vulnerable patients.

The Daily Press Stupski Largest Regional Stupski Foundation http://business.smdailypress.c Foundation Investment to Date announces grant funding om/smdailypress/news/read/3 Grant Seeks to to 7 health systems, 8915995/largest_regional_inv Transform How including AHS, which estment_to_date_seeks_to_tra People Experience will increase ability to nsform_how_people_experien End of Life provide palliative care. ce_end_of_life_across_the_ba Across the Bay Area y_area Oakland Magazine SIDS Fighting to Save Feature story about Dr. https://www.oaklandmagazine Kids from SIDS Donna White Carrey, .com/Oakland- Highland Hospital’s first Magazine/Oakland- chair of pediatrics Magazine-Subscription/ department. Health IT Epic Launch Alameda Health AHS launches EHR https://www.healthitoutcomes Outcomes System Launches system to enhance care .com/doc/alameda-health- Epic Electronic and improve the patient system-launches-epic- Health System experience. electronic-health-system-0001

Social Media Coverage September 13, 2019 – October 15, 2019 Content Topic Summary Outcome Workforce Kristen Thorson, Alameda Health Video was well received on LinkedIn System manager of support services, and Facebook knows that hard work pays off. But she works hard even when she leaves her AHS job. Watch Kristen’s story. #WeServeAll #GreatPlaceToWork

https://www.linkedin.com/feed/update/urn:li:activity:6582344044247158784 Sustainability Alameda Health System is officially This post with the CEO and CIO live on #Epic! Thank you everyone giving the thumbs up after the EHR go for all the dedication it took for us to live date has received the highest reach this milestone. We now have engagement out of any AHS social systemwide access promoting post to date. population health integration resilience & equity! #CareForTheFuture #EHR https://www.linkedin.com/feed/update/urn:li:activity:6583789495035006976 Sustainability Today we officially launched our This was the text the accompanied the new centralized electronic health AHS “September Remix” music video record system, S·A·P·P·H·I·R·E, which has been viewed over 1,000 transforming health care for our times. patients. The new system will provide better coordinated care and access for our patients. We want to thank staff for all their hard work, now, it's time to celebrate! #EHR #Epic #CareForTheFuture #WeServeAll https://youtu.be/LxYO1EeErDw Access, AHS Receives $2M Grant to Expand This was a post promoting the grant sustainability Palliative Care to Transform How received from the Stupski Foundation People Experience End of Life across the Bay Area

https://twitter.com/AlamedaHealth/status/1178688958320037888 Network Join us for the Alameda Hospital A Facebook event was created for the Community Health Fair. The fair Alameda Hospital fair and shared on offers free flu shots (while supplies Supervisor Wilma Chan’s Facebook last), bike helmet giveaway for page. children 12 and under, a variety of health screenings, activities, and exhibits for the entire family.

https://www.facebook.com/events/398806040807506/ Government TY @GavinNewsom and This post showed our support for the Relations @SenHJMitchell, SB 464 has been “California Dignity in Pregnancy and signed into law. "African American Childbirth Act” that targets the women are likely to have disproportionately large amount of complications in their pregnancy not Black women who die giving birth or because of poverty. As healthcare due to pregnancy-related causes. We providers, we must do more - starting also tied the CEOs op-ed on this issue with how we listen and respond" back to the post.

https://twitter.com/AlamedaHealth/status/1181735734132084736