How a fierce lobbying effort amid COVID boosted health funding in California


SACRAMENTO – After more than a decade of unsuccessful pleas from public health advocates, Democratic lawmakers have secured a landmark deal that pledges $ 300 million a year in new state funding to fortify and reimagine the system California’s Hollow Public Health Department, a complex network of services supported in large part by the state’s 61 local health departments.

The deal, introduced last week as the Democratic-controlled Legislature approved a record $ 262.6 billion budget for fiscal year 2021-2022, marked a dramatic reversal for Gov. Gavin Newsom, who had rejected requests the past three years to bolster annual public health spending, arguing that federal funding would suffice. At Newsom’s insistence, the infusion for public health will not start until July 2022.

What persuaded Newsom to change course, according to those involved in the negotiations, was an unprecedented public health campaign backed by lobbyists and unions.

The state’s largest union of civil servants, the Service Employees International Union, joined health leaders in January to create a coalition called California can’t wait setting up a lobbying effort on behalf of public health, a key government function that for years disappeared voiceless in the halls of the California Capitol.

Their target was Newsom, and they made their case to his Cabinet officials, advisers and the public.

“We knew we had to fight,” said Tia Orr, the lead lobbyist for SEIU in California, whose 750,000 members include health care workers, janitors, and city, county and county employees. State. “I hate that it took a crisis, but COVID-19 allowed us to collectively back down, and we all realized we had to be stronger than ever when it comes to public health. “

From January through April, union leaders, public health advocates and professional groups representing local health officials held more than 40 in-person and video meetings with state lawmakers to discuss how years of downsizing budgets had left them without the personnel, laboratory capacity and basic infrastructure necessary for the performance of public health functions.

Divestment had left counties unprepared for the pandemic, they argued, and systems critical to tracking and controlling a range of infectious and chronic diseases had been decimated.

In San Bernardino County, for example, authorities detailed the ground lost to issues such as congenital syphilis and opioid abuse even before the COVID response squeezed resources.

Mono County officials explained that they did not have a public health laboratory and a single communicable disease nurse to conduct contact tracing for a county of 14,000 people.

Also critical to the effort: County health officials have reached outside their inner circle, hiring veteran Sacramento public relations firm Paschal Roth Public Affairs, a power broker whose strategists represent several groups of people. interests with deep pockets, including SEIU.

“Look, we had the key ingredients for a winning campaign: a hard-hitting message, an incredible coalition and an undeniable sense of timing,” said Mike Roth, who heads the firm with his partner, Nikki Paschal. “After what we went through last year with COVID, no one could argue that the issues were not life or death. Public health officials knew they had to approach this differently. “

Epidemiologists, public health nurses and other county workers who were not used to the spotlight became the face of the operation. As Newsom and lawmakers negotiated the budget, the campaign launched an aggressive Twitter campaign that accused Newsom neglecting public health and praised the two Democratic lawmakers who defended the budget request on Capitol Hill, State Senator Richard Pan of Sacramento and Assembly Member Jim Wood of Healdsburg, who chairs legislative health committees.

“I don’t think a lot of people understood the devastation that was happening – it was really this silent erosion of public health funding,” said Michelle Gibbons, executive director of the County Health Executives Association of California. “We had to get people to raise their hands and say, ‘We care,’ and this campaign has helped us use our voice and tell our story in a way we’ve never done before.”

Bruce Pomer, a former lobbyist for the Health Officers Association of California, who went on to lead the organization representing local health workers from 1993 to 2014, said wise lobbying and a strong political coalition made the difference this year. .

“Having SEIU as part of the coalition makes a big difference in whether the legislature is even going to pay attention to you,” Pomer said. “I mean, I haven’t been invited to big and expensive fundraisers. I had to hang out by a door and wait until the end of a nighttime hearing for the chance to speak to a lawmaker. “

The federal government funds most public health activities in California and has significantly increased emergency funding during the pandemic.

Temporary increases in funding have taken the statewide public health budget to $ 4.7 billion so far this year, but health officials say much of that money is of limited use and that the portion of funding from state and local government coffers has not kept up with the cost of doing business.

Although details were not disclosed by the Newsom administration, Pan said the governor has pledged an additional annual investment of $ 300 million from the state general fund starting next fiscal year. .

Public health officials and lobbyists involved in the negotiations say the money will target infrastructure, such as increasing the capacity of public health labs – California has lost 11 labs since 1999 – and modernizing healthcare systems. data strained by the pandemic.

The counties say the money will also give them the ability to tackle public health threats associated with climate change, such as wildfires; develop programs address race-based health inequalities; and build a workforce capable of responding to infectious disease threats, as well as fighting chronic diseases such as diabetes.

“Our goal will be to hire disease investigators to build a robust communicable disease surveillance system,” said Kim Saruwatari, director of public health for Riverside County. “It pains me to say this, but we have almost 13,000 cases of chlamydia every year, and we can only investigate a small percentage of those, for pregnant women or people at high risk, because we just don’t have the manpower. “

This story was produced by Kaiser Health News, who publishes California Healthline, an editorially independent service of the California Health Care Foundation.


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