New California laws 2016: What to expect in the new year

Like bubbles ascending a champagne flute, a bevy of recently passed California policies will float to the surface and take effect this Jan. 1. Here’s a review of some of the major items.

Vaccines
One of 2015’s fiercest fights was over SB 277, which was introduced in the wake of a measles outbreak at Disneyland and requires full vaccination for most children to enroll in school. Schools will begin vetting students to ensure they have their shots in July, before the 2016-2017 school year begins.

Search warrants

Arguing our privacy laws lag behind our technology, lawmakers passed SB 178 to require search warrants before law enforcement can obtain your emails, text messages, Internet search history and other digital data.

Ballot fees
Thinking of filing a ballot initiative? You’ll need more cash. AB 1100 hikes the cost of submitting a proposal from $200 to $2,000, which supporters called a needed screen to discourage frivolous or potentially unconstitutional proposals.

Grocery jobs
When grocery stores get new owners, AB 359 requires the stores to retain employees for at least 90 days and consider keeping them on after that period ends. While workers can still be dismissed in that window for performance-related reasons, the labor-backed bill seeks to protect workers from losing their jobs to buyouts or mergers.

Reproductive services
AB 775 requires any licensed facility offering pregnancy-related services to post a sign advertising the availability of public family planning programs, including abortions. It is aimed at so-called “crisis pregnancy centers,” which pro-abortion rights critics assail for pressuring women into carrying their pregnancies to term.

Cheerleaders
Cheerleaders who root on professional athletes will be treated as employees under California law, with the accompanying wage and hour protections, under AB 202. Assemblywoman Lorena Gonzalez, D-San Diego, who carried the bill, was a Stanford cheerleader.

Testing
High school seniors will no longer need to take a long-standing exit exam to graduate, thanks to SB 172. The bill lifts the requirement through the 2017-2018 school year and also applies retroactively to 2004, meaning students who have completed all the other graduation requirements since then can apply for diplomas.

Guns on campus
Concealed firearms are barred from college campuses and K-12 school grounds under SB 707, which the California College and University Police Chiefs Association sponsored as a public safety corrective.

Equal pay
SB 358 seeks to close the stubborn gap between men and women’s wages by saying they must be paid the same for “substantially similar work,” an upgrade over the current standard, and allowing women to talk about their own pay and inquire about the pay of others without facing discipline. While California already requires equal pay for equal work, women still consistently make less.

Sex ed
Student participation in sexual education courses is currently voluntary. AB 329 would make the courses mandatory unless parents specifically seek an opt-out and would update curricula to include, for example, more information about HIV and the spectrum of gender identity.
Yes means yes

As long as their school districts require health classes to graduate, SB 695 will ensure high school students learn about the “yes means yes” standard of consent to sexual acts. In other words, students will learn they should be getting explicit approval from partners.

Toy guns
Realistic-looking airsoft guns will need to have more features that distinguish them as toys, like a fluorescent trigger guards, thanks to SB 199. Advocates said it would help law enforcement avoid tragic mistakes when making split-second decisions, pointing to the 2013 case of a Santa Rosa boy fatally shot by Sonoma County deputies who mistook his toy gun for the real thing.

Gun restraining orders
Passed last year in response to a troubled young man shooting and killing multiple people in Isla Vista, AB 1014 allows family members to obtain a restraining order temporarily barring gun ownership for a relative they believe to be at risk of committing an act of violence.

Rape kits
AB 1517 prods law enforcement to more quickly process so-called “rape kits,” the forensic evidence collected from sexual assault crime scenes. While the bill doesn’t mandate anything, it encourages law enforcement agencies to send evidence to crime labs sooner and urges crime labs to analyze the data and upload it into a DNA database in a shorter time frame.

Brew bikes
People rolling around midtown Sacramento on beer bikes could get a little tipsier under SB 530. The measure allows alcohol to be consumed on board the multi-person vehicles, which currently travel between different bars but don’t allow imbibing in between, as long as the city authorizes it. The city of Sacramento is working on updating its pedicab ordinance to reflect the new law.

Charity raffles
Professional sports fans could bring home big prizes thanks to SB 549, which authorizes in-game charity raffles allowing the winner to take home 50 percent of ticket sales. That’s a change from the current system, which permits charity raffles only if 90 percent of the proceeds go to the cause.

Pedestrian costs
AB 40 ensures pedestrians and cyclists won’t have to pay tolls on Bay Area bridges like the Golden Gate. While no such tolls yet exist, lawmakers were responding to a proposal to raise money with a Golden Gate Bridge fee.

Back wages
If an employee doesn’t get paid what they are owed, SB 588 allows the California Labor Commissioner to slap a lien on the boss’s property to try and recoup the value of the unpaid wages. This was a slimmed-down version of a prior, unsuccessful bill that was pushed by organized labor but repudiated by business interests – the key difference being that the commissioner, not workers, files the liens.

Franchises
Another bill whose earlier labor-backed, business-opposed version was softened in the name of compromise, AB 525 modifies the relationships between individual franchise business owners and the larger parent company by changing the rules for when the parent company can terminate or refuse to renew a franchise agreement and how the franchise owner can sell or transfer the store.

Transportation companies
The steady drip of new regulations on companies like Uber and Lyft continued with AB 1422, which requires such businesses to give the California Department of Motor Vehicles access to driver records by participating in the agency’s pull notice program.

Air regulations
After a sweeping climate bill spurred objections from lawmakers about the clout of the unelected California Air Resources Board, AB 1288 offered a concession by creating two new spots on the regulator’s board, to be appointed by the Legislature.

Via: http://www.sacbee.com/news/politics-government/capitol-alert/article51702105.html#storylink=cpy

California's ballot could be a blockbuster next November

Call it a dream for California political consultants, a nightmare for voters or an electoral extravaganza: The November 2016 ballot could feature a bigger crop of statewide propositions than at any time in the past decade.

"The voters pamphlet is going to look like the Encyclopaedia Brittanica," said Steve Maviglio, a Democratic campaign strategist.

The list of measures is very much a work in progress. Most campaigns are still gathering voter signatures or waiting for their proposals to be vetted by state officials.

But political strategists have identified at least 15 -- perhaps as many as 19 --measures that all have a shot at going before voters next fall.

The last time California’s ballot was that long was in November 2004, when there were 16 propositions. The March 2000 ballot had 20.

Here are the expected 2016 ballot initiatives

A number of political forces help explain why so many are lined up now. For starters, there’s the 2011 law that moved everything but measures written by the Legislature to the general election ballot. As a result, June primary ballots are now almost barren of contentious campaigns.

There is also a lingering hangover from the state's record-low voter turnout in 2014: a new and extremely low number of voter signatures needed to qualify an initiative for the ballot.

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"There’s no real obstacle this time," said Beth Miller, a Republican campaign consultant.

State law sets the signature threshold at a percentage of votes cast in the most recent gubernatorial election. That has lowered the bar to a level not seen since 1975, opening the door of direct democracy more widely for activists with smaller wallets.

“It’s made it cheaper to qualify an initiative,” said Gale Kaufman, a longtime Democratic campaign consultant who is leading the charge on initiatives to legalize marijuana and prolong a temporary tax increase approved by voters in 2012.

Which of the likely propositions might become a centerpiece campaign next year remains unclear; only five have qualified for the ballot. But perhaps a dozen more are close to securing a spot or have substantial funding behind their signature-gathering efforts.

The effort to legalize recreational use of marijuana, boosted recently by former Facebook and Napster executive Sean Parker, will undoubtedly make national headlines. So, too, might the effort spearheaded by Lt. Gov. Gavin Newsom to ban the possession and sale of large ammunition clips for guns and require background checks on those who buy ammunition.

Tax measures also typically have high profiles. Last week, an alliance of teachers, state and local employees, hospitals and doctors announced a new push to extend the 2012 tax hike. Healthcare groups are backing a proposal to raise California’s cigarette tax by $2 a pack.

Other proposals form a political potpourri of ideas and issues. School groups have qualified a $9-billion school construction and renovation bond measure; organized labor and several Democratic officeholders are backing a proposed increase in the state minimum wage; and two efforts would impose new rules of public disclosure on the legislative process and campaign contributions.

There is a also a closely watched effort to lower the cost of taxpayer-subsidized prescription drugs, with the pharmaceutical industry promising a well-funded campaign to defeat it.

Wild cards that could dramatically affect the state’s electoral landscape include a much-discussed move to substantially shrink the pensions of public employees.

All of this may be the equivalent of a full employment act for political professionals, but a lengthy and dense ballot can turn off voters.

"What ends up happening is voter fatigue," Kaufman said.

Political scientists say voters simply give up on trying to follow so many disparate propositions and skip many of them -- or simply vote no.

A plethora of ballot measures also could raise the costs of television and online advertising to record levels, leaving initiative backers scrambling to raise cash.

"There’s only so many places you can tap the well," said Fiona Hutton, a public affairs strategist in Los Angeles. "And if there are multiple measures, how far does that donor base get stretched?"

And more campaigns will be competing for a limited amount of television and radio ad time.

"Some campaigns are never going to get enough oxygen to be able to inform voters," said Rob Stutzman, a GOP consultant working on the school bond effort.

Perhaps the biggest unknown is whether a 2014 law designed to offer a release valve for the pressure of initiative campaigns will have any effect. It allows backers of an initiative to withdraw their measure if they strike a deal on similar legislation at the state Capitol.

"Are there things that there’s an appetite for the Legislature to deal with?" said strategist Miller. "It's a new wrinkle, and it’s not one that anyone’s ever dealt with before.

By John Myers, Los Angeles Times
Via http://www.latimes.com/politics/la-me-pol-california-ballot-measures-2016-20151108-story.html

California Jolt: State Upends How It Funds and Runs Education

It's hard to find stories of "upheaval" in the way states structure the machinery of public schooling. Wrangling interests tend to allow only a little tinkering under the hood. But California right now is rewriting that script. And the sweeping changes occurring in the state's education system are so politically stunning that those inured to paralysis in Sacramento stand slack-jawed.

Not only is the nation's biggest state calmly implementing the Common Core State Standards that have roiled the waters in a number of other states. But to bolster the success of those higher academic expectations, the Golden State is revamping its entire education architecture, from how dollars flow to schools to how teachers and principals are supported and held accountable.

The changes take dead aim at reversing a longstanding lag in student achievement and, especially, narrowing the socio-economic achievement gap in a state whose schools were once the envy of the nation. The animating force is the new Local Control Funding Formula, the linchpin of 2013's authorizing legislation. Phased in over eight years, the LCFF obliterates the state's old finance system long denigrated as ineffective, dizzyingly complex and, above all, inequitable. In its place is a weighted approach that provides a basic level of funding for every student then targets additional funding to districts with large numbers of students who are more expensive to educate--those from poor families, English learners, and foster children.

While many state funding formulas use a weighted approach to try to account for the higher costs of educating different groups of students, California is taking an extra step. In a profound turnaround, and in keeping with Governor Jerry Brown's principle of "subsidiarity," decision-making responsibility for how to spend the money has been handed to local school districts.

This flips the norm established more than 35 years ago with Proposition 13, the landmark property tax limit, when the state became the school funding distributor as well as decider, largely dictating how locals could use the dollars. Over time, highly regulated "categorical" or specific-purpose programs proliferated.

The one-size-fits-all approach became increasingly counterproductive as the state's diversity exploded in the 1980s. And now, decades later, local educators are being given back the reins. Instead of compliance, their new mandate is to go forth and be creative. Innovate. Make the money matter. Work with your communities to dig into evidence about which kids are struggling with what, and why. Agree on top improvement goals and map out a plan that ties your budget to the actions you're going to take--actions that will help teachers and administrators know and continually get better at using the most effective practices.

Reaction in the state's 1,000 school districts is a stew of excitement, energy, and concern. You'd be hard pressed to find educators who don't applaud the aspiration to level the playing field for the least advantaged kids; more than half the state's six million public school students are low income. Beyond that is the new law's philosophic underpinning:

It's an implicit vote of confidence in California's educators, the opposite of the test-and-punish mode that prevailed nationally under the federal No Child Left Behind act.

At the same time, there's a near-audible gulp. Local school leaders who have complained for years about being hamstrung by Sacramento's restrictions now face, for starters, mindset change. But even exuberant local visionaries know that navigating conflicting parental and community interests can be daunting without the lever of "the state requires it" to push things forward.

The state, of course, still must hold schools accountable. Doing so will now occur by way of each district's annually updated plan that spells out its needs, priorities, and goals within eight statewide priority areas. The priorities start with student achievement but also include less tangibly documentable factors as school climate, student engagement, and parent involvement.

The local planning process has begun, even though details such as progress measures and a promised new system of improvement assistance are not yet fully in place. Watching intently are vocal advocacy groups who worry that too much local flexibility or insufficient transparency, especially for reporting on spending, may translate to diminished services for the very students the LCFF aims to accelerate.

Despite much optimism, no one sees this as a panacea in post-Proposition 13 California where investment in education has, for decades, languished below the national average and sank even lower during the recession. The new law's passage was made possible in part by good government victories--i.e., voter approved changes in legislative and election rules that finally broke legislative gridlock. But a pivotal other factor was the ballot success of Governor Brown's big 2012 gamble: Proposition 30, a temporary tax increase that averted further draconian cuts in recession-decimated school districts.

Since then, California's budget has massively rebounded. But even if activists manage to extend Proposition 30, which fully expires in 2018, and if projections of a long stretch of black ink are correct, it will take years to restore many school districts to pre-recession levels, nevermind to raise base funding from a level that's widely seen as inadequate.

The position of Brown and the state board of education is that the kids can't wait. By clearing away resource-sucking regulations and accreted categorical programs, instead unfettering education dollars to be directed to actual school and student needs, they're betting the state can turn the page on achievement mire.

Are their ambitions quixotic? Not according to years of research findings, notably from an unprecedented set of California school finance and governance studies prompted by the student outcome urgency. Anchored at Stanford and undertaken by national experts--including current State Board of Education president Mike Kirst--the studies culled from experiments in the U.S. and abroad. Findings explicitly called for replacing the "fundamentally flawed" status quo with a system that would "improve the alignment between the accountability system and the decision-making responsibilities, increasing flexibility at the local level."

Guided by these studies, the state is buttressing the LCFF with a pre-emptive system of educator support to be orchestrated by a new state agency, the California Collaborative for Education Excellence. With 10,000 schools and nearly 300,000 teachers, there is intense focus on the problem of uneven local capacity--for aligning classroom practices with the Common Core; for ensuring skilled principal leadership; for revamping district management and budgeting strategies. One favored capacity building approach is to support cross-district partnerships to fast-forward the spread of best practices, using a model pioneered in the state by a group of mostly big districts.

As implementation unfolds, developmental glitches are inevitable. With criticisms simmering among advocates of tighter control, there may not be much leeway for missteps. But the governor is adamant that the state should remain hands off, giving local flexibility time to find its footing before making dramatic adjustments. So far, with momentum stoked by the political miracle of getting this far, the odds for success appear to be on his--and the kids'--side.

Via Joan McRobbie, Huffington Post 12/18/2015

http://www.huffingtonpost.com/joan-mcrobbie/california-jolt-state-upe_b_8833242.html

The California Endowment Divests from Private Prisons

Should any foundation concerned about community well-being be investing in huge corporations whose job it is to ensure as many Americans as possible are kept incarcerated?

The California Endowment evidently does not think so. Yesterday, it announced that that it is divesting from companies “that derive significant annual revenue from the operation of private prisons, jails, detention centers and correctional facilities.”

Rick Cohen wrote about a campaign to divest from private prisons in 2014 and particularly about the campaign’s efforts to try to get the Bill and Melinda Gates Foundation to divest. At that time, he wrote:

The Gates Foundation responded to a protest led by the Latino advocacy group Presente.org in support of prisoners engaged in a hunger strike at the GEO-operated Northwest Detention Center by saying that the positive value of its grantmaking far outweighs its investments in operators of private prisons. The foundation also contends that it somehow doesn’t actually control its own investments, which are directed by the Bill & Melinda Gates Foundation Asset Trust, which operates separately from the foundation.

The campaign to divest from private prisons is asking both public and private entities to dump their holdings in Corrections Corporation of America (CCA) and GEO Group, “America’s largest private prison corporations which have profited from billions in taxpayer money.” Both are publicly traded companies who spend millions on lobbying for policies that will keep our prisons full.

“Public resistance to privatization of correctional, detention, mental health and residential facilities could result in our inability to obtain new contracts or the loss of existing contracts, which could have a material adverse effect on our business, financial condition and results of operations.”—GEO Group, 2013 SEC Annual Report, “Risk Factors”

In announcing its divestment, the Endowment released a short statement.

“The California Endowment strongly supports community safety and stands with communities that experience serious disparities in incarceration rates for non-violent offenses that could be handled through drug treatment and other programs that help prevent non-violent crime,” said Robert K. Ross, MD, president and CEO of The California Endowment. “It is essential our investment strategies take into account the potential impacts they could have on the communities we serve.”

In June, Columbia University became the first university to divest, followed by Hampshire College in Massachusetts.

As Cohen wrote in 2014, “Divestment need not be an anti-corporate strategy at all. It is a pro-values strategy. But it demands that the institutions of our society that purport to be mission- and value-driven, such as private foundations, cannot stand on the sidelines with their billions in tax exempt assets and assume that their five percent devoted to philanthropic output automatically outweighs and camouflages the impacts of the investment of their 95 percent.”

By RUTH MCCAMBRIDGE

via https://nonprofitquarterly.org/2015/12/08/the-california-endowment-divests-from-private-prisons/

California adds just 5,500 jobs in November; unemployment rate declines to 5.7%

California employers added just 5,500 jobs in November, according to federal data — a significant slowdown from more robust monthly gains earlier in the year.

But the state unemployment rate continued its five-year-long decline, dropping to 5.7% in November, the lowest in eight years. The U.S. unemployment rate is 5%.

November's tepid job increases were the lowest one-month jump in more than four years, and far less than the 40,600 job gains the state posted in October.

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But economists cautioned against reading too much into monthly swings in the employment data, which often are subject to revisions. September's numbers, for example, were revised upward from 8,200 positions to 21,100 jobs.

“We're reading the economy on the fly,” said Robert Kleinhenz, chief economist for the Los Angeles County Economic Development Corp. “That's just the nature of these economic statistics.”

Despite the lackluster November, California's payroll employment grew 2.6% over last year, faster than all but six other states and better than the national rate of 1.9%.

Construction continued to be the leading growth sector, as the industry continues to rebound from the housing crash. The high-paying professional and technical services industry — including lawyers, accountants, architects and engineers — also recorded some of the fastest job growth in the state.

The only industries to post losses were mining and logging, along with manufacturing and financial services.

The state unemployment rate is down significantly from a year ago, when it stood at 7.2%. The jobless rate is often criticized as an incomplete economic indicator because it doesn't count discouraged job seekers who have dropped out of the labor force.

Some of those who stopped seeking employment may be returning to the labor force, which has expanded over the last year even as unemployment fell. That suggests newly returned job seekers may be finding success.

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Economists say job growth tends to taper off as an economic expansion progresses. The U.S. is technically in the seventh year of expansion.

Although California's economic growth has outperformed the nation, there are still reasons for many people to believe their fortunes have not improved.

The gap between high and low earners is more pronounced in California because wages for middle-income earners have fallen.

Since 2006, median wages have declined 6.2% in California, compared with 1.9% for the U.S. overall, according to the California Budget & Policy Center.

California's economy is booming, so why is it No. 1 in poverty?

And while the share of part-time workers has declined since the depths of the Great Recession, that segment of the workforce is still larger than in the mid-2000s. About 5.9% of workers in California are considered part-time for economic reasons — meaning that they are unable to find full-time work.

That's down from 9.6% of the workforce in 2010, but still higher than when the economy last peaked in 2006.

“We don't want to miss the point that we are in one of the better times, employment-wise, in the last 40 years in California,” said Michael Bernick, a former director of the California Employment Development Department. “But at the same time, these numbers don't represent a lot of the instability: the part-time, contingent nature of the evolving labor market.”

Via Chris Kirkham, Los Angeles Times
http://www.latimes.com/business/la-fi-california-jobs-20151218-story.html

Poverty Hitting One in Six Californians

The economic recovery in California has not reached a sizable percentage of the population, with more than 16% of Californians living in poverty, according to an analysis released Tuesday by the California Budget and Policy Center.

In most California counties, the poverty rate increased from 2007 to 2014. Of the 40 California counties with available data, 32 had higher poverty rates last year than they did in 2007 before the state's recession began, the study said.

The California Budget and Policy Center is a not-for-profit that conducts independent, nonpartisan budget analysis.

"Millions of Californians continue to struggle to meet their basic needs, even after several years of steady job gains," the study said. "Poverty remained widespread even though the state's unemployment rate declined from a high of 12.2% in 2010 to 7.5% in 2014."

The federal poverty line is about $19,000 for a family of three. The overall rate fell slightly between 2012 and 2014 -- by 0.6% -- but the 2014 level of 16.4% is a full 4 percentage points higher than it was in 2007.

The study highlighted the differences between counties:

• Not only was the poverty rate higher in 32 of the 40 counties with available data from 2007 to 2014, but there was no statistically significant difference in poverty rates in the other 8 counties;
• In Lake County, the poverty rate rose to 25.9% of the population. In Kings County, 26.6% live in poverty;
• In Lake, Kings and San Bernardino counties, the poverty rate jumped by more than 8 percentage points from 2007 to 2014; and
• In 15 other counties, poverty rates in 2014 were 4 to 8 percentage points higher than in 2007. Most of those counties are in the Central Valley and in the Sacramento region.

"Many factors could contribute to the uneven recovery across California's counties," fact sheet author Alissa Anderson wrote. "These include differences in the availability of well-paying jobs and/or of sufficient work hours, as well as changes in county demographics, such as whether large numbers of people who struggle to get by move into a county."

By David Gorn
Via http://www.californiahealthline.org/capitol-desk/2015/12/poverty-hitting-one-in-six-californians

California Voters May Get to Choose Between Two Different Death Penalty Related Ballot Propositions

Faster Executions or None at All? Californians May Get to Choose

If there’s one thing supporters and opponents of the death penalty can agree on, it’s this: The system is broken. Since California reinstated capital punishment in 1977, 117 death row inmates have died. But only 15 of them have been executed. The vast majority have died of natural causes or suicide.

When he was chief justice of the California Supreme Court, Ronald George caused a stir when he said “the leading cause of death on death row in California is old age.” The system, he said, is dysfunctional  — and few would disagree.

Even before a federal judge blocked executions in 2006, the pace of implemented death sentences was slow. It wasn’t unusual for condemned inmates to spend two decades on death row, as their legal appeals slowly wound through the courts. But to death penalty opponents, the seemingly endless delays prove that capital punishment is unworkable and should be scrapped altogether.To death penalty supporters, that delay is a travesty of justice and disrespectful to crime victims and their families who, they say, deserve to see the ultimate sentence implemented.

Come November, California voters could have two completely different options for fixing the system. Two groups are preparing to collect signatures for ballot measures that would present stark choices.

One, the Death Penalty Reform and Savings Act of 2016, would limit inmate appeals, which can drag on for decades, and expedite executions. It would also give the California Department of Corrections and Rehabilitation more latitude in housing condemned inmates and require them to work, with 70 percent of their wages going to crime victims.

The other proposal, which ballot measure proponent Mike Farrell calls “The Justice That Works Act of 2016,” would ban executions altogether and convert all existing death sentences to life in prison without the possibility of parole.

The Death Penalty Reform and Savings Act of 2016 is current being reviewed by the Attorney General’s Office. A similar measure was proposed last year and endorsed by three former California governors. It never made it to the ballot.

An attorney advising proponents of the current death penalty reform measure told me that first effort was “controlled by crime victim families,” suggesting it didn’t have the kind of professional political consultants needed to make it to the ballot.

This time around, he said, Sacramento-based strategist Aaron McLear and his firm, Redwood Pacific, will guide the effort.

This week the nonpartisan Legislative Analyst’s Office released its fiscal review of that measure. While acknowledging the measure would affect various costs, “the magnitude of these effects would depend on how certain provisions in the measure are interpreted and implemented,” the LAO wrote.

In conclusion, it wrote:

• Increased state costs that could be in the tens of millions of dollars annually for several years related to direct appeals and habeas corpus proceedings, with the fiscal impact on such costs being unknown in the longer run.
• Potential state correctional savings that could be in the tens of millions of dollars annually.
• Proponents of the measure to ban capital punishment must be more pleased with the LAO analysis of their measure. The LAO estimates a “net reduction in state and local government costs of potentially around $150 million annually within a few years due to the elimination of the death penalty.” You can be sure that will end up in a TV commercial for the measure.
• 
  
• Proponents of both measures have yet to collect a single signature. Assuming they get a green light from the attorney general and the secretary of state, they’ll have 180 days to collect the necessary signatures to put it before voters.
• 
  
• If both succeed, they’ll likely join a November 2016  ballot with measures related to legalizing pot, raising the minimum wage and strengthening gun control. All that, plus a presidential election and the race to replace retiring U.S. Sen. Barbara Boxer.
• In other words, a political junkie’s dream come true.

By Scott Shafer

Via http://ww2.kqed.org/news/2015/12/14/faster-executions-or-none-at-all-california-voters-may-choose

California Expands Substance Abuse Treatment For Low-Income Residents

After years fighting a heroin addiction, Danny Montgomery, 33, is receiving inpatient treatment that is being paid for by Los Angeles County.

California is overhauling its substance abuse treatment system for low-income people, embarking on a massive experiment to create a smoother path for addicts from detox through recovery.

The state is the first to receive federal permission to revamp drug and alcohol treatment for beneficiaries of Medicaid, known as Medi-Cal in California. Through what's known as a drug waiver, state officials will have new spending flexibility as they try to help people get sober and reduce social and financial costs of people with substance abuse disorders.

Under the waiver, the state plans to expand treatment services, including inpatient care, case management, recovery services and added medication. Beginning next year, drug treatment centers will be able to get reimbursed for providing this much wider range of options to people on Medi-Cal.

Only a small fraction of low-income Californians with substance abuse disorders receive treatment, largely because of restrictions on what Medicaid will pay for.

"This was a long time coming," said Keith Lewis, executive director of Horizon Services, which provides treatment in San Mateo, Santa Clara and Alameda counties. "It's a win/win for people with substance use issues and their families ... and for the people providing those services."

The changes, which will be phased in starting next year, stem in part from the Affordable Care Act, which required that substance abuse treatment be covered for people newly insured through Medicaid or insurance exchanges. The health law allowed states to expand Medicaid to cover millions more people.

Drug rehabilitation providers say the changes will give addicts a better chance at getting — and staying — clean. But they fear the state won't raise the traditionally low Medi-Cal reimbursement rates for treatment, making it harder to provide services and produce the outcomes California is hoping for.

Lewis, of Horizon Services, said that under the waiver he expects drug treatment services to be higher quality and the workforce better trained. But he said that "Medi-Cal rates, which have always been too low, have to go up."

California's Medi-Cal drug treatment program currently costs about $180 million annually, paid through a combination of state and federal funds. There aren't any estimates for costs under the new approach. But the idea is that the changes will help health care expenses overall by enabling more people to get sober and healthier so they stop rotating through treatment centers, jails and hospitals.

Nearly 14 percent of Medicaid recipients are believed to have a substance abuse disorder, according to the National Survey on Drug Use and Health.

The five-year pilot project in California was approved by the federal Centers for Medicare & Medicaid Services in August. Under the waiver, counties will approve treatment for Medi-Cal patients based on medical necessity and criteria established by the American Society of Addiction Medicine.

i

The Tarzana Treatment Centers in Los Angeles County provide outpatient and inpatient care for substance use disorders.

Anna Gorman/KHN

Current federal rules limit drug treatment centers' ability to get reimbursed under Medicaid for residential care. Clinics with more than 16 beds essentially cannot get paid, except for treating pregnant and postpartum women. That restriction will be dropped for California under the waiver.

As a result, Medi-Cal beneficiaries will be able to access up to two 90-day residential stays each year, with the possibility of one 30-day extension if providers determine that it is medically necessary. Certain populations, including those in the criminal justice system, can get approval for longer stays.

The waiver is also designed to provide better coordination between physical, mental health and substance abuse services," according to John Connolly, deputy director of substance abuse prevention and control for the Los Angeles County Department of Public Health. That along with more access could result in fewer emergency room visits and hospitalizations, he said.

That's potentially good news for people like Caitlin Knoles, a resident of Orange County who says she gets turned down for treatment of her methamphetamine addiction every time she tells residential centers she's on Medi-Cal. She has ended up in the hospital more than once because of her addiction.

"It's hard," Knoles said. "I can't get help."

The only way she can reliably get clean now is in jail, she says.

"It'd be nice to have a job and have my family back and just be normal," said Knoles, 24, as she sat outside a liquor store in Laguna Hills.

For the first time, substance abuse disorders will be treated like a disease rather than a short-term illness, said Marlies Perez, chief of the substance use disorder compliance division for the state Department of Health Care Services. "Even though we know it's a chronic condition, we have treated it acutely," she said.

Much depends, however, on reimbursement rates, which are still being negotiated. Clinic officials say they need higher rates to expand services and handle the anticipated influx of clients, many of whom will be seeking rehab for the first time.

"There is a cost to raising the bar on treatment," said Albert Senella, president of the California Association of Alcohol and Drug Program Executives. "If the rates aren't adequate ... we are not going to be able to effectively meet the [new requirements] and the needs of the population."

Senella, who is also CEO of Tarzana Treatment Centers in Tarzana, Calif., said many clinics across the state don't have money to prepare for the overhaul, which will require improving technology and adding and training staff. For now, no plans are in place to provide counties or clinics with startup funds.

Eli Veitzer, interim CEO of Prototypes, which provides treatment services in Los Angeles, Orange and Ventura counties, said the waiver provides an "incredible opportunity" to transform care.

But in addition to fears about rates, Veitzer said he is also worried that 90 days of residential treatment won't be enough for many people. Someone may be able to stem their addiction in three months but will still need more time in a treatment facility to prepare for life outside.

"If their ability to function independently in the community is not addressed, they are likely to relapse," he said.

Danny Montgomery, a 33-year-old patient at Tarzana Treatment Centers, said he needed more than a few months to get clean after nearly a decade on heroin. The addiction, which he estimated cost him up to $100 a day, caused him to lose his job and nearly lose his family.

"The whole thing is a process," said Montgomery, who lives in the San Fernando Valley. "You get the substance removed from your body, but you have to retrain your mind." Montgomery said he tried to get a bed in a residential treatment center but couldn't find one that would take Medi-Cal.

He tried to get clean on his own but it never lasted. Months after beginning his search, Montgomery was finally able to get a spot at Tarzana. He said Los Angeles County is paying for his stay, which began in May.

As worried as they are about reimbursements, clinic operators said a big advantage of the new approach is that it could help stabilize their funding. Providers now depend largely on counties to pay for residential treatment for low-income residents.

"You always suffered the vagaries of the budget cycle," said Vitka Eisen, CEO of HealthRIGHT 360, which provides drug treatment in the Bay Area.

The waiver also means increased oversight of treatment centers.

Last year, a state audit found widespread fraud and questionable billing among Medi-Cal drug treatment providers. The audit followed reports by the Center for Investigative Reporting that clinics were billing for fake clients.

The new system will include more levels of accountability, Perez says, including more stringent requirements for clinics and more local control over contracting.

Knoles, who is addicted to methamphetamine, said she hopes that more people like her will be able to get treatment.

"I've had a lot of friends die from addiction," she said. "Imagine if they'd gotten the help they wanted and needed. Things would have been different."

Anna Gorman is a reporter with Kaiser Health News, a nonprofit news organization covering health care policy and politics. 

Via: http://www.npr.org/sections/health-shots/2015/12/11/459226074/california-expands-substance-abuse-treatment-for-low-income-residents