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High Cost of Hepatitis C Drug Hits California Budget

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By David Siders, Sacramento Bee

Last year, after the Food and Drug Administration approved a breakthrough new drug for hepatitis C, health officials around the country warned of dire consequences for state budgets.

The drug is expensive – about $1,000 a pill, or $84,000 for a regular course of treatment – and many people it could help receive publicly funded care.

In California last week, Gov. Jerry Brown’s administration quantified the impact: Tucked inside Brown’s annual spending plan was $300 million for the cost of new hepatitis C drugs, including Sovaldi, the drug approved in December 2013.

The single budget item – $100 million this fiscal year and $200 million in 2015-16 – eclipses proposed general fund spending.

“It’s huge,” Michael Cohen, Brown’s director of finance, said. “It was clearly something that caught folks by surprise.”

The state estimated that in 2000, about 600,000 people in California were chronically infected with hepatitis C, the blood-borne illness that can ravage the liver. An estimated 5,000 people in the state are estimated to be infected each year.

While older treatments were less effective and brought debilitating, flu-like side effects, Sovaldi offered a high cure rate in a less toxic pill.

But the cost of the treatment and the large number of people lining up for it has forced states to confront an enduring question of health care in America – one exacerbated by the federal health care overhaul’s expansion of Medicaid coverage in the states: How much should the public pay for effective but costly cures?

“The treatment is exceptional,” said state Sen. Ed Hernandez, an optometrist and Los Angeles-area Democrat. “I mean, it’s probably one of the best things to ever happen.”

On the other hand, he said, the cost is alarming: “There’s good, and there’s bad.” The treatment’s emergence comes amid a dramatic expansion of Medi-Cal, the state’s version of Medicaid, with California projecting caseloads growing to almost 12.2 million next year.

“This is a huge exposure to the state,” said Charles Bacchi, president and chief executive officer of the California Association of Health Plans.

The state Department of Health Care Services estimated this week that, as of October, roughly 1,695 Medi-Cal recipients had received Sovaldi or Johnson & Johnson’s hepatitis C drug Olysio, or a combination of the two.

For those treatments, Medi-Cal has paid about $108 million, the state said.

In addition, California Correctional Health Care Services said it has treated 315 inmates with Sovaldi since July, at an estimated cost of about $26 million to $30 million. The illness is often associated with a history of injection drug use and, in older patients, blood transfusions, and is more prevalent in prisons than in the general population.

Prison officials said they anticipate budget savings in future years as cases of cirrhosis and liver cancer decrease due to the cure. Competition may also drive down future costs.

Demand, however, appears to remain high. Julia Logan, quality officer at the California Department of Health Care Services, said shortcomings of old hepatitis C treatments resulted in a “backlog of patients” waiting for Sovaldi and other new drugs. Similarly, in the state prison system, officials said some patients who previously deferred treatment are now being considered for it.

John Martin, chairman and chief executive officer of Gilead Sciences.

John Martin, chairman and chief executive officer of Gilead Sciences.

In future years, Logan said, “I think that there will continue to be many thousands more people getting treated for hepatitis C.”

Shortly after Sovaldi was approved, the drug’s maker, Gilead Sciences Inc., came under intense criticism from lawmakers, insurers and health care advocates for the price. The drug maker reported $8.6 billion in sales of Sovaldi in the first nine months of 2014.

Gilead Sciences did not respond to requests for comment. In an earnings conference call in October, John Martin, the company’s chairman and chief executive officer, said Sovaldi and drugs like it “provide savings to payers, providers, patients and our entire health care system over the long-term.”

 

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Activism

CA Reparations Task Force LA Meeting’s Public Comments Get Heated

“Reparations are designed to repair and heal the damages done to Africans for 400 years who [suffered] through Jim Crow [laws],” California Secretary of State Shirley Weber who authored the task force legislation, Assembly Bill (AB) 3121 in 2020 while serving in the Assembly, said last January. “Reparations are for those who are descendants of slavery. Their ties are permanently severed from their homeland and their ability to return to Africa is almost impossible. We are truly Americans.”

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Antonio‌ ‌Ray‌ ‌Harvey‌ ‌|‌ ‌California‌ ‌Black‌ ‌Media‌

LOS ANGELES – The nine member California Task Force to Study and Develop Reparations Proposals for African Americans convened in Los Angeles at the California Science Center for its tenth meeting on Sept. 23 and Sept. 24.

The meeting opened with comments from the public with speakers passionately delivering their views on what reparations should look like.

Many focused their comments and opinions on who should and should not receive reparations. The opposing views created tension among those in the audience on an issue that the task force resolved months ago.

“I think it’s a good thing. We have a lot of passion in our community and reparations speak to the core of what makes Black Americans. I wouldn’t expect any less,” said Chad Brown, a member of the National Assembly of American Slavery Descendants (NAASDLA) and Coalition of a Just and Equitable California (CJEC).

“This is the process. I expect a lot of passion. It’s passion directed at finding solutions,” Brown told California Black Media.

The temperature in the room rose when Kevin Cosney, associate director of the California Black Power Network (CBPN), addressed the task force members and said that a majority of the members made a “problematic” decision in excluding people such as Africans enslaved in the Caribbean, Native Americans, and persons from the continent of Africa.

“We encourage this task force to be transparent, bold, gracious, expansive, and unified in its work of diverse opinions,” Cosney told the task force. “The fact that you prematurely rushed on eligibility is problematic and disrespects the community’s voice. We would like you to reconsider and take this into account.”

Cosney’s CBPN and Brown’s CJEC are two of seven “anchor organizations,” selected across the state to host “community listening sessions” in conjunction with the task force.

The nonprofit California Black Power Network describes itself as a “growing, united ecosystem of Black empowering grassroots organizations” collaboration to change the lived conditions of Black Californians “by dismantling systemic and anti-Black racism.”

CJEC is a state-wide coalition of organizations, associations, and community members united for reparations for the descendants of enslaved Black American men and women.

California Secretary of State Shirley Weber who authored the task force legislation, Assembly Bill (AB) 3121 in 2020 while serving in the Assembly, has taken the position that compensation should be limited to African Americans who are descendants of Africans enslaved in the United States.

“Reparations are designed to repair and heal the damages done to Africans for 400 years who [suffered] through Jim Crow [laws],” Weber said last January. “Reparations are for those who are descendants of slavery. Their ties are permanently severed from their homeland and their ability to return to Africa is almost impossible. We are truly Americans.”

Last March the task force voted 5-4 that lineage will determine who will be eligible for reparations over race.

Task Force chairperson Kamilah Moore, vice-chair Amos Brown, pastor of Third Baptist Church in San Francisco, and president of his local NAACP branch; University of California-Berkeley professor Jovan Scott Lewis; San Diego City Councilwoman Monica Montgomery-Steppe, and Sen. Steven Bradford (D-Gardena) voted in approval of lineage.

Eligibility is determined by an individual being African American, “the descendant of a [person enslaved as chattel] or the descendant of a free-Black person living in the United States prior to the end of the 19th century,” Moore said.

Attorney Don Tamaki, Assemblymember Reggie Jones-Sawyer (D-Los Angeles), Los Angeles-based attorney Lisa Holder, and Loyola-Marymount professor Cheryl Grills, voted in favor of race.

AB 3121 established the task force with a “special consideration” of those who are descendants of persons enslaved in the United States. Starting with the Atlantic Slave Trade, chattel slavery was sanctioned in the U.S. from 1619 to 1865.

“We agree that there should be special consideration for those that trace their lineage back to Slavery,” Cosney said. “But we also know and understand that the system of white supremacy affects everyone who is Black on this planet and in this country.”

Members from CJEC and CBPN moved their heated discussion outside of the facility after making their comments. But, the conversations cooled off with smiles and gestures of mutual respect for opinions.

Brown said the eligibility issue is settled but he is not at odds with debating the merits of the decision of the task force. He “stands on” the fact that Black families were impacted by slavery and “those families, descendants, are owed reparations.”

“Reparations are not something that is a cure. It is not something meant to change the minds of people,” Brown said. “Reparations are meant to repair a special community that has been impacted by slavery, Jim Crow, convict leasing, mass incarcerations, and the throughline of slave ships and chains.”

The next Task Force in-person meeting is scheduled for Oakland in December 2022 followed by San Diego in January 2023 and Sacramento in February 2023.

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Activism

California Cities are Pilot Testing Guaranteed Basic Income Programs

“The course of this pandemic has revealed the large number of County residents who are living on the brink of the financial crisis, with insufficient savings to weather a job loss, a medical emergency, or a major car repair. This guaranteed income program will help give residents the breathing room they need to better weather those crises,” said Supervisor Sheila Kuehl.

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These programs, including LA County’s Breathe program, are modeled after a universal basic income program that was tested in the city of Stockton. The Stockton Economic Empowerment Demonstration (SEED) provided $500 to 125 low-income residents for 24 months.
These programs, including LA County’s Breathe program, are modeled after a universal basic income program that was tested in the city of Stockton. The Stockton Economic Empowerment Demonstration (SEED) provided $500 to 125 low-income residents for 24 months.

Manny Otiko | California Black Media

Guaranteed basic income isn’t a new idea. Dr. Martin Luther King Jr talked about the idea of low-income people receiving regular checks from the government in the 1960s. It was brought up again during the 2020 presidential campaign when Democratic candidate Andrew Yang, a technology entrepreneur, made it a major part of his platform.

However, Yang was advocating for Universal Basic Income (UBI), which guarantees payments to everyone.

Guaranteed basic income only targets low-income people.

According to Yang, some kind of guaranteed basic income program is going to be necessary for the future when technology makes many jobs obsolete. A 2020 World Economic Forum study predicted that technologies such as artificial intelligence and robotics would eliminate 85 million jobs by 2025. However, guaranteed basic income programs are gaining steam across California as poverty alleviation. Several cities are carrying out pilot programs.

Los Angeles County is conducting a guaranteed basic income pilot program called Breathe. The program provides $1,000 to 1,000 LA County residents over a three-year period. The program will be evaluated by researchers at the University of Pennsylvania’s Center for Guaranteed Income Research.

Breathe is overseen by the county’s Poverty Alleviation Initiative. 180,000 residents applied to take part in the program. On a single day during the process, 95,000 people submitted applications, according to a county press release.

To qualify for Breathe funds, the applicants had to be at least 18 years old, have a single-person household income under $56,000 or $96,000 for a family of four, and have experienced negative impacts due to COVID-19.

One motivation behind the Breathe program was the COVID-19 pandemic, which laid bare the problems of poverty and income inequality.

“The course of this pandemic has revealed the large number of County residents who are living on the brink of the financial crisis, with insufficient savings to weather a job loss, a medical emergency, or a major car repair. This guaranteed income program will help give residents the breathing room they need to better weather those crises,” said Supervisor Sheila Kuehl.

Other guaranteed basic income programs are being pilot-tested in California.

Miracle Messages, an outreach program for the unhoused in San Francisco, started to pilot test a program called Miracle Money last year. Miracle Money provided $500 to homeless people. And the initial program seemed to be a success. According to Miracle Messages, about 50% of the people in the test group were able to find housing after they received the cash payments. Miracle Money was funded by a GoFundMe campaign.

Oakland Resilient Families is a Bay Area program that provides a $500 grant to families for 18 months. The program stresses it is different from universal basic income. “Guaranteed income is meant to provide an income floor but not meant to be a replacement for wages. Guaranteed income can also be targeted to those who need it most,” according to the organization’s website. Oakland Resilient Families is funded by donations.

Mountain View, another Bay Area city is setting up a new guaranteed basic income pilot program called Elevate MV. The pilot program promises to give, for two years, $500 a month to 166 low-income families with at least one child or who are currently pregnant. Elevate MV is operated through the Community Services Agency, a non-profit organization.

In San Diego County a guaranteed income pilot program was launched in March 2020. One hundred and fifty households with young children residing in one of the four priority ZIP codes in the county — Encanto, Paradise Hills, National City and San Ysidro — are receiving $500 a month for two years. The $2.9 million program is run by Jewish Family Service of San Diego with funding from Alliance Healthcare Foundation and from the state’s budget surplus.

These programs, including LA County’s Breathe program, are modeled after a universal basic income program that was tested in the city of Stockton. The Stockton Economic Empowerment Demonstration (SEED) provided $500 to 125 low-income residents for 24 months.

The research showed that the SEED program worked, according to a National Public Radio (NPR) article.

“Among the key findings outlined in a 25-page white paper are that the unconditional cash reduced the month-to-month income fluctuations that households face, increased recipients’ full-time employment by 12 percentage points, and decreased their measurable feelings of anxiety and depression, compared with their control-group counterparts,” said NPR.

Stockton Mayor Michael Tubbs launched the SEED program in 2019. Following the promising results of the pilot program, in 2020 Tubbs launched Mayors for Guaranteed Income, a coalition of 60 mayors who are advocating for a guaranteed income program to ensure that all Americans have an income floor.

Tubbs lost his bid for re-election in 2020 and is now an adviser to Gov. Gavin Newsom who is a proponent of guaranteed income.

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Gov. Newsom Signs Legislation Funding Nation’s First Black Women’s Think Tank

“There are approximately 1.1 million Black females in California. However, there are 75% of Black households headed by single Black mothers and 80% of Black households have Black women breadwinners. There are economic, educational, health, and electoral barriers confronting Black women every day. In California, 23% of Black women live in poverty, according to the Women’s Well-Being Index from the California Budget and Policy Center,” The California Black Women’s Collective (CBWC) stated.

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Based on current information concerning Black women and girls in the state, CBWC’s Think Tank collective specifically aims to provide actionable policy solutions, remove persistent barriers that this group of women faces on a daily basis, and achieve racial and gender equity.
Based on current information concerning Black women and girls in the state, CBWC’s Think Tank collective specifically aims to provide actionable policy solutions, remove persistent barriers that this group of women faces on a daily basis, and achieve racial and gender equity.

Antonio‌ ‌Ray‌ ‌Harvey‌ ‌|‌ ‌California‌ ‌Black‌ ‌Media‌

Last week, Gov. Gavin Newsom signed a budget trailer bill approving $5 million in funding to the California State University at Dominguez Hills (CSUDH) to house the California Black Women’s Think Tank.

The California Black Women’s Collective (CBWC) Empowerment Institute will be a founding partner in the development of the policy research institution.

The legislation, Assembly Bill (AB) 179, authored by Assemblymember Phillip Ting (D-San Francisco), paves the way for establishing a policy institute that will focus on improving structures and practices that impact the lives of Black women and girls across the state.

“The California Black Women’s Collective has diligently worked hard over the last year to make the California Black Women’s Think Tank, the first of its kind in the nation, happen.” Kellie Todd Griffin, speaking for CBWC, told California Black Media.

CBWC in partnership with Black Women Organized for Political Action (BWOPA), is a coalition of more than 1,500 Black Women leaders throughout California.

The coalition utilizes Black women’s expertise and collaboration skills in political, community, and social justice activism to amplify their voices, knowledge, and issues throughout the state.

On June 20, Newsom signed a $308 billion state budget that helps address rising costs for Californians, tackles the state’s most pressing needs, builds reserves, and invests in the state’s future.

(AB) 179, the Budget Act of 2022, implements funding for key priorities established by the California Black Legislative Caucus (CLBC) for this legislative session, including CBWC’s Think Tank.

“We are thankful to the California Legislative Black Caucus (CLBC) that included it as a priority-budget ask and CSUDH for partnering with us on it,” Todd Griffin said.

The CBWC’s goal for the Think Tank is for it to be “relevant and accessible” in providing an “independent, academic, research entity that provides a “rigorous analysis approach to policy,” CBWC explained in a written overview.

The state and CLBC are in support of addressing the need to expand work that drives systematic change, brought forth by CBWC. The Think Tank is an effort to serve as a research institution and resource for lawmakers, elected officials, business leaders, and advocating organizations willing to impact sustainable and scalable change.

“There are approximately 1.1 million Black females in California. However, there are 75% of Black households headed by single Black mothers and 80% of Black households have Black women breadwinners. There are economic, educational, health, and electoral barriers confronting Black women every day. In California, 23% of Black women live in poverty, according to the Women’s Well-Being Index from the California Budget and Policy Center,” CBWC stated.

According to the Status of Black Women report from the Women’s Policy Research (WPR) and information provided by CBWC, the median income for Black women in California is $43,000 a year, compared to $52,000 for white women and $69,000 for white men. The report by WPR also shared that the average cost of childcare for an infant makes up 28% of a Black woman’s average income in the state.

CBWC’s Think Tank intends to approach its work in a data-driven, strategic, and collaborative manner. Based on current information concerning Black women and girls in the state, the collective specifically aims to provide actionable policy solutions, remove persistent barriers that this group of women faces on a daily basis, and achieve racial and gender equity.

The CBWC Empowerment Institute falls in line with these initiatives to help Black women, Todd Griffin asserts.

“The magnitude of this funding allocation will be transformative as we continue the work to improve the quality of life of Black women and girls throughout California,” Todd Griffin said.

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