Legislative Update The Journey of a Sponsored Bill Catrina Reyes, Esq

legislative update

Catrina Reyes, Esq. Vice President of Advocacy and Policy

The Journey of a Sponsored Bill

All legislation starts off as an idea. Factors that CAFP staff, the Legislative Affairs Committee, and the Board of Directors take into account when considering an idea include, amongst others, whether the bill idea advances CAFP’s strategic plan, has a primary care or family physician focus, solves a current problem, is feasible, avoids unintended consequences, and has potential allies and minimal adversaries. Senate Bill 402, CAFP’s sponsored bill this year, met all of these factors. SB 402 would have established multi-payer payment reform pilots in areas hardest hit by COVID-19 with the goal of transitioning primary care physician practices from fee-for-service payments to alternative payment models. After CAFP decides on a bill idea, CAFP staff draft bill language and a fact sheet to “shop” to members of the Legislature to persuade them to author the bill. If the author is a Senator, the bill is introduced at the Senate Desk; if an Assemblymember, at the Assembly Desk, where it is assigned a number and read for the first time. Senator Melissa Hurtado was the author for CAFP’s sponsored bill this year thanks to requests from her constituents and CAFP members, Jasmeet Bains, MD, and Raul Ayala, MD. After the bill is read for the first time, it goes to the Senate or Assembly Rules Committee, where it is assigned to a policy committee. CAFP sponsored bills are typically assigned to the Health Committee. Bills are not heard in policy committee until 30 days after they have been introduced and in print. Prior to a sponsored bill being heard in Committee, CAFP meets with other organizations that could be potential allies as well as members of the Health Committee to garner their support. SB 402 had broad-based support from organizations including the American Academy of Pediatrics (California), American College of Obstetricians and Gynecologists District IX, American Diabetes Association, California Chronic Care Coalition, California Medical Association, California Pan - Ethnic Health Network, California State Council of Service Employees International Union (SEIU California), CaliforniaHealth+ Advocates, Center for Collaborative Solutions, Children's Defense FundCalifornia, Community Health Councils, Latino Coalition for A Healthy California, Primary Care Development Corporation, and Purchaser Business Group on Health. During the Committee hearing, the bill author presents the bill and time is allocated for witnesses in support of and in opposition to the bill. CAFP member, Sumana Reddy, MD, and CAFP Vice President of Advocacy and Policy, Catrina Reyes, testified in support of SB 402. There were no witnesses in opposition. SB 402 passed out of the Senate Health Committee with a unanimous vote.

If the bill has a fiscal impact or a state cost, it will be heard in either the Senate or Assembly Appropriations Committee. The Senate Appropriations Committee placed SB 402 on the Suspense File, because it was assumed to cost the State $3 million to implement. The Appropriations Committee sends any bill with an annual cost of more than $150,000 to the Suspense File. Suspense File bills are then considered at one hearing after the state budget has been prepared and the Committee has a better sense of available revenue. No testimony is

presented – author or witness – at the Suspense File hearing. If a bill does not make it off the Suspense File, it does not continue through the legislative process. Fortunately, after strong grassroots advocacy from CAFP members during CAFP's Advocacy Week, SB 402 made it off the Suspense File and passed out of Senate Appropriations Committee. After the bill passes the Appropriations Committee, it is read for the second time on the Floor. Third Reading is the last stage that a bill goes through in the house of origin before it passes to the second house to go through the committee process all over again. On Third Reading, the author presents the bill for passage by the entire house. Most bills require a majority vote (it must pass by 21 votes in the Senate and 41 votes in the Assembly), while urgency measures and appropriation bills require a two-thirds vote (27 in the Senate, 54 in the Assembly). SB 402 passed the Senate Floor on the Consent Calendar as it had no opposition. Bills may be placed upon the Consent Calendar if they are reported to the Floor with that recommendation, received no “no” votes in committee, and have had no opposition. SB 402 also passed out of the Assembly Health Committee on the Consent Calendar. The bill, however, was again placed on the Suspense File in the Assembly Appropriations Committee and this time did not make it out of the Committee. The bill made it far through the legislative process though, which means we were able to educate many legislators on the importance of investing in primary care and to lay the foundation for future efforts.

If a bill passes the Legislature, it goes to the Governor to sign, approve without signing, or veto. If the Governor vetoes the bill, a two-thirds vote in each house is needed to override the veto. The Governor's Office releases veto messages which explain the veto. If the bill is signed or approved without a signature, it typically goes into effect January 1st of the following year. Throughout the Legislative process, from finding a bill author to getting SB 402 off of the Senate Appropriations Suspense File, it was because of strong advocacy efforts from CAFP members that moved the bill forward. Never doubt the strength of your voices in promoting important issues that impact family physicians and your patients.

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