California Editorial Rdp
San Francisco Chronicle on how California can stay healthy:
California’s population is aging. Without big changes in how the state finds and trains its health care workforce, it soon won’t have enough physicians and other caretakers to look after its people.
That’s the message from a startling new report by the California Future Health Workforce Commission.
The commission, a coalition of CEOs, educators, nurses and physicians who spent nearly two years studying the challenge of providing health care for California’s shifting demographics, has come up with 10 recommendations that they say could eliminate the shortage of primary care physicians and nearly eliminate the shortage of psychiatrists by 2030.
The catch? The recommendations come with a price tag of $3 billion. Implementing an additional 17 important recommendations would require a combined cost of $6 billion.
The numbers sound enormous, but they’re drops in the bucket of California’s total health-care spending. That $3 billion is less than 1 percent of what Californians are expected to spend on health care in 2019 alone.
Plus, the state may have no choice but to change how it’s attracting and training health care workers.
Parts of the state, especially in the fast-growing inland regions, are already experiencing critical shortages of primary care, dental or mental health care providers. The looming retirements of the Baby Boomer generation are expected to create care shortages for millions more Californians.
The most important changes the commission recommends have to do with the structure of health care operations and training in California.
It recommends expanding the authority of nurse practitioners, for example, especially in rural and underserved communities. This would surely incur the wrath of physicians’ associations.
Another recommendation is to establish a family of jobs — with career ladders — for home health care workers. This is the kind of change that could enrage nurses’ groups.
Both ideas must be pursued anyway. California’s population is diverse, but its health care workforce is not. Filling the state’s workforce gaps will require increased investments in attracting, training and retaining people of color to be physicians and nurses, and many of the commission’s recommendations revolve around ways to do this.
It suggests expanding and scaling pipeline programs for lower-income and underrepresented students — starting as early as high school. There’s a particular need for students to pursue the professions facing critical shortages in rural and underserved areas, and the commission recommends offering them scholarships as a form of encouragement. Considering the weight of student debt, the commission’s idea may be a wise one.
As for the all-important question of who will pay for these investments, the answer may be a mix of partnerships, instead of a simple line item from the state. But when it comes the future of health in California, the money may count as a far smaller cost than continuing with the status quo.
Los Angeles Times on California’s pot shops already lobbying for a tax cut:
More than two years after California voters passed Proposition 64 to legalize marijuana, the state’s attempt to create an orderly, regulated marijuana marketplace is still a work in progress.
There are far fewer licensed cannabis businesses than had been expected and tax revenue — which officials had estimated could reach $1 billion — is trickling in at a fraction of what was anticipated. The black market for marijuana is still thriving.
Now, several lawmakers and State Treasurer Fiona Ma have introduced Assembly Bill 286, which would temporarily slash cannabis taxes in an effort to entice illegal marijuana businesses to enter the legal market. Industry groups have been lobbying for this break, arguing that lowering taxes would also bring down the price of regulated marijuana, helping legitimate operators to compete with black market dealers.
“We are helping legal cannabis businesses with their transition into the marketplace, just like we would for any startup industry,” Ma said in a statement.
But cannabis is no ordinary business, and cannabis taxes have a broader purpose than most other taxes.
In fact, the architects of legalization, including a Blue Ribbon Commission on Marijuana Policy created in 2013 by then-Lt. Gov. Gavin Newsom, thought long and hard about how to set the tax structure for the new industry. Prices should be low enough to compete with the black market but high enough to deter heavy usage and use by minors, the commission recommended.
Proposition 64 set the tax rates. However, the initiative also directed the Legislative Analyst’s Office to report to lawmakers by January 2020 on recommendations to adjust the tax rates to undercut the illicit market and discourage underage use while still providing enough money for regulation, law enforcement, research and other programs funded by cannabis tax revenue.
The LAO has already begun that report. There may be good reasons to adjust the tax structure, either temporarily or permanently. Colorado lawmakers raised cannabis taxes a few years after legalization. Washington overhauled its system so that instead of having three taxes collected at various points in the supply chain, there was only a single tax at the retail shop. Shouldn’t California lawmakers wait for a thorough analysis before they start cutting taxes?
Cannabis industry groups argue that businesses can’t wait. Legitimate operators, they say, invested enormous amounts of money to get licensed and to comply with the state’s complex regulations, but they’re being undercut by illegal pot shops and delivery businesses. That’s a real problem. The state needs much more aggressive enforcement to shut down illicit operators.
But high taxes aren’t the only reason the black market persists. Proposition 64 allowed localities to ban cannabis businesses and many have done so. Fewer than 20% of California cities allow retail shops to sell marijuana for recreational use. No matter if a pot business has been operating for years in the gray market that existed prior to regulations, the business can’t become a legitimate, taxpaying entity without local approval. Even in the cities that do allow marijuana businesses, many are still struggling to license in a timely fashion.
No wonder the black market is flourishing.
AB 286 would cut the state cannabis excise tax from 15% to 11% and suspend the cultivation tax of $9.25 per ounce of cannabis flower. Both would be temporary reductions that would end in June 2022. It would not affect local marijuana taxes, which can run from 5% to 15%. Nor would the bill stop localities from raising their taxes even more if lawmakers lower the state tax rates. That would divert revenue from marijuana-related programs laid out in Proposition 64 into local coffers while undercutting the whole purpose of AB 286.
It’s worth remembering that legal recreational sales only started last year in January. It’s not surprising that California is experiencing the growing pains as it transforms the marijuana industry from a largely uncontrolled, unchecked and underground operation into a highly regulated, taxpaying marketplace. (Marijuana remains illegal under federal law.)
This was never going to be an easy process. Lawmakers ought to slow down, wait for the LAO’s recommendations and then think about whether marijuana taxes are helping or hurting California.
The Fresno Bee on solving California’s housing crisis:
First Gov. Gavin Newsom said he wanted 3.5 million new homes to be built to address California’s housing crisis. Next he sent a shock wave through municipalities with a lawsuit no one saw coming.
Newsom, through the Attorney General’s Office, sued the city of Huntington Beach on Jan. 25 for failing to have a housing plan that addresses the needs of all residents in the Orange County coastal community.
The governor’s action was the first of its kind under a new law that allows the state to sue a local jurisdiction found to be out of compliance with its housing goals.
Huntington Beach is not alone. Fifty-one other cities in California are currently listed by the state as having housing plans that are out of compliance with requirements. Among them are a handful of Valley cities — Clovis, Selma, Orange Cove, Dos Palos and Atwater — as well as the coastal resort town of Pismo Beach.
By state law, cities are required to have plans detailing how much housing can be built. Land must be zoned to accommodate a range of housing types — from apartment complexes to upscale single family dwellings.
The lawsuit, and the message it sent, was not lost on Jim Lewis, city manager for Pismo Beach, which has little open land and has some of the most expensive housing in the state: “I think about this (housing) every day. I don’t need the governor hitting me with a bat. That’s not effective.”
That said, Newsom is showing local leaders he is going to approach the wonky subject of housing in a much different manner than his predecessor. He is motivated by California having a housing crisis that, if unsolved or ignored, will weigh down the economy and state’s quality of life.
TENSIONS WITH HUNTINGTON BEACH
Known as Surf City, Huntington Beach has a population of just over 200,000. Nearly 53 percent of residents have a college degree (associate’s, bachelor’s or graduate). The median household income is $94,281.
In 2013 Huntington Beach’s housing plan met state requirements for having adequate numbers of units aimed at all income levels. But then the city amended its plan and reduced the number of homes to be built, particularly at the low end of the income scale.
According to Newsom’s office, state officials tried repeatedly to work with the beach city to revamp its housing plan. But the City Council ultimately rejected a proposed amendment to add new units. It was then the governor decided to file suit.
“The state does not take this action lightly,” Newsom said. “The huge housing costs and sky-high rents are eroding quality of life for families across this state. California’s housing crisis is an existential threat to our state’s future and demands an urgent and comprehensive response.”
Huntington Beach City Attorney Michael Gates said in a statement that the town had complied with the requirements and was working with the Housing and Community Development Department to address concerns.
“This lawsuit by the state is poorly timed,” he said.
PISMO BEACH’S HOUSING PLAN
Farther north is another popular surf city — Pismo Beach. With a steady population of 8,200, Pismo Beach swells on weekends and in the summer when Valley residents arrive to flee the heat.
The particular challenge in Pismo is getting housing built that the workforce can afford, said Lewis. According to Zillow, the median price of a home in Pismo Beach stood at $854,000 in December.
Nine out of 10 new homes built in Pismo are vacation rentals used by people from Fresno and Bakersfield, Lewis said. He added Pismo has $3 million in developer fees it has collected over the years that Lewis wants to put toward constructing affordable homes. “I have begged developers to use the money for affordable housing. They don’t want to do it,” he said. “They want to build vacation rentals with a second story.”
Still, the city is required to have a housing plan that spells out how many homes will be built across a range of income levels. Much of that will come in the form of “accessory dwelling units” — jargon for granny units and secondary dwellings at existing homes. Lewis said Pismo Beach has a good relationship with the state, and expects its plan will be approved this summer — a characterization agreed to by state officials.
MORE LAWSUITS AHEAD?
A Housing and Community Development spokesman said the Valley cities currently on the noncompliance list are working well with the state to get their plans in order.
When it comes to Clovis, Fresno’s neighbor with a population of 110,000, City Manager Luke Serpa said the state determined Clovis did not have enough acreage zoned for high-density housing. The council has since approved that zoning, and he hopes the housing plan will be back in compliance sometime this year.
Serpa also pointed out that Clovis is among the leaders in the state when it comes to adding new housing, the key factor toward easing the crisis. “Clovis continues to issue more permits than most, if not all, cities our size,” he notes.
Newsom left no doubt where he stood when he announced the Huntington Beach lawsuit. “Cities and counties are important partners in addressing this housing crisis, and many cities are making Herculean efforts to meet this crisis head-on,” he said. “But some cities are refusing to do their part to address this crisis and willfully stand in violation of California law. Those cities will be held to account.”
Before turning to the courts, the governor needs to ensure that his Housing and Community Development Department exhausts every avenue to work with cities to bring their housing plans into compliance. They, in turn, must make good-faith efforts to do so.
If both sides work together as they should, a way out of this crisis might be achieved. And a new, better California will be the result.