Governor Vetoes Bill Increasing Access to In-Home Asthma Services in California

Unfortunately, on Friday, October 13th, California Governor Brown vetoed AB 391 (Medi-Cal: Asthma Preventive Services).

Without a doubt this is a setback to our efforts to increase access to proven and cost-effective asthma interventions. However, it’s certainly not the end of our work.

In 2016 we engaged with the California Department of Health Care Services (DHCS) to adopt the federal Medicaid Preventive Service Rule to allow reimbursement for asthma education and in-home assessments provided by qualified non-licensed professionals upon the recommendation of a licensed practitioner.

As we worked with DHCS on the State Plan Amendment (SPA) to adopt the Rule, leadership indicated that they would strongly prefer to move forward in submitting the SPA for federal approval with legislative authority. In his veto message, however, Governor Brown wrote, “The Department of Health Care Services…has considerable administrative authority to make changes to benefits based upon new medical evidence and clinical guidelines. Therefore, [AB 391’s] statutory changes are unnecessary.” Needless to say, we’re surprised and frustrated by the Governor’s veto rationale.

Nevertheless, we remain committed to this work and see a path forward. The bill’s bipartisan and near unanimous support at every vote sends a clear message of legislative support for this change. We are approaching DHCS to move forward with the SPA. The veto is not an end to this work, but an obstacle to overcome.

While we’re disappointed in the veto, we are not losing sight of the fact that our legislative success was due to so many partners who were integral in providing momentum, support and technical assistance in this effort. See below for a full list of formal bill supporters. We also deeply appreciate the leadership from Assemblymember David Chiu, who authored the bill.

On behalf of AB 391’s co-sponsors (RAMP, Children Now and the California Pan Ethnic Health Network), we wish to extend our great appreciation to the many of you who helped get us this far. We will continue to work with you – our broad network of partners – as we move forward with alternative steps to increase access to key asthma preventive services.

Questions? Please email RAMP’s Associate Director, Joel Ervice, at

Thank you for your continued and tireless support!

Advancement Project
Alameda County Board of Supervisors and the Department of Public Health
Allergy One
Alliance for Boys and Men of Color
American Federation of State, County and Municipal Employees, AFL-CIO
American Lung Association of California
Asian Law Alliance
Asthma and Allergy Foundation of American
Asthma Coalition of Kern County
Asthma Coalition of Los Angeles County
Bay Area Regional Health Inequities Initiative
Breathe California
Breathe California of the Bay Area
California Academy of PAs
California Children’s Hospital Association
California Coverage & Health Initiatives
California Health+ Advocates
California Immigrant Policy Center
California School-Based Health Alliance
Central California Asthma Collaborative
Children’s Defense Fund – California
Children’s Hospital Los Angeles
City of Long Beach
City of San Francisco
Clinicas de Salud del Pueblo, Inc.
Comite Civico del Valle, Inc.
Community Action to Fight Asthma
Community Energy Services
Community Health Center Network
Community Health Councils
County Health Executive Association of California
Esperanza Community Housing
Green and Healthy Homes Initiative
Health Access California
Healthy African American Families II
Healthy Homes Collaborative
Imperial County Local Health Authority Commission
Imperial Valley Child Asthma Program
Inquilinos Unidos
La Clinica de la Raza, Inc.
LifeLong Medical Care
Long Beach Alliance for Children with Asthma
Los Angeles County Board of Supervisors and the Department of Public Health
Lung Force
Merced/Mariposa County Asthma Coalition
National Center for Healthy Housing
National Health Law Program
Northern California Center for Well-Being
Oakland Breathmobile
Pacoima Beautiful
Prescott-Joseph Center for Community Enhancement, Inc.
Public Health Advocates
QueensCare Health Center
Roots Community Health Center
Severe Asthma Clinic at Rady Children’s Hospital
St. John’s Well Child and Family Center
The Children’s Clinic
The Children’s Partnership
The Los Angeles Trust for Children’s Health
Tri-City Health Center
United Ways of California
University of California, Los Angeles
University of Southern California
Vision y Compromiso
Various Individuals
Western Center on Law & Poverty
Zuckerberg San Francisco General Hospital