BILL NUMBER: SB 189 CHAPTERED 09/17/03 CHAPTER 407 FILED WITH SECRETARY OF STATE SEPTEMBER 17, 2003 APPROVED BY GOVERNOR SEPTEMBER 16, 2003 PASSED THE SENATE SEPTEMBER 2, 2003 PASSED THE ASSEMBLY AUGUST 28, 2003 AMENDED IN ASSEMBLY AUGUST 25, 2003 AMENDED IN ASSEMBLY JULY 3, 2003 AMENDED IN ASSEMBLY JULY 1, 2003 AMENDED IN SENATE MAY 22, 2003 AMENDED IN SENATE APRIL 7, 2003 INTRODUCED BY Senator Escutia (Coauthors: Senators Kuehl, Romero, Soto, and Vasconcellos) (Coauthors: Assembly Members Chan, Dymally, Hancock, Longville, Lowenthal, and Pavley) FEBRUARY 12, 2003 An act to add Section 104324.25 to the Health and Safety Code, relating to environmental health. LEGISLATIVE COUNSEL'S DIGEST SB 189, Escutia. Environmental health tracking system: chronic disease. Existing law states the intent of the Legislature to establish the Environmental Health Surveillance System (EHSS) for the purpose of establishing ongoing surveillance of the environmental exposures and diseases affecting Californians, with a focus on prevalence and determinants of chronic diseases. Existing law requires the Division of Environmental and Occupational Disease Control within the State Department of Health Services, in consultation with the Office of Environmental Health Hazard Assessment, to require, on or before July 1, 2002, a working group of technical experts, as specified, to develop possible approaches to establishing the EHSS. This bill would enact the California Health Tracking Act of 2003, and would require the State Department of Health Services, the California Environmental Protection Agency, and the University of California to jointly develop and sign a memorandum of understanding to assess the feasibility of integrating existing environmental hazard, exposure, and health outcome data, and describing how the data correspond to specified recommendations of the working group, on or before July 1, 2004. This bill would also require the California Environmental Health Tracking Program to obtain specified information. The bill would authorize the California Environmental Health Tracking Program to collect any relevant information from state agencies, boards, departments, and offices. This bill would make legislative findings that activities requested under the bill are within the scope of existing federal contracts and funding. It would provide that specified provisions of the bill relating to these activities shall be implemented only to the extent that federal funds remain available for the activities specified in those provisions, and that no General Fund moneys shall be used to implement these provisions. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. This act shall be known, and may be cited, as the California Health Tracking Act of 2003. SEC. 2. The Legislature finds and declares all of the following: (a) Approximately 7 out of every 10 deaths in the United States are attributable to chronic diseases. The national cost of chronic diseases is $325 billion in annual health care and lost productivity costs, and this problem needs to be appropriately addressed. (b) California follows this trend with an estimated $75 billion to $90 billion spent annually for health care to treat people with these chronic diseases. (c) The rates of many chronic diseases, including asthma, some birth defects, and cancers, are on the rise. (d) We can and must do a better job of identifying the causes, and preventing the burden, of these diseases. (e) There is growing scientific evidence that environmental factors are strongly linked to the incidence of certain chronic diseases, and are even more strongly linked to these diseases than is genetic predisposition. (f) A gap in critical knowledge exists in understanding the prevalence and incidence of chronic diseases and the environmental factors that may relate to them. (g) State- and community-level incidence data on chronic diseases are needed to identify trends and patterns, and to improve disease prevention efforts. (h) The federal Centers for Disease Control and Prevention (CDC) has provided this state with funds for planning, evaluating, training, tracking, and conducting a pilot demonstration to assist with chronic disease and environmental exposure surveillance and prevention efforts. (i) In the 2002 fiscal year, Congress provided the CDC with funding of $17.5 million to begin developing a nationwide environmental public health tracking network, and to develop capacity for this network in environmental health sections within state and local health departments. (j) California received a three-year, $2.2 million grant for the University of California, and a separate three-year $2.4 million grant for the State Department of Health Services, to help establish an environmental health tracking network. (k) A statewide health tracking network, that integrates data systems and collaborative programs and partnerships involving environmental and public health professionals and agencies will help target resources more efficiently to those areas most in need. (l) In March 2001, the CDC released the first National Report on Human Exposure to Environmental Chemicals. This first edition of the report presents 27 levels of environmental chemicals measured in the United States population, including metals such as lead, mercury, and uranium, cotinine, which is a marker of tobacco smoke exposure, and organophosphate pesticide metabolites, as well as phthalate metabolites. (m) An increasing amount of research indicates that many of the kinds of chemicals measured by the CDC can have an adverse impact on human health. (n) In January 2003, the CDC National Center for Environmental Health issued the second National Report on Human Exposure to Environmental Chemicals. The report presents biomonitoring exposure data for 116 chemicals measured in the United States population, including 89 additional environmental chemicals, including polycyclic aromatic hydrocarbons and various pesticides and herbicides, that were not included in the first report. (o) Senate Bill 702 (Chapter 538 of the Statutes of 2001) makes California the first state in the nation to begin planning a statewide environmental health surveillance system for chronic diseases and environmental exposures, in order to monitor trends in health conditions, such as asthma, learning disabilities, and neurological disorders such as Parkinson's disease and Alzheimer's disease, all of which have suspected links to environmental exposures. (p) This year the Senate Bill 702 expert working group will make recommendations on how to develop an environmental health surveillance system, the associated costs, and the health and environmental measurements that would be used in the system. (q) Currently, the state lacks critical knowledge about the possible links between chronic diseases and chemicals that are present in air, water, soil, dust, food, or other environmental media. Without information obtained by tracking health and its links to environmental factors, California will continue to fight chronic disease with costly treatment, rather than with cost-effective prevention. SEC. 3. Section 104324.25 is added to the Health and Safety Code, to read: 104324.25. (a) On or before July 1, 2004, the State Department of Health Services, the California Environmental Protection Agency, and the University of California shall jointly develop and sign a memorandum of understanding to assess the feasibility of both of the following: (1) Integrating existing environmental hazard, exposure, and health outcome data. (2) Describing how these data correspond to recommendations in the final report of the expert working group established under this chapter regarding the establishment of an environmental health tracking system. (b) The California Environmental Health Tracking Program in the Division of Environmental and Occupational Disease Control of the department shall obtain all the following information: (1) A description of the relevant laws, regulations, and policies that authorize or mandate environmental hazard and disease surveillance. (2) A comprehensive description of California's public health surveillance and environmental hazard, exposure, and health outcome monitoring information systems, including, but not limited to, the purpose, scope, contents, and capabilities of each system. (3) A description of the current sources of financial support for public health surveillance, environmental hazard, exposure, and health outcome monitoring information systems, and related funds. (c) The California Environmental Health Tracking Program may collect any relevant information, including information related to other priority data systems identified by the working group established under this chapter, from any state agency, board, department, or office. (d) (1) The Legislature finds and declares that the activities requested under subdivisions (a) and (b) are within the scope of existing contracts and funding from the federal Centers for Disease Control and Prevention to the State Department of Health Services and the University of California, and are provided to support the planning and development of an environmental health tracking system in California. (2) Subdivisions (a) and (b) shall be implemented only to the extent that federal funds remain available for the activities specified in those subdivisions. No General Fund moneys shall be used to implement subdivisions (a) and (b).