BILL NUMBER: AB 898 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 24, 2007
AMENDED IN ASSEMBLY APRIL 9, 2007
INTRODUCED BY Assembly Member Saldana
(Coauthors: Assembly Members Mendoza , Salas, and
Solorio)
(Coauthors: Senators Cedillo and Romero)
FEBRUARY 22, 2007
An act to add and repeal Article 3 (commencing with Section
104660) of Chapter 2 of Part 3 of Division 103 of the Health and
Safety Code, relating to nutritional education.
LEGISLATIVE COUNSEL'S DIGEST
AB 898, as amended, Saldana. Nutrition education.
Existing law requires the State Department of Health Services to
assess the availability and adequacy of existing state and local food
and nutrition data systems. Existing law also requires the
department to establish and implement, to the extent specified funds
are available, a 5 a day for better health program for the purpose of
promoting public awareness of the need to increase the consumption
of fruits and vegetables as part of a low-fat, high-fiber diet.
Effective July 1, 2007, these above-mentioned duties of the
department will be transferred to the State Department of Public
Health.
Existing law requires the Superintendent of Public Instruction to
monitor school district compliance with specified pupil nutrition and
activity requirements, as specified, and requires certain school
districts to report their compliance to the Superintendent, as
specified.
This bill would require, until January 1, 2015, the State
Department of Public Health to establish and administer a pilot grant
program to award 3-year grants to at least 3 but not more than 5
school health centers, as defined, that utilize the "Promotores de
Salud" model, as defined, to administer a nutrition education and
diabetes and obesity prevention program, as specified.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares all of the
following:
(a) Health care costs and spending in California are rising
dramatically and are expected to continue increasing.
(b) Health care spending in California reached nearly $1.9 billion
in 2004.
(c) In 2002, almost 60 percent of California's health care
expenditures were for people with multiple chronic conditions, such
as heart disease and diabetes.
(d) According to the federal Department of Health and Human
Services, Centers for Disease Control and Prevention, overweight and
obesity medical expenses accounted for over $78 billion in 1998 or
$92.6 billion in 2002.
(e) In California, it was estimated that over $21 billion was
spent in 2000 for costs related to physical inactivity, obesity, and
the overweight.
(f) Obesity rates nationally and in California are continuing to
increase for both adults and adolescents and are projected to
continue increasing.
(g) Recent data from the National Center for Health Statistics
shows that 30 percent of United States adults 20 years of age and
older, over 60 million people, are obese.
(h) In 2001, 26.5 percent of California's children were overweight
and 39.5 were unfit.
(i) Especially high rates of obesity are found among California's
African-American, Latino, and Native-American, including the Alaska
Native, adult populations.
(j) One out of three Latino and African American adolescents is
overweight or at risk of becoming overweight.
(k) Asian Indian, Korean, and Pacific Islander children are noted
to have a higher risk of being overweight than other Asian Americans.
(l) The program utilizing community health workers, known as
"promotores de salud" (promoters of health) provides access and
outreach to health information in a manner that is culturally and
linguistically accessible to the communities in which they work.
(m) By training and using community members as promotores de
salud, this program has demonstrated a significant level of
cost-effectiveness in delivering health care in existing programs
such as asthma, cardiovascular disease, diabetes, and HIV/AIDS.
(n) The use of promotores de salud has proven to provide a
cost-effective method of improving health outcomes for indigent and
underserved population with cultural, linguistic, and financial
barriers to access the health care system.
(o) School health centers, as defined in Section 124174 of the
Health and Safety Code, offer a range of services, including primary
medical care, mental health, reproductive health, and oral health
services.
(p) The majority of communities served by school health centers
are low-income areas where many children lack health coverage and
face significant barriers to care.
(q) The majority of communities served by school health centers
are also more likely to have higher rates of violent injury, poor
nutrition and physical inactivity. Without access to the health
services provided by the school health centers, childhood risk
factors are likely to be translated into higher rates of chronic
conditions in adulthood.
(r) School health centers provide an optimal setting to promote
healthy lifestyles through good nutrition and fitness and provide
preventative health care services, including, but not limited to,
obesity prevention, to children and families.
(s) The pilot program established pursuant to this act is aimed at
improving the health and nutrition of Californians by providing
culturally competent and appropriate information for communities
often overlooked or not receiving health information through
traditional venues.
SEC. 2. Article 3 (commencing with Section 104660) is added to
Chapter 2 of Part 3 of Division 103 of the Health and Safety Code, to
read:
Article 3. Promotores de Salud School Health Center Nutrition
Pilot Project
104660. The following definitions shall apply for the purposes of
this article:
(a) "Central California" means the following counties: Fresno,
Inyo, Kern, Kings, Madera, Mariposa, Merced, Mono, Monterey, San
Benito, San Joaquin, San Luis Obispo, Santa Cruz, Stanislaus, Tulare,
and Tuolumne.
(b) "Department" means the State Department of Public Health.
(c) "Food insecurity" means a condition when members of a
household lack sustained access to enough safe, nutritious, and
socially acceptable foods for a health and productive life due to
physical or economic barriers.
(d) "Northern California" means the following counties: Alameda,
Alpine, Amador, Butte, Calaveras, Colusa, Contra Costa, Del Norte, El
Dorado, Glenn, Humboldt, Lake, Lassen, Marin, Mendocino, Modoc,
Napa, Nevada, Placer, Plumas, Sacramento, San Francisco, San Mateo,
Santa Clara, Shasta, Sierra, Siskiyou, Solano, Sonoma, Sutter,
Tehama, Trinity, Yolo, and Yuba.
(e) "Program" means a promotores de salud model utilized by a
school health center to provide diet education
nutrition education and diabetes and obesity prevention
services.
(f) "Promotores de Salud" means trained community members who are
hired by a private, nonprofit or community-based organization, a
public agency, an institute of higher education, or school, to
provide linguistically and culturally appropriate outreach,
information, education, case management, health prevention service
delivery and access to services intended to improve health outcomes
within an underserved community.
(g) "School health center," has the same meaning as in Section
124174.
(h) "Southern California" means the following counties: Imperial,
Los Angeles, Orange, Riverside, San Bernardino, San Diego, Santa
Barbara, and Ventura.
104660.1. (a) The department shall establish and administer a
pilot grant program to award grants to at least three, but not more
than five, school health centers that utilize the "Promotores de
Salud" model to administer a nutrition education and diabetes
and obesity prevention program.
(b) Grants shall be awarded for a three-year period for operation
in school health center sites, with at least one site in central
California, northern California, and southern California.
(c) A school health center shall be eligible for a grant only if
it is a part of a school in a city or county that has a demonstrated
high rate of obesity, a high or above-average rate of poverty, and
either households with food insecurity or a population with an
above-average number of Food Stamp Program participants. In addition,
an eligible school health center shall be a part of a school that
has at least one of the following:
(1) A high percentage of uninsured children.
(2) A medically underserved population.
(3) A large number of limited-English-proficient pupils.
(4) An Academic Performance Index ranking in the lowest 5 percent
of the state.
(5) A population in which a majority of the students are eligible
for free or reduced-cost meals through the school lunch program of
the federal Department of Agriculture.
(d) The department shall also consider the following criteria in
awarding grants:
(1) The strength of the outreach and educational program.
(2) Evidence of community collaboration, including demonstrated
support of the principal, staff from participating schools, community
members, and other community organizations.
(3) A description of plans to target specific communities.
(4) Evidence that the school health center has identified an
experienced and qualified organization that can provide technical
assistance to the school health center in the recruitment, training
and supervision of promotores de salud for nutrition education
and diabetes and obesity prevention programs.
(5) Other criteria the department may determine applicable and
consistent with the purposes of this chapter.
(e) Each grant application submitted shall include all of the
following:
(1) A budget, including the amount of the requested funding.
(2) A description of how data collection and recordkeeping will be
managed, including records of the population served, the components
of the service, the results of the services, and cost information,
including startup, direct, and indirect costs.
(3) A description of the evaluation of the program that the
applicant plans to provide upon completion of the three-year grant.
The description shall indicate the following:
(A) Total population served.
(B) Total number of hours spent conducting outreach.
(C) Other relevant quantitative measures.
104660.2. Each school health center that receives a grant
pursuant to this article shall do all of the following:
(a) Provide comprehensive nutritional and nutrition information.
(b) Work in collaboration with other local and community programs
that are focused on nutrition, and other obesity prevention and
disease management programs, including, but not limited to, programs
related to diabetes and heart disease.
(c) Promote consumer participation in obesity prevention and
nutrition awareness.
(d) Develop, adopt, periodically review, and, if necessary, revise
a local plan for the use of promotores de salud in the school health
center.
(e) Develop and maintain a local clearinghouse on nutrition
information, including materials and services available.
(f) Collaborate with local and regional councils on nutrition
education and obesity prevention efforts, including the promotion of
other local efforts in relation to obesity prevention and disease
management.
(g) Receive training on the establishment of a promotores de salud
education and obesity prevention program, including, but not limited
to, the curriculum design, use of different outreach models, methods
of data collection and the establishment of geographical and
population targets for outreach, and media or other communication
methods.
104660.3. The grants shall be made in accordance with an
agreement between the department and the school health center.
However, no grant to finance a project shall exceed the total cost of
the program, as determined by the school health center and approved
by the department. Any school health center receiving a grant
pursuant to this article shall agree to use the facility for the
purpose for which the grant was awarded for the duration of the
expected life of the program.
104660.4. (a) Grants shall be made pursuant to this article only
to the extent that funds are appropriated for this purpose in the
annual Budget Act.
(b) In consultation with representatives of school health centers,
community health workers including, but not limited to, promotores
de salud program workers, other community health workers, health care
advocates, primary care clinics, school officials, school
nurses, and other affected parties, the department shall
develop a process and criteria for making grants under this article.
The process and selection criteria shall be approved and a request
for proposals shall be issued on or before December 31, 2009.
104660.5. (a) The department shall, on or before January 1, 2009,
conduct a statewide survey on existing promotores de salud programs
in order to identify and quantify the total number of potential
applicants and suitable skill building trainers for the program
described in Section 104660.1. The survey shall determine all of the
following:
(1) Total number of existing programs in the state.
(2) Location of those programs.
(3) Total staff size of individual programs.
(4) Total number and identity of community-based organizations
with appropriate experience in training promotores de salud in
obesity prevention and nutrition and in providing technical
assistance to the programs that use them.
(5) Any other information relevant to the department's development
of the request for proposal process.
(b) On or before January 1, 2014, the department shall submit to
the Legislature a report that compiles the program evaluations
completed by each individual program demonstrating the overall
effectiveness of the programs. The department may contract with
a private entity to prepare the report.
104660.6. This article shall remain in effect only until January
1, 2015, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2015, deletes or extends
that date.