BILL ANALYSIS
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
543 (Ma)
Hearing Date: 8/17/2009 Amended: 7/16/2009
Consultant: Katie Johnson Policy Vote: Health 10-1
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BILL SUMMARY: AB 543, an urgency measure, would revise the
Nurse-Family Partnership program (NFP) funding mechanism and
would extend the sunset on the California Families and Children
Account from January 1, 2009, to January 1, 2014.
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Fiscal Impact (in thousands)
Major Provisions 2009-10 2010-11 2011-12 Fund
NFP administration in at least $500 up to millions
Private/
9 counties in grants annually, if fundingSpecial/
permits Federal*
*California Families and Children Account
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STAFF COMMENTS:
Existing law, SB 1596 (Runner), Chapter 878, Statutes of 2006,
establishes NFP, to be administered by the California Department
of Public Health (CDPH), and also creates the California
Families and Children Account (account), which sunsets January
1, 2009, if the Director of Finance determines that the account
contains funds insufficient to administer the program, meaning
an amount less than $500,000.
NFP is a voluntary nurse home visiting grant program that aids
low-income, expectant first-time mothers and their children and
families. Existing law requires a county to meet specified
criteria to be eligible to apply for NFP grants from CDPH
including that the county must provide cash or in-kind matching
funds in the amount of 100 percent of the grant award.
There are currently 9 independent NFP programs in 8
counties-Fresno, Kern, Los Angeles, Orange, Riverside,
Sacramento, San Diego (East and West), and San Luis Obispo-that
would be likely to apply for grants. Each county NFP program is
administered by the counties and is funded by a variety of
sources including tobacco taxes (Propositions 10 and 99), county
general funds, Maternal, Child and Health funds, and private
funds. The average annual program budget is $600,000, which
provides for four nurses and a half-time administrator.
Existing law prohibits NFP moneys from being used as a match for
grants currently administered by the department. This bill would
reverse that prohibition and would allow the use of NFP funds as
grant matches for programs administered by CDPH.
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AB 543 (Ma)
Existing law permits the account to accept private donations for
the purposes of administering NFP. This bill would allow the
account to accept federal funds, and other state funds, but
would prohibit the use of state General Fund moneys.
This bill would permit CDPH to apply for grants or solicit
private funds for the purposes of this program, which would
reverse existing law. Administrative costs to CDPH would be
minor and absorbable. Existing law provides that CDPH's
administrative costs may not exceed 5 percent of the moneys in
the account and states that any upfront implementation costs
would be reimbursed by the account funds. For example, if there
is $500,000 in the fund in FY 2009-2010, 5 percent of that
amount would be $25,000, enough to fund approximately .25
percent of a staff person.
This bill would require the Director of the Department of
Finance (DOF) to determine whether there is at least $500,000
available for program implementation. Once the Director has
determined that there are sufficient funds, he or she would be
required to distribute the funds. If he or she has not made that
determination on or before January 1, 2014, the amount in the
account would be immediately distributed to each contributor and
the account would cease to exist. The NFP has received a grant
from UnitedHealth Group/PacifiCare for $535,000 which it intends
to deposit into the account for the purposes of implementing
this bill. In effect, this bill would extend the life of the
account from January 1, 2009, through January 1, 2014. Staff
recommends that this bill be amended to delete the account's
continuous appropriation and to make funds available upon
appropriation by the Legislature.
Although the actual annual expenditures from the account are
unknown, in the first year of implementation, the expenditures
would be at least up to $500,000. Since the average county NFP
budget is $600,000 and, under existing law, a grantee would be
required to match the grant 100 percent, it is possible that a
grantee could match a grant from NFP up to its entire $600,000
budget if funds were available.
In terms of available federal funding, the President's FY 2010
budget identified $124 million in grants to states for various
home visitation programs with a focus on low-income mothers,
pregnant women and young children. The federal budget expects
the program to grow to $1.8 billion by FY 2019 and scores
Medicaid program savings of $664 million over 10 years.
Depending on how the budget moneys are allocated to states, it
is possible that NFP could access some of this funding.
This bill is similar to AB 1826 (Ma) of 2008, which would have
extended the sunset on the account to January 1, 2011. The
Governor vetoed the bill due to the 2008-2009 budget crisis.