BILL ANALYSIS
AB 543
Page 1
GOVERNOR'S VETO
AB 543 (Ma)
As Amended August 24, 2009
2/3 vote
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|ASSEMBLY: |78-0 |(June 2, 2009) |SENATE: |32-1 |(September 1, |
| | | | | |2009) |
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|ASSEMBLY: |77-0 |(September 3, | | | |
| | |2009) | | | |
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Original Committee Reference: HEALTH
SUMMARY : Authorizes the Department of Public Health (DPH) to
use Nurse-Family Partnership (NFP) Program grant moneys as a
match for other grants DPH administers, allows DPH to accept
voluntary donations and federal funds for the NFP Program,
repeals the sunset date of January 1, 2009 for the California
Children and Families Account (Account), sunsets the Account on
January 1, 2014 unless sufficient funds are available, and
revises rules governing the availability of funds for the NFP
Program.
The Senate amendments require the Director of the Department of
Finance (DOF), instead of the State Public Health Officer, to
determine whether there are sufficient funds in the Account;
delete the continuous appropriation and provide that the funds
are available upon appropriation by the Legislature; and, add an
urgency clause, allowing this bill to take effect immediately
upon enactment.
EXISTING LAW :
1)Establishes the NFP Program and requires DPH to administer the
NFP Program for the purpose of making grants to eligible
participating counties to provide voluntary registered nurse
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home visiting services for expectant, first-time, low-income
mothers and their children and families.
2)Requires DPH to distribute NFP Program grants only if the
Director of DOF determines, in writing, that there are
sufficient funds from private donations in the Account.
Sunsets the NFP Program on January 1, 2009 if the Director of
DOF determines that the funds in the Account are insufficient
to implement the NFP Program.
AS PASSED BY THE ASSEMBLY , this bill was substantially similar
to the version approved by the Senate.
FISCAL EFFECT : According to the Senate Appropriations Committee
analysis, this bill will cost $500,000 to millions in private,
special, and federal grants annually, if funding permits.
COMMENTS : The author states this bill is intended to establish
the NFP Program as a statewide pilot program for five years.
The NFP Program matches first-time; low income mothers in their
first trimester of pregnancy to a registered nurse, and assists
them until their child is two years old. According to the
author, the NFP Program had not received, by January 1, 2009,
the $500,000 required by statute for program implementation.
However, the sponsor states it now has sufficient private funds
to activate the Account. Also, according to information
provided by the sponsor, the President's fiscal year 2010 budget
requests $124 million for home visitation programs. Depending
on how the moneys are allocated, the California NFP Program
might be able to access federal funding.
NFP programs currently operate in 23 states. NFP nurses work
with pregnant women to improve prenatal, maternal, and early
childhood health and well-being, focusing on therapeutic
relationships with the family that are designed to improve
family functioning in areas of health, home and neighborhood
environment, family and friends support, parental roles, and
major life events.
In 2005, RAND Institute reported in a study of early childhood
programs that by the time a child in the NFP Program had reached
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15 years of age, the NFP Program cost over $9,000, but provided
societal benefits of about $26,300, for a benefit-to-cost ratio
of 2.88 to one. A 1997 RAND study found that the NFP Program
generated increased tax revenues from increased employment and
earnings; decreased welfare enrollment; reduced expenditures for
education, health, and other services; and, lowered criminal
justice system costs from arrest, adjudication, and
incarceration, yielding a net savings to government programs of
$18,611 per family in 1996 dollars, which was over four times
the cost of the program.
The California NFP Program has documented a 23% reduction in
cigarette smoking during pregnancy. Although the NFP Program
enrolls women who are at higher risk for poor birth outcomes,
only 8% of NFP Program babies were born premature compared to
the overall 2004 California rate of 11%. Additionally 89% of
NFP Program children had received all recommended immunizations
by 24 months, compared with roughly 75% statewide.
California has nine NFP Program sites in the following eight
county health departments: Fresno, Kern, Los Angeles, Orange,
Riverside, Sacramento, San Diego (East and West), and San Luis
Obispo. The NFP Program sites in California have served
approximately 9,000 families, of which 64% are Latino, 14% are
non-Hispanic white, 13% are African-American, 4% are Asian, 4%
are multiracial/other, and 1% are Native American. The median
age of the mother is 18 years. Seventy-two percent are enrolled
in Medi-Cal, and the median annual household income is $13,500.
Funding for the California NFP Program sites is fragmented and
varies by county, but generally comes from Medi-Cal, county
general funds, Proposition 10 (1998 Children and Families First
Act), Maternal and Child Health Program Funds, Tobacco
Settlement Funds, and The California Wellness Foundation.
GOVERNOR'S VETO MESSAGE :
"Since the Nurse-Family Partnership program was signed into law
in 2006, there have been no private or federal funds received by
the state for this program. Since there are no funds to
appropriate, there is no need to extend the sunset date for the
program's fund account.
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"Furthermore, this bill removes the Director of Finance's
discretion regarding the level of sufficient funding and
triggers an arbitrary threshold of $500,000 for the
establishment of a statewide program without the necessary
infrastructure."
Analysis Prepared by : Allegra Kim / HEALTH / (916) 319-2097
FN: 0003379