BILL ANALYSIS SENATE HEALTH COMMITTEE ANALYSIS Senator Elaine K. Alquist, Chair BILL NO: SB 769 S AUTHOR: Alquist B AMENDED: April 2, 2009 HEARING DATE: April 22, 2009 7 CONSULTANT: 6 Moreno/ 9 SUBJECT Federal funding: economic stimulus: local health administration SUMMARY Requires federal funding received pursuant to the American Recovery and Reinvestment Act of 2009 (Recovery Act), for purposes of chronic disease prevention and wellness, to be subject to appropriation by the Legislature commencing with the 2009-10 fiscal year. CHANGES TO EXISTING LAW Existing federal law: Under the Recovery Act, makes supplemental appropriations for job preservation and creation, infrastructure investment, energy efficiency and science, assistance to the unemployed, and state and local fiscal stabilization, for the fiscal year ending September 30, 2009. Existing state law: Establishes local health departments to protect and preserve the public health. Provides for the allocation of state aid to local health departments according to a specified formula for prescribed purposes, including communicable disease control activities and community and public health surveillance activities. Continued--- STAFF ANALYSIS OF SENATE BILL SB 769 (Alquist)Page 2 This bill: Requires federal funding received pursuant to the Recovery Act, for purposes of chronic disease prevention and wellness, to be subject to appropriation by the Legislature commencing with the 2009-10 fiscal year. Provides that its provisions apply when federal funding is allocated and expended for disease control and prevention activities by local health jurisdictions and specifies that funds appropriated for those purposes cannot be used to supplant funding for existing levels of service. Requires allocations to be made by the Department of Public Health (DPH) to the administrative bodies of qualifying local health jurisdictions and requires funds to be used for activities to improve and enhance evidence-based clinical and community-based prevention and wellness strategies authorized by the federal Public Health Services Act that deliver specific measurable health outcomes that address chronic disease rates. FISCAL IMPACT Unknown. BACKGROUND AND DISCUSSION According to the author, this bill will provide guidelines for the distribution of federal stimulus funds to be used for chronic disease control and prevention activities at the local level. The federal stimulus bill states that $650 million "shall be [used] to carry out evidence-based clinical and community-based prevention and wellness strategies? that deliver specific, measurable health outcomes that address chronic disease rates." This bill is to ensure that a maximum amount of the funds allocated by the Recovery Act to California for this purpose are passed along to the local health officers, who are at the front line of these activities. Recovery Act of 2009 The Recovery Act includes spending increases and tax relief, intended to spur an economic recovery and create jobs. The final bill includes $507 billion in spending programs and $282 billion in tax relief. According to a STAFF ANALYSIS OF SENATE BILL SB 769 (Alquist)Page 3 summary of the House Committee on Appropriations, the money allocated for healthcare-related activities is distributed as follows: o Health Information Technology: $19 billion to jumpstart efforts to computerize health records. o Prevention and Wellness Fund: $1 billion to fight preventable chronic diseases and infectious diseases. Of this amount, $300 million goes towards immunization programs and $650 million goes towards clinical and community-based prevention and wellness strategies. o Healthcare Effectiveness Research: $1.1 billion for Healthcare Research and Quality programs to compare the effectiveness of different medical treatments. o Community Health Centers: $2 billion for the provision of services to the uninsured, renovate clinics, and make health information technology improvements. o Training Primary Care Providers: $500 million to address workforce shortages and future demand. o Indian Health Service: $500 million to modernize aging hospitals and health clinics and make healthcare technology upgrades to improve healthcare for underserved rural populations. Arguments in support According to the Health Officers Association of California (HOAC), hiring public health nurses and other professionals will immediately stimulate the economy by providing an infusion of money to local health departments that have been forced to slash their workforce as a result of the economic downturn. HOAC writes that this bill will make sure that public health funding provided by the federal government will be used where it can do the most good, both for the economy and for public health. COMMENTS 1.Work in progress. The author has introduced this bill to provide a vehicle for the prevention and wellness funding that will be going to the states under the Recovery Act. At this point, it is not clear how much prevention and wellness funding will be allocated to public health entities at the federal level and how much will be allocated to states. Once guidance is received from the federal government this bill is likely to be amended. POSITIONS STAFF ANALYSIS OF SENATE BILL SB 769 (Alquist)Page 4 Support: Health Officers Association of California (sponsor) Oppose: None received -- END --