BILL ANALYSIS                                                                                                                                                                                                    Ó






                                 SENATE HEALTH
                               COMMITTEE ANALYSIS
                       Senator Ed Hernandez, O.D., Chair


          BILL NO:       AB 581                                      
          A
          AUTHOR:        John A. Pérez                               
          B
          AMENDED:       May 27, 2011                                
          HEARING DATE:  July 6, 2011                                
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          CONSULTANT:                                                
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          Orr                                                        
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                                     SUBJECT

                            Public health: food access
                                         

                                    SUMMARY  

          Establishes, until January 1, 2015, the California Healthy 
          Food Financing Initiative and Fund for the purpose of 
          expanding access to healthy foods in underserved 
          communities.  Requires the Department of Food and 
          Agriculture (CDFA), in consultation with other specified 
          departments, to implement the initiative and prepare 
          recommendations by July 1, 2012, on promoting food access.  



                             CHANGES TO EXISTING LAW  
          
          Existing law:
          Requires, until January 1, 2013, the California Department 
          of Public Health (CDPH), in conjunction with the CDFA, to 
          develop a "Healthy Food Purchase" pilot program, in no more 
          than seven counties, to increase the sale and purchase of 
          fresh fruits and vegetables in low-income communities, as 
          specified. CDPH must also develop a process for evaluating 
          the effectiveness of the pilot, and contract with an 
          independent external evaluator to conduct the evaluation. 
                                                         Continued---



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          Specifies that CDPH shall apply for available federal 
          matching funds to support the pilot, and that no General 
          Fund monies shall be used to fund the program.

          This bill:
          Establishes the California Healthy Food Financing 
          Initiative (CHFFI) until January 1, 2015, for the purpose 
          of expanding access to nutritious foods in underserved 
          communities, and to eliminate food deserts within seven 
          years. Requires CDFA, in consultation with CDPH and the 
          Department of Social Services (DSS) to implement CHFFI 
          using a diverse mix of funding sources including federal, 
          state, philanthropic, and private resources. 

          Requires, as part of the CHFFI, in consultation with the 
          CDPH and DSS, to provide recommendations to the Legislature 
          by July 1, 2012, regarding actions that need to be taken to 
          promote food access within the state.  It would also 
          require CDFA to coordinate efforts to maximize the funding 
          opportunities provided by the federal 2010 Healthy Food 
          Financing Initiative.

          Authorizes, as part of the CHFFI, the Secretary of Food and 
          Agriculture to establish an advisory group consisting of 
          specified entities to assist with developing these 
          recommendations. 

          Creates, as part of the CHFFI, the CHFFI Fund (Fund) within 
          the state treasury, to be used to leverage specified other 
          funding sources for the purpose of expanding access to 
          healthy foods in underserved communities. 

          Makes findings and declarations about access to healthy 
          food items and the need to protect farmland in California. 
          

                                  FISCAL IMPACT  

          The Assembly Appropriations Committee analysis states that, 
          given California's size and its large number of food 
          deserts, a significant food financing initiative would 
          likely cost tens of millions of dollars. For comparison, 
          the analysis cites that the state of Pennsylvania invested 
          $30 million over a three-year period in their healthy food 
          initiative. 




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                            BACKGROUND AND DISCUSSION  

          The author has introduced AB 581 to increase access to 
          healthy and nutritious foods to underserved urban and rural 
          communities in California.  Known as "food deserts," 
          regions of California with poor access to healthy food 
          generally have a higher incidence of certain types of 
          diseases such as diabetes, cancer, obesity, heart disease, 
          and premature death.  AB 581 brings together CDFA and other 
          state agencies to maximize the impact of the CHFFI and 
          leverage funding from federal and other sources to improve 
          the health of low-income Californians by increasing access 
          to nutritious food. 

          Food deserts
          A food desert is described as a geographic area with 
          limited access to affordable, quality, and nutritious 
          foods. Lack of healthy, affordable food options can lead to 
          higher levels of obesity and other diet-related diseases, 
          such as diabetes, heart disease, and cancer. The Food, 
          Conservation, and Energy Act of 2008, commonly known as the 
          Farm Bill, required the United States Department of 
          Agriculture to study food deserts.  Findings from that 
          study include:

               i)     Of all U.S. households, 2.3 million (2.2 
                 percent) live more than a mile from a supermarket 
                 and do not have access to a vehicle. An additional 
                 3.4 million households (3.2 percent) live between 
                 one-half to 1 mile from a supermarket and do not 
                 have access to a vehicle.
               ii)    Area-based measures of access show that 23.5 
                 million people live in low-income areas (areas where 
                 more than 40 percent of the population has an income 
                 at or below 200 percent of federal poverty 
                 thresholds) that are more than 1 mile from a 
                 supermarket or large grocery store. However, not all 
                 of these 23.5 million people have low incomes. If 
                 estimates are restricted to consider only low-income 
                 people in low-income areas, then 11.5 million people 
                 (4.1 percent of the U.S. population) live in 
                 low-income areas more than 1 mile from a 
                 supermarket.




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               iii)   Data on time-use and travel mode show that 
                 people living in low-income areas with limited 
                 access to healthy food spend significantly more time 
                 (19.5 minutes) traveling to a grocery store than the 
                 national average (15 minutes). However, 93 percent 
                 of those who live in low-income areas with limited 
                 access traveled to the grocery store in a vehicle 
                 they or another household member drove. 
           
           A subset of food deserts are areas increasingly referred to 
          as "food swamps."  A food swamp is a defined geographic 
          area where the overabundance of high-energy foods (for 
          example, caloric snacks sold at convenience stores or high 
          fat, high caloric foods sold at fast food outlets) 
          overwhelms the healthy food options.
          
          Healthy Food Financing Initiative (HFFI)
          In February of 2010, the Obama Administration 
          (Administration) released details of an over $400 million 
          HFFI, which will help bring grocery stores and other 
          healthy food retailers to underserved urban and rural 
          communities across the nation.  The HFFI is a partnership 
          between the federal Departments of the Treasury, 
          Agriculture, and Health and Human Services. The HFFI seeks 
          to promote a range of interventions that expand access to 
          nutritious foods, including developing and equipping 
          grocery stores and other small businesses and retailers 
          selling healthy food in communities that currently lack 
          these options.  These communities are often found in 
          economically distressed areas, and their residents are 
          typically served by fast food restaurants and convenience 
          stores that offer little or no fresh produce.  

          Through this new multi-year HFFI, and by engaging with the 
          private sector, the Administration intends to work toward 
          eliminating food deserts across the country within seven 
          years.  The first year of funding proposes to leverage 
          enough investments to begin expanding healthy foods options 
          into as many as one-fifth of the nation's food deserts, and 
          create thousands of jobs in urban and rural communities 
          across the nation.

          The HFFI appears to be modeled after the Pennsylvania Fresh 
          Food Financing Initiative (FFFI) that the Pennsylvania 




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          Legislature created in 2006.  FFFI is an innovative program 
          that increases the number of supermarkets and grocery 
          stores in underserved communities across the state of 
          Pennsylvania.  Developed as a public-private partnership, 
          FFFI serves the financing needs of operators located or 
          locating in communities where infrastructure costs and 
          credit needs are not met by conventional financial 
          institutions to increase the availability of fresh food in 
          low-income neighborhoods.  FFFI uses market analysis, 
          leveraged capital, and public policy to stimulate 
          supermarket development.  Investing in quality food markets 
          in underserved communities directly benefits low- and 
          moderate-income communities.  
          The initiative will make available a mix of federal tax 
          credits, below-market rate loans, loan guarantees, and 
          grants to attract private sector capital that will more 
          than double the total investment. Federal funds will 
          support projects ranging from the construction or expansion 
          of a grocery store to smaller-scale interventions such as 
          placing refrigerated units stocked with fresh produce in 
          convenience stores.

          Related bills
          AB 70 (Monning) would require the California Health and 
          Human Services Agency to direct the appropriate departments 
          within the agency to apply for federal community 
          transformation grants under the Patient Protection and 
          Affordable Care Act and the Healthy, Hunger-Free Kids Act 
          of 2010, as specified.  AB 70 is pending in the Assembly 
          Health Committee.

          AB 152 (Fuentes) would establish the State Emergency Food 
          Assistance Program (SEFAP) in statute within DSS and allow 
          for federal contributions to SEFAP for the purchase of 
          California grown fresh fruits or vegetables.  Provides a 
          tax credit to California growers for the costs of fresh 
          fruits or vegetables donated to California food banks. 
          Directs CDPH to apply for specified federal funding for 
          obesity prevention and promotion of healthy eating. AB 152 
          is set for hearing in the Senate Governance and Finance 
          Committee on July 6, 2011.
          
          AB 727 (Mitchell) would require the Department of General 
          Services to develop nutritional standards that govern the 
          foods purchased for all state departments, agencies, and 




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          state-run institutions in accordance with the federal 
          dietary guidelines and to develop prescribed guidelines for 
          sustainable purchasing practices and procedures that 
          encourage purchasing from local vendors, farms, and 
          manufacturers when feasible.  AB 727 is set for hearing in 
          the Senate Health Committee on July 6, 2011.

          Prior legislation
          AB 2720 (John A. Perez) of the 2009-2010 Session was 
          substantially similar to AB 581. Vetoed with the message: 
          "While my Administration shares the same goals as the 
          author when it comes to promoting healthy and affordable 
          food access for low-income communities in California, the 
          Healthy Food Financing Initiative has not yet been acted on 
          by Congress. Unless and until those important federal 
          funding details are known, this bill is both premature and 
          unnecessary."
          

                                  PRIOR ACTIONS

           Assembly Agriculture:9- 0
          Assembly Health:    18- 0
          Assembly Appropriations:17- 0
          Assembly Floor:     76- 0
          Senate Agriculture: 6- 0

          Arguments in support
          The California Catholic Conference (CCC) encourages passage 
          of AB 581, and believes that access to food is a basic 
          human right. CCC believes that lack of access to healthy 
          foods can result in hunger, higher levels of obesity and 
          other diet-related diseases.  The Community Clinic 
          Association of Los Angeles County (CCALAC) claims to be 
          committed to both health care and healthy communities, and 
          believes that access to healthy foods is too limited in 
          many California communities, specifically low-income and 
          underserved areas. CCALAC believes that AB 581 directly 
          impacts clinic and health center patients as it would 
          promote and potentially increase access to healthy foods in 
          these communities.  The California Nurses Association (CNA) 
          believes AB 581 would position California to receive 
          federal dollars to finance healthy food options. CNA claims 
          that nurses are on the front lines of providing care to 
          patients who suffer from conditions like diabetes, cancer, 




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          and obesity, and know firsthand about the importance of 
          preventing their onset through healthy diets. 
          

                                     COMMENTS
           
          1.  Double referral. This bill was first referred to the 
          Senate Agriculture Committee, where it passed on a 6-0 
          vote.  
           
          2.  Agriculture Committee amendments.  The author agreed to 
          the following amendments in the Senate Agriculture 
          Committee, which will be taken in Senate Health Committee: 
               a. Set a limit for the number of people on the 
          advisory committee at 21 members. 
               b. Require the advisory group to contain 
               representatives from underserved communities.

          3.  Federal Healthy Food Financing Initiative.  The basis 
          for the Governor's veto of similar legislation last year 
          was that Congress had not enacted the HFFI and the federal 
          funding details were not yet known. In his FY 2012 Budget 
          Proposal, President Obama requested $330M for the HFFI, but 
          Congress has yet to finalize action on this proposal. 


                                    POSITIONS  
                                        
          Support:  American Heart Association
                    California Catholic Conference
                    California Center for Rural Policy at Humboldt 
                    State University
                    California Food Policy Advocates
                    California Medical Association
                    California Nurses Association
                    California Pan-Ethnic Health Network
                    California Primary Care Association
                    California State Association of Counties
                    Community Clinic Association of Los Angeles 
                    County
                    County Health Executives Association of 
                    California
                    County of Santa Clara
                    Latino Coalition for a Healthy California
                    Western Growers




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          Oppose:   None received.


                                   -- END --