BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 1793
AUTHOR: Yamada
INTRODUCED: February 21, 2012
HEARING DATE: June 20, 2012
CONSULTANT: Marchand
SUBJECT : Public health: federal funding: public health
emergencies.
SUMMARY : Eliminates the September 1, 2012, sunset date on
provisions of law governing how federal funding for emergency
preparedness is allocated, and adds long-term health facilities
to the list of entities that can be designated to receive
federal funds for emergency preparedness.
Existing law:
1.Establishes provisions of law to govern those instances when
federal funding is allocated and expended for public health
preparedness and response by local health jurisdictions,
hospitals, clinics, emergency medical systems, and poison
control centers for the prevention of, and response to,
bioterrorist attacks and other public health emergencies.
These provisions become inoperative on September 1, 2012, and
will be repealed on January 1, 2013.
2.Requires federal funding received by the Department of Public
Health (DPH) for bioterrorism preparedness and emergency
response to be subject to appropriation in the annual Budget
Act or other statute.
3.Exempts federal grant funds appropriated by the Budget Act for
public health preparedness and response from being subject to
provisions of law governing contracting by state agencies.
4.Provides for the licensure and regulation of long-term health
care facilities by DPH, including skilled nursing facilities
and intermediate care facilities.
This bill:
1.Adds long-term health facilities to the list of entities that
can be designated by a federal or state agency to receive and
manage funds for public health preparedness and response to
bioterrorist attacks and other public health emergencies,
Continued---
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pursuant to a federally approved collaborative state-local
plan.
2.Deletes the September 1, 2012, sunset date on provisions of
law governing federal funding for public health emergency
preparedness and response.
3.Contains an urgency clause that will make this bill effective
upon enactment.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, negligible state fiscal impact.
PRIOR VOTES :
Assembly Health: 19- 0
Assembly Appropriations:16- 0
Assembly Floor: 72- 0
COMMENTS :
1.Author's statement. During a bioterrorist attack or other
public health emergency, such as an epidemic or flood, the
demand for acute hospital care may surge beyond hospital
capacity or people may not be able to get to an acute care
hospital. Alternative health care facilities and professionals
must also be able to rapidly implement the state-local
emergency plan. Long-term care facilities are numerous, care
for some of our most frail and vulnerable residents, and have
medical professionals and supplies, which is why emergency
planners must include long-term care facilities in their
planning.
Federal law deems long-term facilities as eligible for funding,
while state law does not. For example, the Hospital
Preparedness Program grant requires emergency planners to
include "inpatient facilities and centers" and "long-term
care" facilities in their planning. However, California's
Health and Safety Code limits participants to local health
jurisdictions, hospitals, clinics, emergency medical systems,
and poison control centers. This lack of conformity between
federal and state law is causing confusion about the
participation of long-term care facilities and funding for
their efforts. AB 1793 corrects this discrepancy between
California law and the federal guidelines, allowing emergency
planners to include long-term health care facilities to
preserve public health and safety.
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2.Background on federal grant programs for emergency
preparedness. According to DPH, it receives funding from two
separate federal grant programs for public health emergency
preparedness and response: The Public Health Emergency
Preparedness (PHEP) program, under the Centers for Disease
Control and Prevention (CDC), and the Hospital Preparedness
Program (HPP), administered by the U.S. Department of Health
and Human Services' Assistant Secretary for Preparedness and
Response (ASPR). In the most recent fiscal year (2011-12),
the Budget Act appropriated $102,062,000 from these two
federal grant programs.
DPH states that PHEP funds are restricted to state and local
health departments. DPH allocates 70 percent of the PHEP funds
to local health departments pursuant to a formula in statute
and supports its own preparedness functions with the remaining
30 percent of the allocation.
DPH states that HPP funds are intended for health care facility
and emergency medical services preparedness. DPH allocates 75
percent of the funds directly to, or on behalf of, the local
level. DPH states that the California Hospital Association,
the California Association of Health Facilities, and the
California Primary Care Association receive HPP funds to
strengthen health care facility preparedness. HPP funds are
allocated to county HPP entities to build health care
coalitions. Coalitions include hospitals, clinics, emergency
medical services/systems and long-term care facilities. DPH
states that each county determines the priority for use of HPP
funds by health care facilities and emergency medical
services.
3.Prior legislation. SB 769 (Alquist), Chapter 506, Statutes of
2010, requires federal funding received, pursuant to the
Supplemental Appropriations Act of 2009 (HR 2346), for
pandemic flu, for purposes of state and local public health
and emergency response infrastructure, to be subject to
appropriation by the Legislature commencing with the 2009-10
fiscal year.
SB 1103 (Committee on Budget and Fiscal Review), Chapter 228,
Statutes of 2004, contained statutory changes that enables the
Department of Health Services (now DPH) to allocate federal
funds to local health jurisdictions, clinics, hospitals,
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emergency medical systems, and poison control centers in an
expeditious manner and exempts these expenditures from Public
Contract Code requirements.
SB 406 (Ortiz), Chapter 393, Statutes of 2002, established the
procedures by which federal funding may be allocated to, and
expended by, local health jurisdictions for the prevention of,
and response to, bioterrorism attacks and other public health
emergencies, pursuant to the federally approved collaborative
state-local plan.
4.Support. This bill is supported by the California Association
of Health Facilities, which states that the participation of
the long-term health care community as a resource will be
instrumental in successfully addressing a health care surge
within a community. The Orange County Board of Supervisors
(OCBOS) states in support that this bill would repeal the
sunset date of provisions of law allowing DPH to administer
federal grant funds through agreements which are exempt from
the Public Contract Code. OCBOS states that by allowing the
distribution of funds through allocation agreements rather
than contracts significantly decreases the amount of time
necessary for DPH to process agreements with local health
jurisdictions. The American Federation of State, County and
Municipal Employees, AFL-CIO, states in support that this bill
corrects the discrepancy between California law and the
federal guidelines, allowing emergency planners to include
long-term health care facilities to preserve public health and
safety. The California Commission on Aging supports this bill
to help assure the safety of vulnerable long-term care
residents during times of public health emergencies. The
County Health Executives Association of California states in
support that this bill will continue to ensure that
California's local health departments, and other eligible
entities, receive their share of federal funding for their
public health emergency preparedness activities in an
equitable and timely manner.
SUPPORT AND OPPOSITION :
Support: American Federation of State, County and Municipal
Employees, AFL-CIO
California Association of Health Facilities
California Commission on Aging
County Health Executives Association of California
Crestwood Behavioral Health, Inc.
Orange County Board of Supervisors
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Oppose: None received.
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