BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 2009
                                                                  Page  1

          Date of Hearing:   May 2, 2012

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                  AB 2009 (Galgiani) - As Amended:  April 16, 2012 

          Policy Committee:                              HealthVote:18-0

          Urgency:     No                   State Mandated Local Program: 
          No     Reimbursable:              No

           SUMMARY  

          As proposed to be amended, this bill removes the designation of 
          priority population for free flu vaccine distributed by the 
          California Department of Public Health (CDPH) from individuals 
          60 and older, and instead requires CDPH to provide guidance 
          indicating whether one or more populations groups should be 
          prioritized for flu vaccine.

          Amendments simplify language describing CDPH's issuance of 
          guidance to define priority populations, and clarify that the 
          guidance is exempt from the Administrative Procedures Act.

           FISCAL EFFECT  

          Negligible state costs. 

           COMMENTS  

           1)Rationale  .  The author states that the priority for free flu 
            vaccine given to seniors in current law is outdated and 
            prevents the efficient distribution to all high-risk groups.  
            In particular, she indicates that children are the most 
            vulnerable to catching the flu, and they are also the ones who 
            suffer the most from it.  This bill would update current law 
            to allow the state public health department to identify 
            high-risk groups that are priority populations.

           2)Flu and Flu Vaccine  .  Currently, the state provides about $7 
            million GF worth of flu vaccine to local health jurisdictions. 
             CDPH currently allocates state-purchased influenza vaccine to 
            local health departments based on population and prior annual 
            vaccine usage reported to CDPH.  Local health departments and 








                                                                  AB 2009
                                                                  Page  2

            private, non-profit entities further distribute or directly 
            administer the vaccines.  

            Federal, state, and local public health entities issue and 
            publicize recommendations about who should be vaccinated for 
            flu.  The Centers for Disease Control and Prevention (CDC) 
            recommends a yearly flu vaccine for everyone six months of age 
            and older, and indicates that vaccination of high-risk persons 
            is especially important to decrease their risk of severe flu 
            illness. According to the CDC, high-risk groups currently 
            include young children, pregnant women, people with chronic 
            health conditions like asthma, diabetes, or heart and lung 
            disease, and people 65 years and older. Vaccination also is 
            important for health care workers, and other people who live 
            with or care for high-risk people.

           3)Priority for persons 60 years of age and older  no longer 
            aligns with CDC recommendations.  However, to comply with the 
            law, local health departments currently take various measures 
            to prioritize persons 60 years and older for flu vaccine, 
            including holding clinics only for them, reserving the initial 
            hours of a clinic for them, or providing prioritized service 
            such as an 'express lane'.  CDPH indicates that between 1974 
            (the time the priority was enacted) and now, the federal 
            Advisory Committee on Immunization Practices (ACIP) that 
            advises CDC has revised its recommendations and no longer 
            prioritizes influenza immunization only to older persons. 
            Instead, ACIP currently recommends annual immunization to all 
            persons age 6 months and older.

           4)Access to Flu Vaccine  .  A number of federal, state, and local 
            programs exist to encourage access to flu vaccine. For 
            example, the federal Vaccines for Children Program is a 
            federal program, administered by CDPH, that provides vaccines 
            at no cost to children who might not otherwise be vaccinated 
            because of inability to pay.  Federal law requires commercial 
            health care plans to cover preventative services, including 
            vaccinations, with no cost-sharing.  Many county health 
            departments also provide free or low-cost flu vaccines, 
            including those provided by the state through the free vaccine 
            program addressed by this bill.  Fiscal pressure on county 
            health departments has reduced the robustness of county 
            vaccination programs in recent years.










                                                                  AB 2009
                                                                  Page  3

           Analysis Prepared by  :    Lisa Murawski / APPR. / (916) 319-2081