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 The author states that the priority for free flu vaccine given to seniors in current law is outdated and prevents the efficient distribution to all high-risk groups.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