BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 1149
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|AUTHOR: |Wood |
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|VERSION: |February 27, 2015 |
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|HEARING DATE: |June 10, 2015 | | |
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|CONSULTANT: |Vince Marchand |
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SUBJECT : Public health emergencies: funding.
SUMMARY : Adds trade associations to the list of entities that are
eligible to receive federal funding, that has been allocated to
the Department of Public Health for public health preparedness
and response.
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, long-term health care facilities, clinics,
emergency medical systems, and poison control centers for the
prevention of, and response to, bioterrorist attacks and other
public health emergencies.
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.
This bill:
1)Adds trade associations to the list of entities that are
eligible to receive federal funding, that has been allocated
to the Department of Public Health for public health
preparedness and response.
2)Contains an urgency clause that will make this bill effective
upon enactment.
AB 1149 (Wood) Page 2 of ?
FISCAL
EFFECT : According to the Assembly Appropriations Committee,
this bill has negligible state fiscal effect. This bill
clarifies eligibility for an existing federal grant.
PRIOR
VOTES :
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|Assembly Floor: |78 - 0 |
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|Assembly Appropriations Committee: |17 - 0 |
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|Assembly Health Committee: |18 - 0 |
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COMMENTS :
1)Author's statement. According to the author, historically,
trade associations have played a major role in the Hospital
Preparedness Program (HPP) and have proven to be valuable
assets. The infrastructure and communication channels within
associations make them particularly well suited to tackle the
education and outreach challenges inherent to the HPP. In
2014, CDPH-EPO rendered a new interpretation of current law
and determined that, because associations are not specifically
identified within the code, they are not eligible to receive
funds and help administer the program. Fiscal Year 2013/2014
marked the first year associations were not eligible since the
program originated in 1996. This bill would allow associations
to once again become a valuable resource for the HPP. The
familiarity and credibility trade associations bring to the
table, when dealing with their membership, creates a training
and teaching environment that is uniquely suited to deliver a
high quality program. Finally, by allowing the trade
associations to play their role, the CDPH would save valuable
resources that otherwise would be expended searching for other
entities to execute the program.
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
AB 1149 (Wood) Page 3 of ?
Control and Prevention (CDC), and 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 (2014-15), the Budget Act appropriated
$74,405,196 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 63
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)History of providing HPP funds to trade associations.
According to DPH, both the CDC and the ASPR allow states to
allocate HPP funds to trade associations, which is a standard
practice for many states across the nation. DPH states that
while it has not received any complaints regarding allocating
emergency preparedness and response funds to trade
associations, it is anticipated that if clarification is not
provided, health care leaders across the state will raise
concerns that emergency preparedness funds are not supporting
health care facilities in California.
DPH states that historically, it was able to use the existing
Health and Safety Code language to allocate funds directly to
trade associations, related to the specific itemized list of
facilities and response partners, to provide technical
assistance and to develop templates, checklists and planning
tools that are specific to their members' preparedness and
planning needs. DPH states that this early interpretation of
the statute was based on the premise that sufficient funds
AB 1149 (Wood) Page 4 of ?
were not available, nor was it feasible to allocate emergency
preparedness funds to over 3,000 health care facilities
individually across California. Diluting the funds will not
help individual facilities, but funding trade associations to
develop planning tools and provide education for their members
has advanced and will continue to enhance preparedness for
hospitals, clinics, and long-term care facilities.
In 2012, it was recognized by DPH's Office of Legal Affairs that
the existing language did not include long-term care
facilities; and the California Association of Healthcare
Facilities moved to amend the statute with AB 1793 (Yamada,
Chapter 166, Statutes of 2012). The Governor signed the
legislation that provided an amendment to include long-term
care facilities with the intent that this amendment would
allow DPH to contract directly with the California Association
of Health Facilities to provide tools and training to
long-term care facilities across California to strengthen
their emergency preparedness and response capacity. Since that
time, DPH's Office of Legal Services has concluded that the
current law is specific and only governs those contracts with
local health jurisdictions, hospitals, long-term health care
facilities, clinics, emergency medical systems, and poison
control centers and not trade associations as was the original
interpretation.
4)Prior legislation. AB 1793 (Yamada, Chapter 166, Statutes of
2012) eliminated the September 1, 2012, sunset date on
provisions of law governing how federal funding for emergency
preparedness is allocated, and added long-term health
facilities to the list of entities that can be designated to
receive federal funds for emergency preparedness.
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, emergency medical systems, and poison control
AB 1149 (Wood) Page 5 of ?
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.
5)Support. This bill is sponsored by the California Association
of Health Facilities (CAHF), which states that, the
infrastructure and communication channels within trade
associations make them particularly well suited to tackle the
education and outreach challenges inherent in the HPP. CAHF
states that through almost eight years of funding, CAHF has
developed a nationally recognized, award-winning Disaster
Preparedness Program for Long Term Care through the HPP, and
were one of the first long term care associations in the
country to be funded through the HPP grant program. Recently,
however, DPH has stated that current law does not explicitly
provide authorization for state associations. CAHF states that
this bill will ensure HPP funding continues to be directed at
the associations that are suited to provide appropriate
training and education to health facilities in California. The
California Hospital Association (CHA) states in support that
hospitals have many requirements to be prepared for all
hazards that pose a threat to their communities. CHA states
that through the HPP, it has developed checklists, guidance
documents and other planning tools that have assisted
hospitals and others. According to CHA, this bill will allow
the associations representing hospitals, long term care
providers and community health clinics the ability to directly
contract with DPH and maintain their established programs that
have proven to be effective. The California Primary Care
Association states in support that associations have the
expertise, and state and local authorities have called on
associations for years to assist them in identifying and
addressing the issues in disaster preparedness and response.
SUPPORT AND OPPOSITION :
Support: California Association of Health Facilities (sponsor)
California Hospital Association
California Primary Care Association
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Oppose: None received
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