BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 1149|
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THIRD READING
Bill No: AB 1149
Author: Wood (D)
Introduced:2/27/15
Vote: 27 - Urgency
SENATE HEALTH COMMITTEE: 9-0, 6/10/15
AYES: Hernandez, Nguyen, Hall, Mitchell, Monning, Nielsen,
Pan, Roth, Wolk
SENATE APPROPRIATIONS COMMITTEE: 6-0, 6/22/15
AYES: Lara, Bates, Beall, Hill, Leyva, Mendoza
NO VOTE RECORDED: Nielsen
ASSEMBLY FLOOR: 78-0, 5/14/15 (Consent) - See last page for
vote
SUBJECT: Public health emergencies: funding
SOURCE: California Association of Health Facilities
DIGEST: This bill 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.
ANALYSIS:
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,
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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 DPH for public health preparedness and response.
2)Contains an urgency clause that will make this bill effective
upon enactment.
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, the Emergency Preparedness Office of DPH rendered a new
interpretation of existing law and determined that, because
associations are not specifically identified in the statute,
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 allows 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 DPH would save valuable resources that
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otherwise would be expended searching for other entities to
execute the program.
2)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 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% of the PHEP funds to
local health departments pursuant to a formula in statute and
supports its own preparedness functions with the remaining 30%
of the allocation.
DPH states that HPP funds are intended for health care facility
and emergency medical services preparedness. DPH allocates 63%
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.
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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
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
existing 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.
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.
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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 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.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: No
According to the Senate Appropriations Committee, minor cost
pressures to provide funding to trade associations, rather than
to facilities directly (federal funds). By authorizing trade
associations to receive federal funding (via DPH), individual
health facilities may not receive funding directly. However,
given the very large number of health facilities in the state,
it is not practical for DPH to grant enough funds to individual
facilities to have a practical benefit. Using trade associations
can be a cost-effective way to disseminate information and best
practices to individual facilities.
SUPPORT: (Verified6/24/15)
California Association of Health Facilities (source)
California Hospital Association
California Primary Care Association
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OPPOSITION: (Verified6/24/15)
None received
ARGUMENTS IN 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 existing 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.
ASSEMBLY FLOOR: 78-0, 5/14/15
AYES: Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom,
Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang,
Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle,
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Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina
Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez,
Gordon, Gray, Grove, Hadley, Harper, Roger Hernández, Holden,
Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Lopez, Low,
Maienschein, Mathis, Mayes, McCarty, Melendez, Mullin,
Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Perea,
Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago,
Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber,
Wilk, Williams, Wood, Atkins
NO VOTE RECORDED: Linder, Medina
Prepared by:Vince Marchand / HEALTH /
6/24/15 15:30:02
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