Amended in Senate August 2, 2016

Amended in Senate June 20, 2016

Amended in Assembly May 31, 2016

Amended in Assembly April 6, 2016

California Legislature—2015–16 Regular Session

Assembly Bill No. 2424

Introduced by Assembly Member Gomez

February 19, 2016

An act to add Part 8 (commencing with Section 106050) to Division 103 of the Health and Safety Code, relating to public health.

LEGISLATIVE COUNSEL’S DIGEST

AB 2424, as amended, Gomez. Community-based Health Improvement and Innovation Fund.

Existing law establishes the State Department of Public Health, within the California Health and Human Services Agency, vested with certain duties, powers, functions, jurisdiction, and responsibilities over specified public health programs.

This bill, among other things, would create the Community-based Health Improvement and Innovation Fund in the State Treasury, and the moneys in the fund would be available, upon appropriation by the Legislature, for certain purposes, including, but not limited to, reducing health inequity and disparities in the rates and outcomes of priority chronic health conditions, as defined, preventing the onset of priority chronic health conditions using community-based strategies in communities statewide and with particular focus on health equity priority populations, as defined, and strengthening local, regional, and state level collaborations between public health jurisdictions and health care providers, and across government agencies and community partners to create healthier communities, using a health-in-all-policies approach. The department would be required to use a specified percentage of moneys from the fund for certain public health and administrative activities and would be required to award a specified percentage of moneys from the fund to local health jurisdictions and as competitive grants to eligible applicants to be used to improve health and health equity, as provided.

This bill would create the 13-member Community-based Health Improvement and Innovation Fund Advisory Committee to, among other things, advise the department with respect to policy development, integration, and evaluation of community-based chronic disease and injury prevention activities funded under these provisions, and for development of a master plan of recommendations and proposed strategies for the future implementation of those activities. The bill would require the advisory committee, based on the results of programs supported by these provisions, to produce a comprehensive set of recommendations and proposed strategies for advancing chronic disease and injury prevention throughout the state, to include implementation strategies in the recommendations for each priority chronic health condition throughout the state and identification of areas where innovative solutions are especially needed, and to submit the recommendations and proposed strategies to the Legislature triennially.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

SECTION 1.  

Part 8 (commencing with Section 106050) is
added to Division 103 of the Health and Safety Code, to read:

 

PART 8.  Community-based Health Improvement
and Innovation Fund

 

106050.  

The Legislature finds and declares all of the following:

(a) Over the past century, chronic diseases have emerged as a
predominant challenge to public health. Chronic disease and injury
account for eight of every 10 deaths and begin delete affects end delete begin insert affect end insert the quality
of life of 14 million Californians.

(b) Obesity and diabetes in particular have grown rapidly, posing
a grave threat to health. Today over one-half of California adults
are estimated to have either diabetes or prediabetes. Thirteen
million adults in California, 46 percent of the adult population, are
estimated to have prediabetes or undiagnosed diabetes, while
another 2.5 million adults, 9 percent of the adult population, have
already been diagnosed with diabetes.

(c) The health inequities in this state are stark:

(1) Ethnic minorities and individuals who have low incomes
have higher rates of diabetes. Nearly begin delete one-in-five end delete begin insert 1 in 5 end insert African
Americans and Latinos in California have diabetes, more than
double the rate of Whites.

(2) Nearly 12 years of life separate the life expectancy at the
top and at the bottom of neighborhood clusters in California, from
a life expectancy of 87 years in parts of northwest Santa Clara
County to 75.3 years in the City of Twentynine Palms and the City
of Barstow in the County of San Bernardino.

(3) Economically disadvantaged children are far less likely to
complete the fitness requirements of the physical fitness test offered
to students in grade school.

(4) Adolescents covered by Medi-Cal reported significantly
higher rates of drinking sugar-sweetened beverages and less daily
consumption of vegetables than the general California adolescent
population and were significantly more likely to be obese.

(d) The following short list of risk factors is responsible for
much of the burden of chronic disease: tobacco use, physical
inactivity, unhealthful diet, excessive consumption of alcohol,
hyperlipidemia, and uncontrolled high blood pressure. These risk
factors and chronic conditions are largely preventable, inequitably
distributed, and significantly influenced by the social determinants
of health.

(e) The State Department of Public Health estimates that as
much as 80 percent of heart disease, stroke, and type II diabetes
and more than 30 percent of cancers can be prevented by
eliminating the underlying risk factors.

(f) The economic burden of chronic disease in California weighs
heavily on families, employers, and all levels of government.
Approximately $98 billion, or 42 percent of all health care
expenditures in the state, was spent on treating just six common
chronic health conditions (arthritis, asthma, cardiovascular disease,
diabetes, cancer, and depression) in 2010.

(g) The indirect costs associated with chronic disease in
California are also high. According to the Economic Burden of
Chronic Disease (EBCD) Index, the projected impact of lower
productivity and lost workdays for individuals with chronic
conditions and their caregiving family members in California was
estimated to be $51 billion in 2010.

(h) The cost of health care continues to surpass the rate of
inflation, causing increasing strain on the budgets of families,
employers, and the government. Yet the ability of begin delete healthcare end delete begin insert health
care end insert alone to solve health problems that arise in the community
is limited.

(i) Despite the fact that chronic disease results in decreased
quality of life, premature death, and exorbitant medical costs,
investments in measures that prevent chronic disease have been
minimal.

(j) The United States spends only 2.6 percent of health care
dollars on all public health, yet 75 percent of health care costs are
attributable to preventable health conditions.

(k) Paying for prevention works and upstream strategies have
a remarkable history of success, measured in both cost avoidance
and health improvement. In the County of Los Angeles, smoking
begin delete amongst end delete begin insert among end insert high school students fell from 27 percent to 7
percent between 1997 and 2013, thanks to investment in policy
and environmental changes as well as education.

(l) Childhood obesity begin delete amongst end delete begin insert among end insert Los Angeles Unified
School District 5th graders decreased by 10.6 percent (from 31.2
percent to 27.9 percent) between 2010 and 2013, and leveled off
among 7th and 9th graders, after nine years of steady increases,
reflecting investments to reduce the consumption of
sugar-sweetened beverages, promote healthier eating, and increase
physical activity.

(m) The California Health and Human Services Agency, in
partnership with the State Department of Public Health, has defined
ambitious health improvement goals for the state through the “Let’s
Get Healthy California” initiative, including making California
the healthiest state in the nation by 2022, reducing health
disparities, and achieving better health at lower cost. These goals
cannot be met by improvements in health care or on an individual
basis alone. Meeting these goals requires urgent and substantial
investment in community-based prevention of chronic disease and
injuries.

(n) The Health in All Policies Task Force was established by
Executive Order No. S-04-10 on February 23, 2010, under the
auspices of the Strategic Growth Council (SGC), in order to foster
begin delete multi-agency end delete begin insert multiagency end insert collaboration to identify priority
programs, policies, and strategies to improve the health of
Californians while advancing the SGC’s goals of improving air
and water quality, protecting natural resources and agricultural
lands, increasing the availability of affordable housing, improving
infrastructure systems, promoting public health, planning
sustainable communities, and meeting the state’s climate change
goals.

(o) Senate Concurrent Resolution No. 47 (Resolution Chapter
56 of the Statutes of 2012) affirms the work of the Health in All
Policies Task Force by encouraging public officials in all sectors
and levels of government to recognize that health is influenced by
policies related to air and water quality, natural resources and
agricultural land, affordable housing, infrastructure systems, public
health, sustainable communities, and climate change, and to
consider health when formulating policy, and by encouraging
interdepartmental collaboration with an emphasis on the complex
environmental factors that contribute to poor health and inequities
when developing policies in a wide variety of areas, including, but
not limited to, housing, transportation, education, air quality, parks,
criminal justice, and employment.

(p) The Office of Health Equity was established in Section
131019.5 of the Health and Safety Code in order to achieve the
highest level of health and mental health for all people, with special
attention focused on those who have experienced socioeconomic
disadvantage and historical injustice, and it directs the Office of
Health Equity to work collaboratively with the Health in All
Policies Task Force to promote work to prevent injury and illness
through improved social and environmental factors that promote
health and mental health.

(q) The existing limited resources of funding for chronic disease
prevention are threatened, declining from past levels, and subject
to significant restrictions.

(r) Strategic investment in upstream prevention will protect, not
deplete, the coffers of government. Investment in prevention has
a strong evidence base of positive return on investment through
reducing health care costs on a long-term basis.

106051.  

For purposes of this part, the following terms have
the following definitions:

(a) “Community food projects” means those established in the
federal Food and Nutrition Act of 2008 (7 U.S.C. Sec. 2011 et
seq.) and the federal Food, Conservation, and Energy Act of 2008
(7 U.S.C. Sec. 8701 et seq.) that are designed to increase food
security, including access to a healthy diet in communities. They
may bring representatives from the community, food, and public
health systems together to assess strengths, establish linkages, and
create projects, begin delete non-profit end delete begin insert nonprofit end insert enterprises, or both, that
improve access and self-reliance of community members over
their food needs. These may also include urban or peri-urban farms
and gardens that dedicate production to low-income communities,
food hubs, farm stands, farmers markets, mobile vendors, and
community-supported agriculture projects that provide distribution
systems, and community-owned and managed enterprises that
make healthy food more accessible to low-income families.

(b) “Department” means the State Department of Public Health.

(c) “Fund” means the Community-based Health Improvement
and Innovation Fund.

(d) “Health equity” means efforts to ensure that all people have
full and equal access to opportunities that enable them to lead
healthy lives.

(e) “Health equity priority population” means, for each
condition, populations that exhibit significant disparities with
respect to prevalence of a priority chronic health condition or injury
or worse begin delete outcomes end delete begin insert outcomes, end insert such as higher hospitalization or
death rates. Priority populations may be defined based on race,
ethnicity, geography, socioeconomic status, including income or
education, other factors as defined by the department, or current
findings and recommendations of research, including assessments
of innovations funded by the fund.

(f) “Local health jurisdiction” means a county health department
or a combined health department in the case of counties acting
jointly or a city health department within the meaning of Section
101185.

(g) “Priority chronic health conditions” means asthma, type II
diabetes, cardiovascular and cerebrovascular disease, cancer, dental
disease, obesity, and other chronic conditions and injuries that are
prevalent, largely preventable, and associated with high health
care costs, as defined by the department. High-burden conditions
whose prevention is not adequately supported by other funding
streams shall be prioritized.

106052.  

(a) (1) There is hereby created in the State Treasury
the Community-based Health Improvement and Innovation Fund.
The fund shall consist of any revenues deposited therein, including
any fine or penalty revenue allocated to the fund, any revenue from
appropriations specifically designated to be credited to the fund,
any funds from public or private gifts, grants, or donations, any
interest earned on that revenue, and any funds provided from any
other source.

(2) A target level of annual statewide investment from the fund
shall be established as a set dollar amount per capita, to be allocated
for the purposes described in subdivision (b) and as described in
Section 106053.

(b) (1) Moneys in the fund shall be available, upon
appropriation by the Legislature, for any of the following purposes:

(A) Reducing health inequity and disparities in the rates and
outcomes of priority chronic health conditions and injuries.

(B) Preventing the onset of priority chronic health conditions
using community-based strategies in communities statewide and
with particular focus on health equity priority populations.

(C) Strengthening local, regional, and state level collaborations
between public health jurisdictions and health care providers, and
across government agencies and community partners to create
healthier communities, using a health-in-all-policies approach.

(D) Supporting collaboration between public health entities and
nonhealth organizations and agencies in fields such as, but not
limited to, housing, transportation, land use planning, natural
resources, parks, food access, education, economic development,
community development, and employment, to promote community
environments that support healthy communities and families, and
that reduce inequities in disease and injury using a
health-in-all-policies approach.

(E) Contributing to a stronger evidence base of effective
community-based prevention strategies for priority chronic health
conditions.

(F) Evaluating the effectiveness and cost-effectiveness of
innovative community-based prevention strategies for priority
chronic health conditions, as a basis for future decisions about
investment in those strategies in order to reduce the costs of
providing health care services and to improve population health
status.

(2) Moneys in the fund shall be used to address social,
environmental, and behavioral determinants of chronic disease
and injury at any phase of the life cycle, including, but not limited
to, all of the following:

(A) Promotion of healthy diets, improved access to healthy
foods, and healthy food environments.

(B) Promotion of physical activity and of a safe, physical
activity-promoting environment.

(C) Prevention of unintentional and intentional injury.

(D) Building partnerships to address social determinants of
chronic disease.

(3) In expending moneys from the fund, policy, systems, and
environmental change approaches are to be emphasized, although
funds can support implementation of community-based programs.

(4) Moneys in the fund shall not be used for clinical services.

(5) Revenues deposited in the fund that are unexpended at the
end of a fiscal year shall remain in the fund and not revert to the
General Fund.

(6) The award of contracts, grants, or funding allocations
provided through this part shall be exempt from Part 2
(commencing with Section 10100) of Division 2 of the Public
Contract Code.

106053.  

(a) The department shall be allocated an amount not
greater than 20 percent of the annual appropriation from the fund
for all of the following activities:

(1) Mandatory activities for which the funds shall be used are
as follows:

(A) Statewide media and communications campaigns, which
shall be allocated 9 percent of total funds.

(B) Evaluation of all program activities supported through the
fund, including the creation of a robust evaluation framework,
which shall be allocated at least 5 percent of those funds. This
evaluation framework shall include all of the following:

(i) Regular monitoring of local health jurisdiction awards to
ensure activities are conducted pursuant to approved plans and
consistent with all requirements of this part.

(ii) Measures to ensure funding provided pursuant to this part
supplements and does not supplant existing funding or efforts.

(iii) Data collection and reporting requirements for grant
awardees sufficient to assess impact and monitor compliance with
this part.

(iv) A plan to analyze the impact of this part on process
measures relevant to community health promotion and, if
practicable, on outcome measures.

(C) Other activities, which shall be allocated no more than 6
percent of total funds, as follows:

(i) Overall program implementation and oversight, including
review and approval of local health improvement plans, and
granting of and monitoring the implementation of local health
jurisdiction awards and competitive grant awards.

(ii) The definition of criteria for evidence-based and innovative
approaches to improving health and health equity, with evaluation
criteria appropriate to each type of approach. Criteria for
evidence-based projects shall include cost-effectiveness or
projections of return on investment to the state.

(iii) The definition of priority chronic health conditions and
health equity priority populations based on public health data.

(iv) The definition of criteria for participation of community
partners in local health jurisdiction funding.

(v) The development of tools that can be used by the state and
by grantees to monitor progress towards improving health and
health equity, including establishment of a health equity index and
progress towards “Let’s Get Healthy California” goals.

(2) Discretionary activities, as may be appropriate to support
community-based prevention of priority chronic health conditions
throughout the state, for which the funds may be used, include,
but are not limited to, any of the following:

(A) Research, development, and dissemination of best practices,
including training and technical assistance for grantees.

(B) Development of infrastructure, including, but not limited
to, data resources or information technology resources to be shared
statewide.

(C) Coordination of local efforts.

(D) Development and promotion of statewide initiatives.

(E) Grants or contracts to nonprofit organizations at the state
level to provide technical assistance, resource development, or
other support to the department, local health jurisdictions, and
other grantees directly serving communities.

(3) The department, in consultation with the advisory committee
established pursuant to Section 106054, may define state priorities
and require activities supported by the fund to align with those
priorities in a manner that is consistent with the intent of this part.
The department may narrow the list of priority chronic health
conditions, if necessary, to ensure an effective program.

(4) The department shall require activities pursuant to this part
to be conducted in a manner consistent with principles of
effectiveness, cost efficiency, relevance to community needs,
maximal impact to improve community health, and sustainability
of impact over time.

(b) The department shall award at least 80 percent of total
moneys made available in the annual appropriation from the fund
to eligible applicants to be used consistent with the purposes
described in subdivision (b) of Section 106052. Moneys from the
fund shall be distributed and awarded according to the following
criteria:

(1) (A) At least 47 percent of total funds shall be awarded to
local health jurisdictions and shall be allocated on a formula basis
to local health jurisdictions, or their nonprofit designee, with
approved applications for three-year funding cycles.

(B) Each local health jurisdiction shall submit an application
for a three-year funding cycle, to be reviewed and approved by
the department, that includes all of the following information:

(i) A detailed assessment of community health needs and factors
contributing to those conditions within the local health jurisdiction
with respect to priority chronic health conditions and health equity
priority populations.

(ii) A health improvement and evaluation plan that includes
initiatives focused on health equity priority populations.

(iii) The level of local funds, including in-kind resources, for
community-based prevention activities that was provided in the
most recently completed fiscal year.

(iv) Documentation of the existence and activities of a
community health partnership pursuant to subparagraph (D) of
paragraph (1) of subdivision (b) of Section 106052, which includes
leading health care providers, local health jurisdictions, community
partners, including those serving health equity priority populations,
businesses, and other relevant local government agencies and
community leaders and their commitments to support the efforts.

(v) How funds will be used in a manner consistent with
principles of effectiveness, cost efficiency, relevance to community
needs, maximal impact to improve community begin delete health, sustainability
of impact over time, and projections of return on investment to the
state. end delete begin insert health, and sustainability of impact over time. end insert

(C) Each local health jurisdiction with an approved application
shall receive a base award of two hundred fifty thousand dollars
($250,000) for a three-year funding cycle. The balance of the funds
shall be awarded to local health jurisdictions proportional to the
number of residents living below the federal poverty level.

(D) Health improvement and evaluation plans shall emphasize
sustainable policy, systems, and environmental change approaches
to creating healthier communities.

(E) Local health jurisdictions may come together if they so
desire to submit combined regional applications.

(F) No single recipient may receive more than 30 percent of the
funding allocated to local health jurisdictions on a formula basis.

(G) Recipients of funds pursuant to this paragraph shall maintain
the level of local funds, including in-kind resources, for
community-based prevention activities that were provided in the
most recently completed fiscal year prior to July 2016. Funds
provided pursuant to this paragraph shall supplement and not
supplant existing funding for community-based prevention
activities of priority chronic health conditions.

(H) Local health jurisdiction investments shall prioritize
communities in the third and fourth quartiles of the California
Health Disadvantage Index or other criteria of health equity priority
populations subsequently adopted by the department.

(I) The initial year of funding may be used for needs assessment,
planning, and development.

(2) At least 33 percent of total funds shall be allocated for
competitive grants as follows:

(A) (i) Competitive grants shall be awarded to local or regional
level entities or statewide nonprofit organizations. Funds provided
pursuant to this paragraph shall supplement and not supplant
existing funding for community-based prevention activities of
priority chronic health conditions.

(ii) Local, regional, and state level entities, including nonprofit
and community-based organizations in partnership with other
entities, including, but not limited to, other nonprofit and
community-based organizations, other local public agencies,
schools, religious organizations, businesses, labor unions, health
care plans, hospitals, clinics, other health care providers, or other
community-based entities.

(iii) Each participating health care plan or hospital shall identify
monetary, in-kind, or both, contributions to projects.

(iv) Local or regional projects shall prioritize investments that
serve communities in the third and fourth quartiles of the California
Health Disadvantage Index or other criteria of health equity priority
populations subsequently adopted by the department.

(v) At least 10 percent of the total funds shall be used for
statewide nonprofit organizations to support activities conducted
regionally or at the state level.

(vi) At least 5 percent of total funds shall be used for a
competitive grant program administered by the department to
support healthy food incentives for low-income Californians,
support community food projects, as defined under Section 106051,
and aid community food producers or socially disadvantaged,
beginning, military veteran, or begin delete limited resource end delete begin insert limited-resource end insert
specialty crop producers that improve the health and resilience of
their communities by increasing access to any variety of fresh,
canned, dried, or frozen whole or cut fruits and vegetables without
added sugars, fats or oils, and salt. The department shall coordinate,
as necessary, with the Department of Food and Agriculture to
implement this clause.

(vii) Organizations receiving competitive grants shall coordinate
efforts with the department and any local health jurisdictions where
they are carrying out activities.

(B) (i) Competitive grant applicants shall identify projects as
either an evidence-based or an innovative project.

(ii) Applications for evidence-based projects shall demonstrate
how funds will be used in a manner consistent with principles of
effectiveness, cost efficiency, relevance to community needs,
maximal impact to improve community health, and sustainability
of impact over time.

(iii) At least 10 percent of the funding for competitive grants
shall be set aside for innovative projects that test previously
untested strategies in order to improve the evidence base of
effective community-based prevention strategies for priority
chronic health conditions and injuries.

(iv) Applications for innovative projects shall provide a rationale
for the defined approach and any evidence that suggests the
innovative project will be effective, as well as a plan and resource
allocation for the evaluation.

(v) Competitive grants may be used by organizations for policy
systems or environmental change efforts, direct program delivery,
or for technical assistance to other grantees.

106054.  

(a) There is hereby created the Community-based
Health Improvement and Innovation Fund Advisory Committee
in state government that shall advise the department with respect
to policy development, integration, and evaluation of
community-based chronic disease and injury prevention activities
funded under this part, and for development of a master plan of
recommendations and proposed strategies for the future
implementation of those activities.

(b) The advisory committee shall include, at a minimum, experts
on priority chronic health conditions, effective nonclinical
prevention strategies, policy strategies for chronic disease
prevention, and the unique needs of health equity priority
populations.

(c) The advisory committee shall be composed of 13 members
to be appointed as follows:

(1) One member representing voluntary health organizations
dedicated to the reduction of chronic disease, injuries, or health
inequities appointed by the Speaker of the Assembly.

(2) One member representing an organization that represents
health care employees appointed by the Senate Rules Committee.

(3) One member representing a statewide nonprofit health
organization dedicated to the improvement of public health
appointed by the Governor.

(4) One member representing a community-based organization
with a demonstrated track record implementing community
prevention programs appointed by the Governor.

(5) One representative of a university with expertise in programs
intended to reduce chronic disease appointed by the Governor.

(6) Two representatives of a population group with priority
health conditions appointed by the Governor.

(7) One representative of the Health and Human Services
Agency appointed by the Governor.

(8) One representative of the Department of Food and
Agriculture appointed by the Governor.

(9) One representative of the Health in All Policies Task Force
appointed by the Strategic Growth Council.

(10) One member representing the interests of the general public
appointed by the Governor.

(11) One representative of the California Conference of Local
Health Officers.

(12) One representative from the California Health Benefit
Exchange appointed by the executive board of the exchange.

(d) Members of the advisory committee shall serve for a term
of two years, renewable at the option of the appointing authority.
The initial appointments of members shall be for two or three
years, to be drawn by random lot at the first meeting. The
committee shall be staffed by the department’s coordinator of the
program as described in paragraph (3) of subdivision (a) of Section
106053.

(e) The committee shall meet as often as it deems necessary,
but shall meet not less than four times per year.

(f) The members of the committee shall serve without
compensation, but shall be reimbursed for necessary travel
expenses incurred in the performance of the duties of the
committee.

(g) The committee shall be advisory to the department, the
Department of Food and Agriculture, and the Health and Human
Services Agency, for all of the following purposes:

(1) Evaluation of research on community-based policies,
practices, and programs funded under this part as necessary in
order to assess the overall effectiveness of efforts made by the
programs to reduce the occurrence of preventable chronic disease
and injuries.

(2) Facilitation of programs directed at reducing and eliminating
preventable chronic disease and injury that are operated jointly by
more than one agency or entity. The committee shall propose
strategies for the coordination of proposed programs administered
by the department, the Department of Food and Agriculture, the
Health and Human Services Agency in general, and the efforts of
the other members, such as the Health in All Policies Task Force,
in order to maximize the public benefit of the programs.

(3) Making recommendations to the department, the Department
of Food and Agriculture, and the Health and Human Services
Agency regarding the most appropriate criteria for the selection
of, standards of operation of, and types of activities to be funded
under this part.

(4) Reporting to the Legislature on or before January 1 of each
year on the number and amount of chronic disease and injury
prevention activities funded by the Community-based Health
Improvement and Innovation Fund, the amount of money in the
fund, any moneys previously appropriated to the department, but
unspent by the department, a description and assessment of all
programs funded under this part, and recommendations for any
necessary policy changes or improvements.

(5) Ensuring that the most current research findings regarding
chronic disease and injury prevention are applied in designing the
Community-based Health Improvement and Innovation Fund
activities administered by the department. The department shall
apply the most current findings and recommendations of research,
including assessments of innovations funded by the fund.

(h) (1) Based on the results of programs supported by this part
and any other proven methodologies available to the advisory
committee, the advisory committee shall produce a comprehensive
set of recommendations and proposed strategies for advancing
chronic disease and injury prevention throughout the state.

(2) The recommendations shall include implementation
strategies for each priority chronic health condition throughout the
state and identification of areas where innovative solutions are
especially needed.

(3) The advisory committee shall submit the recommendations
and proposed strategies to the Legislature triennially.

(4) The advisory committee recommendations shall include
specific goals for reduction of the burden of preventable chronic
conditions and injuries by 2030, administrative arrangements,
funding priorities, integration and coordination of approaches by
the department, the Department of Food and Agriculture, local
health jurisdictions, begin delete non-profit end delete begin insert nonprofit end insert and community-based
organizations, the University of California, the Health in All
Policies Task Force, and their support systems, and progress reports
relating to each health equity priority population.

(i) A report submitted pursuant to section shall be submitted in
compliance with Section 9795 of the Government Code.

106055.  

Implementation of this part shall be contingent on an
appropriation provided for this purpose in the annual Budget Act
or other measure.