BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
AB 2424 (Gomez) - Community-based Health Improvement and
Innovation Fund
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|Version: August 2, 2016 |Policy Vote: HEALTH 7 - 0 |
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|Urgency: No |Mandate: No |
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|Hearing Date: August 8, 2016 |Consultant: Brendan McCarthy |
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This bill meets the criteria for referral to the Suspense File.
Bill
Summary: AB 2424 would create the Community-based Health
Improvement Fund, to support programs to improve public health.
Fiscal
Impact:
Unknown costs to support the programs authorized in the bill,
likely in the tens of millions per year (General Fund). The
intention of the bill is to provide funding for a wide array
of programs designed to improve public health and reduce
health disparities. The total amount of funding that would be
available for the Fund would depend on future appropriations.
To have a significant impact on statewide public health,
funding for the program would likely be in the tens of
millions per year. The bill would require local health
jurisdictions to be awarded $250,000 each, which would make up
about one-half of the available funding. This indicates an
overall program size of at least $30 million per year.
One-time startup costs in the millions to develop program
AB 2424 (Gomez) Page 1 of
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guidelines, develop an information technology system to allow
for grant making and oversight, and undertake other
administrative tasks by the Department of Public Health
(General Fund). Given the broad range of potential projects
that could be funded under the bill and the requirements for
monitoring and evaluation of projects, the Department will
incur substantial upfront costs to set up the processes and
systems for implementing the bill, regardless of the future
funding amounts.
Likely ongoing administrative costs in the millions to conduct
public education campaigns, solicit grant proposals, review
applications, oversee grant funding, and perform program
evaluations (General Fund). The amount of ongoing
administrative costs incurred by the Department would depend
on the overall amount of funding made available for the
program.
Unknown potential long-run cost savings to state health care
programs (various funds). There is published research that
indicates a strong cost-benefit ratio for some community-based
public health programs. To the extent that funding authorized
in the future to implement the bill is used to fund
evidence-based public health programs, there are likely to be
improvements in overall public health The Medi-Cal program
provides health care coverage to over 12 million Californians.
Therefore, any overall reduction in health care costs due to
successful public health interventions would likely result in
some unknown level of cost savings to the state and federal
government.
Background: The public health system in the state is a partnership between
the Department of Public Health and local health jurisdictions
(mostly county health departments and a few city health
departments). Historically, the state has provided substantial
funding for public health activities. However, during the
2008-09 and 2009-10 budget years, most state General Fund
funding for public health activities was eliminated. Currently,
public health programs in the state are supported largely by
local funds and federal funds.
Proposed Law:
AB 2424 (Gomez) Page 2 of
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AB 2424 would create the Community-based Health Improvement
Fund, to support programs to improve public health.
Specific provisions of the bill would:
Create the Community-based Health Improvement and Innovation
Fund;
Require a target level of annual statewide investment to be
set, on a per capita basis (presumably by the Department of
Public Health or the advisory committee created in the bill);
Specify the allowable uses of monies in the fund, including
reducing health inequality and disparities, preventing the
onset of chronic conditions, evaluating the effectiveness of
prevention strategies, and other uses;
Require the Fund to be used to address the social,
environmental, and behavioral determinants of chronic disease;
Require the Department of Public Health to allocate up to 20%
of available funding for statewide media campaigns, evaluation
of program activities, program implementation and oversight;
Of the remaining 80% of funding, require at least 47% to be
allocated to local health jurisdictions (including a base
award of $250,000) and 33% to be allocated through competitive
grants;
Establish an advisory committee, with specified membership;
Make implementation of the bill contingent on an appropriation
of funding.
Staff
Comments: The recently enacted 2016 Budget Act includes about
$40 million in new General Fund spending on a variety of public
health programs. None of that funding would be available to fund
the program established in this bill.
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