BILL ANALYSIS
SENATE HEALTH
COMMITTEE ANALYSIS
Senator Elaine K. Alquist, Chair
BILL NO: ACR 29
A
AUTHOR: Jones
C
AMENDED: May 7, 2009
R
HEARING DATE: June 10, 2009
CONSULTANT:
2
Moreno/Orr
9
SUBJECT
Health disparities: racial and ethnic populations
SUMMARY
Requests the California Health and Human Services Agency
(CHHSA) to provide leadership to ensure that, within
existing resources and programs, departments within the
agency implement programs, activities, and strategies that
place a priority focus on preventing, reducing, and
eliminating health disparities among racial and ethnic
population subgroups.
CHANGES TO EXISTING LAW
Existing law:
Establishes the CHHSA, the state agency tasked with
administration and oversight of California's state and
federal programs for health care, social services, public
assistance, and rehabilitation through the following 12
departments: Department of Aging; Department of Alcohol and
Drug Programs; Department of Public Health; Department of
Health Care Services; Department of Mental Health; Managed
Risk Medical Insurance Board; Emergency Medical Services
Authority; Office of Statewide Health Planning and
Continued---
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Development; Department of Child Support Services;
Department of Community Services and Development;
Department of Developmental Services; and, Department of
Rehabilitation.
This resolution:
Requests the CHHSA to provide leadership to ensure that,
within existing resources and programs, departments within
the agency implement programs, activities, and strategies
that place a priority focus on preventing, reducing, and
eliminating health disparities among racial and ethnic
population subgroups.
Encourages interdepartmental collaboration with an emphasis
on the complex social, environmental, and behavioral
factors that contribute to health disparities, particularly
when identifying strategies aimed at the prevention of
chronic diseases, including, but not limited to,
cardiovascular disease.
FISCAL IMPACT
According to the Assembly Appropriations Committee
analysis, no direct fiscal impact for CHHSA and associated
departments to continue oversight of various health
programs serving the diverse needs of California
communities. This resolution encourages the continued
collaboration between departments and an increased emphasis
on reducing health disparities.
BACKGROUND AND DISCUSSION
According to the author, low-income populations and
communities of color disproportionately experience worse
health and safety outcomes across a broad spectrum of
illnesses, injuries, and treatments. The author maintains
that efforts to reduce racial and ethnic disparities in
health and health care in California will continue to fall
short unless the complex interplay of social, physical, and
environmental influences are addressed through
collaborative interdisciplinary actions. As the lead
agency tasked with administrative oversight of California's
state and federal programs for health, the CHHSA is the
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most appropriate state entity to take a leadership role and
facilitate collaboration with state departments in order to
address ethnic and racial health disparities in California.
The author maintains that while some departments within
CHHSA independently operate various programs that address
racial and ethnic disparities, the purpose of this
resolution is to encourage CHHSA to assist with bridging
the silos that currently exist in state government and to
move toward a more comprehensive strategy.
Current agency initiatives
The agency has several initiatives in place to address
health disparities and the unique health needs of special
populations, including:
The Office of Multicultural Health (OMH) is a
shared policy office within the Director's Office of
the Department of Public Health (DPH) and the
Department of Health Care Services (DHCS). It serves
as an advisor on a wide range of multi-cultural and
racial issues and a liaison between the departments
and outside stakeholders working to improve access to
quality health care and eliminate health disparities
among California's diverse racial/ethnic communities.
The Office of Women's Health (OWH) collaborates
with Maternal Child Health programs to address health
disparities in maternal and infant mortality, and
coordinates research done on women's health issues.
The California Diabetes Program (CDP) provides
diabetes educational resources, tools, and data, and
provides information in 19 languages. The CDP has
developed an online portal to include culturally and
linguistically appropriate materials.
Project LEAN and School Health Connections are
focused on reducing health disparities by providing
technical assistance and training to low-income high
risk communities, and promoting a coordinated school
health model with a focus on reducing health
disparities.
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Prior legislation
AB 330 (Hayashi) of 2007 would have required the Office of
Statewide Health Planning and Development, in conjunction
with CHHSA, to develop a health disparity report by January
1, 2009, based on patient hospital discharge data. This
bill was held on suspense in the Assembly Appropriations
Committee.
AB 1142 (Dymally), Chapter 403, Statutes 2005, establishes
the Statewide African American Initiative to address the
disproportionate impact of HIV/AIDS on the health of
African Americans by coordinating prevention and service
networks around the state and increasing the capacity of
core service providers.
ACR 112 (Chan), Res. Chapter 103, Statutes of 2006,
encourages public health and medical officials to target
vaccination efforts toward Asian Pacific Islander children
to decrease the incidence rate of this disease in
California's API communities.
ACR 114 (Coto), Chapter 151, Statutes of 2006, establishes
the Legislative Task Force on Diabetes and Obesity (Task
Force), consisting of 20 members, as specified, to study
the factors contributing to the high rates of diabetes and
obesity in Latinos, African Americans, Asian Pacific
Islanders, and Native Americans in this country, and
requires the Task Force to prepare a report containing
recommendations, no later than December 31, 2007, regarding
ways to reduce the incidence of those debilitating
conditions.
AB 2047 (Machado) of 2002 would have created the Chronic
Disease Prevention Council (Council) within the Department
of Health Services (DHS) (now DPH) to coordinate and
prioritize disease prevention programs. AB 2047 was vetoed
by Governor Gray Davis, who stated that committees similar
to the Council already existed within DHS. The message
directed DHS to utilize an existing advisory committee or
council to fulfill the objectives of the bill.
AB 1847 (Wayne) of 2000 would have created a 12-member
Cardiovascular Disease and Stroke Prevention and Treatment
Task Force within DHS, to create a comprehensive plan that
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contained recommendations addressing changes to statute,
regulations, and policies related to cardiovascular disease
and stroke prevention. AB 1847 was vetoed by Governor Gray
Davis, who cited outstanding fiscal concerns and of overlap
with existing DHS programs.
Arguments in support
Supporters write that studies show that members of
communities of color are much more likely to experience
poor quality of health and health care than their white
counterparts. Supporters also state that the resolution is
an essential step in the development of a comprehensive
strategy that addresses racial and ethnic health
disparities and improving the overall health status of
Californians.
COMMENTS
1. Disaggregating data
According to the U.S. Health Resources Services
Administration, Asian Americans and Pacific Islanders
(AAPI) are often seen as a homogenous ethnic category, so
the failure to make distinctions among specific ethnic
groups can lead to faulty conclusions about their
important health needs. Without disaggregating
demographic and health data, it is difficult to detect
variations in health status among AAPI populations,
hiding serious socioeconomic and health problems both
within and between certain ethnic groups. The author may
wish to add information to encourage CHHSA to address
these disparities within various subpopulations of Asian
Americans and Pacific Islanders.
PRIOR ACTIONS
Assembly Floor 78-0
Assembly Appropriations16-0
Assembly Health 17-0
POSITIONS
Support: American College of Obstetricians and
Gynecologists
American Diabetes Association
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American Federation of State, County and Municipal
Employees, AFL-CIO
American Heart Association
Asian & Pacific Islander American Health Forum
California Academy of Family Physicians
California Black Health Network, Inc.
California Commission on Aging
California Communities United Institute
California Healthcare Institute
California Medical Association
California Pan-Ethnic Health Network
Congress of California Seniors
Daiichi-Sankyo
GlaxoSmithKline
Health Access California
Latino Coalition for Healthy California
Latino Diabetes Association
National Association of Social Workers
Scripps Whittier Diabetes Institute
UCI College of Medicine
One individual
Oppose: None received