BILL ANALYSIS                                                                                                                                                                                                    



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          ASSEMBLY THIRD READING
          ACR 75 (V. Manuel Perez and Ammiano)
          As Amended July 7, 2009
          Majority vote 

           HEALTH              16-0                                        
           
           -------------------------------- 
          |Ayes:|Jones, Fletcher, Adams,   |
          |     |Block, Carter, Conway, De |
          |     |Leon, Emmerson, Gaines,   |
          |     |Hall, Hayashi, Hernandez, |
          |     |Bonnie Lowenthal, Nava,   |
          |     |V. Manuel Perez, Audra    |
          |     |Strickland                |
          |     |                          |
           -------------------------------- 
           SUMMARY  :   Declares October 2009 as California Promotores Month  
          in order to raise awareness of the contributions of promotores  
          and community health workers (CHWs).  Specifically,  this  
          resolution  :  

          1)Endorses the work of promotores and recognizes the leadership  
            provided by Vision y Compromiso ("Vision and Commitment"; VYC)  
            , and various others for their dedication to and collaboration  
            with promotores and CHWs.

          2)States the Legislature's support for promotores' continuing  
            efforts to increase their presence and support the well-being  
            of California communities.

          3)Encourages policies and programs that enhance the status and  
            integration of promotores in the delivery of health care, and  
            incentives and funding to encourage promotores program  
            development and integration. 

          4)Makes legislative findings related to health care delivery;  
            outreach to individuals and families; barriers to health care  
            access; California's uninsured population; the work of  
            promotores and CHWs; the success of promotores and CHWs in  
            improving access to care and health outcomes; the work of VYC;  
            and, the lack of recognition and educational and employment  
            opportunities offered to CHWs and promotores.









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           FISCAL EFFECT  :   None

           COMMENTS  :  According to the author, CHWs and promotores play a  
          critical role in promoting community-based health education and  
          disease prevention, particularly in communities that have been  
          historically underserved.  The author contends this resolution  
          is needed to introduce the CHW/Promotor model to the  
          Legislature, and that the work of promotores and CHWs is vital  
          to our communities and should be honored and celebrated. 

          CHWs, also known as community health outreach workers, community  
          health advocates, peer health promoters, and, in Spanish,  
          promotores/as or promotores/as de salud, are generally community  
          members who work in community settings to connect health care  
          consumers to providers and to promote better health among groups  
          that have traditionally lacked access to adequate health care.   
          CHWs live in the communities in which they work, understand what  
          is meaningful to those communities, communicate in the language  
          of the people, and recognize and incorporate cultural buffers,  
          such as cultural identity, spiritual coping, and traditional  
          health practices, to help community members cope with stress and  
          to promote better health.

          The Centers for Disease Control and Prevention (CDC) states many  
          health programs are turning to CHWs and promotores for their  
          unique ability to serve as bridges between community members and  
          health care services.  CHWs can build partnerships with formal  
          health care delivery systems and provide a community-based  
          system of care and social support that complements the more  
          specialized services of health care providers.  Importantly,  
          CHWs also inform providers about the community's health needs  
          and the cultural relevancy of interventions by helping providers  
          and health care systems build their cultural competence.  CHWs  
          strengthen community networks for care, providing community  
          members with social support and education, and facilitating  
          access to care.  CDC also notes that the Institute of Medicine  
          recommends the use of CHWs as part of a comprehensive,  
          multi-level strategy to address racial and ethnic disparities in  
          health care.  According to CDC, the states of Maryland and Texas  
          require health maintenance organizations and other health care  
          providers to use CHWs to reach priority populations. 

          A February 2003 Commonwealth Fund study found that Latinos who  
          speak primarily Spanish report poorer health status, are less  








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          likely to have a regular doctor, less likely to have seen a  
          doctor in the past two years, and more likely to lack insurance  
          than English-speaking Latinos, Caucasians, or African-Americans.  
           Spanish-speaking Latinos have the most difficulty of any group  
          in understanding information at their doctor's office and with  
          understanding instructions for prescription medication.  In  
          October 2002, the Commonwealth Fund also reported that there is  
          a link between increased cultural competence and the elimination  
          of racial and ethnic disparities in health care.  

          VYC states it was established in 2000 in collaboration with the  
          University of California Riverside, and is the only statewide  
          organization that provides ongoing leadership development,  
          capacity building, and advocacy for CHWs in California.  In  
          2001, VYC initiated the Promotora and Community Health Worker  
          Network (Network) to support promotores and CHWs across  
          California towards achieving healthy and dignified living for  
          immigrant Latinos.  The Network is composed primarily of Latinos  
          who provide low-income Latino communities with culturally  
          appropriate health information and education, advocate for  
          improved access to health care and services, and promote a  
          statewide public policy agenda focused on health care access and  
          health promotion.  The Network is currently active in 10  
          California regions:  San Diego County; Inland Empire (San  
          Bernardino and Riverside Counties); Orange County; Los Angeles  
          including the San Fernando Valley; the Central Coast including  
          San Luis Obispo, Santa Barbara, and Ventura Counties; the  
          Central Valley; Stanislaus County; Marin and Napa Counties; the  
          San Francisco Bay Area; and, Northern California.  VYC states  
          that by building the capacity of promotores and CHWs, it  
          strengthens the capacity of communities to improve their health,  
          organize, confront obstacles to care, and inform health policy.

           
          Analysis Prepared by  :    Allegra Kim / HEALTH / (916) 319-2097 


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