BILL ANALYSIS
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THIRD READING
Bill No: AB 861
Author: Ruskin (D)
Amended: 5/5/09 in Assembly
Vote: 21
ASSEMBLY FLOOR : 76-0, 5/28/09 - See last page for vote
SUBJECT : Public health services: consolidated contracts
SOURCE : Author
DIGEST : This bill requires the Department of Public
Health (DPH) to develop consolidated contracts with local
health jurisdictions (LHJs) administering specified public
health programs.
ANALYSIS : Existing law:
1.Establishes the state Department of Public Health, and
transfers the responsibility for certain programs from
the state Department of Health Services to the state
Department of Public Health.
2.Allows DPH to enter into a single contractual instrument
encompassing services in any number of health service
areas limited to the following: primary care, maternal
and child health, woman, infant, and child care, family
planning, rural health services, migrant and seasonal
farmworker care, child health and disability prevention,
genetic disease, hypertension, grants-in-aid, American
CONTINUED
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Indian health, adult health care, and dental care, except
that federally funded programs requiring separate
accounting and reporting shall preserve the separate
accounting and reporting for contracts executed pursuant
to this article.
3.States legislative intent to promote efficiency in the
administration of multiple contracts between nonprofit
organizations and the divisions of DPH by requiring
uniform provisions concerning fringe benefits.
4.Encourages the minimization of duplicative administrative
systems to foster the development of a comprehensive and
collaborative delivery system of services to children and
youths at the state and local level, and to offer fiscal
incentives in the form of waivers and negotiated
contracts to encourage collaboration.
This bill:
1.Requires DPH to use existing resources to develop and
implement, in consultation with local health jurisdiction
representatives, a model consolidated and streamlined
administration and contracting process with LHJs for
DPH's Center of Infectious Diseases (CID) and the Center
for Family Health (CFH) and for the programs administered
by the respective centers.
2.Requires prior to July 1, 2011, CID and CFH to develop a
single model allocation contract between DPH and LHJs
that includes consistent budget regulations, a single
invoice format, uniform reporting requirements and
outcome measures, and uniform staff time surveys.
3.Allows CID and CFH to waive regulations regarding the
method of providing services and the method of reporting
and accountability as required to meet goals of this
proposed statute, with the exception of regulations
regarding privacy and confidentiality of records, civil
service merit systems, or collective bargaining, or
regulations that would reduce the level of services or
benefits to recipients.
4.Stipulates that nothing in this bill authorizes an LHJ to
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discontinue meeting its obligations under existing law to
provide services or reduce its accountability for the
provision of these services.
Background
Most of DPH's programs are housed within five centers: the
Center for Chronic Disease Prevention and Health Promotion,
CID, CFH, Center for Environmental Health, and the Center
for Health Care Quality (CHCQ).
The Center for Chronic Disease Prevention and Health
Promotion administers programs that address the prevention
and control of chronic diseases including cancer,
cardiovascular diseases, diabetes; the prevention and
control of injuries; and, the prevention and control of
environmental and occupational diseases. The Center
comprises the Division of Chronic Disease and Injury
Control and the Division of Environmental and Occupational
Disease Control.
CID aims to protect the public from the threat of
preventable infectious diseases and assists those living
with an infectious disease in securing prompt and
appropriate access to healthcare, medications and
associated support services. CID does this through an
Office of Infectious Diseases and Emergency Preparedness,
Office of AIDS, and Division of Communicable Disease
Control.
CFH is comprised of four Divisions, including the Genetic
Disease Screening Program, the Office of Family Planning,
the Maternal, Child and Adolescent Health Program and the
Women, Infants and Children Supplemental Nutrition Program.
These divisions oversee a multiplicity of programs that
impact the health and birth outcomes for Californians and
reduce health disparities.
The Center for Environmental Health comprises the Division
of Food Drug and Radiation Safety and the Division of
Drinking Water and Environmental Management, and is
responsible for administering programs that protect the
public from unsafe drinking water, oversees the disposal of
low-level radioactive waste, regulate the generation,
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handling, and disposal of medical waste, and protects and
manages food, drug, medical device, and radiation sources.
CHCQ is responsible for regulatory oversight of health
facilities, health professionals, and clinical and public
health laboratories, and executes this oversight through
the Center's Licensing and Certification program and
Laboratory Field Services Program.
According to the Legislative Analysts Office, the state
currently provides a combination of state and federal funds
to LHJs for over 30 categorical programs. These programs
are targeted to specific populations with particular health
needs. Funding for these programs is allocated in a
variety of ways including on a formula basis and via a
grant application process. Each individual DPH division or
program can currently enter into separate contracts with
each individual LHJ. The LHJs receiving these funds must
comply with many and varied administrative requirements,
which can lead to duplicative efforts in contract
negotiations, staff training, and performance reporting,
among other things.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
ARGUMENTS IN SUPPORT : Supporters claim that local health
departments are currently forced to navigate a labyrinth of
contracts and administrative requirements in order to
administer mandated federal and state public health
programs. They contend that time and energy dedicated to
these administrative requirements would be better spent
maximizing outcomes and services to the people of their
respective local health jurisdictions.
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Anderson, Arambula, Beall, Bill
Berryhill, Tom Berryhill, Blakeslee, Block, Blumenfield,
Brownley, Buchanan, Caballero, Charles Calderon, Carter,
Chesbro, Conway, Cook, Coto, Davis, De La Torre, De Leon,
DeVore, Emmerson, Eng, Feuer, Fletcher, Fong, Fuentes,
Fuller, Furutani, Gaines, Galgiani, Garrick, Gilmore,
Hagman, Hall, Harkey, Hayashi, Hernandez, Hill, Huber,
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Huffman, Jeffries, Jones, Knight, Krekorian, Lieu, Logue,
Bonnie Lowenthal, Ma, Miller, Monning, Nava, Niello,
Nielsen, John A. Perez, V. Manuel Perez, Portantino,
Price, Ruskin, Salas, Saldana, Silva, Skinner, Smyth,
Solorio, Audra Strickland, Swanson, Torlakson, Torres,
Torrico, Tran, Villines, Yamada, Bass
NO VOTE RECORDED: Duvall, Evans, Mendoza, Nestande
CTW:nl 6/17/09 Senate Floor Analyses
SUPPORT/OPPOSITION: NONE RECEIVED
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