BILL ANALYSIS
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
861 (Ruskin)
Hearing Date: 8/27/2009 Amended: 5/5/2009
Consultant: Katie Johnson Policy Vote: Health 9-0
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BILL SUMMARY: AB 861 would require the California Department of
Public Health (CDPH) to develop and implement a model
consolidated and streamlined administration and contracting
process for the department's Center for Infectious Diseases and
Center for Family Health (centers) prior to July 1, 2011.
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Fiscal Impact (in thousands)
Major Provisions 2009-10 2010-11 2011-12 Fund
CDPH contract coordination at least $50 at least $100at
least $100 Federal/
Special
General*
*See staff comments
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STAFF COMMENTS: SUSPENSE FILE.
Existing law establishes the Centers for Infectious Diseases and
Family Health within CDPH, as well as the Centers for
Environmental Health, Chronic Disease Prevention and Health
Promotion, and Health Care Quality. Existing law permits CDPH to
contract with a provider for the provision of health services,
including entering into a single contractual instrument
encompassing services in any number of specified health services
subject areas.
Existing law establishes the Placer County pilot program in
which its health and human services programs have consolidated
contracts with the state. Since many of these individual
programs serve the same population, it can benefit a local
health jurisdiction to have a consolidated health services
system.
Prior to July 1, 2011, this bill would require the Centers for
Infectious Diseases and Family Health to develop and implement a
single model allocation contract between CDPH and local health
jurisdictions that would include consistent budget regulations,
a single invoice format, uniform reporting requirements and
outcome measures, and uniform staff time surveys, among others.
Currently, and likely in the future, funding sources for these
individual programs are not comingled. Since, in many cases, the
state is required to track the federal and special fund
expenditures that pay for these various programs, this presents
a barrier to consolidated contracting and streamlining
accounting and funding that would need to be addressed by CDPH
if this bill were implemented.
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AB 861 (Ruskin)
It is likely that CDPH would need at least a full-time
coordinator to oversee the consolidation of contracts and to
coordinate among the various programs and centers. This would
cost the department approximately $100,000 annually. Funding for
the coordinator would likely come from various special and
federal funds, although it is possible that it would not be an
allowable expense for some of the programs and there could be
General Fund pressure in the total amount to fund the position.
It is unknown whether or not this position would need to exist
in perpetuity, or if the workload would justify additional staff
time.
Additionally, the 2009 Budget Conference Committee (conference
committee) voted to reduce the budgets of the Maternal, Child,
and Adolescent Health programs and the Office of AIDS, which are
areas under the two centers in this bill. It is unknown whether
or not this bill would place an undue burden on offices that
need to restructure due to budget cuts.
This bill would provide that its provisions would not authorize
a local health jurisdiction to discontinue meeting any of its
obligations under existing law to provide services or to reduce
accountability for the provision of these services.
This bill would permit program centers to waive regulations
regarding the method of providing services and the method of
reporting and accountability as may be required to implement
these provisions. This bill would prohibit the waiver of
regulations pertaining to privacy and confidentiality of
records, civil service merit systems, or collective bargaining
or that would result in a decreased amount or level of service.