BILL ANALYSIS
AB 1225
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Date of Hearing: January 12, 2010
ASSEMBLY COMMITTEE ON HEALTH
Dave Jones, Chair
AB 1225 (De La Torre) - As Amended: January 4, 2010
SUBJECT : Emergency and disaster response exercises:
infectious diseases.
SUMMARY : Requires the Department of Public Health (DPH) and
local public health departments (LHDs), when conducting
emergency or disaster preparedness exercises relating to the
outbreak of an infectious disease, to establish a process to
identify deficiencies in preparedness and track measures to
improve preparedness plans. Specifically, this bill :
1)Requires DPH and LHDs, when conducting emergency or disaster
preparedness exercises relating to the outbreak of an
infectious disease, to establish a process to identify
deficiencies in preparedness plans and procedures and track
the implementation of corrective measures to ensure that
necessary improvements to the preparedness plans are made.
Requires the process to provide for the following:
a) Preparation of an after-action report (AAR), as
specified, for each disaster preparedness exercise
conducted, to be submitted within 90 days of the exercise,
or within a time period required by the terms and
conditions federal financial assistance DPH or the LHD has
received to prepare for an act of bioterrorism or other
public health emergency; and,
b) Written procedures to assist in the review,
consideration, and, if applicable, optional implementation
of recommendations included in AARs.
EXISTING LAW :
1)Sets forth the duties of state and local agencies in emergency
and disaster preparedness and response generally under the
California Emergency Services Act.
2)Requires, under the California Code of Regulations:
a) Any city, city and county, or county declaring a local
emergency for which the Governor proclaims a state of
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emergency, and any state agency responding to that
emergency, to complete and transmit an AAR to the Office of
Emergency Services (OES) within 90 days of the close of the
incident period, as specified; and,
b) The AAR to, at a minimum, include a review of:
i) Response actions taken;
ii) Application of the Standard Emergency
Management System (SEMS);
iii) Suggested modifications to SEMS;
iv) Necessary modifications to plans and
procedures; and,
v) Identification of training needs, and recovery
activities to date.
FISCAL EFFECT : This bill has not yet been analyzed by a fiscal
committee. However, the Assembly Appropriations Committee
analysis of an identical bill, AB 2996 (De La Torre) of 2008,
estimated minor absorbable workload to DPH and LHDs to continue
compliance with federal and state emergency preparedness
statutes and regulations. The analysis further notes that many
related funding sources in public health and emergency
preparedness are contingent on compliance with requirements.
COMMENTS :
1)PURPOSE OF THIS BILL . The author states that this bill is
needed because requiring DPH and LHDs to submit AARs after
emergency preparedness exercises will enhance statewide
preparedness and improve the state's ability to identify and
address infectious disease outbreaks. The author notes that
while DPH and LHDs are required to submit AARs after actual
emergencies, existing state and federal requirements do not
mandate AARs for emergency preparedness exercises.
2)INFECTIOUS DISEASE OUTBREAKS AND RESPONSE . An infectious
disease outbreak is one of several types of events that can
trigger an emergency response. Infectious disease emergencies
can be caused by biological agents, including bacteria,
viruses, fungi, and other microorganisms, and can have
natural, accidental, or intentional origins. Examples of
biological agents that are considered high priority
bioterrorism threats include anthrax, avian flu, botulism,
plague, smallpox, and tularemia.
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Responsibility for California's infectious disease response
preparedness lies with several local, state, and federal
entities. The initial response to any type of emergency,
including one caused by an infectious disease, is the
responsibility of the local jurisdiction in which the
emergency occurs. OES is the lead emergency management agency
in California and coordinates the state's response to major
emergencies. OES has identified DPH as the state's lead
department for responding to public health emergencies such as
infectious disease emergencies. DPH is responsible for
coordinating statewide public health assistance during
disasters and providing specialized services using state
health laboratories. The Emergency Medical Services Authority
(EMSA) is responsible for supporting DPH during public health
emergencies by managing the state's medical response and
establishing medical response policies and procedures within
the framework of the overall state response.
3)CALIFORNIA STATE AUDITOR REPORT . In August 2005, the
California State Auditor (CSA) issued a report concerning
California's preparedness to respond to an infectious disease
emergency. The CSA stated that California needs to do more to
improve its preparedness, citing that DPH (then the Department
of Health Services) did not have a tracking system for
following up on recommendations identified in AARs. The CSA
stated that without a tracking system for following AARs, DPH
reduces the likelihood that it will take appropriate and
consistent corrective action. Both OES and EMSA had
established tracking systems in 2005.
The CSA also found that DPH had not met two of the 14 benchmarks
set in the federal Centers for Disease Control and
Prevention's (CDC) 2002 Cooperative Agreement for Public
Health Preparedness and Response for Bioterrorism by the June
2004 deadline. Specifically, benchmarks three and six
required the state to assess its emergency preparedness and
response capabilities related to bioterrorism, other
infectious disease outbreaks, and other public health threats
and emergencies with a view to facilitating planning and
setting implementation priorities and require the development
of regional plans to respond to bioterrorism, other infectious
disease outbreaks, and other public health threats and
emergencies.
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The CSA noted that while each of the five surveyed LHDs
participated in preparedness exercises related to infectious
disease emergencies, none of their plans included any policy
or specific procedure for preparing AARs and following up on
recommendations identified in those reports.
4)HEALTH OFFICERS ASSOCIATION OF CALIFORNIA REPORT . In 2007,
the Health Officers Association of California (HOAC) reported
on a comprehensive assessment of emergency preparedness in
LHDs. The assessment considered infrastructure and used
federal and state funding guidance as a framework. While the
report noted that LHDs have made significant progress in
emergency preparedness since 9/11, LHDs were largely still
only "partially prepared" at the time of the assessments in
2005-2006. Among the report's many recommendations was that
LHDs should develop a written Improvement Plan, which would
include development of an evaluation tool to help in
developing post-event improvement exercises and specify how
and when to generate AARs to enable the identification and
implementation of corrective actions in a timely fashion.
HOAC also states that many LHDs already do AARs after
exercises.
5)CALIFORNIA EMERGENCY SERVICES ACT . The California Emergency
Services Act requires the development of an emergency plan
that describes the principles and methods to be applied in
carrying out emergency operations. In response, OES prepared
the State of California Emergency Plan, which establishes a
system for coordinating all phases of emergency management in
California. The phases include preparedness, response,
recovery and mitigation. In the preparedness phase,
activities are undertaken in advance of an emergency to ensure
readiness for emergency response. Such activities may include
developing emergency plans, training staff, and conducting
exercises to test plans and training.
6)COOPERATIVE AGREEMENTS . California receives preparedness
funding through two cooperative agreements. One is a CDC
Public Health Preparedness and Response for Bioterrorism grant
which focuses on areas such as preparedness planning,
laboratory capacity, and communication and information
technology. The second is a Health Resources and Services
Administration grant for Bioterrorism Hospital Preparedness,
which began in 2002 and specifically targets upgrading the
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preparedness of hospitals and collaborating entities, such as
other states and expert national organizations, to respond to
bioterrorism. Each agreement has specific requirements and
benchmarks that beneficiaries must meet by certain deadlines.
7)STANDARDIZED EMERGENCY MANAGEMENT SYSTEM (SEMS) . The
Standardized Emergency Management System (SEMS) is the system
required by current law to provide an effective response to
multi-agency and multi-jurisdiction emergencies in California.
SEMS consists of five organizational levels which are
activated as necessary. Local governments must use SEMS to be
eligible for funding of their personnel-related costs under
state disaster assistance programs. By standardizing key
elements of the emergency management system, SEMS is intended
to facilitate the flow of information within and between
levels of the system and facilitate coordination among all
responding agencies.
8)NATIONAL INCIDENT MANAGEMENT SYSTEM . According to the Federal
Emergency Management Agency, the National Incident Management
System (NIMS) was developed so responders from different
jurisdictions and disciplines can work together to respond to
natural disasters and emergencies, including acts of
terrorism. NIMS integrates effective practices in emergency
preparedness and response into a comprehensive national
framework for incident management and will enable responders
at all levels to work together more effectively to manage
domestic incidents of any cause, size, or complexity. A
Homeland Security Presidential Directive, all federal
departments and agencies are required to adopt and implement
NIMS, and states, territories, tribes, and local governments
must also implement NIMS to receive federal preparedness
funding. The 2008 NIMS compliance objectives continue to
require states, territories, tribes, and local governments to
incorporate corrective actions into preparedness and response
plans and procedures as a condition of receiving federal
funding.
9)PREVIOUS LEGISLATION .
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a) AB 2584 (De La Torre) of 2005 and AB 2996 (De la Torre)
of 2008 were identical to this bill. Governor
Schwarzenegger vetoed both bills, stating in his veto
message for AB 2996:
I support efforts to ensure that California is
better prepared for public health emergencies.
However, I have previously vetoed similar
legislation based in large part on the fact that the
after-action reports mandated by this bill are
already required by both the State's Standardized
Emergency Management System and the federal
government as a condition of the receipt of federal
funds. As a result, this measure simply duplicates
existing statutes and regulations and would not
increase public safety or improve preparedness and
therefore is unnecessary.
b) AB 1476 (Hayashi) of 2007, would have required OES, in
collaboration with the Office of Homeland Security, on or
before May 1, 2008, to prepare and submit a report to the
Legislature, establishing an action plan to assist state
and local governments in sharing information to achieve
effective disaster response coordination, as provided. AB
1476 would also have required the office to include an
implementation plan with regard to the State Computer
Emergency Data Exchange Program. AB 1476 died in Assembly
Governmental Organization Committee.
10)SUGGESTED AMENDMENT . This bill requires the submission of an
AAR within 90 days of an exercise, but does not specify to
whom the report must be submitted. The author may wish to
clarify the intended recipient of the AARs.
REGISTERED SUPPORT / OPPOSITION :
Support
None on file.
Opposition
None on file.
Analysis Prepared by : Allegra Kim and Melanie Moreno / HEALTH
/ (916) 319-2097
AB 1225
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