BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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          |SENATE RULES COMMITTEE            |                  AB 1225|
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                                 THIRD READING


          Bill No:  AB 1225
          Author:   De La Torre (D)
          Amended:  1/25/10 in Assembly
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  6-0, 6/23/10
          AYES:  Alquist, Cedillo, Leno, Negrete McLeod, Pavley,  
            Romero
          NO VOTE RECORDED:  Strickland, Aanestad, Cox

          SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           ASSEMBLY FLOOR  :  46-22, 1/27/10 - See last page for vote


           SUBJECT  :    Emergency and disaster response exercises:   
          infectious 
                      diseases

           SOURCE  :     Author


           DIGEST  :    This bill requires the Department of Public  
          Health and local public health departments, when conducting  
          emergency or disaster preparedness exercises relating to  
          the outbreak of an infectious disease, to establish a  
          process to identify deficiencies in the preparedness plans  
          and procedures and track implementation of corrective  
          measures, and requires the department to make an  
          after-action report available on its website and/or upon  
          request.

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           ANALYSIS  :    Existing law establishes the California  
          Emergency Services Act, which sets forth the duties of  
          state and local agencies in emergency and disaster  
          preparedness and response.

           Existing regulations  :

          1. Establish the Standardized Emergency Management System  
             (SEMS) to standardize and coordinate emergency response  
             activities involving multiple jurisdictions or agencies.

          2. Require all emergency response agencies to use SEMS in  
             responding to, managing, and coordinating multiple  
             agency or multiple jurisdiction incidents.

          3. Require any city, county, or city and county declaring a  
             local emergency for which the Governor proclaims a state  
             of 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.

          4. Require the after-action report (AAR) to include:

             A.    A review of response actions taken.
             B.    How SEMS was applied.
             C.    Suggested modifications to SEMS.
             D.    Necessary modifications to plans and procedures.
             E.    Identified training needs.
             F.    Recovery activities. 

          This bill:

          1. Requires the Department of Health (DPH) and local health  
             departments (LHD), 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.

          2. Requires the process to provide for the following:








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             A.    Preparation of an AAR for each disaster  
                preparedness exercise conducted, submitted to DPH  
                within 90 days of the exercise, or within a time  
                period required by the terms and conditions of  
                federal financial assistance DPH or the LHD has  
                received to prepare for an act of bioterrorism or  
                other public health emergency.

             B.    After action reports that include a review of  
                identified deficiencies, a review of response  
                actions taken, suggested modifications of plans and  
                procedures, and identifying training needs.

             C.    Written procedures to assist in the review,  
                consideration, and, if applicable, optional  
                implementation of recommendations included in AARs.  
                 

          3. Requires DPH to make an AAR available for the public by  
             posting it on the department's website and/or providing  
             a copy upon request.

          4. Declares intent language to ensure that state and local  
             agencies are as prepared as possible to respond to an  
             outbreak of infectious disease, including an influenza  
             pandemic, and that the provisions of this bill are  
             designed to supplement the terms and conditions of any  
             federal financial assistance that DPH or local public  
             health departments receive to prepare for an act of  
             bioterrorism or other public health emergency.

           Background
           
          Proper emergency preparedness can save lives, protect  
          property, and reduce the costs associated with responding  
          to an emergency.  Preparedness is an ongoing effort, in  
          that an entity can only be as prepared as resources and  
          planning allow.  According to a report by the state  
          auditor, California has completed several tasks relating to  
          responding to infectious disease emergencies, but it can do  
          more to improve its preparedness.

          Responsibility for California's emergency response  
          preparedness lies with several local, state, and federal  







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          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.  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.

          The 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 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.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  Yes

           SUPPORT  :   (Verified  7/28/10)

             --------    

           OPPOSITION  :    (Verified  7/28/10)

          California Department of Public Health

           ARGUMENTS IN SUPPORT  :    The author's office 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  







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          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.

           ARGUMENTS IN OPPOSITION  :    DPH believes this bill is  
          unnecessary because the role of AARs in disaster  
          preparedness is already addressed in various emergency  
          preparedness statutes, regulations, and guidelines.  They  
          claim that SEMS requires the Governor's OES along with  
          local and state agencies to complete an AAR within 120 days  
          from any declared disaster. In addition, the Centers for  
          Disease Control and Prevention Cooperative Agreement  
          Guidance for Public Health Emergency Preparedness also  
          requires development of an AAR and corrective actions after  
          drills, exercises or actual events, as a condition of  
          receiving grant funds for public health emergency  
          preparation. DPH claims to have implemented a written  
          procedure for developing AARs and corrective action plans,  
          and has posted the procedures on the DPH website for use by  
          DPH programs.  They claim they expressed disagreement with  
          the auditor's report, and have been subsequently advised by  
          the auditor that their AAR procedures are in compliance  
          with the auditor's expectations.
           
          ASSEMBLY FLOOR  : 
          AYES:  Adams, Ammiano, Arambula, Beall, Blakeslee, Block,  
            Blumenfield, Bradford, Brownley, Buchanan, Caballero,  
            Chesbro, Coto, Davis, De La Torre, Eng, Evans, Feuer,  
            Fletcher, Fong, Fuentes, Furutani, Galgiani, Hayashi,  
            Hernandez, Hill, Huber, Huffman, Jones, Lieu, Bonnie  
            Lowenthal, Ma, Mendoza, Monning, Nava, John A. Perez,  
            Portantino, Ruskin, Salas, Skinner, Solorio, Swanson,  
            Torres, Torrico, Tran, Yamada
          NOES:  Anderson, Bill Berryhill, Tom Berryhill, Conway,  
            Cook, Fuller, Gaines, Garrick, Gilmore, Hagman, Harkey,  
            Jeffries, Knight, Logue, Miller, Nestande, Niello,  
            Nielsen, Silva, Smyth, Audra Strickland, Villines
          NO VOTE RECORDED:  Charles Calderon, Carter, De Leon,  
            DeVore, Emmerson, Hall, V. Manuel Perez, Saldana,  
            Torlakson, Bass


          CTW:do  8/3/10   Senate Floor Analyses 







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                         SUPPORT/OPPOSITION:  SEE ABOVE

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