BILL ANALYSIS
SENATE HEALTH
COMMITTEE ANALYSIS
Senator Elaine K. Alquist, Chair
BILL NO: AB 2287
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AUTHOR: Monning
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AMENDED: May 28, 2010
HEARING DATE: June 30, 2010
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CONSULTANT:
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Orr/
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SUBJECT
California Health and Human Services Agency:
public health: federal grant opportunities
SUMMARY
Requires the California Health and Human Services Agency
(CHHSA) to direct the appropriate state departments within
the agency to apply for Community Transformation Grants
under the federal Patient Protection and Affordable Care
Act [(PPACA) Public Law 111-148].
CHANGES TO EXISTING LAW
Existing federal law:
Authorizes the Patient Protection and Affordable Care Act
(PPACA), a federal statute signed into law along with the
Health Care and Education Reconciliation Act of 2010, to
increase access to health care through a number of
measures, including expanding Medicaid eligibility,
subsidizing insurance premiums, and setting aside funds for
health promotion and disease prevention, among others.
As a part of PPACA (Section 4201), authorizes the Secretary
of Health and Human Services, acting through the Director
of the Centers for Disease Control and Prevention (CDC), to
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award competitive Community Transformation Grants to state
and local governmental agencies and community-based
organizations for the implementation, evaulation and
dissemination of evidence-based, community preventive
health activities in order to reduce chronic disease rates,
prevent the development of secondary conditions, address
health disparities, and develop a stronger evidence-base of
effective prevention programming, with no less than 20
percent of such grants being awarded to rural and frontier
areas.
Also as a part of PPACA (Section 4002), establishes a
Prevention and Public Health Fund (Fund) to be administered
through the Department of Health and Human Services, Office
of the Secretary, to provide for expanded and sustained
national investment in prevention and public health
programs to improve health and help restrain the rate of
growth in private and public sector health care costs.
Existing state law:
Establishes the California Health and Human Services Agency
(CHHSA), which is the agency tasked with administration and
oversight of California's state and federal programs for
health care, social services, public assistance, and
rehabilitation through the following 12 departments:
Department of Aging; Department of Alcohol and Drug
Programs; Department of Public Health; Department of Health
Care Services; Department of Mental Health; Managed Risk
Medical Insurance Board; Emergency Medical Services
Authority; Office of Statewide Health Planning and
Development; Department of Child Support Services;
Department of Community Services and Development;
Department of Developmental Services; and, Department of
Rehabilitation.
This bill:
Requires CHHSA to direct the appropriate departments within
CHHSA to apply for federal grants under Section 4201 of the
PPACA to allow the state to develop a stronger evidence
base of effective prevention programming, and to engage in
preventive health activities that achieve, at a minimum,
all of the following:
a) Creating healthier school environments, including,
but not limited to, healthful food options and
physical activity;
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b) Creating an infrastructure to support active living
and access to nutritious foods;
c) Developing and promoting programs targeting a
variety of age levels to increase nutrition, physical
activity, smoking cessation, and safety, as well as
address special population needs;
d) Working to highlight healthful food options;
e) Assessing and implementing worksite wellness
programs; and,
f) Prioritizing strategies to reduce racial and ethnic
disparities.
Requires CHHSA to direct the appropriate departments within
CHHSA to make information regarding federal grant
opportunities under Section 4201 of PPACA available to
local government agencies, local public health departments,
school districts, state and local nonprofit organizations,
and Indian tribes through existing channels, and by placing
a link on each relevant department's existing website.
Declares that it is important for the Legislature to ensure
that state agencies maximize their opportunity to obtain
additional federal funds, particularly in cases where doing
so could offset state General Fund costs or assist the
state with the transformation of California's health care
system, under the PPACA.
Declares the intent of the Legislature to take full
advantage of the opportunities through the PPACA to improve
state health care programs and invest in health prevention
and education, with the goal of building, promoting, and
sustaining healthy communities through reducing chronic
disease rates, eliminating conditions that lead to health
disparities, and increasing the cultural and linguistic
appropriateness of health services.
FISCAL IMPACT
According to the Assembly Appropriations Committee
analysis, this bill would have unknown, one-time General
Fund costs in the range of $50,000 to $100,000 to CHHSA to
direct departments under CHHSA jurisdiction to apply for
federal health reform grants and for publicizing funding
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opportunities on departmental websites. Actual costs will
depend on the depth and breadth of an agency related to
attaining and maximizing federal funding. As written, this
bill does not contain a deadline by which CHHSA must
complete the requirements of the bill.
BACKGROUND AND DISCUSSION
According to the author, prevention and wellness are key
elements of the recently passed national health care reform
legislation. Community-based prevention is addressed
through a Prevention and Public Health Fund that provides
support for prevention, wellness, and public health
activities, as well as community transformation grants to
government agencies and community-based organizations for
prevention activities to reduce chronic disease rates and
address health disparities.
The author argues that given the state's current fiscal
challenges, it will be critical for state agencies to
maximize opportunities to obtain additional federal funds
under PPACA. The author further claims that in order to
assist California state and local government agencies and
community-based organizations to be poised to make the most
of the federal health reform grant opportunities, it will
be important for them to have access to detailed
information regarding what is available.
Federal health care reform
On March 23, 2010, President Obama signed the PPACA (P. L.
111-148), as amended by the Health Care and Education
Reconciliation Act of 2010 (P. L. 111-152). Section 4201
of PPACA authorizes the Secretary of the federal Health and
Human Services Agency to award competitive grants to
eligible entities for programs that promote individual and
community health and prevent the incidence of chronic
disease. Communities can carry out programs to prevent and
reduce the incidence of chronic diseases associated with
overweight and obesity, tobacco use, or mental illness; or
other activities that are consistent with the goals of
promoting healthy communities. The section also ensures
that 20 percent of the community transformation grants are
awarded to rural and frontier areas.
Preventive health care
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According to the July 2008 Trust for America's Health
publication, Prevention for a Healthier America, investing
$10 per person per year in proven community-based programs
to increase physical activity, improve nutrition, and
prevent smoking and other tobacco use, could save the
country more than $16 billion annually within five years.
Out of the $16 billion in savings the report found,
Medicare could save more than $5 billion, Medicaid could
save more than $1.9 billion, and private payers could save
more than $9 billion.
The PPACA signed into law March 23, 2010, includes a
variety of population health provisions that impact states
including funding opportunities for state agencies to
prevent chronic disease, improve immunization rates,
promote the public health workforce, and enhance infectious
disease surveillance. According to the author, it will be
important for California to maximize this opportunity to
obtain additional federal funds, particularly in light of
the fiscal challenges currently facing the state, to ensure
that California continues to build, promote, and sustain
healthy communities.
Related bills
AB 2354 (V. Manuel P?rez) of 2010 would require the
California Department of Public Health (DPH), to assess
federal grant opportunities related to promotores in
medically underserved communities pursuant to the federal
PPACA. AB 2354 is in the Senate Health Committee and
scheduled to be heard June 30, 2010.
AB 2345 (De la Torre) of 2010 requires group and individual
health care service plan contracts and health insurance
policies to provide coverage, and not impose cost-sharing
requirements, for preventive services as specified by the
Patient Protection and Affordable Care Act (PPACA).
Expresses the intent of the Legislature to enact
legislation to adopt as state law various patient
protection provisions of the PPACA.
PRIOR ACTIONS
Assembly Jobs, Economic Development, and the Economy:6-0
Assembly Appropriations: 12-0
Assembly Floor: 50-25
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COMMENTS
1. Apply for additional funding. The author may also wish
to require CHHSA to direct the appropriate departments
within CHHSA to apply for federal grants under Section 4002
of PPACA, to allow the state to apply for federal grants
from the Prevention and Public Health Fund.
POSITIONS
Support: 100% Campaign
California Children's Health Initiatives
California Primary Care Association
Children's Partnership
Children Now
Children's Defense Fund-California
PICO California
United Ways of California
Oppose: None received
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