BILL ANALYSIS                                                                                                                                                                                                    



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          Date of Hearing:   June 30, 2009

                            ASSEMBLY COMMITTEE ON HEALTH
                                  Dave Jones, Chair
                  SCR 36 (Alquist) - As Introduced:  April 20, 2009

           SENATE VOTE :   33-0
           
          SUBJECT  :   Adolescent health. 

           SUMMARY  :   Recognizes and commends the California Departments of  
          Public Health (DPH), Education (CDE), and Health Care Services  
          (DHCS) for their "well adolescent" programs and initiatives, and  
          encourages all Californians to recognize and support the efforts  
          of these departments.  Specifically, this  resolution  :

          1)Recognizes and commends the number and scope of "well  
            adolescent" programs and initiatives that DPH, CDE, and DHCS  
            administer.

          2)Encourages all Californians to recognize and support DPH, CDE,  
            and DHCS' focus on improving adolescent health through efforts  
            to prevent chronic diseases, promote improved treatment of  
            chronic diseases, and ensure updated immunizations against  
            preventable diseases.  

          3)Makes findings concerning adolescent health issues, including  
            health behaviors; disease prevention; access to care;  
            preventive health services, including vaccines; national  
            recommendations and programs; immunization coverage; parental  
            awareness; and, return on investment of wellness and  
            prevention programs.

           FISCAL EFFECT :   None

           1)PURPOSE OF THIS RESOLUTION  .  According to the author, this  
            resolution is needed to make a bipartisan statement of the  
            importance of making substantial and measurable progress in  
            reducing the incidence of preventable diseases among all  
            Californians, starting with children.

           2)DPH PROGRAMS  .  DPH administers several adolescent health  
            programs under the Maternal, Child, and Adolescent Health  
            (MCAH) Program, within the Center for Family Health.   
            According to DPH, the Adolescent Family Life Program is  








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            designed to enhance the health, social, economic, and  
            educational well-being of pregnant and parenting adolescents  
            and their children through comprehensive case management that  
            works with client strengths and links clients to services.   
            Recognizing that injuries are the leading cause of death for  
            children and adolescents, there is also a Childhood Injury  
            Prevention Program within MCAH, which works to incorporate  
            injury prevention in local programs and services.  MCAH also  
            receives federal funds to collaborate with state and local  
            agencies to provide health and physical education, as well as  
            social, psychological, and health services to school children,  
            including adolescents.  The Nutrition and Physical Activity  
            Initiative integrates and coordinates promotion of healthy  
            eating and physical activity within MCAH and local programs.   
            In addition, programs within other DPH Centers, such as the  
            Center for Infectious Diseases and the Center for Chronic  
            Disease and Health, engage in a wide array of activities  
            intended to improve the health of adolescents.  The  
            Immunizations Branch provides access to vaccines for eligible  
            low-income children through the federally funded Vaccines for  
            Children Program, and provides schools information on vaccines  
            for adolescents, such as meningococcal vaccine.  The Tobacco  
            Control Program has been a leader in preventing tobacco use,  
            including among adolescents.  DPH programs also focus on  
            preventing violent injuries, including intimate partner  
            violence and sexual violence.

           3)DHCS PROGRAMS  .  According to the DHCS Web site, the Children's  
            Medical Services (CMS) Branch provides a comprehensive system  
            of health care for children through preventive screening,  
            diagnostic, treatment, rehabilitation, and follow-up services  
            through a variety of programs meeting specific health care  
            needs of targeted populations.  The Child Health and  
            Disability Prevention (CHDP) Program enrolls private  
            physicians, local health departments, community clinics,  
            managed care plans, and some local school districts to deliver  
            periodic health assessments for the early detection and  
            prevention of disease and disabilities for low-income children  
            and youth.  A health assessment consists of a health history,  
            physical examination, developmental assessment, nutritional  
            assessment, dental assessment, vision and hearing tests, a  
            tuberculin test, laboratory tests, immunizations, health  
            education, and referral for any needed diagnosis and  
            treatment.  The CHDP Program also oversees the screening and  
            follow-up components of the federally mandated Early and  








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            Periodic Screening, Diagnosis, and Treatment program for  
            Medi-Cal eligible children and youth.  Local CHDP programs  
            also administer the Health Care Program for Children in Foster  
            Care, which is a public health nursing program in county child  
            welfare service agencies and probation departments to provide  
            public health nurse expertise in meeting the medical, dental,  
            mental, and developmental needs of children and youth in  
            foster care.
           
          4)CDE PROGRAMS  .  CDE provides grants for drug and tobacco  
            prevention programs, such as the Safe and Drug-Free Schools  
            and Communities program and Tobacco-Use Prevention Education,  
            resources for the prevention of underage alcohol use, and  
            technical support for sexual health education programs.  In  
            2004, the Superintendent of Public Instruction convened a task  
            force on Childhood Obesity, Type 2 Diabetes, and  
            Cardiovascular Disease.  The task force developed  
            recommendations concerning physical education, health  
            education, and the availability and quality of healthy foods  
            and beverages in schools.  In 2005, CDE established the  
            following four goals for student health: a) support  
            high-quality instructional programs in health education and  
            physical education that provide students with the skills,  
            knowledge, and confidence to develop and maintain active,  
            healthy lifestyles; b) implement nutrition standards for all  
            food and beverages sold on campus; c) increase participation  
            in school meal programs so that no child goes hungry; and, d)  
            create a school environment that supports the health of  
            students.  Progress on the task force recommendations for  
            obesity, diabetes, and cardiovascular disease, and the goals  
            for student health, is unclear.

           5)Coordinated School Health Program  .  The federal Centers for  
            Disease Control and Prevention (CDC) provides funding for  
            California's Coordinated School Health Program (CSHP), a  
            collaboration of CDE and DPH to work with schools, school  
            districts, county offices of education, local health  
            departments, professional organizations, and government  
            agencies.  CSHP promotes coordination of school health and  
            emphasizes physical activity, nutrition, and tobacco use  
            prevention, and also provides human immunodeficiency virus  
            prevention education.  CDC also provides CSHP funding for the  
            California Youth Risk Behavior Survey.

           6)CHILDREN NOW REPORT CARD  .  Children Now, a national children's  








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            advocacy organization, developed state-specific report cards  
            which include adolescent health, among other topics.  On the  
            2009 California Report Card, Children Now gave California a  
            "B-" for adolescent health, stating that too few adolescents  
            have access to the supports and services they need to thrive.   
            Specifically, Children Now cites statistics indicating that  
            one in three high school students report not having access to  
            a caring adult; one in five adolescents report being at risk  
            for depression; one in four report being threatened by a peer;  
            and, one in five sexually active adolescents report engaging  
            in unsafe sex.  Children Now recommends that California ensure  
            that adolescents have strong social supports and access to  
            timely and high-quality services.  Children Now suggests  
            investment in school-based health clinics and health  
            promotion.

           7)SUPPORT  .  GlaxoSmithKline (GSK), sponsor of this resolution,  
            writes it supports this resolution because it is committed to  
            supporting a range of public health education and outreach  
            efforts to help contain the costs of chronic diseases, many of  
            which can be prevented with sound practices at an early age.   
            GSK states its Triple Solution for a Healthier America  
            includes addressing the causes of chronic diseases such as  
            obesity and smoking.  The California Medical Association  
            argues the message in this resolution is crucial and that  
            prevention through well adolescent visits that include  
            education to encourage positive habits and healthy lifestyles  
            are excellent tools to ensure continued health from childhood  
            into adulthood.  The California Hepatitis C Task Force writes  
            in support of this resolution that education and wellness go  
            hand in hand in building a strong and prosperous California.   
            The American College of Obstetricians and Gynecologists,  
            District IX (California) (ACOG-IX) argues in support of this  
            resolution that ACOG-IX supports wellness programs that focus  
            on adolescent health and that adolescents develop behavior in  
            childhood years that affect not only their current health but  
            also their behavior in adulthood.

           8)RELATED LEGISLATION  .  ACR 29 (Jones), pending in the Senate,  
            requests the California Health and Human Services Agency to  
            provide leadership to ensure that, within existing resources  
            and programs, departments within the agency implement  
            programs, activities, and strategies that place a priority  
            focus on preventing, reducing, and eliminating health  
            disparities among racial and ethnic population subgroups.  AB  








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            426 (Hall), pending in the Assembly, requires CDE, in  
            consultation with DPH, and DHCS, to recommend to the  
            Legislature ways to address specific health-related needs of  
            pupils on a school campus, by July 1, 2010.

           REGISTERED SUPPORT / OPPOSITION  :

           Support  
          GlaxoSmithKline (sponsor) 
          American College of Obstetricians and Gynecologists, District IX  
          (California)
          California Hepatitis C Task Force 
          California Medical Association
           
            Opposition  
          None on file. 


           Analysis Prepared by  :    Allegra Kim / HEALTH / (916) 319-2097