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