BILL ANALYSIS
SB 769
Page 1
Date of Hearing: July 7, 2009
ASSEMBLY COMMITTEE ON HEALTH
Dave Jones, Chair
SB 769 (Alquist) - As Amended: June 30, 2009
SENATE VOTE : Not relevant.
SUBJECT : Federal funding: supplemental appropriations:
pandemic flu.
SUMMARY : Provides that federal funding received pursuant to the
federal Supplemental Appropriations Act for pandemic flu
preparedness and response is subject to appropriation by the
Legislature for allocation by the Department of Public Health
(DPH) pursuant to the existing federally approved state-local
plan. Specifically, this bill :
1)Commencing with the 2009-10 fiscal year, makes subject to
appropriation by the Legislature in the annual Budget Act or
other statute federal funding received pursuant to H.R. 2346
(the federal Supplemental Appropriations Act, 2009) for
allocation by DPH for purposes of state and local public
health and emergency response infrastructure related to
pandemic flu, including, but not limited to, epidemiology,
communicable disease response, workforce, laboratory capacity,
public communications, and community mitigation guidance and
planning.
2)Clarifies that this bill governs instances where federal
funding is allocated and expended for disease control and
prevention activities by local health jurisdictions (LHJs).
3)Requires DPH to allocate funds appropriated pursuant to this
bill to LHJs in the same proportion stipulated in the 2008-09
federally approved collaborative state-local plan.
4)Makes legislative findings and declarations.
EXISTING LAW :
1)Subjects funding received by DPH for bioterrorism preparedness
and emergency response to appropriation in the annual Budget
Act or other statute.
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2)Provides for the allocation of federal funding to LHJs for the
purpose of preparing the state for public health emergencies,
including pandemic influenza, according to specified formulas
for specific fiscal years and for specified purposes.
FISCAL EFFECT : The current provisions of this bill have not
been analyzed by a fiscal committee.
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, this bill is
needed to ensure appropriate allocation of federal funding for
emergency response and pandemic preparedness. The author
states that for the past several years, the state has received
federal funds to be used for emergency preparedness and
response to such events as a pandemic flu outbreak. Under the
existing state and local collaborative plan approved by the
federal government, 70% of the funding is distributed to LHJs,
while 30% remains with the state. The federal supplemental
appropriations bill, H.R. 2346, provides $350 million in
one-time funding for state and local public health and
emergency response infrastructure, such as workforce,
laboratory capacity, public communications, and community
mitigation guidance and planning related to the H1N1 influenza
outbreak. However, the author states, there is no linkage
between the H.R. 2346 funds and the existing statutory
mechanisms used to distribute emergency preparedness funds to
LHJs. According to the author, this bill is needed to add the
H.R. 2346 funds to the previous stream of federal funds and
ensure that LHJs receive an adequate share of the funding.
The author further contends this bill facilitates timely
distribution of the funds.
2)BACKGROUND . According to DPH, novel H1N1 is a new influenza
virus which was first detected in people in the United States
in April 2009 and which spreads from person-to-person, similar
to how regular seasonal influenza viruses spread. The
symptoms of novel H1N1 flu virus in people are similar to the
symptoms of seasonal flu and include fever, cough, sore
throat, runny or stuffy nose, body aches, headache, chills,
and fatigue. Some people infected with this virus also report
diarrhea and vomiting. As of June 25, 2009, California had
1,294 confirmed cases and 225 probable cases, including 17
deaths and 142 hospitalizations, though most cases are mild
(for comparison, DPH reports that each year, approximately
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4,500 Californians die from seasonal flu). DPH states that
California hospital admissions and emergency room visits due
to the flu remain higher than normal for this time of year and
higher than what is typically seen during the traditional flu
season (October to May). On June 11, the World Health
Organization raised the Pandemic Alert Level to Phase 6,
indicating that a global pandemic is underway. Although the
H1N1 flu appears to be relatively mild, public health
officials remain concerned because flu viruses mutate quickly
and can become more virulent, in which case, a more serious
outbreak could occur in the fall.
3)RECENT FEDERAL LEGISLATION . On June 24, 2009, President Obama
signed H.R. 2346, the Supplemental Appropriations Act, 2009,
which provides $1.85 billion to prepare for and respond to an
influenza pandemic, including the development and purchase of
vaccine, antivirals, medical supplies, diagnostics, and other
surveillance tools, and to assist international efforts and
respond to international needs relating to the 2009 H1N1
influenza outbreak, of which no less than $350 million is
intended for upgrading state and local capacity. The last
conference report on HR 2346 states supplemental funding is
needed to continue to address the current H1N1 influenza
outbreak, but also to prepare for the potential of future
outbreaks, increased severity of the H1N1 virus, or for the
emergence of a new influenza strain. Therefore, the funding
may be used for an array of pandemic influenza preparedness
and response activities.
4)INFORMATIONAL HEARING ON H1N1 INFLUENZA . On April 30, 2009,
the Senate and Assembly Committees on Health and the Senate
Select Committee on Disaster and Emergency Response held a
joint informational hearing on the H1N1 influenza outbreak.
During this hearing, DPH, California Emergency Management
Agency, Emergency Medical Services Authority, California
Department of Education, California Hospital Association,
California Primary Care Association, Health Officers
Association of California (HOAC), and California Association
of Public Health Laboratory Directors (CAPHLD) testified
regarding their response to the outbreak. Witnesses stated
that due to funding cuts and anticipated personnel losses,
local health departments and local public health laboratories
might be unable to fully respond to a possible resurgence of
H1N1 flu in the fall.
5)SUPPORT . HOAC, sponsor of this bill, writes that for the last
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several years, the state has received federal funds to be used
for emergency preparedness and response to such events as a
pandemic flu outbreak. HOAC states that because of the
economic downturn, California's local health departments have
been forced to lay off vital public health workers. HOAC
recently surveyed its members and estimates that 920 local
public health personnel who were available to deal with the
H1N1 outbreak will not longer be available after July 1. HOAC
argues that this bill is needed to ensure that LHJs receive a
significant portion of the H.R. 2436 funding.
6)PREVIOUS LEGISLATION .
a) SB 678 (Ortiz), Chapter 35, Statutes of 2004
appropriates $18,145,889 in federal funds to DPH (then
Department of Health Services) for implementing
bioterrorism and smallpox preparedness measures by the
state and LHJs.
b) SB 406 (Ortiz), Chapter 393, Statutes of 2002
establishes procedures and requirements to govern the
allocation to, and expenditure by, LHJs of federal funding
related to bioterrorist attacks and other public health
emergencies when LHJs are designated by a federal or state
agency to manage the funds for public health preparedness
and response to bioterrorist attacks and other public
health emergencies, pursuant to a specified federally
approved plan.
7)POLICY QUESTION . During the Informational Hearing on the H1N1
flu outbreak, representatives of primary care clinics and
hospitals expressed concern that they had not received timely
outbreak information from DPH, but also admitted that many of
their members were not enrolled in the California Health Alert
Network (CAHAN). DPH has indicated that a significant
expansion of CAHAN to accommodate all hospitals and clinics
would require increased funding. Should this bill require
some of the state's portion of H.R. 2346 funding be used to
expand CAHAN?
REGISTERED SUPPORT / OPPOSITION :
Support
Health Officers Association of California (sponsor)
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County of Santa Clara Board of Supervisors
Opposition
None on file.
Analysis Prepared by : Allegra Kim / HEALTH / (916) 319-2097