BILL ANALYSIS �
AB 70
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Date of Hearing: January 10, 2012
ASSEMBLY COMMITTEE ON HEALTH
William W. Monning, Chair
AB 70 (Monning) - As Amended: January 5, 2012
SUBJECT : State Department of Public Health: federal funding
opportunities.
SUMMARY : Requires the California Department of Public Health
(DPH) to develop a plan to increase DPH's flexibility to apply
and maximize federal funding opportunities related to health
prevention. Specifically, this bill :
1)Requires DPH to examine its internal processes to develop a
plan for increased responsiveness and flexibility when
applying for federal funding opportunities, using all
appropriate methods at its disposal, including, but not
limited to, direct applications and applications in
partnership with other public nonprofit health entities for
federal grants such as those available under the Affordable
Care Act (ACA), the Healthy, Hunger-Free Kids Act of 2010
(HHFKA), and the farm bill.
2)Makes various legislative findings and declarations, including
the following:
a) Given the significant fiscal challenges ahead for
California, 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 and the health and well-being of California's
children; and,
b) States it is the intent of the Legislature to take full
advantage of federal funding opportunities, such as the
ACA, the HHFKA, and the farm bill to improve state health
care and nutrition programs and invest in health prevention
and education, with the goal of building, promoting, and
sustaining healthy communities through a community
prevention focus that includes efforts toward the reduction
of chronic disease rates, the elimination of conditions
that lead to health disparities, and an increase in the
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cultural and linguistic appropriateness of health and
nutrition services.
EXISTING FEDERAL LAW :
1)Authorizes the ACA (Public Law 111-148), a federal statute
signed into law along with the Health Care and Education
Reconciliation Act of 2010 (Public Law 111-152), 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 other health issues.
2)Authorizes the HHFKA (Public Law 111-296) as a funding
mechanism and sets policy for United States Department of
Agriculture's (USDA's) core nutrition programs: the National
School Lunch Program, the School Breakfast Program, the
Special Supplemental Nutrition Program for Women, Infants and
Children, the Summer Food Service Program, and the Child and
Adult Care Food Program.
3)Authorizes the farm bill, officially known as The Food,
Conservation and Energy Act of 2008 (Public Law 110-246) which
governs federal farm and food policy.
EXISTING STATE LAW establishes and authorizes DPH to protect,
preserve, and advance public health.
FISCAL EFFECT : This bill has not yet not been analyzed by a
fiscal committee.
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, this bill
would help ensure that California takes full advantage of the
federal prevention grant opportunities such as those available
under the federal ACA, the HHFKA, and the farm bill. The
author maintains that the state faces many challenges that
would limit the ability to operate independently to secure
federal and private funding and to implement public health
programs. These barriers include bureaucratic and political
limitations, human resource scarcity, and chronic funding
shortages, among many others. Such problems are exacerbated
by fiscal and economic challenges that limit the ability of
public health agencies to marshal the effort needed to respond
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to emerging funding opportunities. Requiring DPH to examine
its internal processes and develop a plan that considers using
methods such as application partnerships with other public and
non-profit entities or other innovative solutions will help to
mitigate these problems and increase DPH's effectiveness at
securing federal funding. The author argues that the current
state fiscal situation requires that innovative solutions be
advanced to protect and improve the public's health and secure
the maximum level of federal funding to support state and
local public health programs.
2)FEDERAL FUNDING FOR PREVENTION AND HEALTH EDUCATION .
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.
There are a number of federal funding opportunities available
for states to improve their health care and nutrition programs
and invest in health prevention and education with the goal of
building, promoting, and sustaining healthy communities. Such
opportunities include, but are not limited to, the ACA, the
HHFKA, and the farm bill:
a) The ACA. On March 23, 2010, President Barack Obama
signed the ACA as amended by the Health Care and Education
Reconciliation Act of 2010. Section 4201 of the ACA
authorizes the Secretary of the federal Department of
Health and Human Services (DHHS) to award Community
Transformation Grants (CTG) which are competitive grants to
eligible entities for programs that promote individual and
community health and prevent the incidence of chronic
disease. DPH decided not to apply for the CTG funding but
a California-based external non-profit applied
independently and was awarded $5.9 million through the CTG.
Section 4002 of the ACA establishes a Prevention and Public
Health Fund to be administered through DHHS to provide for
expanded and sustained national investment in prevention
and public health programs to improve health and help
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restrain the rate of growth in private and public sector
health care costs.
Programs continue to roll out as the ACA is implemented.
Funding provided through the ACA's Prevention and Public
Health Fund has been released to communities and programs
are currently being implemented, including competitive
funding for CTGs. A further $140 million in CTG funding
will be released in 2012.
b) The HHFKA. On December 13, 2010, President Barack Obama
signed the HHFKA which is part of the reauthorization of
funding for child nutrition. The HHFKA reauthorizes
funding for federal school meal and child nutrition
programs for five years and includes $4.5 billion in new
funding for these programs over 10 years. In addition, the
HHFKA requires the USDA to make significant improvements in
the nutritional standards of school meals and provides
federal grant funding to support nutrition education and
obesity prevention for low-income children and families.
c) The farm bill. The farm bill is major federal
agricultural and nutrition legislation that impacts the
priorities and programs that influence public health. This
comprehensive omnibus bill is renewed every five years and
was last renewed in 2008. More than two-thirds of the 2008
farm bill funding goes to nutrition programs, with
additional funding for food stamps, food banks, locally
produced food and nutrition education to support obesity
prevention programming. The 2012 farm bill is expected to
be sent to President Barack Obama before the fall election.
It will replace the 2008 farm bill, which expires in
September 2012.
3)SUPPORT . According to the Public Health Institute (PHI), the
sponsor of this bill, over the last several decades, DPH has
worked successfully in partnership with local governments and
non-governmental organizations to seek federal and private
funding to implement critical public health programs.
However, PHI maintains that in recent years internal
administrative and bureaucratic hurdles have meant that DPH
missed opportunities to secure additional federal funding and
failed to take full advantage of federal resources that are
available to support preventative health programs, including
funding made available with the ACA. These challenges,
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according to PHI, weaken DPH's ability to apply for and secure
federal funding and threaten to undermine California's public
health infrastructure. The results can mean lost resources,
missed opportunities, and of most concern, lost lives. This
bill, PHI asserts, would help strengthen DPH's capacity and
responsiveness by requiring the development of a comprehensive
plan to respond to federal funding opportunities and
effectively engage and partner with other public and
community-based nonprofit entities to apply for, and
administer available federal funding.
The Western Center on Law and Poverty (WCLP) writes in support
that by encouraging DPH to apply for federal grant
opportunities, outcomes will improve in low-income communities
throughout California. According to WCLP, research indicates
that lower-income Californians are much more likely to report
being in "fair" or "poor" health when compared to their
higher-income counterparts. WCLP argues that as the state
moves into the implementation of health reform, it is
paramount that strategies be employed in order to improve the
health of our communities and that this will happen only if
California seizes the opportunity to apply for these grants.
REGISTERED SUPPORT / OPPOSITION :
Support
Public Health Institute (sponsor)
Western Center on Law and Poverty
Opposition
None on file.
Analysis Prepared by : Tanya Robinson-Taylor / HEALTH / (916)
319-2097