BILL ANALYSIS                                                                                                                                                                                                    �



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          ASSEMBLY THIRD READING
          AB 70 (Monning)
          As Amended January 23, 2012
          Majority vote 

           HEALTH              12-1        APPROPRIATIONS      12-0        
           
           ----------------------------------------------------------------- 
          |Ayes:|Monning, Ammiano, Atkins, |Ayes:|Fuentes, Blumenfield,     |
          |     |Bonilla, Eng, Gordon,     |     |Bradford, Charles         |
          |     |Hayashi,                  |     |Calderon, Campos,         |
          |     |Bonnie Lowenthal,         |     |Chesbro, Gatto, Hall,     |
          |     |Mitchell, Pan,            |     |Hill, Ammiano, Mitchell,  |
          |     |V. Manuel P�rez, Williams |     |Solorio                   |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Smyth                     |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Expands the California Department of Public Health's 
          (DPH) authority to submit applications in partnership with other 
          nonprofit health entities to increase DPH's responsiveness and 
          flexibility when applying for funding opportunities related to 
          health prevention.  Specifically,  this bill  :   

          1)Expands DPH's authority to submit applications in partnership 
            with other nonprofit health entities to increase DPH's 
            responsiveness and flexibility when applying for funding 
            opportunities related to health prevention such as those 
            available under the Affordable Care Act (ACA), the Healthy, 
            Hunger-Free Kids Act of 2010 (HHFKA), and the farm bill.

          2)Permits DPH to take actions specified in 3) below, if all of 
            the following conditions are met:

             a)   There is a request for application, funding opportunity 
               announcement, or other similar solicitation issued by the 
               federal government, a state or local government outside of 
               California, or a nonprofit corporation, or their 
               contractors, grantees, or agents;

             b)   DPH is eligible to apply to the application, funding 
               opportunity announcement, or solicitation; and,









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             c)   The application, funding opportunity announcement, or 
               solicitation is for a public health project that advances 
               the goals described in 7) below and the goals are, in whole 
               or in part, within the powers of DPH.
           
           3)Permits DPH to take any of the following actions if all of the 
            requirements of 2) above have been met: 

             a)   DPH may enter into a memorandum of understanding (MOU) 
               or agreement with another eligible applicant or entity 
               formed by two or more eligible applicants.  Requires the 
               MOU or agreement to provide that the other eligible 
               applicant will respond to the application, funding 
               opportunity announcement, or solicitation as the lead 
               agency; or,

             b)   If eligibility to apply to an application, funding 
               opportunity announcement, or solicitation is restricted to 
               state and local health departments, and entities designated 
               by state and local health departments, permits DPH to enter 
               into a written MOU or agreement with a local health 
               department and its designees, public or private institution 
               of higher education, nonprofit organization, or separate 
               entity controlled by two or more of these entities.  
               Requires the MOU or agreement to provide that the entity 
               will be designated by DPH, in writing, to respond to the 
               solicitation as the lead agency.
           
           4)Permits DPH to notify local health departments, public or 
            private institutions of higher education, nonprofit 
            corporations whose purpose includes public health, and 
            separate entities controlled by two or more of these entities, 
            of the opportunity to submit their credentials for designation 
            as a lead agency pursuant to 3) inclusive, above.  Permits DPH 
            to review the credentials of entities that respond to the 
            notice and designate a qualified lead agency for purposes of 
            responding to and administering the activities described in a 
            request for application, funding opportunity announcement, or 
            other similar solicitation.

          5)Requires a qualified lead agency designee to have the 
            institutional capacity to respond to and administer the 
            activities described in a request for application, funding 
            opportunity announcement, or similar solicitation.








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          6)Requires a qualified lead agency designee to agree in advance 
            to terms and conditions of designation specified by DPH, which 
            are to include, but are not limited to, the following:

             a)   Acceptance of full responsibility for compliance with 
               the terms and conditions of the award;

             b)   Granting of permission to the state to use, reproduce, 
               modify, and distribute intellectual property arising out of 
               the performance of the award to the extent permitted by the 
               award;

             c)   Indemnification of the state from and against any 
               claims, expenses, or liability arising out of the award; 
               and,

             d)   Appropriate provisions for the cancellation of the MOU 
               or agreement for the convenience of the state.

          7)Requires the goals of public health projects described in 
            subdivision 1) above to include any of the following:

             a)   The creation of healthier school and community 
               environments, including, but not limited to, healthful food 
               options, free drinking water, and physical activity;

             b)   The creation of an infrastructure to support active 
               living and access to nutritious foods;

             c)   The development and promotion of programs targeting a 
               variety of age levels to increase healthy eating, physical 
               activity, food security, smoking cessation, mental health, 
               and safety, as well as address special population needs;

             d)   The promotion and improvement of access to healthful 
               food options in schools, child care facilities, 
               communities, worksites, and other settings;

             e)   The assessment and implementation of worksite wellness 
               programs; and,

             f)   The prioritization of strategies to address inequities 
               that lead to racial and ethnic health disparities.








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          8)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 
               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, 








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            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  :  According to the Assembly Appropriations 
          Committee, if the new authority provided in this bill increases 
          DPH's ability to apply for and receive grant funding, the state 
          could receive an increase in grant funding as compared to the 
          status quo.  The amount and likelihood of a potential increase 
          in grant funding is unknown.   

           COMMENTS  :  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 to emerging funding opportunities.  Expanding DPH's 
          authority to use 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.  

           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.
           








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          Analysis Prepared by  :    Tanya Robinson-Taylor / HEALTH / (916) 
          319-2097 

                                                                FN: 0003046