BILL ANALYSIS                                                                                                                                                                                                    �



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          Date of Hearing:  March 27, 2012

                            ASSEMBLY COMMITTEE ON HEALTH
                              William W. Monning, Chair
                 SCR 47 (DeSaulnier) - As Introduced:  June 11, 2011
           
          SUBJECT  :  Health in All Policies.

           SUMMARY  :  Requests that the Strategic Growth Council (SGC) and 
          the member agencies, departments, and offices of the Health in 
          All Policies (HiAP) Task Force provide leadership on 
          implementing the recommendations put forth in the HiAP Task 
          Force Report and encourages interdepartmental collaboration with 
          an emphasis on the complex environmental factors that contribute 
          to poor health and inequities when developing policies across 
          sectors.  Specifically,  this resolution  resolves that the 
          Legislature:

             a)   Request that the SGC and the member agencies, 
               departments, and offices of the HiAP Task Force provide 
               leadership on implementing the recommendations put forth by 
               the HiAP Task Force Report;
             b)   Encourage interdepartmental collaboration with an 
               emphasis on the complex environmental factors that 
               contribute to poor health and inequities when developing 
               policies in a wide variety of areas, including, but not 
               limited to, housing, transportation, education, air 
               quality, parks, criminal justice, and employment;
             c)   Consider both short- and long-term health impacts, 
               costs, and benefits, where appropriate, when weighing the 
               merits of proposed legislation; and,
             d)   Encourage public officials in all sectors and levels of 
               government to recognize that health is influenced by 
               policies related to air and water quality, natural 
               resources and agricultural land, affordable housing, 
               infrastructure systems, public health, sustainable 
               communities, and climate change, and to consider health 
               when formulating policy.

           EXISTING LAW  establishes cabinet-level SGC aimed to improve 
          coordination across state agencies to: a) improve air and water 
          quality; b) protect natural resources and agricultural lands; c) 
          increase the availability of affordable housing; d) promote 
          public health; e) improve transportation; f) encourage greater 
          infill and compact development; g) revitalize community and 








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          urban centers; and, h) assist state and local entities in the 
          planning of sustainable communities and the California Global 
          Warming Solutions Act of 2006.

           FISCAL EFFECT  :  This resolution has not yet been heard by a 
          fiscal committee.
           
          COMMENTS  :   

           1)THE PURPOSE OF THIS RESOLUTION  .  According to the author, this 
            resolution calls on state departments and agencies to work 
            together to address barriers to good health in California's 
            communities.  The author states that according to the December 
            3, 2010, Health in All Policies Task Force Report to the 
            Strategic Growth Council (HiAP Task Force Report), "The health 
            of California's population is largely determined by the 
            social, physical, economic and service environments in which 
            people live, work, study and play.  These environments shape 
            the choices that people make every day, as well as their 
            opportunities and resources for health."  The author maintains 
            that this resolution encourages a collaborative effort in 
            addressing the barriers to good health in California's 
            communities with a focus on addressing the complex 
            environmental factors that contribute to poor health and 
            inequities when developing various policies.  The author 
            argues that this resolution is a necessary step in 
            California's continuing struggle to combat preventable chronic 
            illnesses such as heart disease, stroke, obesity and diabetes.

           2)BACKGROUND  .  According to the June 2011 report, National 
            Prevention Strategy: America's Plan for Better Health and 
            Wellness (The National Prevention Strategy report) many of the 
            strongest predictors of health and well-being fall outside of 
            the health care setting.  Social, economic and environmental 
            factors all influence health.  People with a quality 
            education, stable employment, safe homes and neighborhoods, 
            and access to high quality preventive services tend to be 
            healthier throughout their lives and live longer.  The 
            National Prevention Strategy report explains that preventing 
            disease requires more than providing people with information 
            to make healthy choices.  While this knowledge is critical, 
            communities must reinforce and support health, for example, by 
            making healthier choices easy and affordable.  When sectors 
            such as housing, transportation, labor and education promote 
            prevention-oriented environments and policies, they all 








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            contribute to health.

          According to the HiAP Task Force Report, HiAP is an integrated 
            approach that is being used internationally and in California 
            to achieve better health outcomes and greater sustainability 
            by incorporating a health aspect into policy development 
            across all government sectors.  The HiAP approach uses health 
            as a linking factor in bringing people together from across 
            sectors to address major societal issues, focuses on 
            co-benefits and win-win strategies, and harnesses the power 
            that agencies and departments can bring through their areas of 
            individual expertise.

           3)HiAP TASK FORCE  .  California's HiAP Task Force was established 
            by executive Order S-04-10 by Governor Schwarzenegger on 
            February 23, 2010, under the auspices of the SGC.  The HiAP 
            Task Force is a multi-agency effort to improve state policy 
            and decision-making by encouraging collaborative work towards 
            health and sustainability goals by incorporating health 
            considerations into non-health policy areas.  The HiAP Task 
            Force is comprised of staff from the following agencies, 
            departments, and offices:  Air Resources Board; Business, 
            Transportation, and Housing Agency; Department of Community 
            Services and Development; Department of Education; Department 
            of Finance; Department of Food and Agriculture; Department of 
            Forestry and Fire Protection; Department of Housing and 
            Community Development; Department of Justice; Department of 
            Parks and Recreation; Department of Social Services; 
            Department of Transportation; Environmental Protection Agency; 
            Governor's Office of Planning and Research; Health and Human 
            Services Agency; Labor and Workforce Development Agency; 
            Office of Gang and Youth Violence Policy (funding was 
            abolished in the 2011-12 budget and the office closed December 
            31, 2011); and, Office of traffic safety.  In addition, the 
            HiAP Task Force is staffed and facilitated by the California 
            Department of Public Health.

          The HiAP Task Force was charged with identifying priority 
            actions and strategies for state agencies to improve community 
            health.  Between April and November of 2010, representatives 
            from the 19 California agencies, departments, and offices 
            listed above came together in multiple individual and Task 
            Force meetings, participated in public workshops, and received 
            written comments from a diverse array of stakeholders.  These 
            state leaders have developed a broad-ranging set of 








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            recommendations and were charged with developing 
            implementation plans.  The HiAP Task Force narrowed the 
            recommendations to eleven priority recommendations for 
            near-term implementation at its June 1, 2011 meeting.
           4)HiAP RECOMMENDATIONS  .  According to the HiAP Task Force 
            Report, the recommendations put forth are geared at improving 
            the efficiency, cost-effectiveness, and collaborative nature 
            of state government, while promoting both health and other 
            goals of the SGC and addressing the following two strategic 
            directions:

             a)   Building healthy and safe communities with opportunities 
               for active transportation; safe, healthy, affordable 
               housing; places to be active, including parks, greenspace, 
               and healthy tree canopy; the ability to be active without 
               fear of violence or crime; and access to healthy, 
               affordable foods; and,
             b)   Finding opportunities to add a health lens in public 
               policy and program development and increase collaboration 
               across agencies and with communities.

            Following are the eleven priority recommendations of the HiAP 
            Task Force:


           ---------------------------------------------------------------- 
          |     Topic     |            Priority Recommendation             |
          |---------------+------------------------------------------------|
          |Active         |Support active transportation through           |
          |Transportation |implementation of "Complete Streets."           |
          |---------------+------------------------------------------------|
          |               |Highlight the opportunities presented by SB 375 |
          |               |(Steinberg) Chapter 728, Statutes of 2008, to   |
          |               |promote active transportation.                  |
          |---------------+------------------------------------------------|
          |Housing and    |Promote sustainable development through smart   |
          |Indoor Spaces  |housing siting; Develop recommended processes   |
          |               |for balancing multiple public policy objectives |
          |               |affecting air quality and the permit processing |
          |               |and siting of transit-oriented development.     |
          |---------------+------------------------------------------------|
          |Parks, Urban   |Support urban greening and access to green      |
          |Greening &     |spaces.                                         |
          |Places to be   |                                                |
          |Active         |                                                |








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          |---------------+------------------------------------------------|
          |Community      |Disseminate existing guidance on Crime          |
          |Safety through |Prevention through Environmental Design.        |
          |Violence       |                                                |
          |Prevention     |                                                |
          |---------------+------------------------------------------------|
          |               |Build violence prevention capacity statewide by |
          |               |supporting community-level efforts to engage    |
          |               |and convene stakeholders to develop             |
          |               |data-informed prevention actions, including     |
          |               |through training to promote effective community |
          |               |engagement and joint action.                    |
          |---------------+------------------------------------------------|
          |Healthy Food   |Encourage and expand the availability of        |
          |               |affordable and locally grown produce through    |
          |               |"farm-to-fork" policies and programs.           |
          |               |                                                |
          |---------------+------------------------------------------------|
          |               |Leverage government spending to support healthy |
          |               |eating and sustainable local food systems.      |
          |---------------+------------------------------------------------|
          |Healthy Public |Incorporate a health and health equity          |
          |Policy         |perspective into state guidance, surveys, and   |
          |               |technical assistance documents where feasible   |
          |               |and appropriate.                                |
          |---------------+------------------------------------------------|
          |               |Incorporate health and health equity criteria   |
          |               |into state grant Requests for Applications,     |
          |               |review criteria and scoring, technical          |
          |               |assistance, and monitoring/performance          |
          |               |measures, where feasible and appropriate.       |
          |---------------+------------------------------------------------|
          |               |Explore appropriate ways to integrate health    |
          |               |analysis into existing state projects and       |
          |               |plans.  Design and conduct a feasibility study  |
          |               |to explore possible methods or approaches for   |
          |               |incorporating a health lens into analysis of a  |
          |               |subset of legislation and Budget Change         |
          |               |Proposals, to consider long-term health and     |
          |               |state health-care expenditure consequences of   |
          |               |short-term financial and policy decisions.      |
           ---------------------------------------------------------------- 

           5)SUPPORT  .  According to the sponsors of this bill, the Health 
            Officers Association of California (HOAC), which represents 








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            the physician health officers of California's 61 city and 
            county jurisdictions, this resolution calls on state 
            departments and agencies to work together to address barriers 
            to good health in California's communities.  The HOAC 
            maintains that a variety of state agencies and departments 
            need to work together to ensure good health for all 
            Californians and that it is important for health effects to be 
            considered when any new policy is being developed.  

          6)PREVIOUS LEGISLATION  .  

             a)   SB 732 (Steinberg), Chapter 729, Statutes of 2008, 
               establishes the SGC and appropriates $500,000 from the 
               funding provided by the initiative to the Natural Resources 
               Agency to support the SGC and its activities.  Requires the 
               SGC to take certain actions with regard to coordinating 
               programs of members state agencies to improve air and water 
               quality, improve natural resource protection, increase the 
               availability of affordable housing, improve transportation, 
               meet the goals of the California Global Warming Solutions 
               Act of 2006, encourage sustainable land use planning, and 
               revitalize urban and community centers in a sustainable 
               manner.  Requires the SGC to manage and award grants and 
               loans to support the planning and development of 
               sustainable communities, for preparing, adopting, and 
               implementing general plans, general plan elements, regional 
               plans, or other planning instruments, and for preparing, 
               planning and implementing urban greening plans.  Requires 
               SGC, no later than July 1, 2010, and every year thereafter, 
               to provide a report to the Legislature with specified 
               information regarding the management of the grants and 
               loans.

             b)   SB 375 (Steinberg), Chapter 728, Statutes of 2008, 
               Sustainable Communities and Climate Protection Act of 2008 
               requires the California Air Resources Board (ARB) to 
               provide each region with greenhouse gas emission reduction 
               targets for passenger vehicles.  Requires ARB to establish 
               targets for 2020 and 2035 for each region covered by one of 
               the state's 18 metropolitan planning organizations (MPOs).  
               Requires MPOs to prepare a sustainable communities strategy 
               (SCS) that demonstrates how the region will meet its 
               greenhouse gas reduction target through integrated land 
               use, housing and transportation planning.  Requires the 
               MPO's adopted SCS to be incorporated into that region's 








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               federally enforceable regional transportation plan.  

             c)   AB 32 (Nunez), Chapter 488, Statutes of 2006, California 
               Global Warming Solutions Act of 2006 addresses climate 
               change by establishing comprehensive program to reduce 
               greenhouse gas emissions from all sources throughout the 
               state.  Requires the California ARB to develop regulations 
               and market mechanisms to reduce California's greenhouse gas 
               emissions to 1990 levels by 2020.
           
          REGISTERED SUPPORT / OPPOSITION  :   
           Support  
          Health Officers Association of California

           Opposition  
          None on file.
           
          Analysis Prepared by  :    Tanya Robinson-Taylor / HEALTH / (916) 
          319-2097