HomeMy WebLinkAboutMINUTES - 04061999 - C69 f
TO: BOARD OF SUPERVISORS109
Contra
FROM: William B.Walker, MD, Director of health Services a Costa
County
DATE: March 24, 1999
SUBJECT: SB 269, THE "PUBLIC HEALTH IMPROVEMENT ACT OF 1999•'
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDATIONS:
1. Support SB 269, the "Public Health I_mprovement Act of 1999"
2. Authorize the Chair of the Board of Supervisors to communicate the Board's support for SB 269 to the Contra
Costa Legislative Delegation, and to other California legislators as appropriate.
BACKGRQUND:
SB 269 would increase State funding to local health departments for communicable disease control and public
health epidemiology and surveillance activities. The bill would allocate local health jurisdictions 0.60 dollars
per capita or $100,000,whichever is greater.
In 1947,the State provided 3 million dollars to local health departments for disease prevention activities. Today
the State only makes$708,000 available under this allocation. As a result, California's ability to deal with new
and re-emerging infectious diseases is tenuous, and this state is now identified as the state most likely to
experience the appearance of new disease threats. The number of infectious diseases newly emerging or re-
emerging has increased sharply in just the past few years, including E.coli 0175H7,hantavirus, and cyclospora.
Many microbial agents are developing resistance to antibiotics. California's multiple international ports of entry
and extensive international tourism and immigration make infectious diseases a particular problem., as does the
globalization of our food sources.
CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIQNATURE(S):
ACTION OF BOARD ON April 6a 19 99 _ - APPROVED AS RECOMMENDED _ XX OTHER
VOTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A TRUE
XX UNANIMOUS (ABSENT —— — ) AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
Contact Person: Wendel Brunner,MD, Public Health Dlrector
(925)3136712
CC: William B.Walker,MD, Health Services Director ATTESTED April 6 1999
Public Health Administration PHIL BATCHELOR,CLERK OF THE BOARD OF
SUPERVISORS VD COUNTY ADMINISTRATOR
BY DEPUTY
Page 1 of 2
In Contra Costa we have seen many of these communicable diseases. In particular, tuberculosis has been a
persistent problem, including 36 cases among children in the last three years. SB 269 would provide funding
to strengthen our own infrastructure for the detection and control of communicable diseases.
FISCAL IMPACT
Passage of SB 269 would provide approximately $500,000 per year to Contra Costa County for the control of
communicable disease in our community.
CONSEQUENCE OF NEGATIVE ACTION:
Lack of visible support from local jurisdictions will decrease the possibility of passage of this Public Health
Improvement Acte
Page 2 of 2
SENATE BILL No. 269
Introduced by Senator Ortiz
February 1, 1999
An act to amend Section 101230 of the Health and Safety
Code, relating to public health administration.
LEGISLAnVECOUNSEL'S DIGEST
SE 269, as introduced, Ortiz. Local public health
administration: state aid.
Under existing law, state aid is provided to local health
departments for purposes of public health administration,
including for communicable disease control and community
and public health surveillance activities. Under existing law,
allocation of these funds is made to the administrative bodies
of qualifying local health jurisdictions described as public
health administrative organizations, and includes a basic
allotment of $50,000 per local health jurisdiction or
$0.2171048900 per capita, whichever is greater.
This bill would enact the "Public Health Improvement Act
of 1999," which would increase the basic funding allotment to
$100,000 per local health jurisdiction or $01.60 per capita,
whichever is greater, and would state related legislative
intent.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program. no.
The people of the State of California do enact as follows:
1 SECTION 1. (a) This act shall be known and may be
2 cited as the "Public Health Improvement Act of 1999."
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1
..2-1 (b) The Legislature finds and declares as follows:
2 (1) Local control of communicable diseases is a well
3 recognized core public health function, comparable to
4 the public safety mission of law enforcement.
5 (2) The tools to battle communicable diseases are well
6 known and time honored. These tools involve basic
7 prevention, identification, and control efforts that result
8 in a benefit to all in society. These tools include disease
9 surveillance systems, diagnostic capabilities, disease
10 intervention, health education, and a broad disease
11 prevention program..
12 (3) Local communicable disease control surveillance
13 and reporting activities are the backbone of the state's
14 communicable disease control efforts. Without an
15 effective local reporting and surveillance system, control
16 of communicable disease is not possible in California.
17 (4) The local reporting and surveillance system is
18 severely strained and underfunded. Scientific and
19 professional capacity has not grown with the state's
20 increasing papulation and complexity of problems. There
21 are many instances where key medical and public health
22 laboratory personnel have been reduced in local health
23 departments.
24 (5) The number of infectious diseases newly emerging
25 or reemerging in California has increased sharply in just
26 the past few years. Diseases including bloody diarrhea
27 due to F. Coli 0157:H7, hantavirus pulmonary syndrome,
28 Cyclospora, egg-associated salmonellosis, and bacterial
29 infections resistant to all antibiotics have appeared within
30 the last three years, in addition to the eight new sexually
31 transmitted diseases recognized since 1980. Multiple drug
32 resistant TB, and valley fever have reemerged as major
33 health threats.
34 (6) The federal Centers of Disease Control and
35 Prevention and the United States Food and Drug
36 Administration have both urged state action as a critical
37 part of their emerging pathogens prevention strategy.
38 The FDA has pointed out that only two states, Minnesota
39 and Washington, are well prepared to identify and
40 manage F. Coli 0157:H7 outbreaks. In fact, despite
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1 sporadic cases in contiguous California counties, it was
2 Washington state that alerted California about the recent
3 multistate outbreak initially attributed to raw apple juice.
4 (7) A joint survey of local health departments
5 conducted by the California Conference of Local Health
6 Officers and the State Department of Health Services in
7 1998 determined that over 22 million dollars ($22,000,000)
8 would have to be spent on basic scientific personnel to fill
9 this gap in the capability to control and prevent the
10 spread of disease.
11 (8) In 1947, the Legislature allotted 3 million dollars
12 ($.3,000,000) to local health jurisdictions for the basic core
13 disease prevention services. The current amount is seven
14 hundred eight thousand dollars ($708,000). As a result,
15 basic public health programs, such as communicable
16 disease control and disease surveillance,have eroded.
17 (b) (1) It is therefore the intent of the Legislature
18 that local population-based prevention services be
19 strengthened and enhanced in California to provide for
20 communicable disease control and community health
21 surveillance activities.
22 (2) It is the further intent of the Legislature that, in
23 conjunction with a proposal to enhance funding for an
24 emerging infectious disease program at the state level,
25 that the Legislature seek to enhance and strengthen the
26 capability of local health jurisdictions to form a state-local
27 system to control communicable disease and to closely
28 monitor the health status of the state's population.
29 SEC. 2. Section 101230 of the Health and Safety Code
30 is amended to read:
31 101230. From the appropriation made for the
32 purposes of this article, allocation shall be made to the
33 administrative bodies of qualifying local health
34 jurisdictions described as public health administrative
35 organizations in Section 101185 in the following manner:
36 (a) A basic allotment as follows:
37 To the administrative bodies of local health
38 jurisdictions a basic allotment of
39 X080€) one hundred thousand dollars ($100,000) per
40 local health jurisdiction or
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SB 269 —4-
1 eeatq ($0,2141048990) sixty
4--
sixty cents ($0.60) per capita,
2 whichever is greater. The population estimates used for
3 the calculation of the per capita allotment shall be based
4 on. the Department of Finance's E-1 Report,
5 "City/County Population Estimates with Annual
6 Percentage Changes" as of January 1 of the previous fiscal
7 year. However, if within a county there are one or more
8 city health jurisdictions, the county shall subtract the
9 population of the city or cities from the county total
10 papulation for purposes of calculating the per capita total.
11 If the amounts appropriated are insufficient to fully fund
12 the allocations specified in this subdivision, the State
13 Department of Health Services shall prorate and adjust
14 each local health jurisdiction's allocation using the same
15 percentage that each local health jurisdiction's allocation
16 represents to the total appropriation under the allocation
17 methodology specified in this subdivision.
18 (b) A per capita allotment, determined as follows:
19 After deducting the amounts allowed for the basic
2€3 allotment as provided in subdivision (a), the balance of
21 the appropriation, if any, shall be allotted on a per capita
22 basis to the administrative body of each local health
23 jurisdiction in the proportion that the population of that
24 local health jurisdiction bears to the population of all
25 qualified local health jurisdictions of the state.
26 (c) Beginning in the fiscal year 1998-99, funds
27 appropriated for the purposes of this article shall be used
28 to supplement existing levels of the services described in
29 paragraphs (1) and (2) of subdivision (d) provided by
30 qualifying participating local health jurisdictions. As part
31 of a county's or city's annual realignment trust fund
32 report to the Controller, a participating county or city
33 shall annually certify to the Controller that it has
34 deposited county or city fiends equal to or exceeding the
35 amount described in subdivisions (a) and (b) of Section
36 17608.10. The county or city shall not be required to
37 submit any additional reports or modifications to existing
38 reports to document compliance with this subdivision.
39 Funds shall be disbursed quarterly in advance to local
40 health jurisdictions beginning July 1, 1998. If a county or
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1 city does not accept its allocation, any unallocated funds
2 provided under this section shall be redistributed
3 according to subdivision (b) to the participating counties
4 and cities that remain.
5 (d) Funds shall be used for the following:
6 (1) Communicable disease control activities.
7 Communicable disease control activities shall include,
8 but not be limited to, communicable disease prevention,
9 epidemiologic services, public health laboratory
10 identification, surveillance, immunizations, follow-up
11 care for sexually transmitted disease and tuberculosis
12 control, and support services.
13 (2) Community and public health surveillance
14 activities. These activities shall include, but not be limited
15 to, epidemiological analyses, and monitoring and
16 investigating communicable diseases and illnesses due to
17 other untoward health events.
18 (e) Funds shall not be used for medical services,
19 including jail medical treatment, except as provided in
20 subdivision (d).
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