Bill Text: CA AB93 | 2021-2022 | Regular Session | Amended

California Assembly Bill 93 (Prior Session Legislation)

NOTE: There are more recent revisions of this legislation. Read Latest Draft

Bill Title: Pandemic response practices.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Failed) 2022-02-01 - From committee: Filed with the Chief Clerk pursuant to Joint Rule 56. [AB93 Detail]

Download: California-2021-AB93-Amended.html

Amended IN Assembly January 04, 2022

Amended IN Assembly March 25, 2021

CALIFORNIA LEGISLATURE— 2021–2022 REGULAR SESSION

Assembly Bill

No. 93

Introduced by Assembly Members Eduardo Garcia and Robert Rivas
(Coauthor: Assembly Member Carrillo)
(Coauthor: Senator Hurtado)

December 07, 2020

An act to add Part ~~7.2~~ 7.1 (commencing with Section ~~122445)~~ 122446) to Division 105 of the Health and Safety Code, relating to public health.

LEGISLATIVE COUNSEL'S DIGEST

AB 93, as amended, Eduardo Garcia. Pandemic response practices.

Existing law requires the State Department of Public Health to examine the causes of communicable diseases occurring, or likely to occur, in the state and grants the department certain powers to quarantine, isolate, and inspect persons or places, as necessary to protect or preserve the public health. Existing law sets forth the mechanisms for proclaiming a state of emergency by the Governor or declaring a health emergency by the State Public Health Officer.
Existing law requires the department and the Office of Emergency Services (OES), in coordination with other state agencies, to establish a personal protective equipment (PPE) stockpile, upon appropriation and as necessary. Existing law requires the department to establish guidelines for the procurement, management, and distribution of PPE, as specified. Existing law generally requires a health care employer to maintain an inventory of new, unexpired PPE for use in the event of a declared state of emergency or a local emergency for a pandemic or other health emergency.
This bill would make findings and declarations relating to California’s response to the COVID-19 pandemic. The bill would, during a state of emergency or health emergency in response to a viral pandemic or any other health crisis, as specified, require the Medical and Health Coordination Center within the department to include federally qualified health centers in the organizational response structure established by OES.
The bill would require the department and the California Health and Human Services Agency to, among other things, coordinate in maintaining an annual inventory of the PPE and all other related medical supplies that the state maintains in its stockpiles. The bill would require the department to ensure that all elements in the stockpiles are viable and can be activated and distributed within a reasonable timeframe to address the level of need established by any public health crisis, as specified. No later than December 1, 2023, and every 2 years thereafter, the bill would require the department and the agency to submit a report on the utilization of the equipment and supplies in the state stockpiles to the health and budget legislative committees.
The bill would, subject to an appropriation in the annual Budget Act, require the department to develop a statewide, comprehensive plan to conduct an outreach and education campaign relating to COVID-19. The bill would require the campaign to include components on preventing infections, encouraging vaccination, correcting false information efforts, and addressing health disparities among certain communities. Under the bill, the campaign would commence on November 1, 2023, and operate for at least 3 years.
Existing law establishes the California Health and Human Services Agency, under the direction of the Secretary of California Health and Human Services, which includes, among other departments, the State Department of Public Health and the State Department of Health Care Services. Existing law establishes various programs for the prevention and control of communicable diseases, including programs that provide for the testing for, notifications of exposure to, and tracking by the state of, communicable diseases.
This bill would require the Legislative Analyst’s Office to conduct a comprehensive review and analysis of issues related to the state’s response to the COVID-19 pandemic, including, among others, whether local public health departments were sufficiently staffed and funded to handle specified pandemic-related responsibilities, and what specific measures of accountability the state applied to monitor and confirm that local public health departments were following state directives related to any dedicated COVID-19 funds allocated to counties. The bill would require the office to report to the Joint Legislative Audit Committee and the health committees of the Legislature by June 30, 2022.
The bill would require the state to include community health centers as a part of its organizational pandemic response structure, and would require community health centers, including federally qualified health centers, to serve as points of contact at the local and regional level, in the same manner as local health departments. The bill would require the state to establish a supply chain of medical supplies and equipment necessary to address the level of need established by the COVID-19 pandemic. The bill would authorize the state to provide economic incentives to help relocate manufacturers of medical supplies, as required to address a pandemic or public health crisis.
The bill would require the State Department of Public Health and the State Department of Health Care Services to develop a statewide, comprehensive plan to provide an outreach and education campaign for implementation during a viral pandemic or health care emergency. The bill would require the campaign to focus on those communities in each county with the highest rates of health disparities. The bill would require the education and outreach campaign materials to be culturally sensitive to populations that experienced a high rate of health disparities that contributed to greater susceptibility to COVID-19.
The bill would establish initial priority tiers of priority populations for rapid testing and vaccination during a pandemic. Tier I would include health care workers and first responders and Tier II would include education and childcare workers and food workers, as defined. The bill would require the State Department of Public Health to adopt and enforce all regulations necessary to implement these provisions and provide technical assistance to local health departments. The bill would specify that these provisions do not preclude the department from taking any action within the scope of its authority to address immediate circumstances relative to the pandemic, as specified.
The bill would specify that it would be implemented to the extent permitted by federal law, and would declare that its provisions are severable. The bill would make findings and declarations relating to California’s response to the COVID-19 pandemic.

Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO

The people of the State of California do enact as follows:

SECTION 1.

The Legislature finds and declares all of the following:

(a) From March to December 2020, the national media highlighted the scientific data that ethnic and racial minorities were disproportionately represented in positive cases and deaths caused by COVID-19. Despite this media coverage, little concrete action resulted that measurably improved these trends.

(b) The lack of transparency and allocation of vital equipment and supplies caused the positive rates of COVID-19 to increase to unprecedented levels, and resulted in loss of life throughout the nation.

(c) States pursued their supply chains of ~~protective medical~~ personal protective equipment, including masks and respirators, often competing with one another in securing supply chains of this vital equipment.

(d) California has the most comprehensive and well-funded public health and health care infrastructure in the nation. County health care systems, hospitals, county public health systems, and community health centers all serve the California public. These care systems can provide an integrated model that can handle any public health and natural disaster crisis appropriately.

(e) The State of California, like the federal government, did not create a uniform, disciplined infrastructure to handle the pandemic.

(f) The California health care infrastructure’s full and comprehensive capacity did not function collectively and collaboratively, but rather competitively. This undermines state objectives and did not serve the public well, particularly ethnic and racial minority communities.

(g) Complicating the response and efforts in ethnic and racial minority communities was the complete omission of the state and county public health care systems to integrate the ~~Federally Qualified Health Centers~~ federally qualified health centers (FQHCs) in their local actions. Despite having the United States Assistant Secretary for Preparedness and Response designating FQHCs and community health centers as first responders in a public health crisis, this fact, and potential contributions, were wholly ignored. There were many instances in which health centers’ participation and role could have significantly improved the state’s most impacted communities.

(h) Prime examples of where these problems were experienced most acutely were in farmworker communities throughout the state and African American and Latino communities in urban centers. Significant numbers of “essential workers” reside in these two principal areas, and the incidence of positive virus cases was the highest. Substantial outbreaks occurred in the ~~central valley,~~ Central Valley, along the United States-Mexico border, coastal valleys, the City of Los Angeles, the City of Oakland, and other urban centers.

(i) Exacerbating these problems was the lack of oversight and monitoring of how counties were using and distributing ~~protective medical~~ personal protective equipment, allocating and locating COVID-19 testing, protecting essential workers, and distributing and targeting vaccine application.

(j) The data gathered and provided by the State Department of Public Health ~~reveals~~ reveal that on March 3, 2021, the percentage of Latinos with positive COVID-19 cases was 56.4 percent, and deaths were 49 percent, while the Latino population in the state is 38.9 percent. In July 2020, Latinos accounted for 57 percent of COVID-19 cases and 46 percent of deaths. ~~This data confirms~~ These data confirm that little improvement was made from July 2020 to March 2021.

(k) On February 4, 2021, APM Research Lab reported that “of the more than 444,000 U.S. deaths catalogued in this Color of Coronavirus update, these are the numbers of lives lost by group: Asian (14,019), Black (63,207), Indigenous (4,506), Latino (72,291), Pacific Islander (706), and White (241,440).” These numbers tell us that Latinos are 2.4 times more likely to have died of COVID-19 than White Americans. Similarly, Blacks are 2.1 times more likely, Indigenous people 2.2 times more likely, and Pacific Islanders 2.7 times more likely, to have died from the virus than ~~Whites.”~~ Whites.

(l) Consequences of the lack of uniform policies and of structural and operational failures have made prevention, protection, and compliance with COVID-19 precautions more challenging to bring about. These errors have also caused a lack of confidence and trust that vaccines will be effectively and efficiently distributed to the most vulnerable populations, especially those identified as priorities that have been underserved.

SEC. 2.Part 7.2 (commencing with Section 122445) is added to Division 105 of the Health and Safety Code, to read:
7.2.State Pandemic Response and Vaccine Guidelines
122445.
(a)The Legislative Analyst’s Office shall conduct a comprehensive review and analysis of issues related to the state’s response to the COVID-19 pandemic, including, but not limited to, the following:
~~(1)Whether local public health departments were sufficiently staffed and funded to handle all responsibilities they were entrusted to perform related to the pandemic.~~
(2)Whether local public health departments incorporated local hospitals and community health centers in their plans for dealing with the full array of responsibilities they were assigned, including the distribution of personal protective equipment (PPE), COVID-19 testing supplies, selection of testing sites, and outreach, and education to the general population, particularly communities with high health disparities.
(3)Whether the State Department of Public Health, the State Department of Health Care Services, or county health departments reached out to community health centers and communities identified as having health disparities and high rates of COVID-19 cases and deaths, to build partnerships in providing PPE, testing supplies, and organized outreach and education campaigns to most impacted communities.
(4)Whether the state consulted with relevant federal government agencies or representatives of community health centers regarding involvement of federally funded community health centers in pandemic activities as first responders.
(5)The specific measures of accountability the state applied to monitor and confirm that local public health departments were following state directives related to any dedicated COVID-19 funds allocated to counties, distributing supplies to health care providers in their jurisdictions, improving services, and providing outreach to the most impacted communities.
(6)Why the state did not take a leadership role in creating a supply chain of PPE and other related medical equipment to local public health departments, how quickly and effectively local public health departments were able to develop their supply chains, and whether the state’s decision resulted in any negative consequences for local public health departments dealing with the pandemic.
(7)How the state developed its process for establishing priorities for vaccinating California residents, including the policy and operational issues considered, and the steps taken to respond to the needs of communities with a high rate of health disparities and a disproportionate number of positive cases and deaths.
(b)(1)The office shall commence the review by January 31, 2022, and provide a final report to the Joint Legislative Budget Committee and the health committees of both houses of the Legislature by June 30, 2022.
~~(2)A report submitted pursuant to paragraph (1) shall be submitted in compliance with Section 9795 of the Government Code.~~
122445.1.
(a)During a viral pandemic or similar health care emergency, the state shall include multiple community health centers as a part of its organizational response structure. Community health centers, including federally qualified health centers, shall serve as points of contact for the State Department of Public Health and the State Department of Health Care Services at the local and regional level, as appropriate, in the same manner as local health departments.
(b)The state shall provide for an ongoing supply chain of medical supplies and equipment necessary to address the level of need established by the COVID-19 pandemic. Inventory of this supply shall be conducted every other year, beginning two years after the supply levels are initially established. For purposes of this subdivision, the state may provide economic incentives to help relocate manufacturers of medical supplies, as required to address a public health crisis.
122445.2.
(a)The State Department of Public Health and the State Department of Health Care Services shall collaborate to develop a statewide, comprehensive plan to conduct an outreach and education campaign for implementation during a viral pandemic or health care emergency. The campaign shall continue for at least three fiscal years.
(b)The campaign shall focus on those communities in each county with the highest rates of health disparities, and shall include outreach and education materials in the non-English languages prevalent in each county. Materials shall be culturally sensitive to populations that experienced a high rate of health disparities that contributed to greater susceptibility to COVID-19.
~~(c)The campaign shall provide communities with a high rate of health disparities with information addressing issues, including, but not limited to, all of the following:~~
~~(1)The health and economic consequences of health disparities.~~
~~(2)Initiatives those communities can undertake to combat and change disparity trends.~~
~~(3)Eating habits that contribute to health disparities.~~
~~(4)The effect of housing overcrowding and low wages on health disparities.~~
~~(d)Funds shall be allocated for the outreach and education campaign subject to an appropriation in the annual Budget Act.~~
122445.3.
~~(a)In order to maximize protection of the public, priority tiers for rapid testing and vaccination during a pandemic shall be determined in accordance with this section.~~
~~(b)(1)Tier I priority shall include the following populations:~~
~~(A)Health care workers.~~
~~(B)First responders.~~
~~(2)Tier II priority shall include the following populations:~~
~~(A)Education and childcare workers.~~
~~(B)Food supply workers. For purposes of this section, “food supply worker” includes both of the following:~~
(i)Workers in grocery stores, pharmacies, convenience stores, and other retail locations that sell food or beverage products. The department shall, by regulation, create subcategories within this group, based on frequency and level of food contact.
(ii)Farm and ranch workers, support service workers, and their supplier employees producing food supply domestically and for export to include those engaged in raising, cultivating, harvesting, packing, storing, or delivering to storage or to market or to a carrier for transportation to market any agricultural or horticultural commodity for human consumption .
~~(c)(1)The State Department of Public Health shall adopt and enforce all regulations necessary to implement this section, and provide technical assistance to local health departments as needed.~~
(2)This section does not preclude the department from taking any action within the scope of its authority to address immediate circumstances relative to the pandemic, including, but not limited to, vaccine availability.
122445.4.
~~(a)This part shall be implemented to the extent permitted by federal law.~~
(b)The provisions of this part are severable. If any provision of this part or its application is held invalid, that invalidity shall not affect other provisions or applications that can be given effect without the invalid provision or application.

SEC. 2.

Part 7.1 (commencing with Section 122446) is added to Division 105 of the Health and Safety Code, to read:

PART 7.1. State Pandemic Response
122446.
(a) During a state of emergency proclaimed by the Governor pursuant to Section 8625 of the Government Code, or a health emergency declared by the State Public Health Officer pursuant to Section 101080, in response to a viral pandemic or any other health crisis involving an imminent and proximate threat of the introduction of a contagious, infectious, or communicable disease, chemical agent, noncommunicable biologic agent, toxin, or radioactive agent, the Medical and Health Coordination Center within the State Department of Public Health (department) shall include federally qualified health centers (FQHCs) in the organizational response structure established by the Office of Emergency Services.
(b) (1) The department and the California Health and Human Services Agency shall coordinate in maintaining an annual inventory of the personal protective equipment and all other related medical supplies that the state maintains in its stockpiles. This inventory shall be consistent with the stockpile- and inventory-related provisions described in Section 131021 of this code and Sections 6403.1 and 6403.3 of the Labor Code.
(2) No later than December 1, 2023, and every two years thereafter, the department and the agency shall submit a report on the utilization of the equipment and supplies in the state stockpiles to the Assembly and Senate Committees on Health, the Assembly Committee on Budget, and the Senate Committee on Budget and Fiscal Review.
(3) The department and the agency shall, in consultation with the federal Centers for Disease Control and Prevention (CDC), local public health departments, hospitals, and FQHCs, determine the contents of the stockpiles and the amount of those contents that can be effectively utilized at any given time. The determination shall factor in previous experiences, utilization rates, costs, and availability of a supply chain.
(4) The department shall ensure that all elements in the stockpiles are viable and can be activated and distributed within a reasonable timeframe to address the level of need established by any public health crisis, consistent with Section 131021 of this code and Sections 6403.1 and 6403.3 of the Labor Code.
122446.1.
(a) The State Department of Public Health shall develop a statewide, comprehensive plan to conduct an outreach and education campaign relating to COVID-19, including all of the following components:
(1) Education on factors that contribute to the COVID-19 virus or its variants, the facts surrounding COVID-19, and how vaccinations are developed, clinically tested, monitored, and studied to reduce risks for all individuals receiving a COVID-19 vaccine.
(2) Activities aimed at preventing COVID-19 infections and increases in COVID-19 cases.
(3) Activities aimed at encouraging COVID-19 vaccination and booster shots.
(4) Activities to address and correct the organized false information efforts relating to COVID-19 and that are carried out on social media. The Legislature finds that this false information has been determined to be instrumental in creating confusion, hesitancy, and resistance to being vaccinated against COVID-19 and could lead to a repetition of the high rates of infection and death as possible variants evolve.
(5) Preventive messaging and activities that address how health disparities among specific ethnic or racial groups with the highest rates of COVID-19 positive cases and COVID-19-related deaths result in increased risks for contracting the COVID-19 virus or its variants. For purposes of this paragraph, health disparity conditions include, but are not limited to, diabetes, obesity, and high blood pressure (hypertension).
(6) Any other preventive efforts recommended by the CDC or the State Department of Public Health.
(b) The campaign shall focus on those communities in each county with the highest rates of health disparities, and shall include outreach and education materials in the non-English languages prevalent in each county. Materials shall be culturally sensitive to populations that experienced a high rate of health disparities that contributed to greater susceptibility to COVID-19.
(c) The campaign shall provide communities that have a high rate of health disparities with information addressing, among other issues, all of the following:
(1) The health and economic consequences of health disparities.
(2) Initiatives that those communities can undertake to combat and change health disparity trends.
(3) Eating habits that contribute to health disparities.
(4) The effect of housing overcrowding and low wages on health disparities.
(d) Subject to subdivision (e), implementation of the campaign shall commence on November 1, 2023, and operate for at least three years.
(e) (1) Implementation of this section is subject to an appropriation in the annual Budget Act for purposes of this section.
(2) It is the intent of the Legislature that the future appropriation described in paragraph (1), if made, utilize available federal funds that are allocated to the State of California for activities relating to COVID-19, to the extent that use of those federal funds for the purposes described in this section is authorized by federal law.