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AB-240 Local health department workforce assessment.(2021-2022)

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Date Published: 01/13/2021 09:00 PM
AB240:v99#DOCUMENT


CALIFORNIA LEGISLATURE— 2021–2022 REGULAR SESSION

Assembly Bill
No. 240


Introduced by Assembly Member Rodriguez

January 13, 2021


An act to add and repeal Section 100190 of the Health and Safety Code, relating to public health.


LEGISLATIVE COUNSEL'S DIGEST


AB 240, as introduced, Rodriguez. Local health department workforce assessment.
Existing law establishes the State Department of Public Health to implement various programs throughout the state relating to public health, including licensing and regulating health facilities, control of infectious diseases, and implementing programs relating to chronic health issues. Existing law authorizes the department to implement the required programs through, or with the assistance of, local health departments. Existing law requires the department, after consultation with and approval by the California Conference of Local Health Officers, to establish standards of education and experience for professional and technical personnel employed in local health departments and for the organization and operation of the local health departments.
This bill would require the department to contract with an appropriate and qualified entity to conduct an evaluation of the adequacy of the local health department infrastructure and to make recommendations for future staffing, workforce needs, and resources, in order to accurately and adequately fund local public health. The bill would exempt the department from specific provisions relating to public contracting with regard to this requirement. The bill would require the department to report the findings and recommendations of the evaluation to the appropriate policy and fiscal committees of the Legislature on or before July 1, 2024. The bill would also require the department to convene an advisory group, composed of representatives from public, private, and tribal entities, as specified, to provide input on the selection of the entity that would conduct the evaluation. The bill would further require the advisory group to provide technical assistance and subject matter expertise to the selected entity. The bill would make its provisions contingent on sufficient funding and repeal its provisions on January 1, 2026.
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) Local health departments are the first line of defense against public health threats, including novel pandemics like COVID-19. These organizations rely on trained public health professionals, including epidemiologists, communicable disease investigators, public health nurses, laboratorians, and health educators.
(b) Year after year of federal, state, and local public agencies being underfunded has left the United States ill-prepared for the COVID-19 pandemic. The Trust for America’s Health estimated in April 2019 that public health efforts nationally were underfunded by $4.5 billion and that nationally 55,000 positions were eliminated from public health between 2008 and 2017.
(c) According to the California Future Health Workforce Commission’s February 2019 report, the public health workforce in California is chronically underfunded and most local public health agencies lack personnel with expertise in key areas, including epidemiology and the essential skills to design, implement, and evaluate comprehensive approaches to community health improvement.
(d) In California, both state and local public health agencies face increasing competition with the private sector, which provides higher pay and amenities such as updated technology. Additionally, many public health leaders are nearing retirement.
(e) There are no federal or state guidelines for public health staffing, nor does any state or national organization provide information or data on the composition and training levels of the governmental public health workforce.
(f) Many local health departments in California report challenges in recruiting and retaining well qualified workers, citing a lack of tools for recruiting, limited options for advancement, and instability of funded positions.
(g) Based on urgent workforce shortages and demographic trends, the California Future Health Workforce Commission’s February 2019 report identified the following priority professions in the field of prevention and public health:
(1) State and local health department staff, including, but not limited to, epidemiologists, public health nutritionists, infectious disease experts, and disaster preparedness specialists.
(2) Public health nurses.
(3) Data analysts.
(4) Health administrators.
(5) Community health workers and promoters.
(6) Community health educators.
(h) It is the intent of the Legislature to prepare for the workforce challenges facing public health, and for the next emergency or pandemic, by creating a comprehensive plan to address urgent workforce and infrastructure needs of local health departments.

SEC. 2.

 Section 100190 is added to the Health and Safety Code, to read:

100190.
 (a) The State Department of Public Health shall contract with an appropriate and qualified entity to conduct an evaluation of the adequacy of the local health department infrastructure, and to make recommendations for future staffing, workforce needs, and resources, in order to accurately and adequately fund local public health. This evaluation shall, at a minimum, accomplish all of the following:
(1) Evaluate the public health workforce, including identification of barriers and recommendations for adequate staffing of local health departments, appropriate credentialing, access to training and workforce development, recruitment and retention supports, and incentivizing a pipeline of professionals to work in public health.
(2) Assess the efficacy of health information tools utilized by local health departments.
(3) Evaluate the state’s public health laboratory capacity and make recommendations for laboratories to better meet the needs of local health departments.
(4) Evaluate recent trends with federal and state funding streams provided to local health departments and the resources needed to sustain the work of local health departments.
(b) The evaluation and recommendations shall consider all of the following:
(1) The current state and federal statutory and regulatory environment for public health.
(2) The capacity needed on an ongoing basis to meet the demands in a public health emergency.
(3) Additional factors adding to the work of public health, including social determinants of health, health inequities, climate change, natural disasters, and unique local conditions.
(c) The department shall provide oversight of the entity selected for the evaluation and shall convene an advisory group that shall include representatives of the Emergency Medical Services Authority, County Health Executives Association of California, California Conference of Local Health Officers, public health laboratory directors, public health nurses, communicable disease controllers, tribes, the exclusive representatives of public health workers, local emergency medical services administrators, schools of public health, and organizations aimed at addressing health disparities in California. The advisory group shall do both of the following:
(1) Provide input on the selection of an entity to conduct an evaluation under subdivision (a).
(2) Provide technical assistance and subject matter expertise to the entity selected to conduct the evaluation under subdivision (a).
(d) (1) The department shall report the findings and recommendations of the evaluation to the appropriate policy and fiscal committees of the Legislature on or before July 1, 2024.
(2) The report shall be submitted in compliance with Section 9795 of the Government Code.
(e) For purposes of administering this section, the department is exempt from Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code and is exempt from approval by the Department of General Services prior to the contract’s execution.
(f) The implementation of this bill is contingent upon sufficient funding from state, federal, or private funding for the department to support the advisory group and the evaluation contract.
(g) This section shall remain in effect only until January 1, 2026, and as of that date is repealed.