BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2384
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          Date of Hearing:   April 18, 2006

                            ASSEMBLY COMMITTEE ON HEALTH
                                  Wilma Chan, Chair
                 AB 2384 (Leno) - As Introduced:  February 23, 2006 
           
          SUBJECT  :   Nutrition:  Health Food Purchase Pilot Program.

           SUMMARY :   Establishes a "Healthy Food Purchase" pilot program  
          (pilot program) to increase the sale and purchase of fresh  
          fruits and vegetables in low-income communities.  Specifically,  
           this bill  :  

          1)Requires the Department of Health Services (DHS) to design the  
            pilot program with the following components:
             a)   Strategies aimed at small grocers in targeted low-income  
               neighborhoods to increase the offerings of fresh fruits and  
               vegetables in those communities.  Requires DHS to provide  
               technical assistance, as specified; and,
             b)   Strategies aimed at food stamp recipients to increase  
               their purchase of fresh fruits and vegetables by making  
               those products more affordable, including the development  
               and implementation of financial incentives.  Requires DHS  
               to seek any necessary federal government approvals to allow  
               use of the Food Stamp Electronic Benefits Card, as  
               specified.

          2)Requires DHS to seek all necessary approvals to establish the  
            pilot program, and apply for available federal matching funds  
            to fund the pilot program.

          3) Requires DHS to develop a process for evaluating the  
            effectiveness of the program, and shall make recommendations  
            to the Legislature regarding the possible expansion of the  
            pilot program.       

          4) Makes legislative findings and declarations on the importance  
            of eating healthy and making available fresh fruits and  
            vegetables.   

           EXISTING LAW  :  

          1)Requires DHS to establish and implement, to the extent funds  
            other than state general funds are available, a "5 A Day - For  
            Better Health" program to promote public awareness of the need  
            to increase the consumption of fruits and vegetables as part  
            of a low-fat, high-fiber diet in order to improve health and  






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            prevent major chronic diseases, including diet-related  
            cancers.

          2)Establishes the California Fresh Start Pilot Program within  
            the State Department of Education (DOE), to be administered by  
            DOE in consultation with the Department of Food and  
            Agriculture and DHS, to promote the consumption of fresh  
            fruits and vegetables by school age children.   

          3)Establishes the Women, Infants and Children as a nutrition  
            program that helps pregnant women, new mothers and young  
            children eat well and stay healthy through the use of special  
            checks to buy healthy foods and provides nutritional  
            counseling and support to mothers of young children and  
            resources on breastfeeding and referrals to health coverage  
            programs.

           FISCAL EFFECT  :   Unknown

           COMMENTS  :   

           1)PURPOSE OF THIS BILL  .  According to the California Food Policy  
            Advocates, the sponsor of this bill, AB 2384 strengthens  
            California's efforts to prevent obesity by increasing access  
            to fresh fruit and vegetables in low-income communities where  
            fruit and vegetables typically are unavailable or costly.  It  
            states that there is currently no state law or policy aimed at  
            increasing the availability of fruit and vegetables in  
            low-income neighborhoods.  California, like the other states,  
            has a growing obesity problem, where approximately 60% of our  
            adults and over 25% of our children are obese or overweight.   
            The consequences of obesity are devastating to individuals,  
            characteristically involving diabetes, hypertension, heart  
            disease, cancer and other debilitating disease.  Physicians,  
            nutritionists and other experts recognize the importance of a  
            diet rich in fruit and vegetables as one key strategy in  
            preventing obesity.  Unfortunately, as countless studies  
            document, residents of low-income neighborhoods generally lack  
            access to fruit and vegetables.

           2)OBESITY  .  According to the federal Health and Human Services  
            Department, 64% of Americans are overweight or obese.  Obesity  
            is considered a risk factor for a number of diseases,  
            including diabetes, cardiovascular disease, and cancer.  The  
            Center for Disease Control and Prevention (CDC) released a  
            study in 2004 that found that poor diet and inactivity was  
            linked to 111,909 deaths in the United States in 2000.   






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            Results from the 1999-2002 National Health and Nutrition  
            Examination Survey (NHANES) indicate that 16% of -children and  
            adolescents ages six to nine years are overweight.  This  
            represents a 45% increase from the overweight estimates  
            obtained from NHANES III (1988-94).  According to a national  
            study of costs attributed to being overweight and/or obese,  
            medical expenses accounted for 9.1% of total U.S. medical  
            expenditures in 1998 and may have reached as high as $78.5  
            billion ($92.6 billion in 2002 dollars).  Obesity and being  
            overweight are chronic conditions, and result from a variety  
            of factors including behavior, environment, and genetics.  The  
            two factors that play the largest roles in obesity are  
            behavior and environment, which are also considered the best  
            areas for prevention and treatment.  According to the  
            California Center for Public Health Advocacy (CCPHA), the  
            numbers of overweight and inactive children have reached an  
            all-time high in California.  CCPHA found that statewide,  
            approximately 27% of children are overweight and 40% are  
            unfit.   

           3)GOVERNOR'S OBESITY INITIATIVE  .  The Governor's 2006-2007  
            budget includes a $6 million General Fund proposal to support  
            a comprehensive obesity prevention program.  A goal of the  
            proposal is to support healthy school and workplace  
            environments to promote physical activity and healthy eating.   
            The proposed funding will also support Medi-Cal managed care  
            efforts to increase obesity-related screening and counseling  
            and provide referral and treatment for overweight and  
            at-risk-for-overweight children.


           4)CALIFORNIA OBESITY PREVENTION INITIATIVE (COPI)  .  COPI,  
            established within DHS, is tasked with promoting physical  
            activity and healthy eating, addressing the societal,  
            technological, and environmental influences on obesity to  
            reduce the prevalence of obesity and its associated health  
            risks among Californians.  COPI's Website indicates that its  
            long term goals include reducing the life-long complications  
            of childhood overweight and obesity, and their associated  
            adverse health outcomes, by intervening with children and  
            youth who are high risk; addressing the disparities in obesity  
            prevalence and treatment for underserved and vulnerable  
            populations in California, especially for children and youth;  
            and creating environments that support healthy eating and  
            physical activity for all Californians, particularly for  
            children and youth.







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           5)RELATED LEGISLATION  .  SB 1329 (Alquist), pending in the Senate  
            Health Committee, would require the Department of Housing and  
            Community Development, in partnership with DHS, to establish  
            the "Healthy Food Retailing Initiative" to provide residents  
            of underserved communities with retail markets that would  
            offer healthy, high quality, and affordable food. 

           6)POLICY COMMENTS  .
              a)   Pilot Program  .  The committee may wish to amend the bill  
               to specify the specific number of pilot programs that would  
               be created as a result of this bill.
              b)   Evaluation  .  The committee may wish to amend the bill to  
               specify the components of the evaluation and when DHS must  
               make the recommendations to the Legislature.  
              
           7)SUPPORT  .  Supporters indicate this bill is a solution to the  
            growing obesity problem.  They state that there is a growing  
            need to address the obesity problem among low-income  
            communities because these communities often lack access to  
            affordable fresh fruits and vegetables.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          California Food Policy Advocates (sponsor)
          Alameda County Community Food Bank
          California Catholic Conference
          California Center for Public Health Advocacy
          California Chiropractic Association
          California Food and Justice Coalition
          California Hunger Action Coalition
          California Independent Grocers Association
          Central Coast Hunger Coalition
          City and County of San Francisco
          Community Alliance with Family Farmers
          Food Bank for Monterey County
          Keck Diabetes Prevention Initiative
          Latino Coalition for a Healthy California
          PolicyLink
          Second Harvest Food Bank
          Services, Immigrant Rights and Education Network
          St. Anthony Foundation

           Opposition 
           






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          None on file.
           
          Analysis Prepared by  :    Rosielyn Pulmano / HEALTH / (916)  
          319-2097