Some Say Report Supports Creation of New State Public Health Department
A state audit that is critical of California's readiness to address a disease outbreak or bioterrorist attack was released on Thursday, amid "growing" concerns that the Department of Health Services is too busy with the administration of Medi-Cal "overshadows [the agency's] public health responsibilities," the San Francisco Chronicle reports (Lucas, San Francisco Chronicle, 8/12).
A bill by Sen. Deborah Ortiz (D-Sacramento) would create a state department separate from DHS to oversee public health functions.
Hallye Jordan, a spokesperson for Ortiz, said the audit provided new evidence that DHS was unable to give necessary attention to public health concerns (Hill, Sacramento Bee, 8/12).
The California Medical Association, the Health Officers Association of California and the California Association of Public Health Laboratory Directors have indicated support for the proposed new department. The Little Hoover Commission, which makes recommendations on government restructuring, also has endorsed the plan.
The Legislature last year did not approve two bills that would have created a new health department (San Francisco Chronicle, 8/12).
Auditor Elaine Howle in the report said California is underprepared for an infectious disease outbreak from natural causes, accidents or bioterrorism. The audit said DHS has not reached two of 14 critical guidelines required in agreements with federal agencies that provide money for infectious disease preparedness (Sacramento Bee, 8/12). In addition, DHS has spent $29.1 million of $88 million provided by the federal government since 2002 to help hospitals address bioterrorist threats, according to the audit.
When the audit started in January, the three state agencies that are responsible for public health services did not have formal policies to implement or consider suggestions taken from drills and exercises on emergency response. The Emergency Medical Services Authority, which coordinates statewide emergency medical care, and the Governor's Office of Emergency Services, which coordinates the state's response to major emergencies, have since prepared formal policies.
DHS created a formal policy on July 15, but the audit said the proposal was not entirely satisfactory.
In addition, the audit found that EMSA's Disaster Medical Response Plan had not been updated since 1992, and its Medical Mutual Aid Plan had not been updated since 1974 (San Francisco Chronicle, 8/12).
Howle, in a letter to the Legislature, wrote, "This report concludes that despite completing several tasks for responding to infectious disease emergencies, California needs to do more to improve its preparedness" (Sacramento Bee, 8/12). Howle added, "The agencies are trying to be responsive and take corrective action as soon as possible" (San Francisco Chronicle, 8/12).
DHS spokesperson Ken August said many problems listed in the audit have been corrected. For example, DHS last month developed a process to make changes to its plans based on lessons garnered from exercises, August said.
DHS has signed a contract to complete one of the two unfinished federal benchmarks and CDC has assured the state that it is in compliance with the other benchmark, according to August.
In addition, August said the department had spent or allocated 97% of the money from one federal source and 94% from a separate source (Sacramento Bee, 8/12).
EMSA said it was updating its emergency response plans and will complete them by September 2006 (San Francisco Chronicle, 8/12).