Source: http://www.leginfo.ca.gov/pub/15-16/bill/asm/ab_2401-2450/ab_2424_bill_20160802_amended_sen_v95.htm
Timestamp: 2019-10-20 02:58:31
Document Index: 240191913

Matched Legal Cases: ['art 2', 'art.\n6', 'art\n7', 'art.\n11', 'art.\n14', 'art\n17', 'art.\n14', 'art\n29']

This bill, among other things, would create the Community-based Health Improvement and Innovation Fund in the State Treasury, and the moneys in the fund would be available, upon appropriation by the Legislature, for certain purposes, including, but not limited to, reducing health inequity and disparities in the rates and outcomes of priority chronic health conditions, as defined, preventing the onset of priority chronic health conditions using community-based strategies in communities statewide and with particular focus on health equity priority populations, as defined, and strengthening local, regional, and state level collaborations between public health jurisdictions and health care providers, and across government agencies and community partners to create healthier communities, using a health-in-all-policies approach. The department would be required to use a specified percentage of moneys from the fund for certain public health and administrative activities and would be required to award a specified percentage of moneys from the fund to local health jurisdictions and as competitive grants to eligible applicants to be used to improve health and health equity, as provided.
10account for eight of every 10 deaths andbegin delete affectsend deletebegin insert affectend insert the quality
11of life of 14 million Californians.
P3 1(b) Obesity and diabetes in particular have grown rapidly, posing
2a grave threat to health. Today over one-half of California adults
3are estimated to have either diabetes or prediabetes. Thirteen
4million adults in California, 46 percent of the adult population, are
5estimated to have prediabetes or undiagnosed diabetes, while
6another 2.5 million adults, 9 percent of the adult population, have
7already been diagnosed with diabetes.
8(c) The health inequities in this state are stark:
9(1) Ethnic minorities and individuals who have low incomes
10have higher rates of diabetes. Nearlybegin delete one-in-fiveend deletebegin insert 1 in 5end insert African
11Americans and Latinos in California have diabetes, more than
12double the rate of Whites.
13(2) Nearly 12 years of life separate the life expectancy at the
14top and at the bottom of neighborhood clusters in California, from
15a life expectancy of 87 years in parts of northwest Santa Clara
16County to 75.3 years in the City of Twentynine Palms and the City
17of Barstow in the County of San Bernardino.
18(3) Economically disadvantaged children are far less likely to
19complete the fitness requirements of the physical fitness test offered
20to students in grade school.
21(4) Adolescents covered by Medi-Cal reported significantly
22higher rates of drinking sugar-sweetened beverages and less daily
23consumption of vegetables than the general California adolescent
24population and were significantly more likely to be obese.
25(d) The following short list of risk factors is responsible for
26much of the burden of chronic disease: tobacco use, physical
27inactivity, unhealthful diet, excessive consumption of alcohol,
28hyperlipidemia, and uncontrolled high blood pressure. These risk
29factors and chronic conditions are largely preventable, inequitably
30distributed, and significantly influenced by the social determinants
31of health.
32(e) The State Department of Public Health estimates that as
33much as 80 percent of heart disease, stroke, and type II diabetes
34and more than 30 percent of cancers can be prevented by
35eliminating the underlying risk factors.
36(f) The economic burden of chronic disease in California weighs
37heavily on families, employers, and all levels of government.
38Approximately $98 billion, or 42 percent of all health care
39expenditures in the state, was spent on treating just six common
P4 1chronic health conditions (arthritis, asthma, cardiovascular disease,
2diabetes, cancer, and depression) in 2010.
3(g) The indirect costs associated with chronic disease in
4California are also high. According to the Economic Burden of
5Chronic Disease (EBCD) Index, the projected impact of lower
6productivity and lost workdays for individuals with chronic
7conditions and their caregiving family members in California was
8estimated to be $51 billion in 2010.
9(h) The cost of health care continues to surpass the rate of
10inflation, causing increasing strain on the budgets of families,
11employers, and the government. Yet the ability ofbegin delete healthcareend deletebegin insert health
12careend insert alone to solve health problems that arise in the community
13is limited.
14(i) Despite the fact that chronic disease results in decreased
15quality of life, premature death, and exorbitant medical costs,
16investments in measures that prevent chronic disease have been
17minimal.
18(j) The United States spends only 2.6 percent of health care
19dollars on all public health, yet 75 percent of health care costs are
20attributable to preventable health conditions.
21(k) Paying for prevention works and upstream strategies have
22a remarkable history of success, measured in both cost avoidance
23and health improvement. In the County of Los Angeles, smoking
24begin delete amongstend deletebegin insert amongend insert high school students fell from 27 percent to 7
25percent between 1997 and 2013, thanks to investment in policy
26and environmental changes as well as education.
27(l) Childhood obesitybegin delete amongstend deletebegin insert amongend insert Los Angeles Unified
28School District 5th graders decreased by 10.6 percent (from 31.2
29percent to 27.9 percent) between 2010 and 2013, and leveled off
30among 7th and 9th graders, after nine years of steady increases,
31reflecting investments to reduce the consumption of
32 sugar-sweetened beverages, promote healthier eating, and increase
33physical activity.
34(m) The California Health and Human Services Agency, in
35partnership with the State Department of Public Health, has defined
36ambitious health improvement goals for the state through the “Let’s
37Get Healthy California” initiative, including making California
38the healthiest state in the nation by 2022, reducing health
39disparities, and achieving better health at lower cost. These goals
40cannot be met by improvements in health care or on an individual
P5 1basis alone. Meeting these goals requires urgent and substantial
2investment in community-based prevention of chronic disease and
3injuries.
4(n) The Health in All Policies Task Force was established by
5Executive Order No. S-04-10 on February 23, 2010, under the
6auspices of the Strategic Growth Council (SGC), in order to foster
7begin delete multi-agencyend deletebegin insert multiagencyend insert collaboration to identify priority
8programs, policies, and strategies to improve the health of
9Californians while advancing the SGC’s goals of improving air
10and water quality, protecting natural resources and agricultural
11lands, increasing the availability of affordable housing, improving
12infrastructure systems, promoting public health, planning
13sustainable communities, and meeting the state’s climate change
14goals.
15(o) Senate Concurrent Resolution No. 47 (Resolution Chapter
1656 of the Statutes of 2012) affirms the work of the Health in All
17Policies Task Force by encouraging public officials in all sectors
18and levels of government to recognize that health is influenced by
19policies related to air and water quality, natural resources and
20agricultural land, affordable housing, infrastructure systems, public
21health, sustainable communities, and climate change, and to
22consider health when formulating policy, and by encouraging
23interdepartmental collaboration with an emphasis on the complex
24environmental factors that contribute to poor health and inequities
25when developing policies in a wide variety of areas, including, but
26not limited to, housing, transportation, education, air quality, parks,
27criminal justice, and employment.
28(p) The Office of Health Equity was established in Section
29131019.5 of the Health and Safety Code in order to achieve the
30highest level of health and mental health for all people, with special
31attention focused on those who have experienced socioeconomic
32disadvantage and historical injustice, and it directs the Office of
33Health Equity to work collaboratively with the Health in All
34Policies Task Force to promote work to prevent injury and illness
35through improved social and environmental factors that promote
36health and mental health.
37(q) The existing limited resources of funding for chronic disease
38prevention are threatened, declining from past levels, and subject
39to significant restrictions.
P6 1(r) Strategic investment in upstream prevention will protect, not
2deplete, the coffers of government. Investment in prevention has
3a strong evidence base of positive return on investment through
4reducing health care costs on a long-term basis.
6the following definitions:
7(a) “Community food projects” means those established in the
8federal Food and Nutrition Act of 2008 (7 U.S.C. Sec. 2011 et
9seq.) and the federal Food, Conservation, and Energy Act of 2008
10(7 U.S.C. Sec. 8701 et seq.) that are designed to increase food
11security, including access to a healthy diet in communities. They
12may bring representatives from the community, food, and public
13health systems together to assess strengths, establish linkages, and
14create projects,begin delete non-profitend deletebegin insert nonprofitend insert enterprises, or both, that
15improve access and self-reliance of community members over
16their food needs. These may also include urban or peri-urban farms
17and gardens that dedicate production to low-income communities,
18food hubs, farm stands, farmers markets, mobile vendors, and
19community-supported agriculture projects that provide distribution
20systems, and community-owned and managed enterprises that
21make healthy food more accessible to low-income families.
22(b) “Department” means the State Department of Public Health.
23(c) “Fund” means the Community-based Health Improvement
24and Innovation Fund.
25(d) “Health equity” means efforts to ensure that all people have
26full and equal access to opportunities that enable them to lead
27healthy lives.
28(e) “Health equity priority population” means, for each
29condition, populations that exhibit significant disparities with
30respect to prevalence of a priority chronic health condition or injury
31or worsebegin delete outcomesend deletebegin insert outcomes,end insert such as higher hospitalization or
32death rates. Priority populations may be defined based on race,
33ethnicity, geography, socioeconomic status, including income or
34education, other factors as defined by the department, or current
35findings and recommendations of research, including assessments
36of innovations funded by the fund.
37(f) “Local health jurisdiction” means a county health department
38or a combined health department in the case of counties acting
39jointly or a city health department within the meaning of Section
40101185.
P7 1(g) “Priority chronic health conditions” means asthma, type II
2diabetes, cardiovascular and cerebrovascular disease, cancer, dental
3disease, obesity, and other chronic conditions and injuries that are
4prevalent, largely preventable, and associated with high health
5care costs, as defined by the department. High-burden conditions
6whose prevention is not adequately supported by other funding
7streams shall be prioritized.
9the Community-based Health Improvement and Innovation Fund.
10The fund shall consist of any revenues deposited therein, including
11any fine or penalty revenue allocated to the fund, any revenue from
12appropriations specifically designated to be credited to the fund,
13any funds from public or private gifts, grants, or donations, any
14interest earned on that revenue, and any funds provided from any
15other source.
16(2) A target level of annual statewide investment from the fund
17shall be established as a set dollar amount per capita, to be allocated
18for the purposes described in subdivision (b) and as described in
19Section 106053.
20(b) (1) Moneys in the fund shall be available, upon
21appropriation by the Legislature, for any of the following purposes:
22(A) Reducing health inequity and disparities in the rates and
23outcomes of priority chronic health conditions and injuries.
24(B) Preventing the onset of priority chronic health conditions
25using community-based strategies in communities statewide and
26with particular focus on health equity priority populations.
27(C) Strengthening local, regional, and state level collaborations
28between public health jurisdictions and health care providers, and
29across government agencies and community partners to create
30healthier communities, using a health-in-all-policies approach.
31(D) Supporting collaboration between public health entities and
32nonhealth organizations and agencies in fields such as, but not
33limited to, housing, transportation, land use planning, natural
34resources, parks, food access, education, economic development,
35community development, and employment, to promote community
36environments that support healthy communities and families, and
37that reduce inequities in disease and injury using a
38health-in-all-policies approach.
P8 1(E) Contributing to a stronger evidence base of effective
2community-based prevention strategies for priority chronic health
4(F) Evaluating the effectiveness and cost-effectiveness of
5innovative community-based prevention strategies for priority
6chronic health conditions, as a basis for future decisions about
7investment in those strategies in order to reduce the costs of
8providing health care services and to improve population health
9status.
10(2) Moneys in the fund shall be used to address social,
11environmental, and behavioral determinants of chronic disease
12and injury at any phase of the life cycle, including, but not limited
13to, all of the following:
14(A) Promotion of healthy diets, improved access to healthy
15foods, and healthy food environments.
16(B) Promotion of physical activity and of a safe, physical
17activity-promoting environment.
18(C) Prevention of unintentional and intentional injury.
19(D) Building partnerships to address social determinants of
20chronic disease.
21(3) In expending moneys from the fund, policy, systems, and
24(4) Moneys in the fund shall not be used for clinical services.
25(5) Revenues deposited in the fund that are unexpended at the
28(6) The award of contracts, grants, or funding allocations
29provided through this part shall be exempt from Part 2
30(commencing with Section 10100) of Division 2 of the Public
31Contract Code.
33greater than 20 percent of the annual appropriation from the fund
34for all of the following activities:
35(1) Mandatory activities for which the funds shall be used are
37(A) Statewide media and communications campaigns, which
38shall be allocated 9 percent of total funds.
39(B) Evaluation of all program activities supported through the
40fund, including the creation of a robust evaluation framework,
P9 1which shall be allocated at least 5 percent of those funds. This
2evaluation framework shall include all of the following:
3(i) Regular monitoring of local health jurisdiction awards to
4ensure activities are conducted pursuant to approved plans and
5consistent with all requirements of this part.
6(ii) Measures to ensure funding provided pursuant to this part
7supplements and does not supplant existing funding or efforts.
8(iii) Data collection and reporting requirements for grant
9awardees sufficient to assess impact and monitor compliance with
10this part.
11(iv) A plan to analyze the impact of this part on process
12measures relevant to community health promotion and, if
13practicable, on outcome measures.
14(C) Other activities, which shall be allocated no more than 6
15percent of total funds, as follows:
16(i) Overall program implementation and oversight, including
17review and approval of local health improvement plans, and
18granting of and monitoring the implementation of local health
19jurisdiction awards and competitive grant awards.
20(ii) The definition of criteria for evidence-based and innovative
21approaches to improving health and health equity, with evaluation
22criteria appropriate to each type of approach. Criteria for
23evidence-based projects shall include cost-effectiveness or
24projections of return on investment to the state.
25(iii) The definition of priority chronic health conditions and
26health equity priority populations based on public health data.
27(iv) The definition of criteria for participation of community
28partners in local health jurisdiction funding.
29(v) The development of tools that can be used by the state and
30by grantees to monitor progress towards improving health and
31health equity, including establishment of a health equity index and
32progress towards “Let’s Get Healthy California” goals.
33(2) Discretionary activities, as may be appropriate to support
34community-based prevention of priority chronic health conditions
35throughout the state, for which the funds may be used, include,
36but are not limited to, any of the following:
37(A) Research, development, and dissemination of best practices,
38including training and technical assistance for grantees.
P10 1(B) Development of infrastructure, including, but not limited
2to, data resources or information technology resources to be shared
3statewide.
4(C) Coordination of local efforts.
5(D) Development and promotion of statewide initiatives.
6(E) Grants or contracts to nonprofit organizations at the state
7level to provide technical assistance, resource development, or
8other support to the department, local health jurisdictions, and
9other grantees directly serving communities.
10(3) The department, in consultation with the advisory committee
11established pursuant to Section 106054, may define state priorities
12and require activities supported by the fund to align with those
13priorities in a manner that is consistent with the intent of this part.
14The department may narrow the list of priority chronic health
15conditions, if necessary, to ensure an effective program.
16(4) The department shall require activities pursuant to this part
17to be conducted in a manner consistent with principles of
18effectiveness, cost efficiency, relevance to community needs,
19maximal impact to improve community health, and sustainability
20of impact over time.
21(b) The department shall award at least 80 percent of total
22moneys made available in the annual appropriation from the fund
23to eligible applicants to be used consistent with the purposes
24described in subdivision (b) of Section 106052. Moneys from the
25fund shall be distributed and awarded according to the following
26criteria:
27(1) (A) At least 47 percent of total funds shall be awarded to
28local health jurisdictions and shall be allocated on a formula basis
29to local health jurisdictions, or their nonprofit designee, with
30approved applications for three-year funding cycles.
31(B) Each local health jurisdiction shall submit an application
32for a three-year funding cycle, to be reviewed and approved by
33the department, that includes all of the following information:
34(i) A detailed assessment of community health needs and factors
35contributing to those conditions within the local health jurisdiction
36with respect to priority chronic health conditions and health equity
37priority populations.
38(ii) A health improvement and evaluation plan that includes
39initiatives focused on health equity priority populations.
P11 1(iii) The level of local funds, including in-kind resources, for
2community-based prevention activities that was provided in the
3most recently completed fiscal year.
4(iv) Documentation of the existence and activities of a
5community health partnership pursuant to subparagraph (D) of
6paragraph (1) of subdivision (b) of Section 106052, which includes
7leading health care providers, local health jurisdictions, community
8partners, including those serving health equity priority populations,
9businesses, and other relevant local government agencies and
10community leaders and their commitments to support the efforts.
11(v) How funds will be used in a manner consistent with
12principles of effectiveness, cost efficiency, relevance to community
13needs, maximal impact to improve communitybegin delete health, sustainability
14of impact over time, and projections of return on investment to the
15state.end deletebegin insert health, and sustainability of impact over time.end insert
16(C) Each local health jurisdiction with an approved application
17shall receive a base award of two hundred fifty thousand dollars
18($250,000) for a three-year funding cycle. The balance of the funds
19shall be awarded to local health jurisdictions proportional to the
20number of residents living below the federal poverty level.
21(D) Health improvement and evaluation plans shall emphasize
22sustainable policy, systems, and environmental change approaches
23to creating healthier communities.
24(E) Local health jurisdictions may come together if they so
25desire to submit combined regional applications.
26(F) No single recipient may receive more than 30 percent of the
27funding allocated to local health jurisdictions on a formula basis.
28(G) Recipients of funds pursuant to this paragraph shall maintain
29the level of local funds, including in-kind resources, for
30community-based prevention activities that were provided in the
31most recently completed fiscal year prior to July 2016. Funds
32provided pursuant to this paragraph shall supplement and not
33supplant existing funding for community-based prevention
34activities of priority chronic health conditions.
35(H) Local health jurisdiction investments shall prioritize
36communities in the third and fourth quartiles of the California
39(I) The initial year of funding may be used for needs assessment,
40planning, and development.
P12 1(2) At least 33 percent of total funds shall be allocated for
2competitive grants as follows:
3(A) (i) Competitive grants shall be awarded to local or regional
4level entities or statewide nonprofit organizations. Funds provided
5pursuant to this paragraph shall supplement and not supplant
6existing funding for community-based prevention activities of
7priority chronic health conditions.
8(ii) Local, regional, and state level entities, including nonprofit
9and community-based organizations in partnership with other
10entities, including, but not limited to, other nonprofit and
11community-based organizations, other local public agencies,
12 schools, religious organizations, businesses, labor unions, health
13care plans, hospitals, clinics, other health care providers, or other
14community-based entities.
15(iii) Each participating health care plan or hospital shall identify
16monetary, in-kind, or both, contributions to projects.
17(iv) Local or regional projects shall prioritize investments that
18serve communities in the third and fourth quartiles of the California
19Health Disadvantage Index or other criteria of health equity priority
20populations subsequently adopted by the department.
21(v) At least 10 percent of the total funds shall be used for
22statewide nonprofit organizations to support activities conducted
23regionally or at the state level.
24(vi) At least 5 percent of total funds shall be used for a
25competitive grant program administered by the department to
26support healthy food incentives for low-income Californians,
27support community food projects, as defined under Section 106051,
28and aid community food producers or socially disadvantaged,
29beginning, military veteran, orbegin delete limited resourceend deletebegin insert limited-resourceend insert
30 specialty crop producers that improve the health and resilience of
31their communities by increasing access to any variety of fresh,
32canned, dried, or frozen whole or cut fruits and vegetables without
33added sugars, fats or oils, and salt. The department shall coordinate,
34as necessary, with the Department of Food and Agriculture to
35implement this clause.
36(vii) Organizations receiving competitive grants shall coordinate
37efforts with the department and any local health jurisdictions where
38they are carrying out activities.
39(B) (i) Competitive grant applicants shall identify projects as
40either an evidence-based or an innovative project.
P13 1(ii) Applications for evidence-based projects shall demonstrate
2how funds will be used in a manner consistent with principles of
3effectiveness, cost efficiency, relevance to community needs,
4maximal impact to improve community health, and sustainability
5of impact over time.
6(iii) At least 10 percent of the funding for competitive grants
7shall be set aside for innovative projects that test previously
8untested strategies in order to improve the evidence base of
9effective community-based prevention strategies for priority
10chronic health conditions and injuries.
11(iv) Applications for innovative projects shall provide a rationale
15(v) Competitive grants may be used by organizations for policy
16systems or environmental change efforts, direct program delivery,
17or for technical assistance to other grantees.
19Health Improvement and Innovation Fund Advisory Committee
20in state government that shall advise the department with respect
21to policy development, integration, and evaluation of
22community-based chronic disease and injury prevention activities
23funded under this part, and for development of a master plan of
24recommendations and proposed strategies for the future
25implementation of those activities.
26(b) The advisory committee shall include, at a minimum, experts
27on priority chronic health conditions, effective nonclinical
28prevention strategies, policy strategies for chronic disease
29prevention, and the unique needs of health equity priority
30populations.
31(c) The advisory committee shall be composed of 13 members
32to be appointed as follows:
33(1) One member representing voluntary health organizations
34dedicated to the reduction of chronic disease, injuries, or health
35inequities appointed by the Speaker of the Assembly.
36(2) One member representing an organization that represents
37health care employees appointed by the Senate Rules Committee.
38(3) One member representing a statewide nonprofit health
39organization dedicated to the improvement of public health
40appointed by the Governor.
P14 1(4) One member representing a community-based organization
2with a demonstrated track record implementing community
3prevention programs appointed by the Governor.
4(5) One representative of a university with expertise in programs
5intended to reduce chronic disease appointed by the Governor.
6(6) Two representatives of a population group with priority
7health conditions appointed by the Governor.
8(7) One representative of the Health and Human Services
9Agency appointed by the Governor.
10(8) One representative of the Department of Food and
11Agriculture appointed by the Governor.
12(9) One representative of the Health in All Policies Task Force
13appointed by the Strategic Growth Council.
14(10) One member representing the interests of the general public
15appointed by the Governor.
16(11) One representative of the California Conference of Local
17Health Officers.
18(12) One representative from the California Health Benefit
19Exchange appointed by the executive board of the exchange.
20(d) Members of the advisory committee shall serve for a term
21of two years, renewable at the option of the appointing authority.
22The initial appointments of members shall be for two or three
23years, to be drawn by random lot at the first meeting. The
24committee shall be staffed by the department’s coordinator of the
25program as described in paragraph (3) of subdivision (a) of Section
26106053.
27(e) The committee shall meet as often as it deems necessary,
28but shall meet not less than four times per year.
29(f) The members of the committee shall serve without
30compensation, but shall be reimbursed for necessary travel
31expenses incurred in the performance of the duties of the
32committee.
33(g) The committee shall be advisory to the department, the
34Department of Food and Agriculture, and the Health and Human
35Services Agency, for all of the following purposes:
36(1) Evaluation of research on community-based policies,
37practices, and programs funded under this part as necessary in
38order to assess the overall effectiveness of efforts made by the
39programs to reduce the occurrence of preventable chronic disease
40and injuries.
P15 1(2) Facilitation of programs directed at reducing and eliminating
2preventable chronic disease and injury that are operated jointly by
3more than one agency or entity. The committee shall propose
4strategies for the coordination of proposed programs administered
5by the department, the Department of Food and Agriculture, the
6Health and Human Services Agency in general, and the efforts of
7the other members, such as the Health in All Policies Task Force,
8in order to maximize the public benefit of the programs.
9(3) Making recommendations to the department, the Department
10of Food and Agriculture, and the Health and Human Services
11Agency regarding the most appropriate criteria for the selection
12of, standards of operation of, and types of activities to be funded
13under this part.
14(4) Reporting to the Legislature on or before January 1 of each
15year on the number and amount of chronic disease and injury
16prevention activities funded by the Community-based Health
17Improvement and Innovation Fund, the amount of money in the
18fund, any moneys previously appropriated to the department, but
19 unspent by the department, a description and assessment of all
20programs funded under this part, and recommendations for any
21necessary policy changes or improvements.
22(5) Ensuring that the most current research findings regarding
23chronic disease and injury prevention are applied in designing the
24Community-based Health Improvement and Innovation Fund
25activities administered by the department. The department shall
26apply the most current findings and recommendations of research,
27including assessments of innovations funded by the fund.
28(h) (1) Based on the results of programs supported by this part
29and any other proven methodologies available to the advisory
30committee, the advisory committee shall produce a comprehensive
31set of recommendations and proposed strategies for advancing
32chronic disease and injury prevention throughout the state.
33(2) The recommendations shall include implementation
34strategies for each priority chronic health condition throughout the
35state and identification of areas where innovative solutions are
36especially needed.
37(3) The advisory committee shall submit the recommendations
38and proposed strategies to the Legislature triennially.
39(4) The advisory committee recommendations shall include
40specific goals for reduction of the burden of preventable chronic
P16 1conditions and injuries by 2030, administrative arrangements,
2funding priorities, integration and coordination of approaches by
3the department, the Department of Food and Agriculture, local
4health jurisdictions,begin delete non-profitend deletebegin insert nonprofitend insert and community-based
5organizations, the University of California, the Health in All
6Policies Task Force, and their support systems, and progress reports
7relating to each health equity priority population.
8(i) A report submitted pursuant to section shall be submitted in
9compliance with Section 9795 of the Government Code.
11appropriation provided for this purpose in the annual Budget Act
12or other measure.