BILL ANALYSIS                                                                                                                                                                                                    


          |SENATE RULES COMMITTEE            |                  AB 2635|
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                                 THIRD READING

          Bill No:  AB 2635
          Author:   Portantino (D)
          Amended:  4/5/10 in Assembly
          Vote:     21

           SENATE PUBLIC SAFETY COMMITTEE  :  7-0, 6/29/10
          AYES:  Leno, Cogdill, Cedillo, Hancock, Huff, Steinberg,  

           SENATE HEALTH COMMITTEE  :  8-0, 6/16/10
          AYES:  Alquist, Strickland, Aanestad, Cedillo, Leno,  
            Negrete McLeod, Pavley, Romero
          NO VOTE RECORDED:  Cox

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           ASSEMBLY FLOOR  :  76-0, 5/13/10 (Consent) - See last page  
            for vote

           SUBJECT  :    Communicable disease:  involuntary testing

           SOURCE  :     American Federation of State, County and  

           DIGEST  :    This bill adds nonsworn employees of a law  
          enforcement agency whose job description includes the  
          collection of fingerprints to the list of persons who, when  
          exposed to an arrestee's bodily fluids, can have the  
          arrestee's blood tested for communicable diseases.


                                                               AB 2635

           ANALYSIS  :    

          Existing federal law, establishes the Occupational Exposure  
          to Bloodborne Pathogens Standard to address the significant  
          health risks many employees face as the result of  
          occupational exposure to blood and other potentially  
          infectious materials (OPIM) because they may contain  
          bloodborne pathogens, including, but not limited to  
          hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV  
          (human immunodeficiency virus).

          Existing federal regulation, establishes regulations  
          applicable to all occupational exposure to blood or other  
          potentially infectious materials as defined, by the  
          Occupational Safety and Health Administration, under the  
          United States Department of Labor.

          Existing state law:

          1. Establishes a process whereby a peace officer,  
             firefighter, custodial officer, custody assistant,  
             uniformed employee of a law enforcement agency whose job  
             entails the care or control of inmates in a detention  
             facility, or emergency medical provider who, while  
             acting within the scope of his or her duties, is exposed  
             to an arrestee's blood or bodily fluids, may petition a  
             court for an order requiring testing of the blood or  
             bodily fluids for HIV, hepatitis B, and hepatitis C.

          2. Declares legislative intent that information that may be  
             vital to the health and safety of custodial personnel,  
             custodial medical personnel, peace officers,  
             firefighters and emergency medical personnel who are put  
             at risk in the course of their official duties, be  
             obtained and disclosed in an appropriate manner in order  
             to ensure their health and their relief from groundless  
             fear of infection.  

          Existing state regulations establishes regulations  
          applicable to all occupational exposure to blood or other  
          potentially infectious materials (OPIM) as defined, by the  
          California Department of Industrial Relations, including  
          the use of universal precautions to prevent contact with  


                                                               AB 2635

          blood or OPIM. Under circumstances in which differentiation  
          between body fluid types is difficult or impossible, all  
          body fluids shall be considered potentially infectious  

          This bill adds nonsworn employees of a law enforcement  
          agency whose job description includes the collection of  
          fingerprints to the list of persons who, when exposed to an  
          arrestee's bodily fluids, can have the arrestee's blood  
          tested for communicable diseases.

          Occupational exposure to bloodborne pathogens  .  Blood and  
          other potentially infectious materials have long been  
          recognized as a potential threat to the health of employees  
          who are exposed to these materials by percutaneous contact  
          (penetration of the skin).  Other potentially infectious  
          materials (OPIM) can include human body fluids (semen,  
          vaginal secretions, amniotic fluid, saliva in dental  
          procedures, any body fluid visibly contaminated with blood,  
          etc.), any unfixed tissue or organ from a human living or  
          dead; or HIV-containing cell or tissue cultures, organ  
          cultures, and HIV- or HBV-containing culture medium or  
          other solutions as well as blood, organs, or other tissues  
          from experimental animals infected with HIV or HBV. 

          According to the National Institute for Occupational Safety  
          and Health, exposures to blood and other body fluids occur  
          across a wide variety of occupations.  Health care workers,  
          as well as emergency response and public safety personnel,  
          can be exposed to blood through needlestick and other  
          sharps injuries, as well as through mucous membrane and  
          skin exposures.  The pathogens of primary concern for the  
          Centers for Disease Control and Prevention (CDC) and the  
          National Institute for Occupational Safety and Health are  
          the HIV, hepatitis B virus (HBV), and hepatitis C virus  
          (HCV).  According to CDC recommendations, wounds and skin  
          sites that have been in contact with blood or bodily fluids  
          should be washed with soap and water, and mucous membranes  
          should be flushed with water.  Immediate evaluation must be  
          performed by a health care professional. The evaluation  
          should determine the type of exposure, infectious status of  
          the source, and the susceptibility of the exposed person in  
          order to determine the treatment course.


                                                               AB 2635

          Existing California regulations apply to all occupational  
          exposure to blood or other OPIM as defined, with specified  
          exceptions. The regulations define occupational exposure as  
          "reasonably anticipated skin, eye, mucous membrane, or  
          parenteral contact with blood or other potentially  
          infectious materials that may result from the performance  
          of an employee's duties." Some facilities and operations  
          are considered by Cal/OSHA to involve "occupational  
          exposure," as defined because the intrinsic nature of the  
          facility or operation is such that contact with blood or  
          OPIM is reasonably anticipated for at least some of the  
          employees involved with the facility or operation. 

          Under the regulations, employers of these facilities or  
          operations have the responsibility to conduct an exposure  
          determination to determine which tasks and procedures  
          involve occupational exposure as a part of complying with  
          the written Exposure Control Plan requirements.  Employers  
          whose employees work in facilities other than those that  
          intrinsically involve occupational exposure are still  
          subject to regulations if the individual circumstances of  
          the facility or operation are such that the employee's  
          activities or tasks place them in contact with blood or  

          Each employer who has an employee(s) with occupational  
          exposure to blood or OPIM is required to document an  
          exposure determination.  The exposure determination is made  
          without regard to the use of personal protective equipment  
          since employees are considered exposed even if they wear  
          personal protective equipment.

           Post-exposure procedures  .  Workers who are stuck by a  
          needle or have any other type of exposure to blood or OPIM  
          must receive immediate confidential medical screening and  
          follow-up treatment.  Treatment potentially includes  
          medications to prevent infection, according to current  
          Public Health Service guidelines, as soon as possible.   
          Post-exposure prophylaxis (PEP) is a short-term treatment  
          to reduce the likelihood of infection after exposure to a  
          number of contagious diseases, including HIV, HBV, and HCV.  
           PEP is considered a second line of defense when preventive  
          efforts have failed or were not possible, as is the case  


                                                               AB 2635

          with sexual assault or occupational exposure.  

          In the case of HIV, PEP typically involves providing one or  
          several anti-HIV drugs within 72 hours of exposure, which  
          are then taken for a four- to six-week period.  According  
          to the World Health Organization (WHO), in order for PEP to  
          be most effective in preventing HIV infection, treatment  
          should be commenced as soon as possible after exposure and,  
          ideally, within two to four hours.  One of the first  
          examples of PEP effectiveness was reported in a 1995 study,  
          which showed fewer HIV infections after occupational  
          exposure among health care workers who used PEP versus  
          those who took no prophylaxis after exposure.  A recent  
          Canadian study found that, of 160 patients who had been  
          exposed to HIV and received PEP treatment, only one  
          infection was reported. 

          CDC recommendations for HBV exposure include the initiation  
          of the hepatitis B vaccine series to an unvaccinated person  
          who has been exposed.  PEP with hepatitis B immune globulin  
          (HBIG) and/or hepatitis B vaccine series should be  
          considered after an evaluation of the HBV status of the  
          source and the vaccination and vaccine-response status of  
          the exposed person.  According to the CDC, in the  
          occupational setting, multiple doses of PEP for HBV  
          initiated within one week following exposure, provides an  
          estimated 75 percent protection from infection.  

          According to the CDC, the estimated risk for infection  
          after a needlestick or cut exposure to HCV-infected blood  
          is approximately 1.8 percent.  Additionally, several  
          studies have attempted to assess the effectiveness of  
          potential post-exposure treatment for HCV, but have been  
          difficult to interpret.  No clinical trials have been  
          conducted to assess postexposure use of antiviral agents  
          (interferon) to prevent HCV infection, and antivirals are  
          not FDA approved for this use.  The CDC states that an  
          established infection might need to be present before  
          interferon can be an effective treatment. 

          The author's office introduced this bill to correct an  
          oversight in last year's AB 169 (Portantino), Chapter 417,  


                                                               AB 2635

          Statutes of 2009.  AB 169 includes nonsworn uniformed  
          officers to the category of employees (law enforcement and  
          medical services personnel) who, after exposure to an  
          arrestee's bodily fluids, may have that arrestee's blood  
          tested, either voluntarily or by court order, for specified  
          communicable diseases.  It was brought to the author's  
          office attention that there are other employees who come  
          into contact with arrestees who are frequently exposed to  
          blood or other bodily fluids who are not covered by this  
          provision of law.  This bill adds employees of law  
          enforcement agencies whose duties include the collection of  

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  Yes

           SUPPORT  :   (Verified  6/16/10)

          American Federation of State, County and Municipal  
          Employees (source)

           ARGUMENTS IN SUPPORT  :    The American Federation of State,  
          County, and Municipal Employees is sponsoring this bill.   
          They claim that recently fingerprint identification experts  
          (FIEs) within the Los Angeles Police Department were  
          required, by special order of the chief of police, to  
          gather fingerprints from suspected criminals while they  
          were hospitalized.  However, this is a new duty for FIEs  
          and their classification doesn't have the same protections  
          granted to other law enforcement personnel.  This bill adds  
          FIEs to the list of persons who may seek to have an  
          arrestee's blood tested, either voluntarily or by court  
          order, for specified communicable diseases when the FIE is  
          exposed to that arrestee's blood or bodily fluids while the  
          FIE is acting within the scope of his or her duties.

           ASSEMBLY FLOOR  : 
          AYES: Adams, Ammiano, Anderson, Arambula, Bass, Beall, Bill  
            Berryhill, Tom Berryhill, Blakeslee, Block, Blumenfield,  
            Bradford, Brownley, Buchanan, Charles Calderon, Carter,  
            Chesbro, Conway, Cook, Coto, Davis, De La Torre, De Leon,  
            DeVore, Emmerson, Eng, Evans, Feuer, Fletcher, Fong,  
            Fuentes, Fuller, Furutani, Gaines, Galgiani, Garrick,  


                                                               AB 2635

            Gilmore, Hagman, Hall, Harkey, Hayashi, Hernandez, Hill,  
            Huber, Huffman, Jeffries, Jones, Knight, Lieu, Logue,  
            Bonnie Lowenthal, Ma, Mendoza, Miller, Monning, Nava,  
            Nestande, Niello, Nielsen, V. Manuel Perez, Portantino,  
            Ruskin, Salas, Saldana, Silva, Smyth, Solorio, Audra  
            Strickland, Swanson, Torlakson, Torres, Torrico, Tran,  
            Villines, Yamada, John A. Perez
          NO VOTE RECORDED: Caballero, Norby, Skinner, Vacancy

          CTW:do  8/4/10   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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