BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2668
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          Date of Hearing:   May 5, 2010

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                   AB 2668 (Galgiani) - As Amended:  April 8, 2010 

          Policy Committee:                              Public  
          SafetyVote:  7-0

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill requires CDCR, to the extent lease-revenue bonds funds  
          are available from AB 900 (Solorio, 2007), to install  
          telemedicine infrastructure at "the Medical Facility."

           FISCAL EFFECT

           1)Assuming AB 900 financing is authorized for this purpose  
            (which is the intent of the author's AB 2222, also before the  
            committee today) and depending on the scope of the project(s),  
            costs could range into the millions of dollars (lease-revenue  
            bonds/GF), assuming the author intends this bill to apply only  
            to the proposed Consolidated Care Center in Stockton.

          2)Depending on the extent to which telemedicine proves a more  
            cost-efficient method of providing inmate health care in  
            appropriate cases, the investment in telemedicine will result  
            in significant out-year GF health care savings that should  
            exceed the cost of the attendant telemedicine infrastructure. 

            COMMENTS

          1)Rationale.  The author notes the importance of telemedicine in  
            ongoing state and federal efforts to provide affordable and  
            constitutionally acceptable inmate health care and contends  
            that the cost of building the infrastructure necessary to  
            provide such care should be covered under the existing AB 900  
            lease-revenue bond authority.

           2)Telemedicine a crucial component of CDCR/federal health care  
            receiver health care efforts  . According to the receiver's  








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            April 2010 Cost Containment Report, telemedicine leads to  
            significant cost avoidance in the areas of contract medical  
            and medical custody transportation costs. Telemedicine is also  
            a significant component of the receiver's efforts to identify  
            $800 million in proposed health care savings in the 2010-11  
            state budget. According to the report:
            

           3)NuPhysicia also recommends significantly increased  
            telemedicine investment to address prison health care  
            shortcomings  . In March 2010, NuPhysicia, a private company  
            involved in the telemedicine programs of The University of  
            Texas Medical Branch, released a report -  "Assessment and  
            Evaluation: California's Opportunities for Improved Inmate  
            Health Care Quality and Cost Controls" - that criticized  
            CDCR's underreliance on telemedicine and encouraged the state  
            to integrate telemedicine into daily care. 


           4)The need for the bill is not clear  , as CDCR and the receiver  
            intend to install telemedicine infrastructure at the  
            Consolidated Care Center. 


           5)Telemedicine  is the provision of interactive healthcare via  
            telecommunication technology. Telemedicine allows patients to  
            visit with physicians live over video for immediate care, or  
            via recorded video/still images, patient data is stored and  
            sent to physicians for diagnosis and follow-up treatment at a  
            later time.  


           6)Related Legislation.  


             a)   AB 2222 (Galgiani) authorizes CDCR to install  
               telemedicine fixtures and broadband infrastructure in new  
               or existing buildings authorized pursuant to phase II of AB  
               900 (Solorio, 2007) CDCR Secretary. 

             b)   AB 1785 (Galgiani) Requires CDCR to maintain a statewide  
               telemedicine services program, requires an operational  
               telemedicine program at each institution, and expands  
               existing telemedicine services. AB will be heard by this  
               committee later in the month.








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           Analysis Prepared by  :    Geoff Long / APPR. / (916) 319-2081