BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      



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          |SENATE RULES COMMITTEE            |                  AB 1329|
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                                 THIRD READING


          Bill No:  AB 1329
          Author:   Davis (D)
          Amended:  7/11/11 in Senate
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  9-0, 7/6/11
          AYES:  Hernandez, Strickland, Alquist, Anderson, Blakeslee, 
            De León, DeSaulnier, Rubio, Wolk

           SENATE APPROPRIATIONS COMMITTEE  :  8-0, 8/15/11
          AYES:  Kehoe, Walters, Alquist, Emmerson, Lieu, Pavley, 
            Price, Steinberg
          NO VOTE RECORDED:  Runner

          ASSEMBLY FLOOR  :  78-0, 5/19/11 - See last page for vote


           SUBJECT  :    Ken Maddy California Cancer Registry

           SOURCE  :     Public Health Institute 
                      University of Southern California


           DIGEST  :    This bill requires the Department of Public 
          Health to establish a process to receive applications for, 
          and award a grant to, an agency to operate the statewide 
          Ken Maddy California Cancer Registry.  Exempts these grants 
          from being subject to specified provisions of the Public 
          Contract Code.

           ANALYSIS  :    

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           Existing law  :

          1. Requires Department of Public Health (DPH) to conduct a 
             program of epidemiological assessments of the incidence 
             of cancer.

          2. Requires the program to encompass all areas of the state 
             for which cancer incidence data are available, and to 
             include monitoring of cancers associated with suspected 
             carcinogens encountered by the general public both in 
             occupational locations and in the environment. 

          3. Allows DPH to contract with an agency, including, but 
             not limited to a health systems agency, single or 
             multiple county health departments, or nonprofit 
             professional associations, representing a designated 
             cancer reporting region for the purposes of collecting 
             and collating cancer incidence data. 

          4. Requires the Director of DPH (Director) to establish a 
             statewide system to collect information on the incidence 
             of cancer using population-based cancer registries.

          5. Requires these registries to be implemented or initiated 
             by July 1, 1988, and requires that the statewide cancer 
             reporting system be fully operational by July 1, 1990.

          6. Authorizes the Director to enter into contracts as 
             necessary to conduct the program, and accept grants of 
             public or private funds for the program on behalf of the 
             state. 

          7. Requires the Director to analyze available incidence 
             data and prepare reports and perform studies as 
             necessary to identify cancer hazards to the public 
             health and their remedies.

          8. Mandates the Director to require the reporting of cancer 
             to DPH, or its authorized representative, in areas of 
             the state where cancer information is being collected. 

          9. Requires any hospital or other facility providing 
             therapy to cancer patients to report all cancers 
             diagnosed or treated, in designated cancer reporting 

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             areas, to DPH or an authorized representative, and 
             allows DPH access to those records. 

          10.Requires specified health care providers diagnosing or 
             providing treatment for cancer patients to report all 
             cancers to DPH or an authorized representative, with 
             specified exemptions, and allows DPH access to those 
             records.

          11.Authorizes DPH to fine entities that do not comply with 
             these record-sharing requirements, and requires that 
             fines collected be deposited into the General Fund. 

          12.Requires all information collected for the purpose of 
             the registry be kept confidential.

          13.Allows for the access of this confidential information 
             to specified entities who agree in writing to maintain 
             confidentiality, and who meet other various 
             requirements.

          14.Authorizes contracting between state agencies and 
             private contractors. 

          15.Sets forth requirements for the procurement of goods and 
             services by state agencies.

          16.Sets forth the various responsibilities of the 
             Department of General Services (DGS) in implementing 
             state contracting procedures and policies.  

          17.Permits state agencies to use personal services 
             contracts, when specified conditions are met, in order 
             to achieve cost savings.

          18.Specifies that proposals to contract out work can be 
             eligible for approval if the contractor's wages are at 
             the industry's level and do not significantly undercut 
             state pay rates.

          This bill: 

          1. Deletes DPH's authorization to contract with specified 
             entities representing designated cancer reporting 

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             regions for the purpose of collecting and collating 
             cancer incidence data.

          2. Allows DPH to establish a competitive process to receive 
             applications for, and issue, the award of a grant to an 
             agency for the purpose of operating the statewide cancer 
             reporting system.

          3. Exempts these grants from the State Contract Act in the 
             Public Contract Code that mandate that DGS administer 
             contracts and develop a report describing the need for 
             and terms of the contract.

          4. States that DPH must include appropriate terms and 
             conditions in a grant awarded to ensure the proper use 
             of state funds, including provision for reimbursement of 
             allowable costs, financial reporting, program 
             performance reporting, monitoring of subgrants awarded 
             by the grantee to an agency representing a designated 
             cancer reporting region, retention and access 
             requirements for records, independent auditing, 
             termination, and disposition of assets acquired under 
             the grant.

           Background
           
           California Cancer Registry (CCR) .  The Ken Maddy CCR was 
          established in 1985 and is California's statewide 
          population-based cancer surveillance system.  The CCR 
          collects information about almost all cancers diagnosed in 
          California.  The information is used to develop strategies 
          and policies for cancer prevention, treatment, and control, 
          such as determining where early detection, educational or 
          other programs should be directed.  In addition, health 
          researchers use the data to analyze demographic and 
          geographic factors that affect cancer risk, early 
          detection, and effective treatment of cancer patients. 

          Due to the size and diversity of the California population, 
          more is now known about the occurrence of cancer in diverse 
          populations than ever before.  To date, the CCR has 
          collected detailed information on over 3.4 million cases of 
          cancer among Californians diagnosed from 1988 forward, and 
          more than 162,000 new cases are added annually.  CCR is 

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          recognized as one of the leading cancer registries in the 
          world, and has been the cornerstone of a substantial amount 
          of cancer research.  More than 450 funded research 
          projects, and 1,900 publications have used CCR data.

          CCR is managed by the DPH Cancer Surveillance and Research 
          Branch (CSRB), which is responsible for collecting 
          statewide data about cancer and cancer risk factors, 
          conducting surveillance and research into the causes, 
          cures, and controls of cancer, and communicating the 
          results to the public. CSRB also manages the Survey 
          Research Group, which specializes in conducting scientific 
          health-related surveys, and California's Comprehensive 
          Cancer Control Program, which oversees the California 
          Dialogue on Cancer, a statewide comprehensive cancer 
          control coalition. 

          Similar programs that DPH administers include the Birth 
          Defects Monitoring Program, the Parkinson's Disease 
          Registry, and the California Immunization Registry. DPH 
          also operates a voluntary stroke registry through the 
          California Heart Disease and Stroke Prevention Program.

           CCR funding  .  The state General Fund provided $8.8 million 
          in fiscal year 2010-11 for the state contract to provide 
          partial support for state-level CCR functions, and a 
          portion of the data collection costs incurred in the 
          regional registries.  Federal funding is essential to the 
          CCR.  The majority of the funding to support the statewide 
          registry comes from grants and contracts currently awarded 
          to the regional registries, with consent by the National 
          Cancer Institute's Surveillance, Epidemiology, and End 
          Results Program (SEER) and the federal Centers for Disease 
          Control and Prevention's (CDC) National Program of Cancer 
          Registries.  Current federal SEER funding is $8 million per 
          year over seven years to three California SEER registries.  
          These registries are also able to draw down an additional 
          $10 million in CDC funds.  

           State contracts  .  The state enters into different types of 
          contracts, including contracts for public works projects, 
          information technology projects, and contracts for personal 
          services and consultants.  These contracts are usually 
          subject to a competitive selection process.  Generally, 

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          personal services are required to be performed by civil 
          service employees whenever feasible, pursuant to Government 
          Code Section 19130.  The State Constitution generally 
          requires contracting to be limited to those services that 
          cannot be performed by civil service employees, except as 
          provided for in statute. 

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

          According to the Senate Appropriations Committee, "The 
          ability of CDPH to perform fiscal oversight of the CCR 
          funds could decrease if this program were to move from 
          being administered through a contract to a grant program.  
          Although this bill would require CDPH to include specified 
          terms and conditions in the grant to ensure the proper use 
          of state funds, including provision for reimbursement of 
          allowable costs, financial reporting, program performance, 
          monitoring of the grant, retention and access requirements 
          for records, and independent auditing, CDPH could not 
          compel a grantee to meet specified milestones, deadlines, 
          or deliverables in exchange for funds as it could a 
          contractor.  There could be potentially significant cost 
          pressure to the extent a grantee fails to complete the 
          scope of work contained in the grant within the prescribed 
          budget."

           SUPPORT  :   (Verified  8/16/11)

          Public Health Institute (co-source)
          University of Southern California (co-source)
          American Cancer Society, California Division
          California Cancer Registry
          Cancer Prevention Institute of California
          City of Hope
          Desert Sierra Cancer Surveillance Program, Region 5 of 
          California of the 

           ARGUMENTS IN SUPPORT  :    University of Southern California 
          (USC) states that this bill has been introduced in response 
          to DPH's inability to release a request for 
          proposal/agreement for the operation of the CCR due to 
          administrative barriers.  Since its inception in 1985, the 
          CCR has been a partnership between the state, nonprofit 

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          research entities, and health providers to collect, 
          analyze, and disseminate information on cancer incidence 
          and mortality.  The current five-year grant is set to 
          expire in July 2012, and USC claims that in previous years, 
          the request for proposal/agreement would have been released 
          months ago.  USC claims that if DPH cannot rebid the 
          contract in time, registry functions would be disrupted.  
          This bill seeks to alleviate the current administrative 
          obstacles that DPH has encountered by giving authorization 
          to DPH to issue a competitive granting process for the 
          administration of the program in order to protect the flow 
          of federal funds and streamline the process of funding the 
          registry.


           ASSEMBLY FLOOR  : 
          AYES: Achadjian, Allen, Ammiano, Atkins, Beall, Bill 
            Berryhill, Block, Blumenfield, Bonilla, Bradford, 
            Brownley, Buchanan, Butler, Charles Calderon, Campos, 
            Carter, Cedillo, Chesbro, Conway, Cook, Davis, Dickinson, 
            Donnelly, Eng, Feuer, Fletcher, Fong, Fuentes, Furutani, 
            Beth Gaines, Galgiani, Garrick, Gatto, Gordon, Grove, 
            Hagman, Halderman, Hall, Harkey, Hayashi, Roger 
            Hernández, Hill, Huber, Hueso, Huffman, Jeffries, Jones, 
            Knight, Lara, Logue, Bonnie Lowenthal, Ma, Mansoor, 
            Mendoza, Miller, Mitchell, Monning, Morrell, Nestande, 
            Nielsen, Norby, Olsen, Pan, Perea, V. Manuel Pérez, 
            Portantino, Silva, Skinner, Smyth, Solorio, Swanson, 
            Torres, Valadao, Wagner, Wieckowski, Williams, Yamada, 
            John A. Pérez
          NO VOTE RECORDED: Alejo, Gorell


          CTW:do  8/16/11   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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