BILL ANALYSIS Ó SB 502 Page 1 Date of Hearing: August 17, 2011 ASSEMBLY COMMITTEE ON APPROPRIATIONS Felipe Fuentes, Chair SB 502 (Pavley and De Leon) - As Amended: August 15, 2011 Policy Committee: HealthVote:14 - 5 Urgency: No State Mandated Local Program: No Reimbursable: SUMMARY This bill requires, effective January 1, 2014, that general care, acute care, and specialized hospitals with perinatal units adopt and post an infant-feeding policy either in the perinatal unit or on the hospital's website. In addition, this bill requires that the policy be regularly communicated to the perinatal staff. FISCAL EFFECT Any costs associated with this legislation would be minor and absorbable within existing resources. COMMENTS 1)Rationale . The author states that a growing body of evidence indicates that breastfeeding can affect growth and development in children, while significantly reducing their risk for infections and chronic disease such as diabetes, asthma, and obesity. The author argues that even though regulations require general acute care hospitals to have a written breastfeeding policy, many do not have those policies in place. According to information gathered by California WIC Association (CWA), 14 out of the 22 lowest performing hospitals, those with the highest formula supplementation rates, do not have a breastfeeding policy. The author states the goal of this bill is to provide hospitals with guidance on infant-feeding policies that address both breastfeeding and proper bottle feeding. The author contends this bill is a modest approach that will help SB 502 Page 2 increase the exclusive breastfeeding rates in California hospitals and update current regulations while giving the hospitals a reasonable amount of time to develop their infant-feeding policies and to educate their perinatal unit staff. 2)Infant-Feeding Policies . This bill requires hospitals to adopt either a Baby-Friendly Hospital Initiative (BFHI) infant-feeding model policy or the Department of Public Health's (DPH) infant-feeding model policy. BFHI is a global program sponsored by the World Health Orgnization and UNICEF to encourage and recognize hospitals and birthing centers that offer an optimal level of care for infant-feeding. Since the implementation of BFHI, California has seen a rise in the number of baby-friendly hospitals, growing from 12 in 2006 to 34 in 2010. Hospitals that have adopted BFHI practices and recommendations have the highest rates of breastfeeding in the state. "Model Hospital Policy Recommendations" are the guidelines developed by the Inland Empire Breastfeeding Coalition and approved and provided to hospitals as another resource to improve breastfeeding policies by the DPH. The official guidelines, which are approved and published by DPH, are entitled, "Providing Breastfeeding Support: Model Hospital Policy Recommendations." Both policies include extensive additional instructions, narrative, references and guidelines to assist hospitals and staff in interpreting and applying these guidelines. 3)Health Care Savings Associated with Breastfeeding . Studies have long shown that there are significant health benefits to exclusively breastfeeding for both the child and the mother. Among the benefits for the child are reduced likelihood of obesity, reduced rates of asthma, type 1 and type 2 diabetes, childhood leukemia, lower respiratory tract diseases and gastrointestinal infections, and a lower risk of Sudden Infant Death Syndrome. For mothers, the health benefits include a lower risk of maternal type 2 diabetes, and lower rates of ovarian and breast cancer. A 2010 University of California study on breastfeeding found that if 90% of all women exclusively breastfed their infants for the first six months it would save $13 billion per year in SB 502 Page 3 health care costs and prevent close to 1,000 deaths annually (95% of them infants). 4)Related Legislation . SB 22 (Migden), Statutes of 2007, requires DPH to recommend training for general acute care hospitals and special hospitals to improve breast-feeding rates among mothers and infants. Also requires the Department of Health Care Services to streamline and simplify existing Medi-Cal Program procedures to improve access to lactation support and breast pumps among Medi-Cal recipients. In 2009, AB 513 (De Leon) required health plans and those health insurers that provide maternity benefits to provide coverage for lactation consultation with an international board-certified lactation consultant and the provision of a breast pump. In his veto message, Gov. Schwarzenegger noted, "I share the author's interest in promoting safer, healthier outcomes for mothers and their children. . . . However, the addition of a new mandate, no matter how small, will only serve to increase the overall cost of health care." Analysis Prepared by : Julie Salley-Gray / APPR. / (916) 319-2081