BILL ANALYSIS �
AB 689
Page 1
Date of Hearing: May 1, 2013
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Mike Gatto, Chair
AB 689 (Bonta) - As Amended: April 8, 2013
Policy Committee: HealthVote:17-0
Urgency: No State Mandated Local Program:
No Reimbursable: No
SUMMARY
This bill requires each general acute care hospital to offer an
onsite influenza vaccine annually to all patients prior to
discharge, as specified, and requires hospitals to inform
patients the patient may be required to pay for the vaccination.
FISCAL EFFECT
1)Unknown significant costs to the Medi-Cal program. These
costs would be offset by savings from vaccinations that might
otherwise have been administered in other settings, or from
avoided hospitalizations.
2)If 10% of the approximately 230,000 Medi-Cal fee-for-service
beneficiaries discharged from hospitals October 1 through
April 1 take up the hospital vaccination offer, state GF costs
would be greater than $200,000, assuming an approximate cost
of $20 for an adult vaccine, $9 for a child vaccine (less
costly than an adult vaccine because of the federal Vaccines
for Children program) and a federal matching rate of 50%.
For Medi-Cal beneficiaries enrolled in managed care plans, the
vaccine cost would need to be negotiated in future capitation
rates.
3)Not every discharged patient would decide to be vaccinated.
Some patients would decline out of personal preference or
because they had already been vaccinated.
COMMENTS
AB 689
Page 2
1)Rationale . This bill is intended to update state law to
better reflect federal vaccination recommendations. Current
law, requiring influenza and pneumococcal disease vaccinations
to be offered to patients 65 and older, was enacted by AB 106
(Berg), Chapter 378, Statutes of 2007. AB 106 was based on
recommendations from the Advisory Committee on Immunization
Practices (ACIP) of the Centers for Disease Control and
Prevention (CDC). ACIP's recommendation for influenza
vaccination has been revised to expand the age range to all
persons aged six months and older.
Sanofi Pasteur, one of six licensed flu vaccine producers, in
support, asserts this bill increases the opportunity for an
important preventive health service individuals might
otherwise overlook or miss.
2)Previous Legislation . SB 739 (Speier), Chapter 526, Statutes
of 2006 requires hospitals to, among other things, offer
onsite flu vaccinations, if available, to all hospital
employees at no cost to the employee. It also requires
hospitals to require employees to be vaccinated or, if an
employee elects not to be vaccinated, to declare in writing
that the vaccination was declined.
3)SB 1318 (Wolk) of 2012 would have required clinics and
licensed health care facilities to institute measures designed
to maximize influenza vaccination rates by 2015 and to prevent
persons with privileges on the medical staff and onsite health
care workers affiliated with the clinics or health care
facilities from contracting, and transmitting to patients, the
influenza virus. SB 1318 was vetoed by the governor, who
expressed support for the national goal of a 90% vaccination
rate by 2020 and noted significant progress at the local
level, but objected to moving a mandatory compliance policy
and a date of 2015 rather than 2020.
Analysis Prepared by : Debra Roth / APPR. / (916) 319-2081