Amended in Assembly March 20, 2014

California Legislature—2013–14 Regular Session

Assembly Bill No. 1592

Introduced by Assembly Member Beth Gaines

February 3, 2014

An act begin insert to add Article 1 (commencing with Section 104250) to Chapter 4 of Part 1 of Division 103 of the Health and Safety Code, end insert relating to diabetes.

LEGISLATIVE COUNSEL’S DIGEST

AB 1592, as amended, Beth Gaines. begin delete Diabetes. end delete begin insert California Diabetes Program. end insert

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Existing law establishes the State Department of Public Health and sets forth its powers and duties, including, but not limited to, the administration of the California Diabetes Program.

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This bill would require the department to submit a report to the Legislature by December 31 of each odd-numbered year that is to include, among other things, information on the financial impact of diabetes on the Medi-Cal program, the Public Employees’ Medical and Hospital Care Act, and public health programs, and detailed action plans for combating diabetes with a range of actionable items for consideration by the Legislature, as specified, and would require the department to make the biannual reports available on its Internet Web site. The bill would authorize the department to use statistical data from external sources and requires the State Department of Health Care Services to provide the department with any relevant statistical data for purposes of creating the biannual reports. The bill would require the department to ensure that all grant funds from the federal Centers for Disease Control and Prevention and other federal sources for the California Diabetes Program are expended for the purpose of diabetes prevention, treatment, and awareness pursuant to the grant requirements, and the creation of the biannual reports.

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The bill would also make related findings and declarations.

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Existing law authorizes the State Department of Public Health to perform studies, demonstrate innovative methods, and disseminate information relating to the protection, preservation, and advancement of public health.

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This bill would state the intent of the Legislature to enact legislation that would create a statewide plan to address diabetes in California.

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Vote: majority. Appropriation: no. Fiscal committee:  begin delete no end delete begin insert yes end insert . State-mandated local program: no.

The people of the State of California do enact as follows:

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begin insert SECTION 1. end insert   

end insert

begin insert Article 1 (commencing with Section 104250) is
added to Chapter 4 of Part 1 of Division 103 of the end insert begin insert Health and
Safety Code end insert begin insert , to read: end insert

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Article begin insert 1. end insert   California Diabetes Program

 

begin insert 104250. end insert   

The Legislature finds and declares all of the following:

(a) It is reported by the California Diabetes Program that one
in seven adult Californians has diabetes, and the numbers are
rising rapidly. The actual number of those whose lives are affected
by diabetes is unknown and stands to be much higher when
factoring in the incidence of type 1 diabetes and undiagnosed
gestational diabetes.

(b) California has the greatest number of annual new cases of
diabetes in the United States.

(c) The incidence of diabetes amongst all Californians has
increased 32 percent over the past decade.

(d) Over 11.4 million people in California have prediabetes, a
condition that is a precursor to full onset type 2 diabetes. This
suggests that the total population of those diagnosed will continue
to rise in the absence of interventions.

(e) The prevalence of diagnosed gestational diabetes in
California has increased 60 percent in just seven years, from 3.3
percent of hospital deliveries in 1998 to 5.3 percent of hospital
deliveries in 2005, with the federal Centers for Disease Control
and Prevention stating that the diagnosis rate could run as high
as 18.3 percent.

(f) The fiscal impact to the State of California, including total
health care and related costs for the treatment of diabetes, was
over $35.9 billion in 2010.

(g) A recent study of a large state with a sizable diabetes
population found that the rate of diagnosed diabetes in the state’s
Medicaid population is nearly double that of its general population.

(h) There is no cure for any type of diabetes.

(i) Diabetes when left untreated can lead to serious and costly
complications and a reduced life span.

(j) Many of these serious complications can be delayed or
avoided with timely diagnosis, effective patient self-care, and
improved social awareness.

(k) It is the intent of the Legislature to require the State
Department of Public Health to create a diabetes action plan that
provides policy guidance to prevent, treat, and increase awareness
of diabetes and that aids in the reduction of the fiscal impact of
diabetes to the state.

begin insert 104251. end insert   

(a) The State Department of Public Health, as part
of the California Diabetes Program, shall submit a report to the
Legislature by December 31 of each odd-numbered year that shall
include all of the following:

(1) The financial impact of all types of diabetes on the Medi-Cal
program, the Public Employees’ Medical and Hospital Care Act
(PEMHCA), as administered by the California Public Employees’
Retirement System (CalPERS) for current employees, their families,
and retirees, and public health programs, and shall include both
of the following:

(A) The number of individuals with diabetes covered by
Medi-Cal or PEMHCA, and the number of individuals with
diabetes without insurance.

(B) The cost or impact diabetes and its complications place on
both public and private entities within the state.

(2) The number of persons with diabetes and family members
impacted by prevention and diabetes control programs
implemented by the State Department of Public Health, the
financial toll or impact diabetes and its complications places on
the program, and the financial toll or impact diabetes and its
complications places on the State Department of Public Health in
comparison to other chronic diseases and conditions.

(3) An assessment of the benefits of implemented programs and
activities aimed at preventing and controlling diabetes. The
assessment shall document both of the following:

(A) The amount and source for any funding directed to the State
Department of Public Health from the Legislature for programs
and activities aimed at reaching those with diabetes.

(B) The amount and source for any funding directed to the State
Department of Public Health that may be used for the purposes
of the action plans required pursuant to paragraph (5).

(4) A description of the level of coordination between the State
Department of Public Health, the Medi-Cal program, and CalPERS
in preventing, treating, managing, and increasing awareness of
all forms of diabetes and its complications.

(5) Detailed action plans for combating diabetes with a range
of actionable items for consideration by the Legislature. The plans
shall identify proposed action steps to reduce the impact of type
1 diabetes, type 2 diabetes, gestational diabetes, prediabetes, and
their related complications. The plans shall also identify expected
outcomes of the action steps proposed in the following biennium
while also establishing benchmarks for preventing and controlling
relevant forms of diabetes.

(6) A detailed budget blueprint identifying needs, costs, and
resources required to implement the action plans required pursuant
to paragraph (5) for consideration by the Legislature. The budget
blueprint to the Legislature shall include a cost-benefit analysis
to assist in prioritizing plans by level of efficiency.

(b) The State Department of Public Health shall make the
biannual reports available on its Internet Web site.

(c) A report submitted pursuant to subdivision (a) shall be
submitted in compliance with Section 9795 of the Government
Code.

begin insert 104252. end insert   

(a) In order to reduce potential costs incurred by the
State Department of Public Health in the process of creating the
biannual reports as required pursuant to Section 104251, the State
Department of Public Health may use statistical data from external
sources.

(b) (1) The State Department of Health Care Services shall
provide to the State Department of Public Health any relevant
statistical data for the purposes of the creation of the biannual
report.

(2) To ensure patient privacy, all data transferred to the State
Department of Public Health from the State Department of Health
Care Services shall conform to requirements described in the
federal Health Insurance Portability and Accountability Act of
1996 (Public Law 104-191).

begin insert 104253. end insert   

The State Department of Public Health shall ensure
that all grant funds from the federal Centers for Disease Control
and Prevention and other federal sources for the California
Diabetes Program are expended for the purpose of diabetes
prevention, treatment, awareness pursuant to the grant
requirements, and the creation of the biannual reports as required
pursuant to Section 104251.

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SECTION 1.  

It is the intent of the Legislature to enact
legislation that would create a statewide plan to address diabetes
in California.

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