Amended in Assembly April 23, 2014

Amended in Assembly April 2, 2014

Amended in Assembly March 20, 2014

California Legislature—2013–14 Regular Session

Assembly Bill No. 1592

Introduced by Assembly Member Beth Gaines

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(Coauthors: Assembly Members Fox, Garcia, and Gonzalez)

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February 3, 2014

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

LEGISLATIVE COUNSEL’S DIGEST

AB 1592, as amended, Beth Gaines. California Diabetes Program.

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.

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, begin delete information on the financial impact of diabetes on the Medi-Cal program and public health programs, end delete begin insert an assessment of the benefits of implemented programs and activities aimed at preventing and controlling diabetes, end insert and detailed action plans for combating diabetes with a range of actionable items for consideration by the begin delete Legislature, as specified, end delete begin insert Legislature that will aid in attaining the goals set forth by the State Department of Public Health in the California Wellness Plan for 2014 and the Diabetes Burden Report, end insert 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.

The bill would also make related findings and declarations.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

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

SECTION 1.  

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

 

Article 1.  California Diabetes Program

 

104250.  

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 lifespan.

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

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(k) The State Department of Public Health has created the
California Wellness Plan for 2014 that provides a set of desired
outcomes regarding diabetes in the state.

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(l) The State Department of Public Health will complete a
Diabetes Burden Report by December 31, 2014, and will include
in the report, information on the prevalence of diabetes in
California compared to the rest of the United States, risk factors
for developing diabetes and diabetes complications, and the
prevalence of obesity, inactivity, and cardiovascular disease risk
factors among individuals with diabetes as compared to individuals
without diabetes in California. The report will address the
prevalence of prediabetes, complications of diabetes, and diabetes
mortality in California as compared to the rest of the United States.
The report will also outline the department’s programs and
activities that address the burden of diabetes in California.

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(k)

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begin insert (m) end insert  It is the intent of the Legislature to require the State
Department of Public Health begin insert , as part of the California Diabetes
Program, end insert to create a diabetes action plan that provides policy
guidance to prevent, treat, and increase awareness of diabetes and
begin delete that aids in the reduction of the fiscal impact of diabetes end delete to begin insert aid end insert the
state begin insert in complying with the goals set forth by the State Department
of Public Health in the California Wellness Plan for 2014 and the
Diabetes Burden Report end insert .

104251.  

(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:

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(1) The financial impact of all types of diabetes on the Medi-Cal
program and public health programs, and shall include both of the
following:

(A) The number of individuals with diabetes covered by
Medi-Cal 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.

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(3)

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begin insert (1) end insert  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 begin insert and the State Department of Health
Care Services end insert 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 begin insert and the State Department of Health
Care Services end insert that may be used for the purposes of the action plans
required pursuant to paragraph begin delete (5) end delete begin insert (3) end insert .

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(4)

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begin insert (2) end insert  A description of the level of coordination between the State
Department of Public Health and the begin delete Medi-Cal program end delete begin insert State
Department of Health Care Services end insert in preventing, treating,
managing, and increasing awareness of all forms of diabetes and
its complications begin insert within the Medi-Cal population end insert .

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(5)

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begin insert (3) end insert  Detailed action plans for combating diabetes with a range
of actionable items for consideration by the begin delete 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. end delete begin insert Legislature that will aid in attaining
the goals set forth by the State Department of Public Health in the
California Wellness Plan for 2014 and the Diabetes Burden Report. end insert

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(6)

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begin insert (4) end insert  A detailed budget blueprint identifying needs, costs, and
resources required to implement the action plans required pursuant
to paragraph begin delete (5) end delete begin insert (3) end insert 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.

104252.  

(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).

104253.  

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.