BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 1592
AUTHOR: Gaines
AMENDED: June 23, 2014
HEARING DATE: July 2, 2014
CONSULTANT: Diaz
SUBJECT : California Diabetes Program.
SUMMARY : Requires the Department of Public Health (DPH) to
submit a report to the Legislature regarding a diabetes action
plan for the state. Permits DPH to issue updates, as necessary,
to the reports and requires the report to be posted on their
Internet Web site. Contains an urgency clause that will make
this bill effective upon enactment.
Existing law:
1.Establishes DPH to protect and improve the health of
communities through education, promotion of healthy
lifestyles, and research for disease and injury prevention.
Establishes the California Diabetes Program (CDP) within DPH.
2.Provides DPH with the authority to perform activities that
protect, preserve, and advance public health, including
studies and dissemination of information.
This bill:
1.Requires DPH to submit a report to the Legislature by December
31, 2015, which includes:
a. An assessment of the benefits of implemented
programs and activities aimed at preventing and
controlling diabetes to include the amount and source
for any funding directed to DPH and the Department of
Health Care Services (DHCS) from the Legislature for
programs and activities aimed at reaching those with
diabetes, and any funding that may be used for the
purposes of creating action plans;
b. A description of the level of coordination
between DPH and DHCS in preventing, treating,
managing, and increasing awareness of all forms of
diabetes and its complications within the Medi-Cal
population;
c. Detailed action plans for combating diabetes
Continued---
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with a range of actionable items for consideration by
the Legislature that will aid in attaining the goals
set forth by DPH's California Wellness Plan and
Diabetes Burden Report; and,
d. A detailed budget blueprint identifying needs,
costs, and resources required to implement the
detailed action plans for consideration by the
Legislature. Requires the blueprint to include a
cost-benefit analysis to assist in prioritizing plans
by level of efficiency.
2.Permits DPH to issue updates to the report as necessary and at
its discretion. Requires DPH to make the report and subsequent
updates available on its Internet Web Site and to submit them
to the Legislature, as specified.
3.Requires DHCS to provide DPH with any relevant statistical
data for creating the report. Requires the transferring of the
data to conform to patient privacy requirements in the federal
Health Insurance Portability and Accountability Act of 1996.
Permits DPH to use statistical data from external sources to
reduce potential costs.
4.Requires DPH to include guidelines in the Diabetes Burden
Report that will reduce the fiscal burden of diabetes to the
state.
5.Makes various findings and declarations related to the
prevalence and cost of diabetes in California and steps the
state can take to increase awareness of diabetes.
6.Contains an urgency clause that will make this bill effective
upon enactment.
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1.Costs of about $300,000 (General Fund) annually to DPH for
staff to produce the report.
2.Minor and absorbable costs to DHCS to provide relevant data.
3.To the extent the report makes detailed recommendations to
spend state funds on programs to combat diabetes, this bill
could result in cost pressure to the General Fund.
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3
PRIOR VOTES :
Assembly Health: 19- 0
Assembly Appropriations:17- 0
Assembly Floor: 79- 0
COMMENTS :
1.Author's statement. According to the author, every year,
diabetes costs in California are over $24.5 billion and
increases every year. Nobody is immune and it could strike at
any time. Today, California has no action plan in place to
mitigate the escalating fiscal impact of diabetes. This bill
requires DPH to submit a report and a diabetes action plan to
the Legislature to provide policy guidance that addresses the
escalating fiscal impact of diabetes treatment and care. The
plan will conform to the guidance and goals set forth in the
California Wellness Plan, adopted by DPH earlier this year, as
well as the Diabetes Burden Report that is to be completed by
December 31, 2014.
2.California Diabetes Program. CDP was established in 1981 and
represents a partnership between DPH and the University of
California, San Francisco. It primarily receives its funding
from the Centers for Disease Control and Prevention (CDC). A
few key objectives that CDP focuses on include:
a. Monitoring statewide diabetes health status and risk
factors;
b. Engaging in outreach to increase awareness about the
disease;
c. Guiding public policy to support at-risk and
vulnerable populations;
d. Offering leadership, guidance, and resources to
community health interventions;
e. Seeking to improve the health care delivery system;
and,
f. Reducing diabetes-related health disparities.
CDP achieves these through partnering with different
individual, community, health care, policy, and environmental
entities.
3. Diabetes in California. DPH issued a study, The Burden
of Chronic Disease and Injury, in 2013 that highlights some
of the leading causes of death, such as heart disease,
cancer, stroke, and respiratory disease, all of which have
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a strong connection to obesity. Diabetes is another serious
chronic disease stemming from obesity that adversely
affects quality of life and results in serious medical
costs. The last decade has witnessed a 32 percent rise in
diabetes prevalence, affecting some 3.9 million people and
costing upwards of $24 billion per year. According to the
CDC, more than one-third of U.S. adults are obese, and
approximately 12.5 million children and adolescents ages 2
to 19 years are obese. Research indicates a tripling in the
youth obesity rate over the past three decades. While this
increase has stabilized between the years 2005 and 2010, in
2010, 38 percent of public school children were overweight
and obese. Overweight youth face increased risks for many
serious detrimental health conditions that do not commonly
occur during childhood, including high cholesterol and
type-2 diabetes. Additionally, more than 80 percent of
obese adolescents remain obese as adults.
4.Diabetes Burden Report. The Diabetes Burden Report will
include information on the prevalence of diabetes in
California compared to the rest of the U.S.; risk factors for
developing diabetes and diabetes complications; the prevalence
of obesity, inactivity, and cardiovascular disease risk
factors among diabetics as compared to non-diabetics in
California; the prevalence of pre-diabetes, complications of
diabetes, and diabetes mortality in California compared to the
rest of the nation; and DPH programs and activities that
address the burden of diabetes in California.
5.Related legislation. SB 1316 (Cannella) would have required
DHCS, DPH, and the Board of Administration of the Public
Employees' Retirement System to submit a report to the
Legislature regarding their respective diabetes-related
programs. SB 1316 was never referred out of Senate Rules
Committee.
6.Support. Advanced Medical Technology Association (AdvaMed)
writes that this bill aims to establish collaboration among
state agencies with a vested interest in containing the reach
of the diabetes epidemic by directing them to develop a plan
of action to confront the disease. AdvaMed states that this
bill will help provide the public with an understanding of
what the state is doing to combat the disease and how
legislators can prioritize resources available. The American
Diabetes Association states that it is important that
California prioritize the tremendous implications of diabetes
AB 1592 | Page
5
as a chronic disease in the state, which impacts its overall
health care costs and the health and wellness of its
residents, and states that this bill is an important step in
that direction.
SUPPORT AND OPPOSITION :
Support: Advanced Medical Technology Association
American Diabetes Association
Association of California Healthcare Districts
AstraZeneca Pharmaceuticals LP
BayBio
BIOCOM
California Association of Area Agencies on Aging
California Chronic Care Coalition
California Healthcare Institute
National Association of Hispanic Nurses, Los Angeles
Chapter
Novo Nordisk
1 individual
Oppose: None received.
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