BILL ANALYSIS Ó
AB 1592
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 1592 (Beth Gaines)
As Amended August 19, 2014
2/3 vote. Urgency
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|ASSEMBLY: |79-0 |(May 29, 2014) |SENATE: |35-0 |(August 25, |
| | | | | |2014) |
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Original Committee Reference: HEALTH
SUMMARY : Requires the Department of Public Health (DPH) to
complete and submit to the Legislature a Diabetes Burden Report
by December 31, 2015, which includes, among other things,
actionable items for consideration by the Legislature that will
aid in attaining the goals set forth by DPH in the California
Wellness Plan for 2014 (Plan). Requires DPH to include in the
report guidelines that will reduce the fiscal burden of diabetes
to the state.
The Senate amendments revised the information required to be
included in the report and added the requirement for guidelines
to reduce the fiscal burden of diabetes to the state.
EXISTING LAW : Establishes DPH to protect and improve the health
of communities through education, promotion of healthy
lifestyles, and research for disease and injury prevention.
AS PASSED BY THE ASSEMBLY , this bill required DPH, as part of
the California Diabetes Program (CDP), to submit a report to the
Legislature by December 31, 2015, which includes information on
the fiscal impact of diabetes to the Medi-Cal program, among
other things, as well as provide proposals to reduce the impact
of diabetes and its complications.
FISCAL EFFECT : According to the Senate Appropriations
Committee, one-time costs of about $300,000 for contract staff
to analyze data, develop recommendations, and prepare the report
as well as staff support from DPH (General Fund).
COMMENTS : According to the author, the State of California has
no plan in place to mitigate the escalating fiscal impact of
diabetes, and while there has been extensive legislation enacted
to promote awareness and cost saving measures for conditions
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such as cardiovascular disease and tobacco addiction, current
law is woefully inadequate in regard to diabetes. The author
states that diabetes has reached epidemic levels in California,
and as of 2012, about one in seven adult Californians have
diabetes and many more will be diagnosed in the near future.
Finally, the author states that this bill would require the CDP
to create and submit to the state a diabetes action plan, which
will provide policy guidance addressing the escalating fiscal
impact of diabetes treatment and care.
Diabetes is a chronic medical condition marked by high levels of
blood glucose (a form of sugar) resulting from defects in
insulin production, insulin action, or both. Type 1 diabetes,
previously known as juvenile diabetes, is an autoimmune disease
in which the body does not produce the hormone insulin. There
is no known way to prevent type 1 diabetes. Type 2 diabetes
(previously called non-insulin-dependent diabetes or adult-onset
diabetes) in adults, accounts for about 90% to 95% of all
diagnosed cases of diabetes. It usually begins as insulin
resistance, a disorder in which the cells do not use insulin
properly. As the need for insulin rises, the pancreas gradually
loses its ability to produce it. Gestational diabetes occurs in
pregnant women who have never had diabetes before but have
higher than normal blood glucose levels during pregnancy.
Immediately after pregnancy, 5% to 10% of women with gestational
diabetes are found to have diabetes, usually Type 2 diabetes.
Women who have had gestational diabetes have a 35% to 60% chance
of developing diabetes in the next 10 to 20 years. Prediabetes
is a condition in which individuals have blood glucose levels
higher than normal but not high enough to be classified as
diabetes. People with prediabetes have an increased risk of
developing Type 2 diabetes, heart disease, and stroke. Without
intervention, about one out of four people with prediabetes will
develop diabetes within three to five years. Ethnic minorities
and those who are poor or disadvantaged have especially high
rates of diabetes.
According to the CDP, diabetes costs in California exceed $24
billion each year. Total health care and related costs for the
treatment of diabetes in California are about $24.5 billion.
Direct medical costs (e.g., hospitalizations, medical care,
treatment, supplies) account for about $18.7 billion, the other
$5.8 billion include indirect costs such as disability payments,
time lost from work, and premature death. The average annual
treatment cost per case for diagnosed diabetes in the United
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States (U.S.) was nearly $10,000 in 2007. California has an
estimated 3.9 million adults with diabetes (2010), and the
numbers are rising rapidly.
This year DPH published the Plan, the result of a statewide
process led by DPH to develop a roadmap with partners and create
communities in which people can be healthy through improving the
quality of clinical and community care, increasing access to
usable health information, assuring continued public health
capacity to achieve health equity, and empowering communities to
create healthier environments. The Plan contains short,
intermediate, and long-term objectives with measurable effects
on a variety of chronic diseases, including diabetes. DPH's
chronic disease programs plan to collaborate with local and
state partners, including the Office of Health Equity, engaged
in diabetes prevention to implement the objectives. DPH intends
to monitor the progress of the Plan objectives and publish
regular reports on outcomes.
DPH is currently working on a Diabetes Burden Report with an
anticipated completion of December 31, 2014. The 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, as well as the prevalence
of obesity, inactivity, and cardiovascular disease risk factors
(smoking, hypertension, hypercholesterolemia) among diabetics as
compared to non-diabetics in California. The report will
address the prevalence of pre-diabetes, complications of
diabetes, and diabetes mortality in California compared to the
rest of the nation. The report will also outline DPH programs
and activities that address the burden of diabetes in
California.
Analysis Prepared by : Lara Flynn / HEALTH / (916) 319-2097
FN: 0004840