BILL ANALYSIS Ó
AB 1592
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GOVERNOR'S VETO
AB 1592 (Beth Gaines)
As Amended August 19, 2014
2/3 vote
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|ASSEMBLY: |79-0 |(May 29, 2014) |SENATE: |35-0 |(August 25, |
| | | | | |2014) |
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|ASSEMBLY: |79-0 |(August 26, | | | |
| | |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. Requires DPH to include in the report
guidelines that will reduce the fiscal burden of diabetes to the
state.
The Senate amendments revise 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
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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
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
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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 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.
GOVERNOR'S VETO MESSAGE :
I appreciate the author's efforts to highlight,
monitor and reduce the burden of diabetes in the
state. Unfortunately, the Department of Public Health
already submitted its Diabetes Burden Report to the
federal Centers for Disease Control and Prevention, as
required, and is unable to withdraw the report to
include additional information prescribed by the bill.
Instead, I will direct the Department of Public Health
and the Department of Health Care Services to work
with the author and stakeholders to provide the
information sought by the bill, so that lawmakers and
others will have the facts necessary to assess and
further direct our collective effort to reduce the
prevalence of diabetes in our state.
Analysis Prepared by : Lara Flynn / HEALTH / (916) 319-2097
FN: 0005707
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