BILL ANALYSIS Ó
AB 1898
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 1898 (Brown)
As Amended August 18, 2014
Majority vote
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|ASSEMBLY: |68-2 |(May 19, 2014) |SENATE: |36-0 |(August 27, |
| | | | | |2014) |
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Original Committee Reference: HEALTH
SUMMARY : Adds hepatitis B, hepatitis C, and meningococcal
infection to the list of diseases that local health officer
(LHO) reports to the Department of Public Health (DPH) for the
purpose of the investigation, control, or surveillance of human
immunodeficiency virus/acquired immune deficiency syndrome
(HIV/AIDS) and co-infection.
The Senate amendments specify that this information may only be
disclosed the Centers for Disease Control and Prevention (CDC)
if requested by that agency.
FISCAL EFFECT : According to the Senate Appropriations
Committee, pursuant to Senate Rule 28.8, negligible state costs.
COMMENTS : According to the author, existing law limits
reporting cases of HIV/AIDS that are coinfected to tuberculosis
and sexually transmitted diseases, specifically syphilis,
gonorrhea, or chlamydia. This restriction limits the
completeness of public health reporting because HIV/AIDS related
records may not be disclosed for coinfection with other diseases
and creates barriers to HIV reporting and data used for
follow-up of exposed individuals and impedes the efforts to
prevent disease transmissions. The author argues there are
other conditions of public health importance that should be
included such as hepatitis B and C and meningococcal infection.
The author concludes, to ensure completeness of public health
reporting, facilitating care and treatment, follow-up of exposed
individuals, and other interventions to prevent ongoing disease
transmission, the reporting of other communicable diseases of
public health importance should be included.
DPH is required to establish a list of communicable and
noncommunicable diseases and conditions which LHOs are required
AB 1898
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to report to DPH. LHOs are requires to report cases of
tuberculosis or sexually transmitted diseases when a person is
coinfected with one or more of these and HIV/AIDS. HIV/AIDS has
very specific reporting requirements and restrictions. Health
care providers and laboratories must report cases of HIV
infection to the LHO using patient names, as specified and the
LHO must report unduplicated HIV cases by name to DPH. Exiting
law only permits disclosure of health records for an HIV/AIDS
patient for the purpose of facilitating appropriate HIV/AIDS
medical care and treatment.
Coinfection means infection with more than one disease at the
same time. Some coinfections commonly seen in people infected
with HIV include hepatitis B, hepatitis C, and tuberculosis.
The diseases can be treated although treatment does depend on
the coinfection as the possibility of drug interaction always
exists.
The diseases listed in this bill are very serious, especially
for those infected with HIV. According to the CDC, those with
HIV infection are disproportionately affected by viral
hepatitis. Approximately one-third of people with HIV are
coinfected with either hepatitis B or C. This can cause long
term illness and death. Individuals who are co-infected with
HIV and hepatitis experience greater liver related health
problems than those who are not. Viral hepatitis also
progresses faster among people with HIV. Another disease that
needs to be reported is meningococcal infection, an infection of
the membranes covering the brain and spinal cord. Complications
can include loss of limbs, hearing loss and, in 15% of cases,
death if left untreated.
A variety of national and state privacy laws apply to the data
and exist to protect the rights of patients. All health
department staff that have access to the HIV reporting system
are trained in confidentiality. Existing privacy provisions and
protections in the Health and Safety Code are unchanged by this
bill. This bill ensures patient's confidentiality and privacy
rights are protected be restating current law under the
California Confidentiality of Medical Information Act, that any
disclosure of co-infection shall include only the information
necessary for the purpose of that disclosure and shall be made
only upon the agreement that the information will be kept
confidential and will not be further disclosed without written
authorization.
AB 1898
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According to the sponsor, the Health Officers Association of
California (HOAC), local health departments already receive
information about HIV cases and cases of hepatitis and
meningococcal infection. However, current law forbids health
departments from receiving this information together in one
form. This puts an unnecessary burden on public health
departments and medical care providers, and creates barriers to
effective patient care. In particular, HOAC argues,
organizations and individuals face penalties and fines if they
mention a coinfection when reporting a case.
There is no known opposition to this bill.
Analysis Prepared by : Dharia McGrew / HEALTH / (916) 319-2097
FN: 0005240