BILL NUMBER: SB 1303	AMENDED
	BILL TEXT

	AMENDED IN SENATE  APRIL 2, 2014

INTRODUCED BY   Senator Torres
    (   Principal coauthor:   Assembly Member
  Maienschein  ) 

                        FEBRUARY 21, 2014

   An act to amend Section  38000   122405 
of  , and to add Section 122407 to,  the Health and Safety
Code, relating to  social services.   public
health. 


	LEGISLATIVE COUNSEL'S DIGEST


   SB 1303, as amended, Torres.  Public social services:
direct service contracts.   Public health: hepatitis C.
 
   Existing law, the Hepatitis C Education, Screening, and Treatment
Act, requires the Director of Public Health to develop and implement
a public education and outreach program to raise awareness of the
hepatitis C virus aimed at high-risk groups, physician's offices,
health care workers, and health care facilities that, among other
things, includes hepatitis C counseling, education, and testing, as
appropriate, into local state-funded programs.  
    This bill would require a health care practitioner to offer a
qualifying individual, as defined, a hepatitis C screening test or
hepatitis C diagnostic test, as defined, unless the health care
practitioner reasonably believes, among other things, that the
qualifying individual is being treated for a life threatening
emergency. If an individual consents to a hepatitis C screening test
or diagnostic test and the test is positive or reactive, the health
care practitioner would be required to offer followup health care or
to refer the individual to a health care practitioner who can provide
followup health care. The bill would require that the offering of a
hepatitis C screening test or diagnostic test be culturally and
linguistically appropriate, and would require the director to issue
guidance on the culturally and linguistically appropriate offering of
a test by July 1, 2015. These requirements would not apply to an
individual receiving health care from a health care practitioner in a
hospital or emergency room setting.  
   Existing law states the intent of the Legislature, with respect to
direct service contracts of the departments within the California
Health and Human Services Agency, that the contract approval process
and payment for services rendered occur within specified timeframes.
 
   This bill would make technical, nonsubstantive changes to these
provisions. 
   Vote: majority. Appropriation: no. Fiscal committee:  no
  yes  . State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    Section 122405 of the   Health
and Safety Code   is amended to read: 
   122405.   (a)    The Legislature hereby finds
and declares all of the following: 
   (a) 
    (1)  Hepatitis C is classified as a silent killer, where
no recognizable signs or symptoms occur until severe liver damage
has occurred. 
   (b) 
    (2)  Hepatitis C has been characterized by the World
Health Organization as a disease of primary concern to humanity.

   (c) 
    (3)  Studies indicate that 1.8 percent of the
population, nearly 4 million Americans, carry the virus HCV that
causes hepatitis C. In California, as many as 500,000 individuals may
be carriers and could develop the debilitating and potentially
deadly liver disease associated with hepatitis C in their lifetime.
An expert panel, convened in March by the National Institutes of
Health (NIH), estimated that 30,000 acute new infections occur each
year in the United States, and only 25 to 30 percent of those are
diagnosed. Current data sources indicate that 8,000 to 10,000
Americans die from hepatitis C each year. 
   (d) 
    (4)  Studies also indicate that 39.4 percent of male
inmates and 54.5 percent of female inmates in California correctional
facilities have hepatitis C, 26 times higher than the general
population. Upon their release from prison, these inmates present a
significant health risk to the general population of California. 

   (5) Hepatitis C is the most common bloodborne pathogen in the
United States, and is a leading cause of complications from chronic
liver disease.  
   (6) According to the federal Centers for Disease Control and
Prevention, 2.7 million Americans are living with chronic hepatitis
C, which is almost 1 percent of the entire population of the United
States.  
   (7) Hepatitis C infections are most common among individuals born
between 1945 and 1965, commonly known as the baby boomers.  

   (8) Hepatitis C infections have reached epidemic levels,
especially in underrepresented communities.  
   (9) Up to 75 percent of individuals infected with hepatitis C do
not know they are infected, and are therefore not connected to any
source of care or treatment.  
   (10) In June 2013, the United States Preventive Services Task
Force recommended that all high risk individuals and anyone born
between 1945 and 1965 be screened for hepatitis C. In making this
recommendation, the United States Preventive Services Task Force
cited evidence that early screening and detection can lead to
improved clinical outcomes.  
   (b) Accordingly, it is the intent of the Legislature to do both of
the following:  
   (e)  It is the intent of the Legislature to study 
    (1)     Study  the adequacy of the
health care delivery system as it pertains to hepatitis C. 
   (f)  It is the intent of the Legislature to urge 
    (2)     Urge  the department to make
funds available to community-based nonprofit organizations for
education and outreach with respect to the hepatitis C virus.
   SEC.   2   .    Section 122407 is
added to the   Health and Safety Code   , to read:
 
   122407.  (a) Every qualifying individual who receives medical care
from a health care practitioner shall be offered a hepatitis C
screening test or hepatitis C diagnostic test, unless the health care
practitioner providing those services reasonably believes that any
one of the following applies:
   (1) The individual is being treated for a life-threatening
emergency.
   (2) The individual has previously been offered a hepatitis C
screening test or diagnostic test, or has been the subject of a
hepatitis C screening test or diagnostic test, unless the individual
is a person described in clause (ii), (v), (vii), or (viii) of
paragraph (4) of subdivision (e).
   (3) The individual lacks capacity to consent to a hepatitis C
screening test or diagnostic test.
   (b) If an individual consents to a hepatitis C screening test or
diagnostic test and the test is positive or reactive, the health care
practitioner shall either offer followup health care or refer the
individual to a health care practitioner who can provide followup
health care. The followup health care shall include a hepatitis C
diagnostic test.
   (c) The offering of a hepatitis C screening test or diagnostic
test pursuant to this section shall be culturally and linguistically
appropriate. The director shall issue guidance on the culturally and
linguistically appropriate offering of a test by July 1, 2015.
   (d) This section does not affect the scope of practice of a health
care practitioner or diminish the authority, legal, or professional
obligation of a health care practitioner to offer a hepatitis C
screening test or diagnostic test, or to provide services or care for
the subject of a hepatitis C screening test or diagnostic test.
   (e) As used in this section, the following terms shall have the
following meanings:
   (1) "Health care practitioner" means a physician, surgeon, or any
other health care provider licensed to order a hepatitis C screening
test or hepatitis C diagnostic test.
   (2) "Hepatitis C diagnostic test" means any laboratory test or
tests that detects the presence of the hepatitis C virus in the blood
and provides confirmation of whether the individual has a hepatitis
C virus infection.
   (3) "Hepatitis C screening test" means an FDA-approved laboratory
screening test, FDA-approved rapid point-of-care test, or other
FDA-approved test that detects the presence of hepatitis C antibodies
in the blood.
   (4) "Qualifying individual" means any of the following:
   (i) A person born between the years of 1945 and 1965.
   (ii) A current or former user of an injection drug.
   (iii) A recipient of a blood transfusion, blood product, or organ
transplant before 1992.
   (iv) A recipient of a blood clotting product before 1987.
   (v) An individual who has liver disease or has had abnormal liver
test results.
   (vi) A hemodialysis patient.
   (vii) A health care worker who may be exposed to needle sticks.
   (viii) An individual who is infected with human immunodeficiency
virus (HIV).
   (f) This section does not apply to an individual receiving health
care from a health care practitioner in a hospital or emergency room
setting.  
  SECTION 1.    Section 38000 of the Health and
Safety Code is amended to read:
   38000.  The Legislature states its intent with respect to direct
service contracts of the departments within the California Health and
Human Services Agency as follows:
   (a)  The contract approval process should take no longer than 30
days from the time the administrative agency generating the contract
has approved its provisions.
   (b)  Payment for services rendered shall take no longer than 30
days after an invoice has been approved by the responsible
department.
   (c)  If contract approval or payment or both are delayed, the
state shall notify community based agencies within 15 days with
instructions to either defer or interrupt services to be contracted.
If the state requests an agency to continue providing services,
conditions shall be mutually agreed upon in advance for amortization
of particular additional costs to the agency involved.