BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  SB 1311
                                                                  Page  1

          Date of Hearing:   July 2, 2014 

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mike Gatto, Chair

                     SB 1311 (Hill) - As Amended:  June 26, 2014 

          Policy Committee:                             HealthVote:17-0

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              No

           SUMMARY  

          This bill requires general acute care hospitals to implement an  
          antimicrobial stewardship policy that meets specified criteria,  
          and to report to the Legislature by January 1, 2018 on hospital  
          compliance with the requirement.

           FISCAL EFFECT  

          1)One-time costs of approximately $50,000, likely in 2017, to  
            aggregate data collected through enforcement and prepare a  
            report on compliance (Licensing and Certification Fund).  

          2)Minor and absorbable ongoing costs to the Department of Public  
            Health to oversee compliance among licensed hospitals  
            (Licensing and Certification Fund). 

           COMMENTS  

           1)Purpose  . This bill is intended to strengthen requirements  
            related to antimicrobial stewardship in hospitals. The author  
            states although current law requires hospitals to develop a  
            process for evaluating the judicious use of antibiotics, only  
            half of all hospitals have done so.  

           2)Background  .  Antibiotics are credited with significantly  
            reducing morbidity and mortality associated with bacterial  
            infections.  Unfortunately, widespread use of antibiotics has  
            led to antibiotic resistance, which, according to the World  
            Health Organization (WHO), is an increasingly serious threat  
            to global public health. The WHO indicates evolution of  
            drug-resistant strains is a natural phenomenon, but the use  
            and misuse of antibiotics accelerates their emergence.  








                                                                  SB 1311
                                                                  Page  2

            Drug-resistant infections are often difficult to treat and can  
            be deadly. The Centers for Disease Control and Prevention  
            (CDC) indicates at least 2 million people become infected with  
            resistant bacteria nationwide, and at least 23,000 people die  
            as a direct result of these infections, each year.

            Hospital antibiotic stewardship programs are designed to  
            promote and measure the appropriate use of antibiotics in a  
            hospital setting, and are recommended by WHO, CDC, and DPH.   
            DPH provides technical assistance to hospitals and other  
            facilities to implement local antimicrobial stewardship  
            programs as part of their Healthcare Acquired Infections  
            program, and collects data on these programs that are  
            submitted on a voluntary basis. 
                
            3)Related Legislation  . 
             a)   AB 1437 (Mullin) bans the sale, in California, of a  
               livestock or poultry product if the animal was given a  
               medically important antimicrobial for nontherapeutic use.   
               AB 1437 did not move out of the Assembly Agriculture  
               Committee.

             b)   SB 835 (Hill), also being heard today in this committee,  
               codifies the US Food and Drug Administration (FDA) Guidance  
               for Industry #213, requiring the Secretary (Secretary) of  
               the California Department of Food and Agriculture (CDFA) to  
               refuse to register a drug administered in the feed or  
               drinking water of food animals if that drug is a medically  
               important antimicrobial drug.

           Analysis Prepared by :    Lisa Murawski / APPR. / (916) 319-2081