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