Amended in Assembly March 26, 2015

California Legislature—2015–16 Regular Session

Assembly Bill No. 383

Introduced by Assembly Member Gipson

February 18, 2015

An act to amend Section 122405 of begin insert , and to add Section 122407 to, end insert the Health and Safety Code, relating to public health.

LEGISLATIVE COUNSEL’S DIGEST

AB 383, as amended, Gipson. Public health: hepatitis C.

Existing law, the Hepatitis C Education, Screening, and Treatment Act, sets forth provisions pertaining to education and outreach related to hepatitis C, as specified. begin delete Existing law end delete begin insert The act end insert sets forth begin insert findings, declarations, and end insert the intent of the Legislature with regard to these begin delete provisions. end delete begin insert provisions, and requires the Director of Public Health to, among other things, 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. end insert

This bill would begin delete make technical, nonsubstantive changes to these provisions. end delete begin insert require a primary care clinic to offer each patient who receives primary care services in the clinic, and conduct upon agreement, a hepatitis C screening or diagnostic test, as specified, and would specify the manner in which the results of that test are provided. These requirements would not apply if the patient has taken a hepatitis C screening or diagnostic test, if the patient has been offered a hepatitis C screening or diagnostic test and declined the test within the primary care clinic within the previous 12 months, or to an individual receiving primary care services in a hospital or emergency room setting. The bill would add additional findings and declarations, including that hepatitis C is the most common bloodborne pathogen in the United States, and is a leading cause of complications from chronic liver disease. end insert

Vote: majority. Appropriation: no. Fiscal committee:  begin delete no end delete begin insert yes end insert . 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.  

begin insert (a) end insert begin insert   end insert The Legislature hereby finds and declares begin insert all of end insert
the following:

begin delete

(a)

end delete

begin insert (1) end insert  Hepatitis C is classified as a silent killer, where no
recognizable signs or symptoms occur until severe liver damage
has occurred.

begin delete

(b)

end delete

begin insert (2) end insert  Hepatitis C has been characterized by the World Health
Organization as a disease of primary concern to humanity.

begin delete

(c)

end delete

begin insert (3) end insert  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.

begin delete

(d)

end delete

begin insert (4) end insert  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.

begin insert

(5) Studies indicate that military veterans, particularly Vietnam
War veterans, are disproportionately impacted by hepatitis C
compared to other veterans and nonveterans. It is estimated that
Vietnam War veterans are 5 to 10 times more likely to be infected
with hepatitis C than other Americans.

end insert begin insert

(6) Hepatitis C is the most common bloodborne pathogen in the
United States, and is a leading cause of complications from chronic
liver disease.

end insert begin insert

(7) 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.

end insert begin insert

(8) Hepatitis C infections are most common among individuals
born between 1945 and 1965, commonly known as the baby
boomers.

end insert begin insert

(9) Hepatitis C infections have reached epidemic levels,
especially in underrepresented communities.

end insert begin insert

(10) 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.

end insert begin insert

(11) 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.

end insert begin delete

(e)  It is the intent of the Legislature to study

end delete begin insert

(b) Accordingly, it is the intent of the Legislature to do both of
the following:

end insert

begin insert (1) end insert begin insert   end insert begin insert Study end insert the adequacy of the health care delivery system as it
pertains to hepatitis C.

begin delete

(f) It is the intent of the Legislature to urge

end delete

begin insert (2) end insert begin insert   end insert begin insert Urge end insert the department to make funds available to
community-based nonprofit organizations for education and
outreach with respect to the hepatitis C virus.

begin insert

begin insert SEC. 2. end insert   

end insert

begin insert Section 122407 is added to the end insert begin insert Health and Safety Code end insert begin insert ,
to read: end insert

begin insert

begin insert 122407. end insert   

(a) A primary care clinic shall offer each patient who
receives primary care services in the clinic a hepatitis C screening
or diagnostic test, consistent with the United States Preventative
Services Task Force recommendations for screening and any
federal Centers for Disease Control and Prevention algorithms.
The screening or diagnostic test shall be conducted upon patient
agreement. This subdivision shall not apply if the patient has taken
a hepatitis C screening or diagnostic test, or if the patient has been
offered a hepatitis C screening or diagnostic test and declined the
test within the primary care clinic within the previous 12 months.

(b) Hepatitis C screening or diagnostic testing of minors 12
years of age or older shall comply with Section 6926 of the Family
Code.

(c) This section shall not prohibit a primary care clinic from
charging a patient to cover the cost of the hepatitis C screening
or diagnostic test. The primary care clinic shall be deemed to have
complied with this section if a hepatitis C screening or diagnostic
test is offered.

(d) A primary care clinic shall attempt to provide test results
to the patient before he or she leaves the facility. If that is not
possible, the facility may inform the patient who tests nonreactive
or negative for the hepatitis C virus by letter or by telephone, and
shall inform a patient with a reactive or positive test result in a
manner consistent with state law.

(e) As used in this section, the following terms shall have the
following meanings:

(1) “Primary care clinic” means a clinic as defined in
subdivision (a) of Section 1204 or subdivision (g), (h), or (j) of
Section 1206.

(2) “Hepatitis C diagnostic test” means any laboratory test 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.

(f) This section does not apply to an individual receiving primary
care services in a hospital or emergency room setting.

end insert