Amended in Assembly April 30, 2015

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, and to add begin insert and repeal end insert Section 122407 begin delete to, end delete begin insert of, 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. The act sets forth findings, declarations, and the intent of the Legislature with regard to these 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.

This bill begin delete would end delete begin insert would, until January 1, 2023, end 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.

Vote: majority. Appropriation: no. Fiscal committee: 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:

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

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

(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.

(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) 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.

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

(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.

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

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

(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.

(11) In June 2013, the United States Preventive Services Task
Force recommended that all begin delete high risk end delete begin insert high-risk end insert 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:

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

(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) 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 begin delete Preventative end delete
begin insert Preventive end insert 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 begin delete state law. end delete begin insert Section 120917. end insert

(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.

begin insert

(g) This section shall remain in effect only until January 1, 2023,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2023, deletes or extends that date.

end insert