BILL ANALYSIS Ó
AB 508
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ASSEMBLY THIRD READING
AB
508 (Cristina Garcia)
As Amended January 25, 2016
Majority vote
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|Committee |Votes|Ayes |Noes |
| | | | |
| | | | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Health |19-0 |Bonta, Maienschein, | |
| | |Bonilla, Burke, | |
| | |Chávez, Chiu, Gomez, | |
| | |Gonzalez, Roger | |
| | |Hernández, Lackey, | |
| | |Nazarian, Patterson, | |
| | |Ridley-Thomas, | |
| | |Rodriguez, Santiago, | |
| | |Steinorth, Thurmond, | |
| | |Waldron, Wood | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Appropriations |17-0 |Gomez, Bigelow, | |
| | |Bloom, Bonilla, | |
| | |Bonta, Calderon, | |
| | |Chang, Daly, Eggman, | |
| | |Gallagher, Eduardo | |
| | |Garcia, Holden, | |
| | |Jones, Quirk, Wagner, | |
| | |Weber, Wood | |
AB 508
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SUMMARY: Requires the California Department of Public Health
(DPH) to prepare and publish an annual report regarding the
frequencies of maternal mortality and severe maternal morbidity.
Specifically, this bill:
1)Requires DPH to publish annual reports regarding all maternal
deaths which includes a case review of each death and an
analysis of patient demographics, contributing factors, and
underlying causes.
2)Requires the report to also include an analysis of all cases
of severe maternal morbidity, for which data collection is
practicable, which includes analysis of patient demographics
and underlying causes.
3)Requires DPH, in order to develop accurate reports in a cost
efficient manner, to consider existing resources including
opportunities for partnership with entities engaged in
maternal care quality measurement or improvement.
EXISTING LAW: Establishes DPH to optimize the health and
well-being of the people in California and authorizes DPH to
study births, deaths, marriages, and divorces, in order to
provide a continuing analysis of trends to state agencies and
the Legislature.
FISCAL EFFECT: According to the Assembly Appropriations
Committee:
1)In absence of another fund source, there would be General Fund
(GF) costs to the Maternal, Child, and Adolescent Health
(MCAH) division of DPH to complete the annual study, likely in
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hundreds of thousands of dollars annually. The robustness and
cost of implementation would depend on administrative and
legislative decisions about resource availability for this
purpose.
2)DPH may also incur, on a one-time basis, some level of
infrastructure capacity enhancement in order to process and
store data. For example, new databases, automated processes
or new computer hardware may be required. The level of
one-time costs would increase commensurate with the complexity
of the effort. Higher one-time costs - for example, to
automate certain processes - could also potentially reduce
ongoing personnel costs, depending on the approach chosen.
Alternatively, costs may be avoided if existing resources
could be leveraged - for example, if it was possible to
partner with a nonprofit entity that currently has a data
collection infrastructure.
3)Depending on the availability and approval of federal Title V
funds for this purpose, federal funds could potentially be
used instead of GF. Approximately $39 million in federal
Title V funds are available to California annually. Funding
decisions are based partially on a federally required needs
assessment, and these monies currently fund other maternal,
child, and adolescent health priorities, including $8 million
for state operations and $31 million for local assistance
annually.
COMMENTS: According to the author, Californians have given
birth to more than 500,000 babies each year over the last two
decades. The author notes the maternal death rate increased
from 1999 to 2010, with substantially higher rates for
African-American women, three to four times that of other
groups. Although due to concerted efforts, California has been
able to reverse the overall trend, unlike the rest of the United
States where the numbers continue to escalate.
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The author contends, through the data and reports that would be
provided by this bill, significant practice variations that
exist amongst the 260 obstetrical hospitals in California could
be exposed. And, once exposed these variations and disparities
could be eliminated by creating the tools for systemic change,
such as quality improvement programs developed and implemented
with demonstrated positive outcomes. The author also notes this
bill will build on existing infrastructure and private-public
partnerships, which are the likely cause of the dramatic
improvement in California's maternal outcomes, while the
situation for the rest of the United States continues to
decline.
The author concludes, not only will these efforts save the lives
and quality of life of many California women and their babies,
but health care dollars spent directly by the state for Medi-Cal
births (approximately half of the half million plus births
annually are paid for by Medi-Cal) should be reduced by fewer
complications.
According to a May 2015 MCAH bulletin, rates of maternal deaths
in California have dropped to a low three-year moving average of
6.9 deaths per 100,000 live births in 2011-13. However racial
and ethnic disparities persist. While mortality rates for
African-American women are the lowest they have been since 1999,
African-American women continue to have a three-to four-fold
higher risk of maternal mortality compared to white women.
Analysis Prepared by:
Lara Flynn / HEALTH / (916) 319-2097 FN:
0002575
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