BILL ANALYSIS                                                                                                                                                                                                    Ó




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          |SENATE RULES COMMITTEE            |                       AB 1795|
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                                   THIRD READING 


          Bill No:  AB 1795
          Author:   Atkins (D), et al.
          Amended:  8/24/16 in Senate
          Vote:     21 

           SENATE HEALTH COMMITTEE:  9-0, 6/15/16
           AYES:  Hernandez, Nguyen, Hall, Mitchell, Monning, Nielsen,  
            Pan, Roth, Wolk

           SENATE APPROPRIATIONS COMMITTEE:  5-0, 8/11/16
           AYES: Lara, Beall, Hill, McGuire, Mendoza
           NO VOTE RECORDED: Bates, Nielsen

           ASSEMBLY FLOOR:  77-1, 6/2/16 - See last page for vote

           SUBJECT:   Health care programs:  cancer


          SOURCE:    Susan G. Komen
          
          DIGEST:  This bill makes changes to the Breast and Cervical  
          Cancer Early Detection Program within the Department of Health  
          Care Services regarding eligibility for screenings, as  
          specified.

          Senate Floor Amendments of 8/24/16 clarify that an individual  
          who is diagnosed with a reoccurrence of cancer, as specified, is  
          required to be eligible for an additional period of treatment,  
          as long as the individual meets all other applicable eligibility  
          requirements, and the respective treatment duration limits  
          apply.
          
          ANALYSIS: 










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          Existing law:


          1)Establishes the Medi-Cal program, administered by the  
            Department of Health Care Services (DHCS), under which  
            qualified low-income individuals receive health care services.  
             

          2)Establishes the Breast and Cervical Cancer Early Detection  
            Program, administered by DHCS through the Every Woman Counts  
            (EWC) program, to provide breast and cervical cancer screening  
            services under the Centers for Disease Control and Prevention  
            (CDC) grant at the level of funding budgeted from state and  
            other resources during the fiscal year in which the  
            Legislature has appropriated funds for this purpose. 

          3)Requires a provider or entity that participates in the federal  
            National Breast and Cervical Cancer Early Detection Program  
            (NBCCEDP) to provide screening services to an individual only  
            if the individual's family income has been determined not to  
            exceed 200% of the federal poverty level.

          4)Establishes the Breast and Cervical Cancer Treatment Program  
            (BCCTP) to provide coverage for breast and cervical cancer  
            treatment and services related to cancer diagnosis. Limits the  
            treatment coverage for breast cancer to a period not to exceed  
            18 months and for cervical cancer not to exceed 24 months.  
            Deems an individual's eligibility as having concluded after  
            the respective limits for each cancer condition have been  
            reached.

          This bill:

          1)Requires individuals to be eligible for breast cancer  
            screening and diagnostic services through the EWC program if  
            they meet eligibility requirements and a) are of any age and  
            "symptomatic," as defined, and b) are within the age range for  
            routine breast cancer screening, as recommended by the United  
            States Preventive Services Task Force, subject to any federal  
            action relating to breast cancer screening that overrides  
            those recommendations. 









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          2)Defines "symptomatic" as an individual presenting with an  
            abnormality or change in the look or feel of the breast, as  
            specified.

          3)Requires an individual who is diagnosed with a reoccurrence of  
            breast or cervical cancer to be eligible for an additional  
            period of treatment, as long as the individual meets all other  
            applicable eligibility requirements, and the treatment  
            duration limits specified in 4) above apply.

          Background 

          In 1990, the CDC created the NBCCEDP through Public Law 101-354.  
           This law authorized CDC to grant funds to states to screen a  
          reasonable number of low income, uninsured women for breast and  
          cervical cancers, provide referrals for follow-up and medical  
          treatment for women with abnormal test results, develop and  
          disseminate information for preventing breast and cervical  
          cancers, improve the training of health professionals in  
          preventing these cancers, and monitor the quality of screening  
          procedures. The mission of the EWC program is to save lives by  
          preventing and reducing the devastating effects of cancer  
          through early detection and diagnostic services. EWC provides  
          free clinical breast exams, mammograms, pelvic exams, and Pap  
          tests to California's low income uninsured and underserved  
          women. These screening services facilitate early detection that  
          may prevent untimely cancer deaths. Each year, EWC provides care  
          for approximately 300,000 individuals. According to information  
          available on DHCS's Web site, EWC is funded, in part, by $.01 of  
          the $.02 tax on each pack of cigarettes sold in California that  
          is allocated to the Breast Cancer Fund (BCF).

          The state's Breast and Cervical Cancer Treatment Program (BCCTP)  
          provides coverage for breast and cervical cancer treatment and  
          services related to cancer diagnosis. BCCTP provides treatment  
          coverage for approximately 9,000 individuals each year, through  
          both federal and state funding. Currently, the state-funded  
          BCCTP is not aligned with the federally funded BCCTP, causing  
          gaps in service and treatment for women diagnosed and treated  
          through the state-funded program. Under California's BCCTP,  
          treatment coverage is limited to 18 months for breast cancer and  
          24 months for cervical cancer. Federal funding provides coverage  








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          for the duration of treatment. State funding also does not allow  
          coverage to a woman who is re-diagnosed with the same cancer at  
          the original cancer site while the federally funded program  
          does.  


          


          Comments
          
          1)Author's statement.  According to the author, this bill will  
            help ensure that women have timely access to life-saving  
            services to detect and treat cancer early. This bill affects  
            low-income women in California who are uninsured or  
            underinsured, and it allows them to complete necessary  
            treatment for breast and cervical cancer without an arbitrary  
            deadline to cut-off that critical treatment; it requires that  
            those in remission for breast and cervical cancer who are  
            later re-diagnosed with the same cancer not be turned away for  
            treatment; and it permits those individuals who are  
            symptomatic for breast cancer to receive necessary breast  
            cancer screening services.
            
          

          Related/Prior Legislation
          
          AB 49 (Buchannan, Chapter 351, Statutes of 2014) established the  
          breast cancer awareness special interest license plate program  
          to generate funds to raise awareness of early breast cancer  
          screening. Requires the proceeds from the license plate sales to  
          be deposited in the Breast Cancer Control Account to fund EWC  
          programming.
             
          SB 1348 (Cedillo of 2008) would have required DPH to provide  
          breast cancer screening services to women who are 38 years of  
          age and older and who meet other eligibility standards for  
          breast cancer screening services under existing state and  
          federal law. SB 1248 was held under submission in the Senate  
          Appropriations Committee.









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          AB 478 (Friedman, Chapter 660, Statutes of 1993) established a  
          $.02 tax on each pack of cigarettes sold, with the revenue  
          deposited in the BCF and the proceeds to be divided equally  
          between the Breast Cancer Research Account and the Breast Cancer  
          Control Account.

          AB 2055 (Freidman, Chapter 661, Statutes of 1993) established  
          the Breast Cancer Control Account for purposes of breast cancer  
          research, detection services, and education. Modified the  
          allocation of tobacco tax funds so that 50% of the funds are  
          devoted to research and 50% for early detection services for  
          uninsured and underinsured women.


          FISCAL EFFECT:   Appropriation:    No          Fiscal  
          Com.:YesLocal:   No


          According to the Senate Appropriations Committee:

          1)Likely one-time administrative costs of $150,000 to $300,000  
            to update regulations and make necessary changes to billing  
            systems (General Fund). DHCS will likely need to make changes  
            to existing program regulations and systems for processing  
            claims (for example, no longer denying claims due to the  
            length of treatment time).

          2)Ongoing costs of about $200,000 per year from providing  
            eligibility for the Breast and Cervical Treatment Program for  
            reoccurring cases of cancer (General Fund). In recent years,  
            about 20 women per year were denied coverage because the  
            cancer was a reoccurrence of a previously treated cancer. 

          3)Potential increased costs, up to $2 million per year, to  
            increase eligibility for cancer screening services in the EWC  
            program to symptomatic women under 40 years of age  
            (Proposition 99 funds, federal funds, General Fund). Current  
            law does not limit participation in the EWC program based on  
            age. It is not clear whether symptomatic women who are under  
            40 years of age are currently being denied services. To the  
            extent that they are, and this bill eliminates that  
            limitation, there would be costs to the state. Based on the  








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            reported incidence of cancer in women under 40 years of age,  
            staff estimates those potential additional costs being up to  
            $2 million per year. The EWC program is currently funded with  
            Proposition 99 Tobacco Tax funds and federal funds. To the  
            extent that there are additional costs and those funds are not  
            sufficient to pay for increased costs, there would be pressure  
            to appropriate General Fund for this purpose. (Because the EWC  
            program is not an entitlement, the state would not be  
            obligated to appropriate additional funding.)

          SUPPORT:  (Verified  8/24/16) 

          Susan G. Komen (source)
          American Cancer Society Cancer Action Network
          American Congress of Obstetricians and Gynecologists, District  
          IX (California)
          American Federation of State, County and Municipal Employees
          Association of California Healthcare Districts
          Barbells for Boobs
          Black Women for Wellness
          Brown Temple Christian Methodist Episcopal Church
          California Academy of PAs
          California Association for Nurse Practitioners
          CaliforniaHealth+ Advocates
          California Health Collaborative
          California Life Sciences Association
          California National Organization for Women
          California Nurses Association
          California Radiological Society 
          California Society of Plastic Surgeons
          Cambodian Family Community Center
          Cancer Support Community Benjamin Center
          Cancer Support Community San Francisco Bay Area
          Carrie's TOUCH
          Central City Community Health Center
          County Health Executives Association of California
          Doctors for America
          Health Access
          Health Center Partners of Southern California
          Hope Wellness Center
          Johnson Chapel African Methodist Episcopal Church
          Junior Leagues of California








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          MANA de San Diego
          North Orange County Regional Health Foundation
          Orange County Women's Health Project
          Planned Parenthood Affiliates of California
          Planned Parenthood Orange and San Bernardino Counties
          Sacramento Community Cancer Coalition
          Samoan National Nurses Association
          Serve the People Community Health Center
          Shanti
          St. Mary Medical Center Foundation
          Numerous Individuals


          OPPOSITION:   (Verified8/24/16)




          California Department of Finance




          ARGUMENTS IN SUPPORT:      Supporters of this bill, largely  
          health providers, advocates, and numerous individuals, argue  
          that the state-funded BCCT program is not aligned with the  
          federally funded program, causing gaps in service and treatment  
          for women diagnosed and treated through the EWC program.  
          Supporters also argue that while the Affordable Care Act (ACA)  
          has expanded coverage and reduced California's rate of  
          uninsured, up to 3.4 million Californians remain uninsured, and  
          limited benefit packages, such at the EWC and BCCT programs,  
          continue to be an important resource for that population.  
          Supporters state that this bill will help ensure that women have  
          timely access to receive the necessary services to detect and  
          treatment their cancers early.



          ARGUMENTS IN OPPOSITION:  The California Department of Finance  
          (DOF) argues that this bill creates an ongoing General Fund  
          cost, and the size of the population that will benefit from this  








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          expansion is indeterminate. DOF states that with the  
          implementation of the ACA and the optional expansion of  
          Medi-Cal, individuals have greater access to preventive cancer  
          screenings and treatment. 
          

          ASSEMBLY FLOOR:  77-1, 6/2/16
          AYES:  Achadjian, Alejo, Travis Allen, Arambula, Atkins, Baker,  
            Bloom, Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos,  
            Chang, Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh,  
            Dahle, Daly, Dodd, Eggman, Frazier, Gallagher, Cristina  
            Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez,  
            Gordon, Gray, Grove, Hadley, Roger Hernández, Holden, Irwin,  
            Jones, Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low,  
            Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin,  
            Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Quirk,  
            Ridley-Thomas, Rodriguez, Salas, Santiago, Steinorth, Mark  
            Stone, Thurmond, Ting, Wagner, Waldron, Weber, Wilk, Williams,  
            Wood, Rendon
          NOES:  Harper
          NO VOTE RECORDED:  Bigelow, Beth Gaines

          Prepared by:Reyes Diaz / HEALTH / (916) 651-4111
          8/25/16 17:23:52


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