BILL ANALYSIS Ó SENATE COMMITTEE ON APPROPRIATIONS Senator Ricardo Lara, Chair 2015 - 2016 Regular Session AB 1823 (Bonilla) - California Cancer Clinical Trials Program ----------------------------------------------------------------- | | | | | | ----------------------------------------------------------------- |--------------------------------+--------------------------------| | | | |Version: June 23, 2016 |Policy Vote: HEALTH 9 - 0, ED. | | | 9 - 0 | | | | |--------------------------------+--------------------------------| | | | |Urgency: No |Mandate: No | | | | |--------------------------------+--------------------------------| | | | |Hearing Date: August 8, 2016 |Consultant: Jillian Kissee | | | | ----------------------------------------------------------------- This bill meets the criteria for referral to the Suspense File. Bill Summary: This bill requests the University of California (UC) to establish a board to solicit and receive funds from federal or private sources for the California Cancer Clinical Program (Program) to provide grants to increase patient access to eligible cancer clinical trials in underserved or disadvantaged communities. Fiscal Impact: Start-up: Unknown one-time General Fund cost pressure for the UC to provide oversight and administration of the Program related to initial start-up activities. These costs are AB 1823 (Bonilla) Page 1 of ? required to be reimbursed by moneys donated to the fund (federal or private funds) prior to awarding grants, thereby offsetting the use of state funds. This bill also provides that if the UC determines at any time that the moneys in the fund are insufficient to establish or sustain the Program, it may be terminated. Unknown federal or private funds to administer the Program and award grants. In order to have a viable Program and offer services as described in this bill, UC indicates that funding would likely need to be in the millions. The scope of the Program, including the number of grantees, grant amounts, and administrative support to operate the Program would depend upon future donations. Background: Clinical trials are conducted by pharmaceutical companies seeking approval to market new drugs or existing drugs for additional conditions. In addition, the federal government provides financial support for clinical trials designed to study medical effectiveness or other characteristics of new or existing drugs. In recent years, concerns have been raised that participants in clinical trials tend not to reflect the larger society, which may bias the results of those trials. Research findings indicate that participants in clinical trials are more likely to be male and to be Caucasian than the general population. Clinical trials tend to be conducted at academic medical centers, often requiring patients to receive their care from a new doctor participating in the trial and often requiring substantial paperwork for patients to enroll. These factors and others have tended to limit participation in clinical trials. According to the author, barriers to participation include a lack of awareness, mistrust of research and the medical system, loss of income, and transportation and lodging costs. These ancillary costs of participation fall onto the clinical trial participant who may be unable to pay, and therefore unable to enroll in the trial. The intent of this bill is to assist patients in in paying for the ancillary costs associated with participation in these trials. AB 1823 (Bonilla) Page 2 of ? Proposed Law: This bill requests the UC to establish a board to solicit and receive funds from federal or private sources for the California Cancer Clinical Program (Program) to provide grants to increase patient access to eligible cancer clinical trials in underserved or disadvantaged communities. Key provisions of the bill include: Prior to establishing the Program, the UC may pursue any federal, state, or internal approvals, authorizations, or advice it deems necessary. The UC is authorized to use its own state funds for oversight and administration of the Program relating to the initial start-up costs only. Any resources provided by the UC to establish and operate the Program are required to be reimbursed from moneys donated in the fund prior to distribution of any grants. Only federal or private funds may be used to administer the Program. Funds may be provided to research institutions and hospitals that conduct eligible cancer clinical trials and nonprofit organizations, as specified. Funds may be used for a number of activities, including but not limited to, technical assistance tools to assist patients in identifying available clinical trials, and payment of ancillary costs related to participation in the clinical trial, such as airfare, lodging, child care, and meals. If the UC determines at any time that the moneys in the fund are insufficient to establish or sustain the Program, the UC may terminate the Program. Similarly, if the fund does not receive at least $500,000 by January 1, 2021 or if it is determined that the administrative support allocation allowed by this bill is insufficient, the Program administrator may elect to dissolve the program. Related Legislation: AB 1060 (Bonilla, 2015) proposed establishment of the Cancer Clinical Trials Foundation in the Health and Human Services Agency to administer a grant program substantively similar to that proposed by this bill. AB 1060 was vetoed by AB 1823 (Bonilla) Page 3 of ? the Governor whose message read, in part: "Numerous private organizations already perform this fundraising function. While I support eliminating barriers to take part in clinical trials, I am hesitant to place this new burden on the Health and Human Services Agency which is managing a huge expansion of our health care system." This bill establishes the program in the UC instead of within a state agency. Staff Comments: According to the UC, in order to operate this Program, it must first receive approval from the federal Office of Inspector General. Once approval is received, the UC can receive donations, of which at least $500,000 is required to begin providing grants to increase patient access to eligible cancer clinical trials. According to the UC, this bill outlines the structure of the program that would meet federal approval. The UC has already expended state funds for purposes of gaining permission from federal regulators and engaging in other administrative activities to establish the Program. This bill specifies that any resources provided by the UC to establish and operate the Program are required to be reimbursed from moneys donated in the fund prior to distribution of any grants. The ongoing operation of the Program is intended to be supported entirely by private and federal funds. -- END --