BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
AB 2179 (Gipson) - Hepatitis C testing
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|Version: June 22, 2016 |Policy Vote: B., P. & E.D. 9 - |
| | 0, HEALTH 8 - 0 |
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|Urgency: No |Mandate: No |
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|Hearing Date: August 1, 2016 |Consultant: Brendan McCarthy |
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This bill meets the criteria for referral to the Suspense File.
Bill
Summary: AB 2179 would authorize a hepatitis C counsellor who
meets specific requirements to perform certain hepatitis C
tests.
Fiscal
Impact:
One-time costs of about $150,000 for the development and
adoption of regulations by the Department of Health Care
Services (General Fund).
Ongoing costs of about $500,000 per year to develop training
curricula, train hepatitis C counselors, and provide technical
assistance to local health jurisdictions (General Fund).
Unknown additional costs to the Medi-Cal program to provide
treatment for newly diagnosed hepatitis C cases (General Fund
and federal funds). By making it easier for hepatitis C
counsellors working in certain situations to perform hepatitis
C tests, the bill is likely to result in additional testing
AB 2179 (Gipson) Page 1 of
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and additional diagnoses of hepatitis C. For those individuals
who are eligible for Medi-Cal, there would likely be increased
costs to provide treatment for newly diagnosed hepatitis C
cases. The costs to provide such treatment are unknown and
would depend on the number of new diagnoses amongst the
Medi-Cal population. New hepatitis C drugs on the market have
very high upfront costs (in the tens of thousands per course
of treatment), but are very effective at curing hepatitis C.
In the long-run, early diagnosis and treatment for some
patients, may actually save money. However, a very low
percentage of hepatitis C patients will ever receive a costly
liver transplant. Therefore, it is not known whether
widespread use of these very expensive drugs will actually
save money for the Medi-Cal program in the long-run.
Background: Under current federal and state law, clinical laboratory tests
are classified by their complexity. The level of clinical
complexity determines the qualifications needed to perform those
laboratory tests. The least complex laboratory tests are
referred to as "waived". Under current state law, HIV
counsellors are authorized to perform HIV, hepatitis C, or a
combined test that is categorized as "waived" provided that
specified conditions are met.
Proposed Law:
AB 2179 would authorize a hepatitis C counsellor who meets
specific requirements to perform certain hepatitis C tests.
Specific provisions of the bill would:
Require hepatitis C counselors to meet specified
criteria - such as having been trained by the Department of
Public Health, working in an HIV counselling and testing
site, or work at a site approved by a local health
jurisdiction to provide hepatitis C testing and
counselling;
Permit hepatitis C counsellors who meet one of the above
criteria to perform hepatitis C tests that are waived, if
certain conditions are met;
Impose other restrictions on hepatitis C counsellors
acting under the authority of the bill.
Staff
AB 2179 (Gipson) Page 2 of
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Comments: The bill does not specifically require the Department
of Public Health to develop a training curriculum or train
hepatitis C counsellors. However, the Department indicates that
it anticipates a demand for such training.
The supporters of the bill indicate that there is unmet demand
for hepatitis C screening, particularly in the rural areas of
the state where there is not the same level of HIV-related
public health infrastructure.
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