BILL ANALYSIS Ó AB 2589 Page 1 Date of Hearing: April 19, 2016 ASSEMBLY COMMITTEE ON HEALTH Jim Wood, Chair AB 2589 (Gomez) - As Amended April 5, 2016 SUBJECT: Lactation services and equipment. SUMMARY: Requires the California Department of Public Health (DPH) to coordinate with the Department of Health Care Services (DHCS) to streamline enrollment into the California Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) through the California Health Benefit Exchange (the Exchange); and, requires DPH and DHCS to coordinate on two stakeholder processes, first, to develop measures and outcomes for breastfeeding, and second, to develop and update minimum breast pump and accessory equipment standards. Specifically, this bill: 1)Requires DPH and DHCS to coordinate to develop processes, procedures and an electronic interface for eligibility-related information sharing to streamline enrollment into the WIC program as part of the application process for Medi-Cal and health plans offered through the Exchange. 2)Requires DPH and DHCS to coordinate through a stakeholder process that includes, but is not limited to representatives from health care providers, primary care clinics, health plans, state and local staff from the WIC program and the AB 2589 Page 2 Maternal, Child and Adolescent Health (MCHA) program, and representatives from organizations representing women, infants and children to do both of the following: a) With respect to prenatal care, develop measures and outcomes for breastfeeding that shall include, at a minimum, women's intention to breastfeed, including ethnic diversity; and, b) After birth and following discharge from the hospital or other birthing location, develop measures and outcomes for breastfeeding that include, at a minimum, initiation, duration, exclusivity, and ethnic disparities. 3)Requires DPH and DHCS, no later than January 1, 2018, and every five years thereafter, to coordinate through a stakeholder process to develop and update minimum breast pump and accessory equipment standards for the provision of appropriate and effective breast pumps and accessories. 4)Requires the stakeholder process described in 3) above, to include, but not be limited to representatives from health care providers, health plans, primary care clinics, lactation consultants and specialists, state and local staff from the WIC program, and representatives of manufacturers and distributors of breast pumps and accessories. EXISTING LAW: 1)Establishes DPH to protect and improve the health of communities through education, promotion of healthy lifestyles, and research for disease and injury prevention and requires DPH to include in its public service campaign the AB 2589 Page 3 promotion the benefits of mothers breast-feeding their infants. 2)Requires DPH, to the extent that non-United States Department of Agriculture (USDA) federal funds and private grants or donations are made available, to, no later than July 1, 2008 begin expansion of the breast-feeding peer counseling program at local WIC sites. 3)Requires all general acute care hospitals, and special hospitals providing maternity care to make available a breast feeding consultant, or provide information to the mother on where to receive breast feeding information. 4)Requires all general acute care hospitals and special hospitals that have a perinatal unit to have an infant-feeding policy that promotes breastfeeding according to the World Health Organization's (WHO) Baby-Friendly Hospital Initiative or the DPH Model Hospital Policy Recommendations. 5)Establishes the Exchange (also referred to as Covered California) within state government, as an independent public entity not affiliated with an agency or department, and requires the Exchange to compare and make available through selective contracting health insurance for individual and small business purchasers as authorized under the Patient Protection and Affordable Care Act (ACA). Specifies the powers and duties of the board governing the Exchange, and requires the board to facilitate the purchase of qualified health plans though the Exchange by qualified individuals and small employers. AB 2589 Page 4 6)Requires the board to determine the criteria and process for eligibility, enrollment, and disenrollment of enrollees and potential enrollees in the Exchange and coordinate that process with state and local government entities administering other specified health care coverage programs. 7)Establishes the Medi-Cal program, which is administered by DHCS, under which qualified low-income persons receive health care benefits and, in part, governed and funded by federal Medicaid program provisions. Authorizes DHCS to extend continuous Medi-Cal eligibility to children 19 years of age and younger. EXISTING FEDERAL LAW under the ACA requires health plans and health insurers to provide coverage for breast pumps at no cost-sharing, as a preventative service. FISCAL EFFECT: This bill has not been analyzed by a fiscal committee. COMMENTS: 1)PURPOSE OF THIS BILL. According to the author, evidence indicates that early infant feeding practices can affect later growth and development in children, while significantly reducing their risk for infections and chronic diseases such as diabetes, asthma and obesity. The author notes that the United States Surgeon General, and all the major health organizations, including the American Academy of Pediatrics (AAP) and WHO recommend exclusive breastfeeding for most babies, unless specifically contraindicated, for the first six months and continued breastfeeding with the addition of AB 2589 Page 5 appropriate foods up to at least one year of age. The author contends that California has supported breastfeeding policies that increase rates among low-income women and must continue efforts, and study and collect data relating to breastfeeding exclusivity, initiation, and duration not only in a hospital setting, but at home. The author also states that California has recognized that low-income and minority women have lower rates when it comes to breastfeeding duration, initiation, and exclusivity. The author concludes, in order to help to achieve health equity for new mothers and their children, we must expand data collection outside our hospital settings. 2)BACKGROUND. a) Breastfeeding rates and recommendations. California in-hospital infant feeding practices are monitored using data collected by the Newborn Screening (NBS) Program within DPH. All non-military hospitals providing maternity services are required to complete the Newborn Screening Test Form. In addition to tracking genetic diseases and metabolic disorders, the NBS Program gathers data on all infant feedings for about 24 to 48 hours since birth. The MCAH Program staff analyze this data and publish breastfeeding rates by hospital, county and the State. In addition to the Newborn Screening data, all hospitals with 300 or more births are required to report on the Perinatal Core Measure Set, which includes a measure on exclusive breast milk feeding. According to the federal Centers for Disease Control and Prevention, breastfeeding rates continue to rise in the United States. In 2011, 79% of newborn infants started to breastfeed. Yet breastfeeding does not continue for as long as recommended. Of infants born in 2011, 49% were breastfeeding at 6 months and 27% at 12 months. In the policy statement, "Breastfeeding and the Use of Human Milk," published in the March 2012 issue of Pediatrics, the AB 2589 Page 6 AAP reaffirms its recommendation of exclusive breastfeeding for about the first six months of a baby's life, followed by breastfeeding in combination with the introduction of complementary foods until at least 12 months of age, and continuation of breastfeeding for as long as mutually desired by mother and baby. According to the National Institute of Health, breastfeeding carries many health benefits for infants and mothers, as well as potential economic and environmental benefits for communities. Among the known health benefits are nutritionally balanced meals, some protection against common childhood infections, and better survival during the first year of life, including a lower risk of Sudden Infant Death Syndrome. Other studies suggest that breastfeeding may reduce the risk for certain allergic diseases, asthma, obesity, and type 2 diabetes. It also may help improve an infant's cognitive development. b) WIC. WIC provides Federal grants to states for supplemental foods, health care referrals, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk. WIC requires breast pumps provided to participants to meet equipment specifications to effectively support breastfeeding. c) State breastfeeding support and programs. DPH's MCAH Division and the Genetic Disease Screening Program (GDSP) support DPH efforts to promote breastfeeding. MCAH programs (Black Infant Health Program, Adolescent Family Life Program, California Home Visiting Program, and Local MCAH) discuss the benefits of breastfeeding; the importance of partner and family support; and connect women to peer support groups and professional lactation consultants as needed. The Comprehensive Perinatal Services Program provides technical assistance on breastfeeding to health care providers and their staff. The Regional Perinatal AB 2589 Page 7 Programs of California assist hospital with quality improvement efforts to advance the Model Hospital Policies or Baby Friendly Hospital standards. Some Local MCAH Programs provide professional breastfeeding support directly or through community resources, and promote development of additional lactation professionals in the community. MCAH oversees the Maternal and Infant Health Assessment (MIHA) Survey that tracks breastfeeding measures and outcomes. GDSP collects in-hospital exclusive breastfeeding initiation and percent of breastfed infants receiving formula supplementation while in the hospital. DPH reports "Healthy People 2020" and "California Wellness Plan" promote the increase of California breast feeding rates. DPH's Office of Health Equity's "Portrait of Promise: The California Statewide Plan to Promote Health and Mental Health Equity" cites the benefits of breastfeeding and positive health outcomes. DPH's "Let's Get Healthy California" includes priorities for healthy beginnings and well-being starting with infancy. DPH offers three types of breast pumps to participants: multi-user electric, personal-use electric, and manual. Under the ACA, private insurers must cover the cost of breast pumps; however, it is up to the plan to decide whether the pump is manual or electric. d) Current nutrition program linkages. When a family or individual is applying for Medi-Cal or Covered California, the application includes information that identifies the person as eligible for CalFresh. The system is not completely automated, because the CalFresh application is not auto-populated, but an on-line application is made available and the applicant can fill that out and the AB 2589 Page 8 county is notified of the potential CalFresh participant. Currently there is no electronic linkage for WIC eligibility in Medi-Cal or Covered California enrollment. The applications provide a statewide toll-free number for mothers to call, where they would receive another number or numbers for a local WIC agency. The mother would then call that number to find out if they are eligible. According to the proponents of this bill, CalFresh is working to streamline related data sharing, integration and bridging between programs, including Medi-Cal. WIC and CalFresh are working on data sharing and analysis, particularly related to the participation of children. 3)SUPPORT. The California WIC Association (WIC Association) is a cosponsor of this bill and states that this bill will help to ensure that California families and young children are utilizing the programs that will provide them the most help, and support their own health and nutrition goals as well as the public health and nutrition goals of California. The WIC Association also notes that Breastfeeding has been shown to reduce the incidence of obesity while also contributing to numerous other positive health outcomes for mother and child, and California needs to develop and agree upon measures for breastfeeding in order to evaluate how best to support California women in meeting their infant feeding goals. The California Primary Care Association (CPCA) is a co-sponsor and states this bill will empower California moms to breastfeed their babies by streamlining the enrollment process for the WIC Program, crate new metrics to track breastfeeding AB 2589 Page 9 rates and health outcomes, and require the state to regularly review breast pump equipment standards and reimbursement rates. CPCA concludes, with this simple and comprehensive bill we can support strategies to improve breastfeeding initiation, duration, and exclusivity. 4)PREVIOUS LEGISLATION. a) SB 402 (De Leon), Chapter 666, Statutes of 2013, requires all general acute care hospitals and special hospitals, that have a perinatal unit by January 1, 2025, to adopt the "Ten Steps to Successful Breastfeeding," as adopted by Baby-Friendly USA, per the Baby-Friendly Hospital Initiative (BFHI), or an alternate process adopted by a health care service plan that includes evidenced-based policies and practices and targeted outcomes, or the Model Hospital Policy Recommendations, as defined. b) SB 502 (De Leon and Pavley), Chapter 511, Statutes of 2011, establishes the Hospital Infant Feeding Act requires all general acute care and special hospitals that have a perinatal unit to have an infant-feeding policy, as specified, to clearly post the policy and routinely communicate the policy to perinatal unit staff. 5)SUGGESTED AMENDMENTS. As currently drafted this bill requires DPH and DHCS to establish a stakeholder process to update breast pump standards. However, the ACA has existing minimum requirements for durable medical equipment, which include breast pumps that must be covered by health insurance. The Committee may wish to remove this requirement, since it appears unnecessary and instead amend the bill as follows: 123363. (a) The State Department of Public Health shall coordinate with the State Department of Health Care Services, through a stakeholder engagement process that shall include, but not be limited to, representatives AB 2589 Page 10 from health care providers, primary care clinics, and health plans, state and local staff from the California Special Supplemental Nutrition Program for Women, Infants, and Children (WIC Program) and the Maternal, Child and Adolescent Health program, and representatives from organizations representing women, infants, and children, to doboth ofthe following: (1)Beginning prenatally and continuing through the postpartum period and at least until the infant reaches one year of age, develop measures and outcomes for breastfeeding rates that include, at a minimum, women's intention to breastfeed, breastfeeding initiation rates, exclusivity and duration, and that identify ethnic disparities and sociodemographic differences. The stakeholder process shall take no longer than six months, and the recommendations shall be posted on the departments' Websites by January 1, 2018.(1) With respect to prenatal care, develop measures and outcomes for breastfeeding that shall include, at a minimum, women's intention to breastfeed, including ethnic diversity. (2) After birth and following discharge from the hospital or other birthing location, develop measures and outcomes for breastfeeding that shall include, at a minimum, initiation, duration, exclusivity, and ethnic disparities. (b) No later than January 1, 2018, and every five years thereafter, the State Department of Public Health shall coordinate with the State Department of Health Care Services, through a stakeholder engagement process that shall include, but not be limited to, representatives AB 2589 Page 11 from health care providers, health plans, and primary care clinics, lactation consultants and specialists, state and local staff from the WIC Program, and representatives of manufacturers and distributors of breast pumps and accessories, to develop and update minimum breast pump and accessory equipment standards for the provision of appropriate and effective breast pumps and accessories, taking into account the current reimbursement rates for durable medical equipment related to breastfeeding, including any potential need to modify the reimbursement rates.REGISTERED SUPPORT / OPPOSITION: Support California WIC Association (co-sponsor) California Primary Care Association (co-sponsor) AltaMed Health Services Corporation Ampla Health Association of California Healthcare Districts BreastfeedLA California Academy of Nutrition and Dietetics California Advance Lactation Institute California Breastfeeding Coalition California Food Policy Advocates California Nurse-Midwives Association Children Now Clinica Sierra Vista Community Clinic Association of Los Angeles County Community Clinic Consortium County Health Executives Association of California Family Health Centers of San Diego Fresno EOC WIC Program AB 2589 Page 12 Harmony Health Health Alliance of Northern California Health and Life Organization, Inc. Henry Mayo Newhall Hospital Kheir Center L.A. Trust for Children's Health Marin Community Clinics Maternal and Child Health Access Mountain Valleys Health Centers National Health Law Program North Coast Clinics Network North County Health Services North East Medical Services Northeast Valley Health Corporation Omni Family Health Open Door Community Health Centers Prevention Institute Ravenswood Family Health Center Redwood Community Health Coalition San Ysidro Health Center Solano Public Health WIC Program South of Market Health Center Strategic Alliance for Healthy Food and Activity Environments The Santa Cruz County Breastfeeding Coalition Tiburcio Vasquez Health Center, Inc. Tulare Reginal Medical Center United States Lactation Consultant Association Valley Community Healthcare Watts Healthcare WIC Program Westside Family Health Center White Memorial Community Health Center One Individual Opposition None on file. AB 2589 Page 13 Analysis Prepared by:Lara Flynn / HEALTH / (916) 319-2097