BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                    AB 2696


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          ASSEMBLY THIRD READING


          AB  
          2696 (Beth Gaines)


          As Amended  April 18, 2016


          Majority vote


           ------------------------------------------------------------------ 
          |Committee       |Votes|Ayes                  |Noes                |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |----------------+-----+----------------------+--------------------|
          |Health          |19-0 |Wood, Maienschein,    |                    |
          |                |     |Bonilla, Burke,       |                    |
          |                |     |Campos, Chiu,         |                    |
          |                |     |Dababneh, Gomez,      |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |                |     |Roger Hernández,      |                    |
          |                |     |Lackey, Nazarian,     |                    |
          |                |     |Olsen, Patterson,     |                    |
          |                |     |Ridley-Thomas,        |                    |
          |                |     |Rodriguez, Santiago,  |                    |
          |                |     |Steinorth, Thurmond,  |                    |
          |                |     |Waldron               |                    |
          |                |     |                      |                    |
          |----------------+-----+----------------------+--------------------|
          |Appropriations  |20-0 |Gonzalez, Bigelow,    |                    |
          |                |     |Bloom, Bonilla,       |                    |
          |                |     |Bonta, Calderon,      |                    |
          |                |     |Chang, Daly, Eggman,  |                    |
          |                |     |Gallagher, Eduardo    |                    |








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          |                |     |Garcia, Roger         |                    |
          |                |     |Hernández, Holden,    |                    |
          |                |     |Jones, Obernolte,     |                    |
          |                |     |Quirk, Santiago,      |                    |
          |                |     |Wagner, Weber, Wood   |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
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          SUMMARY:  Requires the Department of Public Health (DPH) to  
          submit a report to the Legislature on or before January 1, 2019,  
          that includes a summary and compilation of recommendations on  
          diabetes prevention and management.  Specifically, this bill:  


          1)Requires the report to include a summary and compilation of  
            recommendations on diabetes prevention and management, if any,  
            from all of the following sources:


             a)   The University of California;


             b)   The federal Centers for Disease Control and Prevention;


             c)   The California Wellness Plan;


             d)   Other statewide diabetes stakeholder groups; and,


             e)   Other entities identified by DPH as having relevant  
               findings and recommendations.


          2)Requires DPH to include in the report any recommendations from  
            the institutions listed in 1) above on all of the following  








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            items:


             a)   Evidence-based strategies to prevent or manage diabetes;


             b)   An analysis of the financial impact diabetes and its  
               complications have on the state; and,


             c)   Policy recommendations for the prevention and management  
               of diabetes.


          3)Requires DPH to include in the report a description of the  
            existing level of coordination between state departments with  
            regard to programmatic activities and the provision of  
            information to the public regarding managing and preventing  
            diabetes and its complications.


          4)Requires DPH, commencing July 1, 2017, to annually post all of  
            the following information on its Internet Web site:


             a)   A summary of the amount and source of any funding  
               directed to DPH for programs and activities aimed at  
               preventing or managing diabetes; and,


             b)   A summary of the expenditures by DPH on programs and  
               activities aimed at preventing or managing diabetes.


          5)Sunsets the reporting requirement on January 1, 2024.


          6)Makes various findings and declarations regarding diabetes,  
            including that there is no cure for any type of diabetes;  








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            however, there is evidence that diabetes can be prevented or  
            delayed in onset through lifestyle changes and medical  
            intervention.


          FISCAL EFFECT:  According to the Assembly Appropriations  
          Committee, the report is consistent with ongoing  
          diabetes-related activities; costs are expected to be absorbable  
          within existing resources. 


          COMMENTS:  According to the author, diabetes has reached  
          epidemic levels in California.  The author states as of 2012,  
          about one in seven adult Californians have diabetes and many  
          more will be diagnosed in the near future and within 10 years,  
          it will be one in three adults.  The author contends that,  
          today, the State of California has no action plan in place to  
          mitigate the escalating fiscal impact of diabetes and this bill  
          would require DPH to create and submit to the State of  
          California a "diabetes action plan."  The author concludes the  
          goal of the plan is to provide policy guidance addressing the  
          escalating fiscal impact of diabetes treatment and care.


          Diabetes.  Diabetes is a chronic medical condition marked by  
          high levels of blood glucose (a form of sugar) resulting from  
          defects in insulin production, insulin action, or both.  Type 1  
          diabetes, previously known as juvenile diabetes, is an  
          autoimmune disease in which the body does not produce the  
          hormone insulin.  Type 2 diabetes (previously called  
          non-insulin-dependent diabetes or adult-onset diabetes),  
          accounts for about 90% to 95% of all diagnosed cases of  
          diabetes.  It usually begins as insulin resistance, a disorder  
          in which the cells do not use insulin properly.  As the need for  
          insulin rises, the pancreas gradually loses its ability to  
          produce it.  Gestational diabetes occurs in pregnant women who  
          have never had diabetes before, but have higher than normal  
          blood glucose levels during pregnancy.  Prediabetes is a  
          condition in which individuals have blood glucose levels higher  








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          than normal but not high enough to be classified as diabetes.   
          People with prediabetes have an increased risk of developing  
          type 2 diabetes, heart disease, and stroke.  Without  
          intervention, about one out of four people with prediabetes will  
          develop diabetes within three to five years.  Ethnic minorities  
          and those who are poor or disadvantaged have especially high  
          rates of diabetes.  


          According to DPH, diabetes costs in California exceed $24  
          billion each year.  Total health care and related costs for the  
          treatment of diabetes in California are about $24.5 billion.   
          Direct medical costs (e.g., hospitalizations, medical care,  
          treatment, supplies) account for about $18.7 billion, the other  
          $5.8 billion include indirect costs such as disability payments,  
          time lost from work, and premature death.  The average annual  
          treatment cost per case for diagnosed diabetes in the U.S. was  
          nearly $10,000 in 2007.  Increased risk of heart disease,  
          stroke, and kidney damage (and the need for dialysis as a  
          result) are the most deadly effects of diabetes.  




          Analysis Prepared by:                                             
                          Lara Flynn / HEALTH / (916) 319-2097  FN:  
          0003268