BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      SB 27  


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          Date of Hearing:  August 19, 2015


                        ASSEMBLY COMMITTEE ON APPROPRIATIONS


                                 Jimmy Gomez, Chair


          SB 27  
          (Hill) - As Amended August 17, 2015


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          Urgency:  No  State Mandated Local Program:  NoReimbursable:  No


          SUMMARY:


          This bill prohibits, beginning January 1, 2018, the use of  
          medically important anti-microbial drugs (MIAMs) for the  
          treatment of livestock animals, except pursuant to a  
          prescription or feed directive from a licensed veterinarian and  
          when, in the professional judgment of a licensed veterinarian,  
          the MIAMs are necessary: (a) to treat a disease or infection;  
          (b) to control the spread of disease or infection; (c) in  
          relation to surgery or a medical procedure; or (d) as  
          prophylaxis to prevent the transmission of disease or infection  
          in specific situations.  The bill forbids the use of MIAMs for  
          growth promotion and feed efficiency.









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          In order to implement and monitor compliance with the MIAM  
          rules, the bill requires the Department of Food and Agriculture  
          (DFA) to:


          1)Coordinate with the federal Food and Drug Administration (FDA)  
            to develop a program to track antimicrobial drug sales, use,  
            resistance, and management practices;


          2)Develop antimicrobial stewardship guidelines on good  
            management practices in consultation with the Veterinary  
            Medical Board (VMB), the Department of Public Health (DPH),  
            universities, and Cooperative Extensions; and 


          3)Conduct outreach and training, and report to the Legislature  
            by January 1, 2019 the results of outreach and monitoring  
            activities.


          FISCAL EFFECT:


          1)Estimated General and Special Fund costs of approximately  
            $864,000 in FY 2015-16 and $4.8 million in FY 2016-17 to  
            develop programs, stewardship guidelines, monitoring systems  
            and procedures, and regulations, as well as begin training,  
            inspections, and MIAMs use tracking.  Annual GF and SF costs  
            of approximately $4.3 million thereafter to continue training,  
            inspections, and tracking.  Some of these costs may be funded  
            from federal and local sources, and potentially offset in part  
            with civil fine revenue.


          2)Potentially significant costs to VMB and DPH to help develop  
            stewardship guidelines and training materials. 









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          COMMENTS:


          1)Purpose.  According to the author, overuse and misuse of  
            antibiotics in livestock animals, especially antibiotics  
            important in human medicine, contributes to antibiotic  
            resistance.  To address the overuse and misuse, this bill is  
            intended to ensure veterinary oversight; encourage judicious  
            use of MIAMS and prohibit use for growth promotion and other  
            nontherapeutic purposes; and monitor MAIM sales, usage,  
            management practices, and resistance.  According to the  
            California Veterinary Medical Association (CVMA), many  
            antimicrobials used in food production are currently available  
            at feed stores and online, without any veterinary prescription  
            or oversight.


          2)Antibiotic Resistant Bacteria.  The Centers for Disease  
            Control (CDC) estimates more than two million people are  
            infected with antibiotic-resistant bacteria in the United  
            States each year, with at least 23,000 of those infections  
            resulting in death.  The CDC claims the use of antibiotics is  
            the single most important factor leading to antibiotic  
            resistance around the world.  According to the World Health  
            Organization, antibiotics are used in greater quantities in  
            healthy food-producing animals than in the treatment of  
            disease in humans.


            The FDA has issued several industry recommendations regarding  
            the use of MIAMs in the feed and drinking water of  
            food-producing animals.  The recommendations contained in  
            Guidance for Industry #152, #213, and #219 establish lists of  
            antibiotics important to human health, promote judicious use  
            of those drugs in food production, and encourage veterinary  
            oversight to ensure compliance with industry best practices.










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            In March 2015, President Obama issued a national action plan  
            on combating antibiotic-resistant bacteria.  The five year  
            action plan articulated goals of slowing the emergence of  
            resistant bacteria, strengthening surveillance efforts,  
            advancing the development and use of rapid diagnostics to  
            identify resistant bacteria, accelerate development of new  
            antibiotics, treatments, and vaccines, and improve  
            collaboration among stakeholders.  For antimicrobial use in  
            food animals, the plan seeks to implement the FDA guidance.


          3)FDA Guidance Insufficient.  SB 835 (Hill), statutes of 2014,  
            sought to codify the FDA guidance, but was vetoed by the  
            Governor.  In his veto message, the Governor indicated most  
            animal producers were voluntarily complying with the FDA  
            guidance, but that more needed to be done study the problem  
            and reduce reliance on antibiotics.


          4)The Prophylactic Problem.  Opponents, led by Natural Resources  
            Defense Council (NRDC), argue SB 27 explicitly authorizes the  
            routine use of antibiotics on animals that are not sick  
            through the exception for prophylactic use to prevent disease  
            transmission or infection.  NRDC argues prophylactic use will  
            allow back door use for nontherapeutic purposes, and is  
            precisely the low-dose use that contributes most to resistant  
            bacteria.


            In response, the CVMA argues the prophylactic use exception  
            has been carefully crafted for judicious use of MIAMs, and the  
            bill explicitly forbids MIAM use for growth promotion and feed  
            efficiency.  Furthermore, CVMA claims the bill requires  
            veterinary input and prescriptions for use of MIAMs, and  
            requires livestock owners to follow veterinary instructions.   
            SB 361 (Hill), a companion bill to this legislation, further  
            requires veterinarians to undertake continuing education  
            pertaining to the judicious use of antimicrobials.









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          5)Voluntary Monitoring.  SB 27 requires DFA to coordinate with  
            the FDA on efforts to expand surveillance of MIAM use and  
            resistant bacteria, relying on voluntary cooperation from  
            participants to gather samples.  Opponents assert such a  
            system is insufficient to provide statistically significant or  
            accurate data on actual MIAM use and resistance.


          


          Analysis Prepared by:Joel Tashjian / APPR. / (916)  
          319-2081