BILL ANALYSIS Ó
SB 361
Page 1
Date of Hearing: August 19, 2015
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Jimmy Gomez, Chair
SB 361
(Hill) - As Amended August 17, 2015
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Urgency: Yes State Mandated Local Program: YesReimbursable:
No
SUMMARY:
This bill, an urgency measure, contains two requirements
intended to combat antimicrobial resistance. Specifically, this
bill:
SB 361
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1)Requires skilled nursing facilities (SNFs) to, by January
2017, adopt and implement antimicrobial stewardship policies;
requires compliance with related federal guidelines, and
allows for state citations for non-compliance.
2)Requires a veterinarian who receives a license after January
1, 2018 to complete an approved course on the judicious use of
antibiotics every four years as part of existing continuing
education (CE) requirements.
FISCAL EFFECT:
1)Minor and absorbable costs to the Licensing and Certification
division of the California Department of Public Health (CDPH)
to verify SNF compliance with the new antimicrobial
stewardship policy requirement during the course of routine
inspections or on a complaint basis (Licensing and
Certification Fund).
2)Minor and absorbable costs to the Veterinary Medical Board to
approve required courses and verify compliance with the new CE
requirement (Veterinary Medical Board Fund).
3)Potential unknown, likely minor information technology costs
to both departments for system modifications to capture the
new requirements (Licensing and Certification Fund /Veterinary
Medical Board Contingent Fund).
COMMENTS:
SB 361
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1)Purpose. The author indicates the overuse and misuse of
antibiotics in medicine is a significant factor driving the
development of antibiotic resistance, a growing public health
threat. This bill intends to ensure best practices in the use
of human and animal antibiotic administration to encourage
judicious use.
2)Antimicrobial Stewardship. Antibiotics are credited with
significantly reducing morbidity and mortality associated with
bacterial infections. Unfortunately, widespread use of
antibiotics has led to antibiotic resistance, which, according
to the World Health Organization (WHO), is an increasingly
serious threat to global public health. The WHO indicates
evolution of drug-resistant strains is a natural phenomenon,
but the use and misuse of antibiotics accelerates their
emergence. Drug-resistant infections are often difficult to
treat and can be deadly. The Centers for Disease Control and
Prevention (CDC) indicates at least 2 million people become
infected with resistant bacteria nationwide, and at least
23,000 people die as a direct result of these infections, each
year. Antibiotic stewardship programs are designed to promote
and measure the appropriate use of antibiotics in a facility,
and are recommended by WHO, CDC, and DPH. DPH provides
technical assistance to hospitals and other facilities to
implement local antimicrobial stewardship programs as part of
their Healthcare Acquired Infections program, and collects
data on these programs that are submitted on a voluntary
basis.
3)Current Related Legislation. SB 27 (Hill) restrict the use of
medically important antimicrobial drugs in livestock, require
a veterinarian's prescription or feed directive for use,
eliminate the over-the-counter availability of these drugs,
require the California Department of Food and Agriculture
(CDFA) to develop a program to track antimicrobial drug use in
livestock and the emergence of antimicrobial-resistant
bacteria, and require CDFA to adopt judicious use and
SB 361
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antimicrobial stewardship guidelines.
4)Prior Related Legislation. SB 1311 (Hill), Chapter 843,
Statutes of 2014, requires all general acute-care hospitals to
adopt and implement an antimicrobial stewardship policy that
includes a process to evaluate the judicious use of
antibiotics.
Analysis Prepared by:Lisa Murawski / APPR. / (916)
319-2081