BILL NUMBER: AB 2280 AMENDED
BILL TEXT
AMENDED IN SENATE JUNE 28, 2006
AMENDED IN SENATE JUNE 15, 2006
AMENDED IN ASSEMBLY APRIL 25, 2006
AMENDED IN ASSEMBLY APRIL 6, 2006
INTRODUCED BY Assembly Member Leno
FEBRUARY 22, 2006
An act to amend Section 120582 of, and to add Section 120846 to,
the Health and Safety Code, relating to public health.
LEGISLATIVE COUNSEL'S DIGEST
AB 2280, as amended, Leno Sexually transmitted diseases.
Existing law permits a physician or nurse practitioner, who
diagnoses a sexually transmitted Chlamydia infection, to prescribe,
dispense, furnish, or otherwise provide prescription antibiotic drugs
to that patient's sexual partner or partners without examination of
that patient's partner or partners.
This bill would extend these provisions to cover gonorrhea or
other sexually transmitted disease infection, as determined by the
department.
Existing law provides for various programs relating to treatment
of persons with human immunodeficiency virus (HIV) and the acquired
immunodeficiency syndrome (AIDS).
This bill would require the State Department of Health Services,
no later than July 1, 2007, to develop a counseling model for all
persons who receive HIV testing at an alternate test site or a clinic
that receives state funding for HIV testing. The bill would require
that the department consider including specified components in the
counseling model, relating to, among other things, risk assessment,
data collection, prevention education, and additional counseling.
This bill would require that the department develop a
reimbursement schedule that accurately reflects the range of services
provided under the counseling model, and that ensures that a
contractor is reimbursed for individual services, as defined in the
counseling model.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares all of the
following:
(a) Sexually transmitted diseases (STDs) in California have been
increasing in recent years and newly reported in 2005 there were
130,700 infections of chlamydia, 34,400 infections of gonorrhea,
6,500 infections of human immunodeficiency virus (HIV), 3,300 cases
of acquired immunodeficiency syndrome (AIDS), and 1,600 infections of
syphilis.
(b) Public health officials employ a variety of methods to control
STD infections, including preventing infections from occurring and
treating patients after exposure to an STD.
(c) Public health officials view changes in STD infection rates as
indicators of change in HIV infection rates and often alter public
HIV intervention efforts in response to notable changes in STD
infection rates.
(d) A key public intervention effort is to increase the number of
people tested for HIV. Studies show that the vast majority of those
testing positive for HIV take steps to prevent its spread to others.
Part of the testing practice is HIV counseling.
(e) Best practice models of HIV counseling that grew out of early
HIV testing have not kept pace with the changes in the HIV/AIDS
epidemic.
(f) The availability of rapid HIV testing, in which a person can
get a preliminary reading of their HIV status in about 20 minutes,
has created opportunities to streamline the current counseling model
and increase the number of people tested.
(g) The availability of treatment has turned HIV from a virtual
death sentence to a managed chronic medical condition for most
patients with HIV that have access to medical care.
(h) Counseling of persons getting an HIV test has been focused on
educating people about HIV prevention techniques, collecting
epidemiological data, and referring people with a positive test
result to treatment and partner notification counseling.
(i) A number of test subjects are persons at low risk for exposure
to HIV, and repeat testers who are tested on a regular basis.
(j) The current counseling model employs the same process
regardless of whether the test subject is at low or high risk of
exposure and whether the test subject is a first-time tester or is a
repeat tester.
(k) While any person who seeks an HIV test should be able to get
one, the limited resources available for testing demand that
confidential and anonymous testing clinics have a range of options
for delivering counseling.
(l) It is the intent of the Legislature that a new HIV counseling
model be developed that allows clinics to increase the number of
persons seeking a HIV test to be able to be tested, and appropriately
reimburses clinics for the services provided to those persons.
SEC. 2. The Legislature also finds and declares all of the
following:
(a) Patient-delivered therapy for chlamydia was authorized in
California by Chapter 835 of the Statutes of 2000 (Senate Bill
658 648 , Ortiz) and enables qualified
medical practitioners to provide prescription antibiotic drugs to a
patient's sexual partner or partners without examination of that
patient's partner or partners.
(b) Since enactment of patient-delivered therapy for chlamydia
published studies have documented that the rate of persistent or
recurrent infections of gonorrhea also can be reduced by utilizing
patient-delivered therapy for sexual partners.
(c) Patient-delivered therapy for gonorrhea is safe and effective
when provided with appropriate instruction, and has recently been
recommended by the federal Centers for Disease Control and
Prevention.
(d) It is the intent of the Legislature to authorize qualified
medical practitioners to provide patient-delivered therapy to the
sexual partners of patients diagnosed with gonorrhea in order to
reduce persistent and recurrent infections.
SEC. 3. Section 120582 of the Health and Safety Code is amended to
read:
120582. (a) Notwithstanding any other provision of law, a
physician and surgeon who diagnoses a sexually transmitted chlamydia,
gonorrhea, or other sexually transmitted infection, as determined by
the department, in an individual patient may prescribe, dispense,
furnish, or otherwise provide prescription antibiotic drugs to that
patient's sexual partner or partners without examination of that
patient's partner or partners. The department may adopt regulations
to implement this section.
(b) Notwithstanding any other provision of law, a nurse
practitioner pursuant to Section 2836.1 of the Business and
Professions Code, a certified nurse-midwife pursuant to Section
2746.51 of the Business and Professions Code, and a physician
assistant pursuant to Section 3502.1 of the Business and Professions
Code may dispense, furnish, or otherwise provide prescription
antibiotic drugs to the sexual partner or partners of a patient with
a diagnosed sexually transmitted chlamydia, gonorrhea, or other
sexually transmitted infection, as determined by the department,
without examination of the patient's sexual partner or partners.
SEC. 4. Section 120846 is added to the Health and Safety Code, to
read:
120846. (a) The department shall, no later than July 1, 2007,
develop a counseling model for all persons who receive HIV testing at
an alternative test site or clinic that receives state funding for
HIV testing. In developing the counseling model, the department shall
seek input from stakeholders, including, but not limited to, local
health jurisdictions and organizations that receive state funding for
HIV testing. The department shall consider including each of the
following components in the counseling model:
(1) A brief risk-assessment mechanism developed by the department
that allows a clinic to ascertain whether a person seeking testing is
at low or high risk of exposure to HIV. The department may recommend
when and how a clinic should use this mechanism, but it shall not be
used to deny testing to a subject who requests it.
(2) A data collection form that may be self-administered by the
test subject, and that includes only questions that must be reported
in accordance with existing state and federal epidemiology report
requirements. Consideration shall be given to reducing the length of
the form and its utility, including whether state or local resources
exist to analyze the data collected. Additional questions may be
added only if new state or federal epidemiology reports are required.
Local health agencies may add questions only with the approval of
the department. While the form may be self-administered, it also may
be completed with the assistance of a counselor at the request of the
test subject.
(3) A prevention education module that comprehensively covers all
pertinent information relative to methods by which a person can
protect himself or herself or his or her sexual or needle-sharing
partners from exposure to HIV. Consideration may be given to
allowing clinics alternative methods of providing the prevention
education module, although no test subject shall be denied the
opportunity to receive prevention education privately and
individually.
(4) Flexibility for clinics to determine the extent of counseling
provided to a test subject based on a test subject's risk factors or
frequency of HIV testing.
(5) Flexibility for clinics to provide counseling to couples or
small groups, as appropriate.
(6) Additional counseling for a test subject whose preliminary
test result is positive. This additional counseling may include, as
needed by the test subject, emotional support, information on
confirmatory testing, referral to care and treatment opportunities,
and a review of methods to prevent exposing others to HIV.
(b) The department shall develop a reimbursement schedule that
accurately reflects the range of services provided under this model.
The reimbursement schedule shall ensure that a contractor is
reimbursed for individual services, as defined in the counseling
model. It is the intent of the Legislature that the reimbursement
schedule be designed to encourage contractors to provide only those
services that are appropriate for each test subject. It is further
the intent of the Legislature that this new model and reimbursement
schedule be cost-neutral, except to the extent that there is an
increase in the volume of test subjects.