BILL ANALYSIS
AB 2280
Page 1
ASSEMBLY THIRD READING
AB 2280 (Leno)
As Amended April 25, 2006
Majority vote
HEALTH 12-0 APPROPRIATIONS
(vote not available)
-----------------------------------------------------------------
|Ayes:|Chan, Aghazarian, Berg, | | |
| |Dymally, Frommer, Jones, | | |
| |Lieu, Montanez, | | |
| |Nakanishi, Negrete | | |
| |McLeod, | | |
| |Ridley-Thomas, Strickland | | |
|-----+--------------------------+-----+--------------------------|
| | | | |
-----------------------------------------------------------------
SUMMARY : Requires the Department of Health Services (DHS), no
later than July 1, 2007, to develop a counseling model, as
specified, for all persons who receive human immunodeficiency
virus (HIV) testing at a clinic that receives funding for HIV
testing. Specifically, this bill :
1)Makes a number of findings and declarations regarding best
practice models of HIV counseling and HIV testing.
2)Requires DHS, no later than July 1, 2007, to 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. Requires DHS, in developing the counseling
model, to seek input from stakeholders, including, but not
limited to, local health jurisdictions and organizations that
receive state funding for HIV testing. Requires DHS to
consider including the following in the counseling model:
a) A brief risk-assessment mechanism developed by DHS that
allows a clinic to ascertain whether a person seeking
testing is at low or high risk of exposure to HIV. Permits
DHS to recommend when and how a clinic should use this
mechanism but prohibits it from being used to deny testing
to a subject who requests it;
b) A data collection form that is self-administered by the
test subject, and that includes only questions that must be
AB 2280
Page 2
reported in accordance with existing state and federal
epidemiology report requirements. Requires consideration
to be given to reducing the length of the form and its
utility including whether state or local resources exist to
analyze the data collected. Permits additional questions
to be added only if new state or federal epidemiology
reports are required. Permits local health agencies to add
questions only with the approval of DHS. Permits the form
to be self-administered and be completed with the
assistance of a counselor at the request of the test
subject;
c) 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 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 can be denied the opportunity to
receive prevention education privately and individually;
d) 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;
e) Flexibility for clinics to provide counseling to couples
or small groups, as appropriate; and,
f) Additional counseling for a test subject whose
preliminary test result is positive. Permits additional
counseling to 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.
3)Requires DHS to develop a reimbursement schedule that
accurately reflects the range of services provided under this
model. Requires the reimbursement schedule to ensure that a
contractor is reimbursed for individual services, as defined
in the counseling model.
4)States that 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
AB 2280
Page 3
subject and 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.
EXISTING LAW provides for various programs relating to
treatment of persons with HIV and the acquired immune deficiency
syndrome (AIDS).
FISCAL EFFECT : According to the Assembly Appropriations
Committee, assuming this bill results in a counseling model that
permits greater testing volume, General Fund (GF) costs in
excess of $1 million annually. For example, if there is a 25%
increase in testing as a result of changes made to the
counseling model, costs would increase by $1.7 million.
(General Fund.) These costs may be partially offset if the
counseling model results in lower reimbursement for counseling.
This bill states legislative intent that the new counseling
model and reimbursement schedule be cost-neutral, except to the
extent that there is an increase in the volume of test subjects.
COMMENTS : According to the author, currently, state funded HIV
testing is contracted to counties which in turn sub-contract
with testing organizations. State law does not address the HIV
test counseling model that has been developed by the DHS and
implemented through contracts. Because test counseling
processes are enforced through contract compliance, and because
various counties administer these contracts, there has been
variation in the flexibility allowed to testing organizations.
As a result, some testing organizations are required through
contract compliance to engage in lengthy processes that may not
be most appropriate for their client base and that limit the
number of people who can be tested. Some testing organizations
are having difficulty testing all the people who wish to be
tested because the counseling protocols demand unnecessary
attention to low risk and serial testers. The purpose of this
bill is to focus resources where they are needed most.
Analysis Prepared by : Melanie Moreno / HEALTH / (916)
319-2097
FN: 0014884