BILL ANALYSIS
Senate Appropriations Committee Fiscal Summary
Senator Kevin Murray, Chairman
2280 (Leno)
Hearing Date: 8/7/2006 Amended: 6/28/2006
Consultant: John Miller Policy Vote: Health 9 - 0
_________________________________________________________________
____
BILL SUMMARY: AB 2280 requires the Department of Health
Services to develop a counseling model for all persons who
receive HIV testing at state supported clinics and authorizes
prescribing of antibiotics without an examination to the
partners of individuals diagnosed with sexually transmitted
diseases.
_________________________________________________________________
____
Fiscal Impact (in thousands)
Major Provisions 2006-07 2007-08 2008-09 Fund
Additional testing $ 0 $ 2,475 $ 0 GF
Regulation development $ 200 $ 0 $ 0 GF
_________________________________________________________________
____
STAFF COMMENTS: This bill meets the criteria for referral to
Suspense.
This bill seeks greater efficiency and cost efficiency in the
prevention and treatment of sexually transmitted diseases. The
bill directs the Department of Health Services to develop a new
counseling model that will allow clinics to increase the number
of persons being tested for HIV by adjusting the counseling
requirement according to the risk of transmission by the
patient. HIV testing protocols were designed 20 years ago, and
nature and demographics of the disease have changed
dramatically. The sponsor makes a case that by allowing
flexibility in the requirements for HIV counseling given with
each blood test, more tests can be performed and more
appropriate and efficient counseling can be administered.
The bill also allows physicians to prescribe antibiotics for the
partners of persons diagnosed with gonorrhea or other sexually
transmitted diseases. Studies have shown that such prescriptions
reduce the numbers of active cases by eliminating the
back-and-forth re-infection between partners. The practice is
recommended by the Centers for Disease Control and has proven
effective in California with Chlamydia infections.
Committee staff cost estimates for this bill conflict with the
department's projections. DHS estimates costs of $2.4 million
with no associated savings from the changes in this bill. Costs
associated with this proposal result from an anticipated
increase in the number of HIV tests. AB 2280 specifies that the
department develop a reimbursement rate that encourages the most
appropriate counseling, requiring that the reimbursement
schedule be cost neutral except for an increase in the volume of
tests. Targeted counseling should reduce costs, allow additional
tests, and not add significantly to the overall costs of testing
as it is unlikely that high risk individuals will forego testing
because of current delays. The department reports that it
annually tests 150,000 individuals at a cost of $8.1 million GF.