BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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          |SENATE RULES COMMITTEE            |                  AB 2280|
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                                 THIRD READING


          Bill No:  AB 2280
          Author:   Leno (D)
          Amended:  8/22/06 in Senate
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  9-0, 06/21/06
          AYES:  Ortiz, Runner, Aanestad, Alquist, Chesbro, Cox,  
            Figueroa, Kuehl, Maldonado

           SENATE APPROPRIATIONS COMMITTEE  :  13-0, 8/17/06
          AYES:  Murray, Aanestad, Alarcon, Alquist, Ashburn, Battin,  
            Dutton, Escutia, Florez, Ortiz, Poochigian, Romero,  
            Torlakson

           ASSEMBLY FLOOR  :  80-0, 5/30/06 - See last page for vote


           SUBJECT  :    Sexually transmitted diseases

           SOURCE  :     AIDS Healthcare Foundation


           DIGEST  :    This bill requires the Department of Health  
          Services to develop a counseling model for all persons who  
          receive human immunodeficiency virus (HIV) testing at a  
          clinic that receives funding for HIV testing, expands  
          provisions of current law to allow specified medical  
          providers to offer patient-delivered therapy to partners of  
          individuals diagnosed with gonorrhea or other  
          sexually-transmitted diseases.  

           ANALYSIS  :    
                                                           CONTINUED





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          Existing law:  

          1.Provides for various programs relating to treatment of  
            persons HIV and the acquired immune deficiency syndrome  
            (AIDS).

          2.Requires an individual to provide informed consent prior  
            to taking an HIV test.

          3.Requires the Department of Health Services (DHS) to  
            authorize training programs for counselors participating  
            in publicly funded HIV testing programs.

          4.Permits specified health care providers who diagnose a  
            sexually transmitted chlamydia infection to prescribe,  
            dispense, furnish and/or otherwise provide prescription  
            antibiotic drugs to that patient's sexual partner(s)  
            without examination of the partner(s), commonly referred  
            to as patient-delivered therapy.

          This bill:  

          1.Makes a number of findings and declarations regarding the  
            incidence of sexually-transmitted diseases, including  
            gonorrhea, and best practice models of HIV counseling and  
            testing.

          2.Requires DHS, no later than July 1, 2007, to develop a  
            counseling model for all persons who receive HIV testing  
            at a test site or clinic that receives state funding for  
            HIV testing, and 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.    

            B.     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.  







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            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.  

            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.  

            F.     Additional counseling for a test subject whose   
                 preliminary test result Is positive including, 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 and ensures that a contractor is reimbursed  
            for individual services.

          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 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.  

          5.Permits a physician, nurse practitioner and other  
            specified health care providers who diagnoses specified  
            sexually transmitted diseases in a patient to prescribe,  
            dispense, furnish and/or otherwise provide prescription  
            antibiotics to the patient's sexual partner(s) without  
            examination of the partner(s). 

          6.Requires DHS to determine if a given sexually-transmitted  
            disease is suitable for patient-delivered therapy.







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           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

          According to the Senate Appropriations Committee:

                          Fiscal Impact (in thousands)

           Major Provisions                2006-07     2007-08   2008-09        
           Fund  
          Additional testing            $0        $2,475$0GF
          Regulation development        $200      $0        $0GF

           SUPPORT  :   (Verified  6/21/06)

          AIDS Healthcare Foundation (source)
          American College of Obstetricians & Gynecologists  
          (California)
          Bienestar Human Services, Inc.
          California National Organization for Women
          Center for AIDS Research, Education and Services
          Drug Policy Alliance Network
          Gay and Lesbian Adolescent Social Services
          Lambda Letters Project
          San Francisco AIDS Foundation


           ARGUMENTS IN SUPPORT  :    Supporters state that best  
          practice models of HIV testing have not kept pace with the  
          changes in the HIV/AIDS epidemic.  The availability of  
          rapid HIV testing has created opportunities to streamline  
          the current counseling model, especially for test subjects  
          who are at low-risk for HIV or who are repeat clients who  
          are tested on a regular basis and must undergo the same  
          counseling protocol repeatedly.  Streamlining the HIV test  
          counseling model will enable local health agencies and  
          service providers to focus counseling resources on those  
          who need the most, while increasing capacity to accommodate  
          everyone who seeks HIV testing.  


          ASSEMBLY FLOOR  :
          AYES:  Aghazarian, Arambula, Baca, Bass, Benoit, Berg,  
            Bermudez, Blakeslee, Bogh, Calderon, Canciamilla, Chan,  







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            Chavez, Chu, Cogdill, Cohn, Coto, Daucher, De La Torre,  
            DeVore, Dymally, Emmerson, Evans, Frommer, Garcia,  
            Goldberg, Hancock, Harman, Haynes, Jerome Horton, Shirley  
            Horton, Houston, Huff, Jones, Karnette, Keene, Klehs,  
            Koretz, La Malfa, La Suer, Laird, Leno, Leslie, Levine,  
            Lieber, Lieu, Liu, Matthews, Maze, McCarthy, Montanez,  
            Mountjoy, Mullin, Nakanishi, Nation, Nava, Negrete  
            McLeod, Niello, Oropeza, Parra, Pavley, Plescia, Richman,  
            Ridley-Thomas, Sharon Runner, Ruskin, Saldana, Salinas,  
            Spitzer, Strickland, Torrico, Tran, Umberg, Vargas,  
            Villines, Walters, Wolk, Wyland, Yee, Nunez


          CTW:nl  8/22/06   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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