BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2280
                                                                  Page  1

          CONCURRENCE IN SENATE AMENDMENTS
          AB 2280 (Leno)
          As Amended August 22, 2006
          Majority vote
           
           ----------------------------------------------------------------- 
          |ASSEMBLY:  |80-0 |(May 30, 2006)  |SENATE: |38-0 |(August 23,    |
          |           |     |                |        |     |2006)          |
           ----------------------------------------------------------------- 
            
           Original Committee Reference:    HEALTH

          SUMMARY  :  Permits a physician or nurse practitioner, who  
          diagnoses a sexually transmitted gonorrhea infection, or other  
          sexually transmitted infection as determined by DHS, to  
          prescribe, dispense, furnish, or otherwise provide prescription  
          antibiotic drugs to that patient's sexual partner or partners  
          without examination.

           The Senate amendments  delete the Assembly version of this bill  
          and instead permit a physician or nurse practitioner, who  
          diagnoses a sexually transmitted gonorrhea infection, or other  
          sexually transmitted infection as determined by DHS, to  
          prescribe, dispense, furnish, or otherwise provide prescription  
          antibiotic drugs to that patient's sexual partner or partners  
          without examination.

           AS PASSED BY THE ASSEMBLY  , this bill:

          1)Required 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.  Required 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.  Required DHS to  
            consider specific factors in the counseling model.

          2)Required DHS to develop a reimbursement schedule that  
            accurately reflects the range of services provided under this  
            model.  Required the reimbursement schedule to ensure that a  
            contractor is reimbursed for individual services, as defined  
            in the counseling model.  

          3)Stated Legislative intent that the reimbursement schedule be  








                                                                  AB 2280
                                                                  Page  2

            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.

           FISCAL EFFECT  :  Unknown. This bill was substantially amended  
          subsequent to its analysis in the Senate Appropriations  
          Committee.

           COMMENTS  :  According to the author, this bill seeks to address  
          an important issue related to the prevention of sexually  
          transmitted disease (STD) by expanding authorization for  
          patient-delivered therapy currently permitted for the sex  
          partners of persons diagnosed with chlamydia to also include the  
          partners of those diagnosed with gonorrhea.  This bill will  
          reduce persistent and recurrent gonorrhea infections by  
          expanding a successful practice already in place for chlamydia.  
          It will also grant new and appropriate authority to DHS  
          regarding PDT. Authorizing qualified medical practitioners to  
          provide patient-delivered therapy to the sex partners of  
          patients diagnosed with gonorrhea is a sensible public health  
          measure for California.


          A February 2005 article published in the New England Journal of  
          Medicine found that Expedited treatment of sex partners reduces  
          the rates of persistent or recurrent gonorrhea or chlamydial  
          infection.  The authors randomly assigned women and heterosexual  
          men with gonorrhea or chlamydial infection to have their  
          partners receive expedited treatment or standard referral.  
          Patients in the expedited-treatment group were offered  
          medication to give to their sex partners, or if they preferred,  
          study staff members contacted partners and provided them with  
          medication without a clinical examination. Patients assigned to  
          expedited treatment of sexual partners were significantly more  
          likely than those assigned to standard referral of partners to  
          report that all of their partners were treated and significantly  
          less likely to report having sex with an untreated partner. 



          Patient-delivered therapy for chlamydia was authorized in  
          California by the passage of SB 648 (Ortiz), Chapter 835,  
          Statutes of 2000, which enables qualified medical practitioners  








                                                                  AB 2280
                                                                  Page  3

          to provide prescription antibiotic drugs to a patient's sexual  
          partner or partners without examination of that patient's  
          partner or partners.  According to the author, since enactment  
          of SB 648, 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 sex partners.

           
          Analysis Prepared by  :    Melanie Moreno / HEALTH / (916)  
          319-2097 




                                                               FN: 0017031