BILL ANALYSIS                                                                                                                                                                                                    



                                                                            
         AB 2280
                                                                Page  1

        CONCURRENCE IN SENATE AMENDMENTS
        AB 2280 (Leno)
        As Amended August 22, 2006
        Majority vote
         
         
         ---------------------------------------------------------------------- 
        |ASSEMBLY: |77-0 |(May 16, 2005)  |SENATE: |38-0 |(August 24, 2006)    |
         ---------------------------------------------------------------------- 
          
         

         ------------------------------------------------------------------------ 
        |COMMITTEE VOTE:  |12-0 |(August 28, 2006)   |RECOMMENDATION: |concur    |
        |                 |     |                    |                |          |
         ------------------------------------------------------------------------ 

        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  








                                                                            
         AB 2280
                                                                Page  2

          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  
          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. 










                                                                            
         AB 2280
                                                                Page  3


        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 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: 0017578