BILL ANALYSIS
AB 2818
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Date of Hearing: April 25, 2006
ASSEMBLY COMMITTEE ON HEALTH
Wilma Chan, Chair
AB 2818 (Maze) - As Amended: April 19, 2006
SUBJECT : Maternal use of narcotics: testing.
SUMMARY : Requires the Department of Health Services (DHS), on
or before January 15, 2008, to develop a plan to establish a
statewide surveillance program to ascertain changes in the rates
of, and patterns of, legal and illegal drug use in California.
Specifically, this bill :
1)Requires the proposal to include a proposed budget to be
provided to the Legislature for consideration. Prohibits the
plan from being implemented with subsequent statutory
authorization.
2)Specifies that the intent of the Legislature is to consider
establishing and funding an ongoing surveillance system that
provides timely information on rates of drug use and changes
in patterns of drug use among the following groups of
California residents:
a) Women of reproductive age;
b) Women receiving prenatal or obstetrics care; and,
c) Newborns
3)States that the purpose of the surveillance system and data
collection is to educate the public and provide the basis for
sound policy decisions.
4)Prohibits the use of the data for enforcement investigations
by child welfare, law enforcement, or other agencies or
groups, or for the diagnosis or treatment of any medical
condition, including addiction.
5)Requires the data to be collected in a way that protects the
safety, dignity, anonymity, and privacy of study participants,
consistent with the highest standards of scientific studies
that utilize human subjects.
6)Requires rigorous and cost-effective collection of the data
and includes among the data collection approaches: anonymous
surveys, serum collection, and analysis or representative
AB 2818
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population sampling.
EXISTING LAW :
1)Establishes the Office of Perinatal Substance Abuse (OPSA),
within the Department of Alcohol and Drug Programs (ADP), to
coordinate pilot projects and planning projects relating to
perinatal substance abuse. Requires OPSA to oversee perinatal
alcohol and drug treatment programs.
2)Allows the establishment of a perinatal coordinating council,
consisting of experts in the areas of alcohol and other drug
treatment, and other drug related fields.
FISCAL EFFECT : Unknown
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, there is a
lack of reliable data on drug abuse patterns in California,
including use among pregnant and parenting women. As a
result, state policies are too often based on media
hyperbole or anecdotal information. Drug use and drug
exposures should be tracked similar to the tracking of the
incidence of West Nile, HIV, or other potentially deadly
infections, through careful collection of surveillance data.
The author also states "by way of background, one need only
review recent debates and discussions about how to best
respond to methamphetamine in California. Most policymakers
admit that the problem has grown over the last twenty years,
but only recently has it excited a legislative response.
Had our state already established public health surveillance
systems to alert us to the increase in methamphetamine abuse
among certain populations, including pregnant women or women
giving birth, we might well have responded a decade ago.
When legislative or administrative staff is asked to provide
background to policymakers, they are forced to cobble
together a collection of old reports, local reports, media
hyperbole, expert opinion, and anecdotes. Lawmakers and the
public require reliable scientific data to help fill this
gap and to provide us a basis for sound policymaking."
2)METHAMPHETAMINE . According to the Substance Abuse and
Mental Health Services Administration (SAMHSA), there has
been a large increase in the abuse of methamphetamine.
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Methamphetamine, a powerful stimulant drug, is commonly
referred to as speed, crystal, crank, go, and ice, a
smokable form of methamphetamine. It is currently the most
widespread amphetamine that is illegally manufactured,
distributed, and abused. The manufacture of methamphetamine
is a relatively simple process and can be carried out by
individuals without special knowledge or expertise in
chemistry. Methamphetamine is often taken in combination
with other drugs such as cocaine and marijuana and, like
heroin and cocaine, can be inhaled, injected, ingested, or
smoked. Methamphetamine use can cause weight loss,
tachycardia (abnormal rapidity of heart action), tachypnea
(abnormal rapidity of respiration), hyperthermia (unusually
high fever), insomnia, and muscular tremors. The behavioral
and psychiatric symptoms include violent behavior,
repetitive activity, memory loss, paranoia, delusions of
reference, auditory hallucinations, and confusion or fright.
SAMHSA states that research shows that males generally have
higher rates of methamphetamine use than females.
3)DRUG MEDI-CAL (DMC) . ADP receives Medi-Cal funding from the
DHS for eligible services provided to Medi-Cal beneficiaries
through an Interagency Agreement. DMC benefits are optional
Medi-Cal benefits. DMC services provide medically necessary
alcohol and other drug treatment to eligible Medi-Cal
recipients. The services include Outpatient Drug Free
Treatment, Narcotic Treatment Program, and Naltrexone
Treatment. In addition, Day Care Rehabilitative Treatment
and Residential Treatment are available to full scope
Medi-Cal beneficiaries under the age of 21 and to pregnant
and postpartum women.
4)PROPOSITION 36 . In 2000, California voters approved
Proposition 36 or the Substance Abuse and Crime Prevention
Act of 2000 (SACPA), which requires probation and drug
treatment instead of incarceration for individuals convicted
of possession, use, transportation for personal use, or
being under the influence of controlled substances and
similar parole violations, but not for the sale or
manufacture of drugs. Eligible offenders receive up to one
year of drug treatment and six months of after care. In
2001, SACPA appropriated $120 million to be distributed to
counties to provide drug treatment and other services.
Funding is subject to terminate after FY 2005-2006, however,
the Governor's 2006-2007 budget proposal included a $120
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million authorization for Proposition 36 but conditioned
this funding on the Legislature enacting policy changes
relating to improving participant outcomes and
accountability.
5)POLICY QUESTIONS .
a) Effectiveness of the program . This bill specifies that the
purpose of the data collection is to ascertain changes in the
rates and patterns of legal and illegal drug use in California
and provide a basis for sound policy decisions. Why should the
data be exclusively collected from women when methamphetamine
use is also rampant among the male population?
b) Collection of data . This bill specifies that serum
collection and analysis is an option when collecting data.
Will a woman be notified of the purpose of the serum
collection?
c) Administration . Are there privacy or other constitutional
rights implicated in this bill?
1)OPPOSITION . Opponents of a previous version of this bill point
out that this bill would impede women from obtaining necessary
medical services because of the fear associated with random drug
testing. Additionally, opponents state that discussing substance
abuse at the onset of a prenatal visit is important in counseling
pregnant women about the implications of substance abuse during
pregnancy. The American Association of University Women maintains
that no tests should be performed on a woman without her consent
and considers this bill unconstitutional.
REGISTERED SUPPORT / OPPOSITION :
Support
None on file.
Opposition
American Association of University Women (previous version)
American Civil Liberties Union (previous version)
American College of Obstetricians and Gynecologists, District IX
(previous version)
California Maternal, Child and Adolescent Health Directors
(previous version)
California Medical Association (previous version)
AB 2818
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California National Organization for Women (previous version)
Planned Parenthood Affiliates of California (previous version)
Planned Parenthood Golden Gate (previous version)
Analysis Prepared by : Rosielyn Pulmano / HEALTH / (916)
319-2097