BILL ANALYSIS
SENATE HEALTH
COMMITTEE ANALYSIS
Senator Elaine K Alquist, Chair
BILL NO: AB 169
A
AUTHOR: Portantino
B
AMENDED: April 14, 2009
HEARING DATE: May 20, 2009
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REFERRAL: Public Safety
6
CONSULTANT:
9
Moreno/cjt
SUBJECT
Communicable disease: involuntary testing
SUMMARY
Adds custodial officers, custody assistants, and nonsworn
uniformed employees of a law enforcement agency, as
defined, to the list of persons who may seek to have an
arrestee's blood tested, either voluntarily or by court
order, for specified communicable diseases when exposed to
an arrestee's bodily fluids while acting within the scope
of his or her duties.
CHANGES TO EXISTING LAW
Existing law:
Establishes procedures by which an arrestee's blood may be
tested, either voluntarily or by court order, for specified
communicable diseases when a peace officer, firefighter, or
emergency medical personnel is exposed to an arrestee's
blood or bodily fluids, as defined, while the peace
officer, firefighter, or emergency medical personnel is
acting within the scope of his or her duties.
Defines a "custodial officer" as a public officer, not a
peace officer, employed by a law enforcement agency in
Continued---
STAFF ANALYSIS OF ASSEMBLY BILL 169 (Portantino) Page
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specified counties, who maintains custody of prisoners and
performs tasks related to the operation of a local
detention facility used for the detention of persons, as
specified. Custodial officers include correctional
officers, jailers, or other similar titles, that may serve
warrants, court orders, writs, and subpoenas in the
detention facility or under circumstances arising directly
out of maintaining custody of prisoners and related tasks.
Defines a "custody assistant" as a full-time employee, not
a peace officer, employed by the county sheriff's
department who assists peace officer personnel in
maintaining order and security in a custody detention,
court detention, or station jail facility of the sheriff's
department. Custody assistants are responsible for
maintaining custody of prisoners
and performing tasks related to the operation of a local
detention facility used for the detention of persons, as
specified.
This bill:
Adds custodial officers, custody assistants, and nonsworn
uniformed employees of law enforcement agencies, as
defined, to the list of persons who may seek to have an
arrestee's blood tested, either voluntarily or by court
order, for specified communicable diseases when exposed to
an arrestee's bodily fluids while acting within the scope
of their duties.
FISCAL IMPACT
According to the Assembly Appropriations Committee
analysis, likely negligible state court cost/savings to the
extent this bill results in additional/fewer hearings for
county detention personnel forced to pursue a court hearing
to obtain an arrestee's blood sample in the wake of a
bodily fluid exposure.
BACKGROUND AND DISCUSSION
According to the author, custodial officers often come in
contact with bodily fluids of persons who have been
arrested, and this bill will extend the benefits of
existing testing provisions to these workers.
STAFF ANALYSIS OF ASSEMBLY BILL 169 (Portantino) Page
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Background
According to the National Institute for Occupational Safety
and Health, exposures to blood and other body fluids occur
across a wide variety of occupations. Health care workers,
as well as emergency response and public safety personnel,
can be exposed to blood through needlestick and other
sharps injuries, as well as through mucous membrane and
skin exposures. The pathogens of primary concern for the
CDC (Centers for Disease Control) and the National
Institute for Occupational Safety and Health are the human
immunodeficiency virus (HIV), hepatitis B virus (HBV), and
hepatitis C virus (HCV). According to CDC recommendations,
wounds and skin sites that have been in contact with blood
or bodily fluids should be washed with soap and water; and
mucous membranes should be flushed with water. Immediate
evaluation must be performed by a health care professional.
The evaluation should determine the type of exposure,
infectious status of the source, and the susceptibility of
the exposed person in order to determine the treatment
course.
Post-exposure prophylaxis
Post-exposure prophylaxis (PEP) is a short-term treatment
to reduce the likelihood of infection after exposure to a
number of contagious diseases, including HIV, HBV, and HCV.
PEP is considered a second line of defense when preventive
efforts have failed or were not possible, as is the case
with sexual assault or occupational exposure. In the case
of HIV, PEP typically involves providing one or several
anti-HIV drugs within 72 hours of exposure, which are then
taken for a four- to six-week period. According to the
World Health Organization (WHO), in order for PEP to be
most effective in preventing HIV infection, treatment
should be commenced as soon as possible after exposure and,
ideally, within two to four hours. One of the first
examples of PEP effectiveness was reported in a 1995 study,
which showed fewer HIV infections after occupational
exposure among health care workers who used PEP versus
those who took no prophylaxis after exposure. A recent
Canadian study found that, of 160 patients who had been
exposed to HIV and received PEP treatment, only one
infection was reported.
CDC recommendations for HBV exposure include the initiation
of the hepatitis B vaccine series to an unvaccinated person
who has been exposed. PEP with hepatitis B immune globulin
STAFF ANALYSIS OF ASSEMBLY BILL 169 (Portantino) Page
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(HBIG) and/or hepatitis B vaccine series should be
considered after an evaluation of the HBV status of the
source and the vaccination and vaccine-response status of
the exposed person. According to the CDC, in the
occupational setting, multiple doses of PEP for HBV,
initiated within one week following exposure, provides an
estimated 75 percent protection from infection.
According to the CDC, the estimated risk for infection
after a needlestick or cut exposure to HCV-infected blood
is approximately 1.8 percent. Additionally, several
studies have attempted to assess the effectiveness of
potential post-exposure treatment for HCV, but have been
difficult to interpret. No clinical trials have been
conducted to assess postexposure use of antiviral agents
(interferon) to prevent HCV infection, and antivirals are
not FDA approved for this use. The CDC states that an
established infection might need to be present before
interferon can be an effective treatment.
Previous legislation
AB 2737 (Feuer), Chapter 554, Statutes of 2008, permits a
peace officer, firefighter, or emergency medical personnel
who, while acting within the scope of his or her duties, is
exposed to an arrestee's blood or bodily fluids, as
defined, to petition the court, ex parte, for an order to
withdraw blood from the arrestee for testing for HIV,
AIDS-related conditions, and HCV.
SB 1239 (Russell), Chapter 708, Statutes of 1994,
authorizes the blood or other tissue or material of a
source patient, as defined, to be tested for HIV pursuant
to a prescribed procedure, either with or without the
consent of the source patient, and authorizes a health care
provider or first responder who experiences a "significant
exposure" to the blood or other potentially infectious
materials of the source patient to be informed of the HIV
status of that patient.
AB 1385 (Alpert), Chapter 519, Statutes of 1998, authorizes
an HIV test to be performed on any available blood or
patient sample of a source patient if that patient is
unable to provide informed consent under specified
conditions.
STAFF ANALYSIS OF ASSEMBLY BILL 169 (Portantino) Page
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SB 2056 (Brulte), Chapter 254, Statutes of 1998, permits,
if the informed consent of the source patient cannot be
obtained because he or she is deceased, an HIV test to be
performed on any blood or patient sample of the patient
legally obtained in the course of providing health care
services at the time of the exposure event.
AB 2423 (Cardenas), Chapter 342, Statutes of 2002, expands
the law to apply to any communicable disease.
Arguments in support
The Service Employees International Union states that this
bill would ensure that all parties in the arrest and
detention process are protected equally while protecting
the public. The American Federation of State, County and
Municipal Employees asserts that this bill will protect all
public safety officers by ensuring access to proper health
care when their duties expose them to communicable
diseases. The California Correctional Supervisors
Organization writes that this is a long overdue and much
needed piece of legislation.
PRIOR ACTIONS
Assembly Public Safety 6-0
Assembly Appropriations16-0
Assembly Floor 75-0
POSITIONS
Support: American Federation of State, County and
Municipal Employees
California Correctional Supervisors Organization
California Peace Officers' Association
Service Employees International Union
Oppose: None received.
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