BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 221
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          CONCURRENCE IN SENATE AMENDMENTS
          AB 221 (Portantino)
          As Amended  August 17, 2009
          2/3 vote.  Urgency
           
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          |ASSEMBLY:  |74-0 |(May 14, 2009)  |SENATE: |35-3 |(September 3,  |
          |           |     |                |        |     |2009)          |
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           Original Committee Reference:   B. & P.  

           SUMMARY  :  Permits HIV counselors to perform skin punctures to  
          withdraw blood for HIV testing, as specified.  

           The Senate amendments  :

          1)Permit an HIV counselor to perform specified HIV tests if he  
            or she has been trained in both rapid HIV test proficiency for  
            skin puncture blood tests, oral swab tests, and in universal  
            infection control precautions, consistent with best infection  
            control practices established by the Division of Occupational  
            Safety and Health in the Department of Industrial Relations  
            and the federal Centers for Disease Control and Prevention  
            (CDC).

          2)State that a second, confirming test must be approved by CDC,  
            not the Food and Drug Administration. 

          3)State that the specified HIV training shall not be construed  
            to certify an HIV counselor as a phlebotomy technician (PT) or  
            a limited phlebotomy technician (LPT), or to fulfill any  
            requirements for certification as a PT or a LPT, unless the  
            HIV counselor has otherwise satisfied the certification, as  
            specified.

          4)Delete the skin puncture training options for an HIV counselor  
            to be trained by a licensed physician and surgeon or by a  
            licensed clinical laboratory scientist and bioanalyst, and the  
            requirement that the HIV counselor have a statement signed by  
            the instructing physician and surgeon, scientist, or  
            bioanalyst that the training has been completed.  

          5)Delete the provision of law permitting an HIV counselor  
            trained, as specified, to be deemed to have demonstrated  








                                                                  AB 221
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            sufficient literacy and comprehension to advance to the LPT  
            training and may substitute successful completion of the HIV  
            counselor curriculum for the requirement for a high school  
            diploma or General Education Development equivalent for a LPT,  
            as specified. 

          6)Require an HIV counselor who was certified prior to September  
            1, 2009, to obtain the specified training by September 1,  
            2011.  

          7)Delete provisions of current law that relate to the use of  
            rapid HIV tests. 

          8)Add an urgency clause.

           EXISTING LAW  permits the Office of AIDS (Office) in the  
          department to participate in a rapid HIV test research program  
          conducted with CDC.  Under this program, HIV counselors trained  
          by the Office may perform skin punctures for purposes of  
          withdrawing blood for test purposes, if the HIV counselor meets  
          prescribed requirements, including holding a valid certification  
          as a LPT by DPH.

           AS PASSED BY THE ASSEMBLY  , this bill was substantially similar  
          to the version passed by the Senate.

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee:

          1)No direct fiscal impact to authorize counselors meeting  
            specified oversight, training, and supervisory requirements to  
            conduct rapid HIV testing via skin punctures.

          2)Minor savings to the extent rapid skin tests become less  
            administratively burdensome and costly to employers who are  
            required to provide approximately $2,500 in training per  
            employee to meet current phlebotomy training requirements.
           
          3)Minor savings in testing costs to the extent this bill results  
            in a shift from a more expensive oral swab test ($12) to a  
            less expensive skin puncture test ($7).  Due to recent budget  
            cuts, the statewide budget for HIV testing has been reduced  
            from $10.4 million to $9.8 million. This bill helps ensure  
            more people are tested with fewer resources.
           








                                                                  AB 221
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          4)Major potential savings per 10 infections prevented.  $3  
            million in public savings will accrue to the extent this bill  
            results in informing 10 additional HIV-positive individuals of  
            their status who would otherwise not be tested.  This estimate  
            assumes a $300,000 (cumulative lifetime savings) lifetime  
            savings per individual as quantified by research.  Research  
            indicates many HIV-positive individuals, once informed of  
            their status, make behavior changes that reduce transmission  
            of the virus.
           

          Analysis Prepared by  :    Sarah Huchel / B. & P. / (916) 319-3301  
                                                       


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