BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1540
                                                                  Page 1

          Date of Hearing:   April 28, 2009

           ASSEMBLY COMMITTEE ON ENVIRONMENTAL SAFETY AND TOXIC MATERIALS
                                Wesley Chesbro, Chair
             AB 1540 (Assembly Health Committee) - As Amended:  April 16,  
                                        2009
           
          SUBJECT  :   Public Health

           SUMMARY  :   Makes technical changes to a variety of health  
          programs and statutes.  Specifically,  this bill  :  

          1)Exempts data collected by the Office of Statewide Health  
            Planning and Development (OSHPD) relating to emergency rooms,  
            ambulatory surgeries and coronary artery bypass graft  
            surgeries from disclosure under the Public Records Act (PRA),  
            similar to the existing PRA exemption for inpatient discharge  
            data.

          2)Authorizes the Department of Managed Health Care (DMHC) to  
            amend, by regulation, any statutorily mandated notice,  
            specifically for purposes of clarity, readability, and  
            accuracy.

          3)Clarifies that specialized health care plans and specialized  
            insurance policies, (i.e. dental and vision plans), are not  
            subject to the requirement of coverage for human  
            immunodeficiency virus (HIV) testing.

          4)Conforms existing state law to the federal Safe Drinking Water  
            Act (SDWA) by:

             a)   Limiting the types pf water suppliers who may certify  
               alternative water sources;
             b)   Providing penalties for violations of turbidity  
               standards for drinking water; and
             c)   Allowing point-of-use devices for water treatment to  
               meet drinking water standards.

          5)Repeals the sunset date in existing law allowing public health  
            tuberculosis workers employed by, or contracted with, a local  
            public health department to administer tuberculosis skin  
            tests.

          6)Extends the sunset date of the California Health Benefits  








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            Review Program (CHBRP) from January 1, 2011, to June 30, 2015.

          7)Conforms provisions relating to Medi-Cal  
            physicians-in-good-standing filing a change of location form  
            to an existing requirement for all Medi-Cal providers to  
            obtain a single National Provider Identifier.

          8)Repeals the sunset date for the Local Education Agency (LEA)  
            Medi-Cal billing option.

          9)Makes other minor technical and non-substantive changes.

           EXISTING LAW:  

          1)Exempts inpatient discharge data collected by OSHPD from the  
            PRA.

          2)Allows DMHC to amend, by regulation, a statutorily mandated  
            notice that must be provided to patients who receive emergency  
            care at a non-contracting hospital for clarity, readability,  
            and accuracy.

          3)Requires health plans and health insurers to provide coverage  
            for HIV testing regardless of whether the testing is related  
            to a primary diagnosis.

          4)Establishes the Drinking Water Program within the Department  
            of Public Health (DPH) to regulate public drinking water  
            systems.

          5)Extends the sunset date authorizing local health departments  
            to certify public health tuberculosis workers to place and  
            measure tuberculosis skin tests from January 1, 2006 to  
            January 1, 2011.

          6)Establishes CHBRP to respond to requests from the Legislature  
            to provide independent analysis of the medical, financial, and  
            public health impacts of proposed health insurance benefit  
            mandates and repeals.  Extends the CHBRP program until January  
            1, 2011.

          7)Establishes the Medi-Cal program, administered by the  
            Department of Health Care Services (DHCS), which provides  
            health benefits to low-income children, their parents, or  
            caretaker relatives, pregnant women, elderly, blind or  








                                                                  AB 1540
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            disabled persons, and other individuals who meet specified  
            eligibility criteria.

          8)Establishes the LEA program to provide the federal share of  
            reimbursement for health assessment and treatment for Medi-Cal  
            eligible children and family members within the school  
            environment.

           FISCAL EFFECT  :   Unknown

           COMMENTS  :

           1)Purpose of this bill  .  This bill is authored by the Assembly  
            Committee on Health as omnibus clean-up legislation containing  
            technical or non-controversial changes to the laws affecting  
            various health and human services agencies including OSHPD,  
            DMHC, DHCS, and DPH.  Many of the provisions make minor,  
            technical, and conforming changes, while other provisions are  
            substantive changes intended to improve the ability of the  
            various agencies to efficiently and effectively administer  
            their respective programs.

           2)Drinking Water Standards  :  According to the DPH, which is  
            sponsoring the provisions of this bill related to drinking  
            water, the changes are needed to ensure that California  
            maintains its federally designated authority to implement a  
            drinking water program that conforms to the federal SDWA and  
            maintains laws and regulations that must be no less stringent  
            than the federal regulations.

            AB 1540 would conform existing state statutes to federal laws.  
             The U.S. Environmental Protection Agency (US-EPA) delegates  
            its authority to California to implement a drinking water  
            program.  As a primacy state (having federally delegated  
            authority), California must enact laws and regulations related  
            to drinking water that conform to the SDWA and must be no less  
            stringent than the federal regulations.

            Should California's laws or regulations fail to comply with  
            the federal SDWA, California may lose its primacy, which would  
            result in the loss of significant federal funds.

            The issues that AB 1540 addresses to ensure federal compliance  
            are:









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             a)   The federal SDWA only allows a water system to certify  
               the alternative water, but current state law allows the  
               water district or "the residential or similar users of the  
               system" to certify the alternative water.

             b)   The federal SDWA requires the same penalty for  
               violations of drinking water turbidity standards as with  
               any other primary drinking water standard.  The state does  
               not currently have the authority to do so for  
               non-continuing turbidity violations.

             c)   The federal SDWA allows a public water system to use  
               point-of-use devices for water treatment to meet drinking  
               water standards.  California law does not allow the use of  
               these devices, which offer a feasible solution for ensuring  
               a safe domestic water supply when other solutions are  
               technically and/or economically impractical.

          3)Technical Amendments:

            Page 23 lines 32 and 38 after "citation" add:  or order.  

           4)DOUBLE REFERRAL  .  This bill has been double-referred because  
            of the drinking water provisions.  This bill was previously  
            considered and passed by the Assembly Health Committee.

           REGISTERED SUPPORT / OPPOSITION  :

           Support

           California Hospital Association
          California Society for Clinical Social Work
          Department of Public Health

           Opposition
           
          None on file.
           

          Analysis Prepared by  :    Bob Fredenburg/ E.S. & T.M. / (916)  
          319-3965