BILL ANALYSIS
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
1640 (Evans)
Hearing Date: 8/2/2010 Amended: 8/2/2010
Consultant: Katie Johnson Policy Vote: Health 8-0
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BILL SUMMARY: AB 1640 would require that women aged 40 years
and older would be eligible for the Every Woman Counts (EWC)
breast and cervical cancer screening program. It would also
require the California Department of Public Health (CDPH) to
notify providers and the Legislature of program changes 90 days
prior to their implementation and would require that the
department must submit its annual EWC report on or before
February 1 of each year and that the report must include
specified information.
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Fiscal Impact (in thousands)
Major Provisions 2010-11 2011-12 2012-13 Fund
EWC additional cost $25,000 $29,750
$35,400General
pressure to cover women
aged 40 - 50
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STAFF COMMENTS: This bill meets the criteria for referral to the
Suspense File.
CDPH took administrative action to limit eligibility to women
aged 50 or over. This bill would permit women aged 40 years and
older to be eligible for the program. Since this bill does not
require that EWC provide services, but only sets eligibility
standards, it would seem that CDPH would still have
administrative authority to be able to continue its
administrative action. There would be General Fund cost pressure
to provide services to women between 40 and 50 years of age in
the amount of approximately $25 million in FY 2010-2011, and
would increase by a factor of approximately 19 percent annually
to accommodate increased caseload. In 2007-2008, the program
screened approximately 250,000 women. The cost per person is
approximately $140.
Additionally, this bill would make findings and declarations
related to the EWC program and breast cancer statistics and
would restate that funding for the EWC would come from the
Breast Cancer Fund. This bill would specify that CDPH's annual
report to the Legislature on EWC would be due on or before
February 1 of each year and would require that specified
additional information be included in the report.
In the event CDPH chooses to make changes to this program, this
bill would require the department to notify providers, and the
Legislature if the changes were to restrict access or reduce
services offered, of changes in the program 90 days prior to
those changes taking effect.
The state's existing breast and cervical cancer screening
program, also known as the Every Woman Counts (EWC) program, is
administered by CDPH and provides free
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AB 1640 (Evans)
breast cancer screening and diagnostic services to women who are
50 years of age or older, live in California, have no health
insurance or a co-payment or deductible that they cannot afford,
and have a family income below 200 percent of the federal
poverty level. The EWC is currently funded with federal Centers
for Disease Control and Prevention (CDC) grants and revenues
from tobacco taxes from the Breast Cancer Control Account and
Proposition 99 funds. To receive federal funding, CDPH must
match every $3 in federal funds with $1 of nonfederal funds.
Funding for the program is finite; the program may provide only
as many mammograms as it has funds. This bill would appropriate
an unspecified amount of General Fund monies for this program.
Existing law requires CDPH to provide breast and cervical cancer
screening services under a federal grant at the level of funding
budget from state and other resources and states that these
screening services are not an entitlement.
Additionally, the EWC refers people with a positive diagnosis to
the Breast and Cervical Cancer Treatment Program (BCCTP), which
is administered by the Department of Health Care Services (DHCS)
and is funded with state and federal funds. It is likely that
this bill would serve more people than EWC currently serves and
would therefore increase the number of people referred to BCCTP.
If BCCTP caseload increased accordingly, the costs of the
program would increase an unknown, but potentially significant
amount.