BILL ANALYSIS
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
1640 (Evans)
Hearing Date: 8/12/2010 Amended: 8/2/2010
Consultant: Katie Johnson Policy Vote: Health 8-0
_________________________________________________________________
____
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.
_________________________________________________________________
____
Fiscal Impact (in thousands)
Major Provisions 2010-11 2011-12 2012-13 Fund
Additional reporting potentially more than $150
annuallySpecial*
requirements
*Breast Cancer Control Account
_________________________________________________________________
____
STAFF COMMENTS: SUSPENSE FILE. AS PROPOSED TO BE AMENDED.
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. 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 EWC program, is administered by CDPH
and provides free breast cancer screening and diagnostic
services to women who are 50 years of age or older, live in
California, have
Page 2
AB 1640 (Evans)
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. 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.
On June 9, 2010, the Budget Conference Committee approved $20.1
million General Fund for the EWC program in order to fund
mammograms for women aged 40 and older. The Governor has yet to
sign a final budget.
The author's proposed amendments would remove the eligibility
requirements. Since this bill would no longer expand EWC
eligibility, the only costs would be to CDPH to update its
report with new data items, which could be over $150,000 in
Breast Cancer Control Account funds to the extent the department
would need to modify its data collection and reporting policies
and procedures.