BILL ANALYSIS
AB 1640
Page 1
CORRECTED - 10/1/2010 Changes per consultant.
CONCURRENCE IN SENATE AMENDMENTS
AB 1640 (Evans and Nava)
As Amended August 18, 2010
Majority vote
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|ASSEMBLY: |61-13|(June 2, 2010) |SENATE: |34-0 |(August 25, |
| | | | | |2010) |
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Original Committee Reference: HEALTH
SUMMARY : Requires the Department of Public Health (DPH), 90
days prior to making policy changes to the Every Woman Counts
(EWC) program, to send written notice outlining the proposed
changes to contractors providing services, and to notify the
Legislature if these changes would restrict access or reduce
services offered.
The Senate amendments :
1)Make legislative declarations and findings regarding breast
cancer prevalence, the benefits of early detection of breast
cancer, the economic burden of breast cancer to the state and
the enrollment freeze on the EWC program.
2)Add the following to the legislative declarations and
findings:
a) The Budget Conference Committee for the 2010-11 fiscal
year (FY) agreed to appropriate an additional $20.1 million
from the General Fund for the Every Woman Counts program,
working to ensure that women 40 years of age and over have
access to these critical preventive services; and,
b) The Budget Conference Committee for the 2010-11 FY
required the Every Woman Counts program to biannually
submit a program estimate, thereby committing to a higher
level of transparency and oversight of this life-saving
program.
3)Delete the following age requirements for a client to receive
services under the EWC program:
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a) Be 40 years of age or older to receive breast cancer
screening services; and,
b) Be 25 years of age or older to receive cervical cancer
screening services.
4)Delete language that required funding for the EWC program to
come from the Breast Cancer Fund, created and distributed
pursuant to the Revenue and Taxation Code, and as appropriated
by the Legislature in the annual Budget Act or other measure.
5)Require DPH, 90 days prior to making policy changes relating
to EWC, to do both of the following:
a) Send written notice outlining the proposed changes to
contractors providing services to the EWC program; and,
b) Notify the Legislature, in writing, of changes if those
changes would restrict access or reduce services offered.
6)Require, on or before February 1 of each year, DPH to submit
an annual report regarding the EWC program to the Legislature
and any other appropriate entity.
7)Add to the reporting requirement referenced in 6) above the
following types of information regarding those served by the
EWC program:
a) The average cost per individual served; and,
b) Information provided to the federal Centers for Disease
Control and Prevention (CDC) on the number of individuals
served based on the federal funds provided.
EXISTING FEDERAL LAW :
1)Establishes the Breast and Cervical Cancer Mortality
Prevention Act of 1990 which creates the National Breast and
Cervical Cancer Early Detection Program (NBCCEDP) and
authorizes CDC to administer grants to states for screening
services for underserved eligible women, 40 years of age and
older.
2)Establishes the Breast and Cervical Cancer Prevention and
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Treatment Act of 2000 which provides states the option to
provide medical assistance through Medicaid to eligible women
who are screened for and found to have breast or cervical
cancer, including precancerous condition, through the NBCCEDP.
EXISTING STATE LAW :
1)Establishes the California Breast Cancer Act of 1993 within
the California Department of Health Services (now DPH) which
mandates 50% of the revenues collected from a $0.02 tax on
tobacco products towards breast cancer control.
2)Requires DPH to provide for breast and cervical cancer
screening services under the NBCCEDP grant, at the level of
funding budgeted from state and other resources during the
fiscal year in which the Legislature has appropriated funds
for this purpose. These screenings are provided under the EWC
program and are not deemed an entitlement.
AS PASSED BY THE ASSEMBLY , this bill was substantially similar
to the version as passed by the Senate.
FISCAL EFFECT : According to the Senate Appropriations Committee
this bill will result in cost pressure to the state General Fund
of $25 million in fiscal year (FY) 2010 through 2011, $29.750
million in FY 2011 through 2012 and $35.4 million in FY 2012
through 2013.
COMMENTS : According to the authors, in December of 2009, in
response to an evolving budget crisis within the EWC program,
DPH announced two significant policy changes effective January
1, 2010 that restrict access to the EWC program: 1) a permanent
increase in the minimum age eligibility for breast cancer
screening services from age 40 to 50; and, 2) a temporary
six-month enrollment freeze for all women seeking breast cancer
screening services from January 1 through June 30, 2010.
According to the authors, these two changes will deny or delay
services to approximately 100,000 women, putting an estimated
1,000 lives at risk by delaying breast cancer diagnosis. The
authors maintain that DPH made these very significant changes to
the program without seeking the customary input from the
Legislature or the breast cancer advocacy community.
The EWC program provides free breast and cervical cancer
screening services to low-income, uninsured, and underinsured
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women. Administered by The Cancer Detection Section at DPH, the
EWC serves approximately 350,000 women per year of the
approximately 1.2 million that are eligible for breast cancer
screening services through the program in California. Prior to
January 1, 2010 the eligibility requirements for EWC were as
follows: 1) must have been 40 years of age or older (25 years or
older for cervical cancer); 2) lived in California; 3) had no
health insurance or had a co-payment or a deductible that was
not affordable; and, 4) had a family income below 200% of the
federal poverty level. According to the CDC, of those women who
received mammography screening in California through the EWC
program from July 2003 to June 2008, 45.1% were between the ages
of 40-49.
Analysis Prepared by : Tanya Robinson-Taylor / HEALTH / (916)
319-2097
FN: 0007146