BILL ANALYSIS
AB 1785
Page 1
Date of Hearing: May 19, 2010
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 1785 (Galgiani) - As Amended: April 28, 2010
Policy Committee: HealthVote:11-6
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill requires the CA Department of Corrections and
Rehabilitation (CDCR) to establish a telemedicine program at all
state prisons by January 1, 2015. Specifically, CDCR:
1)Must include guidelines for determining when and where
telemedicine is preferable.
2)Must be used only in the best interest of the patient.
3)Must ensure telemedicine does not supplant civil service
physician and dental positions.
4)Must annually report to the Legislature regarding telemedicine
objectives and performance.
FISCAL EFFECT
No new net costs or savings as this bill essentially codifies
current CDCR/federal medical receivership practice and planning.
The receivership estimates continued implementation of the
existing telemedicine program will result in annual GF savings
in the range of $10 million. Telemedicine is a significant
component of the receiver's ongoing prison health care
"turn-around plan" as well as the governor's proposal to reduce
correctional health care spending by $800 million in 2010-11.
COMMENTS
1)Rationale . According to the receivership, the sponsor of this
measure, while this bill is not necessary for implementation
of the ongoing telemedicine program, it is important to "to
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ensure the sustainability of a cost-effective prison health
care system once the Receivership has returned control of
prison health care back to some State entity. By codifying
these nationally recognized standards of effective medicine,
the legislature will establish some oversight of the State
prison health care system in order to ensure that it does not
once again backslide to an unconstitutional level in the
future."
2)Telemedicine provides interactive healthcare via
telecommunication technology. Telemedicine allows patients to
visit with physicians live over video for immediate care, or
via recorded video/still images, patient data is stored and
sent to physicians for diagnosis and follow-up treatment at a
later time.
3)The CDCR telemedicine problem, as stated by the receivership
in its October 2009 Utilization Management Project Charter, is
"the absence of strong leadership to nurture the program as
well as insufficient expanded telemedicine infrastructure to
support a significantly expanded telemedicine program. The
Receiver will put in place strong leadership within the
telemedicine program with a direction to upgrade CDCR's
telemedicine technologies, assess and expand staffing as
appropriate and engage with the UC system and others to
establish a vastly expanded the telemedicine program."
According to the receivership in its April 2010 Cost
Containment Report, telemedicine will result in significant
savings in contract medical and medical custody transportation
and guarding as well as protecting public safety by having
fewer inmates in transit.
4)Background - The California Prison Health Care Receivership is
a non-profit organization created to house the activities of
the federal Receiver. The Receivership was established by U.S.
District Court Judge Thelton E. Henderson as the result of a
2001 class action law suit (Plata v. Schwarzenegger) over the
quality of medical care in the state's 33 prisons. The court
found that the care violated the Eighth Amendment of the U.S.
Constitution, which forbids cruel and unusual punishment of
the incarcerated.
In 2006, the court appointed the receiver to oversee the
delivery of inmate medical care within CDCR. According to the
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Department of Finance (DOF) in a 2010-11 budget change
proposal, since 2006 the receiver has significantly increased
the number of clinical staff, clinician pay, access to CDCR
clinicians, and referrals to specialists and contracted
providers, which has resulted in the cost of inmate medical
services increasing from $883 million in 2005-06 to $2 billion
in 2008-09 with a slight reduction in expenditures anticipated
for 2009-10 and 2010-11.
5)Related Legislation .
a) AB 1817 (Arambula), also before the committee today, and
also sponsored by the receiver, requires CDCR to maintain a
medical utilization management program.
b) AB 2747 (Lowenthal), also before the committee today,
and also sponsored by the receiver, requires CDCR to
maintain and operate a comprehensive pharmacy services
program.
c) AB 2668 (Galgiani), on this committee's Suspense File,
requires CDCR to install telemedicine fixtures and
broadband infrastructure in the CDCR Medical Facility.
d) AB 2222 (Galgiani), on this committee's Suspense File,
authorizes CDCR to install telemedicine fixtures and
broadband infrastructure in new or existing buildings
authorized pursuant to phase II of AB 900.
e) AB 2233 (Nielsen), on this committee's Suspense File,
requires CDCR to create a new system of inmate health care
delivery and work with UC and the receiver to assess the
concept of turning inmate health care over to the UC
system.
Analysis Prepared by : Geoff Long / APPR. / (916) 319-2081