BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2222
                                                                  Page  1

          Date of Hearing:   May 5, 2010

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                   AB 2222 (Galgiani) - As Amended:  April 6, 2010 

          Policy Committee:                              Public  
          SafetyVote:  7-0

          Urgency:     No                   State Mandated Local Program:   
          No     Reimbursable:               

           SUMMARY  

          This bill authorizes the Department of Corrections and  
          Rehabilitation (CDCR) to install telemedicine fixtures and  
          broadband infrastructure in new or existing buildings authorized  
          pursuant to phase II of AB 900 (Solorio, 2007) which has the  
          effect of authorizing lease-revenue bond financing for this  
          purpose.

          (Phase II of AB 900 authorizes $2.5 billion for construction of  
          up to 4,000 beds at or near existing facilities, up to 2,000  
          medical and/or mental health beds, and up to 10,000 reentry beds  
          in multiple locations, while Phase I authorizes $3.6 billion for  
          up to 12,000 beds at or near existing facilities, up to 6,000  
          medical and/or mental health beds, and 6,000 reentry beds.)   
           
          FISCAL EFFECT

           1)Depending on the extent to which CDCR opts to use this  
            authority, costs could range into the tens of millions of  
            dollars (lease-revenue bonds/GF), though CDCR already has the  
            authority to use authorized bond funds for telemedicine  
            infrastructure at new facilities. 

          2)Depending on the extent to which telemedicine proves a more  
            cost-efficient method of providing inmate health care in  
            appropriate cases, the investment in telemedicine will result  
            in significant out-year health care savings that should exceed  
            the cost of telemedicine infrastructure. (GF) 

           COMMENTS









                                                                 AB 2222
                                                                  Page  2

          1)Rationale.  The author notes the importance of telemedicine in  
            ongoing state and federal efforts to provide affordable and  
            constitutionally acceptable inmate health care and contends  
            that the cost of building the infrastructure necessary to  
            provide such care should be covered under the existing AB 900  
            lease-revenue bond authority.
           
          2)Telemedicine a crucial component of CDCR/federal health care  
            receiver health care efforts  . According to the receiver's  
            April 2010 Cost Containment Report, telemedicine leads to  
            significant cost avoidance in the areas of contract medical  
            and medical custody transportation costs. Telemedicine is also  
            a significant component of the receiver's efforts to identify  
            $800 million in proposed health care savings in the 2010-11  
            state budget.




           3)NuPhysicia also recommends significantly increased  
            telemedicine investment to address prison health care  
            shortcomings  . In March 2010, NuPhysicia, a private company  
            involved in the telemedicine programs of The University of  
            Texas Medical Branch, released a report -  "Assessment and  
            Evaluation: California's Opportunities for Improved Inmate  
            Health Care Quality and Cost Controls" - that criticized  
            CDCR's underreliance on telemedicine and encouraged the state  
            to integrate telemedicine into daily care. 


           4)It is not clear why the bill limits funding to phase II, as  
            CDCR has not even started phase I.  


           5)The proposed spending authority does not appear to be  
            necessary  as CDCR may use bond funds for telemedicine  
            infrastructure in new construction.  


           6)Telemedicine  is the provision of 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.  








                                                                  AB 2222
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           7)Related Legislation.  


             a)   AB 2668 (Galgiani) requires CDCR to install telemedicine  
               fixtures and broadband infrastructure in the CDCR Medical  
               Facility, based upon the availability of funding. AB 2668  
               is also before this committee today.

             b)   AB 1785 (Galgiani) requires CDCR to maintain a statewide  
               telemedicine services program, requires an operational  
               telemedicine program at each institution, and expands  
               existing telemedicine services. AB 1785 will be heard by  
               this committee later in the month.






           
           Analysis Prepared by  :    Geoff Long / APPR. / (916) 319-2081