BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2541
                                                                  Page  1

          Date of Hearing:   May 12, 2010

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                 AB 2541 (Portantino) - As Amended:  April 28, 2010 

          Policy Committee:                              Health Vote:18-0

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill deletes the HIV exemption from authorized electronic  
          reporting in order to increase federal funding provided to  
          California for HIV and AIDS services. Under current law more  
          than 80 reportable diseases (such as tuberculosis and hepatitis)  
          may be reported electronically by providers and labs to local  
          health jurisdictions. HIV is currently exempt from that  
          authorization. 

           FISCAL EFFECT  

          1)According to a recent report by the Legislative Analyst's  
            Office (LAO) on HIV surveillance and federal funding,  
            California could increase receipt of federal Ryan White Act  
            funding by several million to low tens of millions of dollars  
            annually by increasing the number of HIV infections reported. 

          2)Increased federal funds would be used to reduce GF spending.  
            The Ryan White Act provides $125 million in federal funding  
            per year to California. California spends roughly $1.2 billion  
            a year (40% GF) on medical treatment and HIV/AIDS programs.  

          3)According to the LAO, only about 36,000 cases of HIV have been  
            reported by name (a federal funding requirement) to local  
            health jurisdictions. This number likely represents only  
            one-third to one-half of HIV cases statewide. 

          4)Unknown costs to DPH to modify an effort already underway to  
            develop a web-based electronic laboratory reporting (ELR)  
            system. 

           COMMENTS  








                                                                  AB 2541
                                                                  Page  2


           1)Rationale  . This bill is sponsored by the AIDS Healthcare  
            Foundation to improve California's HIV surveillance and to  
            ensure the state's competitiveness for federal Ryan White Care  
            Act funding. This bill is in response to a February 2010  
            report by the LAO about the underreporting of HIV infections  
            and actions needed to improve disease surveillance to increase  
            federal funding in this area. 

           2)Background  . Under state law, more than 80 diseases are  
            reported by providers and labs to local public health  
            jurisdictions. The data collected helps state and local health  
            authorities plan for the prevention and control of these  
            diseases. Laboratories use a variety of methods to report  
            diseases, including phone, fax, or secure electronic delivery.  
            Historically, HIV has been treated differently than other  
            diseases. Under current law HIV cannot be reported  
            electronically and must be reporting using methods such as  
            hand delivery or registered mail. This handling of HIV  
            reporting is administratively burdensome and does not maximize  
            data matching opportunities to increase the identification of  
            HIV-positive patients. 

           3)Name-Based Reporting  . Although HIV has been identified since  
            1983, California first required labs and providers to report  
            HIV cases to local health authorities in 2002 by a code,  
            rather than a patient's name. California switched to  
            name-based reporting in 2006 in order to not risk major losses  
            of federal Ryan White Act funding. The state has been in a  
            transition period between code-based reporting and full  
            name-based reporting. According to DPH estimates, California's  
            failure to be fully name-based in HIV reporting, meant the  
            lost of $3 million to $7 million in federal funding in 2009. 
           
           4)Related Legislation  . SB 699 (Soto) Chapter 20, Statutes of  
            2006, requires health care providers and laboratories to  
            report HIV cases by the patient's name rather than code in  
            order to comply with federal funding requirements.

           

           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081