BILL ANALYSIS
AB 2786
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Date of Hearing: April 20, 2010
ASSEMBLY COMMITTEE ON HEALTH
William W. Monning, Chair
AB 2786 (Committee on Health) - As Amended: April 14, 2010
SUBJECT : List of reportable diseases and conditions.
SUMMARY : Allows the California Department of Public Health
(DPH) to modify the list of communicable diseases and conditions
for which clinical labs must submit specimens to the local
public health laboratory to undergo further testing and allows
DPH to modify the list at any time in consultation with the
California Conference of Local Health Officers (CCLHO) and the
California Association of Public Health Laboratory Directors
(CAPHLD). Specifically, this bill :
1)Makes specified legislative findings and declarations
regarding the need to enable prompt identification of an
outbreak, send positive specimens to the public health
laboratory for identification, and enable DPH to include newly
emerging diseases and conditions in a timely manner.
2)Requires DPH to establish a list of communicable diseases and
conditions for which clinical laboratories shall submit a
culture or a specimen to the local public health laboratory to
undergo further study.
3)Permits DPH to modify the list at any time, after consultation
with the CCLHO and the CAPHLD, without being subject to
California's Administrative Procedures Act (APA), which
governs the adoption of regulations, but requires that DPH
file the revised list with the Secretary of State for
publication in the California Code of Regulations (CCR).
4)Exempts clinical labs that fail to submit cultures or
specimens for mandatory diseases from civil and criminal
penalties, unless the requirement has been noticed by DPH for
at least six months in the CCR.
5)Deletes specific diseases that are enumerated in law as
mandatory reportable diseases, thereby allowing DPH to
reconstitute the list in consultation with CCLHO.
EXISTING LAW :
AB 2786
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1)Requires DPH to establish a list of diseases and conditions
which health care providers and local health officers are
required to report to the local public health department.
Allows DPH to modify this list and exempts this modification
from requirements, governing changes in administrative
regulations under APA.
2)Under regulation, requires labs to report test results on
certain diseases considered to be of "public health
importance."
3)Existing law does not exempt DPH from complying with APA
requirements when modifying the list of reportable diseases
and conditions for which public health labs are required to
submit specimens.
FISCAL EFFECT : This bill has not been analyzed by a fiscal
committee.
COMMENTS :
1)PURPOSE OF THIS BILL . According to the sponsor, the Health
Officers Association of California (HOAC), this bill will
allow DPH and local public health authorities to respond to a
public health emergency in a timely manner. The sponsor notes
that there have been instances in which DPH has requested
clinical laboratories to submit specimens on a voluntary basis
for shiga-toxin producing E. coli and Meningococcal disease.
Providing these samples on a voluntary basis does not ensure a
large enough sample size to detect common source outbreaks.
This was apparent during the recent E. coli outbreak, during
which clinical laboratories in California were not performing
the additional tests necessary for identifying clusters of
cases revealing a common source outbreak.
2)BACKGROUND . Health care providers who know of a case, or
suspected case, of any disease or condition on the DPH list
are required to report to the local health officer of the
jurisdiction where the patient resides and are required to
send specimens to a clinical laboratory. Clinical
laboratories include all hospital laboratories and community
laboratories that receive tests from health care providers for
analysis. Clinical laboratories are also required by
regulation to report positive specimens to the local public
AB 2786
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health department. Currently laboratories are required to
report communicable diseases, pathogens, and viral infections.
Clinical laboratories are required to submit specimens for
those listed diseases and conditions, while specimens for
non-listed diseases and conditions are submitted on a
voluntary basis. If there is a known or suspected outbreak of
a particular disease or condition that is listed, the local
health officer must report to DPH within a specified time
period, and take the necessary steps to prevent further
contamination or infection.
The list of communicable diseases and conditions for which
laboratories must submit cultures is established by regulation
and adding or deleting a disease or condition requires an
administrative regulation change under APA. The APA was
intended to ensure transparency and full public participation
when agencies change their regulations. The APA does permit
adoption of emergency regulations, but requires a five-day
public notice, and emergency regulations can remain in effect
for up to 180 days. According to the sponsor, it could take
one and one-half to two years for DPH to update the list of
reportable diseases, whereas under AB 2786, it could take as
little as two months.
3)PREVIOUS LEGISLATION .
a) SB 356 (Negrete McLeod) of 2007 is nearly identical to
this bill. SB 356 was vetoed by Governor Schwarzenegger
because the delay in passing 2008-2009 State Budget forced
him to prioritize the bills sent to his desk. According to
the Governor, SB 356 did not meet his standard as priority
legislation.
b) AB 1091 (Negrete McLeod), Chapter 262, Statutes of 2003
allows DPH, in consultation with the California Conference
of Local Health Officers, to modify the list of reportable
diseases that health care providers are required to report.
DPH can modify this list at any time without having to
comply with APA requirements.
REGISTERED SUPPORT / OPPOSITION :
Support
AB 2786
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Health Officers Association of California (sponsor)
California Medical Association
Opposition
None on file.
Analysis Prepared by : Martin Radosevich / HEALTH / (916)
319-2097