BILL ANALYSIS
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
836 (Oropeza)
Hearing Date: 4/26/2010 Amended: 4/7/2010
Consultant: Katie Johnson Policy Vote: Health 7-2
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BILL SUMMARY: SB 836 would appropriate an unspecified amount of
money from the General Fund to the Every Woman Counts program to
provide breast cancer screening and diagnosis to eligible
individuals, as specified, and would expand the scope of
individuals eligible for the program.
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Fiscal Impact (in thousands)
Major Provisions 2010-11 2011-12 2012-13 Fund
Appropriation for breast unknown, but potentially more General
cancer screening than $30 million - $40 million
and diagnosis annually in an amount of millions
to hundreds of millions of dollars
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STAFF COMMENTS: This bill meets the criteria for referral to the
Suspense File.
This bill would appropriate an unspecified amount of General
Fund monies to CDPH for the screening of individuals of any age
who exhibit breast cancer symptoms, as determined by a
physician, and to individuals who are 40 years of age or older,
provided the individual otherwise meets state eligibility
requirements.
This bill would 1) reverse the January 1, 2010, policy changes,
which froze enrollment until July 1, 2010, and limited
eligibility to women aged 50 and older, 2) make eligible
individuals in addition to the women who are already eligible
for the program, including men and transgendered persons, and 3)
additionally make individuals of any age, upon the
recommendation of a physician, eligible for the program. The
amount of General Fund monies necessary to provide services to
these newly eligible categories and reverse the January 1, 2010,
policy changes would be in excess of $30 million - $40 million
by an unknown amount that would likely be in the millions to
hundreds of millions of dollars.
The state's existing breast and cervical cancer screening
program, also known as the Every Woman Counts (EWC) program, is
administered by CDPH and provides free breast cancer screening
and diagnostic services to women who are 50 years of age or
older, live in California, have no health insurance or a
co-payment or deductible that they cannot afford, and have a
family income below 200 percent of the federal poverty level.
The initial age of eligibility was 50 years, but when funds were
available, CDPH had changed the age to 40 until the recent
January 1, 2010, policy change. There were approximately 35,000
women aged 40-49 served during FY 2008-2009. On January 1,
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SB 836 (Oropeza)
2010, CDPH took administrative action and instituted two policy
changes to address budget shortfalls of approximately $10
million - $15 million in FY 2009-2010 and a projected $30
million - $40 million in FY 2010-2011. With the January 1, 2010,
policy changes, there would likely be a $3 million - $5 million
surplus in FY 2009-2010, but an approximately $10 million
shortfall in FY 2010-2011. In 2007-2008, the program screened
approximately 250,000 women and is experiencing caseload growth
at about 20 percent annually. The cost per person is
approximately $140.
The EWC is currently funded with federal Centers for Disease
Control and Prevention (CDC) grants and revenues from tobacco
taxes from the Breast Cancer Control Account and Proposition 99
funds. Funding for the program is finite; the program may
provide only as many mammograms as it has funds. This bill would
appropriate General Fund monies for this program.
Additionally, the EWC refers people with a positive diagnosis to
the Breast and Cervical Cancer Treatment Program (BCCTP), which
is administered by the Department of Health Care Services (DHCS)
and is funded with state and federal funds. It is likely that
this bill would increase the BCCTP caseload and, therefore,
increase the costs of the program an unknown, but potentially
significant amount.