BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 186
                                                                  Page  1

          Date of Hearing:   April 6, 2011

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                   AB 186 (Williams) - As Amended:  March 30, 2011 

          Policy Committee:                              HealthVote:19-0

          Urgency:     No                   State Mandated Local Program: 
          Yes    Reimbursable:              No

           SUMMARY  

          This bill requires the California Department of Public Health 
          (DPA) to establish a list of communicable and food-borne 
          diseases for which clinical laboratories are required to submit 
          a specimen to a local public health laboratory. In addition, 
          this bill provides DPH the authority to modify the list of 
          required specimens without going through the regulatory process 
          under the Administrative Procedures Act (APA). 

          The bill also exempts persons and facilities that fail to submit 
          specimens from civil and criminal penalties unless the 
          requirement has been noticed for six months in the California 
          Code of Regulations.

           FISCAL EFFECT  

          Minor absorbable costs to the DPH to establish and modify the 
          list of required specimens. 

           COMMENTS  
           
           1)Rationale.  This bill is sponsored by the Health Officers 
            Association of California, which states the bill will give the 
            DPH the authority it needs to modify the list of specimens 
            without a lengthy regulatory hearing process. The sponsors 
            state that under the current regulatory process, adding a 
            specimen to the list may take up to two years, and that such a 
            delay impedes the ability of public health authorities to 
            quickly identify and respond to urgent public health threats. 

           2)Disease Reporting.  Approximately 80 diseases and conditions 
            are considered "reportable," meaning that state law requires 








                                                                  AB 186
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            providers and laboratories to report cases to local public 
            health jurisdictions (who in turn report to the state). This 
            reporting allows local and state authorities to do 
            surveillance of diseases in order to monitor and identify 
            potential outbreaks. For a subset of the 80 reportable 
            diseases, DPH requires that specimens, such as a culture or 
            blood samples, be submitted in addition to the disease report. 
             The submission of specimens allows public health authorities 
            to do the analysis necessary to pinpoint whether an outbreak 
            is occurring.  

               DPH currently has authority to modify the list of 
               reportable diseases without going through the normal 
               regulatory process.  This bill would similarly exempt the 
               DPH from going through the normal regulatory process when 
               modifying the list of diseases for which a specimen should 
               be submitted.
               
            3)Related Legislation.   

             a)   AB 2786 (Committee on Health), 2010, contained identical 
               provisions to this bill.  AB 2786 was vetoed by Governor 
               Schwarzenegger, who cited concern that DPH would modify the 
               list unnecessarily without regulatory oversight.

             b)   SB 356 (Negrete-McLeod), 2007, is nearly identical to 
               this bill.  SB 356 was vetoed by Governor Schwarzenegger 
               with a budget delay-related message and no specific 
               feedback about the legislation.

           Analysis Prepared by  :    Lisa Murawski / APPR. / (916) 319-2081