BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 186
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          CONCURRENCE IN SENATE AMENDMENTS
          AB 186 (Williams)
          As Amended August 31, 2011
          Majority vote
           
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          |ASSEMBLY:  |73-0 |(May 5, 2011)   |SENATE: |37-0 |(September 7,  |
          |           |     |                |        |     |2011)          |
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           Original Committee Reference:    HEALTH  

           SUMMARY  :  Requires the Department of Public Health (DPH) to 
          establish a list of communicable diseases and conditions for 
          which clinical laboratories must submit a culture or a specimen 
          to the local public health laboratory to undergo further study.  
          Permits DPH to modify the list of communicable diseases and 
          conditions in consultation with appropriate local public health 
          stakeholders, including, but not limited to, local health 
          officers and public health laboratory directors.

           The Senate amendments  permit the list to be modified in 
          consultation with appropriate local public health stakeholders, 
          including, but not limited to, local health officers and public 
          health laboratory directors.

           AS PASSED BY THE ASSEMBLY  , this bill required 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.  Permitted 
          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 at any time 
          after consultation with the California Conference of Local 
          Health Officers and the California Association of Public Health 
          Laboratory Directors.

           FISCAL EFFECT  :  According to the Senate Appropriations 
          Committee:

           Major Provisions         2011-12      2012-13       2013-14     Fund
           CDPH additional                              minor and 
          absorbable    General
          laboratory staff









                                                                  AB 186
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          Local public health             minor and absorbable   General
          additional laboratory staff

           COMMENTS  :  According to the author, technology is not currently 
          available in California public health laboratories for different 
          sub-typing techniques, such as DNA fingerprinting, that can be 
          used to identify clusters of various organisms that cause 
          illness.  The author states that use of this specialized testing 
          can help identify outbreaks and sources of outbreaks so they can 
          be mitigated, and for this to be an effective public health 
          tool, the public health laboratory needs to obtain the necessary 
          specimens from all sources in order to be able to quickly 
          identify the organisms causing illnesses and compare the 
          subtypes, thus allowing a timely public health response.  The 
          author contends that by allowing DPH to quickly add conditions 
          to the list of diseases for which clinical laboratories must 
          submit specimens, this bill may save lives during an emergency.

          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 the Administrative 
          Procedures Act (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 only remain in effect for up to 180 
          days.  According to the sponsor, Health Officers Association of 
          California (HOAC), it could take one and one-half to two years 
          for DPH to update the list of reportable diseases, whereas under 
          this bill, it could take as little as two months.

          HOAC writes in support of this bill that public health 
          laboratories are the front line in the war against disease 
          outbreaks.  These labs can quickly identify sub-types of 
          contaminants, such as E. coli, so that a common source outbreak 
          can be identified and investigated.  HOAC further states that 
          public health laboratories can also examine avian flu isolates 
          for strain typing to determine their potential to result in a 
          human pandemic.  HOAC contends that this bill will enable public 
          health laboratories to better protect all Californians during 
          the outbreak of a dangerous disease.
           

          Analysis Prepared by  :    Melanie Moreno / HEALTH / (916) 








                                                                  AB 186
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          319-2097 

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