BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
SB 1072 (Strickland) - New born screening
Amended: April 24, 2012 Policy Vote: Health 7-0
Urgency: No Mandate: No
Hearing Date: May 7, 2012 Consultant: Brendan McCarthy
This bill meets the criteria for referral to the Suspense File.
Bill Summary: SB 1072 would require the Department of Public
Health to screen newborns in the state for two additional
inherited conditions.
Fiscal Impact:
Increased Genetic Disease Testing Program costs up to $17
million per year, paid for by fees (Genetic Disease Testing
Fund).
Increased costs to Medi-Cal up to $7.5 million per year for
testing fees (50% General Fund, 50% federal funds).
Increased costs to the Access for Infants and Mothers
Program up to $250,000 per year (35% Proposition 99 funds,
65% federal funds).
Increased costs to CalPERS up to $160,000 per year for
testing fees (55% General Fund, 45% special funds).
Earlier diagnosis of infants covered by public health care
programs with one of these conditions may result in
increased costs, to the extent that ongoing treatments such
as enzyme replacement therapy begin earlier than they would
without screening for these conditions. The extent to which
this will actually increase costs is unknown.
Whether early screening and diagnosis will improve medical
outcomes and reduce future treatment costs to public
healthcare programs is unknown, given the limited
information available on treatment outcomes.
Background: The Department of Public Health operates the Genetic
Disease Testing Program, which screens all newborns in the state
SB 1072 (Strickland)
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for more than 70 inherited conditions. Both the federal
government and the Department have advisory committees that make
recommendations on new conditions that should be added to the
federal screening guidelines and the state screening program.
The Genetic Disease Testing Program is funded by fees assessed
on health plans and insurers for each birth in the state. The
current fee for newborn screening is set at $112.70.
Proposed Law: SB 1072 would add two specific conditions, MPS1
(Hurler Syndrome) and Krabbe to the new born screening test
provided by the Department of Public Health. This additional
screening requirement would sunset on January 1, 2019.
Related Legislation: AB 395 (Pan) Chapter 461 of 2011 added
severe combined immunodeficiency to the newborn screening test.
Staff Comments: Under current law, the Department is authorized
to increase the fee associated with newborn screening to cover
the costs of the program. Based on staff estimates of potential
cost increases, the current fee would have to be raised by up to
$30 per birth. Medi-Cal and other public health care programs
that pay for labor and delivery costs would be required to pay
the additional fees.
At this time, the long-term efficacy of the available treatments
for these two conditions (including enzyme replacement therapy
and stem cell or bone marrow transplantation) is not well
documented. In addition, early screening for these conditions
will likely identify individuals that may only manifest symptoms
later in life. Therefore, it is not possible to determine
whether early diagnosis of these conditions will either improve
health outcomes or reduce overall health care costs.
Neither the advisory committee to the federal Health and Human
Services Agency nor the advisory committee to the Department of
Public Health have recommending including these conditions in
new born screening programs at this time.