BILL ANALYSIS �
AB 1898
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Date of Hearing: March 25, 2014
ASSEMBLY COMMITTEE ON HEALTH
Richard Pan, Chair
AB 1898 (Brown) - As Introduced: February 19, 2014
SUBJECT : Public health records: reporting: HIV/AIDS.
SUMMARY : This bill requires reporting specified diseases along
with a report of HIV/AIDS when an individual is infected with
both HIV/AIDS and one of the specified diseases, referred to as
"coinfection." This bill also authorizes the Department of
Public Health (DPH) to expand the diseases reported when
coinfections with HIV/AIDS occur, provided the diseases are
communicable and chronic and are of public health importance.
EXISTING LAW :
1)Requires DPH to establish a list of communicable and
noncommunicable diseases and conditions which local health
officers (LHOs) are required to report to DPH.
2)Requires the reporting of cases of tuberculosis or sexually
transmitted diseases when a person is coinfected with one or
more of these and HIV/AIDS.
3)Requires health care providers and laboratories to report
cases of HIV infection to the LHO using patient names, as
specified. Requires LHOs to report unduplicated HIV cases by
name to DPH.
4)Permits disclosure of health records for the purpose of
facilitating appropriate HIV/AIDS medical care and treatment.
5)Prohibits the negligent, willful, or malicious disclosure of
the content of any confidential public health record, as
defined, to any third party, except pursuant to a written
authorization, as described or as otherwise authorized by law,
and establishes civil penalties for violations of these
provisions.
FISCAL EFFECT : This bill has not been analyzed by a fiscal
committee.
COMMENTS :
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1)PURPOSE OF THIS BILL . According to the author, existing law
limits reporting cases of HIV/AIDS that are coinfected to
tuberculosis and sexually transmitted diseases, specifically
syphilis, gonorrhea or chlamydia. This restriction limits the
completeness of public health reporting because HIV/AIDS
related records may not be disclosed for coinfection with
other diseases and creates barriers to HIV reporting and data
used for follow-up of exposed individuals and impedes the
efforts to prevent disease transmissions. The author argues
there are other conditions of public health importance that
should be included such as hepatitis B and C, salmonellosis,
meningococcal infection and listeriosis. The author concludes
to ensure completeness of public health reporting,
facilitating care and treatment, follow-up of exposed
individuals, and other interventions to prevent ongoing
disease transmission, the code must allow the reporting of
other communicable diseases of public health importance.
2)BACKGROUND . Coinfection means infection with more than one
disease at the same time. Some coinfections commonly seen in
people infected with HIV include hepatitis B, hepatitis C, and
tuberculosis. The diseases can be treated although treatment
does depend on the coinfection as the possibility of drug
interaction always exists.
The diseases listed in this bill are very serious for those
infected with HIV. According to the Centers for Disease
Control and Prevention (CDC), those with HIV infection are
disproportionately affected by viral hepatitis. Approximately
one-third of people with HIV are coinfected with either
hepatitis B or C. This can cause long term illness and death.
Individuals who are co-infected with HIV and hepatitis
experience greater liver related health problems than those
who are not. Viral hepatitis also progresses faster among
people with HIV. Another disease to be reported is
meningococcal infection, which is a meningitis, meaning it
causes an infection of the membranes covering the brain and
spinal cord. Complications can include loss of limbs, hearing
loss and, in 15% of cases, death if left untreated.
According to the CDC, most persons infected with Salmonella
develop diarrhea, fever, and abdominal cramps 12 to 72 hours
after infection. The illness usually lasts four to seven days,
and most persons recover without treatment. However, in some
individuals, the symptoms may be severe enough to warrant
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hospitalization. In these patients, the Salmonella infection
may spread from the intestines to the blood stream, and then
to other body sites and can cause death unless the person is
treated promptly with antibiotics. The elderly, infants, and
those with impaired immune systems are more likely to have a
severe illness. Recurrent salmonella septicemia is considered
an AIDS defining condition by the CDC.
The CDC describes listeriosis as a serious infection usually
caused by consuming contaminated food. Symptoms can include,
fever, muscle aches, diarrhea, or other gastrointestinal
complications. The CDC notes that this bacterial infection
almost always spreads beyond the gastrointestinal tract.
Those most vulnerable to contracting listeriosis are newborns,
pregnant women, older adults ant those with weakened immune
systems.
3)SUPPORT . According to the sponsor, the Health Officers
Association of California, local health departments already
receive information about HIV cases and cases of listeriosis,
hepatitis, meningococcal infection, and salmonellosis.
However, current law forbids health departments from receiving
this information together in one form. This puts an
unnecessary burden on public health departments and medical
care providers, and creates barriers to effective patient
care. In particular, they argue, organizations and
individuals face penalties and fines if they mention a
coinfection when reporting a case.
4)PREVIOUS LEGISLATION .
a) SB 249 (Leno), Chapter 445, Statutes of 2013, authorizes
the sharing of health records involving the diagnosis,
care, and treatment of HIV or AIDS related to a beneficiary
enrolled in federal Ryan White Act funded programs who may
be eligible for health care under the federal Patient
Protection and Affordable Care Act between DPH and
qualified entities, as specified.
b) AB 2541 (Portantino), Chapter 470, Statutes of 2010,
among its other provisions, requires reporting diseases
when there is a "coinfection" with HIV or AIDS.
5)DOUBLE REFERRAL . This bill is double referred and upon
passage of this Committee, it will be referred to the Assembly
Judiciary Committee.
AB 1898
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REGISTERED SUPPORT / OPPOSITION :
Support
Health Officers Association of California (sponsor)
California Communities United Institute
Numerous individuals
Opposition
None on file.
Analysis Prepared by : Roger Dunstan / HEALTH / (916) 319-2097