BILL ANALYSIS �
AB 1898
Page 1
ASSEMBLY THIRD READING
AB 1898 (Brown)
As Amended May 6, 2014
Majority vote
HEALTH 14-2 JUDICIARY 10-0
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|Ayes:|Pan, Maienschein, Atkins, |Ayes:|Wieckowski, Wagner, |
| |Ch�vez, Chesbro, | |Alejo, Chau, Dickinson, |
| |Gonzalez, Mansoor, | |Garcia, Gorell, |
| |Nazarian, Nestande, | |Maienschein, Muratsuchi, |
| |Patterson, Ridley-Thomas, | |Stone |
| |Wagner, Wieckowski, | | |
| |Skinner | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Ammiano, Gordon | | |
| | | | |
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SUMMARY : Requires the local health officer (LHO) to report
specified diseases to the Department of Public Health (DPH)
along with a report of human immunodeficiency virus or acquired
immunodeficiency syndrome (HIV/AIDS) when an individual is
infected with both HIV/AIDS and one of the specified diseases,
referred to as "coinfection."
FISCAL EFFECT : None
COMMENTS : 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 and meningococcal infection.
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 reporting of other communicable diseases of
AB 1898
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public health importance should be included.
DPH is required to establish a list of communicable and
noncommunicable diseases and conditions which LHOs are required
to report to DPH. LHOs are requires to report cases of
tuberculosis or sexually transmitted diseases when a person is
coinfected with one or more of these and HIV/AIDS. HIV/AIDS has
very specific reporting requirements and restrictions. Health
care providers and laboratories must report cases of HIV
infection to the LHO using patient names, as specified and the
LHO must report unduplicated HIV cases by name to DPH. Exiting
law only permits disclosure of health records for an HIV/AIDS
patient for the purpose of facilitating appropriate HIV/AIDS
medical care and treatment.
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, especially
for those infected with HIV. According to the Centers for
Disease Control and Prevention, 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 that needs to be reported is
meningococcal infection, 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.
A variety of national and state privacy laws apply to the data
and exist to protect the rights of patients. All health
department staff that have access to the HIV reporting system
are trained in confidentiality. Existing privacy provisions and
protections in the Health and Safety Code are unchanged by the
bill.
AB 1898
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According to the sponsor, the Health Officers Association of
California (HOAC), local health departments already receive
information about HIV cases and cases of hepatitis and
meningococcal infection. 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, HOAC argues,
organizations and individuals face penalties and fines if they
mention a coinfection when reporting a case.
Analysis Prepared by : Roger Dunstan / HEALTH / (916) 319-2097
FN: 0003438