Amended in Senate April 2, 2014

Senate Bill No. 1303

Introduced by Senator Torres

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(Principal coauthor: Assembly Member Maienschein)

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February 21, 2014

An act to amend Section begin delete 38000 end delete begin insert 122405 end insert of begin insert , and to add Section 122407 to, end insert the Health and Safety Code, relating to begin delete social services. end delete begin insert public health. end insert

LEGISLATIVE COUNSEL’S DIGEST

SB 1303, as amended, Torres. begin delete Public social services: direct service contracts. end delete begin insert Public health: hepatitis C. end insert

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Existing law, the Hepatitis C Education, Screening, and Treatment Act, requires the Director of Public Health to develop and implement a public education and outreach program to raise awareness of the hepatitis C virus aimed at high-risk groups, physician’s offices, health care workers, and health care facilities that, among other things, includes hepatitis C counseling, education, and testing, as appropriate, into local state-funded programs.

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This bill would require a health care practitioner to offer a qualifying individual, as defined, a hepatitis C screening test or hepatitis C diagnostic test, as defined, unless the health care practitioner reasonably believes, among other things, that the qualifying individual is being treated for a life threatening emergency. If an individual consents to a hepatitis C screening test or diagnostic test and the test is positive or reactive, the health care practitioner would be required to offer followup health care or to refer the individual to a health care practitioner who can provide followup health care. The bill would require that the offering of a hepatitis C screening test or diagnostic test be culturally and linguistically appropriate, and would require the director to issue guidance on the culturally and linguistically appropriate offering of a test by July 1, 2015. These requirements would not apply to an individual receiving health care from a health care practitioner in a hospital or emergency room setting.

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Existing law states the intent of the Legislature, with respect to direct service contracts of the departments within the California Health and Human Services Agency, that the contract approval process and payment for services rendered occur within specified timeframes.

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This bill would make technical, nonsubstantive changes to these provisions.

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Vote: majority. Appropriation: no. Fiscal committee:  begin delete no end delete begin insert yes end insert . State-mandated local program: no.

The people of the State of California do enact as follows:

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begin insert SECTION 1. end insert   

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begin insert Section 122405 of the end insert begin insert Health and Safety Code end insert begin insert is
amended to read: end insert

122405.  

begin insert (a) end insert begin insert   end insert The Legislature hereby finds and declares all of
the following:

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(a)

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begin insert (1) end insert  Hepatitis C is classified as a silent killer, where no
recognizable signs or symptoms occur until severe liver damage
has occurred.

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(b)

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begin insert (2) end insert  Hepatitis C has been characterized by the World Health
Organization as a disease of primary concern to humanity.

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(c)

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begin insert (3) end insert  Studies indicate that 1.8 percent of the population, nearly 4
million Americans, carry the virus HCV that causes hepatitis C.
In California, as many as 500,000 individuals may be carriers and
could develop the debilitating and potentially deadly liver disease
associated with hepatitis C in their lifetime. An expert panel,
convened in March by the National Institutes of Health (NIH),
estimated that 30,000 acute new infections occur each year in the
United States, and only 25 to 30 percent of those are diagnosed.
Current data sources indicate that 8,000 to 10,000 Americans die
from hepatitis C each year.

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(d)

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begin insert (4) end insert  Studies also indicate that 39.4 percent of male inmates and
54.5 percent of female inmates in California correctional facilities
have hepatitis C, 26 times higher than the general population. Upon
their release from prison, these inmates present a significant health
risk to the general population of California.

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(5) Hepatitis C is the most common bloodborne pathogen in the
United States, and is a leading cause of complications from chronic
liver disease.

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(6) According to the federal Centers for Disease Control and
Prevention, 2.7 million Americans are living with chronic hepatitis
C, which is almost 1 percent of the entire population of the United
States.

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(7) Hepatitis C infections are most common among individuals
born between 1945 and 1965, commonly known as the baby
boomers.

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(8) Hepatitis C infections have reached epidemic levels,
especially in underrepresented communities.

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(9) Up to 75 percent of individuals infected with hepatitis C do
not know they are infected, and are therefore not connected to any
source of care or treatment.

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(10) In June 2013, the United States Preventive Services Task
Force recommended that all high risk individuals and anyone born
between 1945 and 1965 be screened for hepatitis C. In making
this recommendation, the United States Preventive Services Task
Force cited evidence that early screening and detection can lead
to improved clinical outcomes.

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(b) Accordingly, it is the intent of the Legislature to do both of
the following:

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(e)  It is the intent of the Legislature to study

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begin insert (1) end insert begin insert   end insert begin insert Study end insert the adequacy of the health care delivery system as it
pertains to hepatitis C.

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(f)  It is the intent of the Legislature to urge

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begin insert (2) end insert begin insert   end insert begin insert Urge end insert the department to make funds available to
community-based nonprofit organizations for education and
outreach with respect to the hepatitis C virus.

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begin insert SEC. end insert begin insert 2 end insert begin insert . end insert   

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begin insert Section 122407 is added to the end insert begin insert Health and Safety Code end insert begin insert ,
to read: end insert

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begin insert 122407. end insert   

(a) Every qualifying individual who receives medical
care from a health care practitioner shall be offered a hepatitis C
screening test or hepatitis C diagnostic test, unless the health care
practitioner providing those services reasonably believes that any
one of the following applies:

(1) The individual is being treated for a life-threatening
emergency.

(2) The individual has previously been offered a hepatitis C
screening test or diagnostic test, or has been the subject of a
hepatitis C screening test or diagnostic test, unless the individual
is a person described in clause (ii), (v), (vii), or (viii) of paragraph
(4) of subdivision (e).

(3) The individual lacks capacity to consent to a hepatitis C
screening test or diagnostic test.

(b) If an individual consents to a hepatitis C screening test or
diagnostic test and the test is positive or reactive, the health care
practitioner shall either offer followup health care or refer the
individual to a health care practitioner who can provide followup
health care. The followup health care shall include a hepatitis C
diagnostic test.

(c) The offering of a hepatitis C screening test or diagnostic
test pursuant to this section shall be culturally and linguistically
appropriate. The director shall issue guidance on the culturally
and linguistically appropriate offering of a test by July 1, 2015.

(d) This section does not affect the scope of practice of a health
care practitioner or diminish the authority, legal, or professional
obligation of a health care practitioner to offer a hepatitis C
screening test or diagnostic test, or to provide services or care for
the subject of a hepatitis C screening test or diagnostic test.

(e) As used in this section, the following terms shall have the
following meanings:

(1) “Health care practitioner” means a physician, surgeon, or
any other health care provider licensed to order a hepatitis C
screening test or hepatitis C diagnostic test.

(2) “Hepatitis C diagnostic test” means any laboratory test or
tests that detects the presence of the hepatitis C virus in the blood
and provides confirmation of whether the individual has a hepatitis
C virus infection.

(3) “Hepatitis C screening test” means an FDA-approved
laboratory screening test, FDA-approved rapid point-of-care test,
or other FDA-approved test that detects the presence of hepatitis
C antibodies in the blood.

(4) “Qualifying individual” means any of the following:

(i) A person born between the years of 1945 and 1965.

(ii) A current or former user of an injection drug.

(iii) A recipient of a blood transfusion, blood product, or organ
transplant before 1992.

(iv) A recipient of a blood clotting product before 1987.

(v) An individual who has liver disease or has had abnormal
liver test results.

(vi) A hemodialysis patient.

(vii) A health care worker who may be exposed to needle sticks.

(viii) An individual who is infected with human
immunodeficiency virus (HIV).

(f) This section does not apply to an individual receiving health
care from a health care practitioner in a hospital or emergency
room setting.

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SECTION 1.  

Section 38000 of the Health and Safety Code is
amended to read:

38000.  

The Legislature states its intent with respect to direct
service contracts of the departments within the California Health
and Human Services Agency as follows:

(a)  The contract approval process should take no longer than
30 days from the time the administrative agency generating the
contract has approved its provisions.

(b)  Payment for services rendered shall take no longer than 30
days after an invoice has been approved by the responsible
department.

(c)  If contract approval or payment or both are delayed, the
state shall notify community based agencies within 15 days with
instructions to either defer or interrupt services to be contracted.
If the state requests an agency to continue providing services,
conditions shall be mutually agreed upon in advance for
amortization of particular additional costs to the agency involved.

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