From: Laurie McBride Date: Tue, 24 Jun 1997 15:12:12 Subject: CA: HIV & Healthcare Legislative Update June 23, 1997 LEGISLATIVE UPDATE: HIV/Health Care Policy Contacts: Laurie McBride, Executive Director Ellen McCormick, Legislative Advocate Sam Catalano, Legislative Assistant 1997 PRIORITIES: 1997-98 CALIFORNIA STATE BUDGET 1997 AIDS Budget The Budget Sub-Committees of Health for both the California State Assembly and State Senate have held their first hearings. Budget Sub-Committee proposals are a critical first step in the budget process. Sub-Committee recommendations form the basis of the legislature's budget package. If the proposals are the same for individual line items from both the Assembly and Senate sides, then the proposals are pretty much set in stone. If they are different, they end up as discussion points in a joint Assembly/Senate budget "conference" committee: the discrepancy must be resolved there. AIDS Drug Assistance Program (ADAP) BACKGROUND: The Governor's Budget proposed a $47,288,000 increase to ADAP. This increase came from $11,659,000 General Fund, $18,600,000 in Title II federal funds, $4,129,000 in drug rebates, and the mandated use of $12,900,000 of local EMA funds. SUB-COMMITTEE RECOMMENDATIONS: Both State Assembly and Senate Sub-Committees agreed that EMAs should not be required to shift funds to ADAP. The $12.9 would now come from General Funds. In fact, the Governor's May Revise budget (updated after budget hearings) now calls for the same: the $12.9 for ADAP coming from State General Funds. At LIFE's February meeting, the House voted to oppose the mandatory requirement that EMAs shift funds to ADAP. Thus LIFE is strongly in support of the current budget proposal. Support Viral Load Testing for ADAP Clients BACKGROUND: The Governor's Budget proposed $3.8 million from the General Fund to initiate viral load testing for ADAP clients. SUB-COMMITTEE RECOMMENDATIONS: Both recommended keeping the $3.8 for this purpose. Centralization of ADAP (Pharmaceutical Benefit Management Contract) BACKGROUND: ADAP pharmacy services are currently administered through a decentralized system. DHS has issued a request for proposal (RFP) to solicit bids from Pharmaceutical Benefit Management companies (PBM). Why? To reduce costs without reducing availability of drugs or capping the number of prescriptions filled. Other benefits would include better data collection, better prices on drugs, and drug rebates to the state. Los Angeles, which utilizes some 40-45% of ADAP in California, does not participate in the state run ADAP program. Thus the state does not realize any rebates from that portion of ADAP use. SUB-COMMITTEE RECOMMENDATIONS: Conference item. The Senate Sub-Committee agreed that centralization was a good idea; the Assembly Sub-Committee called for centralization with a "carve-out" for Los Angeles. The primary proponent of the carve-out is AIDS Healthcare Foundation. Opposed to the carve-out are the members of the AIDS Budget Coalition, including LIFE. Currently: While the full budget accord has not been reached as of this date, it appears that the Senate version, favoring statewide centralization with no carve out for Los Angeles, will prevail. The company picked to administer the statewide ADAP program has proposed a provider network far exceeding the existing network. Further, this company has put in place strong consumer protections. Position: Support Centralization with No Carve-Out Anonymous Testing Services BACKGROUND: The Governor's Budget proposed eliminating $1.6 million General Fund previously used for anonymous HIV testing services in family planning clinics. SUB-COMMITTEE RECOMMENDATIONS: Both recommended keeping the $1.6 for this purpose. Medi-Cal Funding for Recombinant Human Growth Hormone (RHGH) BACKGROUND: The Governor's Budget included $32,410,000 and $57,672,000 in General Fund (and also corresponding federal funds) within the Medi-Cal estimate for the current and budget years, respectively, to fund the State share of the new RHGH drug's costs. State law requires Medi-Cal to cover all new drugs approved by FDA. RHGH has been approved as a means of maintaining body weight for people with AIDS. SUB-COMMITTEE RECOMMENDATIONS: Conference item. The Senate Budget Sub-Committee did not deal with this item. The Assembly Budget Sub-Committee reduced the amount for the current year and budget year by an amount sufficient to cover other budget restorations (e.g., the $12.9 million for ADAP, the $1m for HIV testing in Family Planning Clinics, etc.). This savings is possible because of a much lower utilization of RHGH since its availability in December, 1996. The Governor's May Revise reflects similar savings. AB 889 (Gallegos) Oppose Unless Amended Expanding and speeding up the addition of newly approved drugs to the ADAP formulary. Current law requires that all HIV therapies are included on the Medi-Cal formulary, and all newly approved drugs are added automatically. Thus Medi-Cal recipients have access to the full range of therapies for the treatment of HIV. Under the AIDS Drug Assistance Program (ADAP), however, the drug formulary of existing drugs is limited, and the addition of newly approved drugs is not automatic. Adding new therapies to the ADAP formulary is a prolonged process, involving review by a medical advisory committee and cost neutrality studies by the Department of Health Services and Department of Finance. AB 889 would expand the existing ADAP formulary by requiring the program to give any drug available to any eligible person with certain provisions. Opponents feel that enactment of this bill could actually damage, even bankrupt ADAP since, unlike Medi-Cal, ADAP has limited funds. Once funds run out, there is no mandate in place that would require the state or federal government to continue the program. Even a temporary interruption in the accessibility of ADAP drugs would endanger thousands of Californians. Until the funding mechanism is worked out, LIFE's House of Delegates continues to oppose. ACTIONS: 02/27/97 Introduced 04/08 Assembly Health Committee P 16-0 04/15 amended 4/08, 5/23 05/28 Assembly Appropriations P 15-2 06/03 Assembly Floor P 58-19 STATUS: pending Senate Health Cmte AB 967 (Migden) Support ADAP Funding: Legislation would provide that for the purposes of the Administration of ADAP, the Director of Health Services may request, but not require, a county to shift local or federal funds to administer the program. ACTIONS: 02/27/97 Introduced 05/07 amended 5/7, 5/13 05/13 Assembly Health Cmte P 18-0 05/23 Assembly Floor P 71-0 STATUS: pending Senate Health Cmte 1997 PRIORITIES: DISABILITY DETERMINATIONS/INSURANCE AB 1099 (Migden) Support Making it possible for Medi-Cal recipients living with AIDS to go back to work. Right now, Medi-Cal recipients who go back to work must pay a "share of cost" of any Medi-Cal benefits. Some people living with AIDS want to return to work, but find this "share of cost" a barrier to doing so. For example, an individual earning $2,000 a month would pay roughly $1000 in share of cost, leaving precious little for living and other expenses. AB 1099 would exempt up to $2500/month in earnings from counting toward the share of cost requirement. This exemption would hold until the individual is eligible for and receives full medical insurance coverage. ACTIONS: 02/27/97 Introduced 04/09 amended 04/09, 04/17, 5/15, 5/27 04/22 Assembly Health Committee P 15-1 05/21 Assembly Appropriations P 16-1 06/03 Assembly Floor P 77-1 STATUS: Pending Senate Health Cmte AB 1052 (Villaraigosa) Support Currently, new AIDS drugs are automatically added to the Medi-Cal formulary. This bill would provide for the automatic addition of any new AIDS vaccines and/or "anti-viral agents" used prophylactically. This bill expands existing law from drugs used to "treat" AIDS and opportunistic infections to include vaccines and prophylactic uses of anti-viral agents. ACTIONS: 02/27/97 Introduced 04/22 Assembly Health Committee P 20-0 05/21 Assembly Appropriations P 15-3 05/29 Assembly Floor P 57-16 STATUS: 05/21 Pending Senate Health Cmte AB 1137 (Ducheny) Watch Identical to the initial version of AB 1052 by Villaraigosa. Still in Assembly Health Committee. SB 495 (Rosenthal) Support Would increase weekly benefit cap to $490 from $336 for disability periods beginning January 1, 1998. ACTIONS: 02/20/97 Introduced 04/09 Senate Industrial Relations Cmte P 4-3 05/05 Senate Appropriations Cmte P 8-5 05/27 Senate Floor P 22-15 STATUS: Pending Assembly Insurance Cmte SB 964 (Knight) Oppose Would take away safeguards for employees by making it easier for employers to opt out of State Disability Insurance program through a Voluntary Plan for coverage of disability benefits. ACTIONS: 02/27/97 Introduced 04/14 amended 0423 Senate Industrial Relations Cmte F 3-4 STATUS: Stalled in Senate Industrial Relations SB 1035 (Polanco) Support Sets up a pilot project to allow DHS to study the cost-effectiveness of early intervention for patients who otherwise qualify for Medi-Cal but who are not yet disabled. The bill is designed to study the expense of treatment at certain stages of infection and illness, such as is it more or less expensive to let people get sick before offering treatment? This bill intends to set up a study and come up with some determinations. SB 1035 failed its first vote on the Senate floor; it needed 2/3 vote to pass. The 6/4 amendment made it a majority vote bill. It passed upon reconsideration. ACTIONS: 02/27/97 Introduced 04/16 Senate Health Cmte P 8-0 05/29 Senate Appropriations P 8-2 06/04 Senate Floor F 26-10 06/04 amended 06/05 Senate Floor P 21-11 STATUS: Pending Assembly Health Cmte 1997 PRIORITIES: ACCESS TO HEALTHCARE & SERVICES/ MANAGED CARE AB 7 (Brown) Support Requires every healthcare service plan contract, nonprofit hospital service plan contract, and certain disability insurance policies issued after 1/1/98 to include coverage for a minimum of 48 hours of inpatient care for a woman undergoing a mastectomy. ACTIONS: 12/2/96 Introduced 03/31/97 amended 04/01 Assembly Health Cmte P 19-0 04/08 Assembly Insurance Cmte P 9-3 05/07 Assembly Appropriations P 13-2 05/19 Assembly Floor P 56-15 STATUS: Pending Senate Insurance Cmte AB 12 (Figueroa) Support Requires every health care service plan contract and every individual or group policy of disability insurance issued after 1/1/98 that provides mastectomy coverage to cover a physician ordered follow-up visit within 48 hours of discharge and to cover all complications from a mastectomy. ACTIONS: 12/02/96 Introduced amended 2/27, 2/28, 3/13, 3/31, 5/20 04/01 Assembly Health Cmte P 14-1 04/08 Assembly Insurance Cmte P 13-2 04/23 Assembly Appropriations P 16-3 05/08 Assembly Floor P 65-8 STATUS: Pending Senate Insurance Cmte AB 38 (Figueroa) Support Requires every healthcare service plan contract, nonprofit hospital service plan contract, and certain disability insurance policies issued after 1/1/98 that provide maternity coverage, from restricting benefits for inpatient hospital care to a time period less than 48 hours following a normal vaginal delivery and less than 96 hours for a caesarean section. ACTIONS: 12/02/96 Introduced 03/13 amended 3/13, 4/07, 6/12 04/01 Assembly Health Cmte P 17-1 04/08 Assembly Insurance P 13-0 04/23 Assembly Appropriations P 17-2 05/08 Assembly Floor P 61-12 06/18 Senate Insurance Cmte P 7-0 STATUS: Pending Senate Appropriations AB 269 (Ortiz) Support Prohibits a health facility or physician and surgeon from permitting a patient to depart the facility or physician's office unless a physician or other appropriately licensed health professional has determined that the patient can be safely cared for in the home or other community setting. LIFE's concern that this could interfere with a patient's ability to leave "Against Medical Advice" has been addressed in the current amendments. The bill is strictly intended to protect patients from being released without the some assurances that proper care is available. ACTIONS: 02/13/97 Introduced 04/15 Assembly Health Cmte P 14-5 04/28 amended 4/28, 6/2 05/30 Assembly Appropriations P 13-8 06/04 Assembly Floor P 43-37 STATUS: Pending Senate Insurance Cmte AB 341 (Sweeney) Support Requires a health care service plan and certain disability insurers to authorize payment in a timely manner for a second opinion by an appropriately qualified health professional, if requested by an enrollee or insured. ACTIONS: 02/18/97 Introduced 04/08 Assembly Health Committee P 14-0 04/23 Assembly Appropriations P 19-0 05/19 Assembly Floor P 55-17 STATUS: Pending Senate Insurance Cmte AB 434 (Gallegos) Support Requires the deletion of provisions stating that the reasons for the termination of a provider will only be disclosed if the termination occurs during the contract year. ACTIONS: 02/20/97 Introduced 03/31 amended 03/31, 04/10 04/15 Assembly Health Cmte P 17-0 05/21 Assembly Appropriations P 16-4 06/04 Assembly Floor P 54-13 STATUS: Pending Senate Insurance Cmte AB 497 (Wildman) Support Some health care service plans, disability insurers, and contracting providers have apparently created a "screening" program for calls, that is: put the caller on hold for 10 minutes or more; hope that they don't call back. This bill would require health care plans, disability insurers, and contracting providers to answer phone calls within five minutes and imposes requirements regarding the time frame for appointments with specialists, and for responses to requests for care by patients in acute care. The committee recommended support because people with HIV and AIDS need and deserve timely responses for treatment . ACTIONS: 02/24/97 Introduced 04/08 Assembly Health Committee P 11-5 04/15 amended 04/15, 05/06 05/30 Assembly Appropriations P 13-8 06/04 Assembly Floor P 42-36 STATUS: Pending Senate Insurance Cmte AB 536 (Gallegos) Support Would require a physician who denies service to health plan enrollees to be licensed in California; requires either a physical exam or a thorough review of the patient's medical records prior to a plan's decision to deny care; includes within the practice of medicine, making a decision resulting in denial of services to an enrollee; and requires various disclosures to enrollees. ACTIONS: 02/24/97 Introduced 04/10 amended 04/15 Assembly Health Committee P 16-1 05/28 Assembly Appropriations P 13-6 06/02 Assembly Floor P 55-20 STATUS: Pending Senate Business & Professions Cmte AB 663 (Ortiz) Support Would establish the INTENT of the legislature to create a Public Health Contingency Fund to provide counties with the resources for basic health protection services. Under this bill, would develop public health capacity standards to evaluate each counties "disease control capability". Any county that fails the evaluation would be eligible, based on demonstrated financial need, to receive state funding. There is no funding mechanism tied to this bill. ACTIONS: 02/26/97 Introduced 04/15 Assembly Health Committee P 20-0 05/23 amended 05/28 Assembly Appropriations P 20-0 06/02 Assembly Floor P 79-1 STATUS: Pending Senate Health Cmte AB 794 (Figueroa) Support Requires a healthcare service plan to disclose to any person or organization, upon request, the processes the plan uses to authorize or deny healthcare services by a provider pursuant to the benefits provided by the plan. ACTIONS: 02/26/97 Introduced 04/15 Assembly Health Cmte P 16-0 04/17 amended 4/17, 5/22, 6/17 04/22 Assembly Insurance P 9-1 05/14 Assembly Appropriations P 11-5 05/29 Assembly Floor P 50-22 STATUS: Pending Senate Business & Professions Cmte AB 1100 (Thomson and Perata) Support Would require that health care service plans and disability insurers provide coverage for the diagnosis and treatment of mental illness on the same terms and conditions as coverage for other medical conditions. Proponents argue that mental illness is inappropriately treated because of lack of insurance coverage. ACTIONS: 02/27/97 Introduced 04/15 Assembly Insurance Cmte P 9-3 05/06 amended 05/06, 05/08 05/30 Assembly Appropriations P 15-5 06/05 Assembly Floor P 43-31 STATUS: Pending Senate Insurance Cmte AB 1208 (Migden) Support Would require DHS to study patient care issues on death and dying including: relevant court cases around terminally ill patients, physician assisted suicide, pain management, physician and/or health care provider abandonment, and insurance coverage. ACTIONS: 02/28/97 Introduced 04/17 amended 04/22 Assembly Health Cmte P 15-4 05/14 Assembly Appropriations Cmte P 11-7 05/22 Assembly Floor P 46-29 STATUS: Pending Senate Health Cmte AB 1298 (Villaraigosa) Support Prohibits a health care service plan, disability insurer or a contracting provider from impeding or impairing communication or the right of free association among enrollees or insureds, except to protect the health and safety of enrollees, insureds, and employees. Introduced because some HMO's were not allowing representatives from Health Access to talk with other patients in the waiting room or with employees. ACTIONS: 02/28/97 Introduced 04/08 Assembly Health Cmte P 15-1 04/23 Assembly Appropriations P 14-3 04/28 amended 05/08 Assembly Floor P 73-0 STATUS: Pending Senate Judiciary Cmte SB 253 (Burton) Support Prohibits a health facility from discriminating or retaliating against a patient or employee of that facility because the patient or employee presents a grievance or complaint relating to the care, services or conditions of that facility. ACTIONS: 12/04/96 Introduced 04/09/97 Senate Industrial Relations Cmte P 4-2 04/14 amended 05/12 Senate Appropriations P 7-5 05/22 Senate Floor P 22-15 STATUS: Pending Assembly Health Cmte SB 324 (Rosenthal) Support Requires the definition of the practice of medicine to include making a decision regarding the medical necessity or appropriateness of any diagnosis, treatment, operation, or prescription. ACTIONS: 02/12/97 Introduced 04/14 Senate Business & Professions Cmte P 7-0 05/12 Senate Appropriations Cmte P 7-3 05/28 amended 06/03 Senate Floor P 21-12 STATUS: Pending Assembly Health Cmte 1997 PRIORITIES: HIV PREVENTION/ EDUCATION/ HARM REDUCTION AB 600 (Kuehl) Support Family Access to Care and Treatment Program: To provide preventative health care services to low-income men and women. Preventative health care means screening, including periodic history, physicals, and appropriate laboratory tests; evaluation and counselling; including sexual health, family planning, fitness, psycho-social evaluation, cardiovascular risk, and other health factors; limited treatment including but not limited to treatment of sexual transmitted diseases, necessary immunizations, and contraceptive medical procedures and supplies. Under existing law, these services offered through the Office of Family Planning are restricted to women who can conceive. The purpose of this legislation is to open up the program to all persons who need medical treatment and related services. ACTIONS: 02/25/97 Introduced 04/22 Assembly Health Committee P 13-6 05/30 Assembly Appropriations P 13-8 06/03 amended 06/05 Assembly Floor P 42-32 STATUS: Pending Senate Health Cmte AB 818 (Martinez) Support Existing law requires prenatal care providers to offer HIV testing to pregnant women (along with counselling and referral services). This bill would extend that requirement to include every medical care provider treating any patient from age 15 to 54 years of age. This bill would also require the State Office of AIDS to develop a voucher program for low-income individuals to get home HIV test kits. This voucher program should be implemented by January 1, 1999. LIFE's HIV/Healthcare Committee is in favor of requiring medical care providers to offer HIV testing to all patients. The committee sees a problem with the home HIV testing kits, however, citing problems of unreliability and lack of appropriate counselling. LIFE asked the author to drop the home testing provisions, which was done 5/1. ACTIONS: 02/26/97 Introduced 04/22 Assembly Health Committee P 12-6 05/01 AMENDED [ Support If Amended changed to SUPPORT ] 05/30 Assembly Appropriations P 13-6 06/03 amended 06/05 Assembly Floor P 41-35 STATUS: Pending Senate Health Cmte AB 881 (Runner) Oppose Would require every general acute care hospital to test every newborn; requires disclosure of results to the baby's parents or guardian. Additionally, the bill requires the hospital to report the number of tests with positive results to the Department of Health Services, without revealing the identity of the babies tested. ACTIONS: 02/27/97 Introduced STATUS: Pending Assembly Health Cmte, No hearing date scheduled SB 560 (Hayden) Support Regulated Chemicals Surtax: Creates a new tax to create the California Methamphetamine Reduction and Rehabilitation Fund. Potentially important to us because of the new evidence coming out that links Meth use with HIV sero-conversion. The items to be taxed are limited to cash purchases of specific chemicals used to make Methamphetamines. This legislation is crafted to avoid taxing over-the-counter products like Sudafed (commonly used in meth). It has also been crafted to avoid taxing legitimate uses of specific chemicals purchased in bulk by chemists, pharmacists, and labs. ACTIONS: 02/24/97 Introduced 05/01 amended 5/1, 5/14, 05/07 Senate Revenue & Tax Cmte P 6-0 05/29 Senate Appropriations P 12-0 06/04 Senate Floor P 27-10 STATUS: Pending Assembly Health Cmte SB 862 (Lee) Support If Amended Would establish the Interagency Commission on African American Males, to implement recommendations by the Commission on the Status of African American Males. Problems identified by the first commission included poverty, unemployment, and that "African American males represent 12 percent of the AIDS-related deaths in California". LIFE is seeking amendments to study homophobia within the African-American male community. ACTIONS: 02/26/97 Introduced 04/16 amended 4/16, 5/14, 5/27 05/05 Senate Rules Committee P 3-1 05/22 Senate Appropriations P 8-4 06/05 Senate Floor P 21-13 STATUS: Pending Assembly Consumer Protection Cmte SB 885 (Watson) Support This bill would establish the Clean Needle and Syringe Exchange Pilot Projects, and would authorize pharmacists, physicians, and certain persons authorized under the pilot projects to furnish hypodermic needles and syringes without a prescription or permit. The bill would authorize specified counties and cities to develop pilot projects upon the request of the county or city local health officer. (Same bill introduced last three years). This bill is being co-sponsored by the cities of Los Angeles, Long Beach, San Francisco and Santa Clara. ACTIONS: 02/27/97 Introduced 04/21 amended 04/21, 05/05, 05/12 04/23 Senate Health Committee P 6-1 05/19 Senate Appropriations P 05/27 Senate Floor F 20-16 06/05 Senate Floor P 21-17 STATUS: 05/19 Pending Assembly Health Cmte SB 1007 (Vasconcellos) Support Comprehensive Statewide Plan for Prevention and Treatment of HIV/AIDS: To convene a Strategic Plan Task Force for the treatment of HIV/AIDS into the 21st Century. This planning mechanism will utilize community plans developed by Statewide Working Groups in both Treatment and Prevention, lending them weight in the public policy arena. Findings will also be useful in bill analysis and advocacy as legislators grapple with emerging problems. LIFE sought and received several amendments, including inclusion of PLWH on the Task Force (3 positions out of 15). Another amendment specified the Office of AIDS (OA) Care Section and the OA Prevention Section as having the responsibility to staff the Task Force. ACTIONS: 02/27/97 Introduced 04/14 amended 04/23 Senate Health Cmte P 6-0 05/12 Senate Appropriations Cmte P 9-2 05/22 Senate Floor P 29-6 STATUS: Pending Assembly Health Cmte SB 1110 (Leslie) Oppose Positive Parental Consent Bill: Originally required positive written parental consent before any public school student receives instruction on STDs, AIDS, human sexuality, family life, or any other health education instruction delivered by outside organizations or guest speakers. Further prohibitions on such discussions in general school assemblies even by school personnel without positive parental permission. Also adds emphasis on monogamy and other virtues to existing emphasis on abstinence. Changes requirement for instruction on compassion for people with AIDS to compassion for "anyone with a debilitating handicap(s) and/or terminal disease." Would prohibit teaching compassion (as in tolerance, acceptance, respect) for drug use or any "particular" sexual "lifestyle" or "practice." Substantially amended: Now requires parental notification of guest speakers. Objectionable language about "particular lifestyles" has been removed. Opposition of other groups has changed to neutral or even support. ACTIONS: 02/28/97 Introduced 04/09 Senate Education Committee P 7-1 05/05 amended 05/05, 05/07 05/29 Senate Appropriations P 12-0 06/04 Senate Floor P 27-3 STATUS: Assembly Cmte SB 1301 (Leslie) Oppose Close the bathhouses: Legislative attempt to close the bathhouses. Several amendments were tried, but this bill in all forms was successfully defeated in its first hearing. ACTIONS: 02/28/97 Introduced 04/16 amended 04/22 Senate Judiciary Committee F 4-3 STATUS: Stalled in Senate Judiciary Cmte ( 1997 PRIORITIES: MEDICAL USE OF MARIJUANA AB 610 (Margett) Oppose Creates nearly insurmountable obstacles for the implementation of Proposition 215 by imposing enormous licensing fees and taxes on the cultivation, and separately, the distribution of marijuana for medicinal use. ACTIONS: 02/25/97 INTRODUCED STATUS: Pending hearings in Assembly Health & Assembly Agriculture a Two year bill SB 535 (Vasconcellos) Support Would create a Marijuana Research Program. SB 535 authorizes the University of California to create a California Medical Marijuana Research Center to develop and implement medical marijuana studies and to solicit proposals for research projects. It also appropriates $2 million of State General Fund dollars to the Center to conduct this research. Lack of such research is often cited as a reason for denying the medicinal use of marijuana. Yet research projects at the federal and state level have been blocked for years. SB 535 would push the state to allow serious medical research to begin. ACTIONS: 02/24/97 Introduced 03/31 amended 3/31, 4/10, 5/20, 5/23 04/02 Senate Health & Human Services P 5-2 04/15 Senate Public Safety P 5-2 05/29 Senate Appropriations P 7-1 06/04 Senate Floor P 27-9 STATUS: Pending Assembly Cmte HIV, THE PRISONS AND CRIMINAL JUSTICE AB 29 (Villaraigosa) Support Compassionate Release: This bill would establish a procedure for recalling a prisoner's sentence if the prisoner is found to be terminally ill. This is a re-introduction of last year's legislation which Governor Wilson vetoed. ACTIONS: 12/02/96 Introduced 04/10 amended 04/15 Assembly Public Safety P 8-0 05/21 Assembly Appropriations P 13-5 05/29 Assembly Floor P 56-16 STATUS: Pending Senate Public Safety Cmte SB 705 (Rainey) Oppose Criminalizing the intentional transmission of HIV. Recent amendments limit SB 705's provisions to the intentional transmission of HIV through sexual contact without disclosure. The penalty has been reduced to a felony punishable by imprisonment for 5, 7, or 9 years. Amended out: provisions covering needle sharing, the lesser penalties of exposing someone without intent; plus intent must be proven by prosecutors; obtaining medical records requires a court hearing and disclosure is defined simply as relating HIV status. ACTIONS: 02/25/97 Introduced 04/07 amended 4/07, 4/16, 5/01, 5/06 04/22 Senate Public Safety Cmte P 5-0 05/19 Senate Appropriations P 7-0 05/27 Senate Floor P 25-1 STATUS: Pending Assembly Public Safety Cmte MEDICAL INSURANCE FOR THE UNINSURED LIFE's House of Delegates voted to take a WATCH position on a number of bills designed to expand access and/or eligibility to health insurance for uninsured Californians. We strongly support the concept of universal health coverage. However, LIFE has not analized all the details of these plans. AB 534 (Thomson) Watch Health Care Coverage Expansion Act of 1997. Would cover more children through Medi-Cal and create a program for low-income employees and dependents to provide a basic benefit package. ACTIONS: 02/24/97 Introduce 05/06 Assembly Health P 19-0 05/19 Assembly Floor P 52-20 STATUS: Pending Senate Cmte AB 1112 (Gallegos) Watch California Health Program. Would provide health coverage to uninsured Californians through Medi-Cal. ACTIONS: 02/27/97 Introduced 05/06 Assembly Health P 19-0 05/19 Assembly Floor P 46-25 STATUS: Pending Senate Insurance Cmte AB 1126 (Villaraigosa) Support Would expand Medi-Cal eligibility, without share of cost, to individuals under 19 years of age with family incomes at or below 200 % of poverty. Important to us because of the number of youth with HIV and AIDS who are not accessing any medical care because of cost. Studies show a correlation between lack of access to primary care and primary infection for youth. In California there are 1.7 million youth through age 18 without insurance. Recently the San Francisco DPH released statistics which estimated that there are 4700 young people with HIV in the city (ages 13-26). Less than 10% of these youth are enrolled in HIV care. ACTIONS: 02/27/97 Introduced 04/14 amended 4/14, 4/24 05/06 Assembly Health P 19-0 05/19 Assembly Floor P 48-23 STATUS: Pending Senate Cmte AB 1430 (Figueroa) Watch Health Insurance Act of 1998. Would state the intent of the legislature to offer low-income people the option of receiving medical care through a basic insurance package. Would offer employers lower workers' compensation insurance rates in return for providing basic health insurance. ACTIONS: 02/28/97 Introduced 05/06 Assembly Health P 19-0 05/20 Assembly Floor P 66-10 STATUS: Pending Senate Insurance Cmte SB 954 (Rosenthal) Watch Health Insurance Access for Children and Families Act of 1997. Would establish a program of publicly sponsored health insurance to be provided through commercial and non-profit providers. Specifically for working uninsured residents of California, and to be administered by MRMIP (Managed Risk Medical Insurance Board). ACTIONS: 02/27/97 Introduced 04/17 amended, 4/17, 6/4 04/23 Senate Health Cmte P 5-2 06/04 Senate Appropriations P 06/05 Senate Floor P 21-15 STATUS: Pending Assembly Health Cmte MISC INSURANCE ISSUES AB 49 (Murray) Support Workers Compensation, Death Benefits & HIV Related Disease: This bill would provide that workers' compensation death benefits shall be furnished in the case of the death of a medical health worker or public safety employee, as specified, due to HIV related disease, subject to specified conditions. Under existing law, a proceeding to collect workers' compensation benefits for the death of an asbestos worker must be commenced within one year of the date of death. This bill would provide that the same time limit applies to a proceeding to collect those benefits for the death of a medical health worker or public safety employee, as specified, from an HIV related disease. ACTIONS: 12/02/96 Introduced 03/20/97 amended 03/20, 04/23 04/01 Assembly Insurance Cmte P 9-2 04/16 Assembly Appropriations P 15-3 05/05 Assembly Floor Vote P 70-5 STATUS: Pending Senate Cmte AB 489 (Figueroa) Support Viatical insurance bill sponsored by APLA which would allow owners of group Life Insurance policies to make viatical settlements. ACTIONS: 06/04 Assembly Floor P 75-3 STATUS: Pending Senate Insurance Cmte SB 393 (Rosenthal) Support Existing law, which LIFE supported, requires health insurers and plans to offer and issue health coverage to small employers without any exclusions due to medical underwriting or other than the employers' willingness to make premium payments. Existing law defines small employers as those with 2 to 50 employees. This bill would extend those guidelines to employers with 51 to 100 employees. ACTIONS: 2/14/97 Introduced 04/24 Senate Insurance Cmte P 6-1 05/12 Senate Appropriations Cmte P 06/03 amended 06/05 Senate Floor P 26-5 STATUS: Pending Assembly Health Cmte SB 462 (Rosenthal) Support Existing law prohibits medical providers from charging patients for clinical lab tests if the test is not actually perform or supervised in their offices. This bill would allow physicians to charge for HIV tests, if the test kit bought by the doctors includes the cost of the lab fee. ACTIONS: 2/19/97 Introduced 04/17 Senate Health Cmte P 8-0 STATUS: Pending Senate Appropriations SB 1137 (Kopp) Watch Would allow life and disability agents to be licensed as viatical settlement brokers and would authorize the Insurance Commissioner to adopt conflict of interest regulations. Staff is doing research on the provisions in this bill to require additional education, if any; also checking on conflict of interest issues. ACTIONS: 2/28/97 Introduced amended: 4/09, 4/14, 4/21 04/23 Senate Insurance Cmte P 8-0 05/12 Senate Appropriations Cmte P 05/22 Senate Floor P 38-0 STATUS: Pending Assembly Insurance Cmte SB 1262 (Johnston) Watch Existing law authorizes life and disability insurers to decline an insurance application on the basis of a positive HIV test performed at the discretion of the insurer on the applicant's blood. This bill would expand this to include any test performed by the insurer on any specimen of the applicant. Reflects the changes in testing procedures, including oral tests. ACTIONS: 2/28/97 Introduced 05/07 Senate Health Cmte P 7-0 05/15 Senate Floor Vote P 32-0 STATUS: Pending Assembly Insurance Cmte MEDICAL LIABILITY ISSUES AB 250 (Kuehl) Support Requires that the $250,000 limitation on non-economic losses shall NOT apply if the healthcare provider acted in any of the following ways: 1) consumed alcohol or illegal drugs that impaired his or her ability to perform professional services causing injury to the plaintiff; the healthcare provider has had three or more disciplinary actions taken against him or her; 3) committed sexual abuse or misconduct upon the plaintiff; 4) the injury resulted from gross negligence; 5) the negligence or misconduct resulted in death; 6) the injury was to a person under the age of 14 years. ACTIONS: 02/11/97 Introduced 05/07 Assembly Judiciary Committee P 9-4 STATUS: Assembly Inactive File AB 1220 (Migden) Support Requires that the $250,000 limitation on non-economic losses shall NOT apply if the healthcare provider acted in any of the following ways: 1) refused or delayed evaluation, diagnosis, treatment, or made a referral to another health care provider for the provider's economic benefit; 2) failed to refer to another health care provider who possessed the requisite skill, training and expertise; 3) administered an evaluation, diagnosis, or treatment without possessing the requisite skill, training, or expertise. ACTIONS: 02/28/97 Introduced STATUS: Pending Assembly Judiciary Cmte MEDI-CAL AND AFDC RELATED AB 426 (Gallegos) Support Requires Medi-Cal to test enrollment information materials for cultural and linguistic appropriateness and ease of comprehension. ACTIONS: 02/20/97 Introduced 04/15 Assembly Health Committee P 16-1 05/01 amended 5/1, 5/30 05/28 Assembly Appropriations P 13-8 06/03 Assembly Floor P 65-7 STATUS: Pending Senate Health Cmte SB 163 (Solis) Support Exempts eligible relative caregivers from the 2-year work participation requirements and the 5-year eligibility limitations contained in new federal laws. ACTIONS: 01/16/97 Introduced 03/06 amended 03/06, 03/31, 6/3 03/12 Senate Health Cmte P 8-0 05/29 Senate Appropriations P 8-0 06/04 Senate Floor P 24-10 STATUS: Pending Assembly Cmte s PREVENTION-RELATED ITEMS AB 995 (Pacheco) Oppose Gassing. Irate inmates have been known to throw handfuls of fecal matter at prison guards, an activity known as "gassing." Originally this bill would have made gassing an "assault with a deadly weapon". AB 995 has been amended to make gassing "aggravated battery"; all references to HIV have been taken out; the bill does refer to tuberculosis and hepatitis. ACTIONS: 02/27/97 Introduced 04/15 Assembly Public Safety Cmte P 8-0 04/28 amended 05/30 Assembly Appropriations P 17-4 06/05 Assembly Floor P 76-1 STATUS: Pending Senate Public Safety Cmte SB 274 (Watson) Support Tuberculosis control. Would authorize DHS to make grants to local health jurisdictions or joint entities to fund secured housing for recalcitrant patients to enable local health officers to implement legal orders of detention for the examination and treatment of tuberculosis. ACTIONS: 02/05/97 Introduced STATUS: Pending Senate Health Cmte POSSIBLE LEGISLATIVE POSITIONS SPONSOR: LIFE to participate in drafting, strategy, lobbying, and amendments to bill, in conjunction with the author's office and other sponsors (if any). Support: Support of the bill. Support Seeking Amendment: Support stands regardless of the fate of amendments. Support IF Amended: Support when amendments are accepted. Neutral Watch: No action, just watching. Oppose Unless Amended: Authors and sponsors are notified of LIFE's opposition unless LIFE's amendments are accepted. Oppose No Position