California Performance Review Recommends Changes to Reporting System for HIV Cases, Pesticide Approval
California should track new HIV cases by name instead of by alphanumeric code, the California Performance Review recommended in a report scheduled to be released Tuesday, the Los Angeles Times reports (Rivera, Los Angeles Times, 7/31). According to the Sacramento Bee, the report constitutes the "most detailed and over-arching reorganization in state history" and includes proposals that would "shift power" from legislators to the governor. The proposal would save California about $32 billion over five years by eliminating thousands of state jobs and hundreds of regulatory positions and outsourcing more state services to private businesses (Talev/Smith, Sacramento Bee, 8/2). When the report becomes public, "every proposed change will be targeted by every politician or interest group it will affect," the San Francisco Chronicle reports (Wildermuth, San Francisco Chronicle, 8/1).
Under the report's recommendations, the state would reduce costs by streamlining its public health and welfare programs, giving counties more authority in the process and allowing private firms to bid on programs currently operated by the state. The overhaul would move the Department of Managed Care under the authority of the Health and Human Services Agency and would create a Center for Public Health to oversee all health care planning and risk assessment projects. The plan would allow Medi-Cal applications to be processed online or through the mail (California Healthline, 7/30).
According to the Times, CPR's recommended changes for the state HIV/AIDS reporting system is "likely to provoke one of the most emotional debates among the proposals" included in the report. California in 2002 established the current HIV/AIDS tracking system, which uses codes to track HIV cases and names to track AIDS cases. The restructuring panel concluded that the code-based system is "labor intensive, less accurate and more complex than the name-based system" and could result in the loss of $50 million in federal funding, according to the Times. California is the only one of the five largest states to use code-based data. The report noted that 36 other states use name-based tracking. The report found that the Office of AIDS does not have sufficient funding to evaluate its tracking system and show that it meets CDC standards. According to the Times, CDC "considers code-based data to be unreliable."
Although some health professionals and AIDS advocates have said that a code-based system is "too cumbersome" and could lead to more unreported cases, others say that using patients' names would "compromise confidentiality and make them less likely to get tested," the Times reports. Weinstein said that the current system is "unworkable" and "complicated," making it difficult for the state "to determine whether a person is being counted twice." Fred Dillon, director of policy and communications for the San Francisco AIDS Foundation, said, "Even with name reporting, many jurisdictions say they don't have the time to report, so to say this would fix the system completely is false" (Rivera, Los Angeles Times, 7/31).
The plan also calls for the state to increase its use of federal standards for pesticide approval because the current system often delays the introduction of new regulations without markedly improving public health or the environment, the AP/San Diego Union-Tribune reports. Paul Gosselin, acting director of the Department of Pesticide Regulation, said that increased use of federal pesticide regulations would not compromise California's pesticide regulation system, which he said featured "the toughest pesticide health and safety standards in the nation." However, four advocacy groups -- Californians for Pesticide Reform, Latino Issues Forum, Redefining Progress and the California Rural Legal Assistance Fund -- are expected to hold news conferences tomorrow to oppose the proposed changes. Group representatives say the current system provides inadequate regulation of pesticides and that the proposed changes would further weaken the system (Thompson, AP/San Diego Union-Tribune, 8/2).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.