SACRAMENTO ROUNDUP: A Look Back At Senate Action On Health Care
California Healthline's wrap-up of the 1998 legislative session continues today with a look at action on bills originating in the Senate. Last Friday, CHL summarized important Assembly legislation ( click here to read the story) and the series will conclude tomorrow with a look at legislative action on the managed care issue. Gov. Pete Wilson has until the end of this month to either sign or veto bills passed by both houses of the Legislature, and many bills detailed below are still pending his final decision.
- SB 274: Tuberculosis -- Diane Watson (D-Los Angeles County). SB 274 would allow the DHS to make grants to local health jurisdictions to fund secured housing for tuberculosis patients who repeatedly fail to comply with treatment regimens. This would enable local health officers to implement legal orders of detention for such patients. The bill was placed on inactive file last month at the request of Assemblyman Tom Woods (R-Redding). Click tuberculosis to read CHL coverage of the disease.
- SB 330: Health Plan Mergers -- Herschel Rosenthal (D-San Fernando Valley). SB 330 would increase oversight of proposed health plan mergers, requiring the state attorney general to determine if the deal would create a monopoly. HMOs are currently scrutinized only for health care concerns, not competition concerns. Rosenthal resurrected the bill after it had laid dormant for a year. It was sent to Wilson last month, who said last year that he would veto such a bill. Both gubernatorial candidates have pledged at least a degree of support for the bill. Click here for past coverage of the bill.
- SB 393: Health Care Coverage -- Mid-sized Employer Coverage -- Herschel Rosenthal (D-San Fernando Valley). SB 393 would expand the current small business health care purchasing pool, which is limited to businesses with up to 50 employees, to those companies employing 51 to 100 employees. The Managed Risk Medical Insurance Board, which administers the program, says it gets many inquiries from businesses with more than 50 employees. The bill passed both houses and was sent to the governor Aug. 30. Wilson has indicated that he opposes it, but as of Sept. 14 he had taken no action on the proposal. Click here for past CHL coverage.
- SB 406: Board of Managed Health Care -- Herschel Rosenthal (D-San Fernando Valley). SB 406 would implement a key recommendation of Wilson's managed care reform task force -- creating an independent board to regulate HMOs. The State and Consumer Services Agency would oversee HMOs and other health insurers. Rosenthal said the bill "will help restore public confidence by putting HMO regulation in the sunshine, with board meetings open to public participation. With an independent board in place, HMOs will no longer be the only ones with access to the regulator." After a lengthy conference committee procedure, the measure was adopted Aug. 20 and landed on Wilson's desk Aug. 30. It is still unclear whether Wilson plans to sign it. He said he favors creating an agency that would be run by one gubernatorial appointee, rather than a board jointly appointed by the executive and the legislative branches. Click here to read past CHL coverage of this issue.
- SB 654: Genetic Discrimination -- Patrick Johnson (D-Stockton). SB 654 prohibits discrimination against workers who are predisposed to, but lack the symptoms of such diseases as Alzheimer's, diabetes or cystic fibrosis. The governor signed the bill July 3. The American Cancer Society, the California Medical Association and the American Civil Liberties Union all supported Johnston's measure. Click here to read CHL's coverage of the legislation.
- SB 694: Hepatitis C -- Richard Polanco (D-Los Angeles). SB 694 would empower the Legislature to study the adequacy of the health care delivery system as it relates to hepatitis C and would require the DHS to use any guidelines adopted by the National Institutes of Health or the California advisory committees on hepatitis C to educate physicians and train community service members. The bill was sent to the governor at the end of the legislative session. "Hepatitis C is clearly on the verge of becoming a health crisis in California," said Polanco. "It is four times more prevalent than the virus that causes AIDS, yet the public is virtually unaware of its existence and there are no existing public health programs that address it. I find that shocking." The San Diego chapter of the American Liver Foundation supports the bill. The DHS, however, opposes the bill, calling it an "unfunded mandate." As of Sept. 14, Wilson had not signed the measure. Click here for CHL coverage of SB 694.
- SB 705: Human Immunodeficiency Virus -- Richard Rainey (R-Walnut Creek). SB 705 changes the penalty for knowingly exposing someone to the HIV virus -- by engaging in unprotected sexual contact and not informing the partner of HIV state -- from a misdemeanor to a felony punishable by a jail term of 3,5 or 8 years. The bill would also make the distinction that an HIV-positive person engaging in sex would not necessarily be enough to prove harmful intent. The bill passed the Assembly 67-1 and the Senate 37-0. Wilson is currently considering the bill.
- SB 750: Health Care Coverage -- Herschel Rosenthal (D-San Fernando Valley). SB 750 would require health plans to provide a written summary of certain information concerning bonus or incentive arrangements with physicians. The bill passed the Assembly 74-1 and the Senate 38-0. The governor's approval is pending.
- SB 1125: Health Facilities: Nursing Staff -- Dede Alpert (D-Coronado). SB 1125 would require the DHS to "set minimum nurse-patient ratios and prohibit unlicensed hospital workers from performing a nurse's job." The California Nurses Association supports the bill, contending it would ensure quality care. The California Healthcare Association says the bill is harmful in that it would impose a "one-size-fits-all" approach on hospitals. The DHS also opposes the bill. The bill passed the Legislature Aug. 24. Wilson has not yet indicated his position as of Sept. 14. Click here for coverage of the issue.
- SB 1140: Medicine: Pain Management -- Diane Watson (D-Los Angeles County). SB 1140 would require the state medical board, as part of its continuing education requirements for physicians and surgeons, to disseminate educational materials and information on pain management, specifically as it relates to end-of-life care. The bill passed the Assembly 73-4 and the Senate 29-6. Wilson received the bill Sept. 4, but has not acted on it.
- SB 1385: AIDS Testing -- Dede Alpert (D-San Diego). In cases where a health care worker is exposed to a patient's blood, SB 1385 would permit workers to perform an HIV test on the blood if the source patient is unable to provide informed consent and has no legal representation. Alpert "states that in situations where a health care provider receives a significant exposure to the blood of a patient, this bill gives patients who are unable to the provide informed consent for an HIV test the same legal standing as persons who refuse consent." The bill was sent to Wilson Aug. 27; as of Sept. 14 he had not signed it. Click AIDS testing to read CHL coverage of the issue.
- SB 1504: Health Insurance -- Herschel Rosenthal (D-San Fernando Valley). SB 1504 would require health care service plans to provide subscribers and enrollees with written responses to grievances within 45 days. This bill would also, on and after January 1, 2000, require every health care service plan and every disability insurer to provide an enrollee or insured with the opportunity to seek an independent medical review whenever health care services have been denied, significantly delayed, terminated or otherwise limited by the plan. The bill was passed unanimously by the Senate, but has been bogged down in committee with Assembly Democrats attempting to attach civil liability legislation to it. SB 1504 did not clear the Legislature before adjournment.
- SB 1607: Medi-Cal Contract List -- James Brulte (R-Ranco Cucamonga). SB 1607 would require the director of the DHS to expeditiously negotiate contracts for new drugs and to include them on the list that Medi-Cal covers. It also provides a definition of new drugs and allows the director to adopt regulations on an emergency basis for new drugs that are being negotiated. It passed the Senate by a 37-0 vote but died in the Assembly. Click here to read California Healthline coverage of this bill.
- SB 1653: Health Insurance: Independent Review Process -- Pat Johnston (D-Stockton). Companion bill to SB 1504 above, SB 1653 requires that by Jan. 1, 2000, the Corporations and Insurance commissioners must contract with one or more independent medical review organizations to review instances where a health plan has denied coverage for a patient's care. The bill was suggested by the California Association of Health Plans and United HealthCare. Maureen O'Haren, lobbyist for the CAHP, said, "We know that we've lost the public's trust. We know we have to do something about it." The bill passed the Senate unanimously but was bottled up in the Assembly as a result of some Democrats' effort to pass HMO liability legislation.
- SB 1658: Managed Care/Specialized Health Plans -- Steve Peace (D-El Cajon). SB 1658 would require Mexico-based health care service plans covering Mexican nationals working in California to apply for licensure from the Department of Corporations and allow the department to regulate these plans as it would an in-state plan. It was sent to the governor Aug. 27; as of Sept. 14, he had not signed it.
- SB 1790: Health Coverage/Small Employers -- Herschel Rosenthal (D-San Fernando Valley). SB 1790 allows businesses with less than 50 employees to cover those employees who work 20-29 hours per week the same as those who work more than 30 hours, with respect to requirements on health care service plans and small employer coverage. The bill passed the Assembly 74-0 and the Senate 21-14. Wilson received the bill Aug. 17, and signed it Aug. 28. According to a press release from Rosenthal's office, the bill remedies the problem that arises when different classes of employees are created based on the number of hours they work, with respect to "the level of coverage they have access to or whether or not an insurer has to accept them at all."
- SB 1887: Marijuana Task Force -- John Vasconcellos (D-San Jose). SB 1887 would establish the Medical Marijuana Distribution Task Force to research and make recommendations about the safe and affordable distribution of marijuana to all patients in medical need of the plant. The agency could authorize localities to distribute the substance as well. The bill passed the Senate 21-13, and was referred to the Assembly Health Committee. It failed on first vote, but was granted a motion of reconsideration. It died at the end of the legislative session. Click medical marijuana to read CHL's extensive coverage of the issue.
- SB 2208: Asthma -- Byron Sher (D-Stanford). SB 2208 would request a state assessment into the medical, societal and economic effects of asthma and would provide for a comprehensive asthma control program as recommended. The bill passed the Assembly 49-22 and 24-12 in the Senate. Wilson has not signed it as of Sept. 14.