AB 2399: Pregnancy: prenatal blood testing.
- Session Year: 2015-2016
- House: Assembly
- Latest Version Date: 2016-05-31
(1)Existing law requires the State Department of Public Health to develop standardized, objective information about umbilical cord blood donation to enable a pregnant woman to make an informed decision regarding what she wants to do with the umbilical cord blood. Existing law requires that this information be made available in Cantonese, English, Spanish, and Vietnamese. Existing law prohibits public funds from being used by the department to provide awareness, assistance, and information regarding umbilical cord blood banking options and creates the Umbilical Cord Blood Education Account within the State Treasury, which is funded by private donations, to be used by the department for these purposes, as specified.
Existing law also requires a licensed physician and surgeon, or other person engaged in the prenatal care of a pregnant woman, to obtain a blood specimen from the woman for purposes of determining the presence of hepatitis B or human immunodeficiency virus (HIV). Existing law requires the department State Department of Public Health to develop culturally sensitive informational material in English, Spanish, and other languages to inform a pregnant woman about the purpose of obtaining this blood sample.
Existing law requires the department to develop an education program designed to educate physicians and the public concerning the uses of prenatal testing and the availability of the California Prenatal Screening Program. Existing law requires the department to include specified information in the patient educational information.
This bill would change the language requirements for the umbilical cord blood informational material, the prenatal testing informational material, and the patient educational information material to require the information to be informational material described above to require that it is provided in languages that meet a specified numeric threshold. The bill would also delete provisions that create the Umbilical Cord Blood Education Account and remove the prohibition against using public funds to provide information about umbilical cord blood banking.
(2)Existing law requests the University of California to establish and administer the Umbilical Cord Blood Collection Program for the purpose of collecting units of umbilical cord blood for public use, as defined, in transplantation and providing nonclinical units for specified research. Existing law provides that any funds made available for purposes of the program shall be deposited into the Umbilical Cord Blood Collection Program Fund and that moneys in the fund shall be made available, upon appropriation by the Legislature, for purposes of the program. Existing law provides the program and the program fund shall conclude no later than January 1, 2018.
This bill would extend the existence of the program and the program fund until January 1, 2023.
(3)Existing law requires, until January 1, 2018, the collection of an $18 fee for certified copies of birth certificates. Existing law requires $2 of this $18 fee to be paid to the Umbilical Cord Blood Collection Program Fund.
This bill would extend the $18 fee for certified copies of birth certificates until January 1, 2023. The bill would also extend the collection and deposit of the $2 portion of the fee into the Umbilical Cord Blood Collection Program Fund until January 1, 2023.
(4)Existing law creates the Health Statistics Special Fund which consists of revenues from several sources, including many funds collected by the State Registrar. Until January 1, 2018, Umbilical Cord Blood Program Fund fees are excluded from that fund. Existing law provides that moneys in the Health Statistics Special Fund shall be expended by the State Registrar, as specified, upon appropriation by the Legislature.
This bill would extend the existence of the fund until January 1, 2023.
This bill would include a change in state statute that would result in a taxpayer paying a higher tax within the meaning of Section 3 of Article XIIIA of the California Constitution, and thus would require for passage the approval of 2/3 of the membership of each house of the Legislature.
Existing
(1)Existing law requires the State Department of Public Health to develop standardized, objective information about umbilical cord blood donation to enable a pregnant woman to make an informed decision regarding what she wants to do with the umbilical cord blood. Existing law requires that this information be made available in Cantonese, English, Spanish, and Vietnamese. Existing law prohibits public funds from being used by the department to provide awareness, assistance, and information regarding umbilical cord blood banking options and creates the Umbilical Cord Blood Education Account within the State Treasury, which is funded by private donations, to be used by the department for these purposes, as specified.
Existing law also requires a licensed physician and surgeon, or other person engaged in the prenatal care of a pregnant woman, to obtain a blood specimen from the woman for purposes of determining the presence of hepatitis B or human immunodeficiency virus (HIV). Existing law requires the State Department of Public Health department to develop culturally sensitive informational material in English, Spanish, and other languages, languages to inform a pregnant woman about the purpose of obtaining this blood sample.
Existing law requires the department to develop an education program designed to educate physicians and the public concerning the uses of prenatal testing and the availability of the California Prenatal Screening Program. Existing law requires the department to include specified information in the patient educational information.
This bill would change the language requirements for the umbilical cord blood informational material and material, the prenatal testing informational material from those languages to material, and the patient educational information material to require the information to be provided in languages that meet a specified numeric threshold. The bill would also delete provisions that create the Umbilical Cord Blood Education Account and remove the prohibition against using public funds to provide information about umbilical cord blood banking.
(2)Existing law requests the University of California to establish and administer the Umbilical Cord Blood Collection Program for the purpose of collecting units of umbilical cord blood for public use, as defined, in transplantation and providing nonclinical units for specified research. Existing law provides that any funds made available for purposes of the program shall be deposited into the Umbilical Cord Blood Collection Program Fund and that moneys in the fund shall be made available, upon appropriation by the Legislature, for purposes of the program. Existing law provides the program and the program fund shall conclude no later than January 1, 2018.
This bill would extend the existence of the program and the program fund until January 1, 2023.
(3)Existing law requires, until January 1, 2018, the collection of an $18 fee for certified copies of birth certificates. Existing law requires $2 of this $18 fee to be paid to the Umbilical Cord Blood Collection Program Fund.
This bill would extend the $18 fee for certified copies of birth certificates until January 1, 2023. The bill would also extend the collection and deposit of the $2 portion of the fee into the Umbilical Cord Blood Collection Program Fund until January 1, 2023.
(4)Existing law creates the Health Statistics Special Fund which consists of revenues from several sources, including many funds collected by the State Registrar. Until January 1, 2018, Umbilical Cord Blood Program Fund fees are excluded from that fund. Existing law provides that moneys in the Health Statistics Special Fund shall be expended by the State Registrar, as specified, upon appropriation by the Legislature.
This bill would extend the existence of the fund until January 1, 2023.
This bill would include a change in state statute that would result in a taxpayer paying a higher tax within the meaning of Section 3 of Article XIIIA of the California Constitution, and thus would require for passage the approval of 2/3 of the membership of each house of the Legislature.
Existing law requires the State Department of Public Health to develop standardized, objective information about umbilical cord blood donation to enable a pregnant woman to make an informed decision regarding what she wants to do with the umbilical cord blood. Existing law requires that this information be made available in Cantonese, English, Spanish, and Vietnamese. Existing law prohibits public funds from being used by the department to provide awareness, assistance, and information regarding umbilical cord blood banking options and creates the Umbilical Cord Blood Education Account within the State Treasury, which is funded by private donations, to be used by the department for these purposes, as specified.
Existing law also requires a licensed physician and surgeon, or other person engaged in the prenatal care of a pregnant woman, to obtain a blood specimen from the woman for purposes of determining the presence of hepatitis B or human immunodeficiency virus (HIV). Existing law requires the State Department of Public Health to develop culturally sensitive informational material in English, Spanish, and other languages, to inform a pregnant woman about the purpose of obtaining this blood sample.
This bill would change the language requirements for the umbilical cord blood informational material and the prenatal testing informational material from those languages to languages that meet a specified numeric threshold. The bill would also delete provisions that create the Umbilical Cord Blood Education Account and remove the prohibition against using public funds to provide information about umbilical cord blood banking.
(a)(1)On or before July 1, 2011, the University of California is requested to develop a plan to establish and administer the Umbilical Cord Blood Collection Program for the purpose of collecting units of umbilical cord blood for public use in transplantation and providing nonclinical units for research pertaining to biology and new clinical utilization of stem cells derived from the blood and tissue of the placenta and umbilical cord. The program shall conclude no later than January 1, 2023.
(2)For purposes of this article, public use means both of the following:
(A)The collection of umbilical cord blood units from genetically diverse donors that will be owned by the University of California. This inventory shall be accessible by the National Registry and by qualified California-based and other United States and international registries and transplant centers to increase the likelihood of providing suitably matched donor cord blood units to patients or research participants who are in need of a transplant.
(B)Cord blood units with a lower number of cells than deemed necessary for clinical transplantation and units that meet clinical requirements, but for other reasons are unsuitable, unlikely to be transplanted, or otherwise unnecessary for clinical use, may be made available for research.
(b)(1)In order to implement the collection goals of this program, the University of California may, commensurate with available funds appropriated to the University of California for this program, contract with one or more selected applicant entities that have demonstrated the competence to collect and ship cord blood units in compliance with federal guidelines and regulations.
(2)It is the intent of the Legislature that, if the University of California contracts with another entity pursuant to this subdivision, the following shall apply:
(A)The University of California may use a competitive process to identify the best proposals submitted by applicant entities to administer the collection and research objectives of the program, to the extent that the University of California chooses not to undertake these activities itself.
(B)In order to qualify for selection under this section to receive, process, cryopreserve, or bank cord blood units, the entity shall, at a minimum, have obtained an investigational new drug (IND) exemption from the FDA or a biologic license from the FDA, as appropriate, to manufacture clinical grade cord blood stem cell units for clinical indications.
(C)In order to qualify to receive appropriate cord blood units and placental tissue to advance the research goals of this program, an entity shall, at a minimum, be a laboratory recognized as having performed peer-reviewed research on stem and progenitor cells, including those derived from placental or umbilical cord blood and postnatal tissue.
(3)A medical provider or research facility shall comply with, and shall be subject to, existing penalties for violations of all applicable state and federal laws with respect to the protection of any medical information, as defined in Section 56.05 of the Civil Code, and any personally identifiable information contained in the umbilical cord blood inventory.
(c)The University of California is encouraged to make every effort to avoid duplication or conflicts with existing and ongoing programs and to leverage existing resources.
(d)(1)All information collected pursuant to the program shall be confidential, and shall be used solely for the purposes of the program, including research. Access to confidential information shall be limited to authorized persons who are bound by appropriate institutional policies or who otherwise agree, in writing, to maintain the confidentiality of that information.
(2)Any person who, in violation of applicable institutional policies or a written agreement to maintain confidentiality, discloses any information provided pursuant to this section, or who uses information provided pursuant to this section in a manner other than as approved pursuant to this section, may be denied further access to any confidential information maintained by the University of California, and shall be subject to a civil penalty not exceeding one thousand dollars ($1,000). The penalty provided for in this section shall not be construed to limit or otherwise restrict any remedy, provisional or otherwise, provided by law for the benefit of the University of California or any other person covered by this section.
(3)Notwithstanding the restrictions of this section, an individual to whom the confidential information pertains shall have access to his or her own personal information.
(e)It is the intent of the Legislature that the plan and implementation of the program provide for both of the following:
(1)Limit fees for access to cord blood units to the reasonable and actual costs of storage, handling, and providing units, as well as for related services such as donor matching and testing of cord blood and other programs and services typically provided by cord blood banks and public use programs.
(2)The submittal of the plan developed pursuant to subdivision (a) to the health and fiscal committees of the Legislature.
(f)It is additionally the intent of the Legislature that the plan and implementation of the program attempt to provide for all of the following:
(1)Development of a strategy to increase voluntary participation by hospitals in the collection and storage of umbilical cord blood and identify funding sources to offset the financial impact on hospitals.
(2)Consideration of a medical contingency response program to prepare for and respond effectively to biological, chemical, or radiological attacks, accidents, and other public health emergencies where victims potentially benefit from treatment.
(3)Exploration of the feasibility of operating the program as a self-funding program, including the potential for charging users a reimbursement fee.
SEC. 2.Section 1630 of the Health and Safety Code is amended to read:1630.This article shall remain in effect only until January 1, 2023, and as of that date is repealed, unless a later enacted statute, that is enacted before January 1, 2023, deletes or extends that date.
SEC. 3.Section 102247 of the Health and Safety Code, as amended by Section 169 of Chapter 296 of the Statutes of 2011, is amended to read:102247.(a)There is hereby created in the State Treasury the Health Statistics Special Fund. The fund shall consist of revenues, including, but not limited to, all of the following:
(1)Fees or charges remitted to the State Registrar for record search or issuance of certificates, permits, registrations, or other documents pursuant to Chapter 3 (commencing with Section 26801) of Part 3 of Division 2 of Title 3 of the Government Code, and Chapter 4 (commencing with Section 102525), Chapter 5 (commencing with Section 102625), Chapter 8 (commencing with Section 103050), and Chapter 15 (commencing with Section 103600) of Part 1 of Division 102 of this code.
(2)Funds remitted to the State Registrar by the federal Social Security Administration for participation in the enumeration at birth program.
(3)Funds remitted to the State Registrar by the National Center for Health Statistics pursuant to the federal Vital Statistics Cooperative Program.
(4)Any other funds collected by the State Registrar, except Childrens Trust Fund fees collected pursuant to Section 18966 of the Welfare and Institutions Code, Umbilical Cord Blood Collection Program Fund fees collected pursuant to Section 103625, and fees allocated to the Judicial Council pursuant to Section 1852 of the Family Code, all of which shall be deposited into the General Fund.
(b)Moneys in the Health Statistics Special Fund shall be expended by the State Registrar for the purpose of funding its existing programs and programs that may become necessary to carry out its mission, upon appropriation by the Legislature.
(c)Health Statistics Special Fund moneys shall be expended only for the purposes set forth in this section and Section 102249, and shall not be expended for any other purpose or for any other state program.
(d)It is the intent of the Legislature that the Health Statistics Special Fund provide for the following:
(1)Registration and preservation of vital event records and dissemination of vital event information to the public.
(2)Data analysis of vital statistics for population projections, health trends and patterns, epidemiologic research, and development of information to support new health policies.
(3)Development of uniform health data systems that are integrated, accessible, and useful in the collection of information on health status.
(e)This section shall remain in effect only until January 1, 2023, and as of that date is repealed, unless a later enacted statute, that is enacted before January 1, 2023, deletes or extends that date.
SEC. 4.Section 102247 of the Health and Safety Code, as amended by Section 170 of Chapter 296 of the Statutes of 2011, is amended to read:102247.(a)There is hereby created in the State Treasury the Health Statistics Special Fund. The fund shall consist of revenues, including, but not limited to, all of the following:
(1)Fees or charges remitted to the State Registrar for record search or issuance of certificates, permits, registrations, or other documents pursuant to Chapter 3 (commencing with Section 26801) of Part 3 of Division 2 of Title 3 of the Government Code, and Chapter 4 (commencing with Section 102525), Chapter 5 (commencing with Section 102625), Chapter 8 (commencing with Section 103050), and Chapter 15 (commencing with Section 103600) of Part 1 of Division 102 of this code.
(2)Funds remitted to the State Registrar by the federal Social Security Administration for participation in the enumeration at birth program.
(3)Funds remitted to the State Registrar by the National Center for Health Statistics pursuant to the federal Vital Statistics Cooperative Program.
(4)Any other funds collected by the State Registrar, except Childrens Trust Fund fees collected pursuant to Section 18966 of the Welfare and Institutions Code and fees allocated to the Judicial Council pursuant to Section 1852 of the Family Code, all of which shall be deposited into the General Fund.
(b)Moneys in the Health Statistics Special Fund shall be expended by the State Registrar for the purpose of funding its existing programs and programs that may become necessary to carry out its mission, upon appropriation by the Legislature.
(c)Health Statistics Special Fund moneys shall be expended only for the purposes set forth in this section and Section 102249, and shall not be expended for any other purpose or for any other state program.
(d)It is the intent of the Legislature that the Health Statistics Special Fund provide for the following:
(1)Registration and preservation of vital event records and dissemination of vital event information to the public.
(2)Data analysis of vital statistics for population projections, health trends and patterns, epidemiologic research, and development of information to support new health policies.
(3)Development of uniform health data systems that are integrated, accessible, and useful in the collection of information on health status.
(e)This section shall become operative on January 1, 2023.
SEC. 5.Section 103625 of the Health and Safety Code, as amended by Section 5 of Chapter 402 of the Statutes of 2011, is amended to read:103625.(a)A fee of twelve dollars ($12) shall be paid by the applicant for a certified copy of a fetal death or death record.
(b)(1)A fee of twelve dollars ($12) shall be paid by a public agency or licensed private adoption agency applicant for a certified copy of a birth certificate that the agency is required to obtain in the ordinary course of business. A fee of eighteen dollars ($18) shall be paid by any other applicant for a certified copy of a birth certificate. Four dollars ($4) of any eighteen-dollar ($18) fee is exempt from subdivision (e) and shall be paid either to a county childrens trust fund or to the State Childrens Trust Fund, in conformity with Article 5 (commencing with Section 18965) of Chapter 11 of Part 6 of Division 9 of the Welfare and Institutions Code. Two dollars ($2) of any eighteen-dollar ($18) fee is exempt from subdivision (e) and shall be paid to the Umbilical Cord Blood Collection Program Fund in conformity with Section 1628.
(2)The board of supervisors of any county that has established a county childrens trust fund may increase the fee for a certified copy of a birth certificate by up to three dollars ($3) for deposit in the county childrens trust fund in conformity with Article 5 (commencing with Section 18965) of Chapter 11 of Part 6 of Division 9 of the Welfare and Institutions Code.
(c)A fee of three dollars ($3) shall be paid by a public agency applicant for a certified copy of a marriage record, that has been filed with the county recorder or county clerk, that the agency is required to obtain in the ordinary course of business. A fee of six dollars ($6) shall be paid by any other applicant for a certified copy of a marriage record that has been filed with the county recorder or county clerk. Three dollars ($3) of any six-dollar ($6) fee is exempt from subdivision (e) and shall be transmitted monthly by each local registrar, county recorder, and county clerk to the state for deposit into the General Fund as provided by Section 1852 of the Family Code.
(d)A fee of three dollars ($3) shall be paid by a public agency applicant for a certified copy of a marriage dissolution record obtained from the State Registrar that the agency is required to obtain in the ordinary course of business. A fee of six dollars ($6) shall be paid by any other applicant for a certified copy of a marriage dissolution record obtained from the State Registrar.
(e)Each local registrar, county recorder, or county clerk collecting a fee pursuant to subdivisions (a) to (d), inclusive, shall do the following:
(1)Transmit 15 percent of the fee for each certified copy to the State Registrar by the 10th day of the month following the month in which the fee was received.
(2)Retain 85 percent of the fee for each certified copy solely to support the issuing agency for all activities related to the issuance of certified copies of records pursuant to subdivisions (a) to (d), inclusive.
(f)In addition to the fees prescribed pursuant to subdivisions (a) to (d), inclusive, all applicants for certified copies of the records described in those subdivisions shall pay an additional fee of three dollars ($3), that shall be collected by the State Registrar, the local registrar, county recorder, or county clerk, as the case may be.
(g)The local public official charged with the collection of the additional fee established pursuant to subdivision (f) may create a local vital and health statistics trust fund. The fees collected by local public officials pursuant to subdivision (f) shall be distributed as follows:
(1)Forty-five percent of the fee collected pursuant to subdivision (f) shall be transmitted to the State Registrar.
(2)The remainder of the fee collected pursuant to subdivision (f) shall be deposited into the collecting agencys vital and health statistics trust fund, except that in any jurisdiction in which a local vital and health statistics trust fund has not been established, the entire amount of the fee collected pursuant to subdivision (f) shall be transmitted to the State Registrar.
(3)Moneys transmitted to the State Registrar pursuant to this subdivision shall be deposited in accordance with Section 102247.
(h)Moneys in each local vital and health statistics trust fund shall be available to the local official charged with the collection of fees pursuant to subdivision (f) for the applicable jurisdiction for the purpose of defraying the administrative costs of collecting and reporting with respect to those fees and for other costs as follows:
(1)Modernization of vital record operations, including improvement, automation, and technical support of vital record systems.
(2)Improvement in the collection and analysis of health-related birth and death certificate information, and other community health data collection and analysis, as appropriate.
(i)Funds collected pursuant to subdivision (f) shall not be used to supplant funding in existence on January 1, 2002, that is necessary for the daily operation of vital record systems. It is the intent of the Legislature that funds collected pursuant to subdivision (f) be used to enhance service to the public, to improve analytical capabilities of state and local health authorities in addressing the health needs of newborn children and maternal health problems, and to analyze the health status of the general population.
(j)Each county shall annually submit a report to the State Registrar by March 1 containing information on the amount of revenues collected pursuant to subdivision (f) in the previous calendar year and on how the revenues were expended and for what purpose.
(k)Each local registrar, county recorder, or county clerk collecting the fee pursuant to subdivision (f) shall transmit 45 percent of the fee for each certified copy to which subdivision (f) applies to the State Registrar by the 10th day of the month following the month in which the fee was received.
(l)The nine dollar ($9) increase to the base fee authorized in subdivision (a) for a certified copy of a fetal death record or death record and subdivision (b) for a certified copy of a birth certificate shall be applied incrementally as follows:
(1)A five dollar ($5) increase applied as of January 1, 2012.
(2)An additional two dollar ($2) increase applied as of January 1, 2013.
(3)An additional two dollar ($2) increase applied as of January 1, 2014.
(m)In providing for the expiration of the surcharge on birth certificate fees on June 30, 1999, the Legislature intends that juvenile dependency mediation programs pursue ancillary funding sources after that date.
(n)This section shall remain in effect only until January 1, 2023, and as of that date is repealed, unless a later enacted statute, that is enacted before January 1, 2023, deletes or extends that date.
SEC. 6.Section 103625 of the Health and Safety Code, as amended by Section 6 of Chapter 402 of the Statutes of 2011, is amended to read:103625.(a)A fee of twelve dollars ($12) shall be paid by the applicant for a certified copy of a fetal death or death record.
(b)(1)A fee of twelve dollars ($12) shall be paid by a public agency or licensed private adoption agency applicant for a certified copy of a birth certificate that the agency is required to obtain in the ordinary course of business. A fee of sixteen dollars ($16) shall be paid by any other applicant for a certified copy of a birth certificate. Four dollars ($4) of any sixteen-dollar ($16) fee is exempt from subdivision (e) and shall be paid either to a county childrens trust fund or to the State Childrens Trust Fund, in conformity with Article 5 (commencing with Section 18965) of Chapter 11 of Part 6 of Division 9 of the Welfare and Institutions Code.
(2)The board of supervisors of any county that has established a county childrens trust fund may increase the fee for a certified copy of a birth certificate by up to three dollars ($3) for deposit in the county childrens trust fund in conformity with Article 5 (commencing with Section 18965) of Chapter 11 of Part 6 of Division 9 of the Welfare and Institutions Code.
(c)A fee of three dollars ($3) shall be paid by a public agency applicant for a certified copy of a marriage record, that has been filed with the county recorder or county clerk, that the agency is required to obtain in the ordinary course of business. A fee of six dollars ($6) shall be paid by any other applicant for a certified copy of a marriage record that has been filed with the county recorder or county clerk. Three dollars ($3) of any six-dollar ($6) fee is exempt from subdivision (e) and shall be transmitted monthly by each local registrar, county recorder, and county clerk to the state for deposit into the General Fund as provided by Section 1852 of the Family Code.
(d)A fee of three dollars ($3) shall be paid by a public agency applicant for a certified copy of a marriage dissolution record obtained from the State Registrar that the agency is required to obtain in the ordinary course of business. A fee of six dollars ($6) shall be paid by any other applicant for a certified copy of a marriage dissolution record obtained from the State Registrar.
(e)Each local registrar, county recorder, or county clerk collecting a fee pursuant to subdivisions (a) to (d), inclusive, shall do the following:
(1)Transmit 15 percent of the fee for each certified copy to the State Registrar by the 10th day of the month following the month in which the fee was received.
(2)Retain 85 percent of the fee for each certified copy solely to support the issuing agency for all activities related to the issuance of certified copies of records pursuant to subdivisions (a) to (d), inclusive.
(f)In addition to the fees prescribed pursuant to subdivisions (a) to (d), inclusive, all applicants for certified copies of the records described in those subdivisions shall pay an additional fee of three dollars ($3), that shall be collected by the State Registrar, the local registrar, county recorder, or county clerk, as the case may be.
(g)The local public official charged with the collection of the additional fee established pursuant to subdivision (f) may create a local vital and health statistics trust fund. The fees collected by local public officials pursuant to subdivision (f) shall be distributed as follows:
(1)Forty-five percent of the fee collected pursuant to subdivision (f) shall be transmitted to the State Registrar.
(2)The remainder of the fee collected pursuant to subdivision (f) shall be deposited into the collecting agencys vital and health statistics trust fund, except that in any jurisdiction in which a local vital and health statistics trust fund has not been established, the entire amount of the fee collected pursuant to subdivision (f) shall be transmitted to the State Registrar.
(3)Moneys transmitted to the State Registrar pursuant to this subdivision shall be deposited in accordance with Section 102247.
(h)Moneys in each local vital and health statistics trust fund shall be available to the local official charged with the collection of fees pursuant to subdivision (f) for the applicable jurisdiction for the purpose of defraying the administrative costs of collecting and reporting with respect to those fees and for other costs as follows:
(1)Modernization of vital record operations, including improvement, automation, and technical support of vital record systems.
(2)Improvement in the collection and analysis of health-related birth and death certificate information, and other community health data collection and analysis, as appropriate.
(i)Funds collected pursuant to subdivision (f) shall not be used to supplant funding in existence on January 1, 2002, that is necessary for the daily operation of vital record systems. It is the intent of the Legislature that funds collected pursuant to subdivision (f) be used to enhance service to the public, to improve analytical capabilities of state and local health authorities in addressing the health needs of newborn children and maternal health problems, and to analyze the health status of the general population.
(j)Each county shall annually submit a report to the State Registrar by March 1 containing information on the amount of revenues collected pursuant to subdivision (f) in the previous calendar year and on how the revenues were expended and for what purpose.
(k)Each local registrar, county recorder, or county clerk collecting the fee pursuant to subdivision (f) shall transmit 45 percent of the fee for each certified copy to which subdivision (f) applies to the State Registrar by the 10th day of the month following the month in which the fee was received.
(l)In providing for the expiration of the surcharge on birth certificate fees on June 30, 1999, the Legislature intends that juvenile dependency mediation programs pursue ancillary funding sources after that date.
(m)This section shall become operative on January 1, 2023.
SEC. 7.Section 123371 of the Health and Safety Code is amended to read:123371.(a)(1)The State Department of Public Health shall develop standardized, objective information about umbilical cord blood donation that is sufficient to allow a pregnant woman to make an informed decision on whether to participate in a private or public umbilical cord blood banking program. The information developed by the department shall enable a pregnant woman to be informed of her option to do any of the following:
(A)Discard umbilical cord blood.
(B)Donate umbilical cord blood to a public umbilical cord blood bank.
(C)Store the umbilical cord blood in a family umbilical cord blood bank for the use by immediate and extended family members.
(D)Donate umbilical cord blood to research.
(2)The information developed pursuant to paragraph (1) shall include, but not be limited to, all of the following:
(A)The current and potential future medical uses of stored umbilical cord blood.
(B)The benefits and risks involved in umbilical cord blood banking.
(C)The medical process involved in umbilical cord blood banking.
(D)Medical or family history criteria that can impact a familys consideration of umbilical cord banking.
(E)An explanation of the differences between public and private umbilical cord blood banking.
(F)The availability and costs of public or private umbilical cord blood banks.
(G)Medical or family history criteria that can impact a familys consideration of umbilical cord blood banking.
(H)An explanation that the practices and policies of blood banks may vary with respect to accreditation, cord blood processing and storage methods, costs, and donor privacy.
(I)An explanation that pregnant women are not required to donate their umbilical cord blood for research purposes.
(b)The information provided by the department pursuant to subdivision (a) shall be made available in the languages that meet the numeric threshold described in Section 14029.91 of the Welfare and Institutions Code, and shall be updated by the department as needed.
(c)The information provided by the department pursuant to subdivision (a) shall be made available on the Internet Web sites of the licensing boards that have oversight over primary prenatal care providers.
(d)(1)A primary prenatal care provider of a woman who is known to be pregnant may, during the first prenatal visit, provide the information required by subdivision (a) to the pregnant woman.
(2)For purposes of this article, a prenatal care provider means a health care provider licensed pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code, or pursuant to an initiative act referred to in that division, who provides prenatal medical care within his or her scope of practice.
SEC. 8.Section 125055 of the Health and Safety Code is amended to read:125055.The department shall:
(a)Establish criteria for eligibility for the prenatal testing program. Eligibility shall include definition of conditions and circumstances that result in a high risk of a detectable genetic disorder or birth defect.
(b)(1)Develop an education program designed to educate physicians and surgeons and the public concerning the uses of prenatal testing and the availability of the program.
(2)(A)Include information regarding environmental health in the California Prenatal Screening Program patient educational information. This environmental health information shall include the following statement:
We encounter chemicals and other substances in everyday life that may affect your developing fetus. Fortunately, there are steps you can take to reduce your exposure to these potentially harmful substances at home, in the workplace, and in the environment. Many Californians are unaware that a number of everyday consumer products may pose potential harm. Prospective parents should talk to their doctor and are encouraged to read more about this topic to learn about simple actions to promote a healthy pregnancy.
(B)The department shall include in the patient educational information links to educational materials derived from peer-reviewed materials based on the best available evidence relating to environmental health and reproductive toxins.
(C)The department shall post the environmental health information described in subparagraphs (A) and (B) on its Internet Web site.
(D)The department shall send a notice to all distributors of the patient educational information informing them of the change to that information. In the notice, the department shall encourage obstetrician-gynecologists and midwives to discuss environmental health with their patients and to direct their patients to the appropriate page or pages in the patient educational information to provide their patients with additional information.
(E)In order to minimize costs, the environmental health information described in this paragraph shall be included when the patient educational information is otherwise revised and reprinted.
(F)The department may modify the language in the patient educational information after consultation with medical and scientific experts in the field of environmental health and reproductive toxins.
(G)The patient educational information shall be made available in the languages that meet the numeric threshold described in Section 14029.91 of the Welfare and Institutions Code, and shall be updated by the department as needed.
(c)Ensure that genetic counseling be given in conjunction with prenatal testing at the approved prenatal diagnosis centers.
(d)Designate sufficient prenatal diagnosis centers to meet the need for these services. Prenatal diagnosis centers shall have equipment and staff trained and capable of providing genetic counseling and performing prenatal diagnostic procedures and tests, including the interpretation of the results of the procedures and tests.
(e)Administer a program of subsidy grants for approved nonprofit prenatal diagnosis centers. The subsidy grants shall be awarded based on the reported number of low-income women referred to the center, the number of prenatal diagnoses performed in the previous year at that center, and the estimated size of unmet need for prenatal diagnostic procedures and tests in its service area. This subsidy shall be in addition to fees collected under other state programs.
(f)Establish any rules, regulations, and standards for prenatal diagnostic testing and the allocation of subsidies as the director deems necessary to promote and protect the public health and safety and to implement the Hereditary Disorders Act (Section 27).
(g)(1)The department shall expand prenatal screening to include all tests that meet or exceed the current standard of care as recommended by nationally recognized medical or genetic organizations, including, but not limited to, inhibin.
(2)The prenatal screening fee increase for expanding prenatal screening to include those tests described in paragraph (1) is forty dollars ($40).
(3)The department shall report to the Legislature regarding the progress of the program with regard to implementing prenatal screening for those tests described in paragraph (1) on or before July 1, 2007. The report shall include the costs of screening, followup, and treatment as compared to costs and morbidity averted by this testing under the program.
(4)(A)The expenditure of funds from the Genetic Disease Testing Fund for the expansion of the Genetic Disease Branch Screening Information System to include the expansion of prenatal screenings, pursuant to paragraph (1), may be implemented through the amendment of the Genetic Disease Branch Screening Information System contracts, and shall not be subject to Chapter 2 (commencing with Section 10290) or Chapter 3 (commencing with Section 12100) of Part 2 of Division 2 of the Public Contract Code, Article 4 (commencing with Section 19130) of Chapter 5 of Part 2 of Division 5 of Title 2 of the Government Code, or Sections 4800 to 5180, inclusive, of the State Administrative Manual as they relate to approval of information technology projects or approval of increases in the duration or costs of information technology projects. This paragraph shall apply to the design, development, and implementation of the expansion, and to the maintenance and operation of the Genetic Disease Branch Screening Information System, including change requests, once the expansion is implemented.
(B)(i)The department may adopt emergency regulations to implement and make specific the amendments to this section made during the 2006 portion of the 200506 Regular Session in accordance with Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code. For the purposes of the Administrative Procedure Act, the adoption of regulations shall be deemed an emergency and necessary for the immediate preservation of the public peace, health and safety, or general welfare. Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, these emergency regulations shall not be subject to the review and approval of the Office of Administrative Law. Notwithstanding Sections 11346.1 and 11349.6 of the Government Code, the department shall submit these regulations directly to the Secretary of State for filing. The regulations shall become effective immediately upon filing by the Secretary of State. Regulations shall be subject to public hearing within 120 days of filing with the Secretary of State and shall comply with Sections 11346.8 and 11346.9 of the Government Code or shall be repealed.
(ii)The Office of Administrative Law shall provide for the printing and publication of these regulations in the California Code of Regulations. Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the regulations adopted pursuant to this chapter shall not be repealed by the Office of Administrative Law and shall remain in effect until revised or repealed by the department.
SEC. 9.SECTION 1.Section 125092 of the Health and Safety Code is amended to read:125092.(a)The department, in consultation with the Office of AIDS and with other stakeholders, including, but not limited to, representatives of professional medical and public health advocacy groups, providers of health care to women and infants infected with or exposed to HIV, and women living with HIV, shall develop culturally sensitive informational material adequate to fulfill the requirements of subdivisions (c) and (d) of Section 125090.
(b)This material shall be made available in the languages that meet the numeric threshold described in Section 14029.91 of the Welfare and Institutions Code when providing information to clients under the Medi-Cal program, and shall be updated by the department as necessary.
(c)This material shall also include information on available referral and consultation resources of experts in prenatal HIV treatment.
(a)(1)On or before July 1, 2011, the University of California is requested to develop a plan to establish and administer the Umbilical Cord Blood Collection Program for the purpose of collecting units of umbilical cord blood for public use in transplantation and providing nonclinical units for research pertaining to biology and new clinical utilization of stem cells derived from the blood and tissue of the placenta and umbilical cord. The program shall conclude no later than January 1, 2018. 2023.
(2)For purposes of this article, public use means both of the following:
(A)The collection of umbilical cord blood units from genetically diverse donors that will be owned by the University of California. This inventory shall be accessible by the National Registry and by qualified California-based and other United States and international registries and transplant centers to increase the likelihood of providing suitably matched donor cord blood units to patients or research participants who are in need of a transplant.
(B)Cord blood units with a lower number of cells than deemed necessary for clinical transplantation and units that meet clinical requirements, but for other reasons are unsuitable, unlikely to be transplanted, or otherwise unnecessary for clinical use, may be made available for research.
(b)(1)In order to implement the collection goals of this program, the University of California may, commensurate with available funds appropriated to the University of California for this program, contract with one or more selected applicant entities that have demonstrated the competence to collect and ship cord blood units in compliance with federal guidelines and regulations.
(2)It is the intent of the Legislature that, if the University of California contracts with another entity pursuant to this subdivision, the following shall apply:
(A)The University of California may use a competitive process to identify the best proposals submitted by applicant entities to administer the collection and research objectives of the program, to the extent that the University of California chooses not to undertake these activities itself.
(B)In order to qualify for selection under this section to receive, process, cryopreserve, or bank cord blood units, the entity shall, at a minimum, have obtained an investigational new drug (IND) exemption from the FDA or a biologic license from the FDA, as appropriate, to manufacture clinical grade cord blood stem cell units for clinical indications.
(C)In order to qualify to receive appropriate cord blood units and placental tissue to advance the research goals of this program, an entity shall, at a minimum, be a laboratory recognized as having performed peer-reviewed research on stem and progenitor cells, including those derived from placental or umbilical cord blood and postnatal tissue.
(3)A medical provider or research facility shall comply with, and shall be subject to, existing penalties for violations of all applicable state and federal laws with respect to the protection of any medical information, as defined in Section 56.05 of the Civil Code, and any personally identifiable information contained in the umbilical cord blood inventory.
(c)The University of California is encouraged to make every effort to avoid duplication or conflicts with existing and ongoing programs and to leverage existing resources.
(d)(1)All information collected pursuant to the program shall be confidential, and shall be used solely for the purposes of the program, including research. Access to confidential information shall be limited to authorized persons who are bound by appropriate institutional policies or who otherwise agree, in writing, to maintain the confidentiality of that information.
(2)Any person who, in violation of applicable institutional policies or a written agreement to maintain confidentiality, discloses any information provided pursuant to this section, or who uses information provided pursuant to this section in a manner other than as approved pursuant to this section, may be denied further access to any confidential information maintained by the University of California, and shall be subject to a civil penalty not exceeding one thousand dollars ($1,000). The penalty provided for in this section shall not be construed to limit or otherwise restrict any remedy, provisional or otherwise, provided by law for the benefit of the University of California or any other person covered by this section.
(3)Notwithstanding the restrictions of this section, an individual to whom the confidential information pertains shall have access to his or her own personal information.
(e)It is the intent of the Legislature that the plan and implementation of the program provide for both of the following:
(1)Limit fees for access to cord blood units to the reasonable and actual costs of storage, handling, and providing units, as well as for related services such as donor matching and testing of cord blood and other programs and services typically provided by cord blood banks and public use programs.
(2)The submittal of the plan developed pursuant to subdivision (a) to the health and fiscal committees of the Legislature.
(f)It is additionally the intent of the Legislature that the plan and implementation of the program attempt to provide for all of the following:
(1)Development of a strategy to increase voluntary participation by hospitals in the collection and storage of umbilical cord blood and identify funding sources to offset the financial impact on hospitals.
(2)Consideration of a medical contingency response program to prepare for and respond effectively to biological, chemical, or radiological attacks, accidents, and other public health emergencies where victims potentially benefit from treatment.
(3)Exploration of the feasibility of operating the program as a self-funding program, including the potential for charging users a reimbursement fee.
SEC. 2.Section 1630 of the Health and Safety Code is amended to read:1630.This article shall remain in effect only until January 1, 2018, 2023, and as of that date is repealed, unless a later enacted statute, that is enacted before January 1, 2018, 2023, deletes or extends that date.
SEC. 3.Section 102247 of the Health and Safety Code, as amended by Section 169 of Chapter 296 of the Statutes of 2011, is amended to read:102247.(a)There is hereby created in the State Treasury the Health Statistics Special Fund. The fund shall consist of revenues, including, but not limited to, all of the following:
(1)Fees or charges remitted to the State Registrar for record search or issuance of certificates, permits, registrations, or other documents pursuant to Chapter 3 (commencing with Section 26801) of Part 3 of Division 2 of Title 3 of the Government Code, and Chapter 4 (commencing with Section 102525), Chapter 5 (commencing with Section 102625), Chapter 8 (commencing with Section 103050), and Chapter 15 (commencing with Section 103600) of Part 1 of Division 102 of this code.
(2)Funds remitted to the State Registrar by the federal Social Security Administration for participation in the enumeration at birth program.
(3)Funds remitted to the State Registrar by the National Center for Health Statistics pursuant to the federal Vital Statistics Cooperative Program.
(4)Any other funds collected by the State Registrar, except Childrens Trust Fund fees collected pursuant to Section 18966 of the Welfare and Institutions Code, Umbilical Cord Blood Collection Program Fund fees collected pursuant to Section 103625, and fees allocated to the Judicial Council pursuant to Section 1852 of the Family Code, all of which shall be deposited into the General Fund.
(b)Moneys in the Health Statistics Special Fund shall be expended by the State Registrar for the purpose of funding its existing programs and programs that may become necessary to carry out its mission, upon appropriation by the Legislature.
(c)Health Statistics Special Fund moneys shall be expended only for the purposes set forth in this section and Section 102249, and shall not be expended for any other purpose or for any other state program.
(d)It is the intent of the Legislature that the Health Statistics Special Fund provide for the following:
(1)Registration and preservation of vital event records and dissemination of vital event information to the public.
(2)Data analysis of vital statistics for population projections, health trends and patterns, epidemiologic research, and development of information to support new health policies.
(3)Development of uniform health data systems that are integrated, accessible, and useful in the collection of information on health status.
(e)This section shall remain in effect only until January 1, 2018, 2023, and as of that date is repealed, unless a later enacted statute, that is enacted before January 1, 2018, 2023, deletes or extends that date.
SEC. 4.Section 102247 of the Health and Safety Code, as amended by Section 170 of Chapter 296 of the Statutes of 2011, is amended to read:102247.(a)There is hereby created in the State Treasury the Health Statistics Special Fund. The fund shall consist of revenues, including, but not limited to, all of the following:
(1)Fees or charges remitted to the State Registrar for record search or issuance of certificates, permits, registrations, or other documents pursuant to Chapter 3 (commencing with Section 26801) of Part 3 of Division 2 of Title 3 of the Government Code, and Chapter 4 (commencing with Section 102525), Chapter 5 (commencing with Section 102625), Chapter 8 (commencing with Section 103050), and Chapter 15 (commencing with Section 103600) of Part 1 of Division 102 of this code.
(2)Funds remitted to the State Registrar by the federal Social Security Administration for participation in the enumeration at birth program.
(3)Funds remitted to the State Registrar by the National Center for Health Statistics pursuant to the federal Vital Statistics Cooperative Program.
(4)Any other funds collected by the State Registrar, except Childrens Trust Fund fees collected pursuant to Section 18966 of the Welfare and Institutions Code and fees allocated to the Judicial Council pursuant to Section 1852 of the Family Code, all of which shall be deposited into the General Fund.
(b)Moneys in the Health Statistics Special Fund shall be expended by the State Registrar for the purpose of funding its existing programs and programs that may become necessary to carry out its mission, upon appropriation by the Legislature.
(c)Health Statistics Special Fund moneys shall be expended only for the purposes set forth in this section and Section 102249, and shall not be expended for any other purpose or for any other state program.
(d)It is the intent of the Legislature that the Health Statistics Special Fund provide for the following:
(1)Registration and preservation of vital event records and dissemination of vital event information to the public.
(2)Data analysis of vital statistics for population projections, health trends and patterns, epidemiologic research, and development of information to support new health policies.
(3)Development of uniform health data systems that are integrated, accessible, and useful in the collection of information on health status.
(e)This section shall become operative on January 1, 2018. 2023.
SEC. 5.Section 103625 of the Health and Safety Code, as amended by Section 5 of Chapter 402 of the Statutes of 2011, is amended to read:103625.(a)A fee of twelve dollars ($12) shall be paid by the applicant for a certified copy of a fetal death or death record.
(b)(1)A fee of twelve dollars ($12) shall be paid by a public agency or licensed private adoption agency applicant for a certified copy of a birth certificate that the agency is required to obtain in the ordinary course of business. A fee of eighteen dollars ($18) shall be paid by any other applicant for a certified copy of a birth certificate. Four dollars ($4) of any eighteen-dollar ($18) fee is exempt from subdivision (e) and shall be paid either to a county childrens trust fund or to the State Childrens Trust Fund, in conformity with Article 5 (commencing with Section 18965) of Chapter 11 of Part 6 of Division 9 of the Welfare and Institutions Code. Two dollars ($2) of any eighteen-dollar ($18) fee is exempt from subdivision (e) and shall be paid to the Umbilical Cord Blood Collection Program Fund in conformity with Section 1628.
(2)The board of supervisors of any county that has established a county childrens trust fund may increase the fee for a certified copy of a birth certificate by up to three dollars ($3) for deposit in the county childrens trust fund in conformity with Article 5 (commencing with Section 18965) of Chapter 11 of Part 6 of Division 9 of the Welfare and Institutions Code.
(c)A fee of three dollars ($3) shall be paid by a public agency applicant for a certified copy of a marriage record, that has been filed with the county recorder or county clerk, that the agency is required to obtain in the ordinary course of business. A fee of six dollars ($6) shall be paid by any other applicant for a certified copy of a marriage record that has been filed with the county recorder or county clerk. Three dollars ($3) of any six-dollar ($6) fee is exempt from subdivision (e) and shall be transmitted monthly by each local registrar, county recorder, and county clerk to the state for deposit into the General Fund as provided by Section 1852 of the Family Code.
(d)A fee of three dollars ($3) shall be paid by a public agency applicant for a certified copy of a marriage dissolution record obtained from the State Registrar that the agency is required to obtain in the ordinary course of business. A fee of six dollars ($6) shall be paid by any other applicant for a certified copy of a marriage dissolution record obtained from the State Registrar.
(e)Each local registrar, county recorder, or county clerk collecting a fee pursuant to subdivisions (a) to (d), inclusive, shall do the following:
(1)Transmit 15 percent of the fee for each certified copy to the State Registrar by the 10th day of the month following the month in which the fee was received.
(2)Retain 85 percent of the fee for each certified copy solely to support the issuing agency for all activities related to the issuance of certified copies of records pursuant to subdivisions (a) to (d), inclusive.
(f)In addition to the fees prescribed pursuant to subdivisions (a) to (d), inclusive, all applicants for certified copies of the records described in those subdivisions shall pay an additional fee of three dollars ($3), that shall be collected by the State Registrar, the local registrar, county recorder, or county clerk, as the case may be.
(g)The local public official charged with the collection of the additional fee established pursuant to subdivision (f) may create a local vital and health statistics trust fund. The fees collected by local public officials pursuant to subdivision (f) shall be distributed as follows:
(1)Forty-five percent of the fee collected pursuant to subdivision (f) shall be transmitted to the State Registrar.
(2)The remainder of the fee collected pursuant to subdivision (f) shall be deposited into the collecting agencys vital and health statistics trust fund, except that in any jurisdiction in which a local vital and health statistics trust fund has not been established, the entire amount of the fee collected pursuant to subdivision (f) shall be transmitted to the State Registrar.
(3)Moneys transmitted to the State Registrar pursuant to this subdivision shall be deposited in accordance with Section 102247.
(h)Moneys in each local vital and health statistics trust fund shall be available to the local official charged with the collection of fees pursuant to subdivision (f) for the applicable jurisdiction for the purpose of defraying the administrative costs of collecting and reporting with respect to those fees and for other costs as follows:
(1)Modernization of vital record operations, including improvement, automation, and technical support of vital record systems.
(2)Improvement in the collection and analysis of health-related birth and death certificate information, and other community health data collection and analysis, as appropriate.
(i)Funds collected pursuant to subdivision (f) shall not be used to supplant funding in existence on January 1, 2002, that is necessary for the daily operation of vital record systems. It is the intent of the Legislature that funds collected pursuant to subdivision (f) be used to enhance service to the public, to improve analytical capabilities of state and local health authorities in addressing the health needs of newborn children and maternal health problems, and to analyze the health status of the general population.
(j)Each county shall annually submit a report to the State Registrar by March 1 containing information on the amount of revenues collected pursuant to subdivision (f) in the previous calendar year and on how the revenues were expended and for what purpose.
(k)Each local registrar, county recorder, or county clerk collecting the fee pursuant to subdivision (f) shall transmit 45 percent of the fee for each certified copy to which subdivision (f) applies to the State Registrar by the 10th day of the month following the month in which the fee was received.
(l)The nine dollar ($9) increase to the base fee authorized in subdivision (a) for a certified copy of a fetal death record or death record and subdivision (b) for a certified copy of a birth certificate shall be applied incrementally as follows:
(1)A five dollar ($5) increase applied as of January 1, 2012.
(2)An additional two dollar ($2) increase applied as of January 1, 2013.
(3)An additional two dollar ($2) increase applied as of January 1, 2014.
(m)In providing for the expiration of the surcharge on birth certificate fees on June 30, 1999, the Legislature intends that juvenile dependency mediation programs pursue ancillary funding sources after that date.
(n)This section shall remain in effect only until January 1, 2018, 2023, and as of that date is repealed, unless a later enacted statute, that is enacted before January 1, 2018, 2023, deletes or extends that date.
SEC. 6.Section 103625 of the Health and Safety Code, as amended by Section 6 of Chapter 402 of the Statutes of 2011, is amended to read:103625.(a)A fee of twelve dollars ($12) shall be paid by the applicant for a certified copy of a fetal death or death record.
(b)(1)A fee of twelve dollars ($12) shall be paid by a public agency or licensed private adoption agency applicant for a certified copy of a birth certificate that the agency is required to obtain in the ordinary course of business. A fee of sixteen dollars ($16) shall be paid by any other applicant for a certified copy of a birth certificate. Four dollars ($4) of any sixteen-dollar ($16) fee is exempt from subdivision (e) and shall be paid either to a county childrens trust fund or to the State Childrens Trust Fund, in conformity with Article 5 (commencing with Section 18965) of Chapter 11 of Part 6 of Division 9 of the Welfare and Institutions Code.
(2)The board of supervisors of any county that has established a county childrens trust fund may increase the fee for a certified copy of a birth certificate by up to three dollars ($3) for deposit in the county childrens trust fund in conformity with Article 5 (commencing with Section 18965) of Chapter 11 of Part 6 of Division 9 of the Welfare and Institutions Code.
(c)A fee of three dollars ($3) shall be paid by a public agency applicant for a certified copy of a marriage record, that has been filed with the county recorder or county clerk, that the agency is required to obtain in the ordinary course of business. A fee of six dollars ($6) shall be paid by any other applicant for a certified copy of a marriage record that has been filed with the county recorder or county clerk. Three dollars ($3) of any six-dollar ($6) fee is exempt from subdivision (e) and shall be transmitted monthly by each local registrar, county recorder, and county clerk to the state for deposit into the General Fund as provided by Section 1852 of the Family Code.
(d)A fee of three dollars ($3) shall be paid by a public agency applicant for a certified copy of a marriage dissolution record obtained from the State Registrar that the agency is required to obtain in the ordinary course of business. A fee of six dollars ($6) shall be paid by any other applicant for a certified copy of a marriage dissolution record obtained from the State Registrar.
(e)Each local registrar, county recorder, or county clerk collecting a fee pursuant to subdivisions (a) to (d), inclusive, shall do the following:
(1)Transmit 15 percent of the fee for each certified copy to the State Registrar by the 10th day of the month following the month in which the fee was received.
(2)Retain 85 percent of the fee for each certified copy solely to support the issuing agency for all activities related to the issuance of certified copies of records pursuant to subdivisions (a) to (d), inclusive.
(f)In addition to the fees prescribed pursuant to subdivisions (a) to (d), inclusive, all applicants for certified copies of the records described in those subdivisions shall pay an additional fee of three dollars ($3), that shall be collected by the State Registrar, the local registrar, county recorder, or county clerk, as the case may be.
(g)The local public official charged with the collection of the additional fee established pursuant to subdivision (f) may create a local vital and health statistics trust fund. The fees collected by local public officials pursuant to subdivision (f) shall be distributed as follows:
(1)Forty-five percent of the fee collected pursuant to subdivision (f) shall be transmitted to the State Registrar.
(2)The remainder of the fee collected pursuant to subdivision (f) shall be deposited into the collecting agencys vital and health statistics trust fund, except that in any jurisdiction in which a local vital and health statistics trust fund has not been established, the entire amount of the fee collected pursuant to subdivision (f) shall be transmitted to the State Registrar.
(3)Moneys transmitted to the State Registrar pursuant to this subdivision shall be deposited in accordance with Section 102247.
(h)Moneys in each local vital and health statistics trust fund shall be available to the local official charged with the collection of fees pursuant to subdivision (f) for the applicable jurisdiction for the purpose of defraying the administrative costs of collecting and reporting with respect to those fees and for other costs as follows:
(1)Modernization of vital record operations, including improvement, automation, and technical support of vital record systems.
(2)Improvement in the collection and analysis of health-related birth and death certificate information, and other community health data collection and analysis, as appropriate.
(i)Funds collected pursuant to subdivision (f) shall not be used to supplant funding in existence on January 1, 2002, that is necessary for the daily operation of vital record systems. It is the intent of the Legislature that funds collected pursuant to subdivision (f) be used to enhance service to the public, to improve analytical capabilities of state and local health authorities in addressing the health needs of newborn children and maternal health problems, and to analyze the health status of the general population.
(j)Each county shall annually submit a report to the State Registrar by March 1 containing information on the amount of revenues collected pursuant to subdivision (f) in the previous calendar year and on how the revenues were expended and for what purpose.
(k)Each local registrar, county recorder, or county clerk collecting the fee pursuant to subdivision (f) shall transmit 45 percent of the fee for each certified copy to which subdivision (f) applies to the State Registrar by the 10th day of the month following the month in which the fee was received.
(l)In providing for the expiration of the surcharge on birth certificate fees on June 30, 1999, the Legislature intends that juvenile dependency mediation programs pursue ancillary funding sources after that date.
(m)This section shall become operative on January 1, 2018. 2023.
SECTION 1.SEC. 7.Section 123371 of the Health and Safety Code is amended to read:123371.(a)(1)The State Department of Public Health shall develop standardized, objective information about umbilical cord blood donation that is sufficient to allow a pregnant woman to make an informed decision on whether to participate in a private or public umbilical cord blood banking program. The information developed by the department shall enable a pregnant woman to be informed of her option to do any of the following:
(A)Discard umbilical cord blood.
(B)Donate umbilical cord blood to a public umbilical cord blood bank.
(C)Store the umbilical cord blood in a family umbilical cord blood bank for the use by immediate and extended family members.
(D)Donate umbilical cord blood to research.
(2)The information developed pursuant to paragraph (1) shall include, but not be limited to, all of the following:
(A)The current and potential future medical uses of stored umbilical cord blood.
(B)The benefits and risks involved in umbilical cord blood banking.
(C)The medical process involved in umbilical cord blood banking.
(D)Medical or family history criteria that can impact a familys consideration of umbilical cord banking.
(E)An explanation of the differences between public and private umbilical cord blood banking.
(F)The availability and costs of public or private umbilical cord blood banks.
(G)Medical or family history criteria that can impact a familys consideration of umbilical cord blood banking.
(H)An explanation that the practices and policies of blood banks may vary with respect to accreditation, cord blood processing and storage methods, costs, and donor privacy.
(I)An explanation that pregnant women are not required to donate their umbilical cord blood for research purposes.
(b)The information provided by the department pursuant to subdivision (a) shall be made available in the languages that meet the numeric threshold described in Section 14029.91 of the Welfare and Institutions Code, and shall be updated by the department as needed.
(c)The information provided by the department pursuant to subdivision (a) shall be made available on the Internet Web sites of the licensing boards that have oversight over primary prenatal care providers.
(d)(1)A primary prenatal care provider of a woman who is known to be pregnant may, during the first prenatal visit, provide the information required by subdivision (a) to the pregnant woman.
(2)For purposes of this article, a prenatal care provider means a health care provider licensed pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code, or pursuant to an initiative act referred to in that division, who provides prenatal medical care within his or her scope of practice.
SEC. 8.Section 125055 of the Health and Safety Code is amended to read:125055.The department shall:
(a)Establish criteria for eligibility for the prenatal testing program. Eligibility shall include definition of conditions and circumstances that result in a high risk of a detectable genetic disorder or birth defect.
(b)(1)Develop an education program designed to educate physicians and surgeons and the public concerning the uses of prenatal testing and the availability of the program.
(2)(A)Include information regarding environmental health in the California Prenatal Screening Program patient educational information. This environmental health information shall include the following statement:
We encounter chemicals and other substances in everyday life that may affect your developing fetus. Fortunately, there are steps you can take to reduce your exposure to these potentially harmful substances at home, in the workplace, and in the environment. Many Californians are unaware that a number of everyday consumer products may pose potential harm. Prospective parents should talk to their doctor and are encouraged to read more about this topic to learn about simple actions to promote a healthy pregnancy.
(B)The department shall include in the patient educational information links to educational materials derived from peer-reviewed materials based on the best available evidence relating to environmental health and reproductive toxins.
(C)The department shall post the environmental health information described in subparagraphs (A) and (B) on its Internet Web site.
(D)The department shall send a notice to all distributors of the patient educational information informing them of the change to that information. In the notice, the department shall encourage obstetrician-gynecologists and midwives to discuss environmental health with their patients and to direct their patients to the appropriate page or pages in the patient educational information to provide their patients with additional information.
(E)In order to minimize costs, the environmental health information described in this paragraph shall be included when the patient educational information is otherwise revised and reprinted.
(F)The department may modify the language in the patient educational information after consultation with medical and scientific experts in the field of environmental health and reproductive toxins.
(G)The patient educational information shall be made available in the languages that meet the numeric threshold described in Section 14029.91 of the Welfare and Institutions Code, and shall be updated by the department as needed.
(c)Ensure that genetic counseling be given in conjunction with prenatal testing at the approved prenatal diagnosis centers.
(d)Designate sufficient prenatal diagnosis centers to meet the need for these services. Prenatal diagnosis centers shall have equipment and staff trained and capable of providing genetic counseling and performing prenatal diagnostic procedures and tests, including the interpretation of the results of the procedures and tests.
(e)Administer a program of subsidy grants for approved nonprofit prenatal diagnosis centers. The subsidy grants shall be awarded based on the reported number of low-income women referred to the center, the number of prenatal diagnoses performed in the previous year at that center, and the estimated size of unmet need for prenatal diagnostic procedures and tests in its service area. This subsidy shall be in addition to fees collected under other state programs.
(f)Establish any rules, regulations, and standards for prenatal diagnostic testing and the allocation of subsidies as the director deems necessary to promote and protect the public health and safety and to implement the Hereditary Disorders Act (Section 27).
(g)(1)The department shall expand prenatal screening to include all tests that meet or exceed the current standard of care as recommended by nationally recognized medical or genetic organizations, including, but not limited to, inhibin.
(2)The prenatal screening fee increase for expanding prenatal screening to include those tests described in paragraph (1) is forty dollars ($40).
(3)The department shall report to the Legislature regarding the progress of the program with regard to implementing prenatal screening for those tests described in paragraph (1) on or before July 1, 2007. The report shall include the costs of screening, followup, and treatment as compared to costs and morbidity averted by this testing under the program.
(4)(A)The expenditure of funds from the Genetic Disease Testing Fund for the expansion of the Genetic Disease Branch Screening Information System to include the expansion of prenatal screenings, pursuant to paragraph (1), may be implemented through the amendment of the Genetic Disease Branch Screening Information System contracts, and shall not be subject to Chapter 2 (commencing with Section 10290) or Chapter 3 (commencing with Section 12100) of Part 2 of Division 2 of the Public Contract Code, Article 4 (commencing with Section 19130) of Chapter 5 of Part 2 of Division 5 of Title 2 of the Government Code, or Sections 4800 to 5180, inclusive, of the State Administrative Manual as they relate to approval of information technology projects or approval of increases in the duration or costs of information technology projects. This paragraph shall apply to the design, development, and implementation of the expansion, and to the maintenance and operation of the Genetic Disease Branch Screening Information System, including change requests, once the expansion is implemented.
(B)(i)The department may adopt emergency regulations to implement and make specific the amendments to this section made during the 2006 portion of the 200506 Regular Session in accordance with Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code. For the purposes of the Administrative Procedure Act, the adoption of regulations shall be deemed an emergency and necessary for the immediate preservation of the public peace, health and safety, or general welfare. Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, these emergency regulations shall not be subject to the review and approval of the Office of Administrative Law. Notwithstanding Sections 11346.1 and 11349.6 of the Government Code, the department shall submit these regulations directly to the Secretary of State for filing. The regulations shall become effective immediately upon filing by the Secretary of State. Regulations shall be subject to public hearing within 120 days of filing with the Secretary of State and shall comply with Sections 11346.8 and 11346.9 of the Government Code or shall be repealed.
(ii)The Office of Administrative Law shall provide for the printing and publication of these regulations in the California Code of Regulations. Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the regulations adopted pursuant to this chapter shall not be repealed by the Office of Administrative Law and shall remain in effect until revised or repealed by the department.
SEC. 2.SEC. 9.Section 125092 of the Health and Safety Code is amended to read:125092.(a)The department, in consultation with the Office of AIDS and with other stakeholders, including, but not limited to, representatives of professional medical and public health advocacy groups, providers of health care to women and infants infected with or exposed to HIV, and women living with HIV, shall develop culturally sensitive informational material adequate to fulfill the requirements of subdivisions (c) and (d) of Section 125090, in 125090.
(b)This material shall be made available in the languages that meet the numeric threshold described in Section 14029.91 of the Welfare and Institutions Code when providing information to clients under the Medi-Cal program. This program, and shall be updated by the department as necessary.
(c)This material shall also include information on available referral and consultation resources of experts in prenatal HIV treatment.
(a)(1)The State Department of Public Health shall develop standardized, objective information about umbilical cord blood donation that is sufficient to allow a pregnant woman to make an informed decision on whether to participate in a private or public umbilical cord blood banking program. The information developed by the department shall enable a pregnant woman to be informed of her option to do any of the following:
(A)Discard umbilical cord blood.
(B)Donate umbilical cord blood to a public umbilical cord blood bank.
(C)Store the umbilical cord blood in a family umbilical cord blood bank for the use by immediate and extended family members.
(D)Donate umbilical cord blood to research.
(2)The information developed pursuant to paragraph (1) shall include, but not be limited to, all of the following:
(A)The current and potential future medical uses of stored umbilical cord blood.
(B)The benefits and risks involved in umbilical cord blood banking.
(C)The medical process involved in umbilical cord blood banking.
(D)Medical or family history criteria that can impact a familys consideration of umbilical cord banking.
(E)An explanation of the differences between public and private umbilical cord blood banking.
(F)The availability and costs of public or private umbilical cord blood banks.
(G)Medical or family history criteria that can impact a familys consideration of umbilical cord blood banking.
(H)An explanation that the practices and policies of blood banks may vary with respect to accreditation, cord blood processing and storage methods, costs, and donor privacy.
(I)An explanation that pregnant women are not required to donate their umbilical cord blood for research purposes.
(b)The information provided by the department pursuant to subdivision (a) shall be made available in Cantonese, English, Spanish, and Vietnamese, the languages that meet the numeric threshold described in Section 14029.91 of the Welfare and Institutions Code, and shall be updated by the department as needed.
(c)The information provided by the department pursuant to subdivision (a) shall be made available on the Internet Web sites of the licensing boards that have oversight over primary prenatal care providers.
(d)(1)A primary prenatal care provider of a woman who is known to be pregnant may, during the first prenatal visit, provide the information required by subdivision (a) to the pregnant woman.
(2)For purposes of this article, a prenatal care provider means a health care provider licensed pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code, or pursuant to an initiative act referred to in that division, who provides prenatal medical care within his or her scope of practice.
(e)The department shall only implement this article upon a determination by the Director of Finance, that sufficient private donations have been collected and deposited into the Umbilical Cord Blood Education Account, which is hereby created in the State Treasury. The moneys in the account shall be available, upon appropriation by the Legislature, for the purposes of this article. No public funds shall be used to implement this article. If sufficient funds are collected and deposited into the account, the Director of Finance shall file a written notice thereof with the Secretary of State.
SEC. 2.Section 125092 of the Health and Safety Code is amended to read:125092.The department, in consultation with the Office of AIDS and with other stakeholders, including, but not limited to, representatives of professional medical and public health advocacy groups, providers of health care to women and infants infected with or exposed to HIV, and women living with HIV, shall develop culturally sensitive informational material adequate to fulfill the requirements of subdivisions (c) and (d) of Section 125090, in English, Spanish, and other languages used by the department the languages that meet the numeric threshold described in Section 14029.91 of the Welfare and Institutions Code when providing information to clients under the Medi-Cal program. This material shall also include information on available referral and consultation resources of experts in prenatal HIV treatment. This material shall be completed by December 31, 2004.
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Date
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Status
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|---|---|
| Feb 18, 2016 | Read first time. To print. |
| Feb 19, 2016 | From printer. May be heard in committee March 20. |
| Mar 8, 2016 | Referred to Com. on HEALTH. |
| Mar 28, 2016 | From committee chair, with author's amendments: Amend, and re-refer to Com. on HEALTH. Read second time and amended. |
| Mar 29, 2016 | Re-referred to Com. on HEALTH. |
| Apr 6, 2016 | From committee: Do pass and re-refer to Com. on APPR. (Ayes 17. Noes 0.) (April 5). Re-referred to Com. on APPR. |
| Apr 13, 2016 | In committee: Set, first hearing. Referred to suspense file. |
| May 27, 2016 | From committee: Amend, and do pass as amended. (Ayes 15. Noes 1.) (May 27). |
| May 31, 2016 | Read second time and amended. Ordered returned to second reading. |
| Jun 1, 2016 | Read second time. Ordered to third reading. |
| Jun 2, 2016 | Read third time. Passed. Ordered to the Senate. |
| Jun 2, 2016 | Read third time. Passed. Ordered to the Senate. (Ayes 79. Noes 0. Page 5190.) |
| Jun 2, 2016 | Read third time. Passed. Ordered to the Senate. (Ayes 79. Noes 0.) |
| Jun 6, 2016 | In Senate. Read first time. To Com. on RLS. for assignment. |
| Jun 9, 2016 | Referred to Com. on HEALTH. |
| Jun 29, 2016 | In committee: Set, first hearing. Hearing canceled at the request of author. |
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Date
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Description
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Location
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Votes
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|---|---|---|---|---|
| Jun 2, 2016 | AB 2399 NAZARIAN Assembly Third Reading | Assembly Floor |
Passed |
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| May 27, 2016 | Do pass as amended. | Assembly Standing Committee on Appropriations |
Passed |
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| Apr 5, 2016 | Do pass and be re-referred to the Committee on [Appropriations] | Assembly Standing Committee on Health |
Passed |
This list shows positions taken on this bill by organizations on the date displayed, which is linked to the original source.
Positions by individuals are not included.
|
Organization
|
Position
|
Date
|
|---|---|---|
| ACL Healthcare Foundation | * Support | Jun 29, 2016 |
| Breast Cancer Fund, The | ** Support | Jun 2, 2016 |
| March of Dimes | ** Support | Jun 29, 2016 |
| University of California | ** Support | Jun 2, 2016 |
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 2399
AUTHOR: | Nazarian | ||
VERSION: | May 31, 2016 | ||
HEARING DATE: | June 29, 2016 | ||
CONSULTANT: | Reyes Diaz | ||
SUBJECT: Pregnancy: prenatal blood testing
SUMMARY:
Requires the Department of Public Health to make informational material, as specified, available in the languages that meet the numeric threshold described in current law when providing language assistance to limited-English-proficient Medi-Cal beneficiaries, as specified.
Existing law:
- Establishes the Department of Public Health (DPH) to protect and improve the health of communities through education, promotion of healthy lifestyles, and research for disease and injury prevention. Provides DPH with the authority to perform activities that protect, preserve, and advance public health, including studies and dissemination of information.
- Requires DPH, in consultation with DPH’s Office of AIDS and with other stakeholders, including providers of health care to women and infants infected with or exposed to human immunodeficiency virus (HIV), to develop culturally sensitive informational material, adequate to fulfill specified requirements, in English, Spanish, and other languages used by DPH when providing information to clients under the Medi-Cal program, including the languages required when providing assistance to limited-English-proficient (LEP) Medi-Cal beneficiaries.
- Requires all managed care plans contracting with the Department of Health Care Services (DHCS) to provide language assistance services to LEP Medic-Cal beneficiaries who are mandatorily enrolled in managed care. Requires DHCS to determine when a LEP population meets the requirement for translation services using one of the following numeric thresholds:
- A population group of at least 3,000 or 5% of the beneficiary population, whichever is fewer, mandatory managed care Medi-Cal beneficiaries, residing in the service area, who indicate their primary language as other than English; or,
- A population group of mandatory managed care Medi-Cal beneficiaries, residing in the service area, who indicate their primary language as other than English, and that meet a concentration standard of 1,000 beneficiaries in a single ZIP Code or 1,500 beneficiaries in two contiguous ZIP Codes.
This bill: Requires DPH to make informational material available in the languages that meet the numeric threshold described in current law when providing language assistance to LEP Medi-Cal beneficiaries, as specified.
FISCAL EFFECT:
According to the Assembly Appropriations Committee, costs to DPH of approximately $30,000 to translate the prenatal information into the additional languages (Genetic Disease Fund).
PRIOR VOTES:
Assembly Floor: | 79 - 0 |
Assembly Appropriations Committee: | 15 - 1 |
Assembly Health Committee: | Not relevant |
COMMENTS:
- Author’s statement. According to the author, currently, a physician engaged in the prenatal care of a pregnant woman is required to obtain a blood specimen from the woman for purposes of determining the presence of hepatitis B or HIV. Existing law also requires DPH to develop culturally sensitive informational material in English, Spanish, and other languages to inform a pregnant woman about the purpose of obtaining this blood sample. This bill requires that this informational material will be translated in all of the same languages in which the Medi-Cal program provides translation services. This bill will ensure a woman receives the vital information related to prenatal testing in the language that she knows best.
- Background. According to DPH’s Office of AIDS Web page, the Perinatal HIV Prevention Project works to assist prenatal care providers in administering HIV testing during a pregnant woman’s prenatal care. The information sheet, “Protecting Yourself and Your Baby,” is available on the Office of AIDS Web page in the following languages: English, Arabic, Armenian, Cambodian, Chinese, Farsi, Hmong, Japanese, Korean, Laotian, Russian, Spanish, Tagalog, and Vietnamese. Managed care plans contracting with DHCS provide language assistance services to LEP Medi-Cal beneficiaries who are mandatorily enrolled in managed care when a regional LEP population meets the certain numeric thresholds.
- Prior legislation. AB 1676 (Dutra, Chapter 749, Statutes of 2003), required DPH, among other things, in consultation with the Office of AIDS and other specified organizations, to develop culturally sensitive informational material concerning HIV testing and information on available referral and consultation resources of experts in prenatal HIV treatment.
- Support. The March of Dimes argues that professional providers of information should provide counseling that is non-directive, enabling prospective parents to make decisions that are right for them as individuals. The March of Dimes states that this bill will ensure that parents have accurate information about their options and that information is presented to them in the appropriate language.
- Policy comment. Current law already requires Medi-Cal beneficiaries to receive information in threshold languages as determined by DHCS. Therefore, the impact of this bill is unclear.
SUPPORT AND OPPOSITION:
Support: March of Dimes
Oppose: None received
-- END --
ASSEMBLY THIRD READING
ATR Bill Id:AB 2399
Author:()
As Amended Ver: May 31, 2016
Majority vote
Committee | Votes | Ayes | Noes |
Health | 17-0 | Wood, Maienschein, Bonilla, Burke, Chiu, Dababneh, Gomez, Lackey, Nazarian, Olsen, Patterson, Ridley-Thomas, Rodriguez, Santiago, Steinorth, Thurmond, Waldron | |
Appropriations | 15-1 | Gonzalez, Bloom, Bonilla, Bonta, Calderon, Chang, Daly, Eggman, Eduardo Garcia, Roger Hernández, Holden, Quirk, Santiago, Weber, Wood | Bigelow |
SUMMARY: Requires the Department of Public Health (DPH) to make the informational materials provided to women and infants infected with or exposed to human immunodeficiency virus (HIV) available in the Medi-Cal threshold languages, as specified.
EXISTING LAW:
- Requires DPH, in consultation with the Office of AIDS and other stakeholders, to develop culturally sensitive informational material adequate to inform pregnant women, at the time of labor or delivery, that they will be tested for HIV, the routine nature of the test, the purpose, risks and benefits of the test, and that she has the right to decline the test.
- Requires all managed care plans contracting with the Department of Health Care Services (DHCS) to provide language assistance services to limited-English-proficient (LEP) Medic-Cal beneficiaries who are mandatorily enrolled in managed care. Requires DHCS to determine when a LEP population meets the requirement for translation services using one of the following numeric thresholds:
- A population group of at least 3,000 or 5% of the beneficiary population, whichever is fewer, mandatory managed care Medi-Cal beneficiaries, residing in the service area, who indicate their primary language as other than English; or,
- A population group of mandatory managed care Medi-Cal beneficiaries, residing in the service area, who indicate their primary language as other than English, and that meet a concentration standard of 1,000 beneficiaries in a single ZIP Code or 1,500 beneficiaries in two contiguous ZIP Codes.
FISCAL EFFECT: According to the Assembly Appropriations Committee, costs to DPH of approximately $30,000 to translate the prenatal information into the additional languages (Genetic Disease Fund).
COMMENTS: According to the author this bill will provide women with the HIV informational material in the language they know best by requiring the materials to be made available in all 14 of the languages used to satisfy the translation services requirements for Medi-Cal managed care plans.
As noted in Existing Law above, managed care plans contracting with DHCS provide language assistance services to LEP Medi-Cal beneficiaries who are mandatorily enrolled in managed care when a regional LEP population meets the certain numeric thresholds. The Medi-Cal threshold languages are: English, Arabic, Armenian, Cambodian, Chinese, Farsi, Hmong, Japanese, Korean, Laotian, Russian, Spanish, Tagalog, and Vietnamese.
Analysis Prepared by: Lara Flynn / HEALTH / (916) 319-2097 FN: 0003253
Date of Hearing: April 13, 2013
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Lorena Gonzalez, Chair
ABPCA Bill Id:AB 2399
Author:(Nazarian) – As Amended Ver:March 28, 2016
Policy Committee: | Health | Vote: | 17 - 0 |
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| ||
|
|
Urgency: No State Mandated Local Program: No Reimbursable: No
SUMMARY:
This bill extends the umbilical cord collection program and contains related provisions. Specifically, this bill:
- Extends the state umbilical cord collection program for an additional five years, from January 1, 2018 to January 1, 2023.
- Extends a $2 fee on certified copies of birth certificates to support the program.
- Requires the California Department of Public Health (CDPH) to publish informational materials regarding umbilical cord blood storage, prenatal testing, and prenatal human immunodeficiency virus (HIV) in multiple languages.
- Repeals existing law making the implementation of a community awareness campaign about umbilical cord blood donation by CDPH contingent upon receiving sufficient private donations, thereby making the requirement operative.
FISCAL EFFECT:
- The state would continue to incur costs to the Health Statistics Special Fund and collect about $2.5 million annually in revenues to support the state umbilical cord collection program through calendar year 2022. The program is currently administered by UC Davis Health System through contract with CDPH.
- Uncertain, significant costs to conduct a public awareness campaign. The costs would depend on the robustness of the effort, and could easily be millions of dollars ongoing for an effective statewide campaign (GF). The current statute requires the campaign provide awareness, assistance, and information regarding umbilical cord blood banking options using brochures, television, print media, radio, Internet Web sites, outdoor advertising, and other media.
- Costs to CDPH of approximately $30,000 to translate the prenatal information into the additional languages (Genetic Disease Fund).
COMMENTS:
- Purpose. According to the author, studies have shown cord blood is a rich source of stem cells that can be used to treat various diseases and disorders. The author believes this is a worthy program that should be extended, and that proposed changes will increase outreach and awareness, thereby increasing the diversity of cord blood collected by the program and available for California's diverse population.
- Uses of Cord Blood. Donated cord blood can be banked for use in transplants. It has been used to treat certain diseases of the blood and immune system, as well as inherited diseases (of red blood cells, the immune system and certain metabolic abnormalities). Cells from cord blood also demonstrate the potential to help conditions that have no cure today by regenerating damaged tissue and restoring lost function after an injury or illness. Cord blood can be donated to a public bank or can be privately banked for personal use, though private banking is generally not recommended unless there is a family history of specific genetic diseases.
- Cord Blood Collection Program. The program whose sunset is extended by this bill was created by AB 52 (Portantino), Chapter 529, Statutes of 2010, and is funded through an additional $2 fee on birth certificate copies. It is a statewide public program designed to capture the genetic diversity of Californians through the collection of cord blood. The program does not administer a public cord blood bank, but sets up collection sites in hospitals and facilitates the relationship between a hospital and public bank. The program attempts to make a hospital's participation in the program cost-neutral by providing contract staff or reimbursing hospitals for their staffing costs, as well as managing the administrative aspects of the collection. Once collected, the blood is stored at a public bank, such as San Diego Blood Bank. Banks register each unit of collected cord blood under the National Marrow Donor Program, which maintains a global registry of available cord blood units.
The collection program targets hospitals that are ethnically diverse, in order to increase the chances that a donor can be found for persons of ethnic heritage that are not currently well-represented among cord blood donors. Banks attempt to match proteins called Human Leukocyte Antigen (HLA), and a person's HLA typing is related to ethnicity. A match between a donor’s and a patient’s HLA markers is essential for a successful transplant outcome.
- Staff Comments. The relationship between birth certificates and cord blood donation appears limited to the fact that they both relate to the birth of a child. In addition, it is unclear what the appropriate ongoing expenditure level is for a program of this type. If this program model is the best way to ensure a diversity of samples is available for the benefit of California's population, the author may wish to consider whether there are alternative funding sources for this program and ensure there is a match between program needs and revenues.
Additionally, while some level of public awareness effort appears to be warranted, the nature of cord blood collection at the time of birth suggests that public education has to be a sustained, ongoing effort to educate new mothers and that targeted approaches may be more cost-effective than large statewide media campaigns.
Analysis Prepared by: Lisa Murawski / APPR. / (916) 319-2081
Date of Hearing: April 5, 2016
ASSEMBLY COMMITTEE ON HEALTH
Jim Wood, Chair
ABPCA Bill Id:AB 2399
Author:(Nazarian) – As Amended Ver:March 28, 2016
SUBJECT: Pregnancy: umbilical cord blood: blood testing.
SUMMARY: Requires the Department of Public Health (DPH) to make available the materials that are provided to expectant parents regarding umbilical cord blood (UCB) storage and prenatal testing and the materials provided to women and infants infected with or exposed to human immunodeficiency virus (HIV) in Medi-Cal threshold languages, as specified. Repeals existing law making the implementation of UCB Community Awareness Campaign by DPH contingent upon receiving sufficient private donations. Extends the sunset of the public Umbilical Cord Blood Collection Program (UCBCP), housed at the University of California (UC), Davis and the $2 collected from the $18 dollar issuance fee for birth certificates for the purposes of funding the UCBCP, from January 1, 2018 to January 1, 2023.
EXISTING LAW:
- Requires DPH, contingent upon sufficient private funding, to conduct the Umbilical Cord Blood Community Awareness Campaign to provide information regarding UCB banking options using brochures, television, print media, and Internet Websites, among other options, where appropriate to disseminate information to licensed prenatal care providers, Family PACT providers, and pregnant women.
- Requires DPH to establish an Internet Website to provide information about umbilical cord blood banking options that is accessible to prenatal care providers, pregnant women, and the general public, and to undertake public education activities related to UCB donation to targeted populations.
- Requires DPH to develop standardized, objective information about UCB donation that is sufficient to allow a pregnant woman to make an informed decision on whether to participate in a private or public umbilical cord blood banking program.
- Requires DPH, in consultation with the Office of AIDS and other stakeholders, to develop culturally sensitive informational material adequate to inform pregnant women, at the time of labor or delivery, that they will be tested for HIV, the routine nature of the test, the purpose, risks and benefits of the test, and that she has the right to decline the test.
- Requires all managed care plans contracting with the Department of Health Care Services (DHCS) to provide language assistance services to limited-English-proficient (LEP) Medic-Cal beneficiaries who are mandatorily enrolled in managed care. Requires DHCS to determine when a LEP population meets the requirement for translation services using one of the following numeric thresholds:
- A population group of at least 3,000 or 5% of the beneficiary population, whichever is fewer, mandatory managed care Medi-Cal beneficiaries, residing in the service area, who indicate their primary language as other than English; or,
- A population group of mandatory managed care Medi-Cal beneficiaries, residing in the service area, who indicate their primary language as other than English, and that meet a concentration standard of 1,000 beneficiaries in a single ZIP Code or 1,500 beneficiaries in two contiguous ZIP Codes.
- Requests the UC to develop a plan to establish and administer the UCBCP for the purpose of collecting units of umbilical cord blood for public use in transplantation and providing nonclinical units for research pertaining to biology and new clinical utilization of stem cells derived from the blood and tissue of the placenta and umbilical cord.
- Creates the Health Statistics Special Fund in the State Treasury which collects various fees to be expended by the State Registrar for the purposes of funding programs, including the UCBCP, which sunsets on January 1, 2018.
- Establishes a fee of $18 for certain applicants requesting a certified copy of a birth or death certificate, two dollars of which must be paid to the UCBCP, until January 1, 2018.
FISCAL EFFECT: This bill has not been analyzed by a fiscal committee.
COMMENTS:
- PURPOSE OF THIS BILL. According to the author, studies have shown UCB to be a rich source of stem cells – stem cells that can be used to treat various genetic disorders that affect the blood and immune system, or leukemia and other cancers. The author notes that, according to the state’s UCBCP, 40% of Californians have never heard of UCB donation. The author states this bill neither encourages nor discourages a pregnant woman from publicly storing, privately storing, donating to research, or discarding UCB, it simply requires DPH to roll out the UCB Community Awareness Campaign that is already on the books but has lacked the required private funding needed to take effect. The author contends, along with the increase in awareness, this bill also provides women with the informational material in the language they know best by requiring the materials to be made available in all 14 of the languages used to satisfy the translation services requirements for Medi-Cal managed care plans.
- BACKGROUND.
- UCB. UCB is a sample of blood taken from a newborn baby's umbilical cord. It is a rich source of stem cells, which are precursors to blood cells. As such, they have been used to treat certain diseases of the blood and immune system. The next largest group is inherited diseases (of red blood cells, the immune system and certain metabolic abnormalities). Stem cells from UCB also demonstrae the potential to help conditions that have no cure today by regenerating damaged tissue and restoring lost function after an injury or illness.
- The Umbilical Cord Blood Collection Program. The UCBCP, administered by UC Davis Health System, is a statewide public program designed to capture the genetic diversity of Californians through the collection of UCB units for unrelated transplantation. The program was created by AB 52 (Portantino), Chapter 529, Statutes of 2010, that funds public UCB banking through an additional $2 fee on birth certificate copies. The collection service is the state's first comprehensive public system for collecting cord blood that is stored at an established, qualified UCB bank. Parents donate their newborns' UCB and have it publicly banked so it is available to anyone for lifesaving transplantations.
UCB can be stored by both public and private cord blood banks. Public UCB banks store UCB for the benefit of the general public, and most U.S. cord blood banks coordinate matching UCB to patients through the National Marrow Donor Program. Private UCB banks are usually for-profit organizations that store UCB for the exclusive use of the donor or donor's relatives. Public UCB banking is supported by the medical community. However, private UCB banking is generally not recommended unless there is a family history of specific genetic diseases. - The California Prenatal Screening Program (CPSP). CPSP currently offers three screening tests to pregnant women in order to identify individuals who are at increased risk for carrying a fetus with a specific birth defect. The CPSP provides pregnant women with a risk assessment for open neural tube defects (NTD), Down syndrome (trisomy 21), trisomy 18 and SLOS (Smith-Lemli-Opitz Syndrome) through one or two blood tests. The screening test indicates risk, but does not diagnose fetal birth defects. For women with screening results indicating a high risk for a birth defect, the CPSP provides free follow-up diagnostic services at State-approved Prenatal Diagnosis Centers. Services offered at these Centers include genetic counseling, ultrasound, and amniocentesis. Participation in the screening testing and follow-up services is voluntary. The cost of the testing through the CPSP is $207.
- The CPSP pamphlet. All pregnant women in California are provided with a pamphlet created by DPH regarding the CPSP by their prenatal care provider. Over the years legislation has been passed to update the pamphlet, and add additional requirements, including information regarding reproductive health and the environment, and information about cord blood banking. Currently the pamphlet is required to be available in Cantonese, English, Spanish and Vietnamese. DPH provides the pamphlet to all prenatal care providers free of charge.
- Medi-Cal translation requirements. As noted in Existing Law above, managed care plans contracting with DHCS provide language assistance services to LEP Medi-Cal beneficiaries who are mandatorily enrolled in managed care when a regional LEP population meets the certain numeric thresholds. The Medi-Cal threshold languages are: English, Arabic, Armenian, Cambodian, Chinese, Farsi, Hmong, Japanese, Korean, Laotian, Russian, Spanish, Tagalog, and Vietnamese.
- UCB. UCB is a sample of blood taken from a newborn baby's umbilical cord. It is a rich source of stem cells, which are precursors to blood cells. As such, they have been used to treat certain diseases of the blood and immune system. The next largest group is inherited diseases (of red blood cells, the immune system and certain metabolic abnormalities). Stem cells from UCB also demonstrae the potential to help conditions that have no cure today by regenerating damaged tissue and restoring lost function after an injury or illness.
- SUPPORT. The American Congress of Obstetricians and Gynecologists (ACOG-IX) District IX - California supports this bill stating, UCB, the blood that remains in the umbilical cord and the placenta after birth, has proven to be a rich source of stem cells which can be used to treat various genetic disorders that affect the blood and immune system. ACOG-IX notes that, according to the March of Dimes Foundation, these stem cells can be used as a potentially safer alternative for transplantation than bone marrow. UCB can be safely collected at birth without any harm caused to the mother or child whereas the bone marrow donor must undergo a formal procedure usually requiring anesthesia and more people are likely to find a match using UCB than individuals that use bone morrow or blood transplantations, which require an almost identical match to be successful. ACOG-IX concludes that awareness of the ability to store UCB is low, especially considering the potential benefits and this bill brings greater awareness to the storage of UCB by repealing the private funding contingency clause.
UC supports this bill stating that an extension in the sunset date for the UCBCP is a continued investment in the future of our diverse state. UC notes that with resources provided through collection of a $2 fee on birth certificate copies, the UCBCP developed collections at 11 hospitals within five metro target areas: Fresno, Los Angeles, Sacramento, San Diego, and the San Francisco Bay area and has successfully listed more than 1,200 cord blood units (with approximately 80% from minority and mixed-race heritage) on the national registry. UC also notes that from the cord units collected through the UCBCP, 21 have been used in life-saving transplantations. - PREVIOUS LEGISLATION.
- AB 52 requests UC to develop a plan to establish and administer the UCBCP for the purpose of collecting units of umbilical cord blood for public use, increases the fee for birth certificate copies by $2 to provide funds to implement the UCBCP, and requires the UC to implement the plan, contingent on an unspecified amount of funds being available in the UCBCP Fund.
- SB 460 (Pavley), Chapter 667, Statutes of 2013, requires DPH to include prescribed information regarding environmental health in the California Prenatal Screening patient educational information, and to post that environmental health information on DPH’s Internet Website. Requires DPH to send a notice to all distributors of the educational information that informs them of the change to that information, and encourages obstetrician-gynecologists and midwives to discuss environmental health with their patients.
REGISTERED SUPPORT / OPPOSITION:
Support
American Congress of Obstetricians and Gynecologists, District IX – California
Breast Cancer Fund
University of California
Opposition
None on file.
Analysis Prepared by: Lara Flynn / HEALTH / (916) 319-2097
Discussed in Hearing
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Bill Author
Bill Co-Author(s):