BILL NUMBER: AB 2786 ENROLLED
BILL TEXT
PASSED THE SENATE AUGUST 30, 2010
PASSED THE ASSEMBLY AUGUST 31, 2010
AMENDED IN SENATE AUGUST 20, 2010
AMENDED IN ASSEMBLY APRIL 14, 2010
INTRODUCED BY Committee on Health (Monning (Chair), Fletcher (Vice
Chair), Ammiano, Carter, Conway, De La Torre, De Leon, Emmerson, Eng,
Hayashi, Hernandez, Jones, Bonnie Lowenthal, Nava, V. Manuel Perez,
Salas, and Smyth)
MARCH 9, 2010
An act to amend Sections 120130 and 121025 of the Health and
Safety Code, relating to public health.
LEGISLATIVE COUNSEL'S DIGEST
AB 2786, Committee on Health. Reportable diseases and conditions.
Existing law requires the State Department of Public Health to
establish a list of reportable communicable and noncommunicable
diseases and conditions, including, but not limited to, diphtheria,
listeria, salmonella, shigella, and streptococcal infection in food
handlers or dairy workers, and typhoid. Existing law requires
reporting by the local health officer of any disease or condition on
the list. Violation of these provisions is a crime.
This bill would delete the specified list of required reportable
diseases and conditions. The bill would require the department to
establish a list of communicable diseases and conditions for which
clinical laboratories are required to submit a culture or specimen to
local and state public health laboratories, as specified.
Under existing law, no civil or criminal penalty, fine, sanction,
finding, or denial, suspension, or revocation of licensure may be
imposed on any person or facility based upon failure to provide
notification of a reportable disease or condition unless the disease
or condition was printed in the California Code of Regulations at
least 6 months prior to the date of the claimed failure.
This bill would limit the above exemption to a licensed physician
and surgeon or a clinical laboratory, and would extend the exemption
to the submission of a culture or specimen, as required, and would
require notification of the licensed physician and surgeon or
clinical laboratory by the department and publication in the
California Code of Regulations at least 6 months prior to the date of
the claimed failure before a penalty, fine, sanction, finding, or
denial, suspension, or revocation of licensure may be imposed.
Existing law prohibits the disclosure of public health records
relating to HIV and AIDS, and the information contained in those
records, with specified exceptions for public health purposes, or
pursuant to a written authorization. Existing law requires a
disclosure of these records or information to include only the
information necessary for the purpose of the disclosure, and to be
made only upon agreement that the information will be kept
confidential and will not be further disclosed without written
authorization. Existing law imposes civil penalties for the
disclosure, whether negligent or willful and malicious, of the
content of a confidential public health record, as defined, as well
as specified criminal penalties, under certain circumstances.
This bill would expand the information disclosure provisions
applicable to the information contained in public health records
relating to HIV and AIDS, including when the person who is the
subject of the record is coinfected with HIV/AIDS, tuberculosis, and
a sexually transmitted disease, as specified. The bill would also
increase the maximum civil penalties applicable for the disclosure of
the content of a public health record, as specified.
This bill would incorporate additional changes to Section 120130
of the Health and Safety Code proposed by AB 2541, to be operative
only if AB 2541 and this bill are both chaptered and become effective
on or before January 1, 2011, and this bill is chaptered last.
To the extent that this bill would increase the duties of the
local public health officer, and would change the definition of an
existing crime, this bill would impose a state-mandated local
program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that with regard to certain mandates no
reimbursement is required by this act for a specified reason.
With regard to any other mandates, this bill would provide that,
if the Commission on State Mandates determines that the bill contains
costs so mandated by the state, reimbursement for those costs shall
be made pursuant to the statutory provisions noted above.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares all of the
following:
(a) The intent of the Legislature is to enable prompt
identification of an outbreak, and rapid reporting and laboratory
identification during an outbreak situation, the emergence of a new
disease or condition, or the recognition of an identified disease or
condition that may constitute a danger to the public's health. During
this outbreak situation, it is absolutely imperative that positive
specimens be sent to the public health laboratory for definitive
identification, subtyping, strain typing, or DNA fingerprinting. The
public health laboratory must obtain the necessary specimens from all
sources in order to be able to quickly identify the organisms
causing illnesses and compare the subtypes, thus allowing a timely
public health response.
(b) By authorizing the State Department of Public Health to
quickly change the list of specimens that must be submitted to the
public health laboratory without going through the administrative
regulation and rulemaking process, this process would enable the
department to include newly emerging diseases and conditions in a
timely manner. Having this authority will allow a more rapid response
by public health officers to an emerging communicable disease or
outbreak.
(c) Recently, there have been several outbreaks of communicable
diseases affecting the health of the public for which rapid
identification, subtyping of the organism, and immediate public
health response have been necessary. The most recent of these
episodes include E. coli in spinach and salmonella in peanut butter,
both affecting the health of a large number of people, nationwide.
(d) Without the ability to rapidly change the requirements for
submission of specimens for testing, the identification of the
organism causing the outbreak and the public health response would be
significantly hampered.
SEC. 2. Section 120130 of the Health and Safety Code is amended to
read:
120130. (a) The department shall establish a list of reportable
diseases and conditions. For each reportable disease and condition,
the department shall specify the timeliness requirements related to
the reporting of each disease and condition, and the mechanisms
required for, and the content to be included in, reports made
pursuant to this section. The list of reportable diseases and
conditions may include both communicable and noncommunicable
diseases. The list may include those diseases that are either known
to be, or suspected of being, transmitted by milk or milk-based
products. The list may be modified at any time by the department,
after consultation with the California Conference of Local Health
Officers. Modification of the list shall be exempt from the
administrative regulation and rulemaking requirements of Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code, and shall be implemented without being adopted
as a regulation, except that the revised list shall be filed with the
Secretary of State and printed in the California Code of Regulations
as required pursuant to subdivision (e). Those diseases listed as
reportable shall be properly reported as required to the department
by the health officer.
(b) The department shall establish a list of communicable diseases
and conditions for which clinical laboratories shall submit a
culture or a specimen to the local public health laboratory to
undergo characterization. The list shall set forth the conditions
under which the culture and specimen shall also be submitted to the
state public health laboratory to undergo further characterization.
The list may be modified at any time by the department, after
consultation with the California Conference of Local Health Officers
and the California Association of Public Health Laboratory Directors.
Both establishment and modification of the list shall be exempt from
the administrative regulation and rulemaking requirements of Chapter
3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title
2 of the Government Code, and shall be implemented without being
adopted as a regulation, except that the initial list and any
modifications shall be filed with the Secretary of State and printed
in the California Code of Regulations as required pursuant to
subdivision (e).
(c) The department may from time to time adopt and enforce
regulations requiring strict or modified isolation, or quarantine,
for any of the contagious, infectious, or communicable diseases, if
in the opinion of the department the action is necessary for the
protection of the public health.
(d) The health officer may require strict or modified isolation,
or quarantine, for any case of contagious, infectious, or
communicable disease, when this action is necessary for the
protection of the public health.
(e) The lists established pursuant to subdivisions (a) and (b) and
any subsequent modifications shall be published in Title 17 of the
California Code of Regulations.
(f) Notwithstanding any other provision of law, no civil or
criminal penalty, fine, sanction, finding, or denial, suspension, or
revocation of licensure for any licensed physician and surgeon or
clinical laboratory may be imposed based upon a failure to provide
the notification of a reportable disease or condition or to provide
the submission of a culture or specimen that is required pursuant to
this section, unless the name of the disease or condition that is
required to be reported or for which a culture or specimen is
required to be submitted was printed in the California Code of
Regulations and the department notified the licensed physician and
surgeon or clinical laboratory of the disease or condition at least
six months prior to the date of the claimed failure to report or
submit.
(g) Commencing July 1, 2009, or within one year of the
establishment of a state electronic laboratory reporting system,
whichever is later, a report generated pursuant to this section by a
laboratory shall be submitted electronically in a manner specified by
the department, except that this electronic reporting requirement
shall not apply to reports of HIV infections. The department shall
allow laboratories that receive incomplete patient information to
report the name of the provider who submitted the request to the
local health officer.
(h) The department may, on its Internet Web site and via
electronic mail, advise out-of-state laboratories that are known to
the department to test specimens from California residents of the new
reporting requirements.
SEC. 2.5. Section 120130 of the Health and Safety Code is amended
to read:
120130. (a) The department shall establish a list of reportable
diseases and conditions. For each reportable disease and condition,
the department shall specify the timeliness requirements related to
the reporting of each disease and condition, and the mechanisms
required for, and the content to be included in, reports made
pursuant to this section. The list of reportable diseases and
conditions may include both communicable and noncommunicable
diseases. The list may include those diseases that are either known
to be, or suspected of being, transmitted by milk or milk-based
products. The list may be modified at any time by the department,
after consultation with the California Conference of Local Health
Officers. Modification of the list shall be exempt from the
administrative regulation and rulemaking requirements of Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code, and shall be implemented without being adopted
as a regulation, except that the revised list shall be filed with the
Secretary of State and printed in the California Code of Regulations
as required pursuant to subdivision (e). Those diseases listed as
reportable shall be properly reported as required to the department
by the health officer.
(b) The department shall establish a list of communicable diseases
and conditions for which clinical laboratories shall submit a
culture or a specimen to the local public health laboratory to
undergo characterization. The list shall set forth the conditions
under which the culture and specimen shall also be submitted to the
state public health laboratory to undergo further characterization.
The list may be modified at any time by the department, after
consultation with the California Conference of Local Health Officers
and the California Association of Public Health Laboratory Directors.
Both establishment and modification of the list shall be exempt from
the administrative regulation and rulemaking requirements of Chapter
3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title
2 of the Government Code, and shall be implemented without being
adopted as a regulation, except that the initial list and any
modifications shall be filed with the Secretary of State and printed
in the California Code of Regulations as required pursuant to
subdivision (e).
(c) The department may from time to time adopt and enforce
regulations requiring strict or modified isolation, or quarantine,
for any of the contagious, infectious, or communicable diseases, if
in the opinion of the department the action is necessary for the
protection of the public health.
(d) The health officer may require strict or modified isolation,
or quarantine, for any case of contagious, infectious, or
communicable disease, when this action is necessary for the
protection of the public health.
(e) The lists established pursuant to subdivisions (a) and (b) and
any subsequent modifications shall be published in Title 17 of the
California Code of Regulations.
(f) Notwithstanding any other provision of law, no civil or
criminal penalty, fine, sanction, finding, or denial, suspension, or
revocation of licensure for a licensed physician and surgeon or a
clinical laboratory may be imposed based upon a failure to provide
the notification of a reportable disease or condition or to provide
the submission of a culture or specimen that is required pursuant to
this section, unless the name of the disease or condition that is
required to be reported or for which the culture or specimen is
required to be submitted was printed in the California Code of
Regulations and the department notified the licensed physician and
surgeon or clinical laboratory of the disease or condition at least
six months prior to the date of the claimed failure to report or
submit.
(g) Commencing July 1, 2009, or within one year of the
establishment of a state electronic laboratory reporting system,
whichever is later, a report generated pursuant to this section or
Section 121022 by a laboratory shall be submitted electronically in a
manner specified by the department. The department shall allow
laboratories that receive incomplete patient information to report
the name of the provider who submitted the request to the local
health officer.
(h) The department may, through its Internet Web site and via
electronic mail, advise out-of-state laboratories that are known to
the department to test specimens from California residents of the new
reporting requirements.
SEC. 3. Section 121025 of the Health and Safety Code is amended to
read:
121025. (a) Public health records relating to human
immunodeficiency virus (HIV) or acquired immunodeficiency syndrome
(AIDS), containing personally identifying information, that were
developed or acquired by a state or local public health agency, or an
agent of that agency, shall be confidential and shall not be
disclosed, except as otherwise provided by law for public health
purposes or pursuant to a written authorization by the person who is
the subject of the record or by his or her guardian or conservator.
(b) In accordance with subdivision (f) of Section 121022, a state
or local public health agency, or an agent of that agency, may
disclose personally identifying information in public health records,
as described in subdivision (a), to other local, state, or federal
public health agencies or to corroborating medical researchers, when
the confidential information is necessary to carry out the duties of
the agency or researcher in the investigation, control, or
surveillance of disease, as determined by the state or local public
health agency.
(c) Except as provided in paragraphs (1) to (3), inclusive, any
disclosure authorized by subdivision (a) or (b) shall include only
the information necessary for the purpose of that disclosure and
shall be made only upon agreement that the information will be kept
confidential and will not be further disclosed without written
authorization, as described in subdivision (a).
(1) Notwithstanding any other provision of law, the following
disclosures shall be authorized for the purpose of enhancing
completeness of HIV/AIDS, tuberculosis, and sexually transmitted
disease coinfection reporting to the federal Centers for Disease
Control and Prevention (CDC):
(A) The local public health agency HIV surveillance staff may
further disclose the information to the health care provider who
provides HIV care to the HIV-positive person who is the subject of
the record for the purpose of assisting in compliance with
subdivision (a) of Section 121022.
(B) Local public health agency tuberculosis control staff may
further disclose the information to state public health agency
tuberculosis control staff, who may further disclose the information,
without disclosing patient identifying information, to the CDC, to
the extent the information is requested by the CDC and permitted by
subdivision (b), for purposes of the investigation, control, or
surveillance of HIV and tuberculosis coinfections.
(C) Local public health agency sexually transmitted disease
control staff may further disclose the information to state public
health agency sexually transmitted disease control staff, who may
further disclose the information, without disclosing patient
identifying information, to the CDC, to the extent it is requested by
the CDC, and permitted by subdivision (b), for the purposes of the
investigation, control, or surveillance of HIV and syphilis,
gonorrhea, or chlamydia coinfection.
(2) Notwithstanding any other provision of law, the following
disclosures shall be authorized for the purpose of facilitating
appropriate HIV/AIDS medical care and treatment:
(A) State public health agency HIV surveillance staff, AIDS Drug
Assistance Program staff, and care services staff may further
disclose the information to local public health agency staff, who may
further disclose the information to the HIV-positive person who is
the subject of the record, or the health care provider who provides
his or her HIV care, for the purpose of proactively offering and
coordinating care and treatment services to him or her.
(B) AIDS Drug Assistance Program staff and care services staff in
the State Department of Public Health may further disclose the
information directly to the HIV-positive person who is the subject of
the record or the health care provider who provides his or her HIV
care, for the purpose of proactively offering and coordinating care
and treatment services to him or her.
(3) Notwithstanding any other provision of law, for the purpose of
facilitating appropriate medical care and treatment of persons
coinfected with HIV, tuberculosis, and syphilis, gonorrhea, or
chlamydia, local public health agency sexually transmitted disease
control and tuberculosis control staff may further disclose the
information to state or local public health agency sexually
transmitted disease control and tuberculosis control staff, the
HIV-positive person who is the subject of the record, or the health
care provider who provides his or her HIV, tuberculosis, and sexually
transmitted disease care.
(4) For the purposes of paragraphs (2) and (3), "staff" does not
include nongovernmental entities.
(d) No confidential public health record, as defined in
subdivision (c) of Section 121035, shall be disclosed, discoverable,
or compelled to be produced in any civil, criminal, administrative,
or other proceeding.
(e) (1) Any person who negligently discloses the content of any
confidential public health record, as defined in subdivision (c) of
Section 121035, to any third party, except pursuant to a written
authorization, as described in subdivision (a), or as otherwise
authorized by law, shall be subject to a civil penalty in an amount
not to exceed five thousand dollars ($5,000), plus court costs, as
determined by the court, which penalty and costs shall be paid to the
person whose record was disclosed.
(2) Any person who willfully or maliciously discloses the content
of any confidential public health record, as defined in subdivision
(c) of Section 121035, to any third party, except pursuant to a
written authorization, or as otherwise authorized by law, shall be
subject to a civil penalty in an amount not less than five thousand
dollars ($5,000) and not more than twenty-five thousand dollars
($25,000), plus court costs, as determined by the court, which
penalty and costs shall be paid to the person whose confidential
public health record was disclosed.
(3) Any person who willfully, maliciously, or negligently
discloses the content of any confidential public health record, as
defined in subdivision (c) of Section 121035, to any third party,
except pursuant to a written authorization, or as otherwise
authorized by law, that results in economic, bodily, or psychological
harm to the person whose confidential public health record was
disclosed, is guilty of a misdemeanor, punishable by imprisonment in
the county jail for a period not to exceed one year, or a fine of not
to exceed twenty-five thousand dollars ($25,000), or both, plus
court costs, as determined by the court, which penalty and costs
shall be paid to the person whose confidential public health record
was disclosed.
(4) Any person who commits any act described in paragraph (1),
(2), or (3), shall be liable to the person whose confidential public
health record was disclosed for all actual damages for economic,
bodily, or psychological harm that is a proximate result of the act.
(5) Each violation of this section is a separate and actionable
offense.
(6) Nothing in this section limits or expands the right of an
injured person whose confidential public health record was disclosed
to recover damages under any other applicable law.
(f) In the event that a confidential public health record, as
defined in subdivision (c) of Section 121035, is disclosed, the
information shall not be used to determine employability, or
insurability of any person.
SEC. 4. Section 2.5 of this bill incorporates amendments to
Section 120130 of the Health and Safety Code proposed by both this
bill and AB 2541. It shall only become operative if (1) both bills
are enacted and become effective on or before January 1, 2011, (2)
each bill amends Section 120130 of the Health and Safety Code, and
(3) this bill is enacted after AB 2541, in which case Section 2 of
this bill shall not become operative.
SEC. 5. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution for
certain costs that may be incurred by a local agency or school
district because, in that regard, this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.
However, if the Commission on State Mandates determines that this
act contains other costs mandated by the state, reimbursement to
local agencies and school districts for those costs shall be made
pursuant to Part 7 (commencing with Section 17500) of Division 4 of
Title 2 of the Government Code.