Bill Text: CA AB2132 | 2023-2024 | Regular Session | Amended

California Assembly Bill 2132

Bill Title: Health care services.

Spectrum: Partisan Bill (Democrat 6-0)

Status: (Introduced) 2024-04-10 - In committee: Set, first hearing. Referred to suspense file. [AB2132 Detail]

Download: California-2023-AB2132-Amended.html

Amended IN Assembly February 27, 2024

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Assembly Bill

No. 2132

Introduced by Assembly Member Low
(Coauthor: Assembly Member Ting)

February 06, 2024

An act to add Section 1316.8 to the Health and Safety Code, relating to health care services.

LEGISLATIVE COUNSEL'S DIGEST

AB 2132, as amended, Low. Health care services.

Existing law provides for the licensure and regulation of health facilities and clinics, including primary care clinics, by the State Department of Public Health. A violation of these provisions is a crime. Existing law requires an adult patient receiving primary care services in certain health care settings to be offered a screening test for hepatitis B and hepatitis C, as specified.

This bill would require an adult patient receiving primary care services in a facility, clinic, unlicensed clinic, center, office, or other setting, as specified, to be offered a tuberculosis (TB) risk assessment and TB screening test, if TB risk factors are identified, to the extent these services are covered under the patient’s health insurance, unless the health care provider reasonably believes certain conditions apply. The bill would also require the health care provider to offer the patient followup health care or refer the patient to a health care provider who can provide followup health care if a screening test is positive, as specified. The bill would prohibit a health care provider who fails to comply with these provisions from being subject to any disciplinary action related to their licensure or certification, or to any civil or criminal liability for that failure. The bill would make related findings and declarations.

Vote: MAJORITY Appropriation: NO Fiscal Committee: NO Local Program: NO

The people of the State of California do enact as follows:

SECTION 1.

The Legislature finds and declares all of the following:

(a) According to the World Health Organization, an estimated 10,600,000 people fell ill with tuberculosis (TB) during 2022. Despite being a preventable and curable disease, 1,300,000 people died from TB in 2022, making it the world’s second leading infectious killer after COVID-19.

(b) According to the federal Centers for Disease Control and Prevention, TB incidence in the United States increased during 2022, compared with that during 2020 and 2021, but remained lower than incidence during the prepandemic years. After a substantial 20.2-percent decline in 2020 and partial rebound (a 9.8-percent increase) in 2021, incidence appears to be returning to prepandemic levels among United States-born and non-United States-born populations.

(c) TB is a life-threatening disease. It spreads through the air with profound medical and economic consequences. More than 2,000,000 Californians (6 percent of the population) are infected with TB, of whom only 20 percent are aware of their infection and just 12 percent have been treated. In 2022, California reported 1,848 new TB cases (a 5-percent increase from the 1,749 cases in 2021), approximately 5 (4.7) out of every 100,000 California residents. This is nearly double the national TB incidence of 2.5 out of every 100,000 persons. Among people with TB disease, one-half are hospitalized and one in six dies within five years of diagnosis. TB hospitalizations are twice as expensive as and four times longer than hospitalizations for other conditions, which is usually about 11 days. In 2022, California medical and societal costs of TB reached $217,000,000.

(d) TB does not impact Californians equally. Those born in countries where TB is endemic, and those living in economically disadvantaged communities, are more often impacted by TB disease. The TB disease rate among people born outside the United States is 13 times higher than United States-born persons. TB disease rates among people who are non-United States-born Asian or Black are 73 and 38 times higher, respectively, than United States-born White people. The TB disease rate among non-United States-born Hispanic people is 34 times that of United States-born White people. Furthermore, persons living in census tracts with low socioeconomic status have higher TB disease incidence rates than those living in high socioeconomic status census tracts, whether measured by education level, poverty, crowding, or California Healthy Places Index (HPI) quartiles. Additionally, persons with TB disease who experience homelessness are 30 percent more likely to die with TB disease than those not experiencing homelessness.

(e) Currently, patients receiving primary care services do not routinely undergo a TB risk assessment and TB screening test.

SEC. 2.

Section 1316.8 is added to the Health and Safety Code, to read:

1316.8.

(a) An adult patient who receives primary care services in a facility, clinic, unlicensed clinic, center, office, or other setting where primary care services are provided, shall be offered a tuberculosis (TB) risk assessment and TB screening test, if TB risk factors are identified, to the extent these services are covered under the patient’s health insurance, based on the latest screening indications recommended by the United States Preventive Services Task Force, unless the health care provider reasonably believes that one of the following conditions applies:

(1) The patient is being treated for a life-threatening emergency.

(2) (A) The patient has previously been offered or has been the subject of a TB risk assessment, TB screening test, or both, and has no new TB risk factors since the last TB risk assessment or TB screening test.

(B) This paragraph does not apply if the health care provider determines that a TB risk assessment, TB screening test, or both should be offered again.

(3) The patient has a documented, previously positive Interferon-Gamma Release Assays (IGRA) test or has previously tested positive for a latent tuberculosis infection (LTBI).
~~(3)~~

(4) The patient lacks capacity to consent to a TB risk assessment, TB screening test, or both.

~~(4)~~

(5) The patient is being treated in the emergency department of a general acute care hospital, as defined in subdivision (a) of Section 1250.

(b) If a patient accepts the offer of the TB screening test and the test is positive, a health care provider shall offer the patient followup health care or refer the patient to a health care provider who can provide followup health care.

(c) This section shall not affect the scope of practice of any health care provider or diminish any authority or legal or professional obligation of any health care provider to offer a TB risk assessment, TB screening test, or both, or to provide services or care for the patient of a TB risk assessment, TB screening test, or both.

(d) A health care provider that fails to comply with the requirements of this section shall not be subject to any disciplinary actions related to their licensure or certification, or to any civil or criminal liability, because of the health care provider’s failure to comply with the requirements of this section.

(e) Section 1290 does not apply to a violation of this section.

(f) For purposes of this section, the following definitions apply:

(1) “Followup health care” includes providing medical management and treatment for TB according to the latest national clinical practice guidelines recommended by the federal Centers for Disease Control and Prevention and the American Thoracic Society.

(2) “Tuberculosis risk assessment” or “TB risk assessment” means a risk assessment questionnaire developed by the State Department of Public Health, in consultation with the California Tuberculosis Controllers Association, to be used to conduct TB risk assessments pursuant to this section.

(3) “Tuberculosis screening test” or “TB screening test” means either an approved intradermal tuberculin test or any other test for TB infection that is recommended by the federal Centers for Disease Control and Prevention and licensed by the United States Food and Drug Administration.