Policy News


June 2011 - CalHEP Supporting Six Viral Hepatitis Bills in California Legislature

CalHEP is supporting six bills under consideration in the California legislature that relate to viral hepatitis. We will continue to update our website with their progress and information to help you voice your support for these important bills.

AB 300, introduced by Assemblymember Fiona Ma (D-San Francisco), imposes minimum statewide standards for the regulation of practitioners engaged in the business of tattooing, body piercing, and the application of permanent cosmetics in California, including evidence of current Hepatitis B vaccination and completion of training in bloodborne pathogens. AB 300 passed the Assembly (72 Ayes, 0 Noes) and will next be heard in the Senate Committee on Health. Read the fact sheet.

AB 310, also introduced by Assemblymember Fiona Ma, would prohibit health care service plans and health insurers that offer outpatient prescription drug coverage from requiring coinsurance from the enrollee as a basis for cost sharing (e.g., specialty drug tiers). The bill would also impose certain limitations on copayments and out-of-pocket expenses for outpatient prescription drugs. AB 310 passed the Assembly Health Committee and has been referred to the Appropriations Committee. Read the fact sheet.

AB 604, introduced by Assemblymember Nancy Skinner (D-Berkeley), would allow the California Department of Public Health to authorize health and social service programs to provide syringe exchange services in any location where the department determines that the conditions exist for the rapid spread of HIV, viral hepatitis or other infections spread through the sharing of used syringes. AB 604 has passed the Assembly (Ayes 52, Noes 26) and has been referred to the Senate Committee on Health consideration on June 15th. Read the fact sheet.

AB 1382, introduced by Roger Hernández (D-West Covina), would authorize HIV counselors to perform hepatitis C virus (HCV) or combined HIV/HCV tests in addition to HIV tests that are classified as waived under the federal Clinical Laboratory Improvement Act (CLIA). Allowing HIV test counselors to also administer HCV or HIV/HCV tests would greatly increase the availability of HCV screening, thus allowing more individuals to get into early treatment and reducing the costs of undetected HCV infections. AB 1382 has passed the Assembly and has been referred to the Senate Committee on Health. Read the fact sheet.

SB 41, introduced by Senator Leland Yee (D-San Francisco),  would remove the existing sunset of the pilot program (2018) that allows all pharmacists throughout the state the discretion to sell sterile syringes without a prescription. SB 41 passed in the Senate (Ayes 24, Noes 13) and will next be heard in the Assembly. Read the fact sheet.

SCR 36, introduced by Senator Sam Blakeslee (R-San Luis Obispo), designates May 19th as California's Viral Hepatitis Awareness Day. This resolution helps to increase awareness among Californians of the importance of viral hepatitis prevention, screening and treatment. This resolution passed - view the resolution.

To express your support for these measures, visit our calls to action page.

February 2011 - Syringe Access Bill in Senate

Senator Leland Yee (D-San Francisco) has reintroduced a syringe access bill, now listed as SB 41. Yee’s legislation would remove the existing sunset of the pilot program (2018) and would allow all pharmacists throughout the state the discretion to sell sterile syringes without a prescription. SB 41 passed the Senate Health Committee and is scheduled to be heard in the Senate Committee on Public Safety on April 26th.

Read the SB 41 fact sheet and CalHEP's letter of support for SB 41.

November 2010 - Senator Yee Will Reintroduce Syringe Access Bill

On the eve of World AIDS Day, State Senator Leland Yee (D-San Francisco) has announced his intention to reintroduce a bill to allow adults to purchase and possess syringes from an authorized source, including licensed pharmacies, physicians and syringe exchange programs. Read the press release.

October 2010 - Governor Vetoes Viral Hepatitis Bills

Late in the evening on September 30th, two hours before deadline to sign or veto bills, Governor Schwarzenegger vetoed two bills that would have reduced the number of new HIV, hepatitis B and hepatitis C cases. Having worked to develop, draft and support these bills, the staff and member organizations of the California Hepatitis Alliance (CalHEP) are extremely disappointed by this news. The Governor's Office chose to ignore the recommendations of numerous medical and scientific bodies, including the Institute of Medicine of the National Academies of Medicine and Science, and his own administration's Department of Public Health to make syringes more widely available through pharmacies and needle exchanges in order to reduce the number of viral hepatitis infections among injection drug users.

Governor Schwarzenegger did sign a bill to sustain the status quo: cities and counties may authorize pharmacists to furnish 10 or fewer syringes to an adult, and cities and counties may authorize syringe exchange services. Currently almost half of Californians live in jurisdictions where there is no safe legal access to sterile syringes without a prescription, and where law enforcement may arrest a person for attempting to comply with the U.S. Public Health service recommendation to injection drug users that they use a new sterile syringe for each injection.


Senate Bill 1029(SB 1029) SB 1029 by Leland Yee, would allow adults to purchase and possess up to 30 syringes from an authorized source, including licensed pharmacies, physicians and syringe exchange programs, passed the State Senate. SB 1029 passed the Senate Health Committee on April 6th (6 in favor, 3 against) and the Business, Professions and Economic Development Committee on April 22nd (5 in favor, 1 against). It passed the full Senate on May 28th (21 in favor, 6 against). SB 1029 passed the Assembly Health Committee on June 23rd (12 in favor, 6 against) and the Business Professions and Consumer Protection Committee on June 30 (6 in favor, 2 against). It also passed the Assembly Appropriations Committee on August 5th (12 in favor, 5 against) and passed in the Assembly on August 26th. The bill received the concurrence vote on August 31st (21 yes, 16 no). Read the SB 1029 Fact Sheet or the bill analysis or a release from Senator Yee's office

Assembly Bill 1858 (AB 1858) authored by Assembly member Bob Blumenfield (D-Van Nuys) would allow California Department of Public Health to authorize syringe exchange services in locations where the conditions exist for the rapid spread of viral hepatitis, HIV or other potentially deadly or disabling diseases. On April 6th, AB 1858 passed Assembly Health Committee (11 in favor, 5 against, 3 abstaining).  AB 1858 passed the Appropriations Committee on May 5th. (12 in favor, 5 against). AB 1858 passed the Assembly on May 13th by 44-29 and the Senate Appropriations Committee on August 12th (7 in favor, 4 against).  It passed the Senate on August 24th (21 yes, 15 no) and passed the Assembly concurrence vote on August 26th.

In 2009, California Hepatitis Alliance consultants wrote model legislation on syringe exchange in California, building on our prior work publishing Syringe Exchange in California: Policy, Programs and Progress. AB 1858 is based on our work, and we continue to work with Bob Blumenfield's office and the sponsors of the legislation to support improved syringe access in California as a key strategy for the prevention and control of viral hepatitis, consistent with the recommendations of the California Department of Public Health and the Institute of Medicine.

Read the AB 1858 Fact Sheet

Assembly Bill 2600 (AB 2600) introduced by Assemblymember Fiona Ma (D-San Francisco), would have amended medical continuing education requirements. Existing law requires the Medical Board of California to establish continuing education requirements for physicians and surgeons, and requires the board to consider including various courses in determining its continuing education requirements. This bill would require the board to consider including a course in the diagnosis and treatment of hepatitis. 

As of August 20, the bill has been amended and no longer addresses viral hepatitis and provider education. Assemblymember Fiona Ma stated, she will continue to support viral hepatitis in the policy arena, but having met the goal of meeting with the California Medical Board and presenting the need for physician education on viral hepatitis that the bill is not essential to advocacy efforts.  CalHEP wishes to thank you for your letters of support to your legislators. 

CalHEP was proud to work with President Pro Tem Ma on AB 2600. Fiona Ma, herself chronically infected with HBV, is a leader on public and professional education regarding the importance of screening for hepatitis.

Assembly Concurrent Resolution 141 (ACR 141) introduced by Assemblymember Sam Blakeslee (R-San Luis Obispo), declared May 19, 2010 to be Viral Hepatitis Awareness Day in California. World Hepatitis Day was observed on May 19 by thousands of individuals and organizations globally. ACR 141 passed unanimously in both houses. We are proud to have this resolution added to those being initiated by many states and countries.
Read ACR 141

The law regarding the sale of syringes as signed by the Governor in 2010.

AB 1701 (Chesbro) would extend from December 31, 2010 to Decmber 31, 2018 the sunset on the Disease Prevention Demonstration Project (DPDP), the pilot program which allows nonprescription sale of syringes (NPSS) in pharmacies. The bill would allow the program to continue in its current form, which requires county and/or city authorization in order for pharmacies to participate. 

August 2010 - CalHEP Presents to Medical Board of California on the Importance of Viral Hepatitis Continuing Education
As a result of the May 19, 2010 California Health Policy Forum on viral hepatitis, co-sponsored by CalHEP, the Medical Board of California requested that CalHEP supply expert testimony on viral hepatitis to the education subcommittee. On July 28, 2010 CalHEP staff and members attended the Medical Board's education subcommittee meeting. CalHEP members, Dr. Sam So, Dr. Diana Sylvestre and Dr. Eddie Cheung presented, along with Dr. Gail Bolan. The presentations were intended to educate the committee and aid in discussions about whether to add viral hepatitis to the 25 credit hours of continuing education. For more on the presentation, read the August CalHEP Newsletter.

August 2010 - Kerry Introduces Bill to Fight Viral Hepatitis

Senator John Kerry (D-Mass.), today introduced the Viral Hepatitis and Liver Cancer Control and Prevention Act of 2010, which calls for a national strategy to prevent and control Hepatitis B and C. Congressman Mike Honda (D-CA) is the legislation’s lead sponsor in the House of Representatives. The bill has been endorsed by over 100 hepatitis focused organizations from across the nation. For more on the bill, read the press release.

  May 2010 - MediCal May Stop Paying for Methadone Treatment

Join Together and the Sacramento Bee reports that California's state Medicaid program would stop paying for methadone maintenance under a plan from Gov. Arnold Schwarzenegger that's aimed at cutting $53 million from MediCal. If the state legislature approves the plan, only pregnant women and minors would be eligible for MediCal reimbursement for methadone treatment. The move also would cost the state $60 million in federal matching funds. An estimated 35,000 patients would lose coverage under Schwarzenegger's plan. One expert said that 70-80 percent of addicts in local methadone programs are MediCal patients. Barry McCaffrey, a former U.S. drug czar, was among the treatment advocates who protested the plan. Testimony before the Senate Budget and Fiscal Review Committee reports that the Governor's proposed cuts in drug offender and drug Medi-Cal programs will immediately raise other state costs seven-fold. 


February 2010 - NVHR: Administration's 2011 Budget Proposal Shortchanges Five Mill, ion, Americans Afflicted with Chronic Viral He, patitis

Washington, DC—Just weeks after the Inst, itute of Medicine (IOM) blasted the federal government for its fa, ilur, e to res, p, ond to the, , nat, ion's viral hepatitis epidemic, the Administration has continued a pattern of neglect with its 2011 budget proposal. In calling for an inadequate funding increase of $1.8 million for the Centers for Disease Control and Prevention's (CDC) Division of Viral Hepatitis, the Administration has shortchanged five million Americans afflicted with chronic viral hepatitis and has failed to translate the IOM's recommendations into decisive action, the National Viral Hepatitis Roundtable (NVHR) said today.
 NVHR is a coalition of more than 150 public, private, and voluntary organizations dedicated to reducing the incidence of infection, morbidity, and mortality from chronic viral hepatitis that afflicts more than 5 million Americans. www.nvhr.org
For more details rea, d the Press Release News Wire article.

February 2010— Calif. Officials Step Up the Fight Against Hepatitis

With a new strategic plan in place, California public health officials hope to break the silence about hepatitis. "It's important to recognize that viral hepatitis is a significant and costly public health problem. Most people who are infected have no symptoms and are completely unaware of their status. We have been silent too long about the problem," said Dr. Gail Bolan, chief of the Sexually Transmitted Diseases Control Branch of the state Department of Public Health.

According to the federal Centers for, Disease Control and Prevention, viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplants. In the United States, an estimated 1.2 million Americans are living with chronic hepatitis B and 3.2 million are living with chronic hepatitis C.
 Earlier this month, Bolan's agency released a comprehensive planning document. Among key findings:
  • The need for awareness of what hepatitis is, how it is transmitted, the availability of simple screening tests and effective vaccination (except for hepatitis C, for which there is no vaccine).  
  • In 2007, state hospitalizations for hepatitis B and C cost $2 billion.
  • The incidence of liver cancer over the next 20 years is expected to increase 59 percent and be highest among Latinos, Asian Americans and Pacific Islanders.

For more details read the Stockton Record article , by Joe Goldeen, Record Staff Writer.

January 2010— Health Report Calls for Hepatitis Awareness Campaign
An estimated 3 million to 5 million people have hepatitis B or C, which can cause liver failure and cancer, and many don't have symptoms. Many doctors underestimate the , problem, the report says. Hepatitis B and C remain se, rious threats to public hea, lth, but , many healthcare providers fail to s, creen at-risk p, atients and don't know h,, ow to, treat those infected w, i, th, the viral di, seases, which can cause liver failure and cancer, according to a report released Monday by the National Academy of Sciences. For more details read the Los Angeles Times article by Rong-Gong Lin II.  American Medical News, on line article by SUSAN J. LANDERS, amednews staff.
January 2010—They're the overlooked viruses: Hepatitis B and , C together infect three to five times more Americans than the AIDS virus does, and most don't know it.

In the next 10 years, these two liver-damaging infections will kill about 150,000 people in the U.S. alone, says a new report Monday from the prestigious Institute of Medicine.In the next 10 years, these two liver-damaging infections will kill about 150,000 people in the U.S. alone, says a new report Monday from the prestigious Institute of Medicine.It calls for a major public health push to decrease the stigma of th, ese simmering viruses, which are to blame for nearly half the liver transplants performed every year."We have allowed gaps in screening, prevention and treatment to go unchecked," said report chairman R. Palmer Beasley of the University of Texas, Houston.

, , For, more details read the Associated Press Article on FoxNews.com , USA Today Report: Hepatitis B, C  overlooked or the Time.com Study: Threat of Hepatitis Underestimated by Laura Fitzpatrick.
Risk Factors
A new Institute of Medicine report stresses the need for physicians to screen patients at risk for viral hepatitis, including:
Hepatitis B
  • People born in areas in which the disease is endemic, including all countries in Africa, Asia, Central America and the Middle East; Alaska natives; and indigenous populations of northern Canada
  • Infants born to infected mothers 
  • Household contacts of people with chronic HBV infection
  • Injection drug users
  • Sexually active people who are not in long-term, mutually monogamous relationships
  • Men who have sex with men
  • Health care and public safety workers at risk for exposure to blood or blood-contaminated body fluids
  • Patients with chronic liver disease
  •  Patients receiving hemodialysis
  • Travelers to countries that have a high prevalence of HBV infection
Hepatitis C
  • People who have ever injected illegal drugs
  • Recipients of clotting-factor concentrates made before 1987
  • Recipients of blood transfusions or organ transplants before July 1992
  • Patients who have ever received long-term hemodialysis treatment
  • People who have known exposures to HCV, such as health care workers who sustained needlesticks involving HCV-positive blood and recipients of organs or blood from donors who later tested positive for HCV
  • All people with HIV
  • Patients who have abnormal liver enzyme tests or other signs of liver disease
  • Children born to HCV-positive mothers (test after 18 months of age to avoid detecting maternal antibodies)

Source: "Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C," Institute of Medicine, January

December 2009— CalHEP and the public health advocacy community celebrates Congressional repeal of a 21-year ban on the use of federal funds to support syringe exchange programs (SEP)

There is no controversy among researchers: over 200 studies concur that SEP are effective in reducing rates of HIV among injection drug users. Sharing of syringes is the leading cause of new infections for hepatitis C in the U.S. and can also transmit hepatitis B & other blood borne diseases. For more details read the U.S. repeals funding ban for needle exchanges, (by Bob Egelko, SF Chronicle Staff Writer) or listen to the audio report, Ban Lifted on Federal Funding for Needle Exchange, (by Susan Sharon, National Public Radio). 
November 2009—‘Bipartisan Support Grows for Addressing Nation’s Hepatitis Scourge’
H.R. 3974, the Viral Hepatitis and Liver Cancer Control Act, was introduced October 29, 2009, in the House of Representatives. Writing in Roll Call on November 6, Lorren Sandt, chair of the National Virus Hepatitis Roundtable and member of CalHEP’s Advisory Committee, said this bill “would help establish, promote and support a comprehensive prevention research and medical management referral program under the Public Health Service Act for chronic hepatitis B and chronic hepatitis C virus infection.” It would provide $90 million in funding in 2011, with additional funding in subsequent years. The legislation spearheaded by Rep. Mike Honda (D-San Jose) has garnered bipartisan support.
October 2009—CalHEP Catalyzes Syringe Exchange Access Efforts
If Senate Bill 1159 is allowed to sunset at the end of 2010, it will again be illegal in California for an adult to purchase or possess syringes without a prescription.
     “In terms of stemming the tide of hepatitis and HIV, this would be a terrible step backward,” said Glenn Backes, CalHEP’s public policy consultant. “CalHEP is catalyzing a major advocacy effort in 2010 on syringe access.”
     Backes worked closely with Sen. John Vasconcellos (D-Santa Clara) from 2001 to 2004 to pass SB 1159 giving pharmacists discretion to sell 10 or fewer sterile syringes to an adult without a prescription in cities and counties that authorize the Disease Prevention Demonstration Project. Backes expects an evaluation of the pilot program to be published by the State Office of AIDS in January and that the evaluation will “provide strong evidence that California is like every other state or country that has removed statutory barriers to accessing syringes, in that we saw a reduction in syringe sharing and no negative effects in terms of crime, drug use, or unsafe discard of syringes.”
     With funding from The Tides Foundation Syringe Access Fund, CalHEP is working to research and draft model legislation to improve access to sterile syringes as a key prevention policy for the control of viral hepatitis, HIV/AIDS, and other blood-borne infections. CalHEP is also working with the Drug Policy Alliance and the Harm Reduction Coalition on these efforts, as well as meeting with representatives from major liver health and AIDS service organizations, and associations that represent pharmacists, health officers, physicians, and nurses in California to catalyze efforts to prevent the sunsetting of SB 1159 next year. Read up on SB 1159 at www.syringeaccess.com.
     CalHEP continues its work to ensure that federal health insurance reforms include provisions to prevent denial of insurance to persons with pre-existing conditions and that all Americans have access to affordable health care. CalHEP is also studying options to fight for increased viral hepatitis testing and treatment dollars in 2010.
     Stay tuned.
May 2009—Assemblyman Blakeslee’s Hepatitis Awareness Day Resolution Passes in the Assembly
Assemblyman Sam Blakeslee’s (R-San Luis Obispo) resolution naming May 19, 2009, Hepatitis Awareness Day passed off the Assembly Floor. The resolution notes the importance of hepatitis awareness education campaigns and accessible screening for hepatitis B and C. In addition, the resolution argues that appropriate treatment can reduce the incidence of hepatitis B and C viral infections on individual and community levels, thereby reducing the financial, physical, and emotional damages wrought by this virus. Blakeslee introduced ACR 35 after Edie Kahn and David Kilburn, representatives from the SLO Hep C Project, talked with the assemblyman about viral hepatitis in California.
April 2008—Dymally Bill to Call for State Hepatitis Plan
CalHEP has worked with the Legislature and communities to develop local and state plans to prevent liver cancer and liver disease, and to prevent and control viral hepatitis. The chair of the Assembly Health Committee, Mervyn Dymally (D-Los Angeles), intends to introduce legislation this spring to require that the California Department of Public Health develop a plan and budget for the 2009-2010 fiscal year. The plan will require culturally appropriate public education campaigns statewide, with attention to Asian Pacific Island, Latino, and African-American communities, which are disproportionately affected by hepatitis and liver disease.
February 2008—Ma Vows to Fight for Comprehensive Viral Hepatitis Control Plan
Assemblymember Fiona Ma (D-San Francisco) has declared her intention to introduce legislation that would require the California Department of Public Health to create a comprehensive plan to control viral hepatitis in the state. Her bill, still being drafted, would likely require the department to submit a budget as part of the governor’s proposed budget for 2009-2010.
January 2008—Bill to Provide Medi-Cal Eligibility for Californians With Chronic Hepatitis B Passes Assembly
On January 29, 2008, AB 158 by Assemblymember Fiona Ma (D-San Francisco) passed the full Assembly by a wide margin with bipartisan support. The legislation provides that persons with chronic hepatitis B infection would be eligible for Medi-Cal without having to be declared “disabled.” Implementation would be contingent on federal approval and financial participation. The bill moved to the Senate, but as of February 1, its first hearing in Senate Health Committee had not been scheduled. Read the bill.



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