CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Assembly Bill No. 3224Introduced by Assembly Member RodriguezFebruary 21, 2020 An act to add Section 120513 to the Health and Safety Code, relating to public health, and making an appropriation therefor. LEGISLATIVE COUNSEL'S DIGESTAB 3224, as introduced, Rodriguez. Sexually transmitted diseases.Existing law requires the State Department of Public Health to allocate funds to local health jurisdictions for sexually transmitted disease prevention and control activities in accordance with specified priorities and activities that include, among others, community-based testing and disease investigation. Existing law suspends this program on December 31, 2021, unless the May Revision required to be released by May 14, 2021, projects specified General Fund revenues. Existing law states the intent of the Legislature to consider alternative solutions to restore this program, should the suspension take effect.This bill would establish a statewide program to direct and support local health departments in providing specified services to individuals experiencing reinfections of syphilis, chlamydia, and gonorrhea, including assessing the health and social needs of those individuals. The bill would authorize a local health department to apply for funding to participate in the program by submitting a spending plan to be approved by the department and would specifically prohibit the department from providing funding unless the department approves the local health departments spending plan.The bill would appropriate $15,000,000 from the General Fund to the State Department of Public Health for the purpose of funding this program.Digest Key Vote: 2/3 Appropriation: YES Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. (a) The Legislature finds and declares all of the following:(1) In 2018, the number of reported sexually transmitted disease (STD) cases in California was 25,344 for syphilis (all stages), which is 265 percent more than 10 years ago, 79,397 for gonorrhea, which is 211 percent more than 10 years ago, and 232,181 for chlamydia, which is 56 percent more than 10 years ago.(2) STDs are increasing in all regions of the state, among all people.(3) Disparities in STD rates persist throughout the state, with the highest among young people (15 to 24 years of age), African American people, people who are gay or bisexual, and men who have sex with men.(4) Syphilis is a major public health problem in the state and has increased in all regions of the state, among all people. In 2018, according to the federal Centers for Disease Control and Prevention (CDC), California was ranked second in the nation for primary and secondary syphilis rates.(5) In 2018, the number of infants born with congenital syphilis in the state had increased for the 6th year in a row. Congenital syphilis can cause severe illness in infants, including premature birth, low birth weight, birth defects, blindness, and hearing loss. Congenital syphilis can also lead to stillbirth and infant death. In 2018, according to the CDC, California ranks fifth in the nation for congenital syphilis rates.(6) Chlamydia and gonorrhea are the most commonly reported STDs in the state. Although these STDs are curable, they often do not show symptoms and go undetected, which can lead to serious complications including infertility. Chlamydia and gonorrhea disproportionately impact people in their teens and twenties.(7) Emerging antibiotic resistance among gonorrhea is a concern. Gonorrhea is among the CDCs top three urgent threats for developing drug resistance.(8) There are many underlying drivers of the increase in STDs, and thus, there is no simple solution. STD risk is fueled by poverty, homelessness, substance use, disparities in access to care, changes in sexual behaviors, and the exchange of sex for money, housing, and other resources.(9) State and local public health departments are uniquely qualified to control the spread of communicable disease. Furthermore, state and local public health staff are actively engaged with clients, medical providers, community partners, and others working to stem the rising tide of STDs.(b) It is the intent of the Legislature to address the rise in the number of sexually transmitted diseases in California, with a particular focus on preventing reoccurrence among individuals who experience reinfections.SEC. 2. Section 120513 is added to the Health and Safety Code, to read:120513. (a) The department shall establish a statewide program to direct and support local health departments in providing the following services to individuals experiencing reinfections of syphilis, chlamydia, and gonorrhea:(1) Assessing the health and social needs of clients.(2) Identifying and resolving client risk factors and obstacles to care.(3) Establishing routine contact with clients, including those who may be difficult locate.(4) Coordinating referrals and connections to address health and social needs, including behavioral health services, housing, homeless assistance, and harm reduction counseling and services.(5) Ensuring clients receive care and followup in a timely manner, including followup with primary care providers.(6) Providing outreach and navigation services to the clients sexual partners.(7) Routine followup education and access to prevention and screening services.(b) (1) A local health department may voluntarily apply for funds to participate in the program established by this section by submitting a spending plan for the departments approval. A spending plan shall demonstrate how funds will support the services listed in subdivision (a). The department may require a spending plan to be submitted in a specified format.(2) The department shall not provide funding to a local health department for participation in the program established by this section unless the department approves the local health departments spending plan submitted pursuant to paragraph (1).SEC. 3. The sum of fifteen million dollars ($15,000,000) is hereby appropriated from the General Fund to the State Department of Public Health for the purpose of funding the program established in Section 120513 of the Health and Safety Code. CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Assembly Bill No. 3224Introduced by Assembly Member RodriguezFebruary 21, 2020 An act to add Section 120513 to the Health and Safety Code, relating to public health, and making an appropriation therefor. LEGISLATIVE COUNSEL'S DIGESTAB 3224, as introduced, Rodriguez. Sexually transmitted diseases.Existing law requires the State Department of Public Health to allocate funds to local health jurisdictions for sexually transmitted disease prevention and control activities in accordance with specified priorities and activities that include, among others, community-based testing and disease investigation. Existing law suspends this program on December 31, 2021, unless the May Revision required to be released by May 14, 2021, projects specified General Fund revenues. Existing law states the intent of the Legislature to consider alternative solutions to restore this program, should the suspension take effect.This bill would establish a statewide program to direct and support local health departments in providing specified services to individuals experiencing reinfections of syphilis, chlamydia, and gonorrhea, including assessing the health and social needs of those individuals. The bill would authorize a local health department to apply for funding to participate in the program by submitting a spending plan to be approved by the department and would specifically prohibit the department from providing funding unless the department approves the local health departments spending plan.The bill would appropriate $15,000,000 from the General Fund to the State Department of Public Health for the purpose of funding this program.Digest Key Vote: 2/3 Appropriation: YES Fiscal Committee: YES Local Program: NO CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Assembly Bill No. 3224 Introduced by Assembly Member RodriguezFebruary 21, 2020 Introduced by Assembly Member Rodriguez February 21, 2020 An act to add Section 120513 to the Health and Safety Code, relating to public health, and making an appropriation therefor. LEGISLATIVE COUNSEL'S DIGEST ## LEGISLATIVE COUNSEL'S DIGEST AB 3224, as introduced, Rodriguez. Sexually transmitted diseases. Existing law requires the State Department of Public Health to allocate funds to local health jurisdictions for sexually transmitted disease prevention and control activities in accordance with specified priorities and activities that include, among others, community-based testing and disease investigation. Existing law suspends this program on December 31, 2021, unless the May Revision required to be released by May 14, 2021, projects specified General Fund revenues. Existing law states the intent of the Legislature to consider alternative solutions to restore this program, should the suspension take effect.This bill would establish a statewide program to direct and support local health departments in providing specified services to individuals experiencing reinfections of syphilis, chlamydia, and gonorrhea, including assessing the health and social needs of those individuals. The bill would authorize a local health department to apply for funding to participate in the program by submitting a spending plan to be approved by the department and would specifically prohibit the department from providing funding unless the department approves the local health departments spending plan.The bill would appropriate $15,000,000 from the General Fund to the State Department of Public Health for the purpose of funding this program. Existing law requires the State Department of Public Health to allocate funds to local health jurisdictions for sexually transmitted disease prevention and control activities in accordance with specified priorities and activities that include, among others, community-based testing and disease investigation. Existing law suspends this program on December 31, 2021, unless the May Revision required to be released by May 14, 2021, projects specified General Fund revenues. Existing law states the intent of the Legislature to consider alternative solutions to restore this program, should the suspension take effect. This bill would establish a statewide program to direct and support local health departments in providing specified services to individuals experiencing reinfections of syphilis, chlamydia, and gonorrhea, including assessing the health and social needs of those individuals. The bill would authorize a local health department to apply for funding to participate in the program by submitting a spending plan to be approved by the department and would specifically prohibit the department from providing funding unless the department approves the local health departments spending plan. The bill would appropriate $15,000,000 from the General Fund to the State Department of Public Health for the purpose of funding this program. ## Digest Key ## Bill Text The people of the State of California do enact as follows:SECTION 1. (a) The Legislature finds and declares all of the following:(1) In 2018, the number of reported sexually transmitted disease (STD) cases in California was 25,344 for syphilis (all stages), which is 265 percent more than 10 years ago, 79,397 for gonorrhea, which is 211 percent more than 10 years ago, and 232,181 for chlamydia, which is 56 percent more than 10 years ago.(2) STDs are increasing in all regions of the state, among all people.(3) Disparities in STD rates persist throughout the state, with the highest among young people (15 to 24 years of age), African American people, people who are gay or bisexual, and men who have sex with men.(4) Syphilis is a major public health problem in the state and has increased in all regions of the state, among all people. In 2018, according to the federal Centers for Disease Control and Prevention (CDC), California was ranked second in the nation for primary and secondary syphilis rates.(5) In 2018, the number of infants born with congenital syphilis in the state had increased for the 6th year in a row. Congenital syphilis can cause severe illness in infants, including premature birth, low birth weight, birth defects, blindness, and hearing loss. Congenital syphilis can also lead to stillbirth and infant death. In 2018, according to the CDC, California ranks fifth in the nation for congenital syphilis rates.(6) Chlamydia and gonorrhea are the most commonly reported STDs in the state. Although these STDs are curable, they often do not show symptoms and go undetected, which can lead to serious complications including infertility. Chlamydia and gonorrhea disproportionately impact people in their teens and twenties.(7) Emerging antibiotic resistance among gonorrhea is a concern. Gonorrhea is among the CDCs top three urgent threats for developing drug resistance.(8) There are many underlying drivers of the increase in STDs, and thus, there is no simple solution. STD risk is fueled by poverty, homelessness, substance use, disparities in access to care, changes in sexual behaviors, and the exchange of sex for money, housing, and other resources.(9) State and local public health departments are uniquely qualified to control the spread of communicable disease. Furthermore, state and local public health staff are actively engaged with clients, medical providers, community partners, and others working to stem the rising tide of STDs.(b) It is the intent of the Legislature to address the rise in the number of sexually transmitted diseases in California, with a particular focus on preventing reoccurrence among individuals who experience reinfections.SEC. 2. Section 120513 is added to the Health and Safety Code, to read:120513. (a) The department shall establish a statewide program to direct and support local health departments in providing the following services to individuals experiencing reinfections of syphilis, chlamydia, and gonorrhea:(1) Assessing the health and social needs of clients.(2) Identifying and resolving client risk factors and obstacles to care.(3) Establishing routine contact with clients, including those who may be difficult locate.(4) Coordinating referrals and connections to address health and social needs, including behavioral health services, housing, homeless assistance, and harm reduction counseling and services.(5) Ensuring clients receive care and followup in a timely manner, including followup with primary care providers.(6) Providing outreach and navigation services to the clients sexual partners.(7) Routine followup education and access to prevention and screening services.(b) (1) A local health department may voluntarily apply for funds to participate in the program established by this section by submitting a spending plan for the departments approval. A spending plan shall demonstrate how funds will support the services listed in subdivision (a). The department may require a spending plan to be submitted in a specified format.(2) The department shall not provide funding to a local health department for participation in the program established by this section unless the department approves the local health departments spending plan submitted pursuant to paragraph (1).SEC. 3. The sum of fifteen million dollars ($15,000,000) is hereby appropriated from the General Fund to the State Department of Public Health for the purpose of funding the program established in Section 120513 of the Health and Safety Code. The people of the State of California do enact as follows: ## The people of the State of California do enact as follows: SECTION 1. (a) The Legislature finds and declares all of the following:(1) In 2018, the number of reported sexually transmitted disease (STD) cases in California was 25,344 for syphilis (all stages), which is 265 percent more than 10 years ago, 79,397 for gonorrhea, which is 211 percent more than 10 years ago, and 232,181 for chlamydia, which is 56 percent more than 10 years ago.(2) STDs are increasing in all regions of the state, among all people.(3) Disparities in STD rates persist throughout the state, with the highest among young people (15 to 24 years of age), African American people, people who are gay or bisexual, and men who have sex with men.(4) Syphilis is a major public health problem in the state and has increased in all regions of the state, among all people. In 2018, according to the federal Centers for Disease Control and Prevention (CDC), California was ranked second in the nation for primary and secondary syphilis rates.(5) In 2018, the number of infants born with congenital syphilis in the state had increased for the 6th year in a row. Congenital syphilis can cause severe illness in infants, including premature birth, low birth weight, birth defects, blindness, and hearing loss. Congenital syphilis can also lead to stillbirth and infant death. In 2018, according to the CDC, California ranks fifth in the nation for congenital syphilis rates.(6) Chlamydia and gonorrhea are the most commonly reported STDs in the state. Although these STDs are curable, they often do not show symptoms and go undetected, which can lead to serious complications including infertility. Chlamydia and gonorrhea disproportionately impact people in their teens and twenties.(7) Emerging antibiotic resistance among gonorrhea is a concern. Gonorrhea is among the CDCs top three urgent threats for developing drug resistance.(8) There are many underlying drivers of the increase in STDs, and thus, there is no simple solution. STD risk is fueled by poverty, homelessness, substance use, disparities in access to care, changes in sexual behaviors, and the exchange of sex for money, housing, and other resources.(9) State and local public health departments are uniquely qualified to control the spread of communicable disease. Furthermore, state and local public health staff are actively engaged with clients, medical providers, community partners, and others working to stem the rising tide of STDs.(b) It is the intent of the Legislature to address the rise in the number of sexually transmitted diseases in California, with a particular focus on preventing reoccurrence among individuals who experience reinfections. SECTION 1. (a) The Legislature finds and declares all of the following:(1) In 2018, the number of reported sexually transmitted disease (STD) cases in California was 25,344 for syphilis (all stages), which is 265 percent more than 10 years ago, 79,397 for gonorrhea, which is 211 percent more than 10 years ago, and 232,181 for chlamydia, which is 56 percent more than 10 years ago.(2) STDs are increasing in all regions of the state, among all people.(3) Disparities in STD rates persist throughout the state, with the highest among young people (15 to 24 years of age), African American people, people who are gay or bisexual, and men who have sex with men.(4) Syphilis is a major public health problem in the state and has increased in all regions of the state, among all people. In 2018, according to the federal Centers for Disease Control and Prevention (CDC), California was ranked second in the nation for primary and secondary syphilis rates.(5) In 2018, the number of infants born with congenital syphilis in the state had increased for the 6th year in a row. Congenital syphilis can cause severe illness in infants, including premature birth, low birth weight, birth defects, blindness, and hearing loss. Congenital syphilis can also lead to stillbirth and infant death. In 2018, according to the CDC, California ranks fifth in the nation for congenital syphilis rates.(6) Chlamydia and gonorrhea are the most commonly reported STDs in the state. Although these STDs are curable, they often do not show symptoms and go undetected, which can lead to serious complications including infertility. Chlamydia and gonorrhea disproportionately impact people in their teens and twenties.(7) Emerging antibiotic resistance among gonorrhea is a concern. Gonorrhea is among the CDCs top three urgent threats for developing drug resistance.(8) There are many underlying drivers of the increase in STDs, and thus, there is no simple solution. STD risk is fueled by poverty, homelessness, substance use, disparities in access to care, changes in sexual behaviors, and the exchange of sex for money, housing, and other resources.(9) State and local public health departments are uniquely qualified to control the spread of communicable disease. Furthermore, state and local public health staff are actively engaged with clients, medical providers, community partners, and others working to stem the rising tide of STDs.(b) It is the intent of the Legislature to address the rise in the number of sexually transmitted diseases in California, with a particular focus on preventing reoccurrence among individuals who experience reinfections. SECTION 1. (a) The Legislature finds and declares all of the following: ### SECTION 1. (1) In 2018, the number of reported sexually transmitted disease (STD) cases in California was 25,344 for syphilis (all stages), which is 265 percent more than 10 years ago, 79,397 for gonorrhea, which is 211 percent more than 10 years ago, and 232,181 for chlamydia, which is 56 percent more than 10 years ago. (2) STDs are increasing in all regions of the state, among all people. (3) Disparities in STD rates persist throughout the state, with the highest among young people (15 to 24 years of age), African American people, people who are gay or bisexual, and men who have sex with men. (4) Syphilis is a major public health problem in the state and has increased in all regions of the state, among all people. In 2018, according to the federal Centers for Disease Control and Prevention (CDC), California was ranked second in the nation for primary and secondary syphilis rates. (5) In 2018, the number of infants born with congenital syphilis in the state had increased for the 6th year in a row. Congenital syphilis can cause severe illness in infants, including premature birth, low birth weight, birth defects, blindness, and hearing loss. Congenital syphilis can also lead to stillbirth and infant death. In 2018, according to the CDC, California ranks fifth in the nation for congenital syphilis rates. (6) Chlamydia and gonorrhea are the most commonly reported STDs in the state. Although these STDs are curable, they often do not show symptoms and go undetected, which can lead to serious complications including infertility. Chlamydia and gonorrhea disproportionately impact people in their teens and twenties. (7) Emerging antibiotic resistance among gonorrhea is a concern. Gonorrhea is among the CDCs top three urgent threats for developing drug resistance. (8) There are many underlying drivers of the increase in STDs, and thus, there is no simple solution. STD risk is fueled by poverty, homelessness, substance use, disparities in access to care, changes in sexual behaviors, and the exchange of sex for money, housing, and other resources. (9) State and local public health departments are uniquely qualified to control the spread of communicable disease. Furthermore, state and local public health staff are actively engaged with clients, medical providers, community partners, and others working to stem the rising tide of STDs. (b) It is the intent of the Legislature to address the rise in the number of sexually transmitted diseases in California, with a particular focus on preventing reoccurrence among individuals who experience reinfections. SEC. 2. Section 120513 is added to the Health and Safety Code, to read:120513. (a) The department shall establish a statewide program to direct and support local health departments in providing the following services to individuals experiencing reinfections of syphilis, chlamydia, and gonorrhea:(1) Assessing the health and social needs of clients.(2) Identifying and resolving client risk factors and obstacles to care.(3) Establishing routine contact with clients, including those who may be difficult locate.(4) Coordinating referrals and connections to address health and social needs, including behavioral health services, housing, homeless assistance, and harm reduction counseling and services.(5) Ensuring clients receive care and followup in a timely manner, including followup with primary care providers.(6) Providing outreach and navigation services to the clients sexual partners.(7) Routine followup education and access to prevention and screening services.(b) (1) A local health department may voluntarily apply for funds to participate in the program established by this section by submitting a spending plan for the departments approval. A spending plan shall demonstrate how funds will support the services listed in subdivision (a). The department may require a spending plan to be submitted in a specified format.(2) The department shall not provide funding to a local health department for participation in the program established by this section unless the department approves the local health departments spending plan submitted pursuant to paragraph (1). SEC. 2. Section 120513 is added to the Health and Safety Code, to read: ### SEC. 2. 120513. (a) The department shall establish a statewide program to direct and support local health departments in providing the following services to individuals experiencing reinfections of syphilis, chlamydia, and gonorrhea:(1) Assessing the health and social needs of clients.(2) Identifying and resolving client risk factors and obstacles to care.(3) Establishing routine contact with clients, including those who may be difficult locate.(4) Coordinating referrals and connections to address health and social needs, including behavioral health services, housing, homeless assistance, and harm reduction counseling and services.(5) Ensuring clients receive care and followup in a timely manner, including followup with primary care providers.(6) Providing outreach and navigation services to the clients sexual partners.(7) Routine followup education and access to prevention and screening services.(b) (1) A local health department may voluntarily apply for funds to participate in the program established by this section by submitting a spending plan for the departments approval. A spending plan shall demonstrate how funds will support the services listed in subdivision (a). The department may require a spending plan to be submitted in a specified format.(2) The department shall not provide funding to a local health department for participation in the program established by this section unless the department approves the local health departments spending plan submitted pursuant to paragraph (1). 120513. (a) The department shall establish a statewide program to direct and support local health departments in providing the following services to individuals experiencing reinfections of syphilis, chlamydia, and gonorrhea:(1) Assessing the health and social needs of clients.(2) Identifying and resolving client risk factors and obstacles to care.(3) Establishing routine contact with clients, including those who may be difficult locate.(4) Coordinating referrals and connections to address health and social needs, including behavioral health services, housing, homeless assistance, and harm reduction counseling and services.(5) Ensuring clients receive care and followup in a timely manner, including followup with primary care providers.(6) Providing outreach and navigation services to the clients sexual partners.(7) Routine followup education and access to prevention and screening services.(b) (1) A local health department may voluntarily apply for funds to participate in the program established by this section by submitting a spending plan for the departments approval. A spending plan shall demonstrate how funds will support the services listed in subdivision (a). The department may require a spending plan to be submitted in a specified format.(2) The department shall not provide funding to a local health department for participation in the program established by this section unless the department approves the local health departments spending plan submitted pursuant to paragraph (1). 120513. (a) The department shall establish a statewide program to direct and support local health departments in providing the following services to individuals experiencing reinfections of syphilis, chlamydia, and gonorrhea:(1) Assessing the health and social needs of clients.(2) Identifying and resolving client risk factors and obstacles to care.(3) Establishing routine contact with clients, including those who may be difficult locate.(4) Coordinating referrals and connections to address health and social needs, including behavioral health services, housing, homeless assistance, and harm reduction counseling and services.(5) Ensuring clients receive care and followup in a timely manner, including followup with primary care providers.(6) Providing outreach and navigation services to the clients sexual partners.(7) Routine followup education and access to prevention and screening services.(b) (1) A local health department may voluntarily apply for funds to participate in the program established by this section by submitting a spending plan for the departments approval. A spending plan shall demonstrate how funds will support the services listed in subdivision (a). The department may require a spending plan to be submitted in a specified format.(2) The department shall not provide funding to a local health department for participation in the program established by this section unless the department approves the local health departments spending plan submitted pursuant to paragraph (1). 120513. (a) The department shall establish a statewide program to direct and support local health departments in providing the following services to individuals experiencing reinfections of syphilis, chlamydia, and gonorrhea: (1) Assessing the health and social needs of clients. (2) Identifying and resolving client risk factors and obstacles to care. (3) Establishing routine contact with clients, including those who may be difficult locate. (4) Coordinating referrals and connections to address health and social needs, including behavioral health services, housing, homeless assistance, and harm reduction counseling and services. (5) Ensuring clients receive care and followup in a timely manner, including followup with primary care providers. (6) Providing outreach and navigation services to the clients sexual partners. (7) Routine followup education and access to prevention and screening services. (b) (1) A local health department may voluntarily apply for funds to participate in the program established by this section by submitting a spending plan for the departments approval. A spending plan shall demonstrate how funds will support the services listed in subdivision (a). The department may require a spending plan to be submitted in a specified format. (2) The department shall not provide funding to a local health department for participation in the program established by this section unless the department approves the local health departments spending plan submitted pursuant to paragraph (1). SEC. 3. The sum of fifteen million dollars ($15,000,000) is hereby appropriated from the General Fund to the State Department of Public Health for the purpose of funding the program established in Section 120513 of the Health and Safety Code. SEC. 3. The sum of fifteen million dollars ($15,000,000) is hereby appropriated from the General Fund to the State Department of Public Health for the purpose of funding the program established in Section 120513 of the Health and Safety Code. SEC. 3. The sum of fifteen million dollars ($15,000,000) is hereby appropriated from the General Fund to the State Department of Public Health for the purpose of funding the program established in Section 120513 of the Health and Safety Code. ### SEC. 3.