104310-104315

HEALTH AND SAFETY CODE
SECTION 104310-104315




104310.  This chapter shall be known and may be cited as the
Prostate Cancer Act of 1998.



104312.  The Legislature finds and declares all of the following:
   (a) California has the highest incidence of and death from
prostate cancer, and due to the increased public awareness of the
disease, the timing is appropriate to establish programs for prostate
cancer education and early detection services for uninsured men.
Despite the advances in the treatment and detection of prostate
cancer, the death rate of this disease continues to climb at an
alarming rate--a rate higher than breast cancer and many other high
profile diseases.
   (b) Approximately 200,000 new cases of prostate cancer will be
diagnosed this year.
   (c) Prostate cancer is the most common cancer in men.
   (d) Prostate cancer has led to an estimated 38,000 deaths
nationally in 1994 and is the second-leading cause of cancer death in
men.
   (e) Nationally, the incidence of prostate cancer increased 50
percent between 1980 and 1990.
   (f) Prostate cancer diagnosis in California nearly doubled over
the five-year period covered by the recently published California
Cancer Registry, from 11,900 new cases in 1988 to 22,200 in 1992. The
age-adjusted incidence rate increased by 65 percent, from 98.6 new
cases per 100,000 males in 1988 to 163 in 1992.
   (g) African Americans have a 30 percent higher risk of developing
prostate cancer than whites, which is the highest risk of any race or
ethnic group.
   (h) About 60 percent of all prostate cancers are discovered before
they have spread.
   (i) The cure rate for prostate cancer, if detected before
metastasis, is 84 percent.
   (j) The majority of commercial managed care plans offer prostate
cancer screening for their members.
   (k) The employment of prostate-specific antigen assays as common
medical practice within suspect categories will enhance early
detection of prostate cancer.


104314.  (a) The Prostate Cancer Fund is hereby established in the
State Treasury. It is the intent of the Legislature that the fund be
funded by an annual appropriation, when funds are available, in the
Budget Act.
   (b) The moneys in the Prostate Cancer Fund shall be expended by
the State Department of Health Services, upon appropriation by the
Legislature, for the purpose of the Prostate Cancer Screening Program
established by Section 104315.



104315.  (a) The Prostate Cancer Screening Program shall be
established in the State Department of Health Services.
   (b) The program shall apply to both of the following:
   (1) Uninsured men 50 years of age and older.
   (2) Uninsured men between 40 and 50 years of age who are at high
risk for prostate cancer, upon the advice of a physician or upon the
request of the patient.
   (c) For purposes of this chapter, "uninsured" means not covered by
any of the following:
   (1) Medi-Cal.
   (2) Medicare.
   (3) A health care service plan contract or policy of disability
insurance that covers screening for prostate cancer for men 50 years
of age and older, and for men between 40 and 50 years of age who are
at high risk for prostate cancer upon the advice of a physician or
upon the request of the patient.
   (4) Any other form of health care coverage that covers screening
for prostate cancer for men 50 years of age and older, and for men
between 40 and 50 years of age who are at high risk for prostate
cancer upon the advice of a physician or upon the request of the
patient.
   (d) The program shall include all of the following:
   (1) Screening of men for prostate cancer as an early detection
health care measure.
   (2) After screening, medical referral of screened men and services
necessary for definitive diagnosis.
   (3) If a positive diagnosis is made, then assistance and advocacy
shall be provided to help the person obtain necessary treatment.
   (4) Outreach and health education activities to ensure that
uninsured men are aware of and appropriately utilize the services
provided by the program.
   (e) Any entity funded by the program shall coordinate with other
local providers of prostate cancer screening, diagnostic, followup,
education, and advocacy services to avoid duplication of effort. Any
entity funded by the program shall comply with any applicable state
and federal standards regarding prostate cancer screening.
   (f) Administrative costs of the department shall not exceed 10
percent of the funds allocated to the program. Indirect costs of the
entities funded by this program shall not exceed 12 percent. The
department shall define "indirect costs" in accordance with
applicable state and federal law.
   (g) Any entity funded by the program shall collect data and
maintain records that are determined by the department to be
necessary to facilitate the state department's ability to monitor and
evaluate the effectiveness of the entities and the program.
Commencing with the program's second year of operation, the
department shall submit an annual report to the Legislature and any
other appropriate entity. The report shall describe the activities
and effectiveness of the program and shall include, but not be
limited to, the following types of information regarding those served
by the program:
   (1) The number.
   (2) The ethnic, geographic, and age breakdown.
   (3) The stages of presentation.
   (4) The diagnostic and treatment status.
   (h) The department or any entity funded by the program shall
collect personal and medical information necessary to administer the
program from any individual applying for services under the program.
The information shall be confidential and shall not be disclosed
other than for purposes directly connected with the administration of
the program or except as otherwise provided by law or pursuant to
prior written consent of the subject of the information.
   (i) The department or any entity funded by the program may
disclose the confidential information to medical personnel and fiscal
intermediaries of the state to the extent necessary to administer
the program, and to other state public health agencies or medical
researchers if the confidential information is necessary to carry out
the duties of those agencies or researchers in the investigation,
control, or surveillance of prostate cancer.
   (j) The department shall adopt regulations to implement the
Prostate Cancer Screening Program in accordance with Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code.
   (k) This section shall not be implemented unless and until funds
are appropriated for this purpose in the annual Budget Act.
   ( l) To implement the Prostate Cancer Screening Program, the
department may contract, to the extent permitted by Section 19130 of
the Government Code, with public and private entities, or utilize
existing health care service provider enrollment and payment
mechanisms, including the Medi-Cal program's fiscal intermediary.
However, the Medi-Cal program's fiscal intermediary shall only be
utilized if services provided under the program are specifically
identified and reimbursed in a manner that does not claim federal
financial reimbursement. Any contracts with, and the utilization of,
the Medi-Cal program's fiscal intermediary shall not be subject to
Chapter 3 (commencing with Section 12100) of Part 2 of Division 2 of
the Public Contract Code. Contracts to implement the Prostate Cancer
Screening Program entered into by the department with entities other
than the Medi-Cal program's fiscal intermediary shall not be subject
to Part 2 (commencing with Section 10100) of Division 2 of the Public
Contract Code.