Bills take aim at Valley fever
Introduced by Kern County legislators — Fong and Salas
Two Kern County Assemblymen are confronting the increasing number of valley fever cases in the Central Valley by introducing six bills in the State Assembly — an effort some are calling the most substantial legislative effort against the disease in California history.
Assemblyman Rudy Salas (D-bakersfield) last week introduced Assembly Bills (AB) 1787, 1788, 1789, and 1790 which will improve doctor training, strengthen worker protections, and streamline the reporting and confirming of Valley fever cases.
Assemblyman Vince Fong (R-kern County) Wednesday introduced AB 1880 and AB 1881, which will seek to improve the reporting process of the disease amongst health officials and the testing process by physicians.
“Valley fever has had — and continues to have — an incredibly devastating impact on so many families and people in California, it is tragically underdiagnosed, and over recent years the rate of infections has spiked alarmingly across the state to a record high,” said Salas in a press release. “The state needs to take strong action to protect Californians from Valley fever and must do more to help the thousands of individuals and families already affected by Valley fever.”
No cure currently exists for valley fever, which has spread exponentially throughout the Central Valley in recent years.
“With the continued rise of residents affected by this disease, this is a vital policy public health priority this year,” said Fong. “These important measures, developed in partnership with our local health officials and valley fever survivors, will provide best practices throughout the state to continue a critical fight against this devastating disease.”
The six bills introduced by Salas and Fong aim to tackle the disease from a variety of angles:
AB 1787 (Salas) sets an annual reporting deadline of March 1 for local health officers to report to CDPH all cases of Valley fever. Currently, there is not an established annual deadline.
AB 1788 (Salas) authorizes CDPH to confirm cases of Valley fever through laboratory testing alone, without the need for costly clinical criteria. Currently, the state requires both the laboratory component and clinical criteria for diagnosis.
AB 1789 (Salas) will strengthen protections for workers by requiring the Division of Occupational Safety and Health (CAL/OSHA) to adopt occupational safety and health standards for all state public works projects to prevent and control Valley fever. Workers are particularly at risk due to the nature of new construction projects that require the disruption of soil.
AB 1790 (Salas) establishes enhanced physician training in the prevention, diagnosis, and treatment of Valley fever to increase accurate diagnoses, reduce delays, and improve treatment for patients suffering from infection.
AB 1880 (Fong) provides consistencies and transparency in the reporting of valley fever cases so state and local health officials are looking at accurate data.
AB 1881 (Fong) ensures that doctors utilize the most efficient and proven exams to test for valley fever.
Valley fever, also known as coccidioidomycosis, is a respiratory infection caused by breathing tiny fungal spores found in the soil in dry,
dusty areas throughout California and the Southwest.
It spreads through the air when soil is disturbed and can be carried for hundreds of miles. The most severe cases affect the bones, skin, eyes, and even the brain. In some cases it can be fatal.
The symptoms of Valley fever can be similar to those of other common illnesses like the common cold and flu, so patients may have delays in getting diagnosed and treated.
The CDC has labeled valley fever a “silent epidemic,” and estimates that 150,000 cases go undiagnosed every year in the United States. Some experts estimate that the number of cases that go undiagnosed may be even higher.
Both Assemblymen were co-authors on each other’s bills. They will be referred to Assembly policy committees in the coming weeks.
The bill package is a bipartisan effort that has gained solidarity among Democrats and Republicans representing the San Joaquin Valley. In addition to legislation, Salas is circulating a budget proposal to appropriate
funds for outreach and research for valley fever, and Fong announced that he is also building a state-federal partnership to enhance valley fever research to help find a cure and treatment options.
“Our fight against valley fever requires our state, local, and federal representatives to work together to bring every available tool and resource to the doctors and health authorities fighting this disease on the front lines,” said Rob Purdie with the Valley Fever Americas Foundation, who described Salas’ bills as the most robust effort in California history to address the disease. “As a survivor of Valley fever, I am really excited and encouraged to see this Valley fever package rolled out.”
Salas’ legislation last year, AB 1279, promised to revamp Valley fever reporting guidelines and bring $2 million in funding to awareness efforts before it was stripped down in the legislative process. It received strong bipartisan support in both houses, but by the time it made it to the governor’s desk, it required only that the state public health department devise a public awareness campaign. The governor vetoed it for lack of funding.
Fong said he and Salas are working together to make another run at state resources in the future. He also noted that Congressman Kevin Mccarthy is a strong advocate at the national level, working with the National Institutes of Health and the Centers for Disease Control to secure more funds for the cause.
“We are optimistic that we can build a coalition to get more resources to fight this disease, raise awareness, and do a public education campaign,” said Fong.
Like Salas and Fong, Purdie is undeterred by last year’s veto, and said his foundation’s efforts and resources will be available to support the bills any way they can as they move through the legislative process this year.
“One stumbling block like AB 1279’s veto isn’t going to stop us. It helps us get better direction and regroup,” said Purdie.
In 2016, the California Department of Public Health (CDPH) reported 5,372 confirmed cases of Valley fever in California, which was the highest total number of recorded since the state began reporting in 1995.
The total number of confirmed cases for 2017 has not yet been released, but the provisional numbers recently released by CDPH indicate that the total this year could be even higher.
For 2017, CDPH reported 7,471 provisional cases, which includes suspected and probable cases along with confirmed cases. By comparison, in 2016 there were 5,417 provisional cases initially reported.
Furthermore, the total number of cases over the last four years — including 2017 — has drastically increased each year and has more than doubled over the same time period.
Valley fever has impacted Kern County harder than any other county in the state. Of the 7,471 provisional cases reported by CDPH for 2017, 2,619 were in Kern County — almost three times the amount of Los Angeles County, which had the second highest number of cases with 887.
Tulare County had 504 provisional cases of Valley fever in 2017, 531 in 2016, and 239 in 2015.
“I am fully committed to any measures that can make a difference in these outbreaks,” said Assemblyman Devon Mathis on the new legislation. “Tulare County is one of the most affected counties in the state, and that is unacceptable. I look forward to bringing more resources to combating Valley fever, and will continue to work with anyone to find a permanent solution.”