Eleventh-hour lawmaking with morning-after questions

Passed in the chaos of the Legislature's last hours, a senator's 'gut and amend' bill on notifying women about breast cancer risks could bring a multimillion-dollar windfall to a firm in his district.

Reporting from Sacramento — It was 12:18 a.m. when Joe Simitian took the microphone on the floor of the California Senate, demanding the attention of bleary-eyed fellow lawmakers in the final moments of this year’s legislative session.

“Members,” said the Palo Alto Democrat, “this is a gut and amend.”

A few hours earlier, using an obscure parliamentary procedure, the senator had carved the contents out of a bill about local gas taxes and “amended” it into a proposal to warn women about breast cancer risks. It was now speeding through the statehouse so fast, and with so little scrutiny, that Simitian would later be on the defensive about one significant effect: a possible multimillion-dollar windfall for a medical business in his district.

Although most bills take months to wend their way through the Legislature, Simitian’s midnight measure was no anomaly. Proposals routinely emerge from nowhere in the waning hours of a lawmaking year and ride a fast track to the governor’s desk, without normal vetting and with standard rules waived. In the chaos, special interests can manipulate state law, sometimes so subtly that they elude detection.

The senator’s bill was one of many that bypassed the usual reviews this year as they flew through lawmakers’ hands at the eleventh hour. They included an exemption from environmental rules for a Los Angeles stadium developer, which Brown signed Tuesday, and a gift to unions that would permit child-care workers to organize. The governor has until Oct. 9 to act on the labor bill, Simitian’s proposal and hundreds of other potential laws.

The perennial late rush shows a legislative process gone haywire, said Larry Gerston, a political science professor at San Jose State. Lawmakers “vote without even reading the bills,” he said. “The breakdown of the process leads to more lawmakers voting on things they don’t fully understand.”

Simitian’s bill is a case study in such unorthodox gambits.

It had all begun months earlier at an ice cream social in his district office. That’s where Amy Colton, a nurse and breast cancer survivor from the small Central Coast city of Soquel, came to him with an idea: Require doctors to notify women if they have dense breast tissue, which can prevent some cancers from being detected on a normal mammogram.

Armed with that information, the women could decide to seek additional screening, Colton reasoned. She hadn’t even known about the issue until she was diagnosed with Stage 3 cancer.

“The radiologist knew I had dense breast tissue, my primary care physician knew,” she told the senator. “The only one who didn’t know was me.”

Simitian was immediately taken by Colton’s story and urged her to enter his annual “There Ought to Be a Law” contest, which she did. He chose her as a winner and introduced regular legislation in February that would do as she asked.

“I became a believer,” he said.

What the senator didn’t know was the source of Colton’s legislative inspiration: a cancer awareness group partially funded by U-Systems, a Sunnyvale company that makes advanced breast screening equipment. The company’s executives have helped foster similar measures across the country as part of an effort to sell their patented $190,000 ultrasound machines, which are automated and do not require specially trained technicians for operation.

In an interview after the bill was passed, Simitian said he’d never heard of U-Systems, even though it is headquartered in his district. The company does no direct lobbying; instead, it encourages breast cancer survivors to advocate for notification laws. After one such measure passed in Connecticut, that state’s largest private radiology practice began using U-Systems’ equipment.

Simitian modeled his bill after the Connecticut law, which had been promoted by the awareness group, called Are You Dense. Founded by Connecticut doctor and breast-cancer survivor Nancy Cappello, the organization urges some women to seek additional screening. She is also the founder of D.E.N.S.E., a similar group whose California chapter is headed by Colton.

Through Cappello’s lobbying efforts, notification legislation has been signed in Illinois and Texas and introduced in multiple other states. Colton said Cappello urged her to go to Simitian.

Cappello won’t say how much money her group gets from U-Systems. She said the company’s chief executive officer, Ron Ho, contacted her in 2009 while she was pushing for the Connecticut law. Two years later, they announced a partnership to work for such legislation across the nation. In a press release last April, Cappello said “the generous support of time and resources from U-Systems will allow us to expand our critical outreach efforts.”

Ho concedes that his company stands to profit if demand for ultrasound screening increases. But he says he is also saving lives.

“It’s a really happy intersection of those two things,” he said.

Simitian’s bill passed the Senate in June. But it stalled in an Assembly committee after the California Medical Assn. lobbied against it, arguing that the notice could spook women not otherwise at risk for cancer.

The measure was left for dead until, hours before the Legislature would adjourn, Assembly Speaker John A. Pérez (D-Los Angeles) agreed to Simitian’s pleas to reconstitute it.

Shortly before 5 p.m., a hearing of the Assembly Health Committee was hastily called on the new bill, SB 791. When a witness delved into reasons to oppose it, she was admonished by the committee chairman, Assemblyman William Monning (D-Carmel): “This is not a full evidentiary hearing.”

The bill was quickly sent to the Assembly floor, bypassing the committee that killed the original proposal. In the Senate, where Simitian presented the measure only hours after rewriting it, there was no committee review at all. Passing both houses on the recommendation of legislative leaders — par for the course in the annual hurry to wrap up — the bill received just 6 no votes in the Assembly and one in the Senate.

When Simitian heard from a reporter several days later about Colton and Cappello’s connection to U-Systems, he said it didn’t matter. He conceded that the gut and amend process can be unseemly but said the notification bill was one of his priorities this year and the earlier, virtually identical measure (SB 173) had been vetted in multiple venues.

“Every time we got the chance to tell our story,” he said, “we had a broad base of support.”