County Supervisors approve ordinance for lab oversight

Board of Supervisors also vote to delay implementing SB 43 until county can build out infrastructure

The Fresno County Board of Supervisors at one of their biweekly convenings.
The Fresno County Board of Supervisors at one of their biweekly convenings.
Darren Fraser
Published December 15, 2023  • 
11:00 am

FRESNO COUNTY – Following the discovery of an illegal biolab in Reedley, the board of supervisors has approved the first reading of an ordinance creating the framework when it comes to inspecting privately funded biolabs, ensuring that no repeat of this circumstance comes into play again.

At its Dec. 12 meeting, the Fresno County Board of Supervisors (Board) passed the “Fresno County Infectious Materials Ordinance,” which will give the county the authority to conduct annual inspections of privately funded biolabs that fall outside the inspection purview of federal government regulations. 

The ordinance, which the Board passed with a 5-0 vote – setting up a second reading and approval at the next Board meeting on Jan. 9 – establishes a “monitoring and inspection system to oversee privately funded laboratories that handle infectious agents without oversight from an existing permitting agency.”

There is no oversight because an existing permitting agency for privately funded biolabs does not exist. This is how Universal Meditech, Inc. and Prestige Biotech, Inc. were able to fly under the government’s radar and run clandestine labs for years in the U.S., until the illegal lab they were operating in Reedley was discovered last December.

The ordinance applies only to non-Clinical Laboratory Improvement Amendments (CLIA) labs and facilities. These include hospitals, health clinics and companies such as LabCorp and other testing facilities.

Cities must sign a memorandum of understanding (MOU) with the county to participate in the program. Labs in the participating cities that do not fall under CLIA regulations must apply for a permit to operate.

County Administrative Officer (CAO) Paul Nerland told the Board the ordinance establishes a single authority for inspections and oversight.

“It’s one ordinance for the county,” Nerland said. “It’s not a patchwork from different cities.”

ENFORCEMENT

According to the ordinance, individuals authorized by the public health department to conduct inspections will have the authority to make arrests – without a warrant – if they have reasonable cause to believe “that the person to be arrested has committed an act in the officer’s or employee’s presence which is a violation of this chapter.”

Violation of the ordinance is a misdemeanor, with a penalty of up to six months in jail and a $1,000 fine per violation. The ordinance states that each day a violation exists, this constitutes a separate violation.

At the Board meeting, Public Health Director David Luchini said the county’s Environmental Health Division will conduct inspections for hazardous materials and infectious agents. Luchini said any facility found to be out of compliance with the county standards will not be issued a permit, or will have their permit revoked.

Supervisor Nathan Magsig asked Luchini if the county’s current hazardous materials inspection program limits what types of materials the county can investigate.

“Yes,” Luchini answered. “There are only certain chemicals CUPA can oversee.” Luchini was referring to the Certified Unified Program Agencies arm of the state’s Department of Toxic Substances Control.

Luchini said that, ideally, the government will eventually expand CLIA to cover private labs.

“The lowest hanging fruit is to expand CLIA oversight to these labs,” he said.

SB 43 

At the meeting, the Board also agreed to delay the implementation of Senate Bill (SB) 43, which expanded the criteria by which law enforcement could place an individual under an involuntary hold due to behavioral health issues.

Under the Lanterman-Petris-Short Act (LPS), police, sheriffs and a limited number of mental health professionals can place a person under an involuntary hold if that person is a danger to themselves or others or who is gravely disabled. 

LPS defines gravely disabled as a condition stemming from a mental health disorder that renders a person incapable of providing for their basic personal needs, such as food, clothing or shelter; or the person has been found mentally incompetent.

Last October, Governor Newsom signed SB 43, which expanded the definition of gravely disabled to include a condition in which a person – because of substance abuse or a co-occurring mental health disorder and a substance abuse disorder, or because of chronic alcoholism – in addition to being incapable of providing for their personal needs, is also incapable of providing for their personal safety or medical care.

At the Dec. 12 Board meeting, Susan Holt, Fresno County Behavioral Health Director and Public Guardian, asked the Board to defer implementing SB 43 until Jan. 1, 2026, to allow the county time to marshal resources and to create the infrastructure needed to deal with the increase in the number of individuals who will be involuntary committed as a result of the scope of SB 43’s classification.

“We don’t want to create chaos in a system that can’t serve them,” said Holt.

SB 43 does allow for a county to defer implementation. Holt said that 24 counties in the state have elected to defer, with only San Francisco and San Luis Obispo counties electing to move forward with the Jan. 1, 2024 effective date.

“There are no involuntary care facilities for individuals with substance abuse disorder,” Holt said. “They don’t exist.” She said the county would have to build facilities and staff to handle the influx of individuals placed under involuntary commitment.

INFRASTRUCTURE

Holt said she had heard from various county court judges; they, too, advocate delaying the implementation of SB 43 until the county has the infrastructure in place to handle the affected population.

“Did SB 43 provide funds for this?” Supervisor Nathan Magsig asked during Tuesday’s discussion.

“No,” said Holt. She went on to explain that the Public Guardian serves as the investigative arm for LPS conservatorships, but they receive no funding for this function.

She added the county is not slated to receive federal funding for SB 43. Magsig asked if the county would receive reimbursement from MediCal. Holt said under limited circumstances. She mentioned a hospital or similar facility may receive MediCal reimbursement for the first 23 hours staff attend to an individual in a crisis situation.

“It feels like the government is forcing us to drive down a road that hasn’t been built,” Supervisor Steve Brandauer said. He acknowledged there are “damaged” people that need assistance.

“My office looks out onto the park,” he said. “I see these damaged people out there walking. Talking to themselves. It’s sad.” Brandauer agreed that the county should defer until it has the resources and infrastructure in place to deal with the situation.

“Law enforcement comes in contact with these folks on a daily basis,” Fresno County Sheriff John Zanoni told the Board. “We’ll see a flood of people the county won’t be able to handle. Emergency rooms won’t be able to handle it.”

Zanoni said the county has over 1,000 law enforcement officials. He said if these officials follow SB 43 to the letter of the law, they will be bringing in too many people for the system to process. “We’ll be bringing them in and releasing them,” said Zanoni.

Supervisor Sal Quintero concluded by the discussion by saying, “Sounds like we need to send Sacramento a letter – ‘Show me the money.’”

Darren Fraser
Reporter