BILL NUMBER: AB 1379 CHAPTERED 09/18/02 CHAPTER 641 FILED WITH SECRETARY OF STATE SEPTEMBER 18, 2002 APPROVED BY GOVERNOR SEPTEMBER 17, 2002 PASSED THE ASSEMBLY AUGUST 25, 2002 PASSED THE SENATE AUGUST 19, 2002 AMENDED IN SENATE JUNE 26, 2002 AMENDED IN SENATE JUNE 18, 2002 AMENDED IN SENATE APRIL 25, 2002 AMENDED IN ASSEMBLY JANUARY 18, 2002 AMENDED IN ASSEMBLY JANUARY 10, 2002 INTRODUCED BY Assembly Member Thomson FEBRUARY 23, 2001 An act to amend Sections 14500.5, 14501, 14502, 14503, 14503.5, 14509, 14509.1, 14510, and 14512 of the Welfare and Institutions Code, relating to family planning. LEGISLATIVE COUNSEL'S DIGEST AB 1379, Thomson. Family planning services. Existing law imposes various functions, powers, and duties on the State Department of Health Services and the Office of Family Planning, which is established in the department, with respect to the provision of family planning services to eligible individuals. Among these powers is the authority to enter into contracts with individuals and various entities as deemed necessary and advisable to carry out the general intent and purposes of providing family planning services. This bill would instead authorize the department and the office to award grants to these individuals and entities for the provision of family planning services, and would make related changes. It would also specify that all grants awarded by the office would be exempt from provisions governing state contracts. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 14500.5 of the Welfare and Institutions Code is amended to read: 14500.5. (a) It is the intent of the Legislature that family planning includes, but is not limited to, an effective means to improve reproductive health by disease prevention and treatment, to reduce the incidence of unintended pregnancies, and to reduce the demand for abortions. It is the intent of the Legislature that no family planning shall be expended other than for the services enumerated in this chapter. It is also the intent of the Legislature that no funds received pursuant to this chapter be used for abortions or services ancillary to abortions. (b) For purposes of this chapter, the following definitions shall apply: (1) "Family planning" means the process of establishing objectives for the number and spacing of children, and selecting the means by which those objectives may be achieved. These means include a broad range of acceptable and effective methods and services to limit or enhance fertility, including contraceptive methods, natural family planning, abstinence methods, and the management of infertility. Family planning services include preconceptional counseling, maternal and fetal health counseling, and general reproductive health care, including diagnosis and treatment of infections and conditions, including cancer, that threaten reproductive capability, and other services as described in Section 14503, except for abortions and services ancillary to abortions as prohibited in Section 14509. Family planning does not include abortion, pregnancy testing solely for the purposes of referral for abortion or services ancillary to abortions, or pregnancy care which is not incident to the diagnosis of a pregnancy, except as otherwise provided for in this chapter. (2) "Abortion as a method of family planning" means the deliberate choice of abortion over other methods to limit the number, gender, and spacing of children, including, but not limited to, contraception, abstinence, and natural family planning methods. (3) "Department" means the State Department of Health Services. (4) "Director" means the Director of Health Services. (5) "Grantee" means an agency, institution, or organization approved by the department to provide family planning services pursuant to this chapter. SEC. 2. Section 14501 of the Welfare and Institutions Code is amended to read: 14501. The Office of Family Planning has all of the following functions, powers, and duties: (a) To make available to citizens of the state of childbearing age comprehensive medical knowledge, assistance, and services relating to the planning of families. (b) To consult with state and local agencies that provide or administer family planning services and to participate in the formulation of regulations and other policy decisions governing the provision or administration of family planning services pursuant to state law or regulation. (c) To establish goals and priorities for all state agencies providing or administering family planning services. (d) To coordinate all family planning services and related programs conducted or administered by state agencies with the federal government so as to maximize the availability of these services by utilizing all available federal funds. (e) To conduct a survey of all of the existing facilities within the state having to do with family planning and infertility and the rendering of advice and assistance on birth control techniques and information. (f) To evaluate all existing programs and to establish in each county a viable program for the dispensation of family planning, infertility, and birth control information and techniques. (g) To develop and administer scientific investigation into problems of infertility and existing and new family planning and birth control techniques. (h) To survey, evaluate, and establish programs of professional education and training for physicians, nurses, medical and nursing students, and other health care practitioners in rendering advice on family planning, infertility, and birth control techniques and information. (i) To enter into agreements with, and award grants to, individuals, colleges, universities, associations, corporations, municipalities, and other units of government as may be deemed necessary and advisable to carry out the general intent and purposes of this article, which may provide for payment by the state within the limit of funds available for material, equipment, and services. (j) To submit a biennial report to the Legislature including, but not limited to, the subjects specified above. (k) To annually update and analyze family planning data. The data shall include, but not be limited to, the following: (1) Client number. (2) Ethnicity. (3) Family size. (4) Method. (5) Family income. (6) Service type. (7) Birthdate. (8) Total billing amount. (9) Pay source. (10) Date of visit. (11) Site number. (12) County of residence. (13) Updated estimates of women in need of subsidized family planning services from the federal government, when available, for all Office of Family Planning clinical service grantees by county of service, as well as statewide totals. SEC. 3. Section 14502 of the Welfare and Institutions Code is amended to read: 14502. The Office of Family Planning may, to the extent funds are available, and not more frequently than once each year, advance up to 25 percent of the yearly allocation to an individual or entity to which it has awarded a grant, pursuant to subdivision (i) of Section 14501, to provide material, equipment, and services. SEC. 4. Section 14503 of the Welfare and Institutions Code is amended to read: 14503. (a) Family planning services shall be offered to all former, current, or potential recipients of childbearing age (as provided by Public Law 92-603) and provided to all eligible individuals who voluntarily request the services. The services shall be offered and provided without regard to marital status, age, or parenthood. Notwithstanding any other provisions of law, the furnishing of these family planning services shall not require the consent of anyone other than the person who is to receive them. Within the meaning of this section, the term "former, current, or potential recipient" means all persons eligible for Medi-Cal benefits under Chapter 7 (commencing with Section 14000) and all persons eligible for public social services for which federal reimbursement is available under the federal Social Security Act (42 U.S.C. Sec. 301 et seq.), except that the term "potential recipients" includes all persons in a family where current social, economic, and health conditions of the family indicate that the family would likely become a recipient of financial assistance within the next five years. (b) Family planning services shall include, but not be limited to: (1) Medical treatment and procedures defined as family planning services under the published Medi-Cal scope of benefits. (2) Medical contraceptive services such as diagnosis, treatment, supplies, and followup. (3) Informational and educational services. (4) Facilitating services such as transportation and child care services needed to attend clinic or other appointments. (5) Screening for chlamydia. (c) To the extent the services under this section are not available under the Medi-Cal program, they shall be provided by a grantee pursuant to a grant awarded by the Office of Family Planning. These grants shall include to the maximum extent possible, cooperative funding and other financial arrangements that permit maximum use of available federal funds. All grants awarded by the Office of Family Planning shall be exempt from Division 2 (commencing with Section 1100) of the Public Contract Code. Information and referral services only shall be available to all other families and children. (d) As the single state agency responsible for the state plan under Title XX of the federal Social Security Act (42 U.S.C. Sec. 1397 et seq.), the State Department of Social Services may provide family planning services pursuant to a purchase of services agreement with the department from funds appropriated for those services. The agreement shall authorize the Office of Family Planning to implement a sliding fee schedule for family planning services provided to clients pursuant to Title XX of the federal Social Security Act in accordance with Section 14501.5. SEC. 5. Section 14503.5 of the Welfare and Institutions Code is amended to read: 14503.5. (a) As used in this section: (1) "AIDS" means acquired immune deficiency syndrome. (2) "Human immunodeficiency virus" or "HIV" means the etiologic virus of AIDS. (3) "HIV test" means "HIV test" as defined in Section 120775 of the Health and Safety Code. (b) The purpose of this article is to ensure that state-funded family planning programs offer AIDS information and referral services to their client population. (c) It is the intent of the Legislature that family planning clients learn how to prevent the transmission of HIV, and that they take steps to prevent its transmission. (d) For purposes of this section, "clients" shall include, but shall not be limited to, all of the following: (1) New clients to a family planning program. (2) Clients making annual visits to a family planning program. (3) Clients seeking pregnancy testing or family planning services. (4) Clients seeking diagnosis and treatment for sexually transmitted diseases. (e) Any family planning program that has a grant from the Office of Family Planning to provide family planning services shall do all of the following: (1) Provide brochures or other written materials to family planning clients that describe the high-risk conditions and behaviors for becoming infected with HIV and ways to prevent the transmission of HIV infection. To the maximum extent possible, the brochure or other written materials provided by any family planning program shall be culturally relevant and appropriate to the client populations served by the programs. (2) Provide, as needed, family planning clients with information about and referrals to local confidential or anonymous testing and counseling sites, AIDS education programs, and other supportive services. (f) Brochures and information required pursuant to subdivision (e) may be incorporated into existing information and health education programs provided by a family planning program. (g) The department shall make every effort to obtain brochures and other written materials from existing resources. Local family planning programs are encouraged to supplement the brochures with other available resources, to the extent that they deem necessary and appropriate. SEC. 6. Section 14509 of the Welfare and Institutions Code is amended to read: 14509. (a) The department shall award grants to persons to provide family planning services pursuant to this chapter. (b) No funds received pursuant to grants awarded by the department pursuant to this chapter shall be used to perform abortions. (c) No funds received pursuant to grants awarded by the department pursuant to this chapter shall be used to fund services ancillary to abortions, including, but not limited to, postabortion examinations. Nothing in this chapter shall be construed to limit the provision of pregnancy testing and counseling as required by the Office of Family Planning on the effective date of this section. (d) Any person awarded a grant by the department pursuant to this chapter shall agree that during the term of the grant it will not be a group, clinic, or organization that, with funds provided pursuant to this chapter, advertises, advocates, or promotes abortion as a method of family planning, or that receives any fee or other consideration as payment for referrals for abortion services. Any person awarded a grant by the department pursuant to this chapter shall agree to the termination of the grant and to return all unexpended funds to the department that have been received from the department pursuant to that grant if the department finds that the grantee has violated this section. SEC. 7. Section 14509.1 of the Welfare and Institutions Code is amended to read: 14509.1. (a) A grantee shall maintain records and accounts, including property, personnel, and financial records, in a form, format, and content that ensures a proper accounting for all family planning funds received pursuant to this chapter. These records shall be made available for examination during normal business hours, and shall be retained at a location determined by the director for four years after the expiration of the grant, with the exception of patient medical records, which shall be retained for at least seven years. Records for nonexpendable personal property shall be retained for three years after final disposition. (b) A grantee shall arrange for an independent audit of the family planning program. The audit shall be done in accordance with department directives and with generally accepted accounting principles for nonprofit corporations and governmental entities. SEC. 8. Section 14510 of the Welfare and Institutions Code is amended to read: 14510. (a) The department shall include provisions in grants with all grantees that explicitly describe the requirements and restrictions of this chapter. (b) The department shall establish a copayment system for services provided pursuant to this chapter. No person whose documented family income is at or below 100 percent of the federal poverty level shall be subject to copayments. (c) The department shall require a grantee to obtain the signature of clients receiving services pursuant to this chapter on a document that, under penalty of perjury, acknowledges that the client meets and complies with the income eligibility requirements of this chapter. SEC. 9. Section 14512 of the Welfare and Institutions Code is amended to read: 14512. It is the intent of the Legislature that all grants for the provision of direct services entered into by the Office of Family Planning under this chapter shall be competitively awarded.