BILL NUMBER: AB 1745 CHAPTERED
BILL TEXT
CHAPTER 330
FILED WITH SECRETARY OF STATE SEPTEMBER 19, 2006
APPROVED BY GOVERNOR SEPTEMBER 19, 2006
PASSED THE ASSEMBLY AUGUST 30, 2006
PASSED THE SENATE AUGUST 24, 2006
AMENDED IN SENATE AUGUST 22, 2006
AMENDED IN SENATE AUGUST 9, 2006
AMENDED IN SENATE JUNE 14, 2006
AMENDED IN SENATE APRIL 6, 2006
INTRODUCED BY Assembly Member Chan
(Principal coauthor: Senator Perata)
(Coauthors: Assembly Members Berg, Jones, and Laird)
(Coauthors: Senators Alquist, Bowen, Figueroa, Kuehl, and Ortiz)
MARCH 2, 2005
An act to add Section 14132.74 to the Welfare and Institutions
Code, relating to Medi-Cal, and making an appropriation therefor.
LEGISLATIVE COUNSEL'S DIGEST
AB 1745, Chan Medi-Cal: pediatric palliative care benefit.
Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Services and under
which qualified low-income persons receive health care benefits,
including hospice benefits. The Medi-Cal program is, in part,
governed and funded by federal Medicaid provisions.
This bill would require the department to develop, as a pilot
project, a pediatric palliative care benefit to evaluate whether, and
to what extent, such a benefit should be offered under the Medi-Cal
program. It would require that the pilot project be implemented only
to the extent that federal financial participation is available, and
would require the department to submit a waiver application for
federal approval.
The bill would require that beneficiaries eligible to receive the
pediatric palliative care benefit be under 21 years of age, and would
allow the department to further limit the population served by the
project to make the above evaluation. It would require that the
services available under the project include those types of services
that are available through the Medi-Cal hospice benefit, and certain
other services. The bill would provide that authorized providers
under the pilot program shall include licensed hospice agencies and
home health agencies licensed to provide hospice care, subject to
criteria developed by the department for provider participation.
The bill would appropriate $75,000 from the General Fund to the
department for these purposes.
Appropriation: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. This act shall be known and may be cited as the Nick
Snow Children's Hospice and Palliative Care Act of 2006.
SEC. 2. Section 14132.74 is added to the Welfare and Institutions
Code, to read:
14132.74. (a) The department, in consultation with interested
stakeholders, shall develop, as a pilot project, a pediatric
palliative care benefit to evaluate whether, and to what extent, such
a benefit should be offered under the Medi-Cal program. The pilot
project shall be implemented only to the extent that federal
financial participation is available.
(b) Beneficiaries eligible to receive the pediatric palliative
care benefit shall be under 21 years of age. The department may
further limit the population served by the pilot project to a size
deemed sufficient to make the evaluation required pursuant to
subdivision (a).
(c) Services covered under the pediatric palliative care benefit
shall be designed to meet the unique needs of children, and shall
include those types of services that are available through the
Medi-Cal hospice benefit. The benefit shall also include the
following services, regardless of whether those services are covered
under the Medi-Cal hospice benefit:
(1) Hospice services that are provided at the same time that
curative treatment is available, to the extent that the services are
not duplicative.
(2) Hospice services provided to individuals whose conditions may
result in death, regardless of the estimated length of the individual'
s remaining period of life.
(3) Any other services that the department determines to be
appropriate.
(d) The department, in consultation with interested stakeholders,
shall determine the medical conditions and prognoses that render a
beneficiary eligible for the benefit.
(e) Providers authorized to provide services under the pilot
program shall include licensed hospice agencies and home health
agencies licensed to provide hospice care, subject to criteria
developed by the department for provider participation.
(f) (1) The department shall submit any necessary application to
the federal Centers for Medicare and Medicaid Services for a waiver
to implement the pilot project described in this section. The
department shall determine the form of waiver most appropriate to
achieve the purposes of this section. The waiver request shall be
included in any waiver application submitted within 12 months after
the effective date of this section, or shall be submitted as an
independent application within that time period. After federal
approval is secured, the department shall implement the waiver within
12 months of the date of approval.
(2) The waiver shall be designed to cover a period of time
necessary to evaluate the medical necessity for, and
cost-effectiveness of, a pediatric palliative care benefit. The
results of the pilot project shall be made available to the
Legislature and appropriate policy and fiscal committees to determine
the effectiveness of the benefit.
(g) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department may implement the provisions of this section by means of
provider bulletins or similar instructions, without the adoption of
regulations. The department shall notify the fiscal and appropriate
policy committees of the Legislature of its intent to issue a
provider bulletin or other similar instruction at least five days
prior to issuance.
(h) (1) Nothing in this section shall result in the elimination or
reduction of any covered benefits or services under the Medi-Cal
program or the California Children's Services Program.
(2) This section shall not affect an individual's eligibility to
receive, concurrently with the benefit provided for in this section,
any services, including home health services, for which the
individual would have been eligible in the absence of this section.
SEC. 3. There is hereby appropriated the sum of seventy-five
thousand dollars ($75,000) from the General Fund to the State
Department of Health Services for expenditure for the purposes of
developing and implementing a pilot project, as provided for in
Section 14132.74 of the Welfare and Institutions Code, to evaluate
whether, and to what extent, a pediatric palliative care benefit
should be offered under the Medi-Cal program. These funds may be used
to fund staff positions to execute, plan, manage, develop, and
implement the pilot project.