BILL NUMBER: AB 1541 INTRODUCED
BILL TEXT
INTRODUCED BY Assembly Member Nava
FEBRUARY 23, 2007
An act to add Section 14134.3 to the Welfare and Institutions
Code, relating to Medi-Cal.
LEGISLATIVE COUNSEL'S DIGEST
AB 1541, as introduced, Nava. Medi-Cal: family planning services.
Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services and
under which qualified low-income persons receive health care
benefits, including family planning services.
This bill would make legislative findings and declarations
regarding family planning services in California. This bill would
also require that all Medi-Cal programs that provide family planning
services shall provide comprehensive clinical family planning
services, as defined. This bill would prohibit a Medi-Cal managed
care plan from restricting the choice of an enrollee regarding the
provider from whom the enrollee may receive family planning services,
so long as the provider is a Medi-Cal provider.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares all of the
following:
(a) Comprehensive family planning services are essential for the
well-being of California women and their families.
(b) For many low-income women of child-bearing age, family
planning services are their primary medical concern and family
planning providers constitute their medical home.
(c) The economic status of poor women and their families is
closely linked to unintended pregnancy.
(d) Comprehensive family planning has proven to be one of the most
cost-effective preventive health care services available. Studies
have shown that for every dollar spent on family planning, California
saves $5.33 in medical and social service costs, over a five-year
period.
(e) Recognition of the cost of unintended pregnancies, in human
terms, societal costs, and government expenditures, has compelled the
federal government to cover $0.90 of every $1 spent for Medi-Cal
family planning services to ensure the availability of services.
(f) Due to the 90-percent federal financial participation for
family planning services, it is clear that for every state dollar
spent on family planning, California saves approximately $50.33 in
medical and social service costs.
(g) In order to maximize the success of family planning programs,
incentives should be provided to eliminate barriers to access and
encourage patient utilization.
(h) Recent evaluations of California's family planning programs
found the following:
(1) More than 250,000 unintended pregnancies were averted in 2002
due to the provision of comprehensive family planning services.
(2) Billions of dollars in cost savings to the state are
attributable to the family planning programs' impact on the number of
unintended pregnancies in California.
(3) In addition to savings attributable to averting unintended
pregnancies, more than $10 dollars in medical costs have been saved
through the provision of chlamydia testing and treatment services by
comprehensive family planning programs.
(4) Annual cervical cancer screenings through comprehensive family
planning programs averted more than 10,000 lifetime cases of
cervical cancer, with most averted cases occurring among women who
are younger than 30 years of age.
(5) Although California ranks number one among the states
regarding family planning service availability, government policies,
and public funding, our state continues to face an unmet need for
family planning services by low-income women of 43 percent.
(i) Both the federal and state governments have recognized the
importance of confidentiality and a high trust factor in the
patient-provider relationship for these particularly sensitive
services by requiring that individuals have freedom of choice in
selecting their family planning providers.
(j) The success of California's major family planning programs is
largely attributable to the elimination of barriers to accessing
family planning services, and the comprehensive nature of the
services provided.
(k) It is the intent of the Legislature that clinical family
planning services covered by the Medi-Cal program cover a
comprehensive list of medical services, drugs, and supplies, and that
all barriers to these services be eliminated or minimized to the
greatest extent possible.
SEC. 2. Section 14134.3 is added to the Welfare and Institutions
Code, to read:
14134.3. (a) Notwithstanding any other provision of law, Medi-Cal
programs that provide family planning services shall provide
comprehensive clinical family planning services, as defined in
subdivision (b).
(b) (1) (A) "Comprehensive clinical family planning services"
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, federal Food and Drug
Administration-approved contraceptive drugs, devices, and supplies,
natural family planning, abstinence methods, and basic, limited
fertility management.
(B) Comprehensive clinical family planning services include, but
are not limited to, preconception counseling, maternal and fetal
health counseling, general reproductive health care, including
diagnosis and treatment of infections and conditions, including
cancer, that threaten reproductive capability, medical family
planning treatment and procedures, including supplies and followup,
and informational, counseling, and educational services.
(C) Comprehensive clinical family planning services do not include
abortion, pregnancy testing solely for the purposes of referral for
abortion or services ancillary to abortions, or pregnancy care that
is not incident to the diagnosis of pregnancy.
(2) Comprehensive clinical family planning services shall include
all of the following:
(A) Family planning related services and male and female
sterilization. Family planning services for men and women shall
include emergency services and services for complications directly
related to the contraceptive method, federal Food and Drug
Administration-approved contraceptive drugs, devices, and supplies,
and followup, consultation, and referral services, as indicated, that
may require treatment authorization requests.
(B) All United States Department of Agriculture, federal Food and
Drug Administration-approved contraceptive drugs, devices, and
supplies that are in keeping with current standards of practice and
from that the individual may choose.
(C) Culturally and linguistically appropriate health education and
counseling services, including informed consent, that include all of
the following:
(i) Psychosocial and medical aspects of contraception.
(ii) Sexuality.
(iii) Fertility.
(iv) Pregnancy.
(v) Parenthood.
(vi) Infertility.
(vii) Reproductive health care.
(viii) Preconception and nutrition counseling.
(ix) Prevention, diagnosis, and treatment of sexually transmitted
infection.
(x) Use of contraceptive methods, federal Food and Drug
Administration-approved contraceptive drugs, devices, and supplies.
(xi) Possible contraceptive consequences and followup.
(xii) Interpersonal communication and negotiation of relationships
to assist individuals and couples in effective contraceptive method
use and planning families.
(D) A comprehensive health history, updated at the next periodic
visit, between 11 and 24 months after initial examination, that
includes a complete obstetrical history, gynecological history,
contraceptive history, personal medical history, health risk factors,
and family health history, including genetic or hereditary
conditions.
(E) A complete physical examination on initial and subsequent
periodic visits.
(c) Family planning services shall be provided to all eligible
recipients pursuant to the following requirements:
(1) Medi-Cal programs shall ensure that recipients' appointments
for family planning services are made in a timely fashion.
(2) The programs shall ensure recipients' strict confidentiality
through the providers' policies, procedures, and training.
(3) Family planning patients shall have the right to choose their
family planning provider, so long as the provider is in compliance
with the provider enrollment requirements of the program. A Medi-Cal
managed care plan shall not restrict the choice of the enrollee
regarding the provider from whom the enrollee may receive family
planning services, so long as the provider is a Medi-Cal provider.
(4) Family planning service providers shall have the ability to
provide all covered services, as set forth in subdivision (b),
inhouse. If family planning service providers are unable to provide
these services inhouse, they shall, in a timely fashion, refer
patients to other providers.