BILL NUMBER: AB 1314	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  APRIL 13, 2009

INTRODUCED BY   Assembly Member Jones

                        FEBRUARY 27, 2009

   An act to add Article 5.5 (commencing with Section 14182) to
Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions
Code, relating to Medi-Cal.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 1314, as amended, Jones. Medi-Cal: health care coverage.
   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. The Medi-Cal program is, in part, governed and funded by
federal Medicaid provisions.
   This bill would require  the department, no later than
February 1, 2010, in consultation with the Legislature, to develop
and submit an application to the federal Centers for Medicare and
Medicaid Services for a waiver that would meet certain objectives,
  the California Health and Human Services Agency, in
consultation with specified entities, to develop a plan to enact
comprehensive reforms to the California health care system and to
make recommendations for   statutory changes necessary to
implement the plan. The plan would include strategies to accomplish
various goals,  including, but not limited to, expanding health
care coverage for low- and moderate-income children and adults 
through a shared responsibility approach that includes contributions
from individuals, employers, and the government,  and reducing
the number of uninsured persons in the state.  The bill would
condition implementation of the waiver upon the enactment of
subsequent statutory authorization.   The agency would
be required to provide the plan and recommendations to the
Legislature no later than April 1, 2010. 
   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.  Article 5.5 (commencing with Section 14182) is added to
Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions
Code, to read:

      Article 5.5.  Health Care Coverage Expansion


   14182.   (a)     The
State Department of Health Care Services, no later than February 1,
2010, in consultation with the Legislature, shall develop and submit
an application to the federal Centers for Medicare and Medicaid
Services for a waiver that would meet all of the following
objectives:   The California Health and Human Services
Agency, in consultation with consumers, health care providers, and
other health care stakeholders, shall develop a plan to enact
comprehensive refor   ms to the California health care
system and make recommendations for statutory changes necessary to
  implement the plan. The agency shall provide the plan and
statutory recommendations to the Legislature no later than April 1,
2010. The plan shall include strategies to accomplish all of the
following:  
   (1) 
    (a)  Expand health care coverage for low- and
moderate-income children and  adults.   adults,
including assistance for those who are most unable to afford to pay
for their own coverage, through a shared responsibility approach that
includes contributions from individuals, employers, and the
government.  
   (2) 
    (b)  Reduce the number of uninsured persons in the
state. 
   (3) 
    (c)  Maximize federal funds for health care coverage and
ensure that California receives federal funds at the maximum
allowable level to match all available state and local expenditures
for health care. 
   (4) 
    (d)  Establish appropriate provider fees to leverage
federal resources and maximize state and local revenues for health
care. 
   (5) 
    (e)  Revise and increase provider payments to ensure
adequate access to primary and specialty health care for persons in
state and local sponsored health care programs. 
   (6) 
    (f)  Reward health care providers for quality care and
enhanced performance. 
   (7) 
    (g)  Secure funding and establish reimbursement
mechanisms to support a vigorous and accountable health care safety
net and delivery system. 
   (8) 
    (h)  Improve fee-for-service health care delivery
systems in state and local health care programs to better coordinate
and manage health care services, emphasize timely primary and
preventive care, and reduce the use and overuse of high-cost
emergency and hospital inpatient services. 
   (9) 
    (i)  Improve coordination and efficiency of state and
local health care programs and mental health care programs. 
   (b) If the federal Centers for Medicare and Medicaid Services
approves the waiver, the department shall only implement the waiver
upon enactment of subsequent statutory authorization.