BILL NUMBER: AB 272	AMENDED
	BILL TEXT

	AMENDED IN SENATE  AUGUST 30, 2011
	AMENDED IN ASSEMBLY  MARCH 7, 2011

INTRODUCED BY   Assembly Member Monning

                        FEBRUARY 7, 2011

    An act to amend Section 12923.5 of, and to repeal
Sections 12693.925 and 12693.95 of, the Insurance Code, relating to
health care coverage.   An act to add Section 15438.10
to the Government Code, relating to health facilities financing, and
making an appropriation therefor. 


	LEGISLATIVE COUNSEL'S DIGEST


   AB 272, as amended, Monning.  Health care coverage:
agencies: reports.  Health care facilities: financing.
 
   The California Health Facilities Financing Authority Act
authorizes the California Health Facilities Financing Authority to
make loans from the continuously appropriated California Health
Facilities Financing Authority Fund to participating health
institutions for financing or refinancing the acquisition,
construction, or remodeling of health facilities. The act defines a
health facility to include various specified facilities and
facilities operated in conjunction with these facilities. It also
defines a participating health institution to mean specified entities
authorized by state law to provide or operate a health facility and
undertake the financing or refinancing of the construction or
acquisition of a project or of working capital, as defined. 

   Existing law authorizes the authority to award grants to any
eligible health facility, as defined, for purposes of financing
defined projects.  
   This bill would authorize the authority to award one or more
grants that, in the aggregate, do not exceed $1,500,000 to one or
more projects designed to demonstrate new or enhanced methods of
delivering health care services, as specified. This bill would
authorize the authority to award additional grants that, in the
aggregate, do not exceed $5,000,000 to eligible recipients, as
defined by the authority, to replicate the model developed by a
project, if specified conditions are met, and would authorize the
authority to adopt regulations relating to this grant program as
emergency regulations. By expanding the purposes for which a
continuously appropriated fund may be used, this bill would make an
appropriation. 
   Existing law requires the Managed Risk Medical Insurance Board to,
by January 20, 2004, report to the Legislature specified information
with regard to the State Children's Health Insurance Program.
Existing law requires the board to provide, by April 15, 1998, a
proposal relating to drug and alcohol treatment programs for
children.  
   This bill would delete those obsolete provisions. 

   Existing law requires the Department of Managed Health Care and
the Department of Insurance to maintain a joint senior level working
group to ensure clarity for health care consumers about who enforces
their patient rights and consistency in the regulations of these
departments. Existing law requires the working group to report its
findings for review by the Insurance Commissioner and the Director of
the Department of Managed Health Care for review and approval and
submission every 5 years to the Legislature.  
   This bill would delete those reporting requirements. 
   Vote: majority. Appropriation:  no   yes
 . Fiscal committee: yes. State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    Section 15438.10 is added to the 
 Government Code  , to read:  
   15438.10.  (a) The Legislature finds and declares the following:
   (1) Many Californians face serious obstacles in obtaining needed
health care services, including, but not limited to, medical, mental
health, and dental services. The obstacles include the existence of
complex medical, physical, or social conditions, including
disabilities, economic disadvantage, and living in remote or
underserved areas that make it difficult to access services.
   (2) With the recent passage of national health care reform, there
is an increased demand for innovative ways to deliver health care to
individuals in a cost-effective manner.
   (3) Technological innovation continues to create opportunities for
developing new methods of delivering needed services to underserved
communities and individuals cost-effectively and with improved health
outcomes.
   (4) There is a need to develop new methods of delivering health
services utilizing innovative models that can be demonstrated to be
effective and then replicated throughout California and that bring
needed care to individuals in need where they live or receive
education, social, or general health services.
   (5) For more than 30 years, the California Health Facilities
Financing Authority has provided financial assistance through
tax-exempt bonds, low interest loans, and grants to health facilities
in California, assisting in the expansion of the availability of
health services and health care facilities throughout the state.
   (b) (1) Following the completion of a competitive selection
process that shall be exempt from the competitive bidding
requirements of Chapter 2 (commencing with Section 10290) of Part 2
of Division 2 of the Public Contract Code, the authority may award
one or more grants that, in the aggregate, do not exceed one million
five hundred thousand dollars ($1,500,000) to one or more projects
designed to demonstrate specified new or enhanced methods of
delivering health care services to improve access to quality health
care for underserved or medically vulnerable populations or
communities, or both, that are effective at enhancing health
outcomes, reducing costs, and improving access to care. These health
care services may include, but are not limited to, medical, mental
health, or dental services for the diagnosis, care, prevention, and
treatment of human illness, or individuals with physical, mental, or
developmental disabilities. More than one demonstration project may
receive a grant pursuant to this section. It is the intent of the
Legislature for a demonstration project that receives a grant to
allow patients to receive screenings, diagnosis, and treatment in
community settings, including, but not limited to, school-based
health centers, adult day care centers, and residential care
facilities for the elderly, and for individuals with mental illness
or developmental disabilities. It is also the intent of the
Legislature for a demonstration project that receives a grant to take
advantage of advances in telecommunications technologies that will
produce a more accessible and cost-effective delivery system for
needed services and improved health outcomes.
   (2) A grant awarded pursuant to this subdivision may be allocated
in increments to a demonstration project over multiple years to
ensure the ability of each demonstration project to complete its
work, as determined by the authority. Prior to the initial allocation
of funds pursuant to this subdivision, the administrators of the
demonstration project shall provide evidence that the demonstration
project has or will have additional funds sufficient to ensure
completion of the demonstration project. If the authority allocates a
grant in increments, each subsequent year's allocation shall be
provided to the demonstration project only upon submission of
research that shows that the project is progressing towards the
identification of a community-based, cost-effective delivery model
that addresses obstacles to receiving health care services in more
traditional settings, improves health outcomes for vulnerable
populations, and can be replicated throughout the state.
   (c) (1) If a demonstration project that receives a grant pursuant
to subdivision (b) is successful at developing a new method of
delivering cost effective community-based health care services that
result in improved health care outcomes, then, beginning in the third
year after the initial allocation of moneys provided pursuant to
subdivision (b), the authority may implement a second grant program
that awards not more than five million dollars ($5,000,000), in the
aggregate, to eligible recipients as defined by the authority, to
replicate in additional California communities the model developed by
a demonstration project that received a grant pursuant to
subdivision (b). Prior to the implementation of this second grant
program, the authority shall prepare and provide a report to the
Legislature and the Governor on the outcomes of the demonstration
project. The report shall be made in accordance with Section 9795.
   (2) If the authority implements the second grant program, the
authority shall also report annually, beginning with the first year
of implementation of the second grant program, to the Legislature and
the Governor regarding the program, including, but not limited to,
the total amount of grants issued pursuant to this subdivision, the
amount of each grant issued, and a description of each demonstration
project awarded funding.
   (3) Grants under this subdivision may be utilized for eligible
costs, as defined in subdivision (c) of Section 15432, including
equipment, information technology, and working capital, as defined in
subdivision (h) of Section 15432.
   (4) The authority may adopt regulations relating to the grant
program authorized pursuant to this subdivision, including
regulations that define eligible recipients, eligible costs, and
minimum and maximum grant amounts, as emergency regulations in
accordance with Chapter 3.5 (commencing with Section 11340) of Part 1
of Division 3 of Title 2. For purposes of Chapter 3.5 (commencing
with Section 11340) of Part 1 of Division 3 of Title 2, including
Section 11349.6, the adoption of the regulations shall be considered
by the Office of Administrative Law to be necessary for the immediate
preservation of the public peace, health and safety, and general
welfare.  
  SECTION 1.    Section 12693.925 of the Insurance
Code is repealed.  
  SEC. 2.    Section 12693.95 of the Insurance Code
is repealed.  
  SEC. 3.    Section 12923.5 of the Insurance Code
is amended to read:
   12923.5.  (a) The Department of Managed Health Care and the
Department of Insurance shall maintain a joint senior level working
group to ensure clarity for health care consumers about who enforces
their patient rights and consistency in the regulations of these
departments.
   (b) The joint working group shall undertake a review and
examination of the Health and Safety Code, the Insurance Code, and
the Welfare and Institutions Code as they apply to the Department of
Managed Health Care and the Department of Insurance to ensure
consistency in consumer protection.
   (c) The joint working group shall review and examine all of the
following processes in each department:
   (1) Grievance and consumer complaint processes, including, but not
limited to, outreach, standard complaints, including coverage and
medical necessity complaints, independent medical review, and
information developed for consumer use.
   (2) The processes used to ensure enforcement of the law,
including, but not limited to, the medical survey and audit process
in the Health and Safety Code and market conduct exams in the
Insurance Code.
   (3) The processes for regulating the timely payment of claims.