BILL NUMBER: SB 136	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  JUNE 22, 2011
	AMENDED IN SENATE  MAY 19, 2011
	AMENDED IN SENATE  APRIL 28, 2011

INTRODUCED BY   Senator Yee

                        JANUARY 31, 2011

    An act to amend Section 14132.725 of the Welfare and
Institutions Code, relating to Medi-Cal.   An act to
amend Section 4217.12 of the Government Code, relating to public
contracts. 



	LEGISLATIVE COUNSEL'S DIGEST


   SB 136, as amended, Yee.  Medi-Cal: telemedicine.
  Energy services contracts: prevailing wages. 

   Existing law defines "public works," for purposes of regulating
public works contracts, as, among other things, construction,
alteration, demolition, installation, or repair work done under
contract and paid for, in whole or in part, out of public funds.
Existing law further requires that, except as specified, not less
than the general prevailing rate of per diem wages be paid to workers
employed on public works and imposes misdemeanor penalties for a
violation of this requirement. Existing law provides that for the
purposes of provisions of law relating to the payment of prevailing
wages, "public works" includes specified types of construction,
alteration, demolition, installation, and repair work.  
   Existing law authorizes public agencies to enter into energy
service contracts and any necessarily related facility ground lease
on terms that its governing body determines are in the best interests
of the public agency, as specified.  
   This bill would provide that energy services contracts entered
into under the above provisions are public works for purposes of the
prevailing wage requirements, as specified.  
   Because the violation of prevailing wage requirements by local
public entities when engaged in these public works projects would
result in the imposition of misdemeanor penalties, this bill would
impose a state-mandated local program.  
   The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.  
   This bill would provide that no reimbursement is required by this
act for a specified reason.  
   Existing law establishes the Medi-Cal program, administered by the
State Department of Health Care Services, under which basic health
care services are provided to qualified low-income persons. The
Medi-Cal program is, in part, governed and funded by federal Medicaid
Program provisions. Existing law provides, to the extent that
federal financial participation is available, that face-to-face
contact between a health care provider and a patient shall not be
required under the Medi-Cal program for teleophthalmology and
teledermatology by store and forward, as defined. Existing law
requires the department to report to the Legislature, on or before
January 1, 2008, the number and type of services provided, and the
payments made related to the application of store and forward
telemedicine as a Medi-Cal benefit. Existing law repeals these
provisions on January 1, 2013.  
   This bill would revise this reporting requirement, as specified,
would require the department to require providers to use the
appropriate billing code, and would extend the implementation of
these provisions until January 1, 2018. 
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program:  no   yes  .


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

   SECTION 1.    Section 4217.12 of the  
Government Code   is amended to read: 
   4217.12.  (a) Notwithstanding any other  provision of
 law, a public agency may enter into an energy service
contract and any necessarily related facility ground lease on terms
that its governing body determines are in the best interests of the
public agency if the determination is made at a regularly scheduled
public hearing, public notice of which is given at least two weeks in
advance, and if the governing body finds:
   (1) That the anticipated cost to the public agency for thermal or
electrical energy or conservation services provided by the energy
conservation facility under the contract will be less than the
anticipated marginal cost to the public agency of thermal,
electrical, or other energy that would have been consumed by the
public agency in the absence of those purchases.
   (2) That the difference, if any, between the fair rental value for
the real property subject to the facility ground lease and the
agreed rent, is anticipated to be offset by below-market energy
purchases or other benefits provided under the energy service
contract.
   (b) State agency heads may make these findings without holding a
public hearing. 
   (c) Energy service contracts entered into pursuant to this section
shall constitute public works projects and comply with Chapter 1
(commencing with Section 1720) of Part 7 of Division 2 of the Labor
Code. 
   SEC. 2.    No reimbursement is required by this act
pursuant to Section 6 of Article XIII B of the California
Constitution because the only costs that may be incurred by a local
agency or school district will be incurred because this act creates a
new crime or infraction, eliminates a crime or infraction, or
changes the penalty for a crime or infraction, within the meaning of
Section 17556 of the Government Code, or changes the definition of a
crime within the meaning of Section 6 of Article XIII B of the
California Constitution.  
  SECTION 1.    Section 14132.725 of the Welfare and
Institutions Code is amended to read:
   14132.725.  (a) For purposes of this section, "teleophthalmology
and teledermatology by store and forward" means an asynchronous
transmission of medical information to be reviewed at a later time by
a physician at a distant site who is trained in ophthalmology or
dermatology or, for teleophthalmology, by an optometrist who is
licensed pursuant to Chapter 7 (commencing with Section 3000) of
Division 2 of the Business and Professions Code, where the physician
or optometrist at the distant site reviews the medical information
without the patient being present in real time.
   (b) (1) Commencing July 1, 2006, to the extent that federal
financial participation is available, face-to-face contact between a
health care provider and a patient shall not be required under the
Medi-Cal program for teleophthalmology and teledermatology by store
and forward. Services appropriately provided through the store and
forward process are subject to billing and reimbursement policies
developed by the department.
   (2) Commencing with the next available general provider bulletin
after January 1, 2012, the department shall require providers billing
for store and forward teleophthalmology and teledermatology to use
the appropriate billing code.
   (3) A patient receiving teleophthalmology or teledermatology by
store and forward shall be notified of the right to receive
interactive communication with the distant specialist physician or
optometrist, and shall receive an interactive communication with the
distant specialist physician or optometrist, upon request. If
requested, communication with the distant specialist physician or
optometrist may occur either at the time of the consultation, or
within 30 days of the patient's notification of the results of the
consultation. If the reviewing optometrist identifies a disease or
condition requiring consultation or referral pursuant to Section 3041
of the Business and Professions Code, that consultation or referral
shall be with an ophthalmologist or other appropriate physician and
surgeon, as required.
   (c) 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, interpret, and make specific this section
by means of all-county letters, provider bulletins, and similar
instructions.
   (d) The health care provider shall comply with the informed
consent provisions of subdivisions (c) to (g), inclusive, of, and
subdivisions (i) and (j) of, Section 2290.5 of the Business and
Professions Code when a patient receives teleophthalmology or
teledermatology by store and forward.
   (e) The department shall report to the appropriate policy and
fiscal committees of the Legislature no later than January 1, 2015,
and again no later than January 1, 2017, all of the following:
   (1) The number and dollar amount of claims billed under the
program established by this section for every year that it has been
implemented.
   (2) The number and dollar amount of all ophthalmology and
dermatology claims for all years that the program established by this
section has been implemented.
   (3) The number and dollar amount of all ophthalmology and
dermatology claims for the three years prior to the authorization of
store and forward.
   (f) This section shall remain in effect only until January 1,
2018, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2018, deletes or extends
that date.