BILL ANALYSIS Ó ------------------------------------------------------------ |SENATE RULES COMMITTEE | SB 946| |Office of Senate Floor Analyses | | |1020 N Street, Suite 524 | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ------------------------------------------------------------ THIRD READING Bill No: SB 946 Author: Senate Health Committee Amended: 5/10/11 Vote: 21 SENATE HEALTH COMMITTEE : 9-0, 5/4/11 AYES: Hernandez, Strickland, Alquist, Anderson, Blakeslee, De León, DeSaulnier, Rubio, Wolk SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8 SUBJECT : Public health SOURCE : Author DIGEST : This bill makes various technical and substantive changes in provisions of law regarding telemedicine, Emergency Medical Services funds, food handling, HIV reporting, the Office of HIPAA Implementation, health insurance, and mental health services payments. ANALYSIS : Telemedicine Existing law: 1. For the purpose of health practitioner requirements, community college training programs, health plan CONTINUED SB 946 Page 2 requirements, and medical payments, defines "telemedicine" to mean the practice of health care delivery, diagnosis, consultation, treatment, transfer of medical data, and education using interactive audio, video, or data communications. 2. Requires that the Department of Health Care Services (DHCS) report to the Legislature by January 1, 2008, on the number and type of services provided and the Medi-Cal payments made related to the application of store-and-forward telemedicine. This bill: 1. Replaces references to "telemedicine" with "telehealth." 2. Deletes the reporting requirement. Emergency Medical Services Existing law: 1. Authorizes counties to establish a Maddy Emergency Medical Services (EMS) fund and to deposit specified penalties, forfeitures, and fines into the fund to reimburse physicians and hospitals for losses from providing uncompensated emergency care, and for other EMS purposes as determined by each county. 2. Requires each county establishing a Maddy EMS fund (Maddy fund) to report to the Legislature on the implementation and status of the Maddy fund beginning January 1, 1989 and on each April 15 thereafter. The report must include the total amount of fines and forfeitures collected, the total amount of penalty assessments collected, the total amount of penalty assessments deposited into the Maddy fund, the fund balance, and the amount of moneys disbursed under the program to physicians and surgeons, to hospitals and to other emergency purposes. This bill requires county Maddy fund reports to include additional information on the types of funds received, CONTINUED SB 946 Page 3 administrative costs, fee schedules and methodologies for reimbursing physicians and hospitals, and contact information for county personnel involved in administration of the fund, as specified. Retail Food Existing law, under the California Retail Food Code (CalCode), provides for the regulation of health and sanitation standards for retail food facilities by the Department of Public Health (CDPH) and vests local health agencies with primary responsibility for enforcing this code. Specifies hand-washing procedures and glove usage guidelines for food handlers. This bill: 1. Specifies that hands must be washed by employees prior to donning gloves for working with food or replacing gloves that were changed or replaced due to specified circumstances. Prohibits single-use gloves from being washed. 2. Provides that an employee with a lesion or wound that is open or draining is prohibited from handling food. Specifies precautions that an employee with a cut, sore, rash, lesion or wound must take when contacting food and food-contact surfaces. HIV Reporting Existing law requires health care providers and clinical laboratories to report HIV infection by patient name to the local health officer, and mandates local health officers to report unduplicated HIV cases by patient name to CDPH. Existing regulations mandate the use of CDPH HIV/AIDS Confidential Case Report form, Adult (CDPH 8641A (05/07)) or Pediatric (CDPH 8641P (05/07). This bill authorizes CDPH to develop a form to be used to report cases of HIV infection to the local health department and to the department, and allows the form to be implemented without promulgating new regulations. CONTINUED SB 946 Page 4 Office of HIPAA Implementation Existing law: 1. Establishes the federal Health Insurance Portability and Accountability Act (HIPAA). 2. Establishes the Office of HIPAA Implementation within the Health and Human Services Agency (HHSA). Establishes a Director of the Office and requires the Director to establish an advisory committee to obtain information on statewide HIPAA implementation activities that must meet at least twice per year. Requires all state entities subject to HIPAA to complete an assessment by January 1, 2001, to determine the impact of HIPAA on their operations. This bill renames the office the Office of Health Information Integrity. Deletes a redundant code section that specifies that the Office be under supervision of a director appointed by the Secretary of HHSA. Deletes the outdated requirement to complete the assessment. Revises the frequency with which the advisory committee meets to as needed. Health Insurance Coverage Existing law: 1. Licenses and regulates health plans, by the Department of Managed Health Care (DMHC), and health insurers, by the Department of Insurance (CDI). 2. Prohibits a carrier or solicitor from encouraging or directing a child or responsible party for a child from applying for coverage with a carrier because of health status, claims experience, industry, occupation, or geographic location, provided that the location is within the carrier's approved service area. Prohibits a carrier from entering into a contract, agreement, or arrangement with a solicitor that provides for or results in payment to the solicitor for the sale of a health benefit plan that is varied because of the health status, claims experience, industry, occupation, or CONTINUED SB 946 Page 5 geographic location of the child. This bill: 1. Replaces references to "solicitor" with "agent or broker" or "agent or broker of the carrier" in specified sections of the Insurance Code. 2. Defines "hotdog" to mean "a whole, cured, cooked sausage that is skinless or stuffed in a casing and that is also known as a frankfurter, frank, further, wiener, red hot, Vienna, bologna, garlic bologna, or knockwurst, and that may be served in a bun or roll." 3. Corrects drafting errors, grammatical errors, and code references. Mental Health Existing law authorizes the Department of Mental Health (DMH) to approve negotiated rates and incentive payments for the provision of Short Doyle/Medi-Cal reimbursable community mental health services (SD/MC services). This bill conforms state law to existing federal regulations and current DMH practice by repealing the authorization to approve negotiated rates and incentive payments for SD/MC services. Background Telehealth provisions . Telemedicine is currently described in statute as the practice of health care delivery, diagnosis, consultation, treatment, transfer of medical data, and education using interactive audio, video, or data communications. According to the California Telemedicine and eHealth Center, telemedicine generally refers to the provision of clinical services from a distance, whereas telehealth more commonly refers to a broader scope of services that includes telemedicine, but also includes other services that can be provided remotely using communication technologies. To reflect this shift in terminology used in common practice, SB 946 changes references in existing law from "telemedicine" to CONTINUED SB 946 Page 6 "telehealth." This bill also deletes an outdated requirement that DHCS report to the Legislature on the number and type of services provided and the Medi-Cal payments made related to the application of store-and-forward telemedicine. Store-and-forward telemedicine is technology that allows a provider or technician at the patient site to capture diagnostic information such as medical images, video and audio clips, and transmits the data to a clinician at a remote site for assessment. These provisions were requested by the California State Rural Health Association and the California Primary Care Association. Emergency Medical Services Fund provisions . Beginning in 1987, the state enacted a series of bills to compensate physicians and medical facilities for emergency medical services provided to patients who do not have health insurance and cannot pay for their medical care. SB 12 (Maddy), Chapter 1240, Statutes of 1987, allows counties to establish Maddy EMS funds (also known as Maddy funds). Revenue sources for Maddy funds are penalty assessments on certain criminal and traffic violations, and a portion of the fees from people attending traffic violator schools. Funds from penalty assessments must be used to reimburse physicians and hospitals for patients who do not make payment for EMS services and have no third-party or government source of payment. Counties with Maddy funds are required to report specified information to the Legislature on the status of their funds. SB 946 requires county Emergency Medical Services Fund reports to include additional information in these reports, including: Reasons for the lack of deposits, if no moneys were deposited into the fund; The amount of funds collected from additional assessments levied by counties on fines, penalties, or forfeitures imposed and collected by the courts for criminal offenses, including violations relating to the control of alcoholic beverages and violations of the Vehicle Code; CONTINUED SB 946 Page 7 The amount of money disbursed for actual administrative costs; Fee schedules and methodologies for reimbursing physicians and hospitals; The amount of moneys available to be disbursed to hospitals, and the amount of claims submitted by hospitals, along with the percentage of those claims that were reimbursed; and The name and contact information for county personnel involved in the administration of the fund. The purpose of these provisions is to provide more transparency and allow a better understanding of how these funds are collected and distributed at the local level. This provision was requested by the California Chapter of the American College of Emergency Physicians (CAL/ACEP). FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes Local: Yes CTW:mw 5/19/11 Senate Floor Analyses SUPPORT/OPPOSITION: NONE RECEIVED **** END **** CONTINUED