BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                            



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                                    THIRD READING


          Bill No:  AB 39
          Author:   Skinner (D), et al.
          Amended:  8/20/14 in Senate
          Vote:     27 - Urgency

           
          PRIOR VOTES NOT RELEVANT


           SUBJECT  :    Medi-Cal:  designated public hospitals

           SOURCE  :     Author


           DIGEST  :    This bill designates Doctors San Pablo as a  
          Designated Public Hospital (DPH), thereby allowing the hospital  
          to access federal Medicaid funds under the states Section 1115  
          Bridge to Reform Medicaid waiver for which they have not  
          received federal approval.

           Senate Floor Amendments  of 8/20/14 delete the prior version of  
          this bill relating to energy conservation and instead add the  
          current language.

           ANALYSIS  :    

          Existing law:

          1.Provides for the Medi-Cal program, which is administered by  
            the Department of Health Care Services (DHCS), under which  
            qualified low-income individuals receive health care services.  
             The Medi-Cal program is, in part, governed and funded by  
            federal Medicaid Program provisions.
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          2.Establishes the Medi-Cal Hospital/Uninsured Care Demonstration  
            Project Act (Act), which revises hospital supplemental payment  
            methodologies under the Medi-Cal program in order to maximize  
            the use of federal funds consistent with federal Medicaid law  
            and to stabilize the distribution of funding for hospitals  
            that provide care to Medi-Cal beneficiaries and uninsured  
            patients. 

          3.Requires DHCS to seek a successor demonstration project or  
            federal waiver of Medicaid law to implement specified  
            objectives, which may include better care coordination for  
            seniors, persons with disabilities, and children with special  
            health care needs.  Provides that to the extent the provisions  
            under the Act do not conflict with the provisions of, or the  
            Special Terms and Conditions of, this demonstration project,  
            the provisions of the Act apply. 

          4.Defines DPHs and requires DPHs to be eligible for specified  
            payments under the demonstration project.

          This bill:

          1.Defines Doctors San Pablo as a DPH, thereby changing how the  
            hospital is reimbursed by Medi-Cal.  Defining Doctors San  
            Pablo as a DPH makes the hospital eligible for cost-based  
            reimbursement in fee-for-service Medi-Cal for inpatient  
            services, but shifts the funding source used to draw down the  
            federal match for these services and disproportionate share  
            (DSH) payments from the state General Fund to local funds  
            (Doctors San Pablo is not a DSH hospital now).  Clarifies that  
            defining Doctors San Pablo as a DPH enables it to access  
            federal funds from the Safety Net Care Pool and the Delivery  
            System Reform Incentive Pool (non-designated public hospitals  
            (NDPH) [Doctors Medical Center is an NDPH] are eligible under  
            state law for these funds but federal approval has not been  
            granted for NDPH to receive these funds).

          2.Appropriates $3 million from the General Fund to the West  
            Contra Costa Healthcare District for support of the Doctors  
            Medical Center.

          3.Makes legislative findings and declarations that a special law  
            is necessary because of the unique circumstances regarding  







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            financing of the West Contra Costa Healthcare District.

          4.Takes effect immediately as an urgency statute.  States the  
            facts constituting the necessity for an urgency statue is in  
            order to prevent the imminent closure of a critical component  
            of the West Contra Costa County safety net by providing  
            funding comparable to other safety net hospitals.

           FISCAL EFFECT  :    Appropriation:  Yes   Fiscal Com.:  Yes    
          Local:  No


          JL:k  8/21/14   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  NONE RECEIVED

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