Amended in Senate August 5, 2014

Amended in Senate July 1, 2014

Amended in Senate June 16, 2014

Amended in Assembly January 16, 2014

Amended in Assembly January 6, 2014

California Legislature—2013–14 Regular Session

Assembly Bill No. 357

Introduced by Assembly Member Pan

February 14, 2013

An act to repeal Chapter 13 (commencing with Section 12693.90) of Part 6.2 of Division 2 of the Insurance Code, and to add Section 14005.271 to the Welfare and Institutions Code, relating to child health.

LEGISLATIVE COUNSEL’S DIGEST

AB 357, as amended, Pan. Medi-Cal Children’s Health Advisory Panel.

Existing law requires the state to implement and administer various child health and disease prevention programs. Existing law establishes the Healthy Families Advisory Board, a 15-member advisory panel appointed by the Managed Risk Medical Insurance Board. Existing law provides for the transition of children from the Healthy Families Program to Medi-Cal, including the transfer of the Healthy Families Advisory Board to the State Department of Health Care Services.

This bill would repeal the Healthy Families Advisory Board and instead rename and recast the board as the Medi-Cal Children’s Health Advisory Panel, an independent, statewide advisory body composed of begin delete 19 end delete begin insert 15 end insert members charged with advising the State Department of Health Care Services on matters relevant to all children enrolled in Medi-Cal and their families, as specified. The bill would require that panel members, except as otherwise specified, be appointed by the department. The bill would specify the powers and duties of the panel and the department in this regard and would require that the department submit, on or before January 1, 2018, begin delete and every 5 years thereafter, end delete a report to the Legislature on the advisory panel’s accomplishments, effectiveness, efficiency, and any recommendations for begin delete improving end delete begin insert statutory changes needed to improve end insert the ability of the advisory panel to fulfill its purpose.

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.  

The Legislature finds and declares all of the
following:

(a) The health and well-being of California’s children should
be among the state’s top priorities, and it is imperative that every
child in California has meaningful health coverage with benefits
that support healthy growth and development.

(b) Children’s health coverage should encompass more than
just treatment of diseases and illnesses, but also cover services and
care to promote healthy development and well-being, identify and
intervene in problems early on, and prevent chronic disease.

(c) All children should receive care that meets recognized
standards of practice.

(d) For the first time in history, the current generation of children
is likely to be less healthy than their parents and live shorter lives.

(e) The incidences and types of chronic disease in children have
both increased and changed dramatically over the past four decades.
One in five children has a mental health problem, and the number
of overweight children has tripled for preschoolers and adolescents
and quadrupled for children 6 to 11 years of age, inclusive.

(f) In 2013, California moved over 750,000 children who had
previously been enrolled in Healthy Families, California’s
Children’s Health Insurance program, into Medi-Cal, California’s
Medicaid program.

(g) Medi-Cal now provides health coverage for roughly 5 million
children, approximately one-half of all California children.

(h) Children eligible for Medi-Cal, including children with
chronic medical conditions and infectious diseases eligible for
California Children’s Services, foster youth and former foster
youth up to 26 years of age, and children from medically
underserved ethnic and geographic populations, are often those
who experience the greatest challenges in accessing a variety of
the high-quality services they need.

(i) In authorizing the Healthy Families transition, the Legislature
authorized the transfer of the Healthy Families Advisory Panel to
the State Department of Health Care Services, which oversees
Medi-Cal.

(j) The Healthy Families Advisory Panel was a 15-member
panel of stakeholders, including parents of children enrolled in
Healthy Families, that advised the Managed Risk Medical
Insurance Board on all policies, regulations, operations, and
implementation of the Healthy Families Program since the
program’s inception in 1998, made recommendations that helped
improve the quality of care for children in Healthy Families, and
served as an important venue for parents of enrollees, active
providers, and other experts to discuss ways to improve the
program.

(k) The modern epidemics facing children today have lifelong
consequences and present significant costs to the economy. The
failure to ensure the health of our children enrolled in Medi-Cal
may jeopardize their ability to function effectively as adults and
for our state to remain strong and competitive in our global society.

begin insert

(l) Children enrolled in Medi-Cal and their families should
benefit from the Medi-Cal Children’s Health Advisory Panel
eventually adopting changes that would allow the panel to better
function in its new environment at the State Department of Health
Care Services and within the changing landscape of the Medi-Cal
program and its stakeholder and advisory processes.

end insert

SEC. 2.  

Chapter 13 (commencing with Section 12693.90) of
Part 6.2 of Division 2 of the Insurance Code is repealed.

SEC. 3.  

Section 14005.271 is added to the Welfare and
Institutions Code, immediately following Section 14005.27, to
read:

14005.271.  

(a) The Healthy Families Advisory Board
established by former Section 12693.90 of the Insurance Code is
hereby renamed the Medi-Cal Children’s Health Advisory Panel.

(b) The Medi-Cal Children’s Health Advisory Panel shall be
an independent, statewide advisory board that shall advise the State
Department of Health Care Services on matters relevant to all
children enrolled in Medi-Cal and their families, including, but
not limited to, emerging trends in the care of children, quality
measurements, communications between the State Department of
Health Care Services and Medi-Cal families, provider network
issues, and Medi-Cal enrollment issues.

(c) The membership of the advisory panel shall be composed
of the following begin delete 19 end delete begin insert 15 end insert members:

begin delete

(1) Three providers who currently participate in Medi-Cal,
including each of the following:

end delete begin delete

(A)

end delete

begin insert (1) end insert  One member who is a licensed, practicing dentist.

begin delete

(B)

end delete

begin insert (2) end insert  One physician and surgeon who is board certified in the area
of family practice medicine.

begin delete

(C)

end delete

begin insert (3) end insert  One physician and surgeon who is board certified in
pediatrics.

begin delete

(2) Five representatives of provider organizations that currently
participate in Medi-Cal, including each of the following:

end delete begin delete

(A)

end delete

begin insert (4) end insert  One representative from a licensed nonprofit primary care
clinic.

begin delete

(B)

end delete

begin insert (5) end insert  One representative from the mental health provider
community.

begin delete

(C)

end delete

begin insert (6) end insert  One representative of the substance abuse provider
community.

begin delete

(D)

end delete

begin insert (7) end insert  One representative of the county public health provider
community.

begin delete

(E)

end delete

begin insert (8) end insert  One representative from a licensed hospital that is on the
disproportionate share list maintained by the State Department of
Health Care Services.

begin delete

(3) (A) Five representatives of the Medi-Cal population, one
of each of the following:

(i)

end delete

begin insert (9) end insert  A current or former foster youth; an attorney, social worker,
probation officer, or court appointed special advocate who currently
represents one or more foster youth; a foster care service provider;
or a child welfare advocate.

begin delete

(ii)

end delete

begin insert (10) end insert  A parent of a Medi-Cal enrollee who has received treatment
services under the California Children’s Services Program within
the past six months.

begin delete

(iii)

end delete

begin insert (11) end insert  A Medi-Cal enrollee who has received services under the
Access for Infants and Mothers Program within the past six months.

begin delete

(iv)

end delete

begin insert (12) end insert  A parent or legal guardian of a Medi-Cal enrollee under
21 years of age who has received mental health services under the
Early and Periodic Screening, Diagnostic, and Treatment Program
(EPSDT) within the past six months.

begin delete

(v) A parent or legal guardian of a Medi-Cal enrollee who has
received services from the enrollee’s Medi-Cal dental managed
care plan within the past year.

end delete begin delete

(B) If a representative cannot be identified to meet the
requirements of any clause in subparagraph (A), a parent or legal
guardian of any Medi-Cal enrollee may be appointed to participate
in lieu of the individual specified in that clause.

end delete begin delete

(4) One representative appointed by the Senate Committee on
Rules.

end delete begin delete

(5) One representative appointed by the Speaker of the
Assembly.

end delete begin delete

(6) Four additional representatives, including each of the
following:

end delete begin delete

(A)

end delete

begin insert (13) end insert  One representative from the health plan community.

begin delete

(B)

end delete

begin insert (14) end insert  One representative from the business community.

begin delete

(C)

end delete

begin insert (15) end insert  One representative from the education community.

begin delete

(D) One in-person assister currently certified to enroll
individuals in Medi-Cal.

end delete

(d) The advisory panel shall elect, from among its members, its
chair. begin delete The chair shall be considered a member of the State
Department of Health Care Service’s Stakeholder Advisory
Committee. end delete begin insert In order to coordinate the activities of the advisory
panel with other advisory bodies whose scope includes children
enrolled in Medi-Cal, the chair shall keep apprised of relevant
Medi-Cal stakeholder meetings by communicating with State
Department of Health Care Services staff assisting the advisory
panel. end insert

(e) The advisory panel members, except as otherwise specified
in paragraphs (4) and (5) of subdivision (c), shall be appointed by
the State Department of Health Care Services, or in the case of
vacancies of three months or greater, by the begin delete chair, except for
vacancies for positions appointed pursuant to paragraphs (4) and
(5) of subdivision (c). end delete begin insert chair. end insert

(f) The advisory panel’s powers and duties include, but are not
limited to, begin delete all end delete begin insert both end insert of the following:

(1) To advise the Director of Health Care Services on all
policies, regulations, and operations of the Medi-Cal program
related to providing health care services to children.

(2) To meet at least quarterly, unless deemed unnecessary by
the chair.

(g) The State Department of Health Care Services’ powers and
duties shall include, but not be limited to, all of the following:

(1) To provide general support and staff assistance to the
advisory panel.

(2) To convene and attend meetings of the advisory panel begin insert at
least end insert quarterly, unless deemed unnecessary by the chair, at
locations that are easily accessible to the public and advisory panel
members, are of sufficient duration for presentation, discussion,
and public comment on each agenda item, and are in accordance
with the Bagley-Keene Open Meeting Act (Article 9 (commencing
with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title
2 of the Government Code).

begin delete

(3) To consider all written recommendations of the advisory
panel and respond in writing to each written recommendation.

(4)

end delete

begin insert (3) end insert  To reimburse the members of the advisory panel for all
necessary travel expenses associated with the activities of the
advisory panel, and to provide a stipend of one hundred dollars
($100) per meeting attended to each panel member who is a
Medi-Cal enrollee or a parent of a Medi-Cal enrollee.

begin delete

(5)

end delete

begin insert (4) end insert  To maintain an Internet Web page on the department’s
Internet Web site dedicated to the advisory panel that shall include,
but not be limited to, all of the following:

(A) The purpose and scope of the advisory panel.

(B) The current membership of the advisory panel.

(C) A list of past and future meetings.

(D) Agendas and other materials made available for past and
future meetings.

(E) Recommendations submitted to the department by the
advisory panel.

(F) The department’s responses to recommendations submitted
by the advisory panel.

(G) Contact information for department staff assisting the
advisory panel.

begin delete

(6)

end delete

begin insert (5) end insert  To inform advisory panel members when new information
is posted to the Internet Web page dedicated to the advisory panel.

begin delete

(7)

end delete

begin insert (6) end insert  Notwithstanding Section 10231.5 of the Government Code,
to submit on or before January 1, 2018, begin delete and every five years
thereafter, end delete a report to the Legislature on the advisory panel’s
accomplishments, effectiveness, efficiency, and any
recommendations for begin delete improving end delete begin insert statutory changes needed to
improve end insert the ability of the advisory panel to fulfill its purpose. The
report shall be submitted in compliance with Section 9795 of the
Government Code.

(h) The Legislature does not intend the addition of this section
to result in a new panel, but rather a continuation of the prior panel
established by former Section 12693.90 of the Insurance Code.
New panel members shall not be appointed until a vacancy occurs.