BILL ANALYSIS                                                                                                                                                                                                    �




                   Senate Appropriations Committee Fiscal Summary
                            Senator Kevin de Le�n, Chair


          AB 505 (Nazarian) - Medi-Cal: managed care: language assistance  
          services.
          
          Amended: June 19, 2013          Policy Vote: Health 6-2
          Urgency: No                     Mandate: No
          Hearing Date: June 24, 2013                             
          Consultant: Brendan McCarthy    
          
          This bill does not meet the criteria for referral to the  
          Suspense File.
          
          
          Bill Summary: AB 505 would require all Medi-Cal managed care  
          plans to provide oral interpretation services to individuals on  
          a 24-hour basis at key points of contact. The bill would also  
          require Medi-Cal managed care plans to translate certain  
          documents into certain languages.

          Fiscal Impact: 
              Ongoing costs likely between $40,000 and $75,000 every  
              three years to determine the thresholds for translating  
              documents by Medi-Cal manage care plans by the Department of  
              Health Care Services (50% General Fund, 50% federal funds). 

              No significant increased costs for providing interpretation  
              and translation services are expected. This bill essentially  
              recodifies existing law and practice, see below.

          Background: The state's Medi-Cal program provides health care  
          services to seniors, the disabled, and certain low income  
          children and their parents. About 5.2 million Medi-Cal  
          beneficiaries (about 70% of the total Medi-Cal population)  
          receive their health care through Medi-Cal managed care. In  
          addition, the state is in the process of shifting certain  
          populations (seniors and persons with disabilities, rural  
          Medi-Cal beneficiaries, and individuals eligible for both  
          Medi-Cal and Medicare) from fee-for-service to managed care. In  
          total, these initiatives are likely to shift about two million  
          Medi-Cal beneficiaries to managed care.

          The federal Civil Rights Act of 1964 and implementing  
          regulations prohibit the discrimination against any person based  








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          on race, color, or national origin by entities that receive  
          federal assistance. The federal Office for Civil Rights enforces  
          these requirements and has indicated through guidance that  
          entities receiving federal funding may be required to provide  
          access to translation services for limited English-speaking  
          program beneficiaries.

          Current state law requires all licensed managed care plans to  
          provide interpretation services to enrollees who are limited  
          English proficient. Current law also requires all licensed  
          managed care plans to provide translation services based on the  
          concentration of non-English speaking enrollees. These  
          requirement apply to Medi-Cal managed care plans, but allow the  
          regulatory agencies to deem Medi-Cal managed care plans in  
          compliance if they meet more stringent requirements through  
          contractual requirements.

          Proposed Law: AB 505 would require all Medi-Cal managed care  
          plans to provide oral interpretation services to individuals on  
          a 24-hour basis at key points of contact. 

          The bill would require Medi-Cal managed care plans to translate  
          certain documents into certain non-English languages. 

          The  bill specifies the thresholds at which managed care plans  
          would be required to translate documents. Specifically, the bill  
          would require translation services to be provided to Medi-Cal  
          beneficiaries who have been mandatorily enrolled in managed care  
          and have indicated that their primary language is not English if  
          1) more than 3,000 live in a managed care plan service area, or  
          2) more than 1,000 live within a single zip code or more than  
          1,500 live within two contiguous zip codes.

          The bill would require the Department of Health Care Services to  
          determine when the thresholds above are met, at least every  
          three years.

          The requirements of the bill would not apply to mental health  
          plans.

          Related Legislation: AB 411 (Pan) would require all Medi-Cal  
          managed care plans to analyze performance measures by race,  
          ethnicity, and primary language to identify disparities in the  
          delivery of services. That bill is in the Senate Health  








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          Committee.

          Staff Comments: The Administrative Procedure Act (beginning at  
          Section 11340 of the Government Code) prohibits state agencies  
          from issuing or enforcing any rule, regulation, order, or  
          standard of general application unless it has been issued as a  
          regulation under the Administrative Procedure Act. 

          Under current practice, the Department has set the translation  
          thresholds through letters to managed care plans. Because this  
          bill requires the Department to set these thresholds and does  
          not exempt the Department from the Administrative Procedures Act  
          requirements, the Department will likely have to adopt these  
          requirements as regulations.
          
          As noted above, Medi-Cal managed care plans are already required  
          under federal and state law to provide interpretation and  
          translation services to enrollees. This bill generally  
          recodifies those requirements. The bill codifies current  
          contractual requirements on managed care plans by specifying the  
          concentrations at which translation services are required. There  
          is not likely to be any increased cost to the managed care plans  
          (and hence to the state through the capitated rates paid to  
          those plans) since this bill does not increase the  
          interpretation or translation requirements on Medi-Cal managed  
          care plans.