BILL ANALYSIS Ó
AB 505
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CONCURRENCE IN SENATE AMENDMENTS
AB 505 (Nazarian)
As Amended May 19, 2014
Majority vote
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|ASSEMBLY: |72-0 |(May 16, 2013) |SENATE: |32-3 |(August 4, |
| | | | | |2014) |
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Original Committee Reference: HEALTH
SUMMARY : Requires the Department of Health Care Services (DHCS)
to require all Medi-Cal managed care plans (MCPs) contracting
with DHCS to provide language assistance services to
limited-English-proficient (LEP) Medi-Cal beneficiaries who are
mandatorily enrolled in managed care by requiring interpretation
services to be provided in any language on a 24-hour basis at
all key points of service, and requiring translation services to
be provided to the language groups identified by DHCS meeting
specified numeric thresholds.
The Senate amendments reduce the threshold for translation
services to 3,000 or 5% of the beneficiary population, whichever
is fewer.
AS PASSED BY THE ASSEMBLY , this bill required DHCS to require
all Medi-Cal managed care plans (MCPs) under contract to provide
Medi-Cal services to provide language assistance to
limited-English-proficient (LEP) enrollees who number at least
3,000 beneficiaries or 1,000 in a single zip code.
FISCAL EFFECT : According to the Senate Appropriations
Committee:
1)Ongoing costs likely between $40,000 and $75,000 every three
years to determine the thresholds for translating documents by
Medi-Cal MCPs by DHCS (50% General Fund, 50% federal funds).
2)No significant increased costs for providing interpretation
and translation services are expected. This bill essentially
recodifies existing law and practice.
COMMENTS : According to the author, this bill is intended to
codify language assistance requirements in current contracts
AB 505
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between DHCS and MCPs, to strengthen these access standards.
The author points out more than 40% of Californians speak a
language other than English at home, and an estimated six to
seven million people are LEP, meaning they speak English less
than very well, which is the definition used by the United
States Census. The author states that for over a decade, DHCS
has required MCPs to provide language assistance to LEP members.
MCPs must provide oral interpretation services, in all
languages, on a 24-hour basis. Currently, by contract,
translation services of written documents, such as application
for enrollment or notice of benefits, must be provided when the
LEP population meets one of the numeric thresholds specified in
this bill. According to the author, the following languages
meet the current threshold required for translation services:
Arabic; Armenian; Cambodian; Cantonese; Farsi; Hmong; Korean;
Mandarin; Russian; Spanish; Tagalog; and, Vietnamese. The
author explains that DHCS instructs the MCPs on how to provide
both the oral interpretation and written translation services
through policy letters and contract requirements. The author
states that in 2003, language assistance requirements were
codified for commercial plans licensed by the Department of
Managed Health Care or at the California Department of
Insurance, but not for MCPs.
Currently Medi-Cal managed care in California serves about seven
million enrollees in all 58 counties. DHCS has embarked upon an
ambitious array of initiatives that has resulted in over two
million new enrollees into MCPs in recent years. Among the
significant initiatives is the movement of approximately 860,000
Healthy Families Program children statewide into the Medi-Cal
program. Another new program began in November of 2010, when
California obtained federal approval for a Section 1115(b)
Medicaid Demonstration Waiver from the Centers for Medicare and
Medicaid Services entitled "A Bridge to Reform Waiver." In
addition, under the Federal Patient Protections and Affordable
Care Act, states must expand Medicaid eligibility up to 138% of
the federal poverty level (FPL) for families, pregnant women,
and children and states have the option to cover childless
adults between ages 19 and 65 with incomes under 138% of the FPL
who are not currently Medi-Cal eligible. California has chosen
to enroll these individuals into Medi-Cal and this expansion is
estimated to result in between one million and 1.4 million more
Californians enrolling in Medi-Cal by 2019. Most of these newly
eligible will be enrolled in MCPs.
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According to the sponsor, California Pan Ethnic Health Network
(CPEHN), this bill strengthens consumer protections for Medi-Cal
managed care enrollees who speak English less than very well.
In addition, CPEHN states that federal and state laws require
health plans to meet the language needs of LEP persons as Title
VI of the 1964 Civil Rights Act prohibits discrimination against
persons based upon national origin, which has been interpreted
to include people who do not speak English very well. CPEHN
states that DHCS requires Medi-Cal MCPs to provide translated
documents when a LEP population makes up a certain percentage or
a threshold of the enrollee population. The provision of oral
interpretation is required 24 hours at all points of contact in
all languages. The thresholds for translation services were
developed as part of a Medi-Cal managed care workgroup convened
by DHCS in the early 1990s when California was planning to
transition the majority of their Medi-Cal beneficiaries into
managed care.
The translation and interpretation requirements for county
Medi-Cal specialty mental health plans differ slightly from
other Medi-Cal MCPs. These plans have a threshold language
standard in regulation that is defined as a language of 3,000
beneficiaries or 5% of the beneficiary population, whichever is
lower, in an identified geographic area.
This bill has no known opposition.
Analysis Prepared by : Roger Dunstan/ HEALTH / (916) 319-2097
FN: 0003554