Amended in Assembly March 21, 2013

California Legislature—2013–14 Regular Session

Assembly BillNo. 1263


Introduced by Assembly Member John A. Pérez

February 22, 2013


An act to add Chapter 13 (commencing with Section 3599.50) to Division 4 of Title 1 of the Government Code, and to add Article 4.6 (commencing with Section 14146) to Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code, relating to Medi-Cal.

LEGISLATIVE COUNSEL’S DIGEST

AB 1263, as amended, John A. Pérez. Medi-Cal: CommuniCal.

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, 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. Existing federal law provides for increased administrative funding for translation and interpretation services provided in connection with the enrollment, retention, and use of services under the Medicaid Program.

This bill would require the department to establish the Medi-Cal Patient-Centered Communication program (CommuniCal), to be administered by a 3rd-party administrator, to, commencing July 1, 2014, provide and reimburse for medical interpretation services to Medi-Cal beneficiaries who are limited English proficient (LEP). This bill would establish the CommuniCal Program Fund in the State Treasury, which would consist of moneys dedicated to the CommuniCal program, to be used upon appropriation by the Legislature to the department solely to fund the CommuniCal program.

Existing law provides for the certification of administrative hearing interpreters and medical examination interpreters for purposes of administrative adjudications.

This bill would require the State Personnel Board to be the certifying body for CommuniCal certified medical interpreters (CCMIs), to establish a certifying examination for those interpreters, and to maintain a registry of those persons who pass the exam, as specified. Commencing July 1, 2014, the bill would require Spanish-language interpreters to pass the exam and be listed on the registry in order to be eligible to provide services under CommuniCal. The bill would require the State Personnel Board, by July 1, 2014, to determine appropriate testing, training, and experience standards for other language interpreters to also be placed on the registry as CCMIs, as specified. The bill would also require the State Personnel Board to establish and charge fees that do not exceed reasonable costs for applicants to take the exam and be certified and listed in the registry and would require the State Personnel Board to adopt quality standards and medical interpretation certification requirements through regulations.begin insert The bill would require the Department of Human Resources to notify the individual of the acceptance or denial of his or her inclusion on the registry within 10 days of the submission of the application.end insert

The Ralph C. Dills Act provides for employer-employee relations between the state and its employees, as specified, including, among other things, the right of state employees to form, join, and participate in the activities of employee organizations for the purpose of representation on all matters of employer-employee relations, as specified.

This bill would provide that CCMIs would have the right to form, join, and participate in the activities of a labor organization of their own choosing for the purpose of representation of specified employer-employee matters. The bill would provide that CCMIs would not be considered state employees for purposes of the bill, but would have the right to be represented by an exclusive labor organization of their own choosing for the purpose of collective bargaining with the state on matters of mutual concern, as specified.

The bill would provide that upon application by petition, authorization cards, or union membership cards of a labor organization adequately showing that a majority of CCMIs in the state desire to be represented exclusively by that labor organization, and no other labor organization is currently certified as the exclusive representative, the Public Employment Relations Board shall certify and grant exclusive representation to that labor organization, and would establish other election procedures to be administered by that board.

The bill would require that any agreement resulting from collective bargaining be legally binding upon the state and committed to writing, and would further require that, upon the completion of discussions and collective bargaining, any agreement be reduced to writing and be presented to the appropriate administrative, legislative, or other governing body in the form of a binding agreement, resolution, bill, law, or other form required for adoption.

The bill would provide that, after the certification of a labor organization, the state shall approve and have deducted, upon authorization in the case of dues deduction, from the appropriate reimbursement or other payment to the employee the monthly amount of dues or service fees as certified by an executive officer of the labor organization, and shall transmit the amount to the treasurer of the labor organization.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

P3    1

SECTION 1.  

The Legislature finds and declares all of the
2following:

3(a) California has long been recognized as one of the most
4racially and linguistically diverse states; the state is home to
5residents who speak over 200 languages.

6(b) Approximately one in five Californians is limited English
7proficient (LEP) and identifies as speaking English less than very
8well.

9(c) Language access and the right to interpretation services is
10required under Title VI of the federal Civil Rights Act of 1964,
11the Dymally-Alatorre Bilingual Services Act of 1973 (Chapter
1217.5 (commencing with Section 7290) of Division 7 of Title 1 of
13the Government Code), the Knox-Keene Health Care Service Plan
14Act of 1975 (Chapter 2.2 (commencing with Section 1340) of
15Division 2 of the Health and Safety Code), Section 11135 of the
16Government Code, Section 1259 of the Health and Safety Code,
17and California civil rights law.

P4    1(d) The demand for medical interpretation services by Medi-Cal
2beneficiaries is significant, with 45.2 percent of Medi-Cal
3beneficiaries speaking a language other than English.

4(e) The state will experience an even greater demand for
5language services as health care reform measures are implemented
6over the next few years and 35 percent of Californians expected
7to become newly eligible for Medi-Cal as a result of the federal
8Patient Protection and Affordable Care Act (Public Law 111-148)
9will speak English less than well.

10(f) In California, language assistance services are provided in
11an uncoordinated manner that lacks transparency and
12accountability, and a majority of services are currently provided
13ad hoc by family members and friends or untrained staff.

14(g) California has the opportunity to meet the growing demand
15early on by accessing millions of dollars in federal matching funds
16to provide medical interpretation services to LEP Medi-Cal
17beneficiaries.

18(h) Professional medical interpretation services help reduce
19avoidable medical errors and provider malpractice liability for
20physicians and other health care providers.

21(i) A coordinated program to offer medical interpreter services
22will improve health care outcomes for LEP Californians and help
23control health care costs that result from a lack of access to
24preventative and primary care.

25

SEC. 2.  

It is the intent of the Legislature to do all of the
26following:

27(a) Create the CommuniCal program, which shall provide
28reliable access to language interpretation for Medi-Cal beneficiaries
29who are limited English proficient.

30(b) Establish a mechanism for accessing federal Medicaid
31matching funds to provide a majority of the funding for the
32CommuniCal program.

33(c) Enable trained and qualified interpreters to meet the demand
34for language services for a significant portion of the estimated
35three million Medi-Cal beneficiaries with limited English
36proficiency.

37(d) Facilitate accurate and timely communication between
38limited-English-proficient patients and their health care providers,
39which will improve quality of care, reduce medical errors, increase
40patient understanding and compliance with health diagnoses and
P5    1care plans, and reduce the cost of health care by eliminating waste,
2such as unnecessary tests and other care.

3

SEC. 3.  

Chapter 13 (commencing with Section 3599.50) is
4added to Division 4 of Title 1 of the Government Code, to read:

5 

6Chapter  13. CommuniCal Certified Medical
7Interpreters
8

 

9Article 1.  Certification and Registration of CommuniCal
10Medical Interpreters
11

 

12

3599.50.  

(a) For purposes of this chapter, the following
13definitions apply:

14(1) “CommuniCal” means the Medi-Cal Patient-Centered
15Communication program established pursuant to Article 4.6
16(commencing with Section 14146) of Chapter 7 of Part 3 of
17Division 9 of the Welfare and Institutions Code.

18(2) “CommuniCal certified medical interpreter” or “CCMI”
19means an interpreter who has been certified pursuant to Section
203599.51.

21(3) “Certifying body” means the State Personnel Board.

22(4) “Exam” means the CommuniCal Certified Medical
23Interpreter Exam.

24(b) Notwithstanding any other law, the State Personnel Board
25shall serve as the CommuniCal certified medical interpreter
26(CCMI) certifying body. The certifying body shall select an
27examination through which competency will be tested and provide
28for the certification of Spanish-language medical interpretation
29within 120 days of the implementation of this bill. The examination
30shall be known as the CommuniCal Certified Medical Interpreter
31Exam. It shall have both an oral and a written component. The oral
32component shall be conducted in person in each of the major
33metropolitan areas in the State of California.

34

3599.51.  

(a) The certifying body shall select a nonprofit
35organization to administer the exam. The nonprofit organization
36shall have a statewide presence. A list of all interpreters who pass
37the exam shall be maintained by the certifying body and shall be
38known as the CommuniCal Certified Medical Interpreter Registry.
39A CCMI is someone who has passed the exam, is listed on the
40registry, and has been issued a certificate by the certifying body
P6    1attesting that the person is a CommuniCal Certified Medical
2Interpreter.

3(b) (1) Commencing July 1, 2014, in order to be eligible to
4provide services under CommuniCal, Spanish-language interpreters
5shall be required to pass the exam and be listed on the registry.

6(2) For those languages of lesser diffusion or languages for
7which a recognized medical interpreter exam has not been created,
8the certifying body shall determine, by July 1, 2014, with certified
9medical interpreters and their exclusive representatives, appropriate
10testing, training, and experience standards for interpreters to also
11be placed on the registry and listed as CommuniCal Certified
12Medical Interpreters.

13(3) In order to meet anticipated demand for services under
14CommuniCal, the state shall certifybegin insert any ofend insert the following individuals
15as certified interpreters and place them on the registry:

16(A) An individual who can demonstrate that as of January 1,
172014, he or she has worked for a minimum of two years asbegin delete aend deletebegin insert an
18in-person end insert
medical interpreter.

19(B) An individual who has graduated from an accredited medical
20interpreter training program at a college or university before
21January 1, 2014.

begin insert

22(4) The Department of Human Resources shall notify the
23individual of the acceptance or denial of his or her inclusion on
24the registry within 10 days of the submission of the application.

end insert
begin insert

25(5) The effective date of the registry shall be January 1, 2014.

end insert
26

3599.52.  

(a) The certifying body shall establish and charge
27fees, which do not exceed the reasonable costs, for applicants to
28take the exam. The certifying body shall establish and charge a
29single fee that does not exceed the reasonable costs for certification
30and listing on the registry. The purpose of these fees is to cover
31the annual projected costs of carrying out this article.

32(b) Each CCMI shall pay a registry and certification fee, not to
33exceed the reasonable costs, for the renewal of the certification
34and continued listing on the registry. The registry and certificate
35fee shall be due on July 1 of each year.

36(c) The certifying body shall establish, maintain, administer,
37and publish annually an updated registry of CCMIs. The certifying
38body may remove the name of a person from the registry if any of
39the following conditions occurs:

40(1) The person is deceased.

P7    1(2) The person notifies the board that the person is unavailable
2for work.

3(3) The person does not submit a registry and certification fee
4or renewal fee as required by subdivision (b).

5(4) The person fails to meet the quality standards and medical
6certification requirements established pursuant to Section 3599.53.

7(d) For the 2013-14 fiscal year only, the fee for certification
8and listing on the registry pursuant to paragraph (3) of subdivision
9(b) of Section 3599.51 is waived.

10

3599.53.  

The certifying body shall adopt quality standards and
11medical interpretation certification requirements through
12regulations, which shall include, but not be limited to, maintaining
13patient confidentiality and familiarity or experience working with
14medical terminology. It shall determine the testing requirements
15for certification in each language and create a list of those
16languages where standards permit registration of the interpreter.

17

3599.54.  

The exclusive representative of CCMIs and a
18begin delete recognizedend delete nonprofit organization shall partner to create and
19administer a training program for medical interpreters, in order to
20prepare interpreters for the exam or other certification standards
21established for languages of lesser diffusion and provide continuing
22education for those CCMIs placed on the registry. A community
23advisory committee shall be established to make recommendations
24on interpreter certification and services.

25

3599.55.  

The relationship of CCMIs to all parties and recipients
26of service is one of independent contractor, unless otherwise
27specified by law.

28

3599.56.  

Only interpreters certified pursuant to this article shall
29be represented bybegin delete the unionend deletebegin insert a labor organizationend insert for purposes of
30collective bargaining pursuant to Article 2 (commencing with
31Section 3610).

32 

33Article 2.  Collective Bargaining for CommuniCal Certified
34Medical Interpreters
35

 

36

3610.  

(a) CCMIs shall have the right to form, join, and
37participate in the activities of a labor organization of their own
38choosing for the purpose of representation on all matters specified
39in this section. The state action antitrust exemption to the
40application of federal and state antitrust laws is applicable to the
P8    1activities of CCMIs and their exclusive representatives authorized
2under this article or other applicable law.

3(b) CCMIs shall have the right to be represented by an exclusive
4labor organization of their own choosing for the purpose of
5collective bargaining with the State of California on matters of
6mutual concern, including, but not limited to, the following:

7(1) Development, maintenance, and application of the registry.

8(2) The setting of reimbursements and rates for state-funded
9medical interpreter programs.

10(3) The allocation, process, procedure, distribution,
11methodology, and manner of payment of interpreter
12reimbursements and rates.

13(4) Professional development, certification and training,
14recruitment and retention of qualified interpreters, and language
15access quality standards.

16(5) Dispute resolution mechanisms binding on third-party
17administrators and their subcontractors of state-funded interpreter
18programs.

19(6) Mechanisms and funding to improve state-funded medical
20interpreter programs and the stability, funding, rules, regulations,
21and operation of state-funded medical interpretation programs.

22(7) Scheduling systems of interpreter services under state-funded
23interpreter programs.

24(8) Mediums and modes of delivery of interpretation services
25under state-funded medical interpretation programs.

26(9) The improvement and expansion of quality medical
27interpretation services.

28(10) The collection and disbursement of established dues or
29fees to the exclusive representative of CCMIs.

30(c) This section shall not apply to work performed as an
31employee of an employer.

32(d) The appropriate bargaining unit for CCMIs shall be a
33statewide unit of eligible CCMIs.

34(e) CCMIs are not public employees and this article does not
35create an employer-employee relationship between CCMIs and
36the state or patient-centered communication brokers for any
37purpose, including, but not limited to, state employee eligibility
38for health or retirement benefits, or vicarious liability in tort.

39

3611.  

A labor organization as referenced in this section is
40defined as a labor organization described in Section 501(c)(5) of
P9    1the Internal Revenue Code which has as its primary purpose the
2representation of public service providers in their relations with
3state and other public entities.

4

3612.  

Upon request by a labor organization that is signed by
520 percent of CCMIs, the certifying body shall furnish to the labor
6organization a list of all CCMIs including full names, telephone
7numbers, e-mail addresses, and mailing or home addresses within
8five days of the request.

9

3613.  

(a) Upon application by petition, authorization cards,
10or union membership cards of a labor organization adequately
11showing that a majority of CCMIs in the state desire to be
12represented exclusively by that labor organization, and no other
13labor organization is currently certified as the exclusive
14representative, the Public Employment Relations Board (PERB)
15shall certify and grant exclusive representation of the CCMIs to
16the labor organization for the purposes set forth in this section.

17(b) Upon application by petition, authorization cards, or union
18membership cards of a labor organization adequately showing that
19less than a majority but at least 30 percent of CCMIs desire to be
20represented exclusively by that labor organization, and no other
21labor organization is currently certified as the exclusive
22representative, the matter to determine representation shall be set
23for a mail ballot election administered by PERB pursuant to its
24rules and regulations for administering elections. If a PERB
25regulation or rule conflicts with this section, this section shall
26control.

27(c) PERB shall accept, review, and certify all valid applications
28submitted pursuant to subdivisions (a) and (b) pursuant to its rules
29and regulations. If a PERB regulation or rule conflicts with this
30section, this section shall control.

31(d) Any representation election shall be a mail ballot election.

32(e) Within 10 days of receipt of an adequate petition,
33authorization cards, or union membership cards necessitating an
34election, PERB shall conduct a preelection conference with the
35labor organization and the state prior to scheduling an election for
36the purpose of clarifying issues, obtaining stipulations, executing
37a directed election order or consent election agreement, and taking
38other actions to expedite the process. The labor organization and
39the state shall engage in a good faith effort to reach a consent
40election agreement stipulating the parties to appear on the ballot,
P10   1the form of the ballot, the CCMIs eligible to vote, the rules
2governing the election, and the date, time, and other specifics of
3the mail ballot election. The state shall be represented by the
4Department of Personnel Administration and the State Department
5of Health Care Services.

6

3614.  

No other labor organization shall be permitted to
7intervene in an election unless prior to the preelection conference,
8by petition, authorization cards, or union membership cards, the
9intervening labor organization adequately shows at least 30 percent
10of CCMIs in the state as of January 1 of the year the application
11is made desire to be represented exclusively by the intervening
12labor organization.

13

3615.  

PERB shall proceed to determine all issues or matters
14in dispute. The determination and a directed election order or
15consent election agreement between the labor organization and
16the state shall be made within seven days of the conference.

17

3616.  

(a) PERB shall initiate a mail ballot election within 10
18days of the execution of a directed election order or consent
19election agreement. The election shall provide for an affirmative
20vote for employee representation by the petitioning employee
21organization. The proposition receiving the votes of a majority of
22all valid votes cast shall win the election. Should no option receive
23an absolute majority vote of all valid votes cast, a runoff vote
24between the two options receiving the highest number of votes
25shall occur within seven days.

26(b) A preelection meeting shall occur with the labor organization
27and the state 30 minutes prior to the mailing of ballots for the
28purpose of resolving any final issues prior to the commencement
29of the mail ballot election.

30(c) The election shall be conducted in accordance with the
31procedures established and approved pursuant to the consent
32election agreement or directed election order.

33(d) The supervising official from PERB shall determine the date
34and time ballots must be received for tabulation, which date shall
35not be sooner than 10 days or more than 20 days from the date the
36voting commences. PERB shall be charged with validating the
37ballots against a list of CCMIs provided by the State Personnel
38Board.

39(e) A labor organization certified by PERB as receiving a
40majority of all valid votes cast is the exclusive representative of
P11   1all CCMIs in the state for purposes set forth in this section. All
2CCMIs who are eligible for the bargaining unit pursuant to Section
33610 subsequent to certification of the labor organization shall be
4part of the bargaining unit and represented by the certified labor
5organization.

6

3617.  

Discussions and collective bargaining between the
7certified labor organization and the state and its designated agents
8in the Department of Personnel Administration and the State
9Department of Health Care Services shall commence within 30
10days upon certification and at any time thereafter upon request of
11the labor organization.

12

3618.  

The state and its designated agents in the Department of
13Personnel Administration and the State Department of Health Care
14Services shall be required to meet with the certified labor
15organization before any regulation is proposed, promulgated, set,
16or otherwise presented concerning any of the purposes for
17collective bargaining set forth in Section 3610.

18

3619.  

Any agreement resulting from collective bargaining shall
19be legally binding upon the state and committed to writing. Upon
20the completion of discussions and collective bargaining, any
21agreement shall be reduced to writing and be presented to the
22appropriate administrative, legislative, or other governing body in
23the form of a binding agreement, resolution, bill, law, or other
24form required for adoption. Nothing herein shall prevent the parties
25from agreeing to and effecting those provisions of an agreement
26which have received legislative approval or those provisions which
27do not require legislative action.

28

3620.  

Nothing in this article shall affect the right of a CCMI
29to authorize a dues or service fee deduction from his or her
30reimbursement.

31

3621.  

(a) After the certification of a labor organization, the
32state shall approve and have deducted, upon authorization in the
33case of dues deduction, from the appropriate reimbursement or
34other payment to members of the labor organization the monthly
35amount of dues or service fees as certified by an executive officer
36of the labor organization and shall transmit the amount to the
37treasurer of the labor organization.

38(b) After the certification of a labor organization, the state shall
39approve and have deducted from the appropriate reimbursement
40or other payment to nonmembers a reasonable fair share service
P12   1fee for the cost of representing them in negotiations, contract
2administration, subsidy rates, benefits, payment systems, training
3opportunities, and other matters related to those purposes listed in
4subdivision (b) of Section 3610. This fair share service fee shall
5not exceed the annual dues paid by members of the labor
6organization. The state shall transmit the amount of the fair share
7fee to the treasurer of the labor organization.

8

3622.  

Dues or fair share service fee obligations shall continue
9in effect as long as the labor organization is the recognized
10bargaining representative, notwithstanding the expiration of any
11agreement between the state and the recognized labor organization.

12

3623.  

(a) The state through its designated agents in the
13Department of Personnel Administration and the State Department
14of Health Care Services shall meet and collectively bargain in good
15faith with representatives of a certified labor organization and shall
16consider fully the proposals made by the labor organization on
17behalf of CCMIs. “Meet and collectively bargain in good faith”
18means that the state and its designated agent and representatives
19of a certified labor organization shall have the mutual obligation
20to collectively bargain within a reasonable length of time in order
21to freely exchange information, opinions, and proposals.

22(b) The state shall not interfere with, intimidate, restrain, coerce,
23or discriminate against CCMIs due to the exercise of their rights
24under this section. A complaint alleging any violation of this
25section shall be processed as an unfair practice charge by PERB
26pursuant to its rules and regulations. The initial determination as
27to whether the charge of unfair practice is justified and, if so, the
28appropriate remedy necessary to effectuate the purposes of this
29section, shall be a matter within the exclusive jurisdiction of PERB.
30PERB shall apply and interpret unfair labor practices consistent
31with existing judicial interpretations of this section. If a PERB
32practice, regulation, interpretation, or rule conflicts with this
33 section, this section shall control.

34

3624.  

Any charging party, respondent, or intervenor aggrieved
35by a final decision or order of PERB in an unfair practice case,
36except a decision of PERB not to issue a complaint in such a case,
37and any party to a final decision or order of PERB in a
38representation, recognition, or election matter that is not brought
39as an unfair practice case, may petition for a writ of extraordinary
40relief from that decision or order pursuant to Section 3520.

P13   1

3625.  

Execution of a valid written agreement between the state
2and the certified labor organization shall bar the filing of an
3application or petition for certification of a majority representative
4for the length of the agreement except as otherwise provided in
5this article. No application or petition for certification shall be
6valid within one year of any prior certification.

7

3626.  

Should any court declare any other provision of this
8chapter void, invalid, illegal, or unconstitutional, the remaining
9provisions shall remain in full force.

10

3627.  

(a) The state shall not encourage or discourage
11membership in a labor organization and shall not discriminate
12against any CCMI on the basis of union activity, concerted action,
13union membership, age, sex, race, religious beliefs, color, national
14origin, sexual orientation, gender identity, or disability in
15accordance with and as required by applicable state and federal
16law. A CCMI shall not be subject to punitive action, or threatened
17with punitive action, for the exercise of lawful action as an elected,
18appointed, or recognized representative of any bargaining unit.

19(b) Unless otherwise stated in this article, the state may adopt
20reasonable rules and regulations after consultation in good faith
21with representatives of a certified labor organization for the
22administration of CCMI employer-employee relations under this
23article. In the case of any conflict between rules and regulations
24enacted pursuant to this article, including those subdivisions
25adopting PERB rules, regulations, or procedures, the provisions
26of this section shall control.

27

3628.  

Nothing in this chapter may be construed to interfere
28with CCMI rights and responsibilities under federal law.

29

SEC. 4.  

Article 4.6 (commencing with Section 14146) is added
30to Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions
31Code
, to read:

32 

33Article 4.6.  CommuniCal
34

 

35

14146.  

For the purposes of this article, the following definitions
36shall apply:

37(a) “CommuniCal” means the Medi-Cal Patient-Centered
38Communication program.

39(b) “CommuniCal certified medical interpreter” or “CCMI”
40means an interpreter certified under the CommuniCal program
P14   1pursuant to Article 1 (commencing with Section 3599.50) of
2Chapter 13 of Division 4 of Title 1 of the Government Code.

3(c) “Department” means the State Department of Health Care
4Services.

5(d) “Medi-Cal managed care organizations” or “MMCOs” means
6all models of Medi-Cal managed care, including county-organized
7health systems, geographic managed care, and two-plan models.

8(e) “Patient-centered communication broker” or “broker” means
9the third-party administrator for the CommuniCal program.

10

14146.10.  

(a) The department shall establish the CommuniCal
11program to provide and reimburse for certified medical
12interpretation services to Medi-Cal beneficiaries who are limited
13English proficient (LEP).

14(b) Commencing July 1, 2014, CommuniCal shall offer medical
15interpreter services to Medi-Cal providers serving Medi-Cal
16beneficiaries on either a fee-for-service or managed care basis
17pursuant to this article. The department shall adopt policies to
18prohibit duplicate payments to CCMIs and Medi-Cal MMCOs for
19beneficiaries enrolled in an MMCO.

20(c) A health care provider or entity entering into a Medi-Cal
21provider agreement or a Medi-Cal managed care contract with the
22state, including MMCOs and their subcontracting plans, and
23fee-for-service providers, may utilize CommuniCal to provide
24medical interpreter services to Medi-Cal beneficiaries.

25(d) All contracts between MMCOs and their subcontractors,
26including health providers and other health plans, shall include
27provisions describing access to CommuniCal medical interpreter
28services.

29(e) The department shall pursue all available sources of federal
30funding to establish and operate CommuniCal and shall seek any
31federal approvals necessary to implement this article.

32

14146.11.  

CommuniCal shall include the provision of
33in-person, telephonic, and video medical interpretation services.
34To meet language access requirements and ensure patient safety,
35in-person interpreter services shall be the preferred mode of
36medical interpretation in the following instances whenever
37possible:

38(a) Family meetings regarding medical care.

39(b) Medical encounters involving difficult or agitated patients.

40(c) Medical encounters to make treatment decisions.

P15   1(d) Obtaining informed consent involving review of documents.

2(e) Any medical encounter that, in the physician’s judgment,
3requires in-person interpretation for the health, safety, or well-being
4of the patient.

5(f) Psychiatric encounters.

6(g) End-of-life discussions.

7

14146.12.  

(a) CommuniCal shall be administered by a
8patient-centered communication broker.

9(b) The department shall create and administer a competitive
10Request for Proposals (RFP), and shall execute the resulting
11contract.

12(c) The broker shall be responsible for all of the following
13duties:

14(1) Registering CCMIs with Medi-Cal.

15(2) Verifying CCMI certification with the State Personnel Board.

16(3) Verifying Medi-Cal eligibility for interpreter services
17utilizing the state’s Medi-Cal Eligibility Data System (MEDS).

18(4) Submitting billing summaries to Medi-Cal, aggregating the
19cost for services provided.

20(5) Ensuring compliance with all Medi-Cal and applicable
21CommuniCal reporting requirements.

22(6) Making payments to CCMIs, including any dues and service
23fee deductions.

24(7) Scheduling CCMI appointments with Medi-Cal providers.

25(8) Monitoring the quality of CommuniCal interpreter services
26and complying with state oversight requirements of the program.

27(9) Creating CommuniCal promotional materials for distribution
28to Medi-Cal providers, MMCOs, and beneficiaries.

29(d) The department shall make all applicable Medi-Cal reporting
30requirements known to the broker and shall be responsible for the
31broker’s compliance with these requirements.

32

14146.13.  

(a) Notwithstanding any other law, only interpreters
33certified pursuant to Article 1 (commencing with Section 3599.50)
34of Chapter 13 of Division 4 of Title 1 of the Government Code
35may participate in CommuniCal.

36(b) CCMIs shall be responsible for all of the following:

37(1) Performing interpreter services independent of other policies,
38rules, or procedures of conduct, except as provided by this article
39or by applicable law.

P16   1(2) Performing interpreter services independent of direction,
2except as otherwise provided by this article and applicable law.

3(3) Preparing and submitting documentation to the broker in
4support of time worked or other services rendered.

5(4) Directing and controlling the manner and means of
6interpretation services, except as otherwise provided in this article.

7(c) Unless otherwise prohibited by this article or applicable law,
8CCMIs may do any of the following:

9(1) Advertise, promote, or otherwise communicate availability
10for services to clients and the general public.

11(2) Provide office space, equipment, support services, forms,
12supplies, and business cards, except as otherwise provided in this
13article.

14(d) (1) For purposes of the CommuniCal program, CCMIs are
15not state employees. CCMIs shall be independent contractors of
16the state.

17(2) For purposes of the CommuniCal program, CCMIs are not
18employees of the broker, health care providers, or consumers.

19(3) The state action antitrust exemption to the application of
20federal and state antitrust laws is applicable to the activities of
21CCMIs and their exclusive representatives authorized under this
22article or other applicable law.

23

14146.135.  

(a) The base reimbursement rate for CCMIs shall
24be no less than sixty dollars ($60) per hour.

25(b) Reimbursement may be adjusted for factors such as
26geography, language spoken, availability of interpreters, level of
27certification, and travel time.

28

14146.14.  

The department shall issue guidance on the
29administration of the CommuniCal program to ensure compliance
30with this article and all applicable state and federal laws by all
31contractors and subcontractors of the program.

32

14146.15.  

(a) The CommuniCal Program Fund is hereby
33created in the State Treasury. Notwithstanding Section 16305.7
34of the Government Code, any interest and dividends earned on
35deposits in the fund shall be retained in the fund for purposes
36specified in subdivision (c).

37(b) Moneys in the fund shall consist of any funds dedicated to
38the CommuniCal program.

P17   1(c) Moneys in the fund shall, upon appropriation by the
2Legislature to the department, be used solely to fund the
3CommuniCal program.



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