Amended in Senate June 13, 2013

Amended in Assembly April 11, 2013

Amended in Assembly March 21, 2013

California Legislature—2013–14 Regular Session

Assembly Bill No. 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 begin delete Department of Human Resources end delete begin insert department end insert to be the certifying body for CommuniCal certified medical interpreters begin delete (CCMIs), to establish a certifying examination for those interpreters, end delete begin insert (CCMIs), and to authorize other interpreters meeting specified requirements, including a screening test, to provide CommuniCal services. The bill would require the department to (1) develop, monitor, and evaluate interpreter competency, qualifications, training, certification, and continuing education, (2) commencing September 1, 2014, to approve an examination and certification process to test and certify the competency of medical interpreters, end insert and begin insert (3) end insert to maintain a registry of those persons who begin delete 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 Department of Human Resources, 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. end delete begin insert meet the requirements end insert begin insert to provide CommuniCal services. The bill would require the department to establish the Community Advisory Committee for purposes of assisting the department in the above-described tasks. end insert The bill would also require the begin delete Department of Human Resources end delete begin insert department end insert to establish and charge fees that do not exceed reasonable costs for applicants to take begin delete the exam end delete begin insert any department-administered examinations end insert and be certified begin insert or authorized end insert and listed in the begin delete registry end delete begin insert registry, end insert and would require the begin delete Department of Human Resources end delete begin insert department, in consultation with the Community Advisory Committee, end insert to adopt quality standards and medical interpretation certification requirements through regulations. begin delete 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 delete

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 begin delete CCMIs end delete begin insert CommuniCal interpreters end insert 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 begin delete CCMIs end delete begin insert CommuniCal interpreters end insert 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 begin delete CCMIs end delete begin insert CommuniCal interpreters end insert 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:

SECTION 1.  

The Legislature finds and declares all of the
following:

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

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

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

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

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

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

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

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

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

SEC. 2.  

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

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

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

(c) Enable trained and qualified interpreters to meet the demand
for language services for a significant portion of the estimated
3,000,000 Medi-Cal beneficiaries with limited English proficiency.

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

SEC. 3.  

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

 

Chapter  13. CommuniCal begin delete Certified end delete Medical
Interpreters

 

Article 1.  Certification and Registration of CommuniCal
Medical Interpreters

 

3599.50.  

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

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

(2) “CommuniCal certified medical interpreter” or “CCMI”
means an interpreter who has been certified pursuant to begin insert subdivision
(b) of end insert Section 3599.51.

begin insert

(3) “CommuniCal interpreter” means an interpreter who is
authorized to provide CommuniCal services pursuant to Section
3599.51.

end insert begin delete

(3)

end delete

begin insert (4) end insert  “Certifying body” begin insert or “department end insert begin insert ” end insert means the begin delete Department
of Human Resources end delete begin insert State Department of Health Care Services end insert .

begin delete

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

end delete begin insert

(5) “Community Advisory Committee” means the committee
established pursuant to Section 3599.53.

end insert

(b) Notwithstanding any other law, the begin delete Department of Human
Resources end delete begin insert State Department of Health Care Services end insert shall serve
as the CommuniCal certified medical interpreter (CCMI) certifying
body. The certifying body shall begin delete select an examination through
which competency will be tested and provide for the certification
of Spanish-language medical interpretation within 120 days of the
implementation of this bill. The examination shall be known as
the CommuniCal Certified Medical Interpreter Exam. It shall have
both an oral and a written component. The oral component shall
be conducted in person in each of the major metropolitan areas in
the State of California. end delete begin insert do both of the following: end insert

begin insert

(1) Develop, monitor, and evaluate interpreter competency,
qualifications, training, certification, and continuing education
requirements for medical interpreters.

end insert begin insert

(2) By September 1, 2014, in consultation with the Community
Advisory Committee, approve an examination and certification
process to test and certify the competency of medical interpreters
pursuant to Section 3599.51.

end insert

begin delete

3599.51.  

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

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

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

(3) In order to meet anticipated demand for services under
CommuniCal, the state shall certify any of the following individuals
as certified interpreters and place them on the registry:

(A) An individual who can demonstrate that as of January 1,
2014, he or she has worked for a minimum of two years as an
in-person medical interpreter.

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

(4) The Department of Human Resources shall 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.

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

end delete begin insert

begin insert 3599.51. end insert   

(a) As a condition of certification, an interpreter
shall complete at least one of the following:

(1) Pass an examination administered by a nonprofit
organization selected by the department that is nationally
accredited to offer certification examinations for health care
interpreters.

(2) Pass an examination developed by a state-established
language testing and certification program that includes, at a
minimum, both an oral and written component and the following
competency standards:

(A) A documented and demonstrated proficiency in both English
and the other specified language.

(B) A fundamental knowledge, in both English and the other
specified language, of health care terminology and concepts
relevant to health care delivery systems.

(C) Education and training in interpreter ethics, conduct,
practice, and confidentiality. The department shall adopt standards
in interpreter ethics, conduct, practice, and confidentiality
promulgated by the California Healthcare Interpreters Association,
the National Council on Interpreting in Health Care, or both.

(3) Achieve the designation of Certified Healthcare Interpreter
from the Certification Commission for Healthcare Interpreters
(CCHI).

(4) Achieve the designation of Certified Medical Interpreter
from the National Board of Certification for Medical Interpreters
(NBCMI).

(b) Each interpreter who has met the requirements of subdivision
(a), is listed on the CommuniCal Medical Interpreter Registry
established pursuant to subdivision (e), and has been issued a
certificate by the certifying body shall be known as a CommuniCal
Certified Medical Interpreter (CCMI).

(c) (1) In addition to the certification process described in
subdivision (b), commencing July 1, 2014, the department shall
authorize CommuniCal services to be provided by an interpreter
of languages of lesser diffusion or languages for which a CCMI
examination has not been created. The department shall send an
authorization letter to any person who satisfies the requirements
of this subdivision.

(2) The certifying body, in consultation with the Community
Advisory Committee, shall authorize an interpreter to provide
CommuniCal services if the interpreter passes a screening test
that includes both of the following:

(A) A written test, which need not be language specific, but
which shall include the following categories of knowledge, skills,
and abilities:

(i) Managing an interpreter encounter.

(ii) Health care terminology.

(iii) Interacting with other health care professionals.

(iv) Preparing for an interpreting encounter.

(v) Cultural responsiveness.

(B) An oral test utilizing the target language spoken by the
interpreter to test his or her linguistic and interpreting skills.

(d) Commencing July 1, 2014, in order to be eligible to provide
CommuniCal services pursuant to Article 4.6 (commencing with
Section 14146) of Chapter 7 of Part 3 of Division 9 of the Welfare
and Institutions Code, an interpreter shall be certified as a CCMI
or shall be authorized to provide CommuniCal services pursuant
to subdivision (c).

(e) The certifying body shall maintain a list of all interpreters
who meet the requirements of subdivisions (b) and (c), which shall
be known as the CommuniCal Medical Interpreter Registry.

(f) (1) In order to meet anticipated demand for services under
CommuniCal, the certifying body shall authorize an interpreter
to provide CommuniCal services, until the interpreter becomes
certified pursuant to subdivision (b) or receives an authorization
letter pursuant to subdivision (c), if the person meets all of the
following requirements:

(A) The interpreter can demonstrate that as of January 1, 2014,
he or she has worked for a minimum of two years as an in-person
medical interpreter.

(B) The interpreter is at least 18 years of age.

(C) The interpreter has a minimum of a United States high
school diploma or General Education Development (GED), or its
equivalent from another country.

(D) The interpreter has demonstrated linguistic proficiency in
English and another specified language.

(2) In addition to the provisional authorization provided in
paragraph (1), the certifying body shall authorize an interpreter
to provide CommuniCal services, until the interpreter becomes
certified pursuant to subdivision (b) or receives an authorization
letter pursuant to subdivision (c), if the person graduated from an
accredited medical interpreter training program at a college or
university before January 1, 2014.

(3) If an interpreter who is authorized to provide CommuniCal
services pursuant to paragraphs (1) and (2) does not become
certified or receive an authorization letter by December 31, 2016,
he or she shall not be authorized to provide CommuniCal services.

end insert

3599.52.  

(a) The certifying body shall establish and charge
fees, which do not exceed the reasonable costs, for applicants to
take begin delete the exam end delete begin insert any department-administered examination offered
pursuant to Section 3599.51 end insert . The certifying body shall establish
and charge a single fee that does not exceed the reasonable costs
for certification begin insert , authorization, end insert and listing on the registry. The
purpose of these fees is to cover the annual projected costs of
carrying out this article.

(b) Each begin delete CCMI end delete begin insert CommuniCal interpreter end insert shall pay a registry
and certification begin insert or authorization end insert fee, not to exceed the reasonable
costs, for the renewal of the certification begin insert or authorization end insert and
continued listing on the registry. The registry and certificate begin insert or
authorization end insert fee shall be due on July 1 of each year.

(c) The certifying body shall establish, maintain, administer,
and publish annually an updated registry of begin delete CCMIs end delete begin insert CommuniCal
interpreters end insert . The certifying body may remove the name of a person
from the registry if any of the following conditions occurs:

(1) The person is deceased.

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

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

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

(d) For the 2013-14 fiscal year only, the fee for certification begin insert ,
authorization, end insert and listing on the registry begin delete pursuant to paragraph
(3) of subdivision (b) of end delete begin insert as described in end insert Section 3599.51 is waived.

3599.53.  

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

begin insert

(b) For purposes of assisting with the tasks described in
subdivision (a), the certifying body shall establish the Community
Advisory Committee. The Community Advisory Committee shall
include interested stakeholders that reflect the diversity of the state
in terms of race, ethnicity, gender, sexual orientation, immigration
status, and geography, including representatives of all of the
following industries:

end insert begin insert

(1) Government.

end insert begin insert

(2) Health care providers, such as health care service plans,
physicians, community and federally qualified health clinics,
hospitals, or both.

end insert begin insert

(3) Limited-English-proficient consumers.

end insert begin insert

(4) Health care or language access advocates.

end insert begin insert

(5) Medical or health care interpreters.

end insert begin insert

(6) Any other expert or individual that the department deems
appropriate.

end insert

3599.54.  

The exclusive representative of begin delete CCMIs end delete begin insert CommuniCal
interpreters end insert and a nonprofit organization begin insert , and the Community
Advisory Committee end insert shall partner to create and administer a training
program for medical interpreters, in order to prepare interpreters
for begin delete the exam end delete begin insert any department-administered examination offered
pursuant to Section 3599.51 end insert or other certification standards
established for languages of lesser diffusion and provide continuing
education for those begin delete CCMIs end delete begin insert CommuniCal interpreters end insert placed on
the registry. begin delete A community advisory committee end delete begin insert The Community
Advisory Committee end insert shall begin delete be established to end delete make recommendations
on interpreter certification and services.

3599.55.  

The relationship of begin delete CCMIs end delete begin insert CommuniCal interpreters end insert
to all parties and recipients of service is one of independent
contractor, unless otherwise specified by law.

3599.56.  

Only begin delete interpreters certified pursuant to this article end delete
begin insert CommuniCal interpreters end insert shall be represented by a labor
organization for purposes of collective bargaining pursuant to
Article 2 (commencing with Section 3610).

 

Article 2.  Collective Bargaining for CommuniCal Certified
Medical Interpreters

 

3610.  

(a)  begin delete CCMIs end delete begin insert CommuniCal interpreters end insert shall have the
right to form, join, and participate in the activities of a labor
organization of their own choosing for the purpose of
representation on all matters specified in this section. The state
action antitrust exemption to the application of federal and state
antitrust laws is applicable to the activities of begin delete CCMIs end delete begin insert CommuniCal
interpreters end insert and their exclusive representatives authorized under
this article or other applicable law.

(b)  begin delete CCMIs end delete begin insert CommuniCal interpreters end insert shall have the right to be
represented by an exclusive labor organization of their own
choosing for the purpose of collective bargaining with the State
of California on matters of mutual concern, including, but not
limited to, the following:

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

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

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

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

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

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

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

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

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

(10) The collection and disbursement of established dues or
fees to the exclusive representative of begin delete CCMIs end delete begin insert CommuniCal
interpreters end insert .

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

(d) The appropriate bargaining unit for begin delete CCMIs end delete begin insert CommuniCal
interpreters end insert shall be a statewide unit of eligible begin delete CCMIs end delete
begin insert CommuniCal interpreters end insert .

(e)  begin delete CCMIs end delete begin insert CommuniCal interpreters end insert are not public employees
and this article does not create an employer-employee relationship
between begin delete CCMIs end delete begin insert CommuniCal interpreters end insert and the state or
patient-centered communication brokers for any purpose, including,
but not limited to, state employee eligibility for health or retirement
benefits, or vicarious liability in tort.

3611.  

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

3612.  

Upon request by a labor organization that is signed by
20 percent of begin delete CCMIs end delete begin insert CommuniCal interpreters end insert , the certifying
body shall furnish to the labor organization a list of all begin delete CCMIs end delete
begin insert CommuniCal interpreters end insert including full names, telephone numbers,
email addresses, and mailing or home addresses within five days
of the request.

3613.  

(a) Upon application by petition, authorization cards,
or union membership cards of a labor organization adequately
showing that a majority of begin delete CCMIs end delete begin insert CommuniCal interpreters end insert 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 (PERB) shall certify and grant exclusive representation of
the begin delete CCMIs end delete begin insert CommuniCal interpreters end insert to the labor organization for
the purposes set forth in this section.

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

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

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

(e) Within 10 days of receipt of an adequate petition,
authorization cards, or union membership cards necessitating an
election, PERB shall conduct a preelection conference with the
labor organization and the state prior to scheduling an election for
the purpose of clarifying issues, obtaining stipulations, executing
a directed election order or consent election agreement, and taking
other actions to expedite the process. The labor organization and
the state shall engage in a good faith effort to reach a consent
election agreement stipulating the parties to appear on the ballot,
the form of the ballot, the begin delete CCMIs end delete begin insert CommuniCal interpreters end insert eligible
to vote, the rules governing the election, and the date, time, and
other specifics of the mail ballot election. The state shall be
represented by the Department of Human Resources and the State
Department of Health Care Services.

3614.  

No other labor organization shall be permitted to
intervene in an election unless prior to the preelection conference,
by petition, authorization cards, or union membership cards, the
intervening labor organization adequately shows at least 30 percent
of begin delete CCMIs end delete begin insert CommuniCal interpreters end insert in the state as of January 1
of the year the application is made desire to be represented
exclusively by the intervening labor organization.

3615.  

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

3616.  

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

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

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

(d) The supervising official from PERB shall determine the date
and time ballots must be received for tabulation, which date shall
not be sooner than 10 days or more than 20 days from the date the
voting commences. PERB shall be charged with validating the
ballots against a list of begin delete CCMIs end delete begin insert CommuniCal interpreters end insert provided
by the Department of Human Resources.

(e) A labor organization certified by PERB as receiving a
majority of all valid votes cast is the exclusive representative of
all begin delete CCMIs end delete begin insert CommuniCal interpreters end insert in the state for purposes set
forth in this section. All begin delete CCMIs end delete begin insert CommuniCal interpreters end insert who
are eligible for the bargaining unit pursuant to Section 3610
subsequent to certification of the labor organization shall be part
of the bargaining unit and represented by the certified labor
organization.

3617.  

Discussions and collective bargaining between the
certified labor organization and the state and its designated agents
in the Department of Human Resources and the State Department
of Health Care Services shall commence within 30 days upon
certification and at any time thereafter upon request of the labor
organization.

3618.  

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

3619.  

Any agreement resulting from collective bargaining shall
be legally binding upon the state and committed to writing. Upon
the completion of discussions and collective bargaining, any
agreement shall 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. Nothing herein shall prevent the parties
from agreeing to and effecting those provisions of an agreement
which have received legislative approval or those provisions which
do not require legislative action.

3620.  

Nothing in this article shall affect the right of a begin delete CCMI end delete
begin insert CommuniCal interpreter end insert to authorize a dues or service fee
deduction from his or her reimbursement.

3621.  

(a) 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 members of the labor organization 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.

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

3622.  

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

3623.  

(a) The state, through its designated agents in the
Department of Human Resources and the State Department of
Health Care Services, shall meet and collectively bargain in good
faith with representatives of a certified labor organization and shall
consider fully the proposals made by the labor organization on
behalf of begin delete CCMIs end delete begin insert CommuniCal interpreters end insert . “Meet and collectively
bargain in good faith” means that the state and its designated agent
and representatives of a certified labor organization shall have the
mutual obligation to collectively bargain within a reasonable length
of time in order to freely exchange information, opinions, and
proposals.

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

3624.  

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

3625.  

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

3626.  

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

3627.  

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

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

3628.  

Nothing in this chapter may be construed to interfere
with begin delete CCMI end delete begin insert CommuniCal interpreter end insert rights and responsibilities
under federal law.

SEC. 4.  

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

 

Article 4.6.  CommuniCal

 

14146.  

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

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

(b) “CommuniCal certified medical interpreter” or “CCMI”
means an interpreter certified under the CommuniCal program
pursuant to begin delete Article 1 (commencing with Section 3599.50) of
Chapter 13 of Division 4 of Title 1 end delete begin insert subdivision (b) of Section
3599.51 end insert of the Government Code.

begin insert

(c) “CommuniCal interpreter” means an interpreter who is
authorized to provide CommuniCal services pursuant to Section
3599.51.

end insert begin insert

(d) “Community Advisory Committee” means the committee
established pursuant to Section 3599.53 of the Government Code.

end insert begin delete

(c)

end delete

begin insert (e) end insert  “Department” means the State Department of Health Care
Services.

begin delete

(d)

end delete

begin insert (f) end insert  “Medi-Cal managed care organizations” or “MMCOs” means
all models of Medi-Cal managed care, including county-organized
health systems, geographic managed care, and two-plan models.

begin delete

(e)

end delete

begin insert (g) end insert  “Patient-centered communication broker” or “broker” means
begin delete the end delete begin insert any end insert third-party administrator for the CommuniCal program.

14146.10.  

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

(b) Commencing July 1, 2014, CommuniCal shall offer medical
interpreter services to Medi-Cal providers serving Medi-Cal
beneficiaries on either a fee-for-service or managed care basis
pursuant to this article. The department shall adopt policies to
prohibit duplicate payments to begin delete CCMIs end delete begin insert CommuniCal interpreters end insert
and Medi-Cal MMCOs for beneficiaries enrolled in an MMCO begin insert ,
in consultation with the Community Advisory Committee end insert .

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

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

(e) The department shall pursue all available sources of federal
funding to establish and operate CommuniCal and shall seek any
federal approvals necessary to implement this article begin insert , in
consultation with the Community Advisory Committee end insert .

14146.11.  

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

(a) Family meetings regarding medical care.

(b) Medical encounters involving difficult or agitated patients.

(c) Medical encounters to make treatment decisions.

(d) Obtaining informed consent involving review of documents.

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

(f) Psychiatric encounters.

(g) End-of-life discussions.

begin insert

(h) Other circumstances identified by the Community Advisory
Committee.

end insert

14146.12.  

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

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

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

(1) Registering begin delete CCMIs end delete begin insert CommuniCal interpreters end insert with Medi-Cal.

(2) Verifying begin delete CCMI certification with the Department of Human
Resources end delete begin insert the eligibility of an interpreter to provide CommuniCal
services with the State Department of Health Care Services end insert .

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

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

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

(6) Making payments to begin delete CCMIs end delete begin insert CommuniCal interpreters end insert ,
including any dues and service fee deductions.

(7) Scheduling begin delete CCMI end delete begin insert CommuniCal interpreter end insert appointments
with Medi-Cal providers.

(8) Monitoring the quality of CommuniCal interpreter services
and complying with state oversight requirements of the program begin insert ,
in consultation with the Community Advisory Committee, including
determining the need for multiple brokers to administer
CommuniCal end insert .

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

begin insert

(10) Any other duties determined to be appropriate by the
Community Advisory Committee.

end insert

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

14146.13.  

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

(b)  begin delete CCMIs end delete begin insert CommuniCal interpreters end insert shall be responsible for
all of the following:

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

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

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

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

(c) Unless otherwise prohibited by this article or applicable law,
begin delete CCMIs end delete begin insert CommuniCal interpreters end insert may do any of the following:

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

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

(d) (1) For purposes of the CommuniCal program, begin delete CCMIs end delete
begin insert CommuniCal interpreters end insert are not state employees. begin delete CCMIs end delete
begin insert CommuniCal interpreters end insert shall be independent contractors of the
state.

(2) For purposes of the CommuniCal program, begin delete CCMIs end delete
begin insert CommuniCal interpreters end insert are not employees of the broker, health
care providers, or consumers.

(3) The state action antitrust exemption to the application of
federal and state antitrust laws is applicable to the activities of
begin delete CCMIs end delete begin insert CommuniCal interpreters end insert and their exclusive
representatives authorized under this article or other applicable
law.

14146.135.  

(a) The base reimbursement rate for begin delete CCMIs end delete
begin insert CommuniCal interpreters end insert shall be no less than sixty dollars ($60)
per hour.

(b) Reimbursement may be adjusted for factors begin delete such as end delete begin insert ,
including, but not limited to, end insert geography, language spoken,
availability of interpreters, level of certification, begin delete and end delete travel time begin insert ,
or other factors, in consultation with the Community Advisory
Committee end insert .

14146.14.  

The department shall issue guidance on the
administration of the CommuniCal program to ensure compliance
with this article and all applicable state and federal laws by all
contractors and subcontractors of the program begin insert , in consultation with
the Community Advisory Committee end insert .

14146.15.  

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

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

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