BILL ANALYSIS Ó
AB 1263
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Date of Hearing: May 1, 2013
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Mike Gatto, Chair
AB 1263 (John A. Pérez) - As Amended: April 11, 2013
Policy Committee: HealthVote:13-5
PERSS 5-2
Urgency: No State Mandated Local Program:
No Reimbursable: No
SUMMARY
Establishes the Medi-Cal Patient Centered Communication
(CommuniCal) program at the Department of Health Care Services
(DHCS) to provide and reimburse for certified medical
interpretation services to limited English proficient (LEP)
Medi-Cal enrollees. Establishes a certification process and
registry of CommuniCal certified medical interpreters (CCMI) at
the California Department of Human Resources (CalHR) and grants
CCMI collective bargaining rights with the state. Specifically,
this bill:
1)Requires CommuniCal to offer medical interpreter services
beginning July 1, 2014 and permits providers and health plans
to utilize CommuniCal to provide medical interpreter services
to Medi-Cal beneficiaries, as specified.
2)Requires DHCS to pursue federal funding and seek any necessary
federal approvals.
3)Requires CommuniCal to include in-person, telephonic, and
video medical interpretation services, with in-person
designated as the preferred mode whenever possible, as
specified.
4)Requires DHCS to create and administer a competitive Request
for Proposal (RFP) and to execute a contract for CommuniCal to
be administered by a patient-centered communication broker, as
specified.
5)Includes, among the CCMI certification requirements, an exam
to be administered by a nonprofit organization selected by
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CalHR. Requires CalHR to select an examination for
Spanish-language medical interpretation within 120 days of
this bill's implementation and provides a process by which
testing, training, and experience standards for interpreters
of other languages can be assessed so that interpreters of
those languages may be placed on the registry.
6)Grants CCMIs the right to form, join, and participate in the
activities of a labor organization of their own choosing for
collective bargaining with the state on matters of mutual
concern, as specified, and requires the Public Employment
Relations Board (PERB), to certify a labor organization and
undertake related activities if specified requirements are
met. Provides CCMIs are not public employees.
FISCAL EFFECT
1)One-time costs likely in the hundreds of thousands of dollars
to develop program guidelines, seek necessary federal
approvals, and contract for CommuniCal administration.
2)Ongoing costs potentially exceeding several million dollars
per year to provide interpreter services in fee-for-service
Medi-Cal. The actual cost of this voluntary program will
depend on the demand level for interpreter services not
already being met.
3)Minor costs in Medi-Cal managed care. Under current law,
health plans are required to provide interpretation services,
including managed care plans that contract with the Department
of Health Care Services. It is unclear whether the bill's
provisions would increase costs above what is already
incurred.
4)Potential one-time costs of $139,000 and ongoing annual costs
of $53,000 per year to PERB.
5)State GF costs would be offset by an enhanced federal match of
75%, pursuant to a 2010 federal guidance, rather than the 50%
match generally attributable for administrative costs.
COMMENTS
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1)Rationale . Various federal and state laws require health
providers and health plans receiving federal funding to
provide interpreter services to patients. Despite these
requirements in law, there are indications not all Medi-Cal
beneficiaries receive care in a linguistically appropriate
manner. The author notes, "Language barriers can contribute to
inadequate patient evaluation and diagnosis, lack of
appropriate and/or timely treatment or other medical errors
than can jeopardize patient safety." Enhanced federal
funding opportunities allow California to develop a more
comprehensive language assistance program.
2)Prior legislation . AB 2392 (John A. Pérez) of 2012 was
similar to this bill. AB 2392 passed both houses of the
legislature but was not taken up for concurrence in the
Assembly.
SB 853 (Escutia), Chapter 713, Statutes of 2003, requires the
Department of Managed Health Care and the California
Department of Insurance to adopt regulations to ensure
enrollees have access to language assistance in obtaining
health care services.
3)Related legislation . AB 505 (Nazarian) codifies existing
Medi-Cal MCP requirements to provide language assistance,
translation, and interpretation services when populations
reach specified thresholds. AB 505 is pending in this
committee.
AB 1376 (Roger Hernández) proposes to eliminate CalHR's role
in maintaining the published list of certified administrative
hearing and medical examination interpreters and repeal the
annual fee interpreters previously paid to be included on the
list. AB 1376 grants each department subject to language
assistance responsibilities the ability to qualify and retain
interpreters as needed. AB 1376 passed out of the Assembly
Judiciary and Insurance Committees and is pending in this
committee.
Analysis Prepared by : Debra Roth / APPR. / (916) 319-2081
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