BILL ANALYSIS                                                                                                                                                                                                    Ó




                   Senate Appropriations Committee Fiscal Summary
                            Senator Kevin de León, Chair


          AB 1263 (J. Perez) - Medi-Cal: CommuniCal.
          
          Amended: July 10, 2013          Policy Vote: PE&R 3-2, Health  
          7-2
          Urgency: No                     Mandate: No
          Hearing Date: August 30, 2013                           
          Consultant: Brendan McCarthy    
          
          SUSPENSE FILE.
          
          
          Bill Summary: AB 1263 would require the Department of Health  
          Care Services to establish a program to provide for and  
          reimburse for medical interpretation services provided to  
          Medi-Cal enrollees with limited English proficiency. The bill  
          would grant collective bargaining rights to interpreters  
          providing services through the program.

          Fiscal Impact: 
              One-time costs of $1.4 million to develop program  
              guidelines, seek necessary federal approvals, and develop  
              billing systems (50% General Fund, 50% federal funds).

              One-time costs of about $50,000 to develop regulations  
              relating to collective bargaining of translators by the  
              Public Employment Relations Board (General Fund).

              One-time costs of about $90,000 and ongoing costs of about  
              $50,000 to oversee an election by translators to choose a  
              collective bargaining agent by the Public Employment  
              Relations Board (General Fund).

              Periodic costs up to $1 million for negotiating a  
              memorandum of understanding with the established bargaining  
              unit and overseeing the implementation by the Department of  
              Human Resources (General Fund).

              Ongoing costs of about $30 million per year to provide  
              translation services in fee-for-service Medi-Cal (General  
              Fund and federal funds).

              Unknown costs in Medi-Cal managed care (General Fund and  








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              federal funds). 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 requirement to  
              provide "certified medical interpretation services" at  
              reimbursement rates subject to collective bargaining would  
              increase costs for translation services, above the costs  
              already being incurred.

              The federal financial participation rate for the costs  
              above may vary. For interpretive services provided to  
              children and their family members, the state can claim a 75%  
              federal financial participation rate. However, those costs  
              are only eligible for a 75% federal cost share if they are  
              billed as administrative costs (as opposed to benefits). For  
              childless adults, the rate is generally 50%.

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

          The federal Civil Rights Act of 1964 and implementing  
          regulations prohibit the discrimination against any person based  
          on race, color, or national origin by entities that receive  
          federal assistance. The federal Office for Civil Rights enforces  
          these requirements and has indicated through guidance that  
          entities receiving federal funding may be required to provide  
          access to translation services for limited English-speaking  
          program beneficiaries.

          Current state law requires all licensed managed care plans to  
          provide interpretation services to enrollees who are limited  
          English proficient. Current law also requires all licensed  
          managed care plans to provide translation services based on the  
          concentration of non-English speaking enrollees. These  
          requirement apply to Medi-Cal managed care plans, but allow the  








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          regulatory agencies to deem Medi-Cal managed care plans in  
          compliance if they meet more stringent requirements through  
          contractual requirements.

          Despite these requirements in law, there are indications that  
          not all Medi-Cal beneficiaries are receiving care in a  
          linguistically appropriate manner. According to the California  
          Health Interview Survey, about 8% of adults in Medi-Cal had  
          difficulty understanding their doctor or required another person  
          to help them understand their doctor. Similarly, about 7% of the  
          parents of children enrolled in Medi-Cal had difficulty  
          understanding their doctor or needed another person to help them  
          understand their doctor.

          Proposed Law: AB 1263 would require the Department of Health  
          Care Services to establish a program to provide for and  
          reimburse for medical interpretation services provided to  
          Medi-Cal enrollees with limited English proficiency. The bill  
          would grant interpreters providing services through the program  
          with collective bargaining rights.

          Major provisions of the bill would:
              Require the Department of Health Care Services to establish  
              the "CommuniCal"  program for interpretation services to  
              Medi-Cal beneficiaries;
              Permit Medi-Cal health care providers, in both  
              fee-for-service and managed care, to use CommuniCal;
              Require CommuniCal to be administered by an independent  
              broker;
              Require participating interpreters to be certified by the  
              Department;
              Require certified interpreters to have specified  
              qualifications;
              Grant CommuniCal interpreters the right to be represented  
              by a labor organization, which would be responsible for  
              state-wide collective bargaining for the interpreters;
              Provide the procedures under which interpreters may select  
              a labor organization and the responsibilities of the  
              Department of Human Resources and the Public Employment  
              Relations Board in bargaining with such a labor  
              organization.

          Related Legislation: 
              AB 2392 (J. Perez, 2012) was substantially similar to this  








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              bill. That bill was moved to the Assembly Inactive File on  
              concurrence in Senate amendments.
              AB 505 (Nazarian) would codify current practice regarding  
              language assistance in the Medi-Cal program. That bill is on  
              the Senate Floor.

          Staff Comments: The availability of enhanced federal financial  
          participation for translation services indicates that there may  
          be opportunities to improve access to care for non-English  
          proficient Medi-Cal beneficiaries at a reduced cost to the  
          state. On the other hand, it is not clear whether the program to  
          provide certified translation services, as required under the  
          bill, would be a more economical method of providing translation  
          services than the current methods used by health care providers.  
          If a centralized system managed by the Department is more costly  
          than the methods currently in use, cost savings may be minimal.

          Improving translation services for people with limited English  
          proficiency would likely have mixed impacts on Medi-Cal costs.  
          By improving enrollees' ability to communicate with providers,  
          the bill is likely to enable enrollees to more easily access  
          care, increasing utilization and costs. On the other hand,  
          better communication between a patient and a provider may  
          improve the patient and the provider's ability to manage the  
          patient's health, potentially reducing long-term costs.