Amended in Assembly March 21, 2013

California Legislature—2013–14 Regular Session

Assembly Bill No. 1288

Introduced by Assembly Member V. Manuel Pérez

February 22, 2013

An act to amend begin delete Section 102825 of the Health and Safety Code, relating to death certificates. end delete begin insert Sections 14085.7 and 14085.8 of the Welfare and Institutions Code, relating to health, and making an appropriation therefor. end insert

LEGISLATIVE COUNSEL’S DIGEST

AB 1288, as amended, V. Manuel Pérez. begin delete Death certificates: duties of a physician and surgeon. end delete begin insert Medi-Cal: supplemental hospital funding. end insert

begin insert

Existing law, operative until June 30, 2013, establishes the Medi-Cal Medical Education Supplemental Payment Fund and the Large Teaching Emphasis Hospital and Children’s Hospital Medi-Cal Medical Education Supplemental Payment Fund. Moneys in those funds are continuously appropriated to the State Department of Health Care Services to make supplemental payments to eligible teaching hospitals to reflect additional costs incurred by those hospitals for services rendered to Medi-Cal beneficiaries.

end insert begin insert

This bill would prohibit supplemental payments from those funds to a hospital unless the hospital has demonstrated that it provides primary care, pediatric care, and obstetric and gynecology care to individuals from medically underserved communities. The bill would also extend the operation of these provisions to June 30, 2015, and, by extending the operative period of continuously appropriated funds, would make an appropriation.

end insert begin delete

Existing law requires that each death be registered with the local registrar of births and deaths in the district in which the death was officially pronounced or the body was found. Existing law requires the physician and surgeon last in attendance to complete and attest to the medical and health section data and the time of death on the certificate of death, except as specified. Existing law also requires that the physician and surgeon last in attendance state on the certificate of death the disease or condition directly leading to death, antecedent causes, or other significant conditions contributing to death, as specified.

end delete begin delete

This bill would make a technical, nonsubstantive change to that provision.

end delete

Vote:  begin delete majority end delete begin insert ²⁄₃ end insert . Appropriation:  begin delete no end delete begin insert yes end insert . Fiscal committee:  begin delete no end delete begin insert yes end insert . State-mandated local program: no.

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

begin insert

begin insert SECTION 1. end insert   

end insert

begin insert Section 14085.7 of the end insert begin insert Welfare and Institutions
Code end insert begin insert is amended to read: end insert

14085.7.  

(a) The Medi-Cal Medical Education Supplemental
Payment Fund is hereby created in the State Treasury.
Notwithstanding Section 13340 of the Government Code, the fund
shall be continuously appropriated to, and under the administrative
control of, the department for the purposes specified in this section.
Except as otherwise limited by this section, the fund shall consist
of all of the following:

(1) All public moneys transferred by public agencies to the
department for deposit into the fund, as permitted under Section
433.51 of Title 42 of the Code of Federal Regulations or any other
applicable federal Medicaid laws.

(2) All private moneys donated by private individuals or entities
to the department for deposit in the fund as permitted under
applicable federal Medicaid laws.

(3) Any amounts appropriated to the fund by the Legislature.

(4) Any interest that accrues on amounts in the fund.

(b) Any public agency transferring moneys to the fund may, for
that purpose, utilize any revenues, grants, or allocations received
from the state for health care programs or purposes, unless
otherwise prohibited by law. A public agency may also utilize its
general funds or any other public moneys or revenues for purposes
of transfers to the fund, unless otherwise prohibited by law.

(c) The department shall have the discretion to accept or not
accept moneys offered to the department for deposit in the fund.
If the department accepts moneys pursuant to this section, the
department shall obtain federal matching funds to the full extent
permitted by law. The department shall accept only those funds
that are certified by the transferring or donating entity as qualifying
for federal financial participation under the terms of the Medicaid
Voluntary Contribution and Provider-Specific Tax Amendments
of 1991 (Public Law 102-234) or Section 433.51 of Title 42 of the
Code of Federal Regulations, as applicable, and may return any
funds transferred or donated in error.

(d) Moneys in the fund shall be used as the source for the
nonfederal share of payments to hospitals under this section.
Moneys shall be allocated from the fund by the department and
matched by federal funds in accordance with customary Medi-Cal
accounting procedures for purposes of payments under subdivision
(e). Distributions from the fund shall be supplemental to any other
amounts that hospitals receive under the contracting program.

(e)  begin insert (1) end insert begin insert   end insert For purposes of recognizing medical education costs
incurred for services rendered to Medi-Cal beneficiaries, payments
from this fund shall be negotiated between the California Medical
Assistance Commission and hospitals contracting under this article
that meet the definition of university teaching hospitals or major
(nonuniversity) teaching hospitals as set forth on page 51 and as
listed on page 57 of the department’s report dated May 1991,
entitled “Hospital Peer Grouping.” Payments from the fund shall
be used solely for the purposes identified in the contract between
the hospital and the state.

begin insert

(2) The department shall not make payments from the fund to
a hospital contracting under this article unless the hospital has
demonstrated to the commission’s satisfaction that the hospital
provides primary care, pediatric care, and obstetric and
gynecology care to individuals from medically underserved
communities. This paragraph shall not apply to payments from
the fund made under contracts entered into before the operative
date of the act adding this paragraph.

end insert

(f) The state shall be held harmless from any federal
disallowance resulting from this section. A hospital receiving
supplemental reimbursement pursuant to this section shall be liable
for any reduced federal financial participation resulting from the
implementation of this section with respect to that hospital. The
state may recoup any federal disallowance from the hospital.

(g) This section shall become inoperative on June 30, begin delete 2013, end delete
begin insert 2015, end insert and, as of January 1, begin delete 2014, end delete begin insert 2016, end insert is repealed, unless a later
enacted statute, that becomes operative on or before January 1,
begin delete 2014, end delete begin insert 2016, end insert deletes or extends the dates on which it becomes
inoperative and is repealed.

begin insert

begin insert SEC. 2. end insert   

end insert

begin insert Section 14085.8 of the end insert begin insert Welfare and Institutions Code end insert
begin insert is amended to read: end insert

14085.8.  

(a) The Large Teaching Emphasis Hospital and
Children’s Hospital Medi-Cal Medical Education Supplemental
Payment Fund is hereby created in the State Treasury.

(b) Notwithstanding Section 13340 of the Government Code,
the fund shall be continuously appropriated to, and under the
administrative control of, the department for the purposes specified
in this section.

(c) Except as otherwise limited by this section, the fund shall
consist of all of the following:

(1) All public moneys transferred by public agencies to the
department for deposit into the fund, as permitted under Section
433.51 of Title 42 of the Code of Federal Regulations or any other
applicable federal Medicaid laws.

(2) All private moneys donated by private individuals or entities
to the department for deposit in the fund as permitted under
applicable federal Medicaid laws.

(3) Any amounts appropriated to the fund by the Legislature.

(4) Any interest that accrues on amounts in the fund.

(d) Any public agency transferring moneys to the fund may, for
that purpose, utilize any revenues, grants, or allocations received
from the state for health care programs or purposes, unless
otherwise prohibited by law. A public agency may also utilize its
general funds or any other public moneys or revenues for purposes
of transfers to the fund, unless otherwise prohibited by law.

(e) The department may accept or not accept moneys offered
to the department for deposit in the fund. If the department accepts
moneys pursuant to this section, the department shall obtain federal
matching funds to the full extent permitted by law. The department
shall accept only those funds that are certified by the transferring
or donating entity as qualifying for federal financial participation
under the terms of the Medicaid Voluntary Contribution and
Provider-Specific Tax Amendments of 1991 (Public Law 102-234)
or Section 433.51 of Title 42 of the Code of Federal Regulations,
as applicable, and may return any funds transferred or donated in
error.

(f) Moneys in the fund shall be used as the source for the
nonfederal share of payments to hospitals under this section.
Moneys shall be allocated from the fund by the department and
matched by federal funds in accordance with customary Medi-Cal
accounting procedures for purposes of payments under subdivision
(g). Distributions from the fund shall be supplemental to any other
amounts that hospitals receive under the contracting program.

(g) (1) For purposes of recognizing medical education costs
incurred for services rendered to Medi-Cal beneficiaries, contracts
for payments from the fund may, at the discretion of the California
Medical Assistance Commission, be negotiated between the
commission and hospitals contracting under this article that are
defined as either of the following:

(A) A large teaching emphasis hospital, as set forth on page 51
and listed on page 57 of the department’s report dated May 1991,
entitled “Hospital Peer Grouping,” and meets the definition of
eligible hospital as defined in paragraph (3) of subdivision (a) of
Section 14105.98.

(B) A children’s hospital pursuant to Section 10727 and meets
the definition of eligible hospital as defined in paragraph (3) of
subdivision (a) of Section 14105.98.

(2) Payments from the fund shall be used solely for the purposes
identified in the contract between the hospital and the state.

begin insert

(3) The department shall not make payments from the fund to
a hospital contracting under this article unless the hospital has
demonstrated to the commission’s satisfaction that the hospital
provides primary care, pediatric care, and obstetric and
gynecology care to individuals from medically underserved
communities. This paragraph shall not apply to payments from
the fund made under contracts entered into before the operative
date of the act adding this paragraph.

end insert

(h) The state shall be held harmless from any federal
disallowance resulting from this section. A hospital receiving
supplemental reimbursement pursuant to this section shall be liable
for any reduced federal financial participation resulting from the
implementation of this section with respect to that hospital. The
state may recoup any federal disallowance from the hospital.

(i) This section shall become inoperative on June 30, begin delete 2013, end delete
begin insert 2015, end insert and, as of January 1, begin delete 2014, end delete begin insert 2016, end insert is repealed, unless a later
enacted statute, that becomes operative on or before January 1,
begin delete 2014 end delete begin insert 2016 end insert , deletes or extends the dates on which it becomes
inoperative and is repealed.

begin delete

SECTION 1.  

Section 102825 of the Health and Safety Code
is amended to read:

102825.  

The physician and surgeon last in attendance, or in
the case of a patient in a skilled nursing or intermediate care facility
at the time of death, the physician and surgeon last in attendance
or a licensed physician assistant under the supervision of the
physician and surgeon last in attendance, on a deceased person
shall state on the certificate of death the disease or condition
directly leading to death, antecedent causes, other significant
conditions contributing to death and any other medical and health
section data as may be required on the certificate. He or she shall
also specify the time in attendance, the time he or she last saw the
deceased person alive, and the hour and day on which death
occurred, except in deaths required to be investigated by the
coroner. The physician and surgeon or physician assistant shall
specifically indicate the existence of any cancer as defined in
subdivision (e) of Section 103885, of which the physician and
surgeon or physician assistant has actual knowledge.

A physician and surgeon may designate one or more other
physicians and surgeons who have access to the physician and
surgeon’s records to act as agent for the physician and surgeon for
purposes of the performance of his or her duties under this section,
provided that any person so designated acts in consultation with
the physician and surgeon.

end delete