BILL NUMBER: AB 2325	INTRODUCED
	BILL TEXT


INTRODUCED BY   Assembly Member John A. Pérez

                        FEBRUARY 21, 2014

   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 2325, as introduced, 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,
2015, 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 department to be the certifying body
for CommuniCal certified medical interpreters (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) by September 1, 2015, approve an
examination and certification process to test and certify the
competency of medical interpreters, and (3) maintain a registry of
those persons who meet the requirements 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. The bill would also require the
department to establish and charge fees that do not exceed reasonable
costs for applicants to take any department-administered
examinations and be certified or authorized and listed in the
registry, and would require the department, in consultation with the
Community Advisory Committee, to adopt quality standards and medical
interpretation certification requirements through regulations.
   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 CommuniCal interpreters 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
CommuniCal interpreters 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, including their base reimbursement rate.
   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 CommuniCal
interpreters 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 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.
   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 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 subdivision (b) of
Section 3599.51.
   (3) "CommuniCal interpreter" means an interpreter who is
authorized to provide CommuniCal services pursuant to Section
3599.51.
   (4) "Certifying body" or "department" means the State Department
of Health Care Services.
   (5) "Community Advisory Committee" means the committee established
pursuant to Section 3599.53.
   (6) "Interpreter" means an oral interpreter who is fluent in
English and in a necessary second language, who can accurately speak,
read, and readily interpret the necessary second language, but does
not include a sign language interpreter or a deaf-blind interpreter.
   (b) Notwithstanding any other law, the State Department of Health
Care Services shall serve as the CommuniCal certified medical
interpreter (CCMI) certifying body. The certifying body shall do both
of the following:
   (1) Develop, monitor, and evaluate interpreter competency,
qualifications, training, certification, and continuing education
requirements for medical interpreters.
   (2) By September 1, 2015, 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.
   3599.51.  (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 professional level of language
fluency 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 Interpreting 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).

   (5) Hold a current interpreter's certification pursuant to Article
4 (commencing with Section 68560) of Chapter 2 of Title 8 or Article
8 (commencing with Section 11435.05) of Chapter 4.5 of Part 1 of
Division 3 of Title 2.
   (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, 2015, 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, 2015, 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, 2015, he
or she has worked regularly and professionally as an in-person
medical interpreter during the previous two years.
   (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, 2017, he or she
shall not be authorized to provide CommuniCal services.
   3599.52.  (a) The certifying body shall establish and charge fees,
which do not exceed the reasonable costs, for applicants to take any
department-administered examination offered pursuant to Section
3599.51. The certifying body shall establish and charge a single fee
that does not exceed the reasonable costs for certification,
authorization, and listing on the registry. The purpose of these fees
is to cover the annual projected costs of carrying out this article.

   (b) Each CommuniCal interpreter shall pay a registry and
certification or authorization fee, not to exceed the reasonable
costs, for the renewal of the certification or authorization and
continued listing on the registry. The registry and certificate or
authorization 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 CommuniCal interpreters. 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 or
authorization 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 2014-15 fiscal year only, the fee for certification,
authorization, and listing on the registry as described in Section
3599.51 is waived.
   3599.53.  (a) 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.
   (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:
   (1) Government.
   (2) Health care providers, such as health care service plans,
physicians, community and federally qualified health clinics,
hospitals, or both.
   (3) Limited-English-proficient consumers.
   (4) Health care or language access advocates.
   (5) Medical or health care interpreters.
   (6) Any other expert or individual that the department deems
appropriate.
   3599.54.  The exclusive representative of CommuniCal interpreters
and a nonprofit organization, and the Community Advisory Committee
shall partner to create and administer a training program for medical
interpreters, in order to prepare interpreters for any
department-administered examination offered pursuant to Section
3599.51 or other certification standards established for languages of
lesser diffusion and provide continuing education for those
CommuniCal interpreters placed on the registry. The Community
Advisory Committee shall make recommendations on interpreter
certification and services.
   3599.55.  The relationship of CommuniCal interpreters to all
parties and recipients of service is one of independent contractor,
unless otherwise specified by law.
   3599.56.  Only CommuniCal interpreters shall be represented by a
labor organization for purposes of collective bargaining pursuant to
Article 2 (commencing with Section 3599.70).

      Article 2.  Collective Bargaining for CommuniCal Certified
Medical Interpreters


   3599.70.  (a)  CommuniCal interpreters 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 CommuniCal interpreters and their
exclusive representatives authorized under this article or other
applicable law.
   (b)  CommuniCal interpreters 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 CommuniCal interpreters.
   (c) This section shall not apply to work performed as an employee
of an employer.
   (d) The appropriate bargaining unit for CommuniCal interpreters
shall be a statewide unit of eligible CommuniCal interpreters.
   (e)  CommuniCal interpreters are not public employees and this
article does not create an employer-employee relationship between
CommuniCal interpreters 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.
   3599.71.  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.
   3599.72.  Upon request by a labor organization that is signed by
20 percent of CommuniCal interpreters, the certifying body shall
furnish to the labor organization a list of all CommuniCal
interpreters including full names, telephone numbers, email
addresses, and mailing or home addresses within five days of the
request.
   3599.73.  (a) Upon application by petition, authorization cards,
or union membership cards of a labor organization adequately showing
that a majority of CommuniCal interpreters 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 CommuniCal
interpreters 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 CommuniCal interpreters
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 CommuniCal interpreters 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.
   3599.74.  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 CommuniCal interpreters in the state as of January 1 of the year
the application is made desire to be represented exclusively by the
intervening labor organization.
   3599.75.  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.
   3599.76.  (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 CommuniCal interpreters provided by the State
Department of Health Care Services.
   (e) A labor organization certified by PERB as receiving a majority
of all valid votes cast is the exclusive representative of all
CommuniCal interpreters in the state for purposes set forth in this
section. All CommuniCal interpreters who are eligible for the
bargaining unit pursuant to Section 3599.70 subsequent to
certification of the labor organization shall be part of the
bargaining unit and represented by the certified labor organization.
   3599.77.  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.
   3599.78.  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 3599.70.
   3599.79.  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.
   3599.80.  Nothing in this article shall affect the right of a
CommuniCal interpreter to authorize a dues or service fee deduction
from his or her reimbursement.
   3599.81.  (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 3599.70. 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.
   3599.82.  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.
   3599.83.  (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
CommuniCal interpreters. "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 CommuniCal interpreters 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.
   3599.84.  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.

3599.85.  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.
   3599.86.  Should any court declare any other provision of this
chapter void, invalid, illegal, or unconstitutional, the remaining
provisions shall remain in full force.
   3599.87.  (a) The state shall not encourage or discourage
membership in a labor organization and shall not discriminate against
any CommuniCal interpreter 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 CommuniCal interpreter 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 CommuniCal interpreter 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.
   3599.88.  Nothing in this chapter may be construed to interfere
with CommuniCal interpreter 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
subdivision (b) of Section 3599.51 of the Government Code.
   (c) "CommuniCal interpreter" means an interpreter who is
authorized to provide CommuniCal services pursuant to Section
3599.51.
   (d) "Community Advisory Committee" means the committee established
pursuant to Section 3599.53 of the Government Code.
   (e) "Department" means the State Department of Health Care
Services.
   (f) "Interpreter" means an oral interpreter who is fluent in
English and in a necessary second language, who can accurately speak,
read, and readily interpret the necessary second language, but does
not include a sign language interpreter or a deaf-blind interpreter.
   (g) "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.
   (h) "Patient-centered communication broker" or "broker" means any
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, 2015, 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 CommuniCal interpreters and MMCOs for
beneficiaries enrolled in an MMCO, in consultation with the Community
Advisory Committee.
   (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, in
consultation with the Community Advisory Committee.
   14146.11.  CommuniCal shall include the provision of in-person,
telephonic, and video medical interpretation services by a CommuniCal
interpreter. 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.
   (h) Other circumstances identified by the Community Advisory
Committee.
   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 CommuniCal interpreters with Medi-Cal.
   (2) Verifying the eligibility of an interpreter to provide
CommuniCal services with the State Department of Health Care
Services.
   (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 CommuniCal interpreters, including any dues
and service fee deductions.
   (7) Scheduling CommuniCal interpreter appointments with Medi-Cal
providers.
   (8) Monitoring the quality of CommuniCal interpreter services and
complying with state oversight requirements of the program, in
consultation with the Community Advisory Committee, including
determining the need for multiple brokers to administer CommuniCal.
   (9) Creating CommuniCal promotional materials for distribution to
Medi-Cal providers, MMCOs, and beneficiaries.
   (10) Any other duties determined to be appropriate by the
Community Advisory Committee.
   (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 or authorized 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) CommuniCal interpreters 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,
CommuniCal interpreters 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, CommuniCal
interpreters are not state employees. CommuniCal interpreters shall
be independent contractors of the state.
   (2) For purposes of the CommuniCal program, CommuniCal
interpreters 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
CommuniCal interpreters and their exclusive representatives
authorized under this article or other applicable law.
   14146.135.  (a) The base reimbursement rate for CommuniCal
interpreters shall be subject to collective bargaining.
   (b) Reimbursement may be adjusted for factors, including, but not
limited to, geography, language spoken, availability of interpreters,
level of certification, travel time, or other factors, in
consultation with the Community Advisory Committee.
   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, in consultation with
the Community Advisory Committee.
   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.