Amended in Senate April 8, 2013

Senate Bill No. 488

Introduced by Senator begin delete Rubio end delete begin insert Hueso end insert

February 21, 2013

begin delete An act to amend Section 1374.73 of the Health and Safety Code, relating to health care coverage. end delete begin insert An act to amend Sections 17920.3 and 17961 of the Health and Safety Code, relating to housing. end insert

LEGISLATIVE COUNSEL’S DIGEST

SB 488, as amended, begin delete Rubio end delete   begin insert Hueso end insert . begin delete Health care coverage: pervasive developmental disorder or autism. end delete begin insert Substandard housing: regulations. end insert

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(1) Existing law specifies that any building, including any dwelling unit, shall be deemed to be a substandard building when a health officer determines that, among other things, an infestation of insects, vermin, or rodents exists to the extent that it endangers the life, limb, health, property, safety, or welfare of the public or its occupants, or there is a lack of adequate garbage and rubbish storage and removal facilities.

end insert begin insert

This bill would authorize a local enforcement agency, including an environmental agency, housing department, or building department, to make these determinations, as specified, in addition to a health officer.

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(2) Existing law provides that the housing or building department of every city, county, or city and county is required to enforce within its jurisdiction all of the State Housing Law. Existing law further provides that the health department of every city, county, or city and county, or any environmental agency or local building department, may enforce regulations related to lead hazards, as specified, and is required to coordinate enforcement activities with other interested departments and agencies in order to avoid unnecessary duplication.

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This bill would specify that a local housing department is authorized to enforce regulations related to lead hazards.

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Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law requires health care service plan contracts and health insurance policies to provide coverage for behavioral health treatment, as defined, for pervasive developmental disorder or autism. These provisions are inoperative on July 1, 2014, and are repealed on January 1, 2015.

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This bill would make technical, nonsubstantive changes to those provisions.

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Vote: majority. Appropriation: no. Fiscal committee: no. State-mandated local program: no.

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

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begin insert SECTION 1. end insert   

end insert begin insert

The Legislature finds and declares all of the
following:

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(a) Exposure to pests, such as arthropods and rodents, in one’s
home has clear health impacts. Cockroaches are known to produce
allergens that trigger asthma, especially in children. A study
conducted by the National Institutes of Health found that cockroach
allergens are the primary contributor to childhood asthma in
inner-city homes. House mice can spread a type of meningitis. Bed
bug bites can cause itching and become infected, while bed bug
infestations have been linked to severe mental stress.

end insert begin insert

(b) State law limits the enforcement authority for pest
infestations to county health officers. Cities lacking an agreement
or the resources needed to contract with a county for the services
of the county health officer are left without any authority to address
pest infestations.

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begin insert

begin insert SEC. 2. end insert   

end insert

begin insert Section 17920.3 of the end insert begin insert Health and Safety Code end insert begin insert is
amended to read: end insert

17920.3.  

Any building or portion thereof including any
dwelling unit, guestroom or suite of rooms, or the premises on
which the same is located, in which there exists any of the
following listed conditions to an extent that endangers the life,
limb, health, property, safety, or welfare of the public or the
occupants thereof shall be deemed and hereby is declared to be a
substandard building:

(a) Inadequate sanitation shall include, but not be limited to,
the following:

(1) Lack of, or improper water closet, lavatory, or bathtub or
shower in a dwelling unit.

(2) Lack of, or improper water closets, lavatories, and bathtubs
or showers per number of guests in a hotel.

(3) Lack of, or improper kitchen sink.

(4) Lack of hot and cold running water to plumbing fixtures in
a hotel.

(5) Lack of hot and cold running water to plumbing fixtures in
a dwelling unit.

(6) Lack of adequate heating.

(7) Lack of, or improper operation of required ventilating
equipment.

(8) Lack of minimum amounts of natural light and ventilation
required by this code.

(9) Room and space dimensions less than required by this code.

(10) Lack of required electrical lighting.

(11) Dampness of habitable rooms.

(12) Infestation of insects, vermin, or rodents as determined by
begin insert a health officer or, if a health officer is not available or a city has
not entered into an agreement with end insert the begin delete health officer. end delete begin insert county for
the provision of these services, as determined by a local
enforcement agency, as defined in subdivision (c) of Section
105251. end insert

(13) General dilapidation or improper maintenance.

(14) Lack of connection to required sewage disposal system.

(15) Lack of adequate garbage and rubbish storage and removal
begin delete facilities end delete begin insert facilities, end insert as determined by begin delete the end delete begin insert a end insert health begin delete officer. end delete begin insert officer
or local enforcement agency, as defined in subdivision (c) of
Section 105251. end insert

(b) Structural hazards shall include, but not be limited to, the
following:

(1) Deteriorated or inadequate foundations.

(2) Defective or deteriorated flooring or floor supports.

(3) Flooring or floor supports of insufficient size to carry
imposed loads with safety.

(4) Members of walls, partitions, or other vertical supports that
split, lean, list, or buckle due to defective material or deterioration.

(5) Members of walls, partitions, or other vertical supports that
are of insufficient size to carry imposed loads with safety.

(6) Members of ceilings, roofs, ceilings and roof supports, or
other horizontal members which sag, split, or buckle due to
defective material or deterioration.

(7) Members of ceiling, roofs, ceiling and roof supports, or other
horizontal members that are of insufficient size to carry imposed
loads with safety.

(8) Fireplaces or chimneys which list, bulge, or settle due to
defective material or deterioration.

(9) Fireplaces or chimneys which are of insufficient size or
strength to carry imposed loads with safety.

(c) Any nuisance.

(d) All wiring, except that which conformed with all applicable
laws in effect at the time of installation if it is currently in good
and safe condition and working properly.

(e) All plumbing, except plumbing that conformed with all
applicable laws in effect at the time of installation and has been
maintained in good condition, or that may not have conformed
with all applicable laws in effect at the time of installation but is
currently in good and safe condition and working properly, and
that is free of cross connections and siphonage between fixtures.

(f) All mechanical equipment, including vents, except equipment
that conformed with all applicable laws in effect at the time of
installation and that has been maintained in good and safe
condition, or that may not have conformed with all applicable laws
in effect at the time of installation but is currently in good and safe
condition and working properly.

(g) Faulty weather protection, which shall include, but not be
limited to, the following:

(1) Deteriorated, crumbling, or loose plaster.

(2) Deteriorated or ineffective waterproofing of exterior walls,
roof, foundations, or floors, including broken windows or doors.

(3) Defective or lack of weather protection for exterior wall
coverings, including lack of paint, or weathering due to lack of
paint or other approved protective covering.

(4) Broken, rotted, split, or buckled exterior wall coverings or
roof coverings.

(h) Any building or portion thereof, device, apparatus,
equipment, combustible waste, or vegetation that, in the opinion
of the chief of the fire department or his deputy, is in such a
condition as to cause a fire or explosion or provide a ready fuel to
augment the spread and intensity of fire or explosion arising from
any cause.

(i) All materials of construction, except those begin delete which end delete begin insert that end insert are
specifically allowed or approved by this code, and begin delete which end delete begin insert that end insert have
been adequately maintained in good and safe condition.

(j) Those premises on which an accumulation of weeds,
vegetation, junk, dead organic matter, debris, garbage, offal, rodent
harborages, stagnant water, combustible materials, and similar
materials or conditions constitute fire, health, or safety hazards.

(k) Any building or portion thereof that is determined to be an
unsafe building due to inadequate maintenance, in accordance with
the latest edition of the Uniform Building Code.

(l) All buildings or portions thereof not provided with adequate
exit facilities as required by this code, except those buildings or
portions thereof whose exit facilities conformed with all applicable
laws at the time of their construction and that have been adequately
maintained and increased in relation to any increase in occupant
load, alteration or addition, or any change in occupancy.

When an unsafe condition exists through lack of, or improper
location of, exits, additional exits may be required to be installed.

(m) All buildings or portions thereof that are not provided with
the fire-resistive construction or fire-extinguishing systems or
equipment required by this code, except those buildings or portions
thereof that conformed with all applicable laws at the time of their
construction and whose fire-resistive integrity and
fire-extinguishing systems or equipment have been adequately
maintained and improved in relation to any increase in occupant
load, alteration or addition, or any change in occupancy.

(n) All buildings or portions thereof occupied for living,
sleeping, cooking, or dining purposes that were not designed or
intended to be used for those occupancies.

(o) Inadequate structural resistance to horizontal forces.

“Substandard building” includes a building not in compliance
with Section 13143.2.

However, a condition that would require displacement of sound
walls or ceilings to meet height, length, or width requirements for
ceilings, rooms, and dwelling units shall not by itself be considered
sufficient existence of dangerous conditions making a building a
substandard building, unless the building was constructed, altered,
or converted in violation of those requirements in effect at the time
of construction, alteration, or conversion.

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begin insert SEC. 3. end insert   

end insert

begin insert Section 17961 of the end insert begin insert Health and Safety Code end insert begin insert is
amended to read: end insert

17961.  

(a) The housing or building department or, if there is
no building department acting pursuant to this section, the health
department of every city, county, or city and county, or any
environmental agency authorized pursuant to Section 101275, shall
enforce within its jurisdiction all of this part, the building standards
published in the State Building Standards Code, and the other rules
and regulations adopted pursuant to this part pertaining to the
maintenance, sanitation, ventilation, use, or occupancy of apartment
houses, hotels, or dwellings. The health department or the
environmental agency may, in conjunction with a local housing
or building department acting pursuant to this section, enforce
within its jurisdiction all of this part, the building standards
published in the State Building Standards Code, and the other rules
and regulations adopted pursuant to this part pertaining to the
maintenance, sanitation, ventilation, use, or occupancy of apartment
houses, hotels, or dwellings. Each department and agency, as
applicable, shall coordinate enforcement activities with each other
and interested departments and agencies in order to avoid
unnecessary duplication.

(b) Notwithstanding subdivision (a), the health department of
every city, county, or city and county, or any environmental agency
authorized pursuant to Section 101275 may, in addition to the local
building begin insert or housing end insert department, if any, enforce within its
jurisdiction the provisions of Section 17920.10 and shall coordinate
enforcement activities with other interested departments and
agencies in order to avoid unnecessary duplication.

(c) The State Department of Health Services may enforce
Section 17920.10 if any local agency or department specified in
subdivisions (a) and (b) enters into a written agreement, approved
and published pursuant to local government procedures, with the
State Department of Health Services to enforce that section, or
provides the State Department of Health Services with a written
request to enforce that section for a specific case following the
identification of a lead poisoned child in that jurisdiction.

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SECTION 1.  

Section 1374.73 of the Health and Safety Code
is amended to read:

1374.73.  

(a) (1) Every health care service plan contract that
provides hospital, medical, or surgical coverage shall also provide
coverage for behavioral health treatment for pervasive
developmental disorder or autism no later than July 1, 2012. The
coverage shall be provided in the same manner and shall be subject
to the same requirements as provided in Section 1374.72.

(2) Notwithstanding paragraph (1), as of the date that proposed
final rulemaking for essential health benefits is issued, this section
does not require any benefits to be provided that exceed the
essential health benefits that all health plans will be required by
federal regulations to provide under Section 1302(b) of the federal
Patient Protection and Affordable Care Act (Public Law 111-148),
as amended by the federal Health Care and Education
Reconciliation Act of 2010 (Public Law 111-152).

(3) This section shall not affect services for which an individual
is eligible pursuant to Division 4.5 (commencing with Section
4500) of the Welfare and Institutions Code or Title 14
(commencing with Section 95000) of the Government Code.

(4) This section shall not affect or reduce any obligation to
provide services under an individualized education program, as
defined in Section 56032 of the Education Code, or an individual
service plan, as described in Section 5600.4 of the Welfare and
Institutions Code, or under the Individuals with Disabilities
Education Act (20 U.S.C. Sec. 1400, et seq.) and its implementing
regulations.

(b) Every health care service plan subject to this section shall
maintain an adequate network that includes qualified autism service
providers who supervise and employ qualified autism service
professionals or paraprofessionals who provide and administer
behavioral health treatment. Nothing shall prevent a health care
service plan from selectively contracting with providers within
these requirements.

(c) For the purposes of this section, the following definitions
shall apply:

(1) “Behavioral health treatment” means professional services
and treatment programs, including applied behavior analysis and
evidence-based behavior intervention programs, that develop or
restore, to the maximum extent practicable, the functioning of an
individual with pervasive developmental disorder or autism and
that meet all of the following criteria:

(A) The treatment is prescribed by a physician and surgeon
licensed pursuant to Chapter 5 (commencing with Section 2000)
of, or is developed by a psychologist licensed pursuant to Chapter
6.6 (commencing with Section 2900) of, Division 2 of the Business
and Professions Code.

(B) The treatment is provided under a treatment plan prescribed
by a qualified autism service provider and is administered by one
of the following:

(i) A qualified autism service provider.

(ii) A qualified autism service professional supervised and
employed by the qualified autism service provider.

(iii) A qualified autism service paraprofessional supervised and
employed by a qualified autism service provider.

(C) The treatment plan has measurable goals over a specific
timeline that is developed and approved by the qualified autism
service provider for the specific patient being treated. The treatment
plan shall be reviewed no less than once every six months by the
qualified autism service provider and modified whenever
appropriate, and shall be consistent with Section 4686.2 of the
Welfare and Institutions Code pursuant to which the qualified
autism service provider does all of the following:

(i) Describes the patient’s behavioral health impairments to be
treated.

(ii) Designs an intervention plan that includes the service type,
number of hours, and parent participation needed to achieve the
plan’s goal and objectives, and the frequency at which the patient’s
progress is evaluated and reported.

(iii) Provides intervention plans that utilize evidence-based
practices, with demonstrated clinical efficacy in treating pervasive
developmental disorder or autism.

(iv) Discontinues intensive behavioral intervention services
when the treatment goals and objectives are achieved or no longer
appropriate.

(D) The treatment plan is not used for purposes of providing or
for the reimbursement of respite, day care, or educational services
and is not used to reimburse a parent for participating in the
treatment program. The treatment plan shall be made available to
the health care service plan upon request.

(2) “Pervasive developmental disorder or autism” shall have
the same meaning and interpretation as used in Section 1374.72.

(3) “Qualified autism service provider” means either of the
following:

(A) A person, entity, or group that is certified by a national
entity, such as the Behavior Analyst Certification Board, that is
accredited by the National Commission for Certifying Agencies,
and who designs, supervises, or provides treatment for pervasive
developmental disorder or autism, provided the services are within
the experience and competence of the person, entity, or group that
is nationally certified.

(B) A person licensed as a physician and surgeon, physical
therapist, occupational therapist, psychologist, marriage and family
therapist, educational psychologist, clinical social worker,
professional clinical counselor, speech-language pathologist, or
audiologist pursuant to Division 2 (commencing with Section 500)
of the Business and Professions Code, who designs, supervises,
or provides treatment for pervasive developmental disorder or
autism, provided the services are within the experience and
competence of the licensee.

(4) “Qualified autism service professional” means an individual
who meets all of the following criteria:

(A) Provides behavioral health treatment.

(B) Is employed and supervised by a qualified autism service
provider.

(C) Provides treatment pursuant to a treatment plan developed
and approved by the qualified autism service provider.

(D) Is a behavioral service provider approved as a vendor by a
California regional center to provide services as an Associate
Behavior Analyst, Behavior Analyst, Behavior Management
Assistant, Behavior Management Consultant, or Behavior
Management Program as defined in Section 54342 of Title 17 of
the California Code of Regulations.

(E) Has training and experience in providing services for
pervasive developmental disorder or autism pursuant to Division
4.5 (commencing with Section 4500) of the Welfare and
Institutions Code or Title 14 (commencing with Section 95000)
of the Government Code.

(5) “Qualified autism service paraprofessional” means an
uncertified and unlicensed individual who meets all of the
following criteria:

(A) Is employed and supervised by a qualified autism service
provider.

(B) Provides treatment and implements services pursuant to a
treatment plan developed and approved by the qualified autism
service provider.

(C) Meets the criteria set forth in the regulations adopted
pursuant to Section 4686.3 of the Welfare and Institutions Code.

(D) Has adequate education, training, and experience, as
certified by a qualified autism service provider.

(d) This section shall not apply to the following:

(1) A specialized health care service plan that does not deliver
mental health or behavioral health services to enrollees.

(2) A health care service plan contract in the Medi-Cal program
(Chapter 7 (commencing with Section 14000) of Part 3 of Division
9 of the Welfare and Institutions Code).

(3) A health care service plan contract in the Healthy Families
Program (Part 6.2 (commencing with Section 12693) of Division
2 of the Insurance Code).

(4) A health care benefit plan or contract entered into with the
Board of Administration of the Public Employees’ Retirement
System pursuant to the Public Employees’ Medical and Hospital
Care Act (Part 5 (commencing with Section 22750) of Division 5
of Title 2 of the Government Code).

(e) Nothing in this section shall be construed to limit the
obligation to provide services under Section 1374.72.

(f) As provided in Section 1374.72 and in paragraph (1) of
subdivision (a), in the provision of benefits required by this section,
a health care service plan may utilize case management, network
providers, utilization review techniques, prior authorization,
copayments, or other cost sharing.

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

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