BILL ANALYSIS Ó SB 870 Page 1 ( Without Reference to File ) SENATE THIRD READING SB 870 (Budget and Fiscal Review Committee) As Amended June 13, 2014 Majority vote. Budget Bill Appropriation Takes Effect Immediately SENATE VOTE :Vote not relevant SUMMARY : This is one of two Omnibus Health Trailer Bills for 2014-15. This bill contains necessary changes related to the Budget Act of 2014. This bill makes various statutory changes to implement the 2014-15 budget. Specifically, this bill : 1)Requires behavioral health treatment (BHT) to be a covered Medi-Cal service for individuals under age 21 to the extent required by the federal government. Requires the Department of Health Care Services (DHCS) to implement this benefit only after: a) receiving all necessary federal approvals to obtain federal funds for these services; b) an appropriation for necessary state funding has been made; and c) DHCS has consulted with stakeholders. Authorizes DHCS to enter into new contracts, and amend existing contracts, to provide or arrange for BHT services. Authorizes DHCS to seek approval of necessary state plan amendments or waivers to implement this benefit. 2)Expresses the intent of the Legislature that Medi-Cal rates be adjusted on an ongoing basis to ensure adequate access to services based on access monitoring performed by DHCS. 3)Increases the Medi-Cal reimbursement rates for Programs of All Inclusive Care for the Elderly (PACE), beginning April 1, 2015, by increasing payments from a minimum of 90% of the equivalent fee-for-service cost to a minimum of 95% of the equivalent fee-for-service cost. 4)Authorizes DHCS to collect supplemental rebates on specialty high cost drugs, such as hepatitis C treatments and blood factor. Requires DHCS to set the clinical guidelines for these drugs. Requires that capitation payments to managed care plans be reduced to account for these classes of drugs, and instead, provide plans with a "kick" payment when drugs in SB 870 Page 2 the class are prescribed. 5)Establishes a three-year pilot program in Los Angeles County to enable school districts to allow students enrolled in Medi-Cal managed care plans to receive vision care services at school through a mobile vision service provider. Requires the Medi-Cal managed care plans in a participating county to contract with one or more mobile vision care service providers to deliver the services if a school district enters into a memorandum of understanding with a mobile vision care service provider. Requires the Medi-Cal managed care plan to compensate the mobile vision services provider for the cost of the vision examination, dispensing of the lenses, and eyeglass frames. Requires DHCS to annually adjust capitation rates for participating Medi-Cal managed care plans. 6)Authorizes a one-time appropriation of $3.2 million from the Major Risk Medical Insurance Fund to be allocated to health benefit plans that are funded by contributions made by agricultural employers, where 85% or more of the plan's eligible participants are agricultural employees for work performed and covered under a collective bargaining agreement, and meet other specified requirements. 7)Authorizes a one-time appropriation of $37.5 million from the Major Risk Medical Insurance Fund to be allocated to DHCS for purposes of electronic health records technical assistance in accordance with the State Medicaid Health Information Technology Plan, as specified in Welfare and Institutions Code Section 14046.1. 8)Requires the Department of Public Health (DPH) to establish up to four two-year public health demonstration projects by awarding competitive grants for innovative, evidence-based approaches to provide outreach, human immunodeficiency virus (HIV) and hepatitis C screenings, and linkage to, and retention in, quality health care for vulnerable and underserved individuals with a high risk for HIV infection. Requires DPH to evaluate the projects to determine statewide applicability and specifies the qualifications of grant applicants. 9)Authorizes the Office of Statewide Health Planning and Development to make grants, through contracts with medical SB 870 Page 3 residency programs, to support new residency slots that meet all of the qualifications of the Song Brown Program. Requires that the new residency slots, in order to receive financial support, give priority to graduates of California-based medical schools. 10)Reappropriates Department of Developmental Services Funds. COMMENT : This bill is a budget trailer bill within the 2014-15 budget package to implement actions taken affecting the Departments of Developmental Services, Health Care Services and Public Health, and the Office of Statewide Health Planning and Development. Analysis prepared by : Andrea Margolis / BUDGET / (916) 319-2099 FN: 0003961