Senate BillNo. 1465


Introduced by Committee on Health (Senators Hernandez (Chair), Anderson, Beall, De León, DeSaulnier, Evans, Monning, Nielsen, and Wolk)

March 20, 2014


An act to amend Sections 8880.5, 14670.3, and 14670.5 of the Government Code, to amend Section 1797.98b of the Health and Safety Code, to amend and renumber Section 10961 of the Insurance Code, to amend Sections 667.5, 830.3, 830.5, and 3000 of the Penal Code, to amend Section 2356 of the Probate Code, and to amend Sections 736, 5328.15, 6000, 6002, 6600, 6601, 6608.7, 6609, 9717, 10600.1, 14043.26, 14105.192, 14169.51, 14169.52, 14169.53, 14169.55, 14169.56, 14169.58, 14169.59, 14169.61, 14169.63, 14169.65, 14169.66, 14169.72, 14312, 14451, 15657.8, 16541, and 17608.05 of the Welfare and Institutions Code, relating to health, and declaring the urgency thereof, to take effect immediately.

LEGISLATIVE COUNSEL’S DIGEST

SB 1465, as introduced, Committee on Health. Health.

(1) Existing law establishes the Maddy Emergency Medical Services (EMS) Fund, and authorizes each county to establish an emergency medical services fund for reimbursement of costs related to emergency medical services. Existing law requires each county establishing a fund to, on January 1, 1989, and each April 15 thereafter, report to the Legislature on the implementation and status of the Emergency Medical Services Fund, as specified.

This bill would instead require each county to submit its reports to the Emergency Medical Services Authority. The bill would require the authority to compile and forward a summary of each county’s report to the appropriate policy and fiscal committees of the Legislature.

(2) Existing law creates the California Health Benefit Exchange for the purpose of facilitating the enrollment of qualified individuals and small employers in qualified health plans. Existing law requires the Exchange to enter into contracts with and certify as a qualified health plan bridge plan products that meet specified requirements. Existing law provides for the regulation of health insurers by the Department of Insurance and defines a bridge plan product to include an individual health benefit plan offered by a health insurer. Existing law requires, until 5 years after federal approval of bridge plan products, a health insurer selling a bridge plan product to provide specified enrollment periods and to maintain a medical loss ratio of 85% for the product. Existing law specifies that the remaining provisions of the chapter of law to which these requirements regarding bridge plan products were added became inoperative on January 1, 2014.

This bill would relocate those requirements regarding bridge plan products to a different chapter of law and make other technical, nonsubstantive changes.

(3) 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 law requires an applicant or provider, as defined, to submit a complete application package for enrollment, continuing enrollment, or enrollment at a new location or a change in location. Existing law generally requires the department to give written notice as to the status of an application to an applicant or provider within 180 days after receiving an application package, or from the date of notifying an applicant or provider that he or she does not qualify as a preferred provider, notifying the applicant or provider if specified circumstances apply.

This bill would require the department to notify the applicant or provider if the application package is withdrawn by request of the applicant and the department’s review is canceled.

(4) Existing law, subject to federal approval, imposes a hospital quality assurance fee, as specified, on certain general acute care hospitals, to be deposited into the Hospital Quality Assurance Revenue Fund. Existing law, subject to federal approval, requires that moneys in the Hospital Quality Assurance Revenue Fund be continuously appropriated during the first program period of January 1, 2014, to December 31, 2016, inclusive, and available only for certain purposes, including paying for health care coverage for children, as specified, and making supplemental payments for certain services to private hospitals and increased capitation payments to Medi-Cal managed care plans. Existing law also requires the payment of direct grants to designated and nondesignated public hospitals in support of health care expenditures funded by the quality assurance fee for the first program period. For subsequent program periods, existing law authorizes the payment of direct grants for designated and nondesignated public hospitals and requires that the moneys in the Hospital Quality Assurance Revenue Fund be used for the above-described purposes upon appropriation by the Legislature in the annual Budget Act.

This bill would define the term “fund” to mean the Hospital Quality Assurance Revenue Fund for the purposes of these provisions and would make other technical, conforming changes to these provisions.

(5) Existing law provides for state hospitals for the care, treatment, and education of mentally disordered persons, which are under the jurisdiction of the State Department of State Hospitals.

This bill would make technical, nonsubstantive changes to various provisions of law to, in part, delete obsolete references to the State Department of Mental Health. The bill would also make other technical, nonsubstantive changes.

(6) This bill would declare that it is to take effect immediately as an urgency statute.

Vote: 23. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

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

P3    1

SECTION 1.  

Section 8880.5 of the Government Code is
2amended to read:

3

8880.5.  

Allocations for education:

4The California State Lottery Education Fund is created within
5the State Treasury, and is continuously appropriated for carrying
6out the purposes of this chapter. The Controller shall draw warrants
7on this fund and distribute them quarterly in the following manner,
8provided that the payments specified in subdivisions (a) to (g),
9inclusive, shall be equal per capita amounts.

10(a) (1) Payments shall be made directly to public school
11districts, including county superintendents of schools, serving
12kindergarten and grades 1 to 12, inclusive, or any part thereof, on
P4    1the basis of an equal amount for each unit of average daily
2attendance, as defined by law and adjusted pursuant to subdivision
3 (l).

4(2) For purposes of this paragraph, in each of the 2008-09,
52009-10, 2010-11, 2011-12, 2012-13, 2013-14, and 2014-15
6fiscal years, the number of units of average daily attendance in
7each of those fiscal years for programs for public school districts,
8including county superintendents of schools, serving kindergarten
9and grades 1 to 12, inclusive, shall include the same amount of
10average daily attendance for classes for adults and regional
11occupational centers and programs used in the calculation made
12pursuant to this subdivision for the 2007-08 fiscal year.

13(b) Payments shall also be made directly to public school
14districts serving community colleges, on the basis of an equal
15amount for each unit of average daily attendance, as defined by
16law.

17(c) Payments shall also be made directly to the Board of Trustees
18of the California State University on the basis of an amount for
19each unit of equivalent full-time enrollment. Funds received by
20the trustees shall be deposited in and expended from the California
21State University Lottery Education Fund, which is hereby created
22or, at the discretion of the trustees, deposited in local trust accounts
23in accordance with subdivision (j) of Section 89721 of the
24Education Code.

25(d) Payments shall also be made directly to the Regents of the
26University of California on the basis of an amount for each unit
27of equivalent full-time enrollment.

28(e) Payments shall also be made directly to the Board of
29Directors of the Hastings College of the Law on the basis of an
30amount for each unit of equivalent full-time enrollment.

31(f) Payments shall also be made directly to the Department of
32the Youth Authority for educational programs serving kindergarten
33and grades 1 to 12, inclusive, or any part thereof, on the basis of
34an equal amount for each unit of average daily attendance, as
35defined by law.

36(g) Payments shall also be made directly to the two California
37Schools for the Deaf, the California School for the Blind, and the
38three Diagnostic Schools for Neurologically Handicapped Children,
39on the basis of an amount for each unit of equivalent full-time
40enrollment.

P5    1(h) Payments shall also be made directly to the State Department
2of Developmental Services and the State Department ofbegin delete Mental
3Healthend delete
begin insert State Hospitalsend insert for clients with developmental or mental
4disabilities who are enrolled in state hospital education programs,
5including developmental centers, on the basis of an equal amount
6for each unit of average daily attendance, as defined by law.

7(i) No Budget Act or other statutory provision shall direct that
8payments for public education made pursuant to this chapter be
9used for purposes and programs (including workload adjustments
10and maintenance of the level of service) authorized by Chapters
11498, 565, and 1302 of the Statutes of 1983, Chapter 97 or 258 of
12the Statutes of 1984, or Chapter 1 of the Statutes of the 1983-84
13Second Extraordinary Session.

14(j) School districts and other agencies receiving funds distributed
15pursuant to this chapter may at their option utilize funds allocated
16by this chapter to provide additional funds for those purposes and
17programs prescribed by subdivision (i) for the purpose of
18enrichment or expansion.

19(k) As a condition of receiving any moneys pursuant to
20subdivision (a) or (b), each school district and county
21superintendent of schools shall establish a separate account for the
22receipt and expenditure of those moneys, which account shall be
23clearly identified as a lottery education account.

24(l) Commencing with the 1998-99 fiscal year, and each year
25thereafter, for purposes of subdivision (a), average daily attendance
26shall be increased by the statewide average rate of excused
27absences for the 1996-97 fiscal year as determined pursuant to the
28provisions of Chapter 855 of the Statutes of 1997. The statewide
29average excused absence rate, and the corresponding adjustment
30factor required for the operation of this subdivision, shall be
31certified to the State Controller by the Superintendent of Public
32Instruction.

33(m) It is the intent of this chapter that all funds allocated from
34the California State Lottery Education Fund shall be used
35exclusively for the education of pupils and students and no funds
36shall be spent for acquisition of real property, construction of
37facilities, financing of research, or any other noninstructional
38purpose.

39

SEC. 2.  

Section 14670.3 of the Government Code is amended
40to read:

P6    1

14670.3.  

Notwithstanding Section 14670, the Director of
2General Services, with the consent of the State Department of
3begin delete Mental Healthend deletebegin insert Developmental Servicesend insert, may let to a nonprofit
4corporation, for the purpose of conducting an educational and work
5program for persons with intellectual disabilities, and for a period
6not to exceed 55 years, real property not exceeding five acres
7located within the grounds of the Fairview State Hospital.

8The lease authorized by this section shall be nonassignable and
9shall be subject to periodic review every five years. The review
10shall be made by the Director of General Services, who shall do
11both of the following:

12(a) Assure the state that the original purposes of the lease are
13being carried out.

14(b) Determine what, if any, adjustment should be made in the
15terms of the lease.

16The lease shall also provide for an initial capital outlay by the
17lessee of thirty thousand dollars ($30,000) prior to January 1, 1976.
18The capital outlay may be, or may have been, contributed before
19or after the effective date of the act adding this section.

20

SEC. 3.  

Section 14670.5 of the Government Code is amended
21to read:

22

14670.5.  

Notwithstanding Section 14670, the Director of
23General Services, with the consent of the State Department of
24begin delete Mental Healthend deletebegin insert Developmental Servicesend insert may let to a nonprofit
25corporation, for the purpose of establishing and maintaining a
26rehabilitation center for persons with intellectual disabilities, for
27a period not exceeding 20 years, real property, not exceeding five
28acres, located within the grounds of the Fairview State Hospital
29in Orange County, and that is retained by the state primarily to
30provide a peripheral buffer area, or zone, between real property
31that the state hospital is located on and adjacent real property, if
32the director deems the letting is in the best interests of the state.

33

SEC. 4.  

Section 1797.98b of the Health and Safety Code is
34amended to read:

35

1797.98b.  

(a)  Each county establishing a fund, on January 1,
361989, and on each April 15 thereafter, shall report to thebegin delete Legislatureend delete
37begin insert authorityend insert on the implementation and status of the Emergency
38Medical Services Fund. begin deleteThe end deletebegin insertNotwithstanding Section 10231.5 of
39the Government Code, the authority shall compile and forward a
40summary of each county’send insert
reportbegin insert to the appropriate policy and
P7    1 fiscal committees of the Legislature. Each county report, and the
2summary compiled by the authority,end insert
shall cover thebegin insert immediatelyend insert
3 preceding fiscal year, and shall include, but not be limited to, all
4of the following:

5(1)  The total amount of fines and forfeitures collected, the total
6amount of penalty assessments collected, and the total amount of
7penalty assessments deposited into the Emergency Medical
8Services Fund, or, if no moneys were deposited into the fund, the
9reason or reasons for the lack of deposits. The total amounts of
10penalty assessments shall be listed on the basis of each statute that
11provides the authority for the penalty assessment, including
12Sections 76000, 76000.5, and 76104 of the Government Code, and
13Section 42007 of the Vehicle Code.

14(2) The amount of penalty assessment funds collected under
15Section 76000.5 of the Government Code that are used for the
16purposes of subdivision (e) of Section 1797.98a.

17(3) The fund balance and the amount of moneys disbursed under
18the program to physicians and surgeons, for hospitals, and for other
19emergency medical services purposes, and the amount of money
20disbursed for actual administrative costs. If funds were disbursed
21for other emergency medical services, the report shall provide a
22description of each of those services.

23(4) The number of claims paid to physicians and surgeons, and
24the percentage of claims paid, based on the uniform fee schedule,
25as adopted by the county.

26(5) The amount of moneys available to be disbursed to
27physicians and surgeons, descriptions of the physician and surgeon
28claims payment methodologies, the dollar amount of the total
29allowable claims submitted, and the percentage at which those
30claims were reimbursed.

31(6) A statement of the policies, procedures, and regulatory action
32taken to implement and run the program under this chapter.

33(7) The name of the physician and surgeon and hospital
34administrator organization, or names of specific physicians and
35surgeons and hospital administrators, contacted to review claims
36payment methodologies.

37(8) A description of the process used to solicit input from
38physicians and surgeons and hospitals to review payment
39distribution methodology as described in subdivision (a) of Section
401797.98e.

P8    1(9) An identification of the fee schedule used by the county
2pursuant to subdivision (e) of Section 1797.98c.

3(10) (A) A description of the methodology used to disburse
4moneys to hospitals pursuant to subparagraph (B) of paragraph
5(5) of subdivision (b) of Section 1797.98a.

6(B) The amount of moneys available to be disbursed to hospitals.

7(C) If moneys are disbursed to hospitals on a claims basis, the
8dollar amount of the total allowable claims submitted and the
9percentage at which those claims were reimbursed to hospitals.

10(11) The name and contact information of the entity responsible
11for each of the following:

12(A) Collection of fines, forfeitures, and penalties.

13(B) Distribution of penalty assessments into the Emergency
14Medical Services Fund.

15(C) Distribution of moneys to physicians and surgeons.

16(b) (1) Each county, upon request, shall make available to any
17member of the public the reportbegin delete requiredend deletebegin insert provided to the authorityend insert
18 under subdivision (a).

19(2) Each county, upon request, shall make available to any
20member of the public a listing of physicians and surgeons and
21hospitals that have received reimbursement from the Emergency
22Medical Services Fund and the amount of the reimbursement they
23have received. This listing shall be compiled on a semiannual basis.

24

SEC. 5.  

Section 10961 of the Insurance Code is amended and
25renumbered to read:

26

begin delete10961.end delete
27begin insert10965.18.end insert  

(a) For purposes of thisbegin delete articleend deletebegin insert chapterend insert, a bridge
28plan product shall mean an individual health benefit plan that is
29offered by a health insurer licensed under thisbegin delete chapterend deletebegin insert partend insert that
30contracts with the Exchange pursuant to Title 22 (commencing
31with Section 100500) of the Government Code.

32(b) On and afterbegin delete the effective date of this sectionend deletebegin insert September 30,
332013end insert
, if a health insurance policy has not been filed with the
34commissioner, a health insurer that contracts with thebegin delete California
35Health Benefitend delete
Exchange to offer a qualified bridge plan product
36pursuant to Section 100504.5 of the Government Code shall file
37the policy form with the commissioner pursuant to Section 10290.

38(c) (1) Notwithstanding subdivision (a) of Section 10965.3, a
39health insurer selling a bridge plan product shall not be required
40to fairly and affirmatively offer, market, and sell the health
P9    1insurer’s bridge plan product except to individuals eligible for the
2bridge plan product pursuant to the State Department of Health
3Care Services and the Medi-Cal managed care plan’s contract
4entered into pursuant to Section 14005.70 of the Welfare and
5Institutions Code, provided the health care service plan meets the
6requirements of subdivision (b) of Section 14005.70 of the Welfare
7and Institutions Code.

8(2) Notwithstanding subdivision (c) of Section 10965.3, a health
9insurer selling a bridge plan product shall provide an initial open
10enrollment period of six months, and an annual enrollment period
11and a special enrollment period consistent with the annual
12enrollment and special enrollment periods of the Exchange.

13(d) A health insurer that contracts with thebegin delete California Health
14Benefitend delete
Exchange to offer a qualified bridge plan product pursuant
15to Sectionbegin delete 100504end deletebegin insert 100504.5end insert of the Government Code shall
16maintain a medical loss ratio of 85 percent for the bridge plan
17product. A health insurer shall utilize, to the extent possible, the
18same methodology for calculating the medical loss ratio for the
19bridge plan product that is used for calculating the health insurer’s
20medical loss ratio pursuant to Section 10112.25 and shall report
21its medical loss ratio for the bridge plan product to the department
22as provided in Section 10112.25.

23(e) This section shall become inoperative on the October 1 that
24is five years after the date that federal approval of the bridge plan
25option occurs, and, as of the second January 1 thereafter, is
26 repealed, unless a later enacted statute that is enacted before that
27date deletes or extends the dates on which it becomes inoperative
28and is repealed.

29

SEC. 6.  

Section 667.5 of the Penal Code is amended to read:

30

667.5.  

Enhancement of prison terms for new offenses because
31of prior prison terms shall be imposed as follows:

32(a) Where one of the new offenses is one of the violent felonies
33specified in subdivision (c), in addition to and consecutive to any
34other prison terms therefor, the court shall impose a three-year
35term for each prior separate prison term served by the defendant
36where the prior offense was one of the violent felonies specified
37in subdivision (c). However, no additional term shall be imposed
38under this subdivision for any prison term served prior to a period
39of 10 years in which the defendant remained free of both prison
P10   1custody and the commission of an offense which results in a felony
2conviction.

3(b) Except where subdivision (a) applies, where the new offense
4is any felony for which a prison sentence or a sentence of
5imprisonment in a county jail under subdivision (h) of Section
61170 is imposed or is not suspended, in addition and consecutive
7to any other sentence therefor, the court shall impose a one-year
8term for each prior separate prison term or county jail term imposed
9under subdivision (h) of Section 1170 or when sentence is not
10suspended for any felony; provided that no additional term shall
11be imposed under this subdivision for any prison term or county
12jail term imposed under subdivision (h) of Section 1170 or when
13sentence is not suspended prior to a period of five years in which
14the defendant remained free of both the commission of an offense
15which results in a felony conviction, and prison custody or the
16imposition of a term of jail custody imposed under subdivision (h)
17of Section 1170 or any felony sentence that is not suspended. A
18term imposed under the provisions of paragraph (5) of subdivision
19(h) of Section 1170, wherein a portion of the term is suspended
20by the court to allow mandatory supervision, shall qualify as a
21prior county jail term for the purposes of the one-year enhancement.

22(c) For the purpose of this section, “violent felony” shall mean
23any of the following:

24(1) Murder or voluntary manslaughter.

25(2) Mayhem.

26(3) Rape as defined in paragraph (2) or (6) of subdivision (a)
27of Section 261 or paragraph (1) or (4) of subdivision (a) of Section
28262.

29(4) Sodomy as defined in subdivision (c) or (d) of Section 286.

30(5) Oral copulation as defined in subdivision (c) or (d) of Section
31288a.

32(6) Lewd or lascivious act as defined in subdivision (a) or (b)
33of Section 288.

34(7) Any felony punishable by death or imprisonment in the state
35prison for life.

36(8) Any felony in which the defendant inflicts great bodily injury
37on any person other than an accomplice which has been charged
38and proved as provided for in Section 12022.7, 12022.8, or 12022.9
39on or after July 1, 1977, or as specified prior to July 1, 1977, in
40Sections 213, 264, and 461, or any felony in which the defendant
P11   1uses a firearm which use has been charged and proved as provided
2in subdivision (a) of Section 12022.3, or Section 12022.5 or
312022.55.

4(9) Any robbery.

5(10) Arson, in violation of subdivision (a) or (b) of Section 451.

6(11) Sexual penetration as defined in subdivision (a) or (j) of
7Section 289.

8(12) Attempted murder.

9(13) A violation of Section 18745, 18750, or 18755.

10(14) Kidnapping.

11(15) Assault with the intent to commit a specified felony, in
12violation of Section 220.

13(16) Continuous sexual abuse of a child, in violation of Section
14288.5.

15(17) Carjacking, as defined in subdivision (a) of Section 215.

16(18) Rape, spousal rape, or sexual penetration, in concert, in
17violation of Section 264.1.

18(19) Extortion, as defined in Section 518, which would constitute
19a felony violation of Section 186.22 of the Penal Code.

20(20) Threats to victims or witnesses, as defined in Section 136.1,
21which would constitute a felony violation of Section 186.22 of the
22Penal Code.

23(21) Any burglary of the first degree, as defined in subdivision
24(a) of Section 460, wherein it is charged and proved that another
25person, other than an accomplice, was present in the residence
26during the commission of the burglary.

27(22) Any violation of Section 12022.53.

28(23) A violation of subdivision (b) or (c) of Section 11418. The
29Legislature finds and declares that these specified crimes merit
30special consideration when imposing a sentence to display society’s
31condemnation for these extraordinary crimes of violence against
32the person.

33(d) For the purposes of this section, the defendant shall be
34deemed to remain in prison custody for an offense until the official
35discharge from custody, including any period of mandatory
36supervision, or until release on parole or postrelease community
37supervision, whichever first occurs, including any time during
38which the defendant remains subject to reimprisonment or custody
39in county jail for escape from custody or is reimprisoned on
40revocation of parole or postrelease community supervision. The
P12   1additional penalties provided for prior prison terms shall not be
2imposed unless they are charged and admitted or found true in the
3action for the new offense.

4(e) The additional penalties provided for prior prison terms shall
5not be imposed for any felony for which the defendant did not
6serve a prior separate term in state prison or in county jail under
7subdivision (h) of Section 1170.

8(f) A prior conviction of a felony shall include a conviction in
9another jurisdiction for an offense which, if committed in
10California, is punishable by imprisonment in the state prison or in
11county jail under subdivision (h) of Section 1170 if the defendant
12served one year or more in prison for the offense in the other
13jurisdiction. A prior conviction of a particular felony shall include
14a conviction in another jurisdiction for an offense which includes
15all of the elements of the particular felony as defined under
16California law if the defendant served one year or more in prison
17for the offense in the other jurisdiction.

18(g) A prior separate prison term for the purposes of this section
19shall mean a continuous completed period of prison incarceration
20imposed for the particular offense alone or in combination with
21concurrent or consecutive sentences for other crimes, including
22any reimprisonment on revocation of parole which is not
23accompanied by a new commitment to prison, and including any
24reimprisonment after an escape from incarceration.

25(h) Serving a prison term includes any confinement time in any
26state prison or federal penal institution as punishment for
27commission of an offense, including confinement in a hospital or
28other institution or facility credited as service of prison time in the
29jurisdiction of the confinement.

30(i) For the purposes of this section, a commitment to the State
31Department of Mentalbegin delete Healthend deletebegin insert Health, or its successor the State
32Department of State Hospitals,end insert
as a mentally disordered sex
33offender following a conviction of a felony, which commitment
34exceeds one year in duration, shall be deemed a prior prison term.

35(j) For the purposes of this section, when a person subject to
36the custody, control, and discipline of the Secretary of Corrections
37and Rehabilitation is incarcerated at a facility operated by the
38Division of Juvenile Justice, that incarceration shall be deemed to
39be a term served in state prison.

P13   1(k) (1) Notwithstanding subdivisions (d) and (g) or any other
2provision of law, where one of the new offenses is committed
3while the defendant is temporarily removed from prison pursuant
4to Section 2690 or while the defendant is transferred to a
5community facility pursuant to Section 3416, 6253, or 6263, or
6while the defendant is on furlough pursuant to Section 6254, the
7 defendant shall be subject to the full enhancements provided for
8in this section.

9(2) This subdivision shall not apply when a full, separate, and
10consecutive term is imposed pursuant to any other provision of
11law.

12

SEC. 7.  

Section 830.3 of the Penal Code, as amended by
13Section 37 of Chapter 515 of the Statutes of 2013, is amended to
14read:

15

830.3.  

The following persons are peace officers whose authority
16extends to any place in the state for the purpose of performing
17their primary duty or when making an arrest pursuant to Section
18836 as to any public offense with respect to which there is
19immediate danger to person or property, or of the escape of the
20perpetrator of that offense, or pursuant to Section 8597 or 8598 of
21the Government Code. These peace officers may carry firearms
22only if authorized and under those terms and conditions as specified
23by their employing agencies:

24(a) Persons employed by the Division of Investigation of the
25Department of Consumer Affairs and investigators of the Medical
26Board of California and the Board of Dental Examiners, who are
27designated by the Director of Consumer Affairs, provided that the
28primary duty of these peace officers shall be the enforcement of
29the law as that duty is set forth in Section 160 of the Business and
30Professions Code.

31(b) Voluntary fire wardens designated by the Director of
32Forestry and Fire Protection pursuant to Section 4156 of the Public
33Resources Code, provided that the primary duty of these peace
34officers shall be the enforcement of the law as that duty is set forth
35in Section 4156 of that code.

36(c) Employees of the Department of Motor Vehicles designated
37in Section 1655 of the Vehicle Code, provided that the primary
38duty of these peace officers shall be the enforcement of the law as
39that duty is set forth in Section 1655 of that code.

P14   1(d) Investigators of the California Horse Racing Board
2designated by the board, provided that the primary duty of these
3peace officers shall be the enforcement of Chapter 4 (commencing
4with Section 19400) of Division 8 of the Business and Professions
5Code and Chapter 10 (commencing with Section 330) of Title 9
6of Part 1 of this code.

7(e) The State Fire Marshal and assistant or deputy state fire
8marshals appointed pursuant to Section 13103 of the Health and
9Safety Code, provided that the primary duty of these peace officers
10shall be the enforcement of the law as that duty is set forth in
11Section 13104 of that code.

12(f) Inspectors of the food and drug section designated by the
13chief pursuant to subdivision (a) of Section 106500 of the Health
14and Safety Code, provided that the primary duty of these peace
15officers shall be the enforcement of the law as that duty is set forth
16in Section 106500 of that code.

17(g) All investigators of the Division of Labor Standards
18 Enforcement designated by the Labor Commissioner, provided
19that the primary duty of these peace officers shall be the
20enforcement of the law as prescribed in Section 95 of the Labor
21Code.

22(h) All investigators of the State Departments of Health Care
23Services, Public Health, Social Services,begin delete Mental Health,end deletebegin insert State
24Hospitals,end insert
and Alcohol and Drug Programs, the Department of
25Toxic Substances Control, the Office of Statewide Health Planning
26and Development, and the Public Employees’ Retirement System,
27provided that the primary duty of these peace officers shall be the
28enforcement of the law relating to the duties of his or her
29department or office. Notwithstanding any other provision of law,
30investigators of the Public Employees’ Retirement System shall
31not carry firearms.

32(i) The Chief of the Bureau of Fraudulent Claims of the
33Department of Insurance and those investigators designated by the
34chief, provided that the primary duty of those investigators shall
35be the enforcement of Section 550.

36(j) Employees of the Department of Housing and Community
37Development designated under Section 18023 of the Health and
38Safety Code, provided that the primary duty of these peace officers
39shall be the enforcement of the law as that duty is set forth in
40Section 18023 of that code.

P15   1(k) Investigators of the office of the Controller, provided that
2the primary duty of these investigators shall be the enforcement
3of the law relating to the duties of that office. Notwithstanding any
4other law, except as authorized by the Controller, the peace officers
5designated pursuant to this subdivision shall not carry firearms.

6(l) Investigators of the Department of Business Oversight
7designated by the Commissioner of Business Oversight, provided
8that the primary duty of these investigators shall be the enforcement
9of the provisions of law administered by the Department of
10Business Oversight. Notwithstanding any other provision of law,
11the peace officers designated pursuant to this subdivision shall not
12carry firearms.

13(m) Persons employed by the Contractors State License Board
14designated by the Director of Consumer Affairs pursuant to Section
157011.5 of the Business and Professions Code, provided that the
16primary duty of these persons shall be the enforcement of the law
17as that duty is set forth in Section 7011.5, and in Chapter 9
18(commencing with Section 7000) of Division 3, of that code. The
19Director of Consumer Affairs may designate as peace officers not
20more than 12 persons who shall at the time of their designation be
21assigned to the special investigations unit of the board.
22Notwithstanding any other provision of law, the persons designated
23pursuant to this subdivision shall not carry firearms.

24(n) The Chief and coordinators of the Law Enforcement Branch
25of the Office of Emergency Services.

26(o) Investigators of the office of the Secretary of State designated
27by the Secretary of State, provided that the primary duty of these
28peace officers shall be the enforcement of the law as prescribed
29in Chapter 3 (commencing with Section 8200) of Division 1 of
30Title 2 of, and Section 12172.5 of, the Government Code.
31Notwithstanding any other provision of law, the peace officers
32designated pursuant to this subdivision shall not carry firearms.

33(p) The Deputy Director for Security designated by Section
348880.38 of the Government Code, and all lottery security personnel
35assigned to the California State Lottery and designated by the
36director, provided that the primary duty of any of those peace
37officers shall be the enforcement of the laws related to assuring
38the integrity, honesty, and fairness of the operation and
39administration of the California State Lottery.

P16   1(q) begin insert(1)end insertbegin insertend insertInvestigators employed by the Investigation Division
2of the Employment Development Department designated by the
3director of the department, provided that the primary duty of those
4peace officers shall be the enforcement of the law as that duty is
5set forth in Section 317 of the Unemployment Insurance Code.

begin delete

6 Notwithstanding

end delete

7begin insert(2)end insertbegin insertend insertbegin insertNotwithstanding end insertany other provision of law, the peace
8officers designated pursuant to this subdivision shall not carry
9firearms.

10(r) The chief and assistant chief of museum security and safety
11of the California Science Center, as designated by the executive
12director pursuant to Section 4108 of the Food and Agricultural
13Code, provided that the primary duty of those peace officers shall
14be the enforcement of the law as that duty is set forth in Section
154108 of the Food and Agricultural Code.

16(s) Employees of the Franchise Tax Board designated by the
17board, provided that the primary duty of these peace officers shall
18be the enforcement of the law as set forth in Chapter 9
19(commencing with Section 19701) of Part 10.2 of Division 2 of
20the Revenue and Taxation Code.

21(t) begin insert(1)end insertbegin insertend insertNotwithstanding any other provision of this section, a
22peace officer authorized by this section shall not be authorized to
23carry firearms by his or her employing agency until that agency
24has adopted a policy on the use of deadly force by those peace
25officers, and until those peace officers have been instructed in the
26employing agency’s policy on the use of deadly force.

begin delete

27 Every

end delete

28begin insert(2)end insertbegin insertend insertbegin insertEvery end insertpeace officer authorized pursuant to this section to
29carry firearms by his or her employing agency shall qualify in the
30use of the firearms at least every six months.

31(u) Investigators of the Department of Managed Health Care
32designated by the Director of the Department of Managed Health
33Care, provided that the primary duty of these investigators shall
34be the enforcement of the provisions of laws administered by the
35Director of the Department of Managed Health Care.
36Notwithstanding any other provision of law, the peace officers
37designated pursuant to this subdivision shall not carry firearms.

38(v) The Chief, Deputy Chief, supervising investigators, and
39investigators of the Office of Protective Services of the State
40Department of Developmental Services, provided that the primary
P17   1duty of each of those persons shall be the enforcement of the law
2relating to the duties of his or her department or office.

3(w) This section shall become inoperative on July 1, 2014, and,
4as of January 1, 2015, is repealed, unless a later enacted statute,
5that becomes operative on or before January 1, 2015, deletes or
6extends the dates on which it becomes inoperative and is repealed.

7

SEC. 8.  

Section 830.3 of the Penal Code, as added by Section
838 of Chapter 515 of the Statutes of 2013, is amended to read:

9

830.3.  

The following persons are peace officers whose authority
10extends to any place in the state for the purpose of performing
11their primary duty or when making an arrest pursuant to Section
12836 as to any public offense with respect to which there is
13immediate danger to person or property, or of the escape of the
14perpetrator of that offense, or pursuant to Section 8597 or 8598 of
15the Government Code. These peace officers may carry firearms
16only if authorized and under those terms and conditions as specified
17by their employing agencies:

18(a) Persons employed by the Division of Investigation of the
19Department of Consumer Affairs and investigators of the Board
20of Dental Examiners, who are designated by the Director of
21Consumer Affairs, provided that the primary duty of these peace
22officers shall be the enforcement of the law as that duty is set forth
23in Section 160 of the Business and Professions Code.

24(b) Voluntary fire wardens designated by the Director of
25Forestry and Fire Protection pursuant to Section 4156 of the Public
26Resources Code, provided that the primary duty of these peace
27officers shall be the enforcement of the law as that duty is set forth
28in Section 4156 of that code.

29(c) Employees of the Department of Motor Vehicles designated
30in Section 1655 of the Vehicle Code, provided that the primary
31duty of these peace officers shall be the enforcement of the law as
32that duty is set forth in Section 1655 of that code.

33(d) Investigators of the California Horse Racing Board
34designated by the board, provided that the primary duty of these
35peace officers shall be the enforcement of Chapter 4 (commencing
36 with Section 19400) of Division 8 of the Business and Professions
37Code and Chapter 10 (commencing with Section 330) of Title 9
38of Part 1 of this code.

39(e) The State Fire Marshal and assistant or deputy state fire
40marshals appointed pursuant to Section 13103 of the Health and
P18   1Safety Code, provided that the primary duty of these peace officers
2shall be the enforcement of the law as that duty is set forth in
3Section 13104 of that code.

4(f) Inspectors of the food and drug section designated by the
5chief pursuant to subdivision (a) of Section 106500 of the Health
6and Safety Code, provided that the primary duty of these peace
7officers shall be the enforcement of the law as that duty is set forth
8in Section 106500 of that code.

9(g) All investigators of the Division of Labor Standards
10Enforcement designated by the Labor Commissioner, provided
11that the primary duty of these peace officers shall be the
12enforcement of the law as prescribed in Section 95 of the Labor
13Code.

14(h) All investigators of the State Departments of Health Care
15Services, Public Health, Social Services,begin delete Mental Health,end deletebegin insert State
16Hospitals,end insert
and Alcohol and Drug Programs, the Department of
17Toxic Substances Control, the Office of Statewide Health Planning
18and Development, and the Public Employees’ Retirement System,
19provided that the primary duty of these peace officers shall be the
20enforcement of the law relating to the duties of his or her
21department or office. Notwithstanding any other provision of law,
22investigators of the Public Employees’ Retirement System shall
23not carry firearms.

24(i) The Chief of the Bureau of Fraudulent Claims of the
25Department of Insurance and those investigators designated by the
26chief, provided that the primary duty of those investigators shall
27be the enforcement of Section 550.

28(j) Employees of the Department of Housing and Community
29Development designated under Section 18023 of the Health and
30Safety Code, provided that the primary duty of these peace officers
31shall be the enforcement of the law as that duty is set forth in
32Section 18023 of that code.

33(k) Investigators of the office of the Controller, provided that
34the primary duty of these investigators shall be the enforcement
35of the law relating to the duties of that office. Notwithstanding any
36other law, except as authorized by the Controller, the peace officers
37designated pursuant to this subdivision shall not carry firearms.

38(l) Investigators of the Department of Business Oversight
39designated by the Commissioner of Business Oversight, provided
40that the primary duty of these investigators shall be the enforcement
P19   1of the provisions of law administered by the Department of
2Business Oversight. Notwithstanding any other provision of law,
3the peace officers designated pursuant to this subdivision shall not
4carry firearms.

5(m) Persons employed by the Contractors State License Board
6designated by the Director of Consumer Affairs pursuant to Section
77011.5 of the Business and Professions Code, provided that the
8primary duty of these persons shall be the enforcement of the law
9as that duty is set forth in Section 7011.5, and in Chapter 9
10(commencing with Section 7000) of Division 3, of that code. The
11Director of Consumer Affairs may designate as peace officers not
12more than 12 persons who shall at the time of their designation be
13assigned to the special investigations unit of the board.
14Notwithstanding any other provision of law, the persons designated
15pursuant to this subdivision shall not carry firearms.

16(n) The Chief and coordinators of the Law Enforcement Branch
17of the Office of Emergency Services.

18(o) Investigators of the office of the Secretary of State designated
19by the Secretary of State, provided that the primary duty of these
20peace officers shall be the enforcement of the law as prescribed
21in Chapter 3 (commencing with Section 8200) of Division 1 of
22Title 2 of, and Section 12172.5 of, the Government Code.
23Notwithstanding any other provision of law, the peace officers
24designated pursuant to this subdivision shall not carry firearms.

25(p) The Deputy Director for Security designated by Section
268880.38 of the Government Code, and all lottery security personnel
27assigned to the California State Lottery and designated by the
28director, provided that the primary duty of any of those peace
29officers shall be the enforcement of the laws related to assuring
30the integrity, honesty, and fairness of the operation and
31administration of the California State Lottery.

32(q) begin insert(1)end insertbegin insertend insertInvestigators employed by the Investigation Division
33of the Employment Development Department designated by the
34director of the department, provided that the primary duty of those
35peace officers shall be the enforcement of the law as that duty is
36set forth in Section 317 of the Unemployment Insurance Code.

begin delete

37 Notwithstanding

end delete

38begin insert(2)end insertbegin insertend insertbegin insertNotwithstanding end insertany other provision of law, the peace
39officers designated pursuant to this subdivision shall not carry
40firearms.

P20   1(r) The chief and assistant chief of museum security and safety
2of the California Science Center, as designated by the executive
3director pursuant to Section 4108 of the Food and Agricultural
4Code, provided that the primary duty of those peace officers shall
5be the enforcement of the law as that duty is set forth in Section
64108 of the Food and Agricultural Code.

7(s) Employees of the Franchise Tax Board designated by the
8board, provided that the primary duty of these peace officers shall
9be the enforcement of the law as set forth in Chapter 9
10(commencing with Section 19701) of Part 10.2 of Division 2 of
11the Revenue and Taxation Code.

12(t) begin insert(1)end insertbegin insertend insertNotwithstanding any other provision of this section, a
13peace officer authorized by this section shall not be authorized to
14carry firearms by his or her employing agency until that agency
15has adopted a policy on the use of deadly force by those peace
16officers, and until those peace officers have been instructed in the
17employing agency’s policy on the use of deadly force.

begin delete

18 Every

end delete

19begin insert(2)end insertbegin insertend insertbegin insertEvery end insertpeace officer authorized pursuant to this section to
20carry firearms by his or her employing agency shall qualify in the
21use of the firearms at least every six months.

22(u) Investigators of the Department of Managed Health Care
23designated by the Director of the Department of Managed Health
24Care, provided that the primary duty of these investigators shall
25be the enforcement of the provisions of laws administered by the
26Director of the Department of Managed Health Care.
27Notwithstanding any other provision of law, the peace officers
28designated pursuant to this subdivision shall not carry firearms.

29(v) The Chief, Deputy Chief, supervising investigators, and
30investigators of the Office of Protective Services of the State
31Department of Developmental Services, provided that the primary
32duty of each of those persons shall be the enforcement of the law
33relating to the duties of his or her department or office.

34(w) This section shall become operative July 1, 2014.

35

SEC. 9.  

Section 830.5 of the Penal Code is amended to read:

36

830.5.  

The following persons are peace officers whose authority
37extends to any place in the state while engaged in the performance
38of the duties of their respective employment and for the purpose
39of carrying out the primary function of their employment or as
40required under Sections 8597, 8598, and 8617 of the Government
P21   1Code, as amended by Section 44 of Chapter 1124 of the Statutes
2of 2002. Except as specified in this section, these peace officers
3may carry firearms only if authorized and under those terms and
4conditions specified by their employing agency:

5(a) A parole officer of the Department of Corrections and
6Rehabilitation, or the Department of Corrections and
7Rehabilitation, Division of Juvenile Parole Operations, probation
8officer, deputy probation officer, or a board coordinating parole
9agent employed by the Juvenile Parole Board. Except as otherwise
10provided in this subdivision, the authority of these parole or
11probation officers shall extend only as follows:

12(1) To conditions of parole, probation, mandatory supervision,
13or postrelease community supervision by any person in this state
14on parole, probation, mandatory supervision, or postrelease
15community supervision.

16(2) To the escape of any inmate or ward from a state or local
17institution.

18(3) To the transportation of persons on parole, probation,
19mandatory supervision, or postrelease community supervision.

20(4) To violations of any penal provisions of law which are
21discovered while performing the usual or authorized duties of his
22or her employment.

23(5) (A) To the rendering of mutual aid to any other law
24enforcement agency.

25(B) For the purposes of this subdivision, “parole agent” shall
26have the same meaning as parole officer of the Department of
27Corrections and Rehabilitation or of the Department of Corrections
28and Rehabilitation, Division of Juvenile Justice.

29(C) Any parole officer of the Department of Corrections and
30Rehabilitation, or the Department of Corrections and
31Rehabilitation, Division of Juvenile Parole Operations, is
32authorized to carry firearms, but only as determined by the director
33on a case-by-case or unit-by-unit basis and only under those terms
34and conditions specified by the director or chairperson. The
35Department of Corrections and Rehabilitation, Division of Juvenile
36Justice, shall develop a policy for arming peace officers of the
37Department of Corrections and Rehabilitation, Division of Juvenile
38Justice, who comprise “high-risk transportation details” or
39“high-risk escape details” no later than June 30, 1995. This policy
40shall be implemented no later than December 31, 1995.

P22   1(D) The Department of Corrections and Rehabilitation, Division
2of Juvenile Justice, shall train and arm those peace officers who
3comprise tactical teams at each facility for use during “high-risk
4escape details.”

5(b) A correctional officer employed by the Department of
6Corrections and Rehabilitation, or of the Department of Corrections
7and Rehabilitation, Division of Juvenile Justice, having custody
8of wards or any employee of the Department of Corrections and
9Rehabilitation designated by the secretary or any correctional
10counselor series employee of the Department of Corrections and
11Rehabilitation or any medical technical assistant series employee
12designated by the secretary or designated by the secretary and
13employed by the State Department ofbegin delete Mental Healthend deletebegin insert State
14Hospitalsend insert
or any employee of the Board of Parole Hearings
15designated by the secretary or employee of the Department of
16Corrections and Rehabilitation, Division of Juvenile Justice,
17designated by the secretary or any superintendent, supervisor, or
18employee having custodial responsibilities in an institution operated
19by a probation department, or any transportation officer of a
20probation department.

21(c) The following persons may carry a firearm while not on
22duty: a parole officer of the Department of Corrections and
23Rehabilitation, or the Department of Corrections and
24Rehabilitation, Division of Juvenile Justice, a correctional officer
25or correctional counselor employed by the Department of
26Corrections and Rehabilitation, or an employee of the Department
27of Corrections and Rehabilitation, Division of Juvenile Justice,
28having custody of wards or any employee of the Department of
29Corrections and Rehabilitation designated by the secretary. A
30parole officer of the Juvenile Parole Board may carry a firearm
31while not on duty only when so authorized by the chairperson of
32the board and only under the terms and conditions specified by
33the chairperson. Nothing in this section shall be interpreted to
34require licensure pursuant to Section 25400. The director or
35chairperson may deny, suspend, or revoke for good cause a
36person’s right to carry a firearm under this subdivision. That person
37shall, upon request, receive a hearing, as provided for in the
38negotiated grievance procedure between the exclusive employee
39representative and the Department of Corrections and
P23   1Rehabilitation, Division of Juvenile Justice, or the Juvenile Parole
2Board, to review the director’s or the chairperson’s decision.

3(d) Persons permitted to carry firearms pursuant to this section,
4either on or off duty, shall meet the training requirements of Section
5832 and shall qualify with the firearm at least quarterly. It is the
6responsibility of the individual officer or designee to maintain his
7or her eligibility to carry concealable firearms off duty. Failure to
8maintain quarterly qualifications by an officer or designee with
9any concealable firearms carried off duty shall constitute good
10cause to suspend or revoke that person’s right to carry firearms
11off duty.

12(e) The Department of Corrections and Rehabilitation shall
13allow reasonable access to its ranges for officers and designees of
14either department to qualify to carry concealable firearms off duty.
15The time spent on the range for purposes of meeting the
16qualification requirements shall be the person’s own time during
17the person’s off-duty hours.

18(f) The secretary shall promulgate regulations consistent with
19this section.

20(g) “High-risk transportation details” and “high-risk escape
21details” as used in this section shall be determined by the secretary,
22or his or her designee. The secretary, or his or her designee, shall
23consider at least the following in determining “high-risk
24transportation details” and “high-risk escape details”: protection
25of the public, protection of officers, flight risk, and violence
26potential of the wards.

27(h) “Transportation detail” as used in this section shall include
28transportation of wards outside the facility, including, but not
29limited to, court appearances, medical trips, and interfacility
30transfers.

begin delete

31(i) This section is operative January 1, 2012.

end delete
32

SEC. 10.  

Section 3000 of the Penal Code is amended to read:

33

3000.  

(a) (1) The Legislature finds and declares that the period
34immediately following incarceration is critical to successful
35reintegration of the offender into society and to positive citizenship.
36It is in the interest of public safety for the state to provide for the
37effective supervision of and surveillance of parolees, including
38the judicious use of revocation actions, and to provide educational,
39vocational, family and personal counseling necessary to assist
40parolees in the transition between imprisonment and discharge. A
P24   1sentence resulting in imprisonment in the state prison pursuant to
2Section 1168 or 1170 shall include a period of parole supervision
3or postrelease community supervision, unless waived, or as
4otherwise provided in this article.

5(2) The Legislature finds and declares that it is not the intent of
6this section to diminish resources allocated to the Department of
7Corrections and Rehabilitation for parole functions for which the
8department is responsible. It is also not the intent of this section
9to diminish the resources allocated to the Board of Parole Hearings
10to execute its duties with respect to parole functions for which the
11board is responsible.

12(3) The Legislature finds and declares that diligent effort must
13be made to ensure that parolees are held accountable for their
14criminal behavior, including, but not limited to, the satisfaction of
15restitution fines and orders.

16(4) For any person subject to a sexually violent predator
17proceeding pursuant to Article 4 (commencing with Section 6600)
18of Chapter 2 of Part 2 of Division 6 of the Welfare and Institutions
19Code, an order issued by a judge pursuant to Section 6601.5 of the
20Welfare and Institutions Code, finding that the petition, on its face,
21supports a finding of probable cause to believe that the individual
22named in the petition is likely to engage in sexually violent
23predatory criminal behavior upon his or her release, shall toll the
24period of parole of that person, from the date that person is released
25by the Department of Corrections and Rehabilitation as follows:

26(A) If the person is committed to the State Department ofbegin delete Mental
27Healthend delete
begin insert State Hospitalsend insert as a sexually violent predator and
28subsequently a court orders that the person be unconditionally
29discharged, the parole period shall be tolled until the date the judge
30enters the order unconditionally discharging that person.

31(B) If the person is not committed to the State Department of
32begin delete Mental Healthend deletebegin insert State Hospitalsend insert as a sexually violent predator, the
33tolling of the parole period shall be abrogated and the parole period
34shall be deemed to have commenced on the date of release from
35the Department of Corrections and Rehabilitation.

36(5) Paragraph (4) applies to persons released by the Department
37of Corrections and Rehabilitation on or after January 1, 2012.
38Persons released by the Department of Corrections and
39Rehabilitation prior to January 1, 2012, shall continue to be subject
P25   1to the law governing the tolling of parole in effect on December
231, 2011.

3(b) Notwithstanding any provision to the contrary in Article 3
4(commencing with Section 3040) of this chapter, the following
5shall apply to any inmate subject to Section 3000.08:

6(1) In the case of any inmate sentenced under Section 1168 for
7a crime committed prior to July 1, 2013, the period of parole shall
8not exceed five years in the case of an inmate imprisoned for any
9offense other than first or second degree murder for which the
10inmate has received a life sentence, and shall not exceed three
11years in the case of any other inmate, unless in either case the
12Board of Parole Hearings for good cause waives parole and
13discharges the inmate from custody of the department. This
14subdivision shall also be applicable to inmates who committed
15crimes prior to July 1, 1977, to the extent specified in Section
161170.2. In the case of any inmate sentenced under Section 1168
17for a crime committed on or after July 1, 2013, the period of parole
18shall not exceed five years in the case of an inmate imprisoned for
19any offense other than first or second degree murder for which the
20inmate has received a life sentence, and shall not exceed three
21years in the case of any other inmate, unless in either case the
22department for good cause waives parole and discharges the inmate
23from custody of the department.

24(2) (A) For a crime committed prior to July 1, 2013, at the
25expiration of a term of imprisonment of one year and one day, or
26a term of imprisonment imposed pursuant to Section 1170 or at
27the expiration of a term reduced pursuant to Section 2931 or 2933,
28if applicable, the inmate shall be released on parole for a period
29not exceeding three years, except that any inmate sentenced for
30an offense specified in paragraph (3), (4), (5), (6), (11), or (18) of
31subdivision (c) of Section 667.5 shall be released on parole for a
32period not exceeding 10 years, unless a longer period of parole is
33specified in Section 3000.1.

34(B) For a crime committed on or after July 1, 2013, at the
35expiration of a term of imprisonment of one year and one day, or
36a term of imprisonment imposed pursuant to Section 1170 or at
37the expiration of a term reduced pursuant to Section 2931 or 2933,
38if applicable, the inmate shall be released on parole for a period
39of three years, except that any inmate sentenced for an offense
40specified in paragraph (3), (4), (5), (6), (11), or (18) of subdivision
P26   1(c) of Section 667.5 shall be released on parole for a period of 10
2years, unless a longer period of parole is specified in Section
33000.1.

4(3) Notwithstanding paragraphs (1) and (2), in the case of any
5offense for which the inmate has received a life sentence pursuant
6to subdivision (b) of Section 209, with the intent to commit a
7specified sex offense, or Section 667.51, 667.61, or 667.71, the
8period of parole shall be 10 years, unless a longer period of parole
9is specified in Section 3000.1.

10(4) (A) Notwithstanding paragraphs (1) to (3), inclusive, in the
11case of a person convicted of and required to register as a sex
12offender for the commission of an offense specified in Section
13261, 262, 264.1, 286, 288a, paragraph (1) of subdivision (b) of
14Section 288, Section 288.5, or 289, in which one or more of the
15victims of the offense was a child under 14 years of age, the period
16of parole shall be 20 years and six months unless the board, for
17good cause, determines that the person will be retained on parole.
18The board shall make a written record of this determination and
19transmit a copy of it to the parolee.

20(B) In the event of a retention on parole, the parolee shall be
21entitled to a review by the board each year thereafter.

22(C) There shall be a board hearing consistent with the procedures
23set forth in Sections 3041.5 and 3041.7 within 12 months of the
24date of any revocation of parole to consider the release of the
25inmate on parole, and notwithstanding the provisions of paragraph
26(3) of subdivision (b) of Section 3041.5, there shall be annual
27parole consideration hearings thereafter, unless the person is
28released or otherwise ineligible for parole release. The panel or
29board shall release the person within one year of the date of the
30revocation unless it determines that the circumstances and gravity
31of the parole violation are such that consideration of the public
32safety requires a more lengthy period of incarceration or unless
33there is a new prison commitment following a conviction.

34(D) The provisions of Section 3042 shall not apply to any
35hearing held pursuant to this subdivision.

36(5) (A) The Board of Parole Hearings shall consider the request
37of any inmate whose commitment offense occurred prior to July
381, 2013, regarding the length of his or her parole and the conditions
39thereof.

P27   1(B) For an inmate whose commitment offense occurred on or
2after July 1, 2013, except for those inmates described in Section
33000.1, the department shall consider the request of the inmate
4regarding the length of his or her parole and the conditions thereof.
5For those inmates described in Section 3000.1, the Board of Parole
6Hearings shall consider the request of the inmate regarding the
7length of his or her parole and the conditions thereof.

8(6) Upon successful completion of parole, or at the end of the
9maximum statutory period of parole specified for the inmate under
10paragraph (1), (2), (3), or (4), as the case may be, whichever is
11earlier, the inmate shall be discharged from custody. The date of
12the maximum statutory period of parole under this subdivision and
13paragraphs (1), (2), (3), and (4) shall be computed from the date
14of initial parole and shall be a period chronologically determined.
15Time during which parole is suspended because the prisoner has
16absconded or has been returned to custody as a parole violator
17shall not be credited toward any period of parole unless the prisoner
18is found not guilty of the parole violation. However, the period of
19parole is subject to the following:

20(A) Except as provided in Section 3064, in no case may a
21prisoner subject to three years on parole be retained under parole
22supervision or in custody for a period longer than four years from
23the date of his or her initial parole.

24(B) Except as provided in Section 3064, in no case may a
25prisoner subject to five years on parole be retained under parole
26supervision or in custody for a period longer than seven years from
27the date of his or her initial parole.

28(C) Except as provided in Section 3064, in no case may a
29 prisoner subject to 10 years on parole be retained under parole
30supervision or in custody for a period longer than 15 years from
31the date of his or her initial parole.

32(7) The Department of Corrections and Rehabilitation shall meet
33with each inmate at least 30 days prior to his or her good time
34release date and shall provide, under guidelines specified by the
35parole authority or the department, whichever is applicable, the
36conditions of parole and the length of parole up to the maximum
37period of time provided by law. The inmate has the right to
38reconsideration of the length of parole and conditions thereof by
39the department or the parole authority, whichever is applicable.
40The Department of Corrections and Rehabilitation or the board
P28   1may impose as a condition of parole that a prisoner make payments
2on the prisoner’s outstanding restitution fines or orders imposed
3pursuant to subdivision (a) or (c) of Section 13967 of the
4Government Code, as operative prior to September 28, 1994, or
5subdivision (b) or (f) of Section 1202.4.

6(8) For purposes of this chapter, and except as otherwise
7described in this section, the board shall be considered the parole
8authority.

9(9) (A)  On and after July 1, 2013, the sole authority to issue
10warrants for the return to actual custody of any state prisoner
11released on parole rests with the court pursuant to Section 1203.2,
12except for any escaped state prisoner or any state prisoner released
13prior to his or her scheduled release date who should be returned
14to custody, and Section 5054.1 shall apply.

15(B) Notwithstanding subparagraph (A), any warrant issued by
16the Board of Parole Hearings prior to July 1, 2013, shall remain
17in full force and effect until the warrant is served or it is recalled
18by the board. All prisoners on parole arrested pursuant to a warrant
19issued by the board shall be subject to a review by the board prior
20to the department filing a petition with the court to revoke the
21parole of the petitioner.

22(10) It is the intent of the Legislature that efforts be made with
23respect to persons who are subject to Section 290.011 who are on
24parole to engage them in treatment.

25

SEC. 11.  

Section 2356 of the Probate Code is amended to read:

26

2356.  

(a) No ward or conservatee may be placed in a mental
27health treatment facility under this division against the will of the
28ward or conservatee. Involuntary civil placement of a ward or
29conservatee in a mental health treatment facility may be obtained
30only pursuant to Chapter 2 (commencing with Section 5150) or
31Chapter 3 (commencing with Section 5350) of Part 1 of Division
325 of the Welfare and Institutions Code. Nothing in this subdivision
33precludes the placing of a ward in a state hospital under Section
346000 of the Welfare and Institutions Code upon application of the
35guardian as provided in that section. The Director ofbegin delete Mental Healthend delete
36begin insert State Hospitalsend insert shall adopt and issue regulations defining “mental
37health treatment facility” for the purposes of this subdivision.

38(b) No experimental drug as defined in Section 111515 of the
39Health and Safety Code may be prescribed for or administered to
40a ward or conservatee under this division. Such an experimental
P29   1drug may be prescribed for or administered to a ward or
2conservatee only as provided in Article 4 (commencing with
3Section 111515) of Chapter 6 of Part 5 of Division 104 of the
4Health and Safety Code.

5(c) No convulsive treatment as defined in Section 5325 of the
6Welfare and Institutions Code may be performed on a ward or
7conservatee under this division. Convulsive treatment may be
8performed on a ward or conservatee only as provided in Article 7
9(commencing with Section 5325) of Chapter 2 of Part 1 of Division
105 of the Welfare and Institutions Code.

11(d) No minor may be sterilized under this division.

12(e) This chapter is subject to a valid and effective advance health
13care directive under the Health Care Decisions Law (Division 4.7
14(commencing with Section 4600)).

15

SEC. 12.  

Section 736 of the Welfare and Institutions Code is
16amended to read:

17

736.  

(a) Except as provided in Section 733, the Department
18of Corrections and Rehabilitation, Division of Juvenile Facilities,
19shall accept a ward committed to it pursuant to this article if the
20Director of the Division of Juvenile Justice believes that the ward
21can be materially benefited by the division’s reformatory and
22educational discipline, and if the division has adequate facilities,
23staff, and programs to provide that care. A ward subject to this
24section shall not be transported to any facility under the jurisdiction
25of the division until the superintendent of the facility has notified
26the committing court of the place to which that ward is to be
27transported and the time at which he or she can be received.

28(b) To determine who is best served by the Division of Juvenile
29Facilities, and who would be better served by the State Department
30ofbegin delete Mental Healthend deletebegin insert State Hospitalsend insert, the Director of the Division of
31Juvenile Justice and the Director ofbegin delete the State Department of Mental
32Healthend delete
begin insert State Hospitalsend insert shall, at least annually, confer and establish
33policy with respect to the types of cases that should be the
34responsibility of each department.

35

SEC. 13.  

Section 5328.15 of the Welfare and Institutions Code
36 is amended to read:

37

5328.15.  

All information and records obtained in the course
38of providing services under Division 5 (commencing with Section
395000), Division 6 (commencing with Section 6000), or Division
407 (commencing with Section 7000), to either voluntary or
P30   1involuntary recipients of services shall be confidential. Information
2and records may be disclosed, however, notwithstanding any other
3provision of law, as follows:

4(a) To authorized licensing personnel who are employed by, or
5who are authorized representatives of, the State Department of
6Public Health, and who are licensed or registered health
7professionals, and to authorized legal staff or special investigators
8who are peace officers who are employed by, or who are authorized
9representatives of the State Department of Social Services, as
10necessary to the performance of their duties to inspect, license,
11and investigate health facilities and community care facilities and
12to ensure that the standards of care and services provided in such
13facilities are adequate and appropriate and to ascertain compliance
14with the rules and regulations to which the facility is subject. The
15confidential information shall remain confidential except for
16purposes of inspection, licensing, or investigation pursuant to
17Chapter 2 (commencing with Section 1250) of, and Chapter 3
18(commencing with Section 1500) of, Division 2 of the Health and
19Safety Code, or a criminal, civil, or administrative proceeding in
20relation thereto. The confidential information may be used by the
21State Department of Public Health or the State Department of
22Social Services in a criminal, civil, or administrative proceeding.
23The confidential information shall be available only to the judge
24or hearing officer and to the parties to the case. Names which are
25confidential shall be listed in attachments separate to the general
26pleadings. The confidential information shall be sealed after the
27conclusion of the criminal, civil, or administrative hearings, and
28shall not subsequently be released except in accordance with this
29subdivision. If the confidential information does not result in a
30criminal, civil, or administrative proceeding, it shall be sealed after
31the State Department of Public Health or the State Department of
32Social Services decides that no further action will be taken in the
33matter of suspected licensing violations. Except as otherwise
34provided in this subdivision, confidential information in the
35possession of the State Department of Public Health or the State
36Department of Social Services shall not contain the name of the
37patient.

38(b) To any board which licenses and certifies professionals in
39the fields of mental health pursuant to state law, when the Director
40ofbegin delete Mental Healthend deletebegin insert State Hospitalsend insert has reasonable cause to believe
P31   1that there has occurred a violation of any provision of law subject
2to the jurisdiction of that board and the records are relevant to the
3violation. This information shall be sealed after a decision is
4reached in the matter of the suspected violation, and shall not
5subsequently be released except in accordance with this
6subdivision. Confidential information in the possession of the
7board shall not contain the name of the patient.

8(c) To a protection and advocacy agency established pursuant
9to Section 4901, to the extent that the information is incorporated
10within any of the following:

11(1) An unredacted facility evaluation report form or an
12unredacted complaint investigation report form of the State
13Department of Social Services. This information shall remain
14confidential and subject to the confidentiality requirements of
15subdivision (f) of Section 4903.

16(2) An unredacted citation report, unredacted licensing report,
17unredacted survey report, unredacted plan of correction, or
18unredacted statement of deficiency of the State Department of
19Public Health, prepared by authorized licensing personnel or
20authorized representatives described in subdivision (n). This
21information shall remain confidential and subject to the
22confidentiality requirements of subdivision (f) of Section 4903.

23

SEC. 14.  

Section 6000 of the Welfare and Institutions Code is
24amended to read:

25

6000.  

(a) Pursuant to applicable rules and regulations
26established by the State Department ofbegin delete Mental Healthend deletebegin insert State
27Hospitalsend insert
or the State Department of Developmental Services, the
28medical director of a state hospital for the mentally disordered or
29developmentally disabled may receive in such hospital, as a boarder
30and patient, any person who is a suitable person for care and
31treatment in such hospital, upon receipt of a written application
32for the admission of the person into the hospital for care and
33treatment made in accordance with the following requirements:

34(1) In the case of an adult person, the application shall be made
35voluntarily by the person, at a time when he is in such condition
36of mind as to render him competent to make it or, if he is a
37conservatee with a conservator of the person or person and estate
38who was appointed under Chapter 3 (commencing with Section
395350) of Part 1 of Division 5 with the right as specified by court
P32   1order under Section 5358 to place his conservatee in a state
2hospital, by his conservator.

3(2) begin insert(A)end insertbegin insertend insertIn the case of a minor person, the application shall be
4made by his parents, or by the parent, guardian, conservator, or
5other person entitled to his custody to any of such mental hospitals
6as may be designated by the Director ofbegin delete Mental Healthend deletebegin insert State
7Hospitalsend insert
or the Director of Developmental Services to admit
8minors on voluntary applications. If the minor has a conservator
9of the person, or the person and the estate, appointed under Chapter
103 (commencing with Section 5350) of Part 1 of Division 5, with
11the right as specified by court order under Section 5358 to place
12the conservatee in a state hospital the application for the minor
13shall be made by his conservator.

begin delete

14Any such

end delete

15begin insert(B)end insertbegin insertend insertbegin insertAny end insertperson received in a state hospital shall be deemed a
16voluntary patient.

begin delete

17 Upon

end delete

18begin insert(C)end insertbegin insertend insertbegin insertUpon end insertthe admission of a voluntary patient to a state hospital
19the medical director shall immediately forward to the office of the
20State Department ofbegin delete Mental Healthend deletebegin insert State Hospitalsend insert or the State
21Department of Developmental Services the record of such
22voluntary patient, showing the name, residence, age, sex, place of
23birth, occupation, civil condition, date of admission of such patient
24to such hospital, and such other information as is required by the
25rules and regulations of the department.

begin delete

26 The

end delete

27begin insert(D)end insertbegin insertend insertbegin insertThe end insertcharges for the care and keeping of a mentally
28disordered person in a state hospital shall be governed by the
29provisions of Article 4 (commencing with Section 7275) of Chapter
303 of Division 7 relating to the charges for the care and keeping of
31mentally disordered persons in state hospitals.

begin delete

32 A

end delete

33begin insert(E)end insertbegin insertend insertbegin insertAend insert voluntary adult patient may leave the hospital or institution
34at any time by giving notice of his desire to leave to any member
35of the hospital staff and completing normal hospitalization
36departure procedures. A conservatee may leave in a like manner
37if notice is given by his conservator.

begin delete

38 A

end delete

39begin insert(F)end insertbegin insertend insertbegin insertAend insert minor person who is a voluntary patient may leave the
40hospital or institution after completing normal hospitalization
P33   1departure procedures after notice is given to the superintendent or
2person in charge by the parents, or the parent, guardian,
3conservator, or other person entitled to the custody of the minor,
4of their desire to remove him from the hospital.

begin delete

5 No

end delete

6begin insert(G)end insertbegin insertend insertbegin insertNoend insert person received into a state hospital, private mental
7 institution, or county psychiatric hospital as a voluntary patient
8during his minority shall be detained therein after he reaches the
9age of majority, but any such person, after attaining the age of
10majority, may apply for admission into the hospital or institution
11for care and treatment in the manner prescribed in this section for
12applications by adult persons.

13(b) The State Department ofbegin delete Mental Healthend deletebegin insert State Hospitalsend insert or
14the State Department of Developmental Services shall establish
15such rules and regulations as are necessary to carry out properly
16the provisions of this section.

17(c) Commencing July 1, 2012, the department shall not admit
18any person to a developmental center pursuant to this section.

19

SEC. 15.  

Section 6002 of the Welfare and Institutions Code is
20amended to read:

21

6002.  

begin insert(a)end insertbegin insertend insert The person in charge of any private institution,
22hospital, clinic, or sanitarium which is conducted for, or includes
23a department or ward conducted for, the care and treatment of
24persons who are mentally disordered may receive therein as a
25voluntary patient any person suffering from a mental disorder who
26is a suitable person for care and treatment in the institution,
27hospital, clinic, or sanitarium who voluntarily makes a written
28application to the person in charge for admission into the
29institution, hospital, clinic, or sanitarium, and who is at the time
30of making the application mentally competent to make the
31application. A conservatee, with a conservator of the person, or
32person and estate, appointed under Chapter 3 (commencing with
33Section 5350) of Part 1 of Division 5, with the right as specified
34by court order under Section 5358 to place his conservatee, may
35be admitted upon written application by his conservator.

begin delete

36After

end delete

37begin insert(b)end insertbegin insertend insertbegin insertAfterend insert the admission of a voluntary patient to a private
38institution, hospital, clinic, or sanitarium the person in charge shall
39forward to the office of the State Department ofbegin delete Mental Healthend delete
P34   1begin insert State Hospitalsend insert a record of the voluntary patient showing such
2information as may be required by rule by the department.

begin delete

3 A

end delete

4begin insert(c)end insertbegin insertend insertbegin insertAend insert voluntary adult patient may leave the hospital, clinic, or
5institution at any time by giving notice of his desire to leave to
6any member of the hospital staff and completing normal
7hospitalization departure procedures. A conservatee may leave in
8a like manner if notice is given by his conservator.

9

SEC. 16.  

Section 6600 of the Welfare and Institutions Code is
10amended to read:

11

6600.  

As used in this article, the following terms have the
12following meanings:

13(a) (1) “Sexually violent predator” means a person who has
14been convicted of a sexually violent offense against one or more
15victims and who has a diagnosed mental disorder that makes the
16person a danger to the health and safety of others in that it is likely
17that he or she will engage in sexually violent criminal behavior.

18(2) For purposes of this subdivision any of the following shall
19be considered a conviction for a sexually violent offense:

20(A) A prior or current conviction that resulted in a determinate
21prison sentence for an offense described in subdivision (b).

22(B) A conviction for an offense described in subdivision (b)
23that was committed prior to July 1, 1977, and that resulted in an
24indeterminate prison sentence.

25(C) A prior conviction in another jurisdiction for an offense that
26includes all of the elements of an offense described in subdivision
27(b).

28(D) A conviction for an offense under a predecessor statute that
29includes all of the elements of an offense described in subdivision
30(b).

31(E) A prior conviction for which the inmate received a grant of
32probation for an offense described in subdivision (b).

33(F) A prior finding of not guilty by reason of insanity for an
34offense described in subdivision (b).

35(G) A conviction resulting in a finding that the person was a
36mentally disordered sex offender.

37(H) A prior conviction for an offense described in subdivision
38(b) for which the person was committed to thebegin delete Department of the
39Youth Authorityend delete
begin insert Division of Juvenile Facilities, Department of
40Corrections and Rehabilitationend insert
pursuant to Section 1731.5.

P35   1(I) A prior conviction for an offense described in subdivision
2(b) that resulted in an indeterminate prison sentence.

3(3) Conviction of one or more of the crimes enumerated in this
4section shall constitute evidence that may support a court or jury
5determination that a person is a sexually violent predator, but shall
6not be the sole basis for the determination. The existence of any
7prior convictions may be shown with documentary evidence. The
8details underlying the commission of an offense that led to a prior
9conviction, including a predatory relationship with the victim, may
10be shown by documentary evidence, including, but not limited to,
11preliminary hearing transcripts, trial transcripts, probation and
12sentencing reports, and evaluations by the State Department of
13begin delete Mental Healthend deletebegin insert State Hospitalsend insert. Jurors shall be admonished that
14they may not find a person a sexually violent predator based on
15prior offenses absent relevant evidence of a currently diagnosed
16mental disorder that makes the person a danger to the health and
17safety of others in that it is likely that he or she will engage in
18sexually violent criminal behavior.

19(4) The provisions of this section shall apply to any person
20against whom proceedings were initiated for commitment as a
21sexually violent predator on or after January 1, 1996.

22(b) “Sexually violent offense” means the following acts when
23committed by force, violence, duress, menace, fear of immediate
24and unlawful bodily injury on the victim or another person, or
25threatening to retaliate in the future against the victim or any other
26person, and that are committed on, before, or after the effective
27date of this article and result in a conviction or a finding of not
28guilty by reason of insanity, as defined in subdivision (a): a felony
29violation of Section 261, 262, 264.1, 269, 286, 288, 288a, 288.5,
30or 289 of the Penal Code, or any felony violation of Section 207,
31209, or 220 of the Penal Code, committed with the intent to commit
32a violation of Section 261, 262, 264.1, 286, 288, 288a, or 289 of
33the Penal Code.

34(c) “Diagnosed mental disorder” includes a congenital or
35acquired condition affecting the emotional or volitional capacity
36that predisposes the person to the commission of criminal sexual
37acts in a degree constituting the person a menace to the health and
38safety of others.

39(d) “Danger to the health and safety of others” does not require
40proof of a recent overt act while the offender is in custody.

P36   1(e) “Predatory” means an act is directed toward a stranger, a
2person of casual acquaintance with whom no substantial
3relationship exists, or an individual with whom a relationship has
4been established or promoted for the primary purpose of
5victimization.

6(f) “Recent overt act” means any criminal act that manifests a
7likelihood that the actor may engage in sexually violent predatory
8criminal behavior.

9(g) Notwithstanding any other provision of law and for purposes
10of this section, a prior juvenile adjudication of a sexually violent
11offense may constitute a prior conviction for which the person
12received a determinate term if all of the following apply:

13(1) The juvenile was 16 years of age or older at the time he or
14she committed the prior offense.

15(2) The prior offense is a sexually violent offense as specified
16in subdivision (b).

17(3) The juvenile was adjudged a ward of the juvenile court
18within the meaning of Section 602 because of the person’s
19commission of the offense giving rise to the juvenile court
20adjudication.

21(4) The juvenile was committed to thebegin delete Department of the Youth
22Authorityend delete
begin insert Division of Juvenile Facilities, Department of
23Corrections and Rehabilitationend insert
for the sexually violent offense.

24(h) A minor adjudged a ward of the court for commission of an
25offense that is defined as a sexually violent offense shall be entitled
26to specific treatment as a sexual offender. The failure of a minor
27to receive that treatment shall not constitute a defense or bar to a
28determination that any person is a sexually violent predator within
29the meaning of this article.

30

SEC. 17.  

Section 6601 of the Welfare and Institutions Code is
31amended to read:

32

6601.  

(a) (1) Whenever the Secretary of the Department of
33Corrections and Rehabilitation determines that an individual who
34is in custody under the jurisdiction of the Department of
35Corrections and Rehabilitation, and who is either serving a
36determinate prison sentence or whose parole has been revoked,
37may be a sexually violent predator, the secretary shall, at least six
38months prior to that individual’s scheduled date for release from
39prison, refer the person for evaluation in accordance with this
40section. However, if the inmate was received by the department
P37   1with less than nine months of his or her sentence to serve, or if the
2inmate’s release date is modified by judicial or administrative
3action, the secretary may refer the person for evaluation in
4accordance with this section at a date that is less than six months
5prior to the inmate’s scheduled release date.

6(2) A petition may be filed under this section if the individual
7was in custody pursuant to his or her determinate prison term,
8parole revocation term, or a hold placed pursuant to Section 6601.3,
9at the time the petition is filed. A petition shall not be dismissed
10on the basis of a later judicial or administrative determination that
11the individual’s custody was unlawful, if the unlawful custody was
12the result of a good faith mistake of fact or law. This paragraph
13shall apply to any petition filed on or after January 1, 1996.

14(b) The person shall be screened by the Department of
15Corrections and Rehabilitation and the Board of Parole Hearings
16based on whether the person has committed a sexually violent
17predatory offense and on a review of the person’s social, criminal,
18and institutional history. This screening shall be conducted in
19accordance with a structured screening instrument developed and
20updated by the State Department ofbegin delete Mental Healthend deletebegin insert State Hospitalsend insert
21 in consultation with the Department of Corrections and
22Rehabilitation. If as a result of this screening it is determined that
23the person is likely to be a sexually violent predator, the
24Department of Corrections and Rehabilitation shall refer the person
25to the State Department ofbegin delete Mental Healthend deletebegin insert State Hospitalsend insert for a full
26evaluation of whether the person meets the criteria in Section 6600.

27(c) The State Department ofbegin delete Mental Healthend deletebegin insert State Hospitalsend insert shall
28evaluate the person in accordance with a standardized assessment
29 protocol, developed and updated by the State Department ofbegin delete Mental
30Healthend delete
begin insert State Hospitalsend insert, to determine whether the person is a
31sexually violent predator as defined in this article. The standardized
32assessment protocol shall require assessment of diagnosable mental
33disorders, as well as various factors known to be associated with
34the risk of reoffense among sex offenders. Risk factors to be
35considered shall include criminal and psychosexual history, type,
36degree, and duration of sexual deviance, and severity of mental
37disorder.

38(d) Pursuant to subdivision (c), the person shall be evaluated
39by two practicing psychiatrists or psychologists, or one practicing
40psychiatrist and one practicing psychologist, designated by the
P38   1Director ofbegin delete Mental Healthend deletebegin insert State Hospitalsend insert. If both evaluators concur
2that the person has a diagnosed mental disorder so that he or she
3is likely to engage in acts of sexual violence without appropriate
4treatment and custody, the Director ofbegin delete Mental Healthend deletebegin insert State
5Hospitalsend insert
shall forward a request for a petition for commitment
6under Section 6602 to the county designated in subdivision (i).
7Copies of the evaluation reports and any other supporting
8documents shall be made available to the attorney designated by
9the county pursuant to subdivision (i) who may file a petition for
10commitment.

11(e) If one of the professionals performing the evaluation pursuant
12to subdivision (d) does not concur that the person meets the criteria
13specified in subdivision (d), but the other professional concludes
14that the person meets those criteria, the Director ofbegin delete Mental Healthend delete
15begin insert State Hospitalsend insert shall arrange for further examination of the person
16by two independent professionals selected in accordance with
17subdivision (g).

18(f) If an examination by independent professionals pursuant to
19subdivision (e) is conducted, a petition to request commitment
20under this article shall only be filed if both independent
21professionals who evaluate the person pursuant to subdivision (e)
22concur that the person meets the criteria for commitment specified
23in subdivision (d). The professionals selected to evaluate the person
24pursuant to subdivision (g) shall inform the person that the purpose
25of their examination is not treatment but to determine if the person
26meets certain criteria to be involuntarily committed pursuant to
27this article. It is not required that the person appreciate or
28understand that information.

29(g) Any independent professional who is designated by the
30Secretary of the Department of Corrections and Rehabilitation or
31the Director ofbegin delete Mental Healthend deletebegin insert State Hospitalsend insert for purposes of this
32section shall not be a state government employee, shall have at
33least five years of experience in the diagnosis and treatment of
34mental disorders, and shall include psychiatrists and licensed
35psychologists who have a doctoral degree in psychology. The
36requirements set forth in this section also shall apply to any
37professionals appointed by the court to evaluate the person for
38purposes of any other proceedings under this article.

39(h) If the State Department ofbegin delete Mental Healthend deletebegin insert State Hospitalsend insert
40 determines that the person is a sexually violent predator as defined
P39   1in this article, the Director ofbegin delete Mental Healthend deletebegin insert State Hospitalsend insert shall
2forward a request for a petition to be filed for commitment under
3this article to the county designated in subdivision (i). Copies of
4the evaluation reports and any other supporting documents shall
5be made available to the attorney designated by the county pursuant
6to subdivision (i) who may file a petition for commitment in the
7superior court.

8(i) If the county’s designated counsel concurs with the
9recommendation, a petition for commitment shall be filed in the
10superior court of the county in which the person was convicted of
11the offense for which he or she was committed to the jurisdiction
12of the Department of Corrections and Rehabilitation. The petition
13shall be filed, and the proceedings shall be handled, by either the
14district attorney or the county counsel of that county. The county
15board of supervisors shall designate either the district attorney or
16the county counsel to assume responsibility for proceedings under
17this article.

18(j) The time limits set forth in this section shall not apply during
19the first year that this article is operative.

20(k) An order issued by a judge pursuant to Section 6601.5,
21finding that the petition, on its face, supports a finding of probable
22cause to believe that the individual named in the petition is likely
23to engage in sexually violent predatory criminal behavior upon his
24or her release, shall toll that person’s parole pursuant to paragraph
25(4) of subdivision (a) of Section 3000 of the Penal Code, if that
26individual is determined to be a sexually violent predator.

27(l) Pursuant to subdivision (d), the attorney designated by the
28county pursuant to subdivision (i) shall notify the State Department
29ofbegin delete Mental Healthend deletebegin insert State Hospitalsend insert of its decision regarding the filing
30of a petition for commitment within 15 days of making that
31decision.

32(m) This section shall become operative on the date that the
33director executes a declaration, which shall be provided to the
34fiscal and policy committees of the Legislature, including the
35Chairperson of the Joint Legislative Budget Committee, and the
36Department of Finance, specifying that sufficient qualified state
37employees have been hired to conduct the evaluations required
38pursuant to subdivision (d), or January 1, 2013, whichever occurs
39first.

P40   1

SEC. 18.  

Section 6608.7 of the Welfare and Institutions Code
2 is amended to read:

3

6608.7.  

The State Department ofbegin delete Mental Healthend deletebegin insert State Hospitalsend insert
4 may enter into an interagency agreement or contract with the
5Department of Correctionsbegin insert and Rehabilitationend insert or with local law
6enforcement agencies for services related to supervision or
7monitoring of sexually violent predators who have been
8conditionally released into the community under the forensic
9conditional release program pursuant to this article.

10

SEC. 19.  

Section 6609 of the Welfare and Institutions Code is
11amended to read:

12

6609.  

Within 10 days of a request made by the chief of police
13of a city or the sheriff of a county, the State Department ofbegin delete Mental
14Healthend delete
begin insert State Hospitalsend insert shall provide the following information
15concerning each person committed as a sexually violent predator
16who is receiving outpatient care in a conditional release program
17in that city or county: name, address, date of commitment, county
18from which committed, date of placement in the conditional release
19program, fingerprints, and a glossy photograph no smaller than
20318 × 318 inches in size, or clear copies of the fingerprints and
21photograph.

22

SEC. 20.  

Section 9717 of the Welfare and Institutions Code is
23amended to read:

24

9717.  

(a) All advocacy programs and any programs similar in
25nature to the Long-Term Care Ombudsman Program that receive
26funding or official designation from the state shall cooperate with
27the office, where appropriate. These programs include, but are not
28limited to, the Office of Human Rights within the State Department
29ofbegin delete Mental Healthend deletebegin insert State Hospitalsend insert, the Office of Patients’ Rights,
30Disability Rights California, and the Department of Rehabilitation’s
31Client Assistance Program.

32(b) The office shall maintain a close working relationship with
33the Legal Services Development Program for the Elderly within
34the department.

35(c) In order to ensure the provision of counsel for patients and
36residents of long-term care facilities, the office shall seek to
37establish effective coordination with programs that provide legal
38services for the elderly, including, but not limited to, programs
39that are funded by the federal Legal Services Corporation or under
P41   1the federal Older Americans Act (42 U.S.C. Sec. 3001 et seq.), as
2amended.

3(d) The department and other state departments and programs
4that have roles in funding, regulating, monitoring, or serving
5long-term care facility residents, including law enforcement
6agencies, shall cooperate with and meet with the office periodically
7and as needed to address concerns or questions involving the care,
8quality of life, safety, rights, health, and well-being of long-term
9care facility residents.

10

SEC. 21.  

Section 10600.1 of the Welfare and Institutions Code
11 is amended to read:

12

10600.1.  

begin insert(a)end insertbegin insertend insert The State Department of Social Services succeeds
13to and is vested with the duties, purposes, responsibilities, and
14jurisdiction exercised by the State Department of Health or the
15State Department of Benefit Payments pursuant to the provisions
16of this division, except those contained in Chapter 7 (commencing
17with Section 14000), Chapter 8 (commencing with Section 14200),
18Chapter 8.5 (commencing with Section 14500), and Chapter 8.7
19(commencing with Section 14520) of Part 3, on the date
20immediately prior to the date this section becomes operative.

begin delete

21The

end delete

22begin insert(b)end insertbegin insertend insertbegin insertTheend insert State Department of Social Services also succeeds to
23and is vested with the duties, purposes, responsibilities, and
24jurisdiction heretofore exercised by the State Department of Health
25with respect to its disability determination function performed
26pursuant to Titles II and XVI of the federal Social Security Act;
27provided, however, that this paragraph shall not vest in the State
28Department of Social Services any power or authority over
29programs for aid or rehabilitation of mentally disordered or
30developmentally disabled persons administered by the State
31Department ofbegin delete Mental Healthend deletebegin insert State Hospitalsend insert or the State
32Department of Developmental Services.

33

SEC. 22.  

Section 14043.26 of the Welfare and Institutions
34Code
is amended to read:

35

14043.26.  

(a) (1) On and after January 1, 2004, an applicant
36that currently is not enrolled in the Medi-Cal program, or a provider
37applying for continued enrollment, upon written notification from
38the department that enrollment for continued participation of all
39providers in a specific provider of service category or subgroup
40of that category to which the provider belongs will occur, or, except
P42   1as provided in subdivisions (b) and (e), a provider not currently
2enrolled at a location where the provider intends to provide
3services, goods, supplies, or merchandise to a Medi-Cal
4beneficiary, shall submit a complete application package for
5enrollment, continuing enrollment, or enrollment at a new location
6or a change in location.

7(2) Clinics licensed by the department pursuant to Chapter 1
8(commencing with Section 1200) of Division 2 of the Health and
9Safety Code and certified by the department to participate in the
10Medi-Cal program shall not be subject to this section.

11(3) Health facilities licensed by the department pursuant to
12Chapter 2 (commencing with Section 1250) of Division 2 of the
13Health and Safety Code and certified by the department to
14participate in the Medi-Cal program shall not be subject to this
15section.

16(4) Adult day health care providers licensed pursuant to Chapter
173.3 (commencing with Section 1570) of Division 2 of the Health
18and Safety Code and certified by the department to participate in
19the Medi-Cal program shall not be subject to this section.

20(5) Home health agencies licensed pursuant to Chapter 8
21(commencing with Section 1725) of Division 2 of the Health and
22Safety Code and certified by the department to participate in the
23Medi-Cal program shall not be subject to this section.

24(6) Hospices licensed pursuant to Chapter 8.5 (commencing
25with Section 1745) of Division 2 of the Health and Safety Code
26and certified by the department to participate in the Medi-Cal
27program shall not be subject to this section.

28(b) A physician and surgeon licensed by the Medical Board of
29California or the Osteopathic Medical Board of California, or a
30dentist licensed by the Dental Board of California, practicing as
31an individual physician practice or as an individual dentist practice,
32as defined in Section 14043.1, who is enrolled and in good standing
33in the Medi-Cal program, and who is changing locations of that
34individual physician practice or individual dentist practice within
35the same county, shall be eligible to continue enrollment at the
36 new location by filing a change of location form to be developed
37by the department. The form shall comply with all minimum
38federal requirements related to Medicaid provider enrollment.
39Filing this form shall be in lieu of submitting a complete
40application package pursuant to subdivision (a).

P43   1(c) (1) Except as provided in paragraph (2), within 30 days
2after receiving an application package submitted pursuant to
3subdivision (a), the department shall provide written notice that
4the application package has been received and, if applicable, that
5there is a moratorium on the enrollment of providers in the specific
6provider of service category or subgroup of the category to which
7the applicant or provider belongs. This moratorium shall bar further
8processing of the application package.

9(2) Within 15 days after receiving an application package from
10a physician, or a group of physicians, licensed by the Medical
11Board of California or the Osteopathic Medical Board of California,
12or a change of location form pursuant to subdivision (b), the
13department shall provide written notice that the application package
14or the change of location form has been received.

15(d) (1) If the application package submitted pursuant to
16subdivision (a) is from an applicant or provider who meets the
17criteria listed in paragraph (2), the applicant or provider shall be
18considered a preferred provider and shall be granted preferred
19provisional provider status pursuant to this section and for a period
20of no longer than 18 months, effective from the date on the notice
21from the department. The ability to request consideration as a
22preferred provider and the criteria necessary for the consideration
23shall be publicized to all applicants and providers. An applicant
24or provider who desires consideration as a preferred provider
25pursuant to this subdivision shall request consideration from the
26department by making a notation to that effect on the application
27package, by cover letter, or by other means identified by the
28department in a provider bulletin. Request for consideration as a
29preferred provider shall be made with each application package
30submitted in order for the department to grant the consideration.
31An applicant or provider who requests consideration as a preferred
32provider shall be notified within 60 days whether the applicant or
33provider meets or does not meet the criteria listed in paragraph
34(2). If an applicant or provider is notified that the applicant or
35provider does not meet the criteria for a preferred provider, the
36application package submitted shall be processed in accordance
37with the remainder of this section.

38(2) To be considered a preferred provider, the applicant or
39provider shall meet all of the following criteria:

P44   1(A) Hold a current license as a physician and surgeon issued by
2the Medical Board of California or the Osteopathic Medical Board
3of California, which license shall not have been revoked, whether
4stayed or not, suspended, placed on probation, or subject to other
5limitation.

6(B) Be a current faculty member of a teaching hospital or a
7children’s hospital, as defined in Section 10727, accredited by the
8Joint Commission or the American Osteopathic Association, or
9be credentialed by a health care service plan that is licensed under
10the Knox-Keene Health Care Service Plan Act of 1975 (Chapter
112.2 (commencing with Section 1340) of Division 2 of the Health
12and Safety Code) or county organized health system, or be a current
13member in good standing of a group that is credentialed by a health
14care service plan that is licensed under the Knox-Keene Act.

15(C) Have full, current, unrevoked, and unsuspended privileges
16at a Joint Commission or American Osteopathic Association
17accredited general acute care hospital.

18(D) Not have any adverse entries in the federal Healthcare
19Integrity and Protection Data Bank.

20(3) The department may recognize other providers as qualifying
21as preferred providers if criteria similar to those set forth in
22paragraph (2) are identified for the other providers. The department
23shall consult with interested parties and appropriate stakeholders
24to identify similar criteria for other providers so that they may be
25considered as preferred providers.

26(e) (1) If a Medi-Cal applicant meets the criteria listed in
27paragraph (2), the applicant shall be enrolled in the Medi-Cal
28 program after submission and review of a short form application
29to be developed by the department. The form shall comply with
30all minimum federal requirements related to Medicaid provider
31enrollment. The department shall notify the applicant that the
32department has received the application within 15 days of receipt
33of the application. The department shall enroll the applicant or
34notify the applicant that the applicant does not meet the criteria
35listed in paragraph (2) within 90 days of receipt of the application.

36(2) Notwithstanding any other provision of law, an applicant or
37provider who meets all of the following criteria shall be eligible
38for enrollment in the Medi-Cal program pursuant to this
39subdivision, after submission and review of a short form
40application:

P45   1(A) The applicant’s or provider’s practice is based in one or
2more of the following: a general acute care hospital, a rural general
3acute care hospital, or an acute psychiatric hospital, as defined in
4subdivisions (a) and (b) of Section 1250 of the Health and Safety
5Code.

6(B) The applicant or provider holds a current, unrevoked, or
7unsuspended license as a physician and surgeon issued by the
8Medical Board of California or the Osteopathic Medical Board of
9California. An applicant or provider shall not be in compliance
10with this subparagraph if a license revocation has been stayed, the
11licensee has been placed on probation, or the license is subject to
12any other limitation.

13(C) The applicant or provider does not have an adverse entry
14in the federal Healthcare Integrity and Protection Data Bank.

15(3) An applicant shall be granted provisional provider status
16under this subdivision for a period of 12 months.

17(f) Except as provided in subdivision (g), within 180 days after
18receiving an application package submitted pursuant to subdivision
19(a), or from the date of the notice to an applicant or provider that
20the applicant or provider does not qualify as a preferred provider
21under subdivision (d), the department shall give written notice to
22the applicant or provider that any of the following applies, or shall
23on the 181st day grant the applicant or provider provisional
24provider status pursuant to this section for a period no longer than
2512 months, effective from the 181st day:

26(1) The applicant or provider is being granted provisional
27provider status for a period of 12 months, effective from the date
28on the notice.

29(2) The application package is incomplete. The notice shall
30identify additional information or documentation that is needed to
31complete the application package.

32(3) The department is exercising its authority under Section
3314043.37, 14043.4, or 14043.7, and is conducting background
34checks, preenrollment inspections, or unannounced visits.

35(4) The application package is denied for any of the following
36reasons:

37(A) Pursuant to Section 14043.2 or 14043.36.

38(B) For lack of a license necessary to perform the health care
39services or to provide the goods, supplies, or merchandise directly
P46   1or indirectly to a Medi-Cal beneficiary, within the applicable
2provider of service category or subgroup of that category.

3(C) The period of time during which an applicant or provider
4has been barred from reapplying has not passed.

5(D) For other stated reasons authorized by law.

6(E) For failing to submit fingerprints as required by federal
7Medicaid regulations.

8(F) For failing to pay an application fee as required by federal
9Medicaid regulations.

begin insert

10(5) The application package is withdrawn by request of the
11applicant or provider and the department’s review is canceled.

end insert

12(g) Notwithstanding subdivision (f), within 90 days after
13receiving an application package submitted pursuant to subdivision
14(a) from a physician or physician group licensed by the Medical
15Board of California or the Osteopathic Medical Board of California,
16or from the date of the notice to that physician or physician group
17that does not qualify as a preferred provider under subdivision (d),
18or within 90 days after receiving a change of location form
19submitted pursuant to subdivision (b), the department shall give
20written notice to the applicant or provider that either paragraph
21(1), (2), (3),begin delete orend delete (4)begin insert, or (5)end insert of subdivision (f) applies, or shall on the
2291st day grant the applicant or provider provisional provider status
23pursuant to this section for a period no longer than 12 months,
24effective from the 91st day.

25(h) (1) If the application package that was noticed as incomplete
26under paragraph (2) of subdivision (f) is resubmitted with all
27requested information and documentation, and received by the
28department within 60 days of the date on the notice, the department
29shall, within 60 days of the resubmission, send a notice that any
30of the following applies:

31(A) The applicant or provider is being granted provisional
32provider status for a period of 12 months, effective from the date
33on the notice.

34(B) The application package is denied for any other reasons
35provided for in paragraph (4) of subdivision (f).

36(C) The department is exercising its authority under Section
3714043.37, 14043.4, or 14043.7 to conduct background checks,
38preenrollment inspections, or unannounced visits.

39(2) (A) If the application package that was noticed as
40incomplete under paragraph (2) of subdivision (f) is not resubmitted
P47   1 with all requested information and documentation and received
2by the department within 60 days of the date on the notice, the
3application package shall be denied by operation of law. The
4applicant or provider may reapply by submitting a new application
5package that shall be reviewed de novo.

6(B) If the failure to resubmit is by a currently enrolled provider
7as defined in Section 14043.1, including providers applying for
8continued enrollment, the failure may make the provider also
9subject to deactivation of the provider’s number and all of the
10business addresses used by the provider to provide services, goods,
11supplies, or merchandise to Medi-Cal beneficiaries.

12(C) Notwithstanding subparagraph (A), if the notice of an
13incomplete application package included a request for information
14or documentation related to grounds for denial under Section
1514043.2 or 14043.36, the applicant or provider shall not reapply
16for enrollment or continued enrollment in the Medi-Cal program
17or for participation in any health care program administered by
18the department or its agents or contractors for a period of three
19years.

20(i) (1) If the department exercises its authority under Section
2114043.37, 14043.4, or 14043.7 to conduct background checks,
22preenrollment inspections, or unannounced visits, the applicant or
23provider shall receive notice, from the department, after the
24conclusion of the background check, preenrollment inspection, or
25unannounced visit of either of the following:

26(A) The applicant or provider is granted provisional provider
27status for a period of 12 months, effective from the date on the
28notice.

29(B) Discrepancies or failure to meet program requirements, as
30prescribed by the department, have been found to exist during the
31preenrollment period.

32(2) (A) The notice shall identify the discrepancies or failures,
33and whether remediation can be made or not, and if so, the time
34period within which remediation must be accomplished. Failure
35to remediate discrepancies and failures as prescribed by the
36department, or notification that remediation is not available, shall
37result in denial of the application by operation of law. The applicant
38or provider may reapply by submitting a new application package
39that shall be reviewed de novo.

P48   1(B) If the failure to remediate is by a currently enrolled provider
2as defined in Section 14043.1, including providers applying for
3continued enrollment, the failure may make the provider also
4subject to deactivation of the provider’s number and all of the
5business addresses used by the provider to provide services, goods,
6supplies, or merchandise to Medi-Cal beneficiaries.

7(C) Notwithstanding subparagraph (A), if the discrepancies or
8failure to meet program requirements, as prescribed by the director,
9included in the notice were related to grounds for denial under
10Section 14043.2 or 14043.36, the applicant or provider shall not
11reapply for three years.

12(j) If provisional provider status or preferred provisional provider
13status is granted pursuant to this section, a provider number shall
14be used by the provider for each business address for which an
15application package has been approved. This provider number
16shall be used exclusively for the locations for which it was
17approved, unless the practice of the provider’s profession or
18delivery of services, goods, supplies, or merchandise is such that
19services, goods, supplies, or merchandise are rendered or delivered
20at locations other than the provider’s business address and this
21practice or delivery of services, goods, supplies, or merchandise
22has been disclosed in the application package approved by the
23department when the provisional provider status or preferred
24provisional provider status was granted.

25(k) Except for providers subject to subdivision (c) of Section
2614043.47, a provider currently enrolled in the Medi-Cal program
27at one or more locations who has submitted an application package
28for enrollment at a new location or a change in location pursuant
29to subdivision (a), or filed a change of location form pursuant to
30subdivision (b), may submit claims for services, goods, supplies,
31or merchandise rendered at the new location until the application
32package or change of location form is approved or denied under
33this section, and shall not be subject, during that period, to
34deactivation, or be subject to any delay or nonpayment of claims
35as a result of billing for services rendered at the new location as
36herein authorized. However, the provider shall be considered during
37that period to have been granted provisional provider status or
38preferred provisional provider status and be subject to termination
39of that status pursuant to Section 14043.27. A provider that is
40subject to subdivision (c) of Section 14043.47 may come within
P49   1the scope of this subdivision upon submitting documentation in
2the application package that identifies the physician providing
3supervision for every three locations. If a provider submits claims
4for services rendered at a new location before the application for
5that location is received by the department, the department may
6deny the claim.

7(l) An applicant or a provider whose application for enrollment,
8continued enrollment, or a new location or change in location has
9been denied pursuant to this section, may appeal the denial in
10accordance with Section 14043.65.

11(m) (1) Upon receipt of a complete and accurate claim for an
12individual nurse provider, the department shall adjudicate the claim
13within an average of 30 days.

14(2) During the budget proceedings of the 2006-07 fiscal year,
15and each fiscal year thereafter, the department shall provide data
16to the Legislature specifying the timeframe under which it has
17processed and approved the provider applications submitted by
18individual nurse providers.

19(3) For purposes of this subdivision, “individual nurse providers”
20are providers authorized under certain home- and community-based
21waivers and under the state plan to provide nursing services to
22Medi-Cal recipients in the recipients’ own homes rather than in
23institutional settings.

24(n)  The amendments to subdivision (b), which implement a
25change of location form, and the addition of paragraph (2) to
26subdivision (c), the amendments to subdivision (e), and the addition
27of subdivision (g), which prescribe different processing timeframes
28for physicians and physician groups, as contained in Chapter 693
29of the Statutes of 2007, shall become operative on July 1, 2008.

30(o) (1) This section shall become operative on the effective
31date of the state plan amendment necessary to implement this
32section, as stated in the declaration executed by the director
33pursuant to paragraph (2).

34(2) Upon approval of the state plan amendment necessary to
35implement this section under Sections 455.434 and 455.450 of
36Title 42 of the Code of Federal Regulations, the director shall
37execute a declaration, to be retained by the director, that states that
38this approval has been obtained and the effective date of the state
39plan amendment. The department shall post the declaration on its
P50   1Internet Web site and transmit a copy of the declaration to the
2Legislature.

3

SEC. 23.  

Section 14105.192 of the Welfare and Institutions
4Code
is amended to read:

5

14105.192.  

(a) The Legislature finds and declares the
6following:

7(1) Costs within the Medi-Cal program continue to grow due
8to the rising cost of providing health care throughout the state and
9also due to increases in enrollment, which are more pronounced
10during difficult economic times.

11(2) In order to minimize the need for drastically cutting
12enrollment standards or benefits during times of economic crisis,
13it is crucial to find areas within the program where reimbursement
14levels are higher than required under the standard provided in
15Section 1902(a)(30)(A) of the federal Social Security Act and can
16be reduced in accordance with federal law.

17(3) The Medi-Cal program delivers its services and benefits to
18Medi-Cal beneficiaries through a wide variety of health care
19providers, some of which deliver care via managed care or other
20contract models while others do so through fee-for-service
21arrangements.

22(4) The setting of rates within the Medi-Cal program is complex
23and is subject to close supervision by the United States Department
24of Health and Human Services.

25(5) As the single state agency for Medicaid in California, the
26department has unique expertise that can inform decisions that set
27or adjust reimbursement methodologies and levels consistent with
28the requirements of federal law.

29(b) Therefore, it is the intent of the Legislature for the
30department to analyze and identify where reimbursement levels
31can be reduced consistent with the standard provided in Section
321902(a)(30)(A) of the federal Social Security Act and consistent
33with federal and state law and policies, including any exemptions
34contained in the provisions of the act that added this section,
35provided that the reductions in reimbursement shall not exceed 10
36percent on an aggregate basis for all providers, services and
37products.

38(c) Notwithstanding any other provision of law, the director
39shall adjust provider payments, as specified in this section.

P51   1(d) (1) Except as otherwise provided in this section, payments
2shall be reduced by 10 percent for Medi-Cal fee-for-service benefits
3for dates of service on and after June 1, 2011.

4(2) For managed health care plans that contract with the
5department pursuant to this chapter or Chapter 8 (commencing
6with Section 14200), except contracts with Senior Care Action
7Network and AIDS Healthcare Foundation, payments shall be
8reduced by the actuarial equivalent amount of the payment
9reductions specified in this section pursuant to contract
10amendments or change orders effective on July 1, 2011, or
11thereafter.

12(3) Payments shall be reduced by 10 percent for non-Medi-Cal
13programs described in Article 6 (commencing with Section 124025)
14of Chapter 3 of Part 2 of Division 106 of the Health and Safety
15Code, and Section 14105.18, for dates of service on and after June
161, 2011. This paragraph shall not apply to inpatient hospital
17services provided in a hospital that is paid under contract pursuant
18to Article 2.6 (commencing with Section 14081).

19(4) (A) Notwithstanding any other provision of law, the director
20may adjust the payments specified in paragraphs (1) and (3) of
21this subdivision with respect to one or more categories of Medi-Cal
22providers, or for one or more products or services rendered, or any
23combination thereof, so long as the resulting reductions to any
24category of Medi-Cal providers, in the aggregate, total no more
25than 10 percent.

26(B) The adjustments authorized in subparagraph (A) shall be
27implemented only if the director determines that, for each affected
28product, service or provider category, the payments resulting from
29the adjustment comply with subdivision (m).

30(e) Notwithstanding any other provision of this section,
31payments to hospitals that are not under contract with the State
32Department of Health Care Services pursuant to Article 2.6
33(commencing with Section 14081) for inpatient hospital services
34provided to Medi-Cal beneficiaries and that are subject to Section
3514166.245 shall be governed by that section.

36(f) Notwithstanding any other provision of this section, the
37following shall apply:

38(1) Payments to providers that are paid pursuant to Article 3.8
39(commencing with Section 14126) shall be governed by that article.

P52   1(2) (A) Subject to subparagraph (B), for dates of service on and
2after June 1, 2011, Medi-Cal reimbursement rates for intermediate
3care facilities for the developmentally disabled licensed pursuant
4to subdivision (e), (g), or (h) of Section 1250 of the Health and
5Safety Code, and facilities providing continuous skilled nursing
6care to developmentally disabled individuals pursuant to the pilot
7project established by Section 14132.20, as determined by the
8applicable methodology for setting reimbursement rates for these
9facilities, shall not exceed the reimbursement rates that were
10applicable to providers in the 2008-09 rate year.

11(B) (i) If Section 14105.07 is added to the Welfare and
12Institutions Code during the 2011-12 Regular Session of the
13Legislature, subparagraph (A) shall become inoperative.

14(ii) If Section 14105.07 is added to the Welfare and Institutions
15Code during the 2011-12 Regular Session of the Legislature, then
16for dates of service on and after June 1, 2011, payments to
17intermediate care facilities for the developmentally disabled
18licensed pursuant to subdivision (e), (g), or (h) of Section 1250 of
19the Health and Safety Code, and facilities providing continuous
20skilled nursing care to developmentally disabled individuals
21pursuant to the pilot project established by Section 14132.20, shall
22be governed by the applicable methodology for setting
23reimbursement rates for these facilities and by Section 14105.07.

24(g) The department may enter into contracts with a vendor for
25the purposes of implementing this section on a bid or nonbid basis.
26In order to achieve maximum cost savings, the Legislature declares
27that an expedited process for contracts under this subdivision is
28necessary. Therefore, contracts entered into to implement this
29section and all contract amendments and change orders shall be
30exempt from Chapter 2 (commencing with Section 10290) of Part
312 Division 2 of the Public Contract Code.

32(h) To the extent applicable, the services, facilities, and
33payments listed in this subdivision shall be exempt from the
34payment reductions specified in subdivision (d) as follows:

35(1) Acute hospital inpatient services that are paid under contracts
36pursuant to Article 2.6 (commencing with Section 14081).

37(2) Federally qualified health center services, including those
38facilities deemed to have federally qualified health center status
39pursuant to a waiver pursuant to subsection (a) of Section 1115 of
40the federal Social Security Act (42 U.S.C. Sec. 1315(a)).

P53   1(3) Rural health clinic services.

2(4) Payments to facilities owned or operated by the State
3Department ofbegin delete Mental Healthend deletebegin insert State Hospitalsend insert or the State
4Department of Developmental Services.

5(5) Hospice services.

6(6) Contract services, as designated by the director pursuant to
7subdivision (k).

8(7) Payments to providers to the extent that the payments are
9funded by means of a certified public expenditure or an
10intergovernmental transfer pursuant to Section 433.51 of Title 42
11of the Code of Federal Regulations. This paragraph shall apply to
12payments described in paragraph (3) of subdivision (d) only to the
13extent that they are also exempt from reduction pursuant to
14subdivision (l).

15(8) Services pursuant to local assistance contracts and
16interagency agreements to the extent the funding is not included
17in the funds appropriated to the department in the annual Budget
18Act.

19(9) Breast and cervical cancer treatment provided pursuant to
20Section 14007.71 and as described in paragraph (3) of subdivision
21(a) of Section 14105.18 or Article 1.5 (commencing with Section
22104160) of Chapter 2 of Part 1 of Division 103 of the Health and
23Safety Code.

24(10) The Family Planning, Access, Care, and Treatment (Family
25PACT) Program pursuant to subdivision (aa) of Section 14132.

26(i) Subject to the exception for services listed in subdivision
27(h), the payment reductions required by subdivision (d) shall apply
28to the benefits rendered by any provider who may be authorized
29to bill for the service, including, but not limited to, physicians,
30podiatrists, nurse practitioners, certified nurse-midwives, nurse
31anesthetists, and organized outpatient clinics.

32(j) Notwithstanding any other provision of law, for dates of
33service on and after June 1, 2011, Medi-Cal reimbursement rates
34applicable to the following classes of providers shall not exceed
35the reimbursement rates that were applicable to those classes of
36 providers in the 2008-09 rate year, as described in subdivision (f)
37of Section 14105.191, reduced by 10 percent:

38(1) Intermediate care facilities, excluding those facilities
39identified in paragraph (2) of subdivision (f). For purposes of this
40section, “intermediate care facility” has the same meaning as
P54   1defined in Section 51118 of Title 22 of the California Code of
2Regulations.

3(2) Skilled nursing facilities that are distinct parts of general
4acute care hospitals. For purposes of this section, “distinct part”
5has the same meaning as defined in Section 72041 of Title 22 of
6the California Code of Regulations.

7(3) Rural swing-bed facilities.

8(4) Subacute care units that are, or are parts of, distinct parts of
9general acute care hospitals. For purposes of this subparagraph,
10“subacute care unit” has the same meaning as defined in Section
1151215.5 of Title 22 of the California Code of Regulations.

12(5) Pediatric subacute care units that are, or are parts of, distinct
13parts of general acute care hospitals. For purposes of this
14subparagraph, “pediatric subacute care unit” has the same meaning
15as defined in Section 51215.8 of Title 22 of the California Code
16of Regulations.

17(6) Adult day health care centers.

18(7) Freestanding pediatric subacute care units, as defined in
19Section 51215.8 of Title 22 of the California Code of Regulations.

20(k) Notwithstanding Chapter 3.5 (commencing with Section
2111340) of Part 1 of Division 3 of Title 2 of the Government Code,
22the department may implement and administer this section by
23means of provider bulletins or similar instructions, without taking
24regulatory action.

25(l) The reductions described in this section shall apply only to
26payments for services when the General Fund share of the payment
27is paid with funds directly appropriated to the department in the
28annual Budget Act and shall not apply to payments for services
29paid with funds appropriated to other departments or agencies.

30(m) Notwithstanding any other provision of this section, the
31payment reductions and adjustments provided for in subdivision
32(d) shall be implemented only if the director determines that the
33payments that result from the application of this section will
34comply with applicable federal Medicaid requirements and that
35federal financial participation will be available.

36(1) In determining whether federal financial participation is
37available, the director shall determine whether the payments
38comply with applicable federal Medicaid requirements, including
39those set forth in Section 1396a(a)(30)(A) of Title 42 of the United
40States Code.

P55   1(2) To the extent that the director determines that the payments
2do not comply with the federal Medicaid requirements or that
3federal financial participation is not available with respect to any
4payment that is reduced pursuant to this section, the director retains
5the discretion to not implement the particular payment reduction
6or adjustment and may adjust the payment as necessary to comply
7with federal Medicaid requirements.

8(n) The department shall seek any necessary federal approvals
9for the implementation of this section.

10(o) (1) The payment reductions and adjustments set forth in
11this section shall not be implemented until federal approval is
12obtained.

13(2) To the extent that federal approval is obtained for one or
14more of the payment reductions and adjustments in this section
15and Section 14105.07, the payment reductions and adjustments
16set forth in Section 14105.191 shall cease to be implemented for
17the same services provided by the same class of providers. In the
18event of a conflict between this section and Section 14105.191,
19other than the provisions setting forth a payment reduction or
20adjustment, this section shall govern.

21(3) When federal approval is obtained, the payments resulting
22from the application of this section shall be implemented
23retroactively to June 1, 2011, or on any other date or dates as may
24be applicable.

25(4) The director may clarify the application of this subdivision
26by means of provider bulletins or similar instructions, pursuant to
27subdivision (k).

28(p) Adjustments to pharmacy drug product payment pursuant
29to this section shall no longer apply when the department
30determines that the average acquisition cost methodology pursuant
31to Section 14105.45 has been fully implemented and the
32department’s pharmacy budget reduction targets, consistent with
33payment reduction levels pursuant to this section, have been met.

34

SEC. 24.  

Section 14169.51 of the Welfare and Institutions
35Code
is amended to read:

36

14169.51.  

For purposes of this article, the following definitions
37shall apply:

38(a) “Acute psychiatric days” means the total number of Medi-Cal
39specialty mental health service administrative days, Medi-Cal
40specialty mental health service acute care days, acute psychiatric
P56   1administrative days, and acute psychiatric acute days identified in
2the Final Medi-Cal Utilization Statistics for the state fiscal year
3preceding the rebase calculation year as calculated by the
4department as of the retrieval date.

5(b) “Acute psychiatric per diem supplemental rate” means a
6fixed per diem supplemental payment for acute psychiatric days.

7(c) “Annual fee-for-service days” means the number of
8fee-for-service days of each hospital subject to the quality assurance
9fee, as reported on the days data source.

10(d) “Annual managed care days” means the number of managed
11care days of each hospital subject to the quality assurance fee, as
12reported on the days data source.

13(e) “Annual Medi-Cal days” means the number of Medi-Cal
14days of each hospital subject to the quality assurance fee, as
15reported on the days data source.

16(f) “Base calendar year” means a calendar year that ends before
17a subject fiscal year begins, but no more than six years before a
18subject fiscal year begins. Beginning with the third program period,
19the department shall establish the base calendar year during the
20rebase calculation year as the calendar year for which the most
21recent data is available that the department determines is reliable.

22(g) “Converted hospital” means a private hospital that becomes
23a designated public hospital or a nondesignated public hospital on
24or after the first day of a program period.

25(h) “Days data source” means either: (1) if a hospital’s Annual
26Financial Disclosure Report for its fiscal year ending in the base
27calendar year includes data for a full fiscal year of operation, the
28hospital’s Annual Financial Disclosure Report retrieved from the
29Office of Statewide Health Planning and Development as retrieved
30by the department on the retrieval date pursuant to Section
3114169.59, for its fiscal year ending in the base calendar year; or
32(2) if a hospital’s Annual Financial Disclosure Report for its fiscal
33year ending in the base calendar year includes data for more than
34one day, but less than a full year of operation, the department’s
35best and reasonable estimates of the hospital’s Annual Financial
36Disclosure Report if the hospital had operated for a full year.

37(i) “Department” means the State Department of Health Care
38Services.

39(j) “Designated public hospital” shall have the meaning given
40in subdivision (d) of Section 14166.1.

P57   1(k) “Director” means the Director of Health Care Services.

2(l) “Exempt facility” means any of the following:

3(1) A public hospital, which shall include either of the following:

4(A) A hospital, as defined in paragraph (25) of subdivision (a)
5of Section 14105.98.

6(B) A tax-exempt nonprofit hospital that is licensed under
7subdivision (a) of Section 1250 of the Health and Safety Code and
8operating a hospital owned by a local health care district, and is
9affiliated with the health care district hospital owner by means of
10the district’s status as the nonprofit corporation’s sole corporate
11member.

12(2) With the exception of a hospital that is in the Charitable
13Research Hospital peer group, as set forth in the 1991 Hospital
14Peer Grouping Report published by the department, a hospital that
15is designated as a specialty hospital in the hospital’s most recently
16filed Office of Statewide Health Planning and Development
17Hospital Annual Financial Disclosure Report, as of the first day
18of a program period.

19(3) A hospital that satisfies the Medicare criteria to be a
20long-term care hospital.

21(4) A small and rural hospital as specified in Section 124840
22of the Health and Safety Code designated as that in the hospital’s
23most recently filed Office of Statewide Health Planning and
24Development Hospital Annual Financial Disclosure Report, as of
25the first day of a program period.

26(m) “Federal approval” means the approval by the federal
27government of both the quality assurance fee established pursuant
28to this article and the supplemental payments to private hospitals
29described pursuant to this article.

30(n) “Fee-for-service per diem quality assurance fee rate” means
31a fixed fee on fee-for-service days.

32(o) “Fee-for-service days” means inpatient hospital days as
33reported on the days data source where the service type is reported
34as “acute care,” “psychiatric care,” or “rehabilitation care,” and
35the payer category is reported as “Medicare traditional,” “county
36 indigent programs-traditional,” “other third parties-traditional,”
37“other indigent,” or “other payers,” for purposes of the Annual
38Financial Disclosure Report submitted by hospitals to the Office
39of Statewide Health Planning and Development.

begin insert

P58   1(p) “Fund” means the Hospital Quality Assurance Revenue
2Fund established by Section 14167.35.

end insert
begin delete

3(p)

end delete

4begin insert(q)end insert “General acute care days” means the total number of
5Medi-Cal general acute care days, including well baby days, less
6any acute psychiatric inpatient days, paid by the department to a
7hospital for services in the base calendar year, as reflected in the
8state paid claims file on the retrieval date.

begin delete

9(q)

end delete

10begin insert(r)end insert “General acute care hospital” means any hospital licensed
11pursuant to subdivision (a) of Section 1250 of the Health and Safety
12Code.

begin delete

13(r)

end delete

14begin insert(s)end insert “General acute care per diem supplemental rate” means a
15fixed per diem supplemental payment for general acute care days.

begin delete

16(s)

end delete

17begin insert(t)end insert “High acuity days” means Medi-Cal coronary care unit days,
18pediatric intensive care unit days, intensive care unit days, neonatal
19intensive care unit days, and burn unit days paid by the department
20to a hospital for services in the base calendar year, as reflected in
21the state paid claims file prepared by the department on the retrieval
22date.

begin delete

23(t)

end delete

24begin insert(u)end insert “High acuity per diem supplemental rate” means a fixed per
25diem supplemental payment for high acuity days for specified
26hospitals in Section 14169.55.

begin delete

27(u)

end delete

28begin insert(v)end insert “High acuity trauma per diem supplemental rate” means a
29fixed per diem supplemental payment for high acuity days for
30specified hospitals in Section 14169.55 that have been designated
31as specified types of trauma hospitals.

begin delete

32(v)

end delete

33begin insert(w)end insert “Hospital community” includes, but is not limited to, the
34statewide hospital industry organization and systems representing
35general acute care hospitals.

begin delete

36(w)

end delete

37begin insert(x)end insert “Hospital inpatient services” means all services covered
38under Medi-Cal and furnished by hospitals to patients who are
39admitted as hospital inpatients and reimbursed on a fee-for-service
40basis by the department directly or through its fiscal intermediary.
P59   1Hospital inpatient services include outpatient services furnished
2by a hospital to a patient who is admitted to that hospital within
324 hours of the provision of the outpatient services that are related
4to the condition for which the patient is admitted. Hospital inpatient
5services do not include services for which a managed health care
6plan is financially responsible.

begin delete

7(x)

end delete

8begin insert(y)end insert “Hospital outpatient services” means all services covered
9under Medi-Cal furnished by hospitals to patients who are
10registered as hospital outpatients and reimbursed by the department
11on a fee-for-service basis directly or through its fiscal intermediary.
12Hospital outpatient services do not include services for which a
13managed health care plan is financially responsible, or services
14rendered by a hospital-based federally qualified health center for
15which reimbursement is received pursuant to Section 14132.100.

begin delete

16(y)

end delete

17begin insert(z)end insert “Managed care days” means inpatient hospital days as
18reported on the days data source where the service type is reported
19as “acute care,” “psychiatric care,” or “rehabilitation care,” and
20the payer category is reported as “Medicare managed care,”
21“county indigent programs-managed care,” or “other third
22parties-managed care,” for purposes of the Annual Financial
23Disclosure Report submitted by hospitals to the Office of Statewide
24Health Planning and Development.

begin delete

25(z)

end delete

26begin insert(aa)end insert “Managed care per diem quality assurance fee rate” means
27a fixed fee on managed care days.

begin delete

28(aa)

end delete

29begin insert(ab)end insert (1) “Managed health care plan” means a health care
30delivery system that manages the provision of health care and
31receives prepaid capitated payments from the state in return for
32providing services to Medi-Cal beneficiaries.

33(2) (A) Managed health care plans include county organized
34health systems and entities contracting with the department to
35provide or arrange services for Medi-Cal beneficiaries pursuant
36to the two-plan model, geographic managed care, or regional
37managed care for the rural expansion. Entities providing these
38services contract with the department pursuant to any of the
39following:

40(i) Article 2.7 (commencing with Section 14087.3).

P60   1(ii) Article 2.8 (commencing with Section 14087.5).

2(iii) Article 2.81 (commencing with Section 14087.96).

3(iv) Article 2.82 (commencing with Section 14087.98).

4(v) Article 2.91 (commencing with Section 14089).

5(B) Managed health care plans do not include any of the
6following:

7(i) Mental health plans contracting to provide mental health care
8for Medi-Cal beneficiaries pursuant to Chapter 8.9 (commencing
9 with Section 14700).

10(ii) Health plans not covering inpatient services such as primary
11care case management plans operating pursuant to Section
1214088.85.

13(iii) Program for All-Inclusive Care for the Elderly organizations
14operating pursuant to Chapter 8.75 (commencing with Section
1514591).

begin delete

16(ab)

end delete

17begin insert(ac)end insert “Medi-Cal days” means inpatient hospital days as reported
18on the days data source where the service type is reported as “acute
19care,” “psychiatric care,” or “rehabilitation care,” and the payer
20category is reported as “Medi-Cal traditional” or “Medi-Cal
21 managed care,” for purposes of the Annual Financial Disclosure
22Report submitted by hospitals to the Office of Statewide Health
23Planning and Development.

begin delete

24(ac)

end delete

25begin insert(ad)end insert “Medi-Cal fee-for-service days” means inpatient hospital
26days as reported on the days data source where the service type is
27reported as “acute care,” “psychiatric care,” or “rehabilitation
28care,” and the payer category is reported as “Medi-Cal traditional”
29for purposes of the Annual Financial Disclosure Report submitted
30by hospitals to the Office of Statewide Health Planning and
31Development.

begin delete

32(ad)

end delete

33begin insert(ae)end insert “Medi-Cal managed care days” means the total number of
34general acute care days, including well baby days, listed for the
35county organized health system and prepaid health plans identified
36in the Final Medi-Cal Utilization Statistics for the state fiscal year
37preceding the rebase calculation year, as calculated by the
38department as of the retrieval date.

begin delete

39(ae)

end delete

P61   1begin insert(af)end insert “Medi-Cal managed care fee days” means inpatient hospital
2days as reported on the days data source where the service type is
3reported as “acute care,” “psychiatric care,” or “rehabilitation
4care,” and the payer category is reported as “Medi-Cal managed
5care” for purposes of the Annual Financial Disclosure Report
6submitted by hospitals to the Office of Statewide Health Planning
7and Development.

begin delete

8(af)

end delete

9begin insert(ag)end insert “Medi-Cal per diem quality assurance fee rate” means a
10fixed fee on Medi-Cal days.

begin delete

11(ag)

end delete

12begin insert(ah)end insert “Medicaid inpatient utilization rate” means Medicaid
13inpatient utilization rate as defined in Section 1396r-4 of Title 42
14of the United States Code and as set forth in the Final Medi-Cal
15Utilization Statistics for the state fiscal year preceding the rebase
16calculation year, as calculated by the department as of the retrieval
17date.

begin delete

18(ah)

end delete

19begin insert(ai)end insert “New hospital” means a hospital operation, business, or
20facility functioning under current or prior ownership as a private
21hospital that does not have a days data source or a hospital that
22has a days data source in whole, or in part, from a previous operator
23where there is an outstanding monetary obligation owed to the
24 state in connection with the Medi-Cal program and the hospital is
25not, or does not agree to become, financially responsible to the
26department for the outstanding monetary obligation in accordance
27with subdivision (d) of Section 14169.61.

begin delete

28(ai)

end delete

29begin insert(aj)end insert “Nondesignated public hospital” means either of the
30following:

31(1) A public hospital that is licensed under subdivision (a) of
32Section 1250 of the Health and Safety Code, is not designated as
33a specialty hospital in the hospital’s most recently filed Annual
34Financial Disclosure Report, as of the first day of a program period,
35and satisfies the definition in paragraph (25) of subdivision (a) of
36Section 14105.98, excluding designated public hospitals.

37(2) A tax-exempt nonprofit hospital that is licensed under
38subdivision (a) of Section 1250 of the Health and Safety Code, is
39not designated as a specialty hospital in the hospital’s most recently
40filed Annual Financial Disclosure Report, as of the first day of a
P62   1program period, is operating a hospital owned by a local health
2care district, and is affiliated with the health care district hospital
3owner by means of the district’s status as the nonprofit
4corporation’s sole corporate member.

begin delete

5(aj)

end delete

6begin insert(ak)end insert “Outpatient base amount” means the total amount of
7payments for hospital outpatient services made to a hospital in the
8base calendar year, as reflected in the state paid claims files
9prepared by the department as of the retrieval date.

begin delete

10(ak)

end delete

11begin insert(al)end insert “Outpatient supplemental rate” means a fixed proportional
12supplemental payment for Medi-Cal outpatient services.

begin delete

13(al)

end delete

14begin insert(am)end insert “Prepaid health plan hospital” means a hospital owned by
15a nonprofit public benefit corporation that shares a common board
16of directors with a nonprofit health care service plan, which
17exclusively contracts with no more than two medical groups in the
18state to provide or arrange for professional medical services for
19the enrollees of the plan, as of the effective date of this article.

begin delete

20(am)

end delete

21begin insert(an)end insert “Prepaid health plan hospital managed care per diem quality
22assurance fee rate” means a fixed fee on non-Medi-Cal managed
23care fee days for prepaid health plan hospitals.

begin delete

24(an)

end delete

25begin insert(ao)end insert “Prepaid health plan hospital Medi-Cal managed care per
26diem quality assurance fee rate” means a fixed fee on Medi-Cal
27managed care fee days for prepaid health plan hospitals.

begin delete

28(ao)

end delete

29begin insert(ap)end insert “Private hospital” means a hospital that meets all of the
30following conditions:

31(1) Is licensed pursuant to subdivision (a) of Section 1250 of
32the Health and Safety Code.

33(2) Is in the Charitable Research Hospital peer group, as set
34forth in the 1991 Hospital Peer Grouping Report published by the
35department, or is not designated as a specialty hospital in the
36hospital’s most recently filed Office of Statewide Health Planning
37and Development Annual Financial Disclosure Report, as of the
38first day of a program period.

39(3) Does not satisfy the Medicare criteria to be classified as a
40long-term care hospital.

P63   1(4) Is a nonpublic hospital, nonpublic converted hospital, or
2converted hospital as those terms are defined in paragraphs (26)
3to (28), inclusive, respectively, of subdivision (a) of Section
414105.98.

5(5) Is not a nondesignated public hospital or a designated public
6hospital.

begin delete

7(ap)

end delete

8begin insert(aq)end insert “Program period” means a period not to exceed three years
9during which a fee model and a supplemental payment model
10developed under this article shall be effective. The first program
11period shall be the period beginning January 1, 2014, and ending
12December 31, 2016, inclusive. The second program period shall
13be the period beginning on January 1, 2017, and ending June 30,
142019. Each subsequent program period shall begin on the day
15immediately following the last day of the immediately preceding
16program period and shall end on the last day of a state fiscal year,
17as determined by the department.

begin delete

18(aq)

end delete

19begin insert(ar)end insert “Quality assurance fee” means the quality assurance fee
20assessed pursuant to Section 14169.52 and collected on the basis
21of the quarterly quality assurance fee.

begin delete

22(ar)

end delete

23begin insert(as)end insert (1) “Quarterly quality assurance fee” means, with respect
24to a hospital that is not a prepaid health plan hospital, the sum of
25all of the following:

26(A) The annual fee-for-service days for an individual hospital
27multiplied by the fee-for-service per diem quality assurance fee
28rate, divided by four.

29(B) The annual managed care days for an individual hospital
30multiplied by the managed care per diem quality assurance fee
31rate, divided by four.

32(C) The annual Medi-Cal days for an individual hospital
33multiplied by the Medi-Cal per diem quality assurance fee rate,
34divided by four.

35(2) “Quarterly quality assurance fee” means, with respect to a
36hospital that is a prepaid health plan hospital, the sum of all of the
37following:

38(A) The annual fee-for-service days for an individual hospital
39multiplied by the fee-for-service per diem quality assurance fee
40rate, divided by four.

P64   1(B) The annual managed care days for an individual hospital
2multiplied by the prepaid health plan hospital managed care per
3diem quality assurance fee rate, divided by four.

4(C) The annual Medi-Cal managed care fee days for an
5individual hospital multiplied by the prepaid health plan hospital
6Medi-Cal managed care per diem quality assurance fee rate, divided
7by four.

8(D) The annual Medi-Cal fee-for-service days for an individual
9hospital multiplied by the Medi-Cal per diem quality assurance
10fee rate, divided by four.

begin delete

11(as)

end delete

12begin insert(at)end insert “Rebase calculation year” means a state fiscal year during
13which the department shall rebase the data, including, but not
14limited to, the days data source, used for the following: acute
15psychiatric days, annual fee-for-service days, annual managed care
16days, annual Medi-Cal days, fee-for-service days, general acute
17care days, high acuity days, managed care days, Medi-Cal days,
18Medi-Cal fee-for-service days, Medi-Cal managed care days,
19Medi-Cal managed care fee days, outpatient base amount, and
20transplant days, pursuant to Section 14169.59. Beginning with the
21third program period, the rebase calculation year for a program
22period shall be the last subject fiscal year of the immediately
23preceding program period.

24begin insert(au)end insert “Rebase year” means the first state fiscal year of a program
25period and shall immediately follow a rebase calculation year.

begin delete

26(au)

end delete

27begin insert(av)end insert “Retrieval date” means a day for each data element during
28the last quarter of the rebase calculation year upon which the
29department retrieves the data, including, but not limited to, the
30days data source, used for the following: acute psychiatric days,
31annual fee-for-service days, annual managed care days, annual
32Medi-Cal days, fee-for-service days, general acute care days, high
33acuity days, managed care days, Medi-Cal days, Medi-Cal
34fee-for-service days, Medi-Cal managed care days, Medi-Cal
35managed care fee days, outpatient base amount, and transplant
36days, pursuant to Section 14169.59. The retrieval date for each
37data element may be a different date within the quarter as
38determined to be necessary and appropriate by the department.

begin delete

39(av)

end delete

P65   1begin insert(aw)end insert “Subacute supplemental rate” means a fixed proportional
2supplemental payment for acute inpatient services based on a
3hospital’s prior provision of Medi-Cal subacute services.

begin delete

4(aw)

end delete

5begin insert(ax)end insert “Subject fiscal quarter” means a state fiscal quarter
6beginning on or after the first day of a program period and ending
7on or before the last day of a program period.

begin delete

8(ax)

end delete

9begin insert(ay)end insert “Subject fiscal year” means a state fiscal year beginning
10on or after the first day of a program period and ending on or before
11the last day of a program period.

begin delete

12(ay)

end delete

13begin insert(az)end insert “Subject month” means a calendar month beginning on or
14after the first day of a program period and ending on or before the
15last day of a program period.

begin delete

16(az)

end delete

17begin insert(ba)end insert “Transplant days” means the number of Medi-Cal days for
18Medicare Severity-Diagnosis Related Groups (MS-DRGs) 1, 2, 5
19to 10, inclusive, 14, 15, or 652, according to the Patient Discharge
20file from the Office of Statewide Health Planning and Development
21for the base calendar year accessed on the retrieval date.

begin delete

22(ba)

end delete

23begin insert(bb)end insert “Transplant per diem supplemental rate” means a fixed per
24diem supplemental payment for transplant days.

begin delete

25(bb)

end delete

26begin insert(bc)end insert “Upper payment limit” means a federal upper payment
27limit on the amount of the Medicaid payment for which federal
28financial participation is available for a class of service and a class
29of health care providers, as specified in Part 447 of Title 42 of the
30Code of Federal Regulations. The applicable upper payment limit
31shall be separately calculated for inpatient and outpatient hospital
32services.

33

SEC. 25.  

Section 14169.52 of the Welfare and Institutions
34Code
is amended to read:

35

14169.52.  

(a) There shall be imposed on each general acute
36care hospital that is not an exempt facility a quality assurance fee,
37except that a quality assurance fee under this article shall not be
38imposed on a converted hospital for the periods when the hospital
39is a public hospital or a new hospital with respect to a program
40period.

P66   1(b) The department shall compute the quarterly quality assurance
2fee for each subject fiscal year during a program period pursuant
3to Section 14169.59.

4(c) Subject to Section 14169.63, on the later of the date of the
5department’s receipt of federal approval or the first day of each
6program period, the following shall commence:

7(1) Within 10 business days following receipt of the notice of
8federal approval, the department shall send notice to each hospital
9subject to the quality assurance fee, which shall contain the
10following information:

11(A) The date that the state received notice of federal approval.

12(B) The quarterly quality assurance fee for each subject fiscal
13year.

14(C) The date on which each payment is due.

15(2) The hospitals shall pay the quarterly quality assurance fee,
16based on a schedule developed by the department. The department
17shall establish the date that each payment is due, provided that the
18first payment shall be due no earlier than 20 days following the
19department sending the notice pursuant to paragraph (1), and the
20payments shall be paid at least one month apart, but if possible,
21the payments shall be paid on a quarterly basis.

22(3) Notwithstanding any other provision of this section, the
23amount of each hospital’s quarterly quality assurance fee for a
24program period that has not been paid by the hospital before 15
25days prior to the end of a program period shall be paid by the
26hospital no later than 15 days prior to the end of a program period.

27(4) Each hospital described in subdivision (a) shall pay the
28quarterly quality assurance fees that are due, if any, in the amounts
29and at the times set forth in the notice unless superseded by a
30subsequent notice from the department.

31(d) The quality assurance fee, as assessed pursuant to this
32section, shall be paid by each hospital subject to the fee to the
33department for deposit in thebegin delete Hospital Quality Assurance Revenue
34Fund.end delete
begin insert fund.end insert Deposits may be accepted at any time and shall be
35credited toward the program period for which the fees were
36assessed. This article shall not affect the ability of a hospital to
37pay fees assessed for a program period after the end of that program
38period.

39(e) This section shall become inoperative if the federal Centers
40for Medicare and Medicaid Services denies approval for, or does
P67   1not approve before December 1, 2016, the implementation of the
2quality assurance fee pursuant to this article or the supplemental
3payments to private hospitals pursuant to this article for the first
4program period.

5(f) In no case shall the aggregate fees collected in a federal fiscal
6year pursuant to this section, former Section 14167.32, Section
714168.32, and Section 14169.32 exceed the maximum percentage
8of the annual aggregate net patient revenue for hospitals subject
9to the fee that is prescribed pursuant to federal law and regulations
10as necessary to preclude a finding that an indirect guarantee has
11been created.

12(g) (1) Interest shall be assessed on quality assurance fees not
13paid on the date due at the greater of 10 percent per annum or the
14rate at which the department assesses interest on Medi-Cal program
15overpayments to hospitals that are not repaid when due. Interest
16shall begin to accrue the day after the date the payment was due
17and shall be deposited in thebegin delete Hospital Quality Assurance Revenue
18Fund.end delete
begin insert fund.end insert

19(2) In the event that any fee payment is more than 60 days
20overdue, a penalty equal to the interest charge described in
21paragraph (1) shall be assessed and due for each month for which
22the payment is not received after 60 days.

23(h) When a hospital fails to pay all or part of the quality
24assurance fee on or before the date that payment is due, the
25department may immediately begin to deduct the unpaid assessment
26and interest from any Medi-Cal payments owed to the hospital,
27or, in accordance with Section 12419.5 of the Government Code,
28from any other state payments owed to the hospital until the full
29amount is recovered. All amounts, except penalties, deducted by
30the department under this subdivision shall be deposited in the
31begin delete Hospital Quality Assurance Revenue Fund.end deletebegin insert fund.end insert The remedy
32provided to the department by this section is in addition to other
33remedies available under law.

34(i) The payment of the quality assurance fee shall not be
35considered as an allowable cost for Medi-Cal cost reporting and
36reimbursement purposes.

37(j) The department shall work in consultation with the hospital
38community to implement this article.

39(k) This subdivision creates a contractually enforceable promise
40on behalf of the state to use the proceeds of the quality assurance
P68   1fee, including any federal matching funds, solely and exclusively
2for the purposes set forth in this article, to limit the amount of the
3proceeds of the quality assurance fee to be used to pay for the
4health care coverage of children as provided in Section 14169.53,
5to limit any payments for the department’s costs of administration
6to the amounts set forth in this article, to maintain and continue
7prior reimbursement levels as set forth in Section 14169.68 on the
8effective date of that section, and to otherwise comply with all its
9obligations set forth in this article, provided that amendments that
10arise from, or have as a basis for, a decision, advice, or
11determination by the federal Centers for Medicare and Medicaid
12Services relating to federal approval of the quality assurance fee
13or the payments set forth in this article shall control for the
14purposes of this subdivision.

15(l) (1) Subject to paragraph (2), the director may waive any or
16all interest and penalties assessed under this article in the event
17that the director determines, in his or her sole discretion, that the
18hospital has demonstrated that imposition of the full quality
19assurance fee on the timelines applicable under this article has a
20high likelihood of creating a financial hardship for the hospital or
21a significant danger of reducing the provision of needed health
22care services.

23(2) Waiver of some or all of the interest or penalties under this
24subdivision shall be conditioned on the hospital’s agreement to
25make fee payments, or to have the payments withheld from
26payments otherwise due from the Medi-Cal program to the hospital,
27on a schedule developed by the department that takes into account
28the financial situation of the hospital and the potential impact on
29services.

30(3) A decision by the director under this subdivision shall not
31be subject to judicial review.

32(4) If fee payments are remitted to the department after the date
33determined by the department to be the final date for calculating
34the final supplemental payments for a program period under this
35article, the fee payments shall be refunded to general acute care
36hospitals, pro rata with the amount of quality assurance fee paid
37by the hospital in the program period, subject to the limitations of
38federal law. If federal rules prohibit the refund described in this
39paragraph, the excess funds shall be used as quality assurance fees
40for the next program period for general acute care hospitals, pro
P69   1rata with the quality assurance fees paid by the hospital for the
2program period.

3(5) If during the implementation of this article, fee payments
4that were due under former Article 5.21 (commencing with Section
514167.1) and former Article 5.22 (commencing with Section
614167.31), or former Article 5.226 (commencing with Section
714168.1) and Article 5.227 (commencing with Section 14168.31),
8or Article 5.228 (commencing with Section 14169.1) and Article
95.229 (commencing with Section 14169.31) are remitted to the
10department under a payment plan or for any other reason, and the
11final date for calculating the final supplemental payments under
12those articles has passed, then those fee payments shall be
13deposited in the fund to support the uses established by this article.

14

SEC. 26.  

Section 14169.53 of the Welfare and Institutions
15Code
is amended to read:

16

14169.53.  

(a) (1) All fees required to be paid to the state
17pursuant to this article shall be paid in the form of remittances
18payable to the department.

19(2) The department shall directly transmit the fee payments to
20the Treasurer to be deposited in thebegin delete Hospital Quality Assurance
21Revenue Fund, created pursuant to Section 14167.35.end delete
begin insert fund.end insert
22 Notwithstanding Section 16305.7 of the Government Code, any
23interest and dividends earned on deposits in the fund from the
24proceeds of the fee assessed pursuant to this article shall be retained
25in the fund for purposes specified in subdivision (b).

26(b) (1) Notwithstanding subdivision (c) of Section 14167.35,
27subdivision (b) of Section 14168.33, and subdivision (b) of Section
2814169.33, all funds from the proceeds of the fee assessed pursuant
29to this article in thebegin delete Hospital Quality Assurance Revenue Fund,end delete
30begin insert fund,end insert together with any interest and dividends earned on money
31in the fund, shall continue to be used exclusively to enhance federal
32financial participation for hospital services under the Medi-Cal
33program, to provide additional reimbursement to, and to support
34quality improvement efforts of, hospitals, and to minimize
35uncompensated care provided by hospitals to uninsured patients,
36as well as to pay for the state’s administrative costs and to provide
37funding for children’s health coverage, in the following order of
38priority:

39(A) To pay for the department’s staffing and administrative
40costs directly attributable to implementing this article, not to exceed
P70   1two hundred fifty thousand dollars ($250,000) for each subject
2fiscal quarter, exclusive of any federal matching funds.

3(B) To pay for the health care coverage, as described in
4subdivision (g), except that for the two subject fiscal quarters in
5the 2013-14 fiscal year, the amount for children’s health care
6coverage shall be one hundred fifty-five million dollars
7($155,000,000) for each subject fiscal quarter, exclusive of any
8federal matching funds.

9(C) To make increased capitation payments to managed health
10care plans pursuant to this article and Section 14169.82, including
11the nonfederal share of capitation payments to managed health
12care plans pursuant to this article and Section 14169.82 for services
13provided to individuals who meet the eligibility requirements in
14Section 1902(a)(10)(A)(i)(VIII) of Title XIX of the federal Social
15Security Act (42 U.S.C. Sec. 1396a(a)(10)(A)(i)(VIII)), and who
16meet the conditions described in Section 1905(y) of the federal
17Social Security Act (42 U.S.C. Sec. 1396d(y)).

18(D) To make increased payments and direct grants to hospitals
19pursuant to this article and Section 14169.83, including the
20nonfederal share of payments to hospitals under this article and
21Section 14169.83 for services provided to individuals who meet
22the eligibility requirements in Section 1902(a)(10)(A)(i)(VIII) of
23Title XIX of the federal Social Security Act (42 U.S.C. Sec.
241396a(a)(10)(A)(i)(VIII)), and who meet the conditions described
25in Section 1905(y) of the federal Social Security Act (42 U.S.C.
26Sec. 1396d(y)).

27(2) Notwithstanding subdivision (c) of Section 14167.35,
28subdivision (b) of Section 14168.33, and subdivision (b) of Section
2914169.33, and notwithstanding Section 13340 of the Government
30Code, the moneys in thebegin delete Hospital Quality Assurance Revenue
31Fundend delete
begin insert fundend insert shall be continuously appropriated during the first
32program period only, without regard to fiscal year, for the purposes
33of this article, Article 5.229 (commencing with Section 14169.31),
34Article 5.228 (commencing with Section 14169.1), Article 5.227
35(commencing with Section 14168.31), former Article 5.226
36(commencing with Section 14168.1), former Article 5.22
37(commencing with Section 14167.31), and former Article 5.21
38(commencing with Section 14167.1).

39(3) For subsequent program periods, the moneys in thebegin delete Hospital
40Quality Assurance Revenue Fundend delete
begin insert fundend insert shall be used, upon
P71   1appropriation by the Legislature in the annual Budget Act, for the
2purposes of this article and Sections 14169.82 and 14169.83.

3(c) Any amounts of the quality assurance fee collected in excess
4of the funds required to implement subdivision (b), including any
5funds recovered under subdivision (d) of Section 14169.61, shall
6be refunded to general acute care hospitals, pro rata with the
7amount of quality assurance fee paid by the hospital, subject to
8the limitations of federal law. If federal rules prohibit the refund
9described in this subdivision, the excess funds shall be used as
10quality assurance fees for the next program period for general acute
11care hospitals, pro rata with the amount of quality assurance fees
12paid by the hospital for the program period.

13(d) Any methodology or other provision specified in this article
14may be modified by the department, in consultation with the
15hospital community, to the extent necessary to meet the
16requirements of federal law or regulations to obtain federal
17approval or to enhance the probability that federal approval can
18be obtained, provided the modifications do not violate the spirit,
19purposes, and intent of this article and are not inconsistent with
20the conditions of implementation set forth in Section 14169.72.
21The department shall notify the Joint Legislative Budget Committee
22and the fiscal and appropriate policy committees of the Legislature
2330 days prior to implementation of a modification pursuant to this
24subdivision.

25(e) The department, in consultation with the hospital community,
26shall make adjustments, as necessary, to the amounts calculated
27pursuant to Section 14169.52 in order to ensure compliance with
28the federal requirements set forth in Section 433.68 of Title 42 of
29the Code of Federal Regulations or elsewhere in federal law.

30(f) The department shall request approval from the federal
31Centers for Medicare and Medicaid Services for the implementation
32of this article. In making this request, the department shall seek
33specific approval from the federal Centers for Medicare and
34Medicaid Services to exempt providers identified in this article as
35exempt from the fees specified, including the submission, as may
36be necessary, of a request for waiver of the broad-based
37requirement, waiver of the uniform fee requirement, or both,
38pursuant to paragraphs (1) and (2) of subdivision (e) of Section
39433.68 of Title 42 of the Code of Federal Regulations.

P72   1(g) (1) For purposes of this subdivision, the following
2definitions shall apply:

3(A) “Actual net benefit” means the net benefit determined by
4the department for a net benefit period after the conclusion of the
5net benefit period using payments and grants actually made, and
6fees actually collected, for the net benefit period.

7(B) “Aggregate fees” means the aggregate fees collected from
8hospitals under this article.

9(C) “Aggregate payments” means the aggregate payments and
10grants made directly or indirectly to hospitals under this article,
11including payments and grants described in Sections 14169.54,
1214169.55, 14169.57, and 14169.58, and subdivision (b) of Section
1314169.82.

begin delete

14(D) “Fund” means the Hospital Quality Assurance Revenue
15Fund established pursuant to Section 14167.35.

end delete
begin delete

16(E)

end delete

17begin insert(D)end insert “Net benefit” means the aggregate payments for a net benefit
18period minus the aggregate fees for the net benefit period.

begin delete

19(F)

end delete

20begin insert(E)end insert “Net benefit period” means a subject fiscal year or portion
21thereof that is in a program period and begins on or after July 1,
222014.

begin delete

23(G)

end delete

24begin insert(F)end insert “Preliminary net benefit” means the net benefit determined
25by the department for a net benefit period prior to the beginning
26of that net benefit period using estimated or projected data.

27(2) The amount of funding provided for children’s health care
28coverage under subdivision (b) for a net benefit period shall be
29equal to 24 percent of the net benefit for that net benefit period.

30(3) The department shall determine the preliminary net benefit
31for all net benefit periods in the first program period before July
321, 2014. The department shall determine the preliminary net benefit
33for all net benefit periods in a subsequent program period before
34the beginning of the program period.

35(4) The department shall determine the actual net benefit and
36make the reconciliation described in paragraph (5) for each net
37benefit period within six months after the date determined by the
38 department pursuant to subdivision (h).

39(5) For each net benefit period, the department shall reconcile
40the amount of moneys in the fund used for children’s health
P73   1coverage based on the preliminary net benefit with the amount of
2the fund that may be used for children’s health coverage under
3this subdivision based on the actual net benefit. For each net benefit
4period, any amounts that were in the fund and used for children’s
5health coverage in excess of the 24 percent of the actual net benefit
6shall be returned to the fund, and the amount, if any, by which 24
7percent of the actual net benefit exceeds 24 percent of the
8preliminary net benefit shall be available from the fund to the
9department for children’s health coverage. The department shall
10notify the Joint Legislative Budget Committee and the fiscal and
11appropriate policy committees of the Legislature of the results of
12the reconciliation for each net benefit period pursuant to this
13 paragraph within five working days of performing the
14reconciliation.

15(6) The department shall make all calculations and
16reconciliations required by this subdivision in consultation with
17the hospital community using data that the department determines
18is the best data reasonably available.

19(h) After consultation with the hospital community, the
20department shall determine a date upon which substantially all
21fees have been paid and substantially all supplemental payments,
22grants, and rate range increases have been made for a program
23period, which date shall be no later than two years after the end
24of a program period. After the date determined by the department
25pursuant to this subdivision, no further supplemental payments
26shall be made under the program period, and any fees collected
27with respect to the program period shall be used for a subsequent
28program period consistent with this section. Nothing in this
29subdivision shall affect the department’s authority to collect quality
30assurance fees for a program period after the end of the program
31period or after the date determined by the department pursuant to
32this subdivision. The department shall notify the Joint Legislative
33Budget Committee and fiscal and appropriate policy committees
34of that date within five working days of the determination.

35(i) Use of the fee proceeds to enhance federal financial
36participation pursuant to subdivision (b) shall include use of the
37proceeds to supply the nonfederal share, if any, of payments to
38hospitals under this article for services provided to individuals
39who meet the eligibility requirements in Section
401902(a)(10)(A)(i)(VIII) of Title XIX of the federal Social Security
P74   1Act (42 U.S.C. Sec. 1396a(a)(10)(A)(i)(VIII)), and who meet the
2conditions described in Section 1905(y) of the federal Social
3Security Act (42 U.S.C. Sec. 1396d(y)) such that expenditures for
4services provided to the individual are eligible for the enhanced
5federal medical assistance percentage described in that section.

6

SEC. 27.  

Section 14169.55 of the Welfare and Institutions
7Code
is amended to read:

8

14169.55.  

(a) Private hospitals shall be paid supplemental
9amounts for the provision of hospital inpatient services for each
10subject fiscal quarter in a program period as set forth in this section.
11The supplemental amounts shall be in addition to any other
12amounts payable to hospitals with respect to those services and
13shall not affect any other payments to hospitals. The inpatient
14supplemental amounts shall result in payments to hospitals that
15equal the applicable federal upper payment limit for the subject
16fiscal year, except that with respect to a subject fiscal year that
17begins before the start of a program period or that ends after the
18end of the program period for which the payments are made, the
19inpatient supplemental amounts shall result in payments to hospitals
20that equal a percentage of the applicable upper payment limit where
21 the percentage equals the percentage of the subject fiscal year that
22occurs during the program period.

23(b) Except as set forth in subdivisions (e) and (f), each private
24hospital shall be paid the sum of the following amounts as
25applicable for the provision of hospital inpatient services for each
26subject fiscal quarter:

27(1) A general acute care per diem supplemental rate multiplied
28by the hospital’s general acute care days.

29(2) An acute psychiatric per diem supplemental rate multiplied
30by the hospital’s acute psychiatric days.

31(3) A high acuity per diem supplemental rate multiplied by the
32number of the hospital’s high acuity days if the hospital’s Medicaid
33inpatient utilization rate is less than the percent required to be
34eligible to receive disproportionate share replacement funds for
35the state fiscal year ending in the base calendar year and greater
36than 5 percent and at least 5 percent of the hospital’s general acute
37care days are high acuity days.

38(4) A high acuity trauma per diem supplemental rate multiplied
39by the number of the hospital’s high acuity days if the hospital
40qualifies to receive the amount set forth in paragraph (3) and has
P75   1been designated as a Level I, Level II, Adult/Ped Level I, or
2Adult/Ped Level II trauma center by the Emergency Medical
3Services Authority established pursuant to Section 1797.1 of the
4Health and Safety Code.

5(5) A transplant per diem supplemental rate multiplied by the
6number of the hospital’s transplant days if the hospital’s Medicaid
7inpatient utilization rate is less than the percent required to be
8eligible to receive disproportionate share replacement funds for
9the state fiscal year ending in the base calendar year and greater
10than 5 percent.

11(6) A payment for hospital inpatient services equal to the
12subacute supplemental rate multiplied by the Medi-Cal subacute
13payments as reflected in the state paid claims file prepared by the
14department as of the retrieval date for the base calendar year if the
15private hospital provided Medi-Cal subacute services during the
16base calendar year.

17(c) In the event federal financial participation for a subject fiscal
18year is not available for all of the supplemental amounts payable
19to private hospitals under subdivision (b) due to the application of
20an upper payment limit or for any other reason, both of the
21following shall apply:

22(1) The total amount payable to private hospitals under
23subdivision (b) for the subject fiscal year shall be reduced to reflect
24the amount for which federal financial participation is available.

25(2) The amount payable under subdivision (b) to each private
26hospital for the subject fiscal year shall be equal to the amount
27computed under subdivision (b) multiplied by the ratio of the total
28amount for which federal financial participation is available to the
29total amount computed under subdivision (b).

30(d) If the amount otherwise payable to a hospital under this
31section for a subject fiscal year exceeds the amount for which
32federal financial participation is available for that hospital, the
33amount due to the hospital for that subject fiscal year shall be
34reduced to the amount for which federal financial participation is
35available.

36(e) Payments shall not be made under this section for the periods
37when a hospital is a new hospital during a program period.

38(f) Payments shall be made to a converted hospital that converts
39during a subject fiscal quarter by multiplying the hospital’s
40begin delete outpatientend delete supplemental payment as calculated in subdivision (b)
P76   1by the number of days that the hospital was a private hospital in
2the subject fiscal quarter, divided by the number of days in the
3subject fiscal quarter. Payments shall not be made to a converted
4hospital in any subsequent subject fiscal quarter.

5

SEC. 28.  

Section 14169.56 of the Welfare and Institutions
6Code
is amended to read:

7

14169.56.  

(a) The department shall increase capitation
8payments to Medi-Cal managed health care plans for each subject
9fiscal year as set forth in this section.

10(b) (1) Subject to the limitation in paragraph (2), the increased
11capitation payments shall be made as part of the monthly capitated
12payments made by the department to managed health care plans.
13The aggregate amount of increased capitation payments to all
14Medi-Cal managed health care plans for each subject fiscal year,
15or portion thereof, shall be the maximum amount for which federal
16financial participation is available on an aggregate statewide basis
17for the applicable subject fiscal year within a program period, or
18portion thereof.

19(2) (A) The limitation in subparagraph (B) shall be applied with
20respect to a subject fiscal year or portion thereof for which the
21federal matching assistance percentage is less than 90 percentage
22for expenditures for services furnished to individuals who meet
23the eligibility requirements in Section 1902(a)(10)(A)(i)(VIII) of
24Title XIX of the federal Social Security Act (42 U.S.C. Sec.
251396a(a)(10)(A)(i)(VIII)), and who meet the conditions described
26in Section 1905(y) of the federal Social Security Act (42 U.S.C.
27Sec. 1396d(y)).

28(B) During a subject fiscal year or portion thereof described in
29subparagraph (A), the aggregate amount of the increased capitation
30payments under this section shall not exceed the aggregate amount
31of the increased capitation payments that would be made if the
32nonfederal share of the increased capitation payments were the
33amount that the nonfederal share would have been if the federal
34 matching assistance percentage were 90 percent for expenditures
35for services furnished to individuals who meet the eligibility
36requirements in Section 1902(a)(10)(A)(i)(VIII) of Title XIX of
37the federal Social Security Act (42 U.S.C. Sec.
381396a(a)(10)(A)(i)(VIII)), and who meet the conditions described
39in Section 1905(y) of the federal Social Security Act (42 U.S.C.
40Sec. 1396d(y)).

P77   1(c) The department shall determine the amount of the increased
2capitation payments for each managed health care plan for each
3subject fiscal year or portion thereof during a program period. The
4department shall consider the composition of Medi-Cal enrollees
5in the plan, the anticipated utilization of hospital services by the
6plan’s Medi-Cal enrollees, and other factors that the department
7determines are reasonable and appropriate to ensure access to
8high-quality hospital services by the plan’s enrollees.

9(d) The amount of increased capitation payments to each
10Medi-Cal managed health care plan shall not exceed an amount
11that results in capitation payments that are certified by the state’s
12actuary as meeting federal requirements, taking into account the
13requirement that all of the increased capitation payments under
14this section shall be paid by the Medi-Cal managed health care
15plans to hospitals for hospital services to Medi-Cal enrollees of
16the plan.

17(e) (1) The increased capitation payments to managed health
18care plans under this section shall be made to support the
19availability of hospital services and ensure access to hospital
20services for Medi-Cal beneficiaries. The increased capitation
21payments to managed health care plans shall commence within 90
22days after the date on which all necessary federal approvals have
23been received, and shall include, but not be limited to, the sum of
24the increased payments for all prior months for which payments
25are due.

26(2) To secure the necessary funding for the payment or payments
27made pursuant to paragraph (1), the department may accumulate
28funds in thebegin delete Hospital Quality Assurance Revenue Fund, established
29pursuant to Section 14167.35,end delete
begin insert fund,end insert for the purpose of funding
30managed health care capitation payments under this article
31regardless of the date on which capitation payments are scheduled
32to be paid in order to secure the necessary total funding for
33managed health care payments by the end of a program period.

34(f) Payments to managed health care plans that would be paid
35consistent with actuarial certification and enrollment in the absence
36of the payments made pursuant to this section, including, but not
37limited to, payments described in Section 14182.15, shall not be
38reduced as a consequence of payments under this section.

P78   1(g) (1) Each managed health care plan shall expend 100 percent
2of any increased capitation payments it receives under this section
3on hospital services as provided in Section 14169.57.

4(2) The department may issue change orders to amend contracts
5with managed health care plans as needed to adjust monthly
6capitation payments in order to implement this section.

7(3) For entities contracting with the department pursuant to
8Article 2.91 (commencing with Section 14089), any incremental
9increase in capitation rates pursuant to this section shall not be
10subject to negotiation and approval by the department.

11(h) (1) In the event federal financial participation is not
12available for all of the increased capitation payments determined
13for a month pursuant to this section for any reason, the increased
14capitation payments mandated by this section for that month shall
15be reduced proportionately to the amount for which federal
16financial participation is available.

17(2) The determination under this subdivision for any month in
18a program period shall be made after accounting for all federal
19financial participation necessary for full implementation of Section
2014182.15 for that month.

21

SEC. 29.  

Section 14169.58 of the Welfare and Institutions
22Code
is amended to read:

23

14169.58.  

(a) (1) For the first program period, designated
24public hospitals shall be paid direct grants in support of health care
25expenditures, which shall not constitute Medi-Cal payments, and
26which shall be funded by the quality assurance fee set forth in this
27article. For the first program period, the aggregate amount of the
28grants to designated public hospitals funded by the quality
29assurance fee set forth in this article shall be forty-five million
30dollars ($45,000,000) in the aggregate for the two subject fiscal
31quarters in the 2013-14 subject fiscal year, ninety-three million
32dollars ($93,000,000) for the 2014-15 subject fiscal year, one
33hundred ten million five hundred thousand dollars ($110,500,000)
34for the 2015-16 subject fiscal year, and sixty-two million five
35hundred thousand dollars ($62,500,000) in the aggregate for the
36two subject fiscal quarters in the 2016-17 subject fiscal year.

37(2) (A) Of the direct grant amounts set forth in paragraph (1),
38the director shall allocate twenty-four million five hundred
39thousand dollars ($24,500,000) in the aggregate for the two subject
40fiscal quarters in the 2013-14 subject fiscal year, fifty million five
P79   1hundred thousand dollars ($50,500,000) for the 2014-15 subject
2fiscal year, sixty million five hundred thousand dollars
3($60,500,000) for the 2015-16 subject fiscal year, and thirty-four
4million five hundred thousand dollars ($34,500,000) in the
5aggregate for the two subject fiscal quarters in the 2016-17 subject
6fiscal year among the designated public hospitals pursuant to a
7methodology developed in consultation with the designated public
8hospitals.

9(B) Of the direct grant amounts set forth in subparagraph (A),
10the director shall distribute six million one hundred twenty-five
11thousand dollars ($6,125,000) for each subject fiscal quarter in the
122013-14 subject fiscal year, six million three hundred twelve
13thousand five hundred dollars ($6,312,500) for each subject fiscal
14quarter in the 2014-15 subject fiscal year, seven million five
15hundred sixty-two thousand five hundred dollars ($7,562,500) for
16each subject fiscal quarter in the 2015-16 subject fiscal year, and
17eight million six hundred twenty-five thousand dollars ($8,625,000)
18for each subject fiscal quarter in the 2016-17 subject fiscal year
19in accordance with the timeframes specified in subdivision (a) of
20Section 14169.66.

21(C) Of the direct grant amounts set forth in subparagraph (A),
22the director shall distribute six million one hundred twenty-five
23thousand dollars ($6,125,000) for each subject fiscal quarter in the
242013-14 subject fiscal year, six million three hundred twelve
25thousand five hundred dollars ($6,312,500) for each subject fiscal
26quarter in the 2014-15 subject fiscal year, seven million five
27hundred sixty-two thousand five hundred dollars ($7,562,500) for
28each subject fiscal quarter in the 2015-16 subject fiscal year, and
29eight million six hundred twenty-five thousand dollars ($8,625,000)
30for each subject fiscal quarter in the 2016-17 subject fiscal year
31only upon 100 percent of the rate range increases being distributed
32to managed health care plans pursuant to subparagraph (D) for the
33respective subject fiscal quarter. If the rate range increases pursuant
34to subparagraph (D) are distributed to managed health care plans,
35the direct grant amounts described in this subparagraph shall be
36distributed to designated public hospitals no later than 30 days
37after the rate range increases have been distributed to managed
38health care plans pursuant to subparagraph (D).

39(D) Of the direct grant amounts set forth in paragraph (1), twenty
40 million five hundred thousand dollars ($20,500,000) in the
P80   1aggregate for the two subject fiscal quarters in the 2013-14 subject
2fiscal year, forty-two million five hundred thousand dollars
3($42,500,000) for the 2014-15 subject fiscal year, fifty million
4dollars ($50,000,000) for the 2015-16 subject fiscal year, and
5twenty-eight million dollars ($28,000,000) in the aggregate for the
6two subject fiscal quarters in the 2016-17 subject fiscal year shall
7be withheld from payment to the designated public hospitals by
8the director, and shall be used as the nonfederal share for rate range
9increases, as defined in paragraph (4) of subdivision (b) of Section
1014301.4, to risk-based payments to managed care health plans that
11contract with the department to serve counties where a designated
12public hospital is located. The rate range increases shall apply to
13managed care rates for beneficiaries other than newly eligible
14beneficiaries, as defined in subdivision (s) of Section 17612.2, and
15shall enable plans to compensate hospitals for Medi-Cal health
16services and to support the Medi-Cal program. Each managed
17health care plan shall expend 100 percent of the rate range increases
18on hospital services within 30 days of receiving the increased
19payments. Rate range increases funded under this subparagraph
20shall be allocated among plans pursuant to a methodology
21developed in consultation with the hospital community.

22(3) Notwithstanding any other provision of law, any amounts
23withheld from payment to the designated public hospitals by the
24director as the nonfederal share for rate range increases, including
25those described in subparagraph (D) of paragraph (2), shall not be
26considered hospital fee direct grants as defined under subdivision
27(k) of Section 17612.2 and shall not be included in the
28determination under paragraph (1) of subdivision (a) of Section
2917612.3.

30(b) (1) For the first program period, nondesignated public
31hospitals shall be paid direct grants in support of health care
32expenditures, which shall not constitute Medi-Cal payments, and
33which shall be funded by the quality assurance fee set forth in this
34article. For the first program period, the aggregate amount of the
35grants funded by the quality assurance fee set forth in this article
36to nondesignated public hospitals shall be twelve million five
37hundred thousand dollars ($12,500,000) in the aggregate for two
38subject fiscal quarters in the 2013-14 subject fiscal year,
39twenty-five million dollars ($25,000,000) for the 2014-15 subject
40fiscal year, thirty million dollars ($30,000,000) for the 2015-16
P81   1subject fiscal year, and seventeen million five hundred thousand
2dollars ($17,500,000) in the aggregate for the two subject fiscal
3quarters in the 2016-17 subject fiscal year.

4(2) (A) Of the direct grant amounts set forth in paragraph (1),
5 the director shall allocate two million five hundred thousand dollars
6($2,500,000) in the aggregate for the two subject fiscal quarters
7in the 2013-14 subject fiscal year, five million dollars ($5,000,000)
8for the 2014-15 subject fiscal year, six million dollars ($6,000,000)
9for the 2015-16 subject fiscal year, and three million five hundred
10thousand dollars ($3,500,000) in the aggregate for the two subject
11fiscal quarters in the 2016-17 subject fiscal year among the
12nondesignated public hospitals pursuant to a methodology
13developed in consultation with the nondesignated public hospitals.

14(B) Of the direct grant amounts set forth in paragraph (1), ten
15million dollars ($10,000,000) in the aggregate for the two subject
16fiscal quarters in the 2013-14 subject fiscal year, twenty million
17dollars ($20,000,000) for the 2014-15 subject fiscal year,
18twenty-four million dollars ($24,000,000) for the 2015-16 subject
19fiscal year, and fourteen million dollars ($14,000,000) in the
20aggregate for the two subject fiscal quarters in the 2016-17 subject
21fiscal year shall be withheld from payment to the nondesignated
22public hospitals by the director, and shall be used as the nonfederal
23share for rate range increases, as defined in paragraph (4) of
24subdivision (b) of Section 14301.4, to risk-based payments to
25managed care health plans that contract with the department. The
26rate range increases shall enable plans to compensate hospitals for
27Medi-Cal health services and to support the Medi-Cal program.
28Each managed health care plan shall expend 100 percent of the
29rate range increases on hospital services within 30 days of receiving
30the increased payments. Rate range increases funded under this
31subparagraph shall be allocated among plans pursuant to a
32methodology developed in consultation with the hospital
33community.

34(c) If the amounts set forth in this section for rate range increases
35are not actually used for rate range increases as described in this
36section, the direct grant amounts set forth in this section that are
37withheld pursuant to subparagraph (D) of paragraph (2) of
38subdivision (a) and subparagraph (B) of paragraph (2) of
39subdivision (b) shall be returned thebegin delete Hospital Quality Assurance
P82   1Revenue Fundend delete
begin insert fundend insert subject to paragraph (4) of subdivision (l) of
2Section 14169.52.

3(d) For subsequent program periods, designated public hospitals
4and nondesignated public hospitals may be paid direct grants
5pursuant to subdivision (e) of Section 14169.59 upon appropriation
6in the annual Budget Act.

7

SEC. 30.  

Section 14169.59 of the Welfare and Institutions
8Code
is amended to read:

9

14169.59.  

(a) The department shall determine during each
10rebase calculation year the number of subject fiscal years in the
11next program period.

12(b) During each rebase calculation year, the department shall
13retrieve the data, including, but not limited to, the days data source,
14used to determine the following for the subsequent program period:
15acute psychiatric days, annual fee-for-service days, annual managed
16care days, annual Medi-Cal days, fee-for-service days, general
17acute care days, high acuity days, managed care days, Medi-Cal
18days, Medi-Cal fee-for-service days, Medi-Cal managed care days,
19Medi-Cal managed care fee days, outpatient base amount, and
20transplant days. The department shall pull data from the most
21recent base calendar year for which the department determines
22reliable data is available for all hospitals.

23(c) begin insert(1)end insertbegin insertend insert During each rebase calculation year, the department
24shall determine all of the followingbegin insert supplemental paymentend insert rates
25for the subsequent program period, whichbegin insert supplemental paymentend insert
26 rates shall be specified in provisional language in the annual Budget
27Act:

begin delete

28(1)

end delete

29begin insert(end insertbegin insertA)end insert The acute psychiatric per diem supplemental rate for each
30subject fiscal year during the program period.

begin delete

31(2) The fee-for-service per diem quality assurance fee rate for
32each subject fiscal year during the program period.

end delete
begin delete

33(3)

end delete

34begin insert(end insertbegin insertB)end insert The general acute care per diem supplemental rate for each
35subject fiscal year during the program period.

begin delete

36(4)

end delete

37begin insert(end insertbegin insertC)end insert The high acuity per diem supplemental rate for each subject
38fiscal year during the program period.

begin delete

39(5)

end delete

P83   1begin insert(end insertbegin insertD)end insert The high acuity trauma per diem supplemental rate for each
2subject fiscal year during the program period.

begin delete

3(6) The managed care per diem quality assurance fee rate for
4each subject fiscal year during the program period.

5(7) The Medi-Cal per diem quality assurance fee rate for each
6subject fiscal year during the program period.

7(8)

end delete

8begin insert(end insertbegin insertE)end insert The outpatient supplemental rate for each subject fiscal year
9during the program period.

begin delete

10(9) The prepaid health plan hospital managed care per diem
11quality assurance fee rate for each subject fiscal year during the
12program period.

end delete
begin delete

13(10) The prepaid health plan hospital Medi-Cal managed care
14per diem quality assurance fee rate for each subject fiscal year
15during the program period.

end delete
begin delete

16(11)

end delete

17begin insert(F)end insert The subacute supplemental rate for each subject fiscal year
18during the program period.

begin delete

19(12)

end delete

20begin insert(G)end insert The transplant per diem supplemental rate for each subject
21fiscal year during the program period.

begin insert

22(2) During each rebase calculation year, the department shall
23determine all of the following fee rates for the subsequent program
24period, which fee rates shall be specified in provisional language
25in the annual Budget Act:

end insert
begin insert

26(A) The fee-for-service per diem quality assurance fee rate for
27each subject fiscal year during the program period.

end insert
begin insert

28(B) The managed care per diem quality assurance fee rate for
29each subject fiscal year during the program period.

end insert
begin insert

30(C) The Medi-Cal per diem quality assurance fee rate for each
31subject fiscal year during the program period.

end insert
begin insert

32(D) The prepaid health plan hospital managed care per diem
33quality assurance fee rate for each subject fiscal year during the
34program period.

end insert
begin insert

35(E) The prepaid health plan hospital Medi-Cal managed care
36per diem quality assurance fee rate for each subject fiscal year
37during the program period.

end insert

38(d) The department shall determine the rates set forth in
39begin delete paragraphs (1) to (12), inclusive, ofend delete subdivision (c) based on the
40data retrieved pursuant to subdivision (b). Each rate determined
P84   1by the department shall be the same for all hospitals to which the
2rate applies. These rates shall be specified in provisional language
3in the annual Budget Act. The department shall determine the rates
4in accordance with all of the following:

5(1) The rates shall meet the requirements of federal law and be
6established in a manner to obtain federal approval.

7(2) The department shall consult with the hospital community
8in determining the rates.

9(3) The supplemental payments and other Medi-Cal payments
10for hospital outpatient services furnished by private hospitals for
11each fiscal year shall equal as close as possible the applicable
12federal upper payment limit.

13(4) The supplemental payments and other Medi-Cal payments
14for hospital inpatient services furnished by private hospitals for
15each fiscal year shall equal as close as possible the applicable
16federal upper payment limit.

17(5) The increased capitation payments to managed health care
18plans shall result in the maximum payments to the plans permitted
19by federal law.

20(6) The quality assurance fee proceeds shall be adequate to make
21the expenditures described in this article, but shall not be more
22than necessary to make the expenditures.

23(7) The relative values of per diem supplemental payment rates
24to one another for the various categories of patient days shall be
25generally consistent with the relative values during the first
26program period under this article.

27(8) The relative values of per diem fee rates to one another for
28the various categories of patient days shall be generally consistent
29with the relative values during the first program period under this
30article.

31(9) The rates shall result in supplemental payments and quality
32assurance fees that are consistent with the purposes of this article.

33(e) During each rebase calculation year, the director shall
34determine the amounts and allocation methodology, if any, of
35direct grants to designated public hospitals and nondesignated
36public hospitals for each subject fiscal year in a program period,
37in consultation with the hospital community. The amounts and
38allocation methodology may include a withhold of direct grants
39to be used as the nonfederal share for rate range increases. These
P85   1amounts shall be specified in provisional language in the annual
2Budget Act.

3(f) begin insert(1)end insertbegin insertend insert Notwithstanding any other provision in this article, the
4following shall apply to the first program period under this article:

begin delete

5(1)

end delete

6begin insert(end insertbegin insertA)end insert The first program period under this article shall be the period
7from January 1, 2014, to December 31, 2016, inclusive.

begin delete

8(2)

end delete

9begin insert(end insertbegin insertB)end insert The acute psychiatric days shall be those identified in the
10Final Medi-Cal Utilization Statistics for the 2012-13 state fiscal
11year as calculated by the department as of December 17, 2012.

begin delete

12(3) The acute psychiatric per diem supplemental rate shall be
13nine hundred sixty-five dollars ($965) for the two remaining subject
14fiscal quarters in the 2013-14 subject fiscal year, nine hundred
15seventy dollars ($970) for the subject fiscal quarters in the 2014-15
16subject fiscal year, nine hundred seventy-five dollars ($975) for
17the subject fiscal quarters in the 2015-16 subject fiscal year and
18nine hundred seventy-five dollars ($975) for the first two subject
19fiscal quarters in the 2016-17 subject fiscal year.

end delete
begin delete

20(4)

end delete

21begin insert(C)end insert The days data source shall be the hospital’s Annual Financial
22Disclosure Report filed with the Office of Statewide Health
23Planning and Development as of June 6, 2013, for its fiscal year
24ending during the 2010 calendar year.

begin delete

25(5) The fee-for-service per diem quality assurance fee rate shall
26be three hundred seventy-four dollars and ninety-one cents
27($374.91) for the two remaining subject fiscal quarters in the
282013-14 subject fiscal year, four hundred twenty-five dollars and
29twenty-two cents ($425.22) for the subject fiscal quarters in the
302014-15 subject fiscal year, four hundred eighty dollars and eleven
31cents ($480.11) for the subject fiscal quarters in the 2015-16
32subject fiscal year, and five hundred forty-two dollars and ten cents
33($542.10) for the first two subject fiscal quarters in the 2016-17
34subject fiscal year.

35(6)

end delete

36begin insert(end insertbegin insertD)end insert The general acute care days shall be those identified in the
372010 calendar year, as reflected in the state paid claims file on
38April 26, 2013.

begin delete

39(7) The general acute care per diem supplemental rate shall be
40eight hundred twenty-four dollars and forty cents ($824.40) for
P86   1the two remaining subject fiscal quarters in the 2013-14 subject
2fiscal year, one thousand one hundred ten dollars and sixty-seven
3cents ($1,110.67) for the subject fiscal quarters in the 2014-15
4subject fiscal year, one thousand three hundred thirty-five dollars
5and forty-two cents ($1,335.42) for the subject fiscal quarters in
6the 2015-16 subject fiscal year, and one thousand four hundred
7forty-one dollars and twenty cents ($1,441.20) for the first two
8subject fiscal quarters in the 2016-17 subject fiscal year.

9(8)

end delete

10begin insert(E)end insert The high acuity days shall be those paid during the 2010
11calendar year, as reflected in the state paid claims file prepared by
12the department on April 26, 2013.

begin delete

13(9) The high acuity per diem supplemental rate shall be two
14thousand five hundred dollars ($2,500) for the two remaining
15subject fiscal quarters in the 2013-14 subject fiscal year, two
16thousand five hundred dollars ($2,500) for the subject fiscal
17quarters in the 2014-15 subject fiscal year, two thousand five
18hundred dollars ($2,500) for the subject fiscal quarters in the
192015-16 subject fiscal year, and two thousand five hundred dollars
20($2,500) for the first two subject fiscal quarters in the 2016-17
21subject fiscal year.

22(10) The high acuity trauma per diem supplemental rate shall
23be two thousand five hundred dollars ($2,500) for the two
24remaining subject fiscal quarters in the 2013-14 subject fiscal
25year, two thousand five hundred dollars ($2,500) for the subject
26fiscal quarters in the 2014-15 subject fiscal year, two thousand
27five hundred dollars ($2,500) for the subject fiscal quarters in the
282015-16 subject fiscal year, and two thousand five hundred dollars
29($2,500) for the first two subject fiscal quarters in the 2016-17
30subject fiscal year.

31(11) The managed care per diem quality assurance fee rate shall
32be one hundred forty-five dollars ($145) for the two remaining
33subject fiscal quarters in the 2013-14 subject fiscal year, one
34hundred forty-five dollars ($145) for the subject fiscal quarters in
35the 2014-15 subject fiscal year, one hundred seventy dollars ($170)
36for the subject fiscal quarters in the 2015-16 subject fiscal year,
37and one hundred seventy dollars ($170) for the first two subject
38fiscal quarters in the 2016-17 subject fiscal year.

39(12)

end delete

P87   1begin insert(F)end insert The Medi-Cal managed care days shall be those identified
2in the Final Medi-Cal Utilization Statistics for the 2012-13 fiscal
3year, as calculated by the department as of December 17, 2012.

begin delete

4(13) The Medi-Cal per diem quality assurance fee rate shall be
5four hundred fifty-seven dollars and ten cents ($457.10) for the
6two remaining subject fiscal quarters in the 2013-14 subject fiscal
7year, four hundred ninety-seven dollars and eight cents ($497.08)
8for the subject fiscal quarters in the 2014-15 subject fiscal year,
9five hundred sixty-eight dollars and fifteen cents ($568.15) for the
10subject fiscal quarters in the 2015-16 subject fiscal year, and six
11hundred eighteen dollars and fourteen cents ($618.14) for the first
12two subject fiscal quarters in the 2016-17 subject fiscal year.

13(14)

end delete

14begin insert(G)end insert The outpatient base amount shall be those payments for
15outpatient services made to a hospital in the 2010 calendar year,
16as reflected in the state paid claims files prepared by the department
17on April 26, 2013.

begin delete

18(15) The outpatient supplemental rate shall be 119 percent of
19the outpatient base amount for the two remaining subject fiscal
20quarters in the 2013-14 subject fiscal year, 268 percent of the
21outpatient base amount for the subject fiscal quarters in the
222014-15 subject fiscal year, 292 percent of the outpatient base
23amount for the subject fiscal quarters in the 2015-16 subject fiscal
24year, and 151 percent of the outpatient base amount for the first
25two subject fiscal quarters in the 2016-17 subject fiscal year.

26(16) The prepaid health plan hospital managed care per diem
27quality assurance fee rate shall be eighty-one dollars and twenty
28cents ($81.20) for the two remaining subject fiscal quarters in the
292013-14 subject fiscal year, eighty-one dollars and twenty cents
30($81.20) for the subject fiscal quarters in the 2014-15 subject fiscal
31year, ninety-five dollars and twenty cents ($95.20) for the subject
32fiscal quarters in the 2015-16 subject fiscal year, and ninety-five
33dollars and twenty cents ($95.20) for the first two subject fiscal
34quarters in the 2016-17 subject fiscal year.

35(17) The prepaid health plan hospital Medi-Cal managed care
36per diem quality assurance fee rate shall be two hundred fifty-five
37dollars and ninety-seven cents ($255.97) for the two remaining
38subject fiscal quarters in the 2013-14 subject fiscal year, two
39hundred seventy-eight dollars and thirty-seven cents ($278.37) for
40the subject fiscal quarters in the 2014-15 subject fiscal year, three
P88   1hundred eighteen dollars and sixteen cents ($318.16) for the subject
2fiscal quarters in the 2015-16 subject fiscal year, and three hundred
3forty-six dollars and sixteen cents ($346.16) for the first two subject
4 fiscal quarters in the 2016-17 subject fiscal year.

5(18) The subacute supplemental rate shall be 50 percent for the
6two remaining subject fiscal quarters in the 2013-14 subject fiscal
7year, 55 percent for the subject fiscal quarters in the 2014-15
8subject fiscal year, 60 percent for the subject fiscal quarters in the
92015-16 subject fiscal year, and 60 percent for the first two subject
10fiscal quarters in the 2016-17 subject fiscal year of the Medi-Cal
11subacute payments paid by the department to the hospital during
12the 2010 calendar year, as reflected in the state paid claims file
13prepared by the department on April 26, 2013.

14(19)

end delete

15begin insert(H)end insert The transplant days shall be those identified in the 2010
16Patient Discharge file from the Office of Statewide Health Planning
17and Development accessed on June 28, 2011.

begin delete

18(20) The transplant per diem supplemental rate shall be two
19thousand five hundred dollars ($2,500) for the two remaining
20subject fiscal quarters in the 2013-14 subject fiscal year, two
21thousand five hundred dollars ($2,500) for the subject fiscal
22quarters in the 2014-15 subject fiscal year, two thousand five
23hundred dollars ($2,500) for the subject fiscal quarters in the
242015-16 subject fiscal year, and two thousand five hundred dollars
25($2,500) for the first two subject fiscal quarters in the 2016-17
26subject fiscal year.

27(21) Upon federal approval or conditional federal approval
28described in Section 14169.63, the director shall have the discretion
29to revise the fee-for-service per diem quality assurance fee rate,
30the managed care per diem quality assurance fee rate, the Medi-Cal
31per diem quality assurance fee rate, the prepaid health plan hospital
32managed care per diem quality assurance fee rate, or the prepaid
33health plan hospital Medi-Cal managed care per diem quality
34assurance fee rate, based on the funds required to make the
35payments specified in this article, in consultation with the hospital
36 community.

37(22)

end delete

38begin insert(I)end insert With respect to a hospital described in subdivision (f) of
39Section 14165.50, both of the following shall apply:

begin delete

40(A)

end delete

P89   1begin insert(i)end insert The hospital shall not be considered a new hospital as defined
2inbegin delete subdivision (ah) ofend delete Section 14169.51 for the purposes of this
3article.

begin delete

4(B)

end delete

5begin insert(ii)end insert To the extent permitted by federal law and other federal
6requirements, the department shall use the best available and
7reasonable current estimates or projections made with respect to
8the hospital for an annual period as the data, including, but not
9limited to, the days data source and data described as being derived
10from a state paid claims file, used for all purposes, including, but
11not limited to, the calculation of supplemental payments and the
12quality assurance fee. The estimates and projections shall be
13deemed to reflect paid claims and shall be used for each data
14element regardless of the time period otherwise applicable to the
15data element. The data elements include, but are not limited to,
16acute psychiatric days, annual fee-for-service days, annual managed
17care days, annual Medi-Cal days, fee-for-service days, general
18acute care days, high acuity days, managed care days, Medi-Cal
19days, Medi-Cal fee-for-service days, Medi-Cal managed care days,
20Medi-Cal managed care fee days, outpatient base amount, and
21transplant days.

begin insert

22(2) Notwithstanding any other provision in this article, the
23following shall apply to determine the supplemental payment rates
24for the first program period:

end insert
begin insert

25(A) The acute psychiatric per diem supplemental rate shall be
26nine hundred sixty-five dollars ($965) for the two remaining subject
27fiscal quarters in the 2013-14 subject fiscal year, nine hundred
28seventy dollars ($970) for the subject fiscal quarters in the 2014-15
29subject fiscal year, nine hundred seventy-five dollars ($975) for
30the subject fiscal quarters in the 2015-16 subject fiscal year and
31nine hundred seventy-five dollars ($975) for the first two subject
32fiscal quarters in the 2016-17 subject fiscal year.

end insert
begin insert

33(B) The general acute care per diem supplemental rate shall be
34eight hundred twenty-four dollars and forty cents ($824.40) for
35the two remaining subject fiscal quarters in the 2013-14 subject
36fiscal year, one thousand one hundred ten dollars and sixty-seven
37cents ($1,110.67) for the subject fiscal quarters in the 2014-15
38subject fiscal year, one thousand three hundred thirty-five dollars
39and forty-two cents ($1,335.42) for the subject fiscal quarters in
40the 2015-16 subject fiscal year, and one thousand four hundred
P90   1forty-one dollars and twenty cents ($1,441.20) for the first two
2subject fiscal quarters in the 2016-17 subject fiscal year.

end insert
begin insert

3(C) The high acuity per diem supplemental rate shall be two
4thousand five hundred dollars ($2,500) for the two remaining
5subject fiscal quarters in the 2013-14 subject fiscal year, two
6thousand five hundred dollars ($2,500) for the subject fiscal
7quarters in the 2014-15 subject fiscal year, two thousand five
8hundred dollars ($2,500) for the subject fiscal quarters in the
92015-16 subject fiscal year, and two thousand five hundred dollars
10($2,500) for the first two subject fiscal quarters in the 2016-17
11subject fiscal year.

end insert
begin insert

12(D) The high acuity trauma per diem supplemental rate shall
13be two thousand five hundred dollars ($2,500) for the two
14remaining subject fiscal quarters in the 2013-14 subject fiscal
15year, two thousand five hundred dollars ($2,500) for the subject
16fiscal quarters in the 2014-15 subject fiscal year, two thousand
17five hundred dollars ($2,500) for the subject fiscal quarters in the
182015-16 subject fiscal year, and two thousand five hundred dollars
19($2,500) for the first two subject fiscal quarters in the 2016-17
20subject fiscal year.

end insert
begin insert

21(E) The outpatient supplemental rate shall be 119 percent of
22the outpatient base amount for the two remaining subject fiscal
23quarters in the 2013-14 subject fiscal year, 268 percent of the
24outpatient base amount for the subject fiscal quarters in the
252014-15 subject fiscal year, 292 percent of the outpatient base
26amount for the subject fiscal quarters in the 2015-16 subject fiscal
27year, and 151 percent of the outpatient base amount for the first
28two subject fiscal quarters in the 2016-17 subject fiscal year.

end insert
begin insert

29(F) The subacute supplemental rate shall be 50 percent for the
30two remaining subject fiscal quarters in the 2013-14 subject fiscal
31year, 55 percent for the subject fiscal quarters in the 2014-15
32subject fiscal year, 60 percent for the subject fiscal quarters in the
332015-16 subject fiscal year, and 60 percent for the first two subject
34fiscal quarters in the 2016-17 subject fiscal year of the Medi-Cal
35subacute payments paid by the department to the hospital during
36the 2010 calendar year, as reflected in the state paid claims file
37prepared by the department on April 26, 2013.

end insert
begin insert

38(G) The transplant per diem supplemental rate shall be two
39thousand five hundred dollars ($2,500) for the two remaining
40subject fiscal quarters in the 2013-14 subject fiscal year, two
P91   1thousand five hundred dollars ($2,500) for the subject fiscal
2quarters in the 2014-15 subject fiscal year, two thousand five
3hundred dollars ($2,500) for the subject fiscal quarters in the
42015-16 subject fiscal year, and two thousand five hundred dollars
5($2,500) for the first two subject fiscal quarters in the 2016-17
6subject fiscal year.

end insert
begin insert

7(3) Notwithstanding any other provision in this article, the
8following shall apply to determine the fee rates for the first
9program period:

end insert
begin insert

10(A) The fee-for-service per diem quality assurance fee rate shall
11be three hundred seventy-four dollars and ninety-one cents
12($374.91) for the two remaining subject fiscal quarters in the
132013-14 subject fiscal year, four hundred twenty-five dollars and
14twenty-two cents ($425.22) for the subject fiscal quarters in the
152014-15 subject fiscal year, four hundred eighty dollars and eleven
16cents ($480.11) for the subject fiscal quarters in the 2015-16
17subject fiscal year, and five hundred forty-two dollars and ten
18cents ($542.10) for the first two subject fiscal quarters in the
192016-17 subject fiscal year.

end insert
begin insert

20(B) The managed care per diem quality assurance fee rate shall
21be one hundred forty-five dollars ($145) for the two remaining
22subject fiscal quarters in the 2013-14 subject fiscal year, one
23hundred forty-five dollars ($145) for the subject fiscal quarters in
24the 2014-15 subject fiscal year, one hundred seventy dollars ($170)
25for the subject fiscal quarters in the 2015-16 subject fiscal year,
26and one hundred seventy dollars ($170) for the first two subject
27fiscal quarters in the 2016-17 subject fiscal year.

end insert
begin insert

28(C) The Medi-Cal per diem quality assurance fee rate shall be
29four hundred fifty-seven dollars and ten cents ($457.10) for the
30two remaining subject fiscal quarters in the 2013-14 subject fiscal
31 year, four hundred ninety-seven dollars and eight cents ($497.08)
32for the subject fiscal quarters in the 2014-15 subject fiscal year,
33five hundred sixty-eight dollars and fifteen cents ($568.15) for the
34subject fiscal quarters in the 2015-16 subject fiscal year, and six
35hundred eighteen dollars and fourteen cents ($618.14) for the first
36two subject fiscal quarters in the 2016-17 subject fiscal year.

end insert
begin insert

37(D) The prepaid health plan hospital managed care per diem
38quality assurance fee rate shall be eighty-one dollars and twenty
39cents ($81.20) for the two remaining subject fiscal quarters in the
402013-14 subject fiscal year, eighty-one dollars and twenty cents
P92   1($81.20) for the subject fiscal quarters in the 2014-15 subject
2fiscal year, ninety-five dollars and twenty cents ($95.20) for the
3subject fiscal quarters in the 2015-16 subject fiscal year, and
4ninety-five dollars and twenty cents ($95.20) for the first two
5subject fiscal quarters in the 2016-17 subject fiscal year.

end insert
begin insert

6(E) The prepaid health plan hospital Medi-Cal managed care
7per diem quality assurance fee rate shall be two hundred fifty-five
8dollars and ninety-seven cents ($255.97) for the two remaining
9subject fiscal quarters in the 2013-14 subject fiscal year, two
10hundred seventy-eight dollars and thirty-seven cents ($278.37) for
11the subject fiscal quarters in the 2014-15 subject fiscal year, three
12hundred eighteen dollars and sixteen cents ($318.16) for the subject
13fiscal quarters in the 2015-16 subject fiscal year, and three
14hundred forty-six dollars and sixteen cents ($346.16) for the first
15two subject fiscal quarters in the 2016-17 subject fiscal year.

end insert
begin insert

16(F) Upon federal approval or conditional federal approval
17described in Section 14169.63, the director shall have the
18discretion to revise the fee-for-service per diem quality assurance
19fee rate, the managed care per diem quality assurance fee rate,
20the Medi-Cal per diem quality assurance fee rate, the prepaid
21health plan hospital managed care per diem quality assurance fee
22rate, or the prepaid health plan hospital Medi-Cal managed care
23per diem quality assurance fee rate, based on the funds required
24to make the payments specified in this article, in consultation with
25the hospital community.

end insert

26(g) Notwithstanding any other provision in this article, the
27following shall apply to the second program period under this
28article:

29(1) The second program period under this article shall begin on
30January 1, 2017, and shall end on June 30, 2019.

31(2) The retrieval date shall occur between October 1, 2016, and
32 December 31, 2016.

33(3) The base calendar year shall be the 2013 calendar year, or
34a more recent calendar year for which the department determines
35reliable data is available.

36(4) The rebase calculation year shall be the 2015-16 state fiscal
37year.

38(5) With respect to a hospital described in subdivision (f) of
39Section 14165.50, both of the following shall apply:

P93   1(A) The hospital shall not be considered a new hospital as
2defined in subdivisionbegin delete (ah)end deletebegin insert (ai)end insert of Section 14169.51 for the
3purposes of this article.

4(B) To the extent permitted by federal law or other federal
5requirements, the department shall use the best available and
6reasonable current estimates or projections made with respect to
7the hospital for an annual period as to the data, including, but not
8limited to, the days data source and data described as being derived
9from a state paid claims file, used for all purposes, including, but
10not limited to, the calculation of supplemental payments and the
11quality assurance fee. The estimates and projections shall be
12deemed to reflect paid claims and shall be used for each data
13element regardless of the time period otherwise applicable to the
14data element. The data elements include, but are not limited to,
15acute psychiatric days, annual fee-for-service days, annual managed
16care days, annual Medi-Cal days, fee-for-service days, general
17acute care days, high acuity days, managed care days, Medi-Cal
18days, Medi-Cal fee-for-service days, Medi-Cal managed care days,
19Medi-Cal managed care fee days, outpatient base amount, and
20transplant days.

21(i) Commencing January 2016, the department shall provide a
22clear narrative description along with fiscal detail in the Medi-Cal
23estimate package, submitted to the Legislature in January and May
24of each year, of all of the calculations made by the department
25pursuant to this section for the second program period and every
26program period thereafter.

27

SEC. 31.  

Section 14169.61 of the Welfare and Institutions
28Code
is amended to read:

29

14169.61.  

(a) (1) Except as provided in this section, all data
30and other information relating to a hospital that are used for the
31purposes of this article, including, without limitation, the days data
32source, shall continue to be used to determine the payments to that
33hospital, regardless of whether the hospital has undergone one or
34more changes of ownership.

35(2) All supplemental payments to a hospital under this article
36shall be made to the licensee of a hospital on the date the
37supplemental payment is made. All quality assurance fee payments
38under this article shall be paid by the licensee of a hospital on the
39date the quarterly quality assurance fee payment is due.

P94   1(b) The data of separate facilities prior to a consolidation shall
2be aggregated for the purposes of this article if: (1) a private
3hospital consolidates with another private hospital, (2) the facilities
4operate under a consolidated hospital license, (3) data for a period
5prior to the consolidation is used for purposes of this article, and
6(4) neither hospital has had a change of ownership on or after the
7effective date of this article unless paragraph (2) of subdivision
8(d) has been satisfied by the new owner. Data of a facility that was
9a separately licensed hospital prior to the consolidation shall not
10be included in the data, including the days data source, for the
11purpose of determining payments to the facility or the quality
12assurance fees due from the facility under the article for any time
13 period during which the facility is closed. A facility shall be
14deemed to be closed for purposes of this subdivision on the first
15day of any period during which the facility has no general acute,
16psychiatric, or rehabilitation inpatients for at least 30 consecutive
17days. A facility that has been deemed to be closed under this
18subdivision shall no longer be deemed to be closed on the first
19subsequent day on which it has general acute, psychiatric, or
20rehabilitation inpatients.

21(c) The payments to a hospital under this article shall not be
22made, and the quality assurance fees shall not be due, for any
23period during which the hospital is closed. A hospital shall be
24deemed to be closed on the first day of any period during which
25the hospital has no general acute, psychiatric or rehabilitation
26inpatients for at least 30 consecutive days. A hospital that has been
27deemed to be closed under this subdivision shall no longer be
28deemed to be closed on the first subsequent day on which it has
29general acute, psychiatric or rehabilitation inpatients. Payments
30under this article to a hospital and installment payments of the
31aggregate quality assurance fee due from a hospital that is closed
32during any portion of a subject fiscal quarter shall be reduced by
33applying a fraction, expressed as a percentage, the numerator of
34which shall be the number of days during the applicable subject
35fiscal quarter that the hospital is closed during the subject fiscal
36year and the denominator of which shall be the number of days in
37the subject fiscal quarter.

38(d) The following provisions shall apply only for purposes of
39this article, and shall have no application outside of this article nor
P95   1shall they affect the assumption of any outstanding monetary
2obligation to the Medi-Cal program:

3(1) The director shall develop and describe in provider bulletins
4and on the department’s Internet Web site a process by which the
5new operator of a hospital that has a days data source in whole or
6in part from a previous operator may enter into an agreement with
7the department to confirm that it is financially responsible or to
8become financially responsible to the department for the
9outstanding monetary obligation to the Medi-Cal program of the
10previous operator in order to avoid being classified as a new
11hospital for purposes of this article. This process shall be available
12for changes of ownership that occur before, on, or after January
131, 2014, but only in regard to payments under this article and
14otherwise shall have no retroactive effect.

15(2) The outstanding monetary obligation referred to in
16subdivisionbegin delete (ah)end deletebegin insert (ai)end insert of Section 14169.51 shall include
17responsibility for all of the following:

18(A) Payment of the quality assurance fee established pursuant
19to this article.

20(B) Known overpayments that have been asserted by the
21department or its fiscal intermediary by sending a written
22communication that is received by the hospital prior to the date
23that the new operator becomes the licensee of the hospital.

24(C) Overpayments that are asserted after such date and arise
25from customary reconciliations of payments, such as cost report
26settlements, and, with the exception of overpayments described in
27subparagraph (B), shall exclude liabilities arising from the
28fraudulent or intentionally criminal act of a prior operator if the
29new operator did not knowingly participate in or continue the
30fraudulent or criminal act after becoming the licensee.

31(3) The department shall have the discretion to determine
32whether the new owner properly and fully agreed to be financially
33responsible for the outstanding monetary obligation in connection
34with the Medi-Cal program and seek additional assurances as the
35department deems necessary, except that a new owner that executes
36an agreement with the department to be financially responsible for
37the monetary obligations as described in paragraph (1) shall be
38conclusively deemed to have agreed to be financially responsible
39for the outstanding monetary obligation in connection with the
40Medi-Cal program. The department shall have the discretion to
P96   1establish the terms for satisfying the outstanding monetary
2obligation in connection with the Medi-Cal program, including,
3but not limited to, recoupment from amounts payable to the hospital
4under this section.

5

SEC. 32.  

Section 14169.63 of the Welfare and Institutions
6Code
is amended to read:

7

14169.63.  

(a) Notwithstanding any other provision of this
8article requiring federal approvals, the department may impose
9and collect the quality assurance fee and may make payments
10under this article, including increased capitation payments, based
11upon receiving a letter from the federal Centers for Medicare and
12Medicaid Services or the United States Department of Health and
13Human Services that indicates likely federal approval, but only if
14and to the extent that the letter is sufficient as set forth in
15subdivision (b).

16(b) In order for the letter to be sufficient under this section, the
17director shall find that the letter meets both of the following
18requirements:

19(1) The letter is in writing and signed by an official of the federal
20Centers for Medicare and Medicaid Services or an official of the
21United States Department of Health and Human Services.

22(2) The director, after consultation with the hospital community,
23has determined, in the exercise of his or her sole discretion, that
24the letter provides a sufficient level of assurance to justify advanced
25implementation of the fee and payment provisions.

26(c) Nothing in this section shall be construed as modifying the
27requirement under Section 14169.69 that payments shall be made
28only to the extent a sufficient amount of funds collected as the
29quality assurance fee are available to cover the nonfederal share
30of those payments.

31(d) Upon notice from the federal government that final federal
32approval for the fee model under this article or for the supplemental
33payments to private hospitals under Section 14169.54 or 14169.55
34has been denied, any fees collected pursuant to this section shall
35be refunded and any payments made pursuant to this article shall
36be recouped, including, but not limited to, supplemental payments
37and grants, increased capitation payments, payments to hospitals
38by health care plans resulting from the increased capitation
39payments, and payments for the health care coverage of children.
40To the extent fees were paid by a hospital that also received
P97   1payments under this section, the payments may first be recouped
2from fees that would otherwise be refunded to the hospital prior
3to the use of any other recoupment method allowed under law.

4(e) Any payment made pursuant to this section shall be a
5conditional payment until final federal approval has been received.

6(f) The director shall have broad authority under this section to
7collect the quality assurance fee for an interim period after receipt
8of the letter described in subdivision (a) pending receipt of all
9necessary federal approvals. This authority shall include discretion
10to determine both of the following:

11(1) Whether the quality assurance fee should be collected on a
12full or pro rata basis during the interim period.

13(2) The dates on which payments of the quality assurance fee
14are due.

15(g) The department may draw against thebegin delete Hospital Quality
16Assurance Revenue Fundend delete
begin insert fundend insert for all administrative costs
17associated with implementation under this article, consistent with
18subdivision (b) of Section 14169.53.

19(h) This section shall be implemented only to the extent federal
20financial participation is not jeopardized by implementation prior
21to the receipt of all necessary final federal approvals.

22

SEC. 33.  

Section 14169.65 of the Welfare and Institutions
23Code
is amended to read:

24

14169.65.  

(a) Upon receipt of a letter that indicates likely
25federal approval that the director determines is sufficient for
26implementation under Section 14169.63, or upon the receipt of
27federal approval, the following shall occur:

28(1) To the maximum extent possible, and consistent with the
29availability of funds in thebegin delete Hospital Quality Assurance Revenue
30Fund,end delete
begin insert fund,end insert the department shall make all of the payments under
31Sections 14169.54, 14169.55, and 14169.56, including, but not
32limited to, supplemental payments and increased capitation
33payments, prior to the end of a program period, except that the
34increased capitation payments under Section 14169.56 shall not
35be made until federal approval is obtained for these payments.

36(2) The department shall make supplemental payments to
37hospitals under this article consistent with the timeframe described
38in Section 14169.66 or a modified timeline developed pursuant to
39Section 14169.64.

P98   1(b) If any payment or payments made pursuant to this section
2are found to be inconsistent with federal law, the department shall
3recoup the payments by means of withholding or any other
4available remedy.

5(c) This section shall not affect the department’s ongoing
6authority to continue, after the end of a program period, to collect
7quality assurance fees imposed on or before the end of the program
8period.

9

SEC. 34.  

Section 14169.66 of the Welfare and Institutions
10Code
is amended to read:

11

14169.66.  

The department shall make disbursements from the
12begin delete Hospital Quality Assurance Revenue Fundend deletebegin insert fundend insert consistent with
13the following:

14(a) Fund disbursements shall be made periodically within 15
15days of each date on which quality assurance fees are due from
16hospitals.

17(b) The funds shall be disbursed in accordance with the order
18of priority set forth in subdivision (b) of Section 14169.53, except
19that funds may be set aside for increased capitation payments to
20managed care health plans pursuant to subdivision (e) of Section
2114169.56.

22(c) The funds shall be disbursed in each payment cycle in
23accordance with the order of priority set forth in subdivision (b)
24of Section 14169.53 as modified by subdivision (b), and so that
25the supplemental payments and direct grants to hospitals and the
26increased capitation payments to managed health care plans are
27made to the maximum extent for which funds are available.

28(d) To the maximum extent possible, consistent with the
29availability of funds in thebegin delete Hospital Quality Assurance Revenue
30Fundend delete
begin insert fundend insert and the timing of federal approvals, the supplemental
31payments and direct grants to hospitals and increased capitation
32payments to managed health care plans under this article shall be
33made before the last day of a program period.

34(e) The aggregate amount of funds to be disbursed to private
35hospitals shall be determined under Sections 14169.54 and
3614169.55. The aggregate amount of funds to be disbursed to
37managed health care plans shall be determined under Section
3814169.56. The aggregate amount of direct grants to designated
39and nondesignated public hospitals shall be determined under
40Section 14169.58.

P99   1

SEC. 35.  

Section 14169.72 of the Welfare and Institutions
2Code
is amended to read:

3

14169.72.  

This article shall become inoperative if any of the
4following occurs:

5(a) The effective date of a final judicial determination made by
6any court of appellate jurisdiction or a final determination by the
7United States Department of Health and Human Services or the
8federal Centers for Medicare and Medicaid Services that the quality
9assurance fee established pursuant to this article, or Section
1014169.54 or 14169.55, cannot be implemented. This subdivision
11shall not apply to any final judicial determination made by any
12court of appellate jurisdiction in a case brought by hospitals located
13outside the state.

14(b) The federal Centers for Medicare and Medicaid Services
15denies approval for, or does not approve on or before the last day
16of a program period, the implementation of Sections 14169.52,
1714169.53, 14169.54, and 14169.55, and the department fails to
18modify Section 14169.52, 14169.53, 14169.54, or 14169.55
19pursuant to subdivision (d) of Section 14169.53 in order to meet
20the requirements of federal law or to obtain federal approval.

21(c) A final judicial determination by the California Supreme
22Court or any California Court of Appeal that the revenues collected
23pursuant to this article that are deposited in thebegin delete Hospital Quality
24Assurance Revenue Fundend delete
begin insert fundend insert are either of the following:

25(1) “General Fund proceeds of taxes appropriated pursuant to
26Article XIII B of the California Constitution,” as used in
27 subdivision (b) of Section 8 of Article XVI of the California
28Constitution.

29(2) “Allocated local proceeds of taxes,” as used in subdivision
30(b) of Section 8 of Article XVI of the California Constitution.

31(d) The department has sought but has not received federal
32financial participation for the supplemental payments and other
33costs required by this article for which federal financial
34participation has been sought.

35(e) A lawsuit related to this article is filed against the state and
36a preliminary injunction or other order has been issued that results
37in a financial disadvantage to the state. For purposes of this
38subdivision, “financial disadvantage to the state” means either of
39the following:

40(1) A loss of federal financial participation.

P100  1(2) A cost to the General Fund that is equal to or greater than
2one-quarter of 1 percent of the General Fund expenditures
3authorized in the most recent annual Budget Act.

4(f) The proceeds of the fee and any interest and dividends earned
5on deposits are not deposited into thebegin delete Hospital Quality Assurance
6Revenue Fundend delete
begin insert fundend insert or are not used as provided in Section
714169.53.

8(g) The proceeds of the fee, the matching amount provided by
9the federal government, and interest and dividends earned on
10deposits in the begin deleteHospital Quality Assurance Revenue Fundend deletebegin insert fundend insert
11 are not used as provided in Section 14169.68.

12

SEC. 36.  

Section 14312 of the Welfare and Institutions Code
13 is amended to read:

14

14312.  

The director shall adopt all necessary rules and
15regulations to carry out the provisions of this chapter. In adopting
16such rules and regulations, the director shall be guided by the needs
17of eligible persons as well as prevailing practices in the delivery
18of health care on a prepaid basis. Except where otherwise required
19by federal law or by this part, the rules and regulations shall be
20consistent with the requirements of the Knox-Keene Health Care
21Service Plan Act of 1975begin delete, or the provisions of Chapter 11A
22(commencing with Section 11491) of Part 2 of Division 2 of the
23Insurance Code, as appropriateend delete
.

24

SEC. 37.  

Section 14451 of the Welfare and Institutions Code
25 is amended to read:

26

14451.  

Services under a prepaid health plan contract shall be
27provided in accordance with the requirements of the Knox-Keene
28Health Care Service Plan Act of 1975begin delete, or the requirements of
29Chapter 11A (commencing with Section 11491) of Part 2 of
30Division 2 of the Insurance Code, as appropriateend delete
.

31

SEC. 38.  

Section 15657.8 of the Welfare and Institutions Code
32 is amended to read:

33

15657.8.  

(a) An agreement to settle a civil action for physical
34abuse, as defined in Section 15610.63, neglect, as defined in
35Section 15610.57, or financial abuse, as defined in Section
3615610.30, of an elder or dependent adult shall not include any of
37the following provisions, whether the agreement is made before
38or after filing the action:

39(1) A provision that prohibits any party to the dispute from
40contacting or cooperating with the county adult protective services
P101  1agency, the local law enforcement agency, the long-term care
2ombudsman, the California Department of Aging, the Department
3of Justice, the Licensing and Certification Division of the State
4Department of Public Health, the State Department of
5Developmental Services, the State Department ofbegin delete Mental Healthend delete
6begin insert State Hospitalsend insert, a licensing or regulatory agency that has
7jurisdiction over the license or certification of the defendant, any
8other governmental entity, a protection and advocacy agency, as
9defined in Section 4900, or the defendant’s current employer if
10the defendant’s job responsibilities include contact with elders,
11dependent adults, or children, provided that the party contacting
12or cooperating with one of these entities had a good faith belief
13that the information he or she provided is relevant to the concerns,
14duties, or obligations of that entity.

15(2) A provision that prohibits any party to the dispute from filing
16a complaint with, or reporting any violation of law to, the county
17adult protective services agency, the local law enforcement agency,
18the long-term care ombudsman, the California Department of
19Aging, the Department of Justice, the Licensing and Certification
20Division of the State Department of Public Health, the State
21Department of Developmental Services, the State Department of
22begin delete Mental Healthend deletebegin insert State Hospitalsend insert, a licensing or regulatory agency
23that has jurisdiction over the license or certification of the
24defendant, any other governmental entity, a protection and
25advocacy agency, as defined in Section 4900, or the defendant’s
26current employer if the defendant’s job responsibilities include
27contact with elders, dependent adults, or children.

28(3) A provision that requires any party to the dispute to withdraw
29a complaint he or she has filed with, or a violation he or she has
30reported to, the county adult protective services agency, the local
31law enforcement agency, the long-term care ombudsman, the
32California Department of Aging, the Department of Justice, the
33Licensing and Certification Division of the State Department of
34Public Health, the State Department of Developmental Services,
35the State Department ofbegin delete Mental Healthend deletebegin insert State Hospitalsend insert, a licensing
36or regulatory agency that has jurisdiction over the license or
37certification of the defendant, any other governmental entity, a
38protection and advocacy agency, as defined in Section 4900, or
39the defendant’s current employer if the defendant’s job
P102  1responsibilities include contact with elders, dependent adults, or
2children.

3(b) A provision described in subdivision (a) is void as against
4public policy.

5(c) This section shall apply only to an agreement entered on or
6after January 1, 2013.

7

SEC. 39.  

Section 16541 of the Welfare and Institutions Code
8 is amended to read:

9

16541.  

The council shall be comprised of the following
10members:

11(a) The Secretary of California Health and Human Services,
12who shall serve as cochair.

13(b) The Chief Justice of the California Supreme Court, or his
14or her designee, who shall serve as cochair.

15(c) The Superintendent of Public Instruction, or his or her
16designee.

17(d) The Chancellor of the California Community Colleges, or
18his or her designee.

19(e) The executive director of the State Board of Education.

20(f) The Director of Social Services.

21(g) The Director of Health Services.

22(h) The Director ofbegin delete Mental Healthend deletebegin insert State Hospitalsend insert.

23(i) The Director of Alcohol and Drug Programs.

24(j) The Director of Developmental Services.

25(k) The Director of the Youth Authority.

26(l) The Administrative Director of the Courts.

27(m) The State Foster Care Ombudsperson.

28(n) Four foster youth or former foster youth.

29(o) The chairpersons of the Assembly Human Services
30Committee and the Assembly Judiciary Committee, or two other
31Members of the Assembly as appointed by the Speaker of the
32Assembly.

33(p) The chairpersons of the Senate Human Services Committee
34and the Senate Judiciary Committee, or two other members
35appointed by the President pro Tempore of the Senate.

36(q) Leaders and representatives of county child welfare, foster
37care, health, education, probation, and mental health agencies and
38departments, child advocacy organizations; labor organizations,
39recognized professional associations that represent child welfare
40and foster care social workers, tribal representatives, and other
P103  1groups and stakeholders that provide benefits, services, and
2advocacy to families and children in the child welfare and foster
3care systems, as recommended by representatives of these groups
4and as designated by the cochairs.

5

SEC. 40.  

Section 17608.05 of the Welfare and Institutions
6Code
is amended to read:

7

17608.05.  

(a) As a condition of deposit of funds from the Sales
8Tax Account of the Local Revenue Fund into a county’s local
9health and welfare trust fund mental health account, the county or
10city shall deposit each month local matching funds in accordance
11with a schedule developed by the State Department of Mental
12Healthbegin insert, or its successor the State Department of State Hospitals,end insert
13 based on county or city standard matching obligations for the
141990-91 fiscal year for mental health programs.

15(b) A county, city, or city and county may limit its deposit of
16matching funds to the amount necessary to meet minimum federal
17maintenance of effort requirements, as calculated by the State
18Department ofbegin delete Mental Healthend deletebegin insert State Hospitalsend insert, subject to the
19approval of the Department of Finance. However, the amount of
20the reduction permitted by the limitation provided for by this
21subdivision shall not exceed twenty-five million dollars
22($25,000,000) per fiscal year on a statewide basis.

23(c) Any county, city, or city and county that elects not to apply
24maintenance of effort funds for community mental health programs
25shall not use the loss of these expenditures from local mental health
26programs for realignment purposes, including any calculation for
27poverty-population shortfall for clause (iv) of subparagraph (B)
28of paragraph (2) of subdivision (c) of Section 17606.05.

29

SEC. 41.  

This act is an urgency statute necessary for the
30immediate preservation of the public peace, health, or safety within
31the meaning of Article IV of the Constitution and shall go into
32immediate effect. The facts constituting the necessity are:

33In order to ensure the health and safety of Californians by
34updating existing law consistent with current practices at the
35earliest possible time, it is necessary that this act take effect
36immediately.



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