BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 94|
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THIRD READING
Bill No: AB 94
Author: Committee on Budget
Amended: 6/16/15 in Senate
Vote: 21
SENATE BUDGET & FISCAL REVIEW COMMITTEE: 11-5, 6/18/15
AYES: Leno, Allen, Beall, Block, Hancock, Mitchell, Monning,
Pan, Pavley, Roth, Wolk
NOES: Nielsen, Anderson, Moorlach, Nguyen, Stone
ASSEMBLY FLOOR: Not relevant
SUBJECT: Health
SOURCE: Author
DIGEST: This bill is the omnibus health trailer bill, and
contains changes to implement the 2015-16 Budget.
ANALYSIS: This bill makes the following statutory changes to
implement the 2015-16 Budget.
1) Medi-Cal: Coverage for Undocumented Children. This bill
provides Medi-Cal coverage to children who are otherwise
eligible for Medi-Cal except for their immigration status,
effective no sooner than May 1, 2016.
2) Medi-Cal: Elimination of Dental Provider Payment Reductions.
This bill eliminates the 10% Medi-Cal payment reductions
pursuant to AB 97 (Committee on Budget, Chapter 3, Statutes
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of 2011) for dental providers effective July 1, 2015.
3) Hepatitis C Linkage to and Retention in Care Projects. This
bill establishes hepatitis C linkage to care demonstration
pilot projects for three years to allow for innovative,
evidence-based approaches to provide outreach, hepatitis C
screenings, and linkage to, and retention in, quality health
care for the most vulnerable and underserved individuals
living with or at risk for hepatitis C viral infection.
4) Syringe Exchange Program. This bill authorizes the Department
of Public Health (DPH) to purchase sterile hypodermic needles
and syringes, and other materials, for distribution to
syringe exchange programs.
5) Pre-Exposure Prophylaxis (PrEP) Access and Outreach. This
bill establishes a PrEP navigator program to develop
protocols to conduct outreach to targeted populations, to
provide PrEP education to clients and to assess and refer to
appropriate clinical care and prevention services.
6) Robert F. Kennedy Health Plan. This bill requires the
Department of Health Care Services (DHCS) to allocate $2.5
million Major Risk Medical Insurance Fund on a one-time basis
to the Robert F. Kennedy Health Plan for purposes of
purchasing stop loss insurance.
7) LifeLong Community Clinic. This bill requires DHCS to
allocate $2 million Major Risk Medical Insurance Fund on a
one-time basis to the LifeLong Medical Care clinic in Contra
Costa County.
8) Licensing and Certification Long-Term Care Facility Complaint
Investigation Timelines. This bill specifies that DPH is
required to:
a) For complaints that involve a threat of imminent danger
or death or serious bodily harm that are received on or
after July 1, 2016, the department shall complete the
investigation within 90 days of receipt. This time period
may be extend up to an additional 60 days if the
investigation cannot be completed due to extenuating
circumstances. If there is an extension, the department
shall notify the facility and the complainant in writing
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of this extension and the extenuating circumstances and
document the extenuating circumstances in its final
determination. Any citation issued as a result of the
complaint investigation shall be issued and served within
30 days of the completion of the complaint investigation.
b) For all other categories of complaints received on or
after July 1, 2017, the department shall complete the
investigation within 90 days of receipt. This time period
may be extend up to an additional 90 days if the
investigation cannot be completed due to extenuating
circumstances. If there is an extension, the department
shall notify the facility and the complainant in writing
of this extension and the extenuating circumstances and
document the extenuating circumstances in its final
determination. Any citation issued as a result of the
complaint investigation shall be issued and served within
30 days of the completion of the complaint investigation.
c) For all complaints received on or after July 1, 2018,
the department shall complete the investigation within 60
days of receipt. This time period may be extend up to an
additional 60 days if the investigation cannot be
completed due to extenuating circumstances. If there is an
extension, the department shall notify the facility and
the complainant in writing of this extension and the
extenuating circumstances and document the extenuating
circumstances in its final determination. Any citation
issued as a result of the complaint investigation shall be
issued and served within 30 days of the completion of the
complaint investigation.
d) Report on an annual basis (in the Licensing and
Certification Fee report) data on the department's
compliance these new timelines.
e) Beginning with the 2018-19 Licensing and Certification
November Program budget estimate, the department shall
evaluate the feasibility of reducing investigation
timelines based on experience implementing the timeframes
described above.
f) States the intent of the Legislature that the
department continues to seek to reduce long-term care
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complaint investigation timelines to less than 60 days
with a goal of meeting a 45-day timeline.
9) Hospital Complaint Investigation Notification. This bill
requires DPH to notify the hospital and complainant if any,
if an investigation regarding hospital complaints is not
completed in the required timeframe. This notification shall
document the extenuating circumstances as to why the
investigation has not been completed and the anticipated
completion date.
10)Coordinated Care Initiative (CCI): Multipurpose Senior
Services Program (MSSP) Transition Timeline. This bill
extends the date in which MSSP transitions from a federal
waiver to a managed care benefit in the CCI counties. This
bill extends the date to December 31, 2017, but will allow an
earlier transition in a county or region when the MSSP site
and managed care plan mutually agree they are ready to
transition, want to transition early, and have demonstrated
that they have met readiness criteria. Existing law states
that MSSP would transition after 19 months of MSSP
beneficiary enrollment into managed care. This bill also
specifies that if CCI is terminated, MSSP would revert to a
waiver benefit.
11)California Healthcare Eligibility, Enrollment, and Retention
System Electronic Modified Adjusted Gross Income (MAGI)
Determination. This bill removes the sunset provision to
allow for continued electronic verification of Medi-Cal
eligibility information.
12)Medi-Cal: Ground Emergency Medical Transportation (GEMT)
Supplemental Reimbursement Program. This bill modifies the
existing GEMT Supplemental Reimbursement Program in order to
maximize federal financial participation for public GEMT
provider's services, subject to federal approval.
13)Health Home Program (HHP). This bill provides DHCS with the
authority to establish a HHP Account in the Special Deposit
Fund within the State Treasury in order to collect and
allocate non-General Fund public or private grant funds, to
be expended upon appropriation by the Legislature, for the
purposes of implementing the HHP pursuant to AB 361
(Mitchell, Chapter 642, Statutes of 2013).
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14)Medi-Cal: Eliminate Nonemergency Emergency Room Copay. This
bill eliminates the statutory references implementing a
nonemergency emergency room copay in Medi-Cal, as this policy
has been removed from the Medi-Cal budget. The budget removes
the assumption that the state would implement a copayment for
nonemergency emergency room usage pursuant to AB 97
(Committee on Budget, Chapter 3, Statutes of 2011) and AB
1467 (Committee on Budget, Chapter 23, Statutes of 2012)
which was expected to result in about $34 million ($17
million General Fund) savings. This copay has never been
implemented as it had not received approval from the federal
Centers for Medicare and Medicaid.
15)Medi-Cal: County Eligibility Administration Cost-of-Living
Adjustment (COLA). This bill suspends the COLA for county
eligibility administration for 2015-16.
16)Limited Benefit and Special Populations Programs Enroller
Education. This bill requires enrolling providers who
participate in Every Woman Counts, Family Planning Access
Care and Treatment, and IMProving Access, Counseling, and
Treatment for Californians with Prostate Cancer, to provide
to the enrolling individuals, information on how to apply for
insurance affordability programs, in a manner determined by
DHCS.
17)Child Health and Disability Prevention (CHDP) Program Dental
Referral. This bill requires CHDP programs and providers to
refer all Medi-Cal-eligible children participating in CHDP
who are one year of age and older to a dentist participating
in the Medi-Cal program, rather than at age three.
18)Food Safety Stipulated Judgment. This bill authorizes the
deposit into the Food Safety Fund of awards to DPH pursuant
to court orders or settlements for food safety-related
activities.
19)Genetic Disease Screening Program (GDSP) Prenatal Screening
Program. This bill clarifies that private health insurance
plans cannot consider the GDSP Prenatal Screening Program to
be an out-of-network provider.
20)California Gambling Education and Treatment Services
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(CalGETS). This bill deletes outdated verbiage related to the
CalGETS program.
21)Investment in Mental Health Wellness Grants. This bill allows
the California Health Facilities Financing Authority to use
up to $3 million in unencumbered Mental Health Wellness Grant
funds, authorized by SB 82 (Committee on Budget and Fiscal
Review, Chapter 34, Statutes of 2013) for peer respite
programs.
22)Clinical Laboratories Test Procedures. This bill authorizes
clinical laboratories to use the federally-approved
equivalent quality control testing approach until December
31, 2015, and individualized quality control plan commencing
January 1, 2016, pursuant to the federal state operations
manual adopted by the federal Centers for Medicare and
Medicaid Services.
23)Office of Systems Integration. This bill requires the Office
of Systems Integration to report to the Legislature by April
1, 2017 on the feasibility, benefits, costs, and risks of
installing the MAGI Eligibility Decision Engine in all, two,
or just one of the SAW Consortia systems.
24)Covered California Regulatory Authority. This bill extends
Covered California's current emergency regulations rulemaking
authority for an additional year until January 1, 2017;
extends Covered California's ability to readopt emergency
regulations until January 1, 2020, for emergency regulations
adopted prior to the effective date of the Budget Act of
2015; and provides limited statutory exemptions from the
Administrative Procedure Act's rulemaking requirements for
(a) standard plan designs, and (b) separate regulations for
each procurement.
25)AIDS Drug Assistance Program (ADAP) Modernization. This bill
updates financial eligibility for ADAP and the Office of AIDS
Health Insurance Premium Payment program to consider family
size and to increase the income limit of $50,000 for these
programs, which is estimated to be 447% federal poverty level
(FPL) to 500% FPL or $58,350 for a single individual and
$98,950 for a three-person household.
26)Medi-Cal: Enrollment Application Assistance Payments. This
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bill reallocates any remaining funds for Medi-Cal application
assistance payments, for eligible applications submitted
through June 30, 2015, to county outreach and enrollment
grants and to extend the date by which county outreach and
enrollment grant funds can be spent from June 30, 2016 to
June 30, 2018.
27)Major Risk Medical Insurance Program (MRMIP). This bill
expedites the MRMIP and Guaranteed Issue Pilot reconciliation
process.
28)Appropriation. This bill appropriates $50 million from the
HHP Account to DHCS to implement the HHP.
FISCAL EFFECT: Appropriation: Yes Fiscal
Com.:YesLocal: Yes
SUPPORT: (Verified6/17/15)
None received
OPPOSITION: (Verified6/17/15)
None received
Prepared by:Michelle Baass / B. & F.R. / (916) 651-4103
6/18/15 18:50:14
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