BILL ANALYSIS Ó
AB 294
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Date of Hearing: April 7, 2015
ASSEMBLY COMMITTEE ON HEALTH
Rob Bonta, Chair
AB 294
(Lackey and Steinorth) - As Amended March 23, 2015
SUBJECT: Health and human services: state plans: federal
waivers: public notice.
SUMMARY: Requires any department within the California Health
and Human Services Agency (CHHSA) to post on the first page of
its website information about any federally approved state plan
or waiver of federal laws or regulations.
EXISTING LAW:
1)Creates the CHHSA with its 10 constituent departments and a
number of other offices and entities.
2)Requires or authorizes state agencies to develop state plans
and waiver proposals for submission to the federal government,
consistent with federal law. Existing federal law provides
for required state plans to implement federal programs and
grants federal agencies authority in specified circumstances
to waive applicable portions of federal law. In particular,
states may be granted waivers of federal law to implement
demonstration projects in their Medicaid programs.
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FISCAL EFFECT: This bill has not been analyzed by a fiscal
committee.
COMMENTS:
1)PURPOSE OF THIS BILL. According to the author, this bill will
increase transparency for programs administered within CHHSA.
Many of these programs are federal programs partially or fully
funded with federal funds and operating under federal
requirements. According to the author, frequently the federal
government will require the designated state agency to submit
a state plan for the operation of the program. In addition,
states often obtain federal waivers as they test more
innovative approaches to implementing federal law. The author
argues this bill would increase transparency and government
accountability for these programs by requiring that the
administering departments within CHHSA place a copy of the
approved state plans and waivers on the front page of the
department's Website. The author concludes that this will
allow the public to gain knowledge of the programs and improve
CHHSA's abilities to provide critical services to
Californians.
2)SUPPORT. According to the Coalition of California Welfare
Rights Organizations, this bill's sponsor, is needed because
in certain cases the only way for the public to access the
details of a federal waiver is through a public information
request. The supporters note that this bill would not only
improve transparency to the public, but also save valuable
resources for departments by taking away the need for public
information requests. Supporters also note that some
departments within CHHSA already post approved waivers on
their Websites, such as Department of Health Care Services
(DHCS) which posts Medi-Cal waivers, however, other
departments such as Department of Social Services do not post
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waivers.
The Western Center on Law and Poverty (WCLP) supports this
bill, noting that the plans and waivers are available through
public records act requests but are not readily accessible to
the public. WCLP argues that this bill will make these
documents more accessible to the public and make these
government programs more transparent and work better for the
people they serve.
3)BACKGROUND. Of particular importance for health policy, is
the proposed Medicaid waiver request for the Medi-Cal program.
Medicaid (known as Medi-Cal in California) is a joint
federal-state program to provide health coverage to low-income
individuals. Section 1115 of the federal Social Security Act
(Act) gives the Secretary of the federal Department of Health
and Human Services (HHS) authority to waive provisions of
major health and welfare programs authorized under the Act.
This includes certain federal Medicaid requirements in any
experimental pilot or demonstration project which, in the
judgment of the HHS Secretary, is likely to assist in
promoting the objectives of Medicaid. In addition, Section
1115 also allows states to use federal Medicaid funds to
reimburse for costs in ways that are not otherwise allowed
under federal Medicaid law. DHCS has submitted a waiver
application to the federal government for consideration.
4)Suggested Technical Amendment. The proposed technical
amendment would clarify that all plans and waivers could be
accessed by one link and change "first" page to "home" page.
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Section 135: If a department within the California Health and
Human Services Agency has received approval of an operational
state plan by a federal agency, or has applied and has been
approved for a waiver from a federal law or regulation, the
department shall make any and all approved plans or waiver
applications the approved plan or waiver application available
to the public by publishing a hyperlink to that information on
the first home page of the department's Internet Web site at the
time the department is otherwise updating its Internet Web site.
Section 3500: If a department within the California Health and
Human Services Agency has received approval of an operational
state plan by a federal agency, or has applied and has been
approved for a waiver from a federal law or regulation, the
department shall make any and all approved plans or waiver
applications the approved plan or waiver application available
to the public by publishing a hyperlink to that information on
the first home page of the department's Internet Web site at the
time the department is otherwise updating its Internet Web site.
5)RELATED LEGISLATION.
a) AB 72 (Bonta), requires DHCS to submit an application to
the federal Centers for Medicare and Medicaid Services for
a waiver to implement a demonstration project that furthers
the delivery of high-quality and cost-efficient care for
Medi-Cal beneficiaries. AB 72 is pending in this
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Committee.
b) SB 36 (Ed Hernandez) is substantially similar to AB 72
and is pending in the Senate Committee on Health.
REGISTERED SUPPORT / OPPOSITION:
Support
Coalition of California Welfare Rights Organizations (sponsor)
California Alternative Payment Program Association
The Alliance
Western Center on Law and Poverty
Opposition
None on file.
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Analysis Prepared by:Roger Dunstan / HEALTH / (916) 319-2097