BILL ANALYSIS Ó
SENATE COMMITTEE ON HUMAN SERVICES
Senator McGuire, Chair
2015 - 2016 Regular
Bill No: AB 294
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|Author: |Lackey |
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|Version: |May 21, 2015 |Hearing |June 9, 2015 |
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|Urgency: |No |Fiscal: |Yes |
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|Consultant|Mareva Brown |
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Subject: Health and human services: state plans: federal
waivers: public notice
SUMMARY
This bill requires any department within the California Health
and Human Services Agency (CHHSA) to post on the home page of
its website information about any federally approved state plan
or waiver of federal laws or regulations.
ABSTRACT
Existing law:
1) Creates the CHHSA with its 10 constituent departments
and a number of other boards and entities. (GOV 12803)
2) Requires the state Department of Health Care Services
(DHCS) to post the following on its Internet Web site. (WIC
14100.3.)
a. All submitted state plan amendments and all
federal waiver applications and requests for new
waivers, waiver amendments, and waiver renewals and
extensions within 10 business days from the date the
department submits these documents for approval to the
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federal Centers for Medicare and Medicaid Services
(CMS).
b. All final approval or denial letters and
accompanying documents for all submitted state plan
amendments and federal waiver applications and
requests within 10 business days from the date the
department receives notification of final approval or
denial from CMS.
c. Notice from DHCS to CMS that it is withdrawing
a submitted state plan amendment or federal waiver
application or request, as defined, within 10 business
days from the date the department notifies CMS of the
withdrawal.
d. All pending submitted state plan amendments
and federal waiver applications and requests, which
the department submitted to CMS in 2009 and every year
thereafter.
This bill:
1) Adds a new Part 0.5 to Health and Safety code commencing
with HSC 135 and a new Division 3.5 to Welfare and
Institutions code, commencing with a new Section 3500, both
requiring that a department within the California Health
and Human Services Agency that 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
federal regulation, to make any and all approved plans or
waiver applications available to the public by publishing a
hyperlink to that information on the homepage of the
department's Internet Web site.
FISCAL IMPACT
An Assembly Appropriations Committee analysis projected
negligible state fiscal effect and noted that the bill will
apply to ten departments under CHHSA, some of which already are
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likely compliant.
BACKGROUND AND DISCUSSION
Purpose of the bill:
According to the author, this bill will increase transparency
for state-run and federally funded programs within the Health
and Human Services Agency by requiring that the state
departments place a copy of any approved state plans or waivers
on the front page of the administering department's web site.
This will allow the public to gain knowledge of the programs and
improve departments' abilities to provide critical services to
Californians, the author states. The author also states that
some federally required plans and federal waivers are not
readily accessible to the public because they are not placed on
the web page of the single state agency responsible for the
administration of the program.
Federal waivers
State agencies are required to develop state plans and permitted
to submit waiver proposals to the federal government, as
instructed by the relevant federal agencies, to waive
requirements of specific programs. An example would be the
substantial Home and Community-Based Services waiver, which
permits California to receive federally matched Medicaid funding
for services outside of a health care institution.
California has several Medicaid waivers, including the Section
1115 Research & Demonstration Projects, which allow states
program flexibility to test new or existing approaches to
financing and delivering services. Section 1915(b) Managed Care
Waivers allow states to provide services through managed care
delivery systems or otherwise limit people's choice of
providers. Section 1915(c) Home and Community-Based Services
Waivers allow states to provide long-term care services in home
and community settings rather than institutional settings.
These and other waivers enable California to receive federal
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funding for a number of programs through Medicaid waivers or
state plan language including In-Home Supportive Services,
services for individuals with developmental disabilities, those
with AIDS or HIV, assisted living services, in home operations
or pediatric palliative care, services for individuals with
serious mental illness and others.
Additionally, California has federal waivers within its CalFresh
food benefit program to maintain nutrition benefits to
individuals who are unable to find employment during a
recession, waivers to fund various innovations in the foster
care program, and others.
Posting practices
Currently, state departments post waivers and state plans to
varying degrees and in various places. The Department of Health
Care Services, which is responsible for managing for all
Medi-Cal waivers, regardless of the department that is applying
them to the provision of services, has a website page devoted to
the waivers. A link to the waiver page is on the right side of
the DHCS home page. The Department of Developmental Services
also has a webpage for its waivers and a link from its home page
to the waiver page, however the link is identified as a home and
community based services site, rather than a waiver site.
The Health and Human Services Agency also has a waiver page, but
does not have a link from the homepage. The Department of Aging
does not appear to have a waiver page specifically, although
some information about relevant waivers is on its home page. The
Department of Social Services (CDSS) does not have a waiver link
on its home page, although it receives waivers from the USDA for
its CalFresh program and from the Administration on Families and
Children for its child welfare programs. Much of the waiver
information released from CDSS about waivers and plans is in the
form of instruction letters to counties or other, similar,
directives.
Related legislation:
AB 82 (Committee on Budget, Chapter 23, Statutes of 2013) added
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the requirement for DHCS to post all waiver and state plan
information submitted to the federal CMS on its Internet website
within 10 days.
AB 1216 (Bonta, 2015) modifies the requirement for DHCS to post
all state plan amendments and waiver information submitted to
CMS from 10 days to within 7 business days from the date of
submission, and requires DHCS to accept public comment on all
state plan amendments and waivers, as specified.
PRIOR VOTES
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|Assembly Floor: |77 - |
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|Assembly Appropriations Committee: |17 - |
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|Assembly Health Committee: |18 - |
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POSITIONS
Support:
Coalition of California Welfare Rights Organizations
(Sponsor)
AFSCME
Alliance
California Alternative Payment Program Association
California Hunger Action Coalition
Western Center on Law and Poverty
Oppose:
California Department of Finance
ARGUMENTS IN SUPPORT
The bill's sponsor, California Coalition of Welfare Rights
Organizations, writes that California's numerous plans and
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waivers are not readily accessible to the public, although some
specific plans are required to be posted. "This bill would make
California's state plans and waivers readily accessible to the
public to enhance government transparency."
ARGUMENTS IN OPPOSITION
The Department of Finance writes in opposition to this bill that
SB 294 is unnecessary. "If there are any gaps in what is being
posted, Agency can direct the affected departments to publish
the remaining documents. It is our understanding that
departments under Agency already publish most of their federally
approved operational state plans or federal waiver applications
on their respective websites."
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