BILL ANALYSIS                                                                                                                                                                                                    Ó




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          |SENATE RULES COMMITTEE            |                        AB 294|
          |Office of Senate Floor Analyses   |                              |
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                                   THIRD READING 


          Bill No:  AB 294
          Author:   Lackey (R) and Steinorth (R), et al.
          Amended:  6/15/15 in Senate
          Vote:     21  

           SENATE HUMAN SERVICES COMMITTEE:  5-0, 6/9/15
           AYES:  McGuire, Berryhill, Hancock, Liu, Nguyen

          SENATE APPROPRIATIONS COMMITTEE:  Senate Rule 28.8

           ASSEMBLY FLOOR:  77-0, 4/30/15 - See last page for vote

           SUBJECT:   Health and human services:  state plans:  federal  
                     waivers:  public notice


          SOURCE:    Coalition of California Welfare Rights Organizations

          DIGEST:   This bill requires any department within the  
          California Health and Human Services Agency (CHHSA) to post on  
          the homepage of its Web site information about any federally  
          approved state plan or waiver of federal laws or regulations.

          ANALYSIS:


          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)









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             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 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 adds a new Part 0.5 to the Health and Safety Code,  
          commencing with HSC 135, and a new Division 3.5 to the Welfare  
          and Institutions Code, commencing with a new Section 3500, both  
          requiring that a department within the CHHSA 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  
          waivers available to the public by publishing a hyperlink to  
          that information on the homepage of the department's Internet  
          Web site.

          Background

          Federal waivers








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          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  
          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. 


          Comments


          Currently, state departments post waivers and state plans to  








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          varying degrees and in various places. The DHCS, which is  
          responsible for managing all Medi-Cal waivers, regardless of the  
          department that is applying them to the provision of services,  
          has a Web site page devoted to the waivers. A link to the waiver  
          page is on the right side of the DHCS homepage. 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 CHHSA 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 U.S. Department of  
          Agriculture for its CalFresh program and from the Administration  
          for Children and Families 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. 

          FISCAL EFFECT:   Appropriation:    No          Fiscal  
          Com.:YesLocal:   No


          SUPPORT:   (Verified  6/23/15)


          Coalition of California Welfare Rights Organizations (source)
          AFSCME
          Alliance
          California Alternative Payment Program Association
          California Association of Public Authorities for IHSS
          California Hunger Action Coalition
          Western Center on Law and Poverty


          OPPOSITION:   (Verified  6/23/15)


          Department of Finance








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          ARGUMENTS IN SUPPORT:      According to the author, this bill  
          will increase transparency for state-run and federally funded  
          programs within the CHHSA 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.


          ARGUMENTS IN OPPOSITION:      The Department of Finance (DOF)  
          writes in opposition to this bill that it is unnecessary. "If  
          there are 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." DOF  
          also stated that this bill should not result in fiscal impacts  
          to any departments under the CHHSA as the costs to publish the  
          necessary documents are likely to be minor and absorbable.

          ASSEMBLY FLOOR:  77-0, 4/30/15
          AYES:  Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom,  
            Bonilla, Bonta, Brough, Brown, Burke, Calderon, Chang, Chau,  
            Chiu, Chu, Cooley, Cooper, Dababneh, Dahle, Daly, Dodd,  
            Eggman, Frazier, Beth Gaines, Gallagher, Cristina Garcia,  
            Eduardo Garcia, Gatto, Gipson, Gonzalez, Gordon, Gray, Grove,  
            Hadley, Harper, Roger Hernández, Holden, Irwin, Jones,  
            Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low,  
            Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin,  
            Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Perea,  
            Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago,  
            Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber,  
            Wilk, Williams, Wood, Atkins
          NO VOTE RECORDED:  Campos, Chávez, Gomez









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          Prepared by:Mareva Brown / HUMAN S. / (916) 651-1524
          6/24/15 16:23:23


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