BILL ANALYSIS Ó ----------------------------------------------------------------- |SENATE RULES COMMITTEE | AB 294| |Office of Senate Floor Analyses | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ----------------------------------------------------------------- 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) AB 294 Page 2 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 AB 294 Page 3 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 AB 294 Page 4 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 AB 294 Page 5 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 AB 294 Page 6 Prepared by:Mareva Brown / HUMAN S. / (916) 651-1524 6/24/15 16:23:23 **** END ****