BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                     AB 294


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          CONCURRENCE IN SENATE AMENDMENTS


          AB  
          294 (Lackey and Steinorth)


          As Amended  June 15, 2015


          Majority vote


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          |ASSEMBLY:  | 77-0 | (April 30,    |SENATE: |38-0  | (August 20,     |
          |           |      |2015)          |        |      |2015)            |
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          Original Committee Reference:  HEALTH


          SUMMARY:  Requires any department within the California Health  
          and Human Services Agency (CHHSA) to post on the first page of  
          its Web site information about any federally approved state plan  
          or waiver of federal laws or regulations.


          The Senate amendments add coauthors and make technical,  
          non-substantive changes. 


          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  








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            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.


          FISCAL EFFECT:  According to the Senate Appropriations  
          Committee, pursuant to Senate Rule 28.8, negligible state costs.


          COMMENTS:  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 Web site.  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.


          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 Web sites, 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 waivers.









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          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.


          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.


          There is no opposition on file.


          Analysis Prepared by:                                             
          Roger Dunstan / HEALTH / (916) 319-2097  FN: 0001202


















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