BILL ANALYSIS Ó AB 635 Page 1 CONCURRENCE IN SENATE AMENDMENTS AB 635 (Atkins) As Amended August 18, 2016 Majority vote -------------------------------------------------------------------- |ASSEMBLY: |72-2 |(June 2, 2015) |SENATE: | 31-7 |(August 25, | | | | | | |2016) | | | | | | | | | | | | | | | -------------------------------------------------------------------- Original Committee Reference: HEALTH SUMMARY: Requires the Department of Health Care Services (DHCS) to work with identified stakeholders to conduct a study to identify current requirements for medical interpretation services as well as education, training, and licensure requirements, analyze other state Medicaid programs, and make recommendations on strategies that may be employed regarding the provision of medical interpretation services for Medi-Cal beneficiaries who are limited English proficient (LEP), in compliance with applicable state and federal requirements. Specifically, this bill: 1)Requires the study to assess and make recommendations on pilot projects that would further the objectives of this bill, including funding for those activities and the allowable use of federal funding. AB 635 Page 2 2)Requires DHCS to work with identified stakeholders to establish a pilot project in up to four separate sites to evaluate a mechanism to provide and improve medical interpretation services for LEP Medi-Cal beneficiaries, as specified. Requires DHCS to take into account both the need for those services, and the recommendations from the study. 3)Authorizes DHCS to use or contract with an external vendor or other subject matter experts to implement this bill. Requires DHCS to consult with identified stakeholders regarding the draft initial scope of work that will be used to seek and evaluate proposals. 4)Requires DHCS, commencing in 2017, during the annual state budget process, to provide an update to the Legislature regarding this bill's implementation. 5)Authorizes DHCS to expend up to $3,000,000 under the Budget Act of 2016, for the support of activities related to a medical interpreters pilot project, study, or both. 6)Authorizes DHCS to seek any available federal funding for support of this bill. 7)Makes the expenditure or encumbrance of the funds under this bill contingent on approval by the Department of Finance. 8)Sunsets this bill on July 1, 2020 and repeals its provisions on January 1, 2021. The Senate amendments require DHCS to conduct a study relating to medical interpretation services. FISCAL EFFECT: According to the Senate Appropriations AB 635 Page 3 Committee: 1)One-time costs of $1.4 million to develop program guidelines, seek necessary federal approvals, and develop billing systems (50% General Fund (GF), 50% federal funds (FF)). 2)Ongoing administrative costs of about $600,000 per year for oversight by the DHCS (GF/FF). 3)Ongoing costs of about $30 million per year to provide translation services in fee-for-service Medi-Cal, based on estimates of the existing Medi-Cal fee-for-service population with limited English proficiency (GF/FF). 4)Unknown costs in Medi-Cal managed care (GF/FF). Under current law, health plans are required to provide interpretation services, including managed care plans that contract with the DHCS. It is unclear whether the bill's requirement to provide "certified medical interpretation services" through the program would increase costs above the costs already being incurred. 5)The federal financial participation rate for the costs above may vary. Generally, the federal government pays for 50% of Medi-Cal costs. However, the federal government pays an increased reimbursement rate the former Healthy Families population of 65%. Finally, for the Medi-Cal expansion population, the federal government pays 100% of the cost, declining to 90% by 2020. Federal law allows for a 75% match for certain costs of interpretation that are considered administrative costs. However, DHCS indicates that the provision of interpretation services under the bill would be considered Medi-Cal benefits and would be subject to the normal federal match. COMMENTS: According to the author, California has an AB 635 Page 4 opportunity to draw down enhanced federal funding to develop a more comprehensive language assistance program for LEP beneficiaries. These critical services will help ensure better health outcomes for individuals by reducing language barriers that could lead to lack of or inappropriate preventive and primary care. More than 40% of Californians speak a language other than English at home and almost 7 million Californians are estimated to speak English "less than very well." As a result, language assistance in medical settings is often provided by untrained staff or, more frequently, in an informal manner by family members or friends. The author notes that research finds language barriers can contribute to inadequate patient evaluation and diagnosis; lack of appropriate and/or timely treatment; and/or other medical errors that can jeopardize patient safety and lead to unnecessary procedures and cost. The author concludes, as a recent University of California, Los Angeles report indicates, despite state regulations, health plan enrollees who are LEP still face communication barriers. This bill implements a provision in SB 826 (Leno), Chapter 23, Statutes of 2016 or the Budget Act of 2016. Specifically, SB 826 provides under Provision 14 of Item 4260-101-0001 of Section 2.00 "[o]f the funds appropriated in Schedule (3), $3,000,000 is for the support of activities related to a medical interpreters pilot project, study, or both. Expenditure or encumbrance of these funds is contingent upon the chaptering of future legislation authorizing the medical interpreters pilot project, study, or both, and upon approval by the Department of Finance." Analysis Prepared by: Rosielyn Pulmano / HEALTH / (916) 319-2097 FN: 0004724 AB 635 Page 5