BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      AB 1114


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          ASSEMBLY THIRD READING


          AB  
          1114 (Bonilla)


          As Amended  April 16, 2015


          Majority vote


           ------------------------------------------------------------------- 
          |Committee       |Votes |Ayes                |Noes                  |
          |                |      |                    |                      |
          |                |      |                    |                      |
          |----------------+------+--------------------+----------------------|
          |Health          |18-0  |Bonta, Maienschein, |                      |
          |                |      |Bonilla, Burke,     |                      |
          |                |      |Chávez, Chiu,       |                      |
          |                |      |Gomez, Gonzalez,    |                      |
          |                |      |                    |                      |
          |                |      |                    |                      |
          |                |      |Roger Hernández,    |                      |
          |                |      |Lackey, Nazarian,   |                      |
          |                |      |Patterson,          |                      |
          |                |      |Rodriguez,          |                      |
          |                |      |Santiago,           |                      |
          |                |      |Steinorth,          |                      |
          |                |      |Thurmond, Waldron,  |                      |
          |                |      |Wood                |                      |
          |                |      |                    |                      |
          |                |      |                    |                      |
          |----------------+------+--------------------+----------------------|
          |Appropriations  |17-0  |Gomez, Bigelow,     |                      |
          |                |      |Bonta, Calderon,    |                      |
          |                |      |Chang, Daly,        |                      |
          |                |      |Eggman, Gallagher,  |                      |








                                                                      AB 1114


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          |                |      |                    |                      |
          |                |      |                    |                      |
          |                |      |Eduardo Garcia,     |                      |
          |                |      |Gordon, Holden,     |                      |
          |                |      |Jones, Quirk,       |                      |
          |                |      |Rendon, Wagner,     |                      |
          |                |      |Weber, Wood         |                      |
          |                |      |                    |                      |
          |                |      |                    |                      |
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          SUMMARY:  Clarifies existing law regarding the documents necessary  
          to retain eligibility, benefits or services from Medi-Cal and  
          subsidized programs under Covered California, as defined.   
          Specifically, this bill:  


          1)Defines "forms, letters, and notices" as all application,  
            renewal, and other forms and letters needed to obtain or retain  
            eligibility, benefits, or services from an insurance  
            affordability program, and all notices affecting the legal  
            rights of applicants, beneficiaries and enrollees.
          2)Requires all forms, letters and notices developed pursuant to  
            this bill to be accessible, standardized, and in compliance with  
            federal and state laws, regulation, and guidance.


          3)Requires all forms, letters, and notices developed pursuant to  
            this bill to be written in plain language, be accessible to  
            limited English proficient (LEP) individuals in accordance with  
            state and federal law, and at a minimum, provided at the same  
            threshold of languages as required for Medi-Cal managed care  
            plans.


          FISCAL EFFECT:  According to the Assembly Appropriations  
          Committee:









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          1)Implementation costs for translation and information technology  
            (IT) services to Covered California / Department of Health Care  
            Services, which are joint sponsors of the California Healthcare  
            Eligibility, Enrollment, and Retention System (CalHEERS),  
            potentially in the range of $2 million (General Fund  
            (GF)/federal funds/special funds).  The vast majority of this  
            cost is for IT.


          2)Unknown, potential ongoing cost pressure to the state  
            (GF/federal funds/special funds) for county administrative  
            costs.  Counties determine eligibility for Medi-Cal and Covered  
            California, and would incur additional costs if additional  
            translations are necessary beyond the standard translations  
            included in the automated CalHEERS system.


          COMMENTS:  The author states language is a significant barrier to  
          health care access and coverage to Californians.  While the Health  
          Care Eligibility, Enrollment, and Retention Act has made progress  
          in ensuring that Californians are in compliance with the Patient  
          Protection and Affordable Care Act (ACA) and receiving the health  
          care coverage they need, significant challenges remain for many  
          LEP individuals.  The author states this bill will help ensure LEP  
          individuals not only have access to health care for the first  
          time, but also continue to renew their coverage to receive  
          sustained care.


          Western Center on Law & Poverty, the sponsor of this bill, states  
          that the lack of translated and language-accessible renewal  
          materials is resulting in many consumers not understanding  
          requests for information required to maintain their health  
          coverage.  This has led to undue stress and discontinued access to  
          necessary health care services for LEP Medi-Cal beneficiaries,  
          following receipt of Medi-Cal termination notices.  The sponsor  
          notes that some counties within the state have begun to translate  
          some of the forms into their own threshold languages; however this  








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          is a piecemeal solution to a statewide issue.  The sponsor  
          concludes this bill is necessary to clarify which health care  
          forms are required to be translated for consumers, as a court  
          recently ruled that existing statute does not explicitly contain  
          translation requirements for all forms.  Supporters of this bill  
          state that any notice to a consumer not provided in his or her  
          primary language is legally insufficient to be considered proper  
          notice in terms of a consumer's due process rights.  Supporters  
          note this bill is necessary to clarify existing law and ensure  
          Californians better understand their healthcare coverage.


          This bill has no known opposition.




          Analysis Prepared by:                                               
          An-Chi Tsou / HEALTH / (916) 319-2097  FN: 0000718