BILL ANALYSIS                                                                                                                                                                                                    Ó






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                                   THIRD READING 


          Bill No:  AB 1114
          Author:   Bonilla (D)
          Amended:  9/1/15 in Senate
          Vote:     21  

           SENATE HEALTH COMMITTEE:  8-0, 6/24/15
           AYES:  Hernandez, Nguyen, Mitchell, Monning, Nielsen, Pan,  
            Roth, Wolk
           NO VOTE RECORDED:  Hall

           SENATE APPROPRIATIONS COMMITTEE:  7-0, 8/27/15
          AYES:  Lara, Bates, Beall, Hill, Leyva, Mendoza, Nielsen

           ASSEMBLY FLOOR:  79-0, 6/1/15 - See last page for vote

           SUBJECT:   Health care: eligibility and enrollment


          SOURCE:    Western Center on Law and Poverty

          DIGEST:   This bill defines forms and notices for purposes of  
          existing requirements for insurance affordability  
          program-related application forms and notices to mean  
          application and renewal forms and notices of action needed to  
          obtain or retain eligibility, benefits, or services from an  
          insurance affordability program, thereby requiring these forms  
          and notices to be translated in the same threshold languages as  
          required for Medi-Cal managed care plans.

          ANALYSIS: 
          
          Existing law:









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          1)Requires a single, accessible, standardized paper, electronic,  
            and telephone application for insurance affordability programs  
            to be developed by the Department of Health Care Services  
            (DHCS) in consultation with the Covered California board, as  
            part of a stakeholder process.

          2)Requires the application to be used by all entities authorized  
            to make an eligibility determination for any of the insurance  
            affordability programs and by their agents.

          3)Permits DHCS to develop and require the use of supplemental  
            forms to collect additional information needed to determine  
            eligibility on a basis other than Modified Adjusted Gross  
            Income. 

          4)Establishes requirements for the required forms, including  
            using simple, user-friendly language and instructions, and to  
            only require necessary information. Requires notices developed  
            under the above-described provisions to be accessible and  
            standardized, as appropriate, and to comply with federal and  
            state laws, regulations, and guidance prohibiting  
            discrimination, to be developed using plain language and to be  
            provided in a manner that affords meaningful access to  
            limited-English-proficient (LEP) individuals, in accordance  
            with applicable state and federal law, and at a minimum,  
            provided in the same threshold languages as required for  
            Medi-Cal managed care plans.

          This bill defines "forms and notices" for purposes of existing  
          requirements for insurance affordability program-related  
          application forms and notices to mean application and renewal  
          forms and notices of action needed to obtain or retain  
          eligibility, benefits, or services from an insurance  
          affordability program, thereby requiring these forms and notices  
          to be translated in the same threshold languages as required for  
          Medi-Cal managed care plans.

          Background
          
          AB 1296 (Bonilla, Chapter 641, Statutes of 2011), the Health  
          Care Eligibility, Enrollment, and Retention Act, requires the  
          California Health and Human Services Agency, in consultation  
          with other state departments and stakeholders, to undertake a  
          planning process to develop plans and procedures regarding these  







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          provisions relating to enrollment in state health programs and  
          federal law. AB 1296 also established the existing law  
          requirements for the application form for insurance  
          affordability programs, which are Medi-Cal and coverage with  
          premium or cost-sharing subsidies in Covered California.

          In 2014, a lawsuit was filed alleging that DHCS failed, among  
          other requirements, to perform its duty to translate the 2014  
          redetermination forms in the Medi-Cal threshold languages. The  
          petitioners contended that DHCS is responsible for ensuring  
          languages access in the Medi-Cal program pursuant to Title VI of  
          the federal Civil Rights Act of 1964, Government Code Section  
          11135, and California's Dymally-Alatorre Bilingual Services Act,  
          and that DHCS translated redetermination forms into the eleven  
          written Medi-Cal threshold languages in prior years. The  
          petitioners sought an injunction preventing DHCS from  
          terminating any Medi-Cal benefits until the 2014 redetermination  
          forms were translated into the eleven threshold languages and  
          sent to beneficiaries. 

          The court denied the request for a preliminary injunction,  
          finding that the Dymally-Alatorre Bilingual Services Act  
          provided an alternative to translation of the redetermination  
          forms through the use of translation aids, translation guides or  
          through the use of qualified bilingual individuals. The court  
          also found that the requirements governing Medi-Cal  
          redetermination forms were in a code section separate from the  
          provisions of Health Care Eligibility, Enrollment, and Retention  
          Act. The court stated that if the Legislature wanted to mandate  
          translation of redetermination forms into threshold languages  
          for LEP individuals, it could have included such language in the  
          redetermination statute rather than simply requiring such  
          redetermination forms and notices to be "accessible" to LEP  
          individuals.

          Comments
          
          Author's statement. According to the author, language is a  
          significant barrier to health care access and coverage for many  
          Californians statewide. Forty percent of Medi-Cal members speak  
          a language other than English, with 500,000 of those members  
          speaking a language other than Spanish. This bill will help  
          ensure that those who have limited proficiency in English will  
          not only be able to access health care through Medi-Cal and  







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          Covered California, but can continue to renew their coverage and  
          understand their notices to receive the care necessary for their  
          health and well-being.

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

          According to the Senate Appropriations Committee, unknown costs  
          to make programmatic changes to information technology systems  
          (General Fund, federal funds, special fund). Through the  
          California Healthcare Eligibility, Enrollment, and Retention  
          System (CalHEERS) system, eligibility determinations and  
          notifications for Medi-Cal and Covered California are largely  
          automated. Currently, CalHEERs has only been programmed to issue  
          redetermination forms or notices of action in English or Spanish  
          (depending on the applicant's stated language preference). In  
          order to issue redetermination forms, notices of action, and  
          other documents in the applicant/enrollee's language of  
          preference, the CalHEERs system will need programming changes.


          SUPPORT:   (Verified8/31/15)


          Western Center on Law and Poverty (source)
          Alameda Health Consortium
          American Federation of State, County and Municipal Employees
          Asian Americans Advancing Justice - Los Angeles
          Asian Law Alliance
          California Pan-Ethnic Health Network
          California Primary Care Association
          Community Clinic Association of Los Angeles County
          Community Health Councils, Inc.
          Consumers Union
          Health Access 
          Justice in Aging
          National Health Law Program
          National Immigration Law Center
          Project Inform
          Southeast Asian Resource Action Center


          OPPOSITION:   (Verified8/31/15)








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          Department of Finance

          ARGUMENTS IN SUPPORT:     This bill is sponsored by Western  
          Center on Law and Poverty (WCLP) and supported by other consumer  
          groups to clarify that Medi-Cal and Covered California renewal  
          forms and notices must be translated into and issued in the  
          thirteen Medi-Cal threshold languages. WCLP states California's  
          population is incredibly diverse racially, culturally and  
          linguistically. WCLP states Medi-Cal has a tradition of  
          translating its vital documents including applications, renewal  
          forms and notices of action into the Medi-Cal threshold  
          languages to provide needed language access for its diverse LEP  
          members. 

          Prior to adoption of the Affordable Care Act (ACA) the Medi-Cal  
          annual redetermination forms were translated into the Medi-Cal  
          threshold languages. When the state developed its joint paper  
          health care application for Medi-Cal and Covered California in  
          2013, that application was similarly translated into all the  
          threshold languages. However, in 2014 neither Medi-Cal nor  
          Covered California redetermination forms or notices nor notices  
          of action were issued into languages other than Spanish. The  
          2015 Medi-Cal pre-populated renewal form was translated into the  
          threshold languages and issued in January 2013 but it has not  
          yet been programmed and put into use. WCLP states the result is  
          that, while the single streamlined application asks applicants  
          what their preferred written language is and the state has a  
          record of this language, forms and notices have not been sent in  
          the applicants' language. WCLP believes existing law was  
          intended to require translation of the renewal form, but neither  
          the Medi-Cal nor Covered California renewal forms or notices  
          were translated into the threshold languages in 2014 and DHCS  
          has given conflicting accounts of whether it believes it is  
          obligated to do so. WCLP is sponsoring this clarification that  
          "forms and notices" requiring translation include renewal forms  
          and all forms and notices related to either eligibility or  
          benefits as its local legal services partners have been helping  
          consumers who cannot understand the termination notices they  
          receive because they did not understand any of the requests for  
          information they were sent and did not understand what they  
          needed to do to keep their health coverage. This creates undue  
          stress for beneficiaries and missed appointments or  
          prescriptions.







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          ARGUMENTS IN OPPOSITION:     The Department of Finance (DOF)  
          writes in opposition to the prior version of this bill that this  
          bill would result in costs not included in the current fiscal  
          plan and because of its impact on the CalHEERS and the Statewide  
          Automated Welfare System systems (CalHEERS and SAWs are the  
          Covered California and Medi-Cal eligibility computer systems).  
          DOF argues introducing new requirements to CalHEERS and SAWS is  
          not prudent at this time given the significant workload to  
          update these systems for requirements related to the ACA.


          ASSEMBLY FLOOR:  79-0, 6/1/15
          AYES:  Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom,  
            Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang,  
            Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle,  
            Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina  
            Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, 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,  
            Waldron, Weber, Wilk, Williams, Wood, Atkins
          NO VOTE RECORDED:  Wagner

          Prepared by:Scott Bain / HEALTH / 
          9/1/15 21:20:00


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