BILL ANALYSIS Ó
AB 1117
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ASSEMBLY THIRD READING
AB
1117 (Cristina Garcia)
As Amended June 1, 2015
Majority vote
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|Committee |Votes |Ayes |Noes |
| | | | |
| | | | |
|----------------+------+---------------------+---------------------|
|Health |18-0 |Bonta, Maienschein, | |
| | |Bonilla, Burke, | |
| | |Chávez, Chiu, Gomez, | |
| | |Gonzalez, Roger | |
| | |Hernández, Lackey, | |
| | |Nazarian, Patterson, | |
| | |Ridley-Thomas, | |
| | |Rodriguez, Santiago, | |
| | |Steinorth, Thurmond, | |
| | |Wood | |
| | | | |
|----------------+------+---------------------+---------------------|
|Appropriations |13-1 |Gomez, Bonta, |Bigelow |
| | |Calderon, Chang, | |
| | |Daly, Eggman, | |
| | |Eduardo Garcia, | |
| | |Gordon, Holden, | |
| | |Quirk, Rendon, | |
| | |Weber, Wood | |
| | | | |
| | | | |
AB 1117
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SUMMARY: Establishes a pilot program in Medi-Cal to reward
Medi-Cal managed care organizations (MCOs) and providers for
vaccinating children younger than two years of age. Specifically,
this bill:
1)Directs the Department of Health Care Services (DHCS) to
establish and administer the California Childhood Immunization
Quality Improvement Fund (CCIQIF).
2)Requires DHCS to apply to the Federal Centers for Medicare and
Medicaid Services for a waiver or demonstration project to
implement the CCIQIF within 270 days of the enactment of this
bill.
3)Requires DHCS to consult with stakeholders including the
Medi-Cal Children's Health Advisory Panel and the Managed Care
Advisory workgroup.
4)Directs DHCS to finance the program with voluntary contributions
from MCOs which must be used to draw down federal match for the
program.
5)Provides the demonstration project shall be implemented only if
federal financial participation is available and any necessary
federal approvals have been obtained.
FISCAL EFFECT: According to the Assembly Appropriations
Committee:
1)DHCS would incur costs in the range of low hundreds of thousands
of dollars (program revenues/federal funds), to develop and seek
federal approval for a program. The annual administrative costs
would be of a similar magnitude.
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2)It is unclear precisely how much funding would be raised. A
successful incentive program could be about $30 million per year
(program revenues/federal funds), with $10 million allocated to
provider support.
COMMENTS: According to the author, Medi-Cal health plans and
providers need greater investments and supports to provide the
quality health care services that they are required to deliver to
young children and that parents and taxpayers deserve. The author
argues this bill would bring additional resources to the health
care system to help improve California's relatively low
vaccination rates for two-year-olds, without impacting parents'
ability to make decisions about their children's health care. The
author notes there is no existing law to incentivize Medi-Cal
managed care plans and providers to fully immunize two-year-olds,
and as a result, Medi-Cal has been chronically plagued by low
childhood immunization rates resulting in inefficient use of
public monies and creating a serious public health risk, as
demonstrated by the recent whooping cough and measles outbreaks.
According to the Centers for Disease Control and Prevention,
vaccines contain the same antigens or parts of antigens that cause
diseases, but the antigens in vaccines are either killed or
greatly weakened. Vaccine antigens are not strong enough to cause
disease, but they are strong enough to make the immune system
produce antibodies against them. Memory cells prevent
re-infection when they encounter that disease again in the future.
Vaccines are responsible for the control of many infectious
diseases that were once common around the world, including polio,
measles, diphtheria, pertussis (whooping cough), rubella (German
measles), mumps, tetanus, and Hepatitis b. Vaccine eradicated
smallpox, one of the most devastating diseases in history. Over
the years, vaccines have prevented countless cases of infectious
diseases and saved literally millions of lives.
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California children are required to be fully vaccinated before
they enter kindergarten, with some exceptions. However, there are
no official requirements for younger children, who are often more
susceptible to dire consequences from vaccine-preventable diseases
due to their immature immune systems.
Supporters note that vaccination rates for kids are not as high as
they need to be, posing a risk for all children. They point to
the risk of failing to vaccinate children by the 11,000 cases of
pertussis in California in 2014 and the more recent measles
outbreak in Disneyland. Supporters point out that although there
are requirements for children to be vaccinated prior to going to
school, there are no official requirements for younger children
who often are more susceptible to dire consequences from
infectious diseases because of their immature immunes systems.
Supporters add that other states, such as New York, Louisiana, and
Maine have had successful programs to increase vaccination rates
in young children.
A number of individuals are opposed to this bill.
Analysis Prepared by:
Roger Dunstan / HEALTH / (916) 319-2097 FN:
0000843
AB 1117
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