BILL ANALYSIS                                                                                                                                                                                                    



                                                                    AB 1432


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          Date of Hearing:  April 15, 2015


                        ASSEMBLY COMMITTEE ON APPROPRIATIONS


                                 Jimmy Gomez, Chair


          AB  
          1432 (Bonta) - As Amended March 26, 2015


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          Urgency:  No  State Mandated Local Program:  NoReimbursable:  No


          SUMMARY:


          This bill requires the Department of Health Care Services (DHCS)  
          to: 










                                                                    AB 1432


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             1)   Submit an application to the federal Centers for  
               Medicare and Medicaid Services (CMS) for a waiver to  
               implement a demonstration project to improve care for  
               communities and consumers with substance abuse disorders  
               and co-occurring disorders.


             2)   Submit an implementation plan to the Legislature prior  
               to implementing an approved waiver.  


          FISCAL EFFECT:


          This bill in its current form does not result in additional  
          state costs.  DHCS is already incurring staff costs for  
          development of a waiver related to substance abuse and  
          co-occurring disorders. However, if the bill is amended to  
          include specific waiver provisions, such provisions are likely  
          to have significant fiscal effects.  


          COMMENTS:


          1)Purpose. The author believes this bill is necessary to ensure  
            the provisions of a waiver amendment, an amendment currently  
            being sought by DHCS to improve the Drug Medi-Cal (DMC)  
            delivery system, has needed legislative authority and  
            oversight.


          2)DMC. Drug Medi-Cal services currently include limited  
            residential treatment, outpatient counseling, and narcotic  
            treatment (primarily methadone maintenance treatment for  
            opioid addition).  An effort is underway at DHCS to enhance  
            and better organize services, providing a continuum of care  
            for substance use and co-occurring disorders.   To this end,  
            on November 21, 2014, DHCS submitted a proposal to amend the  








                                                                    AB 1432


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            Special Terms and Conditions of California's current Section  
            1115 "Bridge to Reform" Waiver.  California's DMC Organized  
            Delivery System (DMC-ODS) 1115 demonstration waiver amendment  
            provides a nationally recognized continuum of care model and  
            would implement, on a county opt-in basis, local coordinated  
            delivery systems for substance use services.


          3)Related Legislation. AB 72 (Bonta and Atkins), also being  
            heard today in committee, requires DHCS to submit an  
            application to CMS for a comprehensive new waiver addressing  
            various aspects of the Medi-Cal program.  These bills do not  
            conflict.


          Analysis Prepared by:Lisa Murawski / APPR. / (916) 319-2081