BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: AB 1568
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|AUTHOR: |Bonta and Atkins |
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|VERSION: |June 2, 2016 |
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|HEARING DATE: |June 8, 2016 | | |
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|CONSULTANT: |Scott Bain |
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SUBJECT : Medi-Cal: demonstration project
SUMMARY : Enacts specified statutory provisions of "Medi-Cal 2020," the
state's recently approved five-year federal Section 1115 waiver,
which runs through December 31, 2020, including the Dental
Transformation Initiative, the Whole Person Care program and the
evaluations required under the Special Terms of Conditions
(STCs) of Medi-Cal 2020. Requires the Department of Health Care
Services to conduct or arrange to have conducted studies,
reports and assessments required under the STCs. Urgency bill.
Existing law:
1)Establishes the Medi-Cal program, which is administered by the
Department of Health Care Services (DHCS) and under which
qualified low-income persons receive health care benefits.
Emergency and essential diagnostic and restorative dental
services are part of the covered benefits of the Denti-Cal
program.
2)Establishes a Medicaid Section 1115 demonstration project
under the Medi-Cal program until October 31, 2015 known as
California's Bridge to Reform, to implement specified
objectives, including better care coordination for Seniors and
Persons with Disabilities (SPDs) and maximization of
opportunities to reduce the number of uninsured individuals.
3)Provides for payments under the state's Bridge to Reform
waiver to designated public hospitals (DPHs are the University
of California [UC] and county hospitals), and for federal
disproportionate share (DSH), payments to private hospitals
(referred to as "DSH replacement payments") and non-designated
public hospitals (NDPHs are now referred to as
District/Municipal Public Hospitals or DMPH) through October
AB 1568 (Bonta) Page 2 of ?
1, 2015.
This bill:
1)Requires DHCS to establish and operate the Whole Person Care
(WPC) pilot program as authorized under Medi-Cal 2020 to allow
for development of WPC pilots focused on target populations of
high-risk, high-utilizing Medi-Cal beneficiaries in local
geographic areas.
2)Establishes as the goal of WPC is the coordination of health,
behavioral health, and social services, as applicable, in a
patient-centered manner to improve beneficiary health and
well-being through more efficient and effective use of
resources.
3)Requires WPC pilots to provide an option to a county, city and
county, a health or hospital authority or a consortium of any
of these entities to receive support to integrate care for
particularly vulnerable Medi-Cal beneficiaries who have been
identified as high users of multiple systems and who continue
to have or are at-risk of poor health outcomes.
4)Defines the WPC target population as the population or
populations identified by a WPC pilot through a collaborative
data approach across partnering entities that identifies
common Medi-Cal high-risk, high-utilizing beneficiaries who
frequently access urgent and emergency services, including
across multiple systems. Permits, at the discretion of the WPC
lead entity, and in accordance with guidance as may be issued
by DHCS during the application process and approved by DHCS,
the WPC target population to include individuals who are not
Medi-Cal patients, subject to the funding restrictions in the
STCs regarding the availability of FFP for services provided
to these individuals.
5)Requires WPC pilots to include specific strategies to increase
integration among local governmental agencies, health plans,
providers, and other entities that serve high-risk,
high-utilizing beneficiaries, increase coordination and
appropriate access to care, reduce inappropriate inpatient and
emergency room utilization, improve data collection and
sharing among local entities, improve health outcomes for the
WPC target population and permits it to include other
strategies to increase access to housing and supportive
services.
AB 1568 (Bonta) Page 3 of ?
6)Requires WPC pilots to be approved by DHCS through the process
outlined in the STCs.
7)Makes receipt of WPC services voluntary, and permits
beneficiaries to opt out at any time.
8)Requires the WPC lead entity to be responsible for operating
the WPC pilot, conducting ongoing monitoring of WPC
participating entities, arranging for the required reporting,
ensuring an appropriate financial structure is in place, and
identifying and securing a permissible source of the
nonfederal share for WPC pilot payments.
9)Requires each WPC pilot to include, at a minimum, all of the
following entities as WPC participating entities in addition
to the WPC lead entity:
a) At least one Medi-Cal managed care plan operating
in the geographic area of the WPC pilot;
b) The health services agency or agencies or
department or departments for the geographic region
where the WPC pilot operates, or any other public entity
operating in that capacity for the county or city and
county;
c) The local entities, agencies, or departments
responsible for specialty mental health services for the
geographic area where the WPC pilot operates;
d) At least one other public agency or department,
which may include, but is not limited to, county alcohol
and substance use disorder programs, human services
agencies, public health departments, criminal justice or
probation entities, and housing authorities, regardless
of how many of these fall under the same agency head
within the geographic area where the WPC pilot operates;
and,
e) At least two other community partners serving the
target population within the applicable geographic area.
1)Permits a WPC lead entity to request an exemption from this
requirement from DHCS if a WPC lead entity cannot reach an
agreement with a required participant.
2)Requires DHCS to enter into a pilot agreement with each WPC
lead entity approved for participation in the WPC pilot
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program.
3)Permits the sharing of health information, records, and other
data with and among WPC lead entities, and allows WPC
participating entities to share health information, records,
and other data with and among prospective WPC lead entities
and WPC participating entities in the process of identifying a
proposed target population and preparing an application for a
WPC pilot.
4)Permits WPC pilots to target the focus of their pilot on
individuals at risk of or are experiencing homelessness who
have a demonstrated medical need for housing or supportive
services. Requires, in these instances, WPC participating
entities to include local housing authorities, local continuum
of care programs, community-based organizations, and others
serving the homeless population as entities collaborating and
participating in the WPC pilot.
5)Permits the housing interventions to include tenancy-based
care management services, defined as supports to assist the
target population in locating and maintaining medically
necessary housing, and countywide housing pools.
6)Permits WPC participating entities to include contributions to
a countywide housing pool that will directly provide needed
support for medically necessary housing services, with the
goal of improving access to housing and reducing churn in the
Medi-Cal population.
7)Requires payments to WPC pilots to be disbursed twice a year
to the WPC lead entity following the submission of required
reports.
8)Requires DHCS to issue a WPC pilot application and selection
criteria consistent with the STCs, requires DHCS to approve
applicants that meet the WPC pilot selection criteria
established by DHCS, and requires DHCS to allocate available
funding to those approved WPC pilots up to the full amount of
FFP authorized under the demonstration project for WPC pilots
during each calendar year from 2016 to 2020.
9)Requires that payments to the WPC pilot are intended to
support infrastructure to integrate services among local
entities that serve the WPC target population, to support the
AB 1568 (Bonta) Page 5 of ?
availability of services not otherwise covered or directly
reimbursed by Medi-Cal to improve care for the WPC target
population, and to foster other strategies to improve
integration, reduce unnecessary utilization of health care
services, and improve health outcomes.
10)Requires WPC lead entities to submit mid-year and annual
reports to DHCS, in accordance with the schedules and
guidelines established by DHCS and consistent with the STCs.
11)Requires the nonfederal share of any payments under the WPC
pilot program to consist of voluntary IGTs of funds provided
by participating governmental agencies or entities, in
accordance with this bill and the terms of the pilot
agreement.
12)Requires DHCS to claim FFP for WPC pilot payments using
moneys from the IGTs and FFP, and requires moneys disbursed
from the fund, and all associated FFP to be distributed to WPC
lead entities.
13)Requires DHCS to implement the Dental Transformation
Initiative (DTI) in accordance with the STCs, with the goal of
improving the oral health care for Medi-Cal children zero to
20, inclusive, years of age.
14)Establishes as the purpose of the DTI is to improve the oral
health care for Medi-Cal children with a particular focus on
increasing the statewide proportion of qualifying children
enrolled in the Medi-Cal Dental Program who receive a
preventive dental service by 10 percentage points over a
five-year period.
15)Requires the DTI to include the following four domains as
outlined in the STCs:
a) Increase Preventive Services Utilization for
Children;
b) Caries Risk Assessment and Disease Management Pilot;
c) Increase continuity of care; and,
d) Local Dental Pilot Projects (LDPPs).
1)Requires, under the DTI, incentive payments within each domain
to be available to qualified providers who meet the
AB 1568 (Bonta) Page 6 of ?
requirements of the domain.
2)Requires the DTI to be funded at a maximum of $148 million
annually, and for five years totaling a maximum of $740
million, except as provided in the STCs. Permits unspent funds
to be rolled over to subsequent years.
3)Permits DHCS to earn additional demonstration authority, up to
a maximum of $10 million to be added to the DTI Pool for use
in paying incentives to qualifying providers under DTI by
achieving higher performance improvement, as indicated in the
STCs.
4)Permits providers in either the dental FFS or dental managed
care Medi-Cal delivery systems to participate in the DTI.
5)Requires DHCS to make DTI incentive payments directly to
eligible contracted service office locations.
6)Requires incentive payments to be issued to the service office
location based on the services rendered at the location and
that service office location's compliance with the criteria
enumerated in the STCs.
7)Requires that incentive payments from the DTI Pool are
intended to support and reward eligible service office
locations for achievements within one or more of the project
domains. Prohibits incentive payments from being considered as
a direct reimbursement for dental services under Medi-Cal.
8)Requires service office locations to submit all data in a
manner acceptable to DHCS within one year from the date of
service or by January 31 for the preceding year that the
service was rendered, whichever occurs sooner, to be eligible
for DTI incentive payments associated with that timeframe.
9)Permits DHCS to implement this bill or the STCs by means of
letters or bulletins without taking regulatory action.
Requires notification to the Joint Legislative Budget
Committee and to the Senate Committees on Appropriations,
Budget and Fiscal Review, and Health, and the
Assembly Committees on Appropriations, Budget, and Health within
10 business days after the above-described action is taken.
10)Permits DHCS to enter into exclusive or nonexclusive
AB 1568 (Bonta) Page 7 of ?
contracts or amend existing contracts on a bid or negotiated
basis. Exempts these contracts from specified provisions of
the Public Contract Code and Department of General Services
(DGS) review.
11)Requires DHCS to seek any federal approval as necessary to
implement Medi-Cal 2020, this bill and any changes to the STCs
as deemed necessary. Implements this only to the extent
federal financial participation (FFP) is available and is not
otherwise jeopardized.
12)Permits the DHCS director to modify any process or
methodology in this bill to the extent necessary to comply
with federal law or the STCs, but only if the modification is
consistent with the goals of this bill.
13)Requires the DHCS director develop a methodology by which
payments under Medi-Cal 2020 are reduced if the amount of FFP
is reduced due to the application of penalties in the STC, the
enforcement of the budget neutrality limit or other similar
occurrence.
14)Permits DHCS to claim FFP for expenditures associated with
designated state health programs (DSHP) identified in the
STCs.
15)Establishes the continuously appropriated WPC Pilot Special
Fund in the State Treasury.
16)Requires DHCS to conduct or arrange to have conducted any
study, report, assessment, evaluation or other similar
demonstration project activity required under the STCs,
including
the two evaluations of the Global Payment Program, the PRIME
evaluation, the WPC evaluations, and the DTI evaluation.
17)Makes this bill operative contingent upon the enactment of SB
815 (Hernandez and DeLeon).
18)Would take effect immediately as an urgency statute
FISCAL
EFFECT : According to the Assembly Appropriations Committee of
the previous version of this bill:
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1)DHCS has requested administrative resources through an April
2016 Spring Finance Letter totaling $33.6 million for waiver
implementation over its five-year lifetime, $14 million of
which is for contract costs. DHCS requests $10.8 million in
2016-17. Funding will pay for staff and contract costs for
implementation, monitoring, oversight, evaluation and
assessment, technical assistance, program development, and
related activities (General Fund/federal).
2)Federal matching funds available by waiver program component
are as follows:
PRIME $3.73 billion
Global Payment Program $236 million*
Dental Transformation Initiative $375 million
Designated State Health Programs$375 million
Whole Person Care $1.5 billion
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Total $6.21 billion
*GPP does not include the federal DSH component of funding.
Federal DSH funding over the five-year life of the waiver is
projected to be about $5.8 billion. In addition, only the
first year of federal funding for GPP is shown here. Funding
in subsequent years is based on a study on DPH uncompensated
care.
PRIOR
VOTES :
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|Assembly Floor: |80 - 0 |
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|Assembly Appropriations Committee: |20 - 0 |
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|Assembly Health Committee: |17 - 0 |
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COMMENTS :
1)Author's statement. According to the author, this bill is
needed to provide the statutory framework for implementation
AB 1568 (Bonta) Page 9 of ?
of "Medi-Cal 2020." While the STCs outline the programmatic
and financing elements of Medi-Cal 2020, state law changes are
required, to appropriate funds for the waiver-related WPC
provisions, to enable data sharing as part of WPC projects,
and to codify the provisions of the STCs establishing the DTI
and the WPC. In addition, this bill would require DHCS to
conduct or contract for the waiver-required evaluations. This
bill is a companion measure to SB 815 (Hernandez and De Leon).
2)Federal Section 1115 Medicaid Waivers. Section 1115 of the
Social Security Act authorizes the federal Secretary of Health
and Human Services to allow states to receive federal Medicaid
matching funds without complying with all of the federal
Medicaid rules. Traditionally designed as research and
demonstration programs to test innovative program improvements
and to facilitate coverage expansions to populations not
otherwise eligible for Medicaid, waivers are also used to
allow states to change how services are delivered, and to
change how services are reimbursed. In addition, under Section
1115, states are allowed to use federal Medicaid funds in ways
that are not otherwise allowed under federal law and
regulation (referred to expenditure authority for "costs not
otherwise matchable" or CNOM).
Section 1115 waivers are approved at the discretion of the
Secretary of HHS through negotiations between a state and CMS
for projects that the Secretary determines promote Medicaid
program objectives. Section 1115 waivers are generally
approved for a five-year period and then must be renewed.
Although not required by statute or regulation, longstanding
federal administrative policy has required waivers to be
"budget neutral" for the federal government, meaning that
federal spending under a waiver must not be more than
projected federal spending in the state without the waiver.
On December 30, 2015, DHCS received CMS approval of
"California Medi-Cal 2020 Demonstration" (Medi-Cal 2020). The
five year waiver begins January 1, 2016 and ends December 31,
2020. Medi-Cal 2020 is anticipated to provide $6.2 billion in
federal funds over the five years of the waiver.
3)DTI. The DTI is a new feature of Medi-Cal 2020. It is funded
at $750 million total funds ($375 million in federal funds)
generated from federal waiver funding drawn down for
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Designated State Health Programs. Of this amount, $10 million
in total funds is contingent upon the state meeting statewide
metrics. DTI consists of four domain areas as follows:
a) Domain 1: Increase Preventive Services Utilization
for Children. The goal of this domain is to increase
statewide proportion of children ages 20 and under
enrolled in Medi-Cal who receive a preventive dental
service by 10 percentage points over a five-year period
(the 2014 rate for children was 37.84%). Incentive
payments will be made annually to providers for
utilization and provider participation and will be used
to determine the subsequent year's threshold. Semi-annual
incentive payments will be made to dental provider
service locations that provide preventative services to
an increased number of Medi-Cal children, as compared to
the DHCS-determined baseline. Incentive payments will be
made to the service office locations for rendered
preventive services once they have met the
DHCS-established goal. As of September 2015, there were
5,370 service office locations in California that
participated in Denti-Cal.
b) Domain 2: Caries Risk Assessment and Disease
Management. The goal of this domain is to diagnose early
childhood caries (cavities) by utilizing Caries Risk
Assessments (CRA) to treat caries as a chronic disease
for children ages six and under. The CRA would be a model
that proactively prevents and mitigates oral disease
through the delivery of preventative services in lieu of
more invasive and costly procedures (restorative
services). Children will have treatment plans prescribed
based on caries risk level. DHCS will use a baseline year
with statewide data for the most recent state fiscal year
preceding implementation of the domain. DHCS will track
and report the following measures:
i. Number of, and percentage change in,
restorative services;
ii. Number of, and percentage change in,
preventive dental services;
iii. Utilization of CRA CDT codes and
reduction of caries risk levels (not available in
the baseline year prior to the waiver
implementation);
AB 1568 (Bonta) Page 11 of ?
iv. Change in use of emergency rooms for
dental-related reasons among the targeted
children for this domain; and,
v. Change in number and proportion of
children receiving dental surgery under general
anesthesia.
Dentists must opt-in by completing a DHCS recognized
training program. Treatment plans and associated procedures
will be carried out as follows, over a 12 month period, as
follows:
i. "high risk" children will be
authorized to visit four times;
ii. "moderate risk" children will be
authorized to visit three times; and,
iii. "low risk" children will be
authorized to visit two times.
Incentive payments will be made to providers for successful
completion of caries treatment plan and improvement in
"elevated risk" levels.
a) Domain 3: Increase Continuity of Care. The goal of this
domain is to increase continuity of care for beneficiaries
ages 20 and under for two, three, four, five, and six
continuous periods. DHCS will establish a baseline year
will be based on data from the most recent complete state
fiscal year using claims data to determine the number of
beneficiaries who received an examination each year from
the same service office location for two, three, four,
five, and six year continuous periods. Incentive payments
will be available to service office locations that provide
examinations to an enrolled Medi-Cal child for two, three,
four, five, and six continuous periods. The incentive
payment will be an annual flat payment for providing
continuity of care to the beneficiary.
b) Domain 4: Local Dental Pilot Programs (LDPPs). LDPPS
will address one or more of the three domains through
alternative programs, potentially using strategies focused
on rural areas including local case management initiatives
and education partnerships. DHCS will solicit proposals
once at the beginning of the demonstration and will review,
approve, and make payments for LDPPs in accordance with the
AB 1568 (Bonta) Page 12 of ?
requirements stipulated in the waiver. A maximum of 15
LDPPs will be approved, and no more than 25% of the total
funding in the DTI pool can be used for LDPPs. The specific
strategies, target populations, payment methodologies, and
participating entities will be proposed by the entity
submitting the application for participation and included
in the submission to DHCS. Each pilot application must
designate a responsible county, Tribe, Indian Health
Program, UC or CSU campus as the entity that will
coordinate the pilot.
1)WPC. WPC is a new feature of Medi-Cal 2020. WPC is essentially
a grant program over the five years of the waiver. The
overarching goal of the WPC pilots is the coordination of
health, behavioral health, and social services, as applicable,
in a patient-centered manner with the goals of improved
beneficiary health and well-being through more efficient and
effective use of resources. WPC pilots will provide an option
to participating entities to receive support to integrate care
for beneficiaries who are high-risk and high-utilizers of
multiple systems and continue to have poor health outcomes.
WPC pilots will include collaboration between two or more
public entities (e.g. county mental health plans and local
housing authorities), at least one Medi-Cal managed care
health plan, and other community entities with the goal of
improving health outcomes for the WPC population. Program
strategies would include increasing integration, data sharing
and coordination among county agencies, health plans,
providers, and other entities within the participating county
or counties that serve high-risk, high-utilizing beneficiaries
and develop an infrastructure that will reduce inappropriate
emergency and inpatient utilization, increase coordination and
appropriate access to care and increase collaboration and
integration among the entities participating in the WPC Pilots
over the long term. The WPC target populations, include, but
are not limited to individuals:
a) With repeated incidents of avoidable emergency use,
hospital admissions, or nursing facility placement;
b) With two or more chronic conditions;
c) With mental health and/or substance use disorders;
d) Who are currently experiencing homelessness; and/or,
e) Who are at risk of homelessness, including
individuals who will experience homelessness upon release
AB 1568 (Bonta) Page 13 of ?
from institutions (e.g. hospital, skilled nursing
facility, rehabilitation facility, jail/prison, etc.)
To test interventions that achieve these improved health
outcomes and cost savings, WPC Pilots may focus on Medi-Cal
beneficiaries with a demonstrated medical need for housing and
supportive services. These Pilots would ensure that the
entities collaborating and participating in the Pilot would
include local housing authorities, community-based
organizations, and others serving the homeless population. WPC
pilots with a focus on housing may include interventions such
as tenancy-based care management services and county housing
pools.
Up to $300 million in federal funding is available annually
for WPC. No single WPC pilot will be awarded more than 30% of
total available funding unless additional funds are available
after all initial awards are made. The non-federal share of
funds used to draw down federal funding is through IGTs.
The STCs establish an early implementation schedule for WPC.
DHCS is required to publish a WPC pilot application process,
detailed timeliness and selection criteria by April 1, 2016,
or within 90 days following CMS approval of WPC Pilot
attachments, whichever is later. WPC lead entities must submit
WPC Pilot applications to DHCS by May 15, 2016, or 45 days
after DHCS issues the WPC Pilot application process (whichever
is later). DHCS must complete its review of the application
within 60 days of submission, and will respond to the WPC
Pilot Lead Entity in writing with any questions, concerns or
problems identified. Within 30 days after submission of final
responses to questions about the application, DHCS will take
action on the application and promptly notify the applicant
and CMS of that decision.
1)Waiver required reports, assessments and analyses. The Waiver
also contains several independent analyses of the Medi-Cal
program and evaluations of the Waiver programs, including:
a) Medi-Cal Managed Care Access Assessment (language
contained in SB 815);
b) Uncompensated Care Assessments for California hospitals
(one due in 2016 and one due one in 2017);
c) GPP Evaluations (2 required);
d) PRIME Evaluation; and,
AB 1568 (Bonta) Page 14 of ?
e) Report on CCS pilots
This bill requires DHCS to conduct or arrange to have
conducted any study, report, assessment, evaluation or other
similar demonstration project activity required under the
STCs.
1)Related legislation. SB 815 (Hernandez and De Leon), is a
companion measure to this bill currently pending in the
Assembly Health Committee. The Medi-Cal 2020 waiver includes
four major components: GPP, PRIME, WPC, and DTI. SB 815 bill
contains the provisions implementing the GPP and PRIME and the
access assessment requirements while AB 1568 contains the WPC
and DTI provisions, including all the required evaluations of
the four waiver components. SB 815 is scheduled to be heard in
the Assembly Health Committee on June 8, 2016.
2)Prior legislation.
a) SB 36 (Hernandez and De Leon, Chapter 759, Statutes
of 2015), authorized DHCS to request one or more
temporary waiver extensions to continue the operation of,
and the authorities provided under, the current
"California Bridge to Reform Demonstration," the state's
Section 1115 Medicaid waiver. Requires DHCS to extend and
apply the existing hospital payment methodologies and
allocations on a state fiscal year, annual, partial year,
or other basis, to the extent permitted under any
approved temporary waiver extension, an approved
subsequent waiver, or as otherwise permitted under
federal Medicaid law.
b) AB 1066 (John A. Pérez, Chapter 86, Statutes of
2011), made further statutory changes to implement the
Bridge to Reform for funding DPHs. AB 1066 continued the
FFS cost-based reimbursement for DPHs, with those
hospitals providing the required federal match using
their own funds through CPEs. In addition, AB 1066
established under the waiver a new distribution
methodology for DSH and SNCP funds to DPHs, as specified.
c) AB 342 (John A. Pérez, Chapter 723, Statutes of
2010), enacted the LIHP to provide health care benefits
to uninsured adults up to 200% of the FPL, at county
option through a Medi-Cal waiver demonstration project.
AB 1568 (Bonta) Page 15 of ?
d) SB 208 (Steinberg, Chapter 714, Statutes of 2010),
implemented provisions of the 2010 Section 1115 waiver
including establishing the Public Hospital Investment,
Improvement and Incentive Fund (known as DRSIP)
consisting of IGTs from counties or other specified
governmental entities, to be matched with federal funds
and to be used for investment, improvement and incentive
payments for DPHs and the affiliated governmental
entities (counties and UC); authorized DHCS to require
the mandatory enrollment of SPDs in a Medi-Cal managed
care plan commencing on the later of either June 1, 2011,
or obtaining federal approval; and requires DHCS to
implement pilot projects to provide coordinated care to
children in CCS and to persons who are dually eligible
for Medi-Cal and Medicare.
e) SB 1100 (Perata, Chapter 560, Statutes of 2005),
enacted the statutory framework for implementing a
five-year waiver of federal Medicaid requirements that
provides federal Medicaid funding under the terms of the
waiver to pay DPHs, private, and district hospitals for
services provided to Medi-Cal and uninsured patients.
3)Support. This bill is supported by hospitals and consumer and
labor groups, which write in support of the $6.2 billion in
federal funds and the new waiver funding components, including
PRIME, GPP and WPC. The California State Association of
Counties (CSAC) states that the WPC Pilots will test new care
innovations and leverage lessons learned to improve outcomes;
contain costs; and more effectively coordinate care beyond
traditional health services. CSAC concludes that the Medi-Cal
2020 Waiver renewal is a strong and ambitious blueprint for
building on the success of the Medi-Cal program and its
continued transformation.
Western Center on Law & Poverty (WCLP) writes in support of
the WPC and DTI provisions. WCLP states it supports the WPC
element of the waiver, which would provide federal matching
funds to local collaboratives working to improve health
outcomes for high-risk Medi-Cal beneficiaries by integrating
physical health and behavioral health services together with
social service supports. Because being homeless or at risk for
homelessness is such a significant risk factor and because it
is so difficult to improve health outcomes for people who are
AB 1568 (Bonta) Page 16 of ?
homeless, WCLP urges a stronger emphasis on serving this
population. WCLP also requests the strategies to increase
access to housing and supportive services be required instead
of optional.
WCLP also writes that it supports the inclusion of the DTI in
the waiver and the bill as access to dental services for
children on Medi-Cal has received important attention due to
recent audits and reports and the DTI takes some important
steps to address inadequate access to Denti-Cal services for
children. WCLP states it would have liked to have seen
elements aimed at access for adults as well as dental care for
pregnant women is particularly important. WCLP writes that it
supports the provision stating that dental managed care
providers are eligible for the incentive payments.
SUPPORT AND OPPOSITION (prior version) :
Support: Antelope Valley Hospital
Association of California Healthcare Districts
Bear Valley Community Healthcare District
California Association of Public Hospitals and Health
Systems
California Hospital Association
California Primary Care Association
California State Association of Counties
Coalinga Regional Medical Center
Contra Costa County
County Health Executives Association of California
County of San Bernardino
District Hospital Leadership Forum
El Camino Hospital
Hazel Hawkins Memorial Hospital
Health Access California
Kern County Hospital Authority
Kern Valley Healthcare District
Mammoth Hospital
Marin General Hospital
Mayers Memorial Hospital District
Northern Inyo Hospital
Palo Verde Hospital
Palomar Health
Pioneers Memorial Healthcare District
Plumas District Hospital
Salinas Valley Memorial Healthcare System
San Bernardino Mountains Community Hospital District
AB 1568 (Bonta) Page 17 of ?
San Gorgonio Memorial Hospital
San Joaquin General Hospital
Santa Clara County Board of Supervisors
SEIU California
Seneca Healthcare District
Sierra View Medical Center
Tahoe Forest Hospital District
Tri-City Medical Center
University of California
Urban Counties of California
Western Center on Law and Poverty
Ventura County Board of Supervisors
Washington Hospital Healthcare System
Oppose: None received
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