SB 75,
as amended, Committee on Budget and Fiscal Review. begin deleteBudget Act of 2015. end deletebegin insertHealth.end insert
(1) Under existing law, the State Department of Public Health licenses and regulates clinical laboratories and certain clinical laboratory personnel performing clinical laboratory tests or examinations, subject to certain exceptions. Existing law requires a clinical laboratory to perform all clinical laboratory tests or examinations classified as waived under the federal Clinical Laboratory Improvement Amendments of 1988 (CLIA) in conformity with the manufacturer’s instructions. Existing law requires a clinical laboratory that performs tests or examinations that are not classified as waived under CLIA to establish and maintain a quality control program that meets specified CLIA standards.
end insertbegin insertThis bill would provide that the quality control program may include the clinical laboratory’s use of an alternative quality testing procedure recognized by the Centers for Medicare and Medicaid Services, including equivalent quality control procedures or an Individual Quality Control Plan, as specified.
end insertbegin insert(2) Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA), enacts various health care coverage market reforms that took effect January 1, 2014. Among other things, PPACA requires each state, by January 1, 2014, to establish an American Health Benefit Exchange that facilitates the purchase of qualified health plans by qualified individuals and qualified small employers. Existing state law establishes the California Health Benefit Exchange (the Exchange) within state government for the purpose of facilitating the enrollment of qualified individuals and qualified small employers in qualified health plans, and specifies the powers and duties of the board governing the Exchange. Among other things, existing law grants the board the authority to standardize products to be offered through the Exchange, and requires the board to establish and use a competitive process to select participating carriers and any other contractors, as specified.
end insertbegin insertThis bill would require any product standardized by the board to be discussed by the board during at least one properly noticed board meeting prior to the board meeting at which the board adopts the standardized products. The bill would require the board to adopt a Health Benefit Exchange Contracting Manual incorporating procurement and contracting policies and procedures that shall be followed by the Exchange, as specified. The bill would also exempt any regulations adopted, amended, or repealed by the board to implement these provisions from the Administrative Procedure Act.
end insertbegin insert(3) Existing law authorizes the board of the Exchange to adopt emergency regulations until January 1, 2016. Existing law prohibits the Office of Administrative Law from repealing any emergency regulations adopted until revised or repealed by the board, except that existing law also requires any emergency regulation adopted by the board to be repealed by operation of law, except as specified. Existing law allows more than 2 readoptions of those emergency regulations until January 1, 2017, and allows the emergency regulations adopted by the board to remain in effect for 2 years, as specified.
end insertbegin insertThis bill would extend the authority of the board of the Exchange to adopt emergency regulations until January 1, 2017. The bill would delete the prohibition against the office from repealing any emergency regulation of the board, but would continue to require any emergency regulation adopted by the board to be repealed by operation of law, except as specified. The bill would instead authorize the board to allow more than 2 readoptions of those emergency regulations until January 1, 2020, and would allow the emergency regulations adopted by the board to instead remain in effect for 3 years, as specified.
end insertbegin insert(4) Existing law provides for the licensure and regulation of health care facilities, including skilled nursing facilities and long-term health care facilities, as defined, by the State Department of Public Health. Existing law imposes specified fees for the licensure of skilled nursing facilities.
end insertbegin insertThis bill would require the fees for the licensure of skilled nursing facilities to be increased in a specified manner to generate moneys for expenditure by the California Department of Aging for purposes of its Long Term Care Ombudsman Program for work related to investigating complaints against skilled nursing facilities and increasing visits to those facilities.
end insertbegin insert(5) Existing law requires the State Department of Public Health to follow specified procedures when the department receives a written or oral complaint about a long-term health care facility, as specified, including investigation procedures. Existing law requires the issuance of a citation under specified provisions to be served upon a facility within 3 working days of a final determination, unless a licensee agrees to an extension of time.
end insertbegin insertThis bill would make changes to those investigation procedures, as specified, including, but not limited to, changing the time period for investigation of a complaint and authorizing an extension of that time period under extenuating circumstances. The bill would instead require a citation issued under those provisions to be served within 30 days of a final determination or completion of a complaint investigation, as specified. The bill would make conforming changes to a reporting requirement.
end insertbegin insertExisting law requires the State Department of Public Health, when it receives a complaint or report involving a general acute care hospital, acute psychiatric hospital, or special hospital, that indicates an ongoing threat of imminent danger of death or serious bodily harm, to complete an investigation of the complaint or report within 45 days.
end insertbegin insertIf the department fails to meet those requirements, this bill would require the department to document the extenuating circumstances leading to the failure to meet the 45-day time period, and to provide written notice to the facility and the complainant of the extenuating circumstances and an anticipated completion date.
end insertbegin insert(6) Existing law requires the State Department of Health Care Services to perform various health functions, including providing for breast and cervical cancer screening and treatment for low-income individuals, prostate cancer screening and treatment for low-income and uninsured men, and specified family planning services.
end insertbegin insertThis bill would require, with regard to the above health care programs, providers, or the enrolling entity, as applicable, to make available to all applicants and beneficiaries prior to, or concurrent with, enrollment, information on the manner in which to apply for insurance affordability programs, in a manner determined by the department. The information provided would be required to include the manner in which applications can be submitted for insurance affordability programs, information about the open enrollment periods for the Exchange, and the continuous enrollment aspect of the Medi-Cal program.
end insertbegin insert(7) Existing law creates the Food Safety Fund, as a special fund, and requires all moneys collected by the State Department of Public Health, pursuant to specified authority, to be deposited in the fund, for use by the department, upon appropriation by the Legislature, for the purposes of providing funds necessary to carry out and implement, among other things, inspection provisions relating to food, licensing, inspection, enforcement, and specified provisions relating to water.
end insertbegin insertThis bill would require moneys awarded to the department pursuant to court orders or settlements for the use of food safety-related activities to be deposited in the fund for those same health and safety purposes.
end insertbegin insert(8) Existing law authorizes a public entity that receives General Fund money from the State Department of Public Health for HIV prevention and education to use that money to support clean needle and syringe exchange programs authorized pursuant to law. Existing law requires several conditions to be met for the use of funds in this manner, such as the amount used not exceeding 7.5% of the total amount of General Fund money received for HIV prevention and education.
end insertbegin insertThis bill would authorize the State Department of Public Health to purchase sterile hypodermic needles and syringes, and other supplies, for distribution to syringe exchange programs, for the purpose of reducing the spread of HIV, hepatitis C, and other potentially deadly blood-borne pathogens.
end insertbegin insert(9) Existing law requires the State Public Health Officer to establish, and authorizes him or her to administer, a program to provide drug treatments to persons infected with HIV, to the extent that state and federal funds are appropriated. Existing law makes a person financially eligible to receive services under this program if his or her adjusted gross income does not exceed $50,000 per year, and as specified. Existing law establishes a payment schedule to determine the payment obligation of a person receiving drugs under the program, except as specified. Existing law requires the State Department of Public Health and the Franchise Tax Board to exchange prescribed information in order to verify financial eligibility under the program. Existing law provides that this information constitutes confidential public health records, as specified.
end insertbegin insertThis bill would instead make a person financially eligible to receive services under the program if his or her modified adjusted gross income, as defined, does not exceed 500% of the federal poverty level, as defined, per year based on family size and household income, as defined. The bill would make conforming changes to the provisions that establish a payment schedule and that require the department and the board to exchange information for purposes of determining eligibility.
end insertbegin insert(10) Existing law establishes various programs relating to treatment of persons with the human immunodeficiency virus (HIV) and the acquired immune deficiency syndrome (AIDS). Under existing law, the Office of AIDS, State Department of Public Health, is responsible for coordinating state programs, services, and activities relating to HIV and AIDS, and AIDS-related conditions.
end insertbegin insertThis bill would require the State Department of Public Health, upon an appropriation in the annual Budget Act, to establish the Pre-Exposure Prophylaxis (PrEP) Navigator Services Program, under which the department shall provide for specified activities relating to, among other things, oversight of the program and funding for community-based organizations and local health departments to provide outreach and education services to populations affected by HIV.
end insertbegin insert(11) Existing law requires the State Department of Public Health to make available protocols and guidelines developed by the National Institutes of Health, the University of California at San Francisco, and California legislative advisory committees on hepatitis C for educating physicians and health professionals and training community service professionals and training community service providers on the most recent scientific and medical information on hepatitis C detection, transmission, diagnosis, treatment, and therapeutic decisionmaking.
end insertbegin insertThis bill would establish a 3-year Hepatitis C Linkage to Care demonstration pilot project to allow for innovative, evidence-based approaches to provide outreach, hepatitis C screening, and linkage to, and retention in, quality health care for the most vulnerable and underserved individuals living with, or at high risk for, hepatitis C viral infection. The bill would, upon appropriation, require the department to award funding to community-based organizations or local health jurisdictions to operate demonstration pilot projects, as specified.
end insertbegin insert(12) Existing law requires the governing board of a county to establish a community child health and disability prevention program for the purpose of providing early and periodic evaluation of the health status of children in the county. The program plan is required to include screening and evaluation for each child, including referrals to a dentist participating in the Medi-Cal program for all children 3 years of age and older who are eligible for Medi-Cal.
end insertbegin insertThis bill would, instead, require the program plan to include referrals to a dentist for all children eligible for the Medi-Cal program one year of age and older. Because the bill would require expansion of the county program plan, it would create a state-mandated local program.
end insertbegin insert(13) Existing law requires the State Department of Public Health to establish a program for the development, provision, and evaluation of genetic disease testing. Existing law requires the department to charge a fee to all payers for certain genetic disease screening tests and activities. Existing law requires fees charged for prenatal screening and followup services provided to persons enrolled in the Medi-Cal program, health care service plan enrollees, or persons covered by health insurance policies, to be paid in full and deposited in the Genetic Disease Testing Fund or the Birth Defects Monitoring Program Fund, as prescribed, subject to all terms and conditions of each enrollee’s or insured’s health care service plan or insurance coverage, including, but not limited to, applicable copayments and deductibles.
end insertbegin insertExisting law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. Existing law also provides for the regulation of health insurers by the Department of Insurance. Under existing law, a group or individual health care service plan contract, with designated exceptions, or a health insurer is required to include coverage for the statewide Expanded Alpha Feto Protein (AFP) genetic testing program.
end insertbegin insertThis bill would prohibit coverage by a health care service plan or health insurer for these genetic testing services from being subject to copayment, coinsurance, deductible, or any other form of cost sharing. The services would be paid according to the fee amounts set under the department’s genetic disease testing programs and applicable regulations. The bill also would make various technical and conforming changes.
end insertbegin insertBecause existing law makes a willful violation of the provisions relating to health care services plans a crime, by expanding the definition of this crime, the bill would impose a state-mandated local program.
end insertbegin insert(14) Under existing law, a health care service plan and a health insurer are required to offer a standard benefit plan, as specified, under which health care service plans and insurers are required to continue to provide coverage under the same terms and conditions prescribed under a previously authorized pilot program. Under existing law, the State Department of Health Care Services is responsible for paying the costs of the coverage, completing periodic reconciliation reports with health care service plans and insurers, and adopting appropriate regulations. Existing law requires the department to complete reconciliation with a health care service program or insurer for a given reporting period within 6 months after receiving the plan’s or insurer’s conciliation report.
end insertbegin insertExisting law establishes the California Major Risk Medical Insurance Program (MRMIP), which is administered by the department, operative July 1, 2014. Under existing law, MRMIP provides major risk medical coverage to certain categories of individuals who have been rejected for coverage by at least one private health plan, and meet other program requirements. Existing law specifies the powers and duties of the department with respect to MRMIP. Existing law creates the Major Risk Medical Insurance Fund as a continuously appropriated fund for purposes of funding services under MRMIP and the standard benefit plans described above.
end insertbegin insertThis bill would extend the time within which the department is required to complete reconciliation with plans and insurers, to 18 months after receiving the conciliation report. The bill would authorize the department to implement these provisions in a specified manner.
end insertbegin insertThe bill would also establish procedures that would apply under circumstances in which the department and a health care service plan or health insurer have not agreed to a final reconciliation of the amount to be expended from the Major Risk Medical Insurance Fund or to be reimbursed to the fund for the purposes described above, including provisions relating to the payment of interest or the negotiation of payment plans, as specified.
end insertbegin insert(15) Existing law establishes the Office of Problem and Pathological Gambling within the State Department of Public Health. Under existing law, the office is responsible for developing programs for problem gambling prevention and treatment services for California residents. Existing law defines the terms “pathological gambling disorder” and “problem gambling” for these purposes.
end insertbegin insertThis bill would rename that office the Office of Problem Gambling and would substitute the term “gambling disorder,” as defined, for the terms “pathological gambling disorder” and “problem gambling.” The bill would, among other things, additionally authorize the gambling disorder prevention and treatment programs to provide services to an affected individual, which the bill would define as a person who experiences adverse psychiatric or physical impacts due to another person’s gambling disorder. The bill would also authorize the treatment program to include research and training components, as specified.
end insertbegin insert(16) Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions.
end insertbegin insertThe federal Medicaid Program provisions prohibit payment to a state for medical assistance furnished to an alien who is not lawfully admitted for permanent residence or otherwise permanently residing in the United States under color of law.
end insertbegin insertThis bill would extend eligibility for full-scope Medi-Cal benefits to individuals under 19 years of age who do not have, or are unable to establish, satisfactory immigration status. The bill would direct the State Department of Health Care Services to seek any necessary federal approvals to obtain federal financial participation for these services, and would require that these services be provided with state-only funds only if federal financial participation is not available. Because counties are required to make Medi-Cal eligibility determinations and this bill would expand Medi-Cal eligibility, the bill would impose a state-mandated local program.
end insertbegin insert(17) Existing law, until July 1, 2015, requires the department to retain or delegate the authority to perform Medi-Cal eligibility determinations as set forth in specified provisions related to electronic determination of eligibility.
end insertbegin insertThis bill would delete the repeal date, and would thereby extend the operation of those provisions indefinitely.
end insertbegin insert(18) Existing law authorizes certain ground emergency medical transportation providers to receive supplemental Medi-Cal reimbursement in addition to the rate of payment that the provider would otherwise receive for those services. Existing law specifies the manner in which the supplemental reimbursement is calculated, and requires the nonfederal share of the supplemental reimbursement to be paid only with funds from specified governmental entities.
end insertbegin insertThis bill would require the State Department of Health Care Services to develop a modified supplemental reimbursement program that would seek to increase the reimbursement to an eligible provider, as specified. The bill would provide that the department shall not implement the modified program unless it determines that the modified program would likely result in an overall increase to the supplemental reimbursement available under existing law, and the department receives all necessary federal approvals.
end insertbegin insert(19) Existing law requires, except as otherwise provided, Medi-Cal provider payments and payments for specified non-Medi-Cal programs to be reduced by 10% for dates of service on and after June 1, 2011, and requires payments to Medi-Cal managed health care plans to be reduced by the actuarial equivalent amount of the payment reductions for fee-for-service Medi-Cal benefits, as specified.
end insertbegin insertThis bill would exempt from the application of those reductions dental services and applicable ancillary services for dates of service on or after July 1, 2015, or the effective date of any necessary federal approvals, whichever is later. The bill would also exempt from the application of those reductions payments to dental managed care plans for contract amendments or change orders effective on or after July 1, 2015, or the effective date of any necessary federal approvals, whichever is later.
end insertbegin insert(20) Existing law authorizes the State Department of Health Care Services, subject to federal approval, to create a Health Home Program for Medi-Cal enrollees with chronic conditions, as prescribed, as authorized under federal law.
end insertbegin insertThis bill would create the Health Home Program Account in the Special Deposit Fund within the State Treasury in order to collect and allocate non-General Fund public or private grant funds, to be expended upon allocation by the Legislature, for the purposes of implementing the Health Home Program. The bill would appropriate $50,000,000 from the Health Home Program Account to the State Department of Health Care Services for the purposes of implementing the Health Home Program.
end insertbegin insert(21) Existing law requires Medi-Cal beneficiaries to make set copayments for specified services and, upon federal approval, existing law revises these copayment rates and makes other related changes, as specified.
end insertbegin insertThis bill would delete the revised copayment rate provisions and would make a conforming change.
end insertbegin insert(22) Under existing law, the Legislature finds and declares that linking appropriate funding for county Medi-Cal administrative operations, including annual cost-of-doing-business adjustments, with performance standards will give counties the incentive to meet the performance standards and enable them to continue to do the work they do on behalf of the state. Existing law provides that it is the intent of the Legislature to provide appropriate funding to the counties for the effectual administration of the Medi-Cal program, except for specified fiscal years in regard to any cost-of-doing-business adjustment.
end insertbegin insertThis bill would additionally provide that it is the intent of the Legislature to not appropriate funds for the cost-of-doing-business adjustment for the 2015-16 fiscal year.
end insertbegin insert(23) One of the methods by which Medi-Cal services are provided is pursuant to contracts with various types of managed care health plans. Existing federal law provides for the federal Medicare Program, which is a public health insurance program for persons who are 65 years of age or older and specified persons with disabilities who are under 65 years of age.
end insertbegin insertExisting law requires the State Department of Health Care Services to seek federal approval pursuant to a Medicare or Medicaid demonstration project or waiver, or a combination thereof, to establish a demonstration project, known as the Coordinated Care Initiative, that enables beneficiaries who are dually eligible for the Medi-Cal program and the Medicare Program to receive a continuum of services that maximizes access to, and coordination of, benefits between these programs. Existing law requires that Medi-Cal beneficiaries who have dual eligibility in the Medi-Cal and Medicare programs be assigned as mandatory enrollees into managed care health plans in counties participating in the demonstration project, and requires, beginning January 1, 2015, or 19 months after commencement of beneficiary enrollment into managed care, whichever is later, all Medi-Cal long-term services and supports, which includes Multipurpose Senior Services Program (MSSP) services, to be covered under managed care health contracts and only available through managed care health plans to beneficiaries residing in counties participating in the Coordinated Care Initiative.
end insertbegin insertThis bill would extend the transition date MSSP services are required to be a Medi-Cal benefit only available through managed care health plans to no later than December 31, 2017, or on the date managed care health plans and MSSP providers jointly satisfy the readiness criteria developed by the department, and would make additional conforming changes. The bill would require the department to notify the appropriate fiscal and policy committees of the Legislature of its intent to transition MSSP services to managed care health plans at least 30 days before this transition occurs. The bill would require the department and the California Department of Aging, in consultation with specified entities, to develop readiness criteria, as specified. The bill would require the department to evaluate the readiness of the managed care health plans and MSSP providers to commence the transition of MSSP services to managed care health plans.
end insertbegin insert(24) Existing law requires the State Department of Health Care Services to accept contributions by private foundations in the amount of at least $14,000,000 for purposes of making Medi-Cal in-person enrollment assistance payments to eligible entities and persons, as specified, and in the amount of at least $12,500,000 to provide allocations for the management and funding of Medi-Cal outreach and enrollment activities, as specified. Existing law requires the department to seek federal matching funds for those purposes. Existing law establishes the Healthcare Outreach and Medi-Cal Enrollment Account in the Special Deposit Fund within the State Treasury in order to collect and allocate these funds, as specified.
end insertbegin insertThis bill would require the department to make the in-person enrollment assistance payments described above for submitted applications received through June 30, 2015, that result in approved applications. Once all of those payments have been made, the bill would require the department to allocate any remaining funds accepted pursuant to the in-person enrollment assistance payment provisions to counties to be used for the Medi-Cal outreach and enrollment activities described above. The bill would require those remaining funds that are allocated to those counties to be distributed to community-based organizations providing enrollment assistance to prospective Medi-Cal enrollees, as specified. The bill would authorize those counties to retain a specified amount for administrative costs. The bill would require the department to make an initial allocation to counties for these funds no later than January 1, 2016, and the final allocation no later than June 30, 2016. The bill would make the in-person enrollment assistance provisions inoperative on a specified date.
end insertbegin insert(25) Existing law establishes the California Health Benefit Exchange within state government and specifies the powers and duties of the executive board governing the Exchange. Existing law requires the board to undertake outreach and enrollment activities that seek to assist enrollees and potential enrollees with enrolling in the Exchange, and requires the board to inform individuals of eligibility requirements for the Medi-Cal program, the Healthy Families Program, or any applicable state or local public program, and, if through screening of the application by the Exchange, the Exchange determines that an individual is eligible for any of those programs, to enroll that individual in the program. Existing law requires the department to accept specified contributions by private foundations for purposes of making payments to entities and persons for Medi-Cal in-person enrollment assistance and renewal assistance, and to provide allocations for the management and funding of Medi-Cal outreach and enrollment plans, as specified. Existing law further requires the State Department of Health Care Services to immediately seek an equal amount of federal matching funds. Existing law appropriates specified funds to the department from the Healthcare Outreach and Medi-Cal Enrollment Account for the purposes described above, which are available for encumbrance or expenditure until June 30, 2016, and December 31, 2016, as specified.
end insertbegin insertThis bill would make the requirement that the State Department of Health Care Services accept the private foundation funding for outreach and enrollment grants inoperative on June 30, 2018. The bill would extend the availability of amounts previously appropriated from the Healthcare Outreach and Medi-Cal Enrollment Account and the Federal Trust Fund to June 30, 2018, thereby making an appropriation.
end insertbegin insert(26) This bill would require, upon an appropriation of funds by the Legislature for this purpose, the State Department of Health Care Services to provide a grant to health benefit plans that meet certain criteria for purposes of funding health care coverage for agricultural employees and dependents, as specified.
end insertbegin insert(27) This bill, for the 2015-16 fiscal year and upon appropriation of funds by the Legislature for this purpose, would require the State Department of Health Care Services to provide a grant to LifeLong Medical Care, a federally qualified health center in Contra Costa County, to be used to support LifeLong Medical Care.
end insertbegin insert(28) Existing law, the Budget Act of 2013, appropriates $142,000,000 to the California Health Facilities Financing Authority (CHFFA) for mental health wellness grants. Existing law, the Budget Act of 2013, authorizes these funds to be available for encumbrance or expenditure until June 30, 2016.
end insertbegin insertThis bill would authorize CHFFA to use up to $3,000,000 of these funds, if unencumbered, to develop peer respite sites. The bill would require any grant awards authorized by CHFFA for peer respite sites to be used to expand local resources for the development, capital, equipment acquisition, and applicable program startup or expansion costs to increase bed capacity for peer respite support services. The bill would authorize CHFFA to adopt emergency regulations relating to grants for peer respite sites in accordance with the Administrative Procedure Act.
end insertbegin insert(29) This bill would require the Office of System Integration to report to the Legislature by April 1, 2017, on the feasibility, benefits, costs, and risks of installing the Modified Adjusted Gross Income (MAGI) Eligibility Decision Engine in one, two, or all of the Statewide Automated Welfare System consortia systems.
end insertbegin insert(30) Existing constitutional provisions require that a statute that limits the right of access to the meetings of public bodies or the writings of public officials and agencies be adopted with findings demonstrating the interest protected by the limitation and the need for protecting that interest.
end insertbegin insertThis bill would make legislative findings to that effect.
end insertbegin insert(31) This bill would make legislative findings and declarations as to the necessity of a special statute for LifeLong Medical Care and Contra Costa County.
end insertbegin insert(32) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
end insertbegin insertThis bill would provide that with regard to certain mandates no reimbursement is required by this act for a specified reason.
end insertbegin insertWith regard to any other mandates, this bill would provide that, if the Commission on State Mandates determines that the bill contains costs so mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.
end insertbegin insert(33) This bill would declare that it is to take effect immediately as a bill providing for appropriations related to the Budget Bill.
end insertThe Budget Act of 2014 made appropriations for the support of state government for the 2014-15 fiscal year.
end deleteThis bill would amend the Budget Act of 2014 by amending, adding, and repealing items of appropriation.
end deleteThis bill would declare that it is to take effect immediately as a Budget Bill.
end deleteVote: majority.
Appropriation: yes.
Fiscal committee: yes.
State-mandated local program: begin deleteno end deletebegin insertyesend insert.
The people of the State of California do enact as follows:
It is the intent of the Legislature that, in enacting
2the amendments made to Section 1420 of the Health and Safety
3Code by the act that added this section, the State Department of
4Public Health continue to seek to reduce long-term care compliant
5investigation timelines to less than 60 days with a goal of meeting
6a 45-day timeline.
begin insertSection 1220 of the end insertbegin insertBusiness and Professions Codeend insertbegin insert is
8amended to read:end insert
(a) (1) Each clinical laboratory shall maintain records,
10equipment, and facilities that are adequate and appropriate for the
11services rendered.
12(2) (A) Except for tests or examinations classified as waived
13under CLIA, each clinical laboratory shall enroll, and demonstrate
14successful participation, as defined under CLIA, for each specialty
15and subspecialty in which it performs clinical laboratory tests or
16examinations, in a proficiency testing program approved by the
17department or by HCFA, to the same extent as required by CLIA
18in Subpart H (commencing with Section 493.801) of Title 42 of
19the Code of Federal Regulations. This requirement shall not be
20interpreted to prohibit a
clinical laboratory from performing clinical
21laboratory tests or examinations in a specialty or subspecialty for
22which there is no department or HCFA approved proficiency
23testing program.
24(B) Each clinical laboratory shall authorize its proficiency test
25results to be reported to the department in an electronic format that
26is compatible with the department’s proficiency testing data
27monitoring system and shall authorize the release of proficiency
28tests results to the public to the same extent required by CLIA.
29(b) Each clinical laboratory shall be conducted, maintained, and
30operated without injury to the public health.
31(c) (1) The department shall conduct inspections of licensed
32clinical laboratories no less than once every two years. The
33department shall maintain a record of those inspections
and shall
34ensure that every licensed clinical laboratory in California is
35inspected at least that often.
36(2) Registered clinical laboratories shall not be routinely
37inspected by the department.
P16 1(3) The department shall conduct an investigation of complaints
2received concerning any clinical laboratory, which may include
3an inspection of the laboratory.
4(4) Each licensed or registered clinical laboratory shall be
5subject to inspections by HCFA or HCFA agents, as defined by
6CLIA, as a condition of licensure or registration.
7(d) (1) Each clinical laboratory shall perform all clinical
8laboratory tests or examinations classified as waived under CLIA
9in conformity with the manufacturer’s instructions.
10(2) Except for those clinical laboratories performing only tests
11or examinations classified as waived under CLIA, each clinical
12laboratory shall establish and maintain all of the following:
13(A) A patient test management system that meets the standards
14of CLIA in Subpart J (commencing with Sectionbegin delete 493.1101)end delete
15begin insert 493.1100)end insert of Title 42 of the Code of Federal Regulations.
16(B) A quality control program that meets the requirements of
17CLIA in Subpart K (commencing with Sectionbegin delete 493.1201)end delete
18begin insert 493.1200)end insert of Title 42 of the Code of Federalbegin delete Regulations.end delete
19begin insert Regulations as in effect on January 1, 2015, and that may include
20the clinical laboratory’s use of the following alternative quality
21control testing procedures recognized by the federal Centers for
22Medicare and Medicaid Services (CMS):end insert
23(i) Until December 31, 2015, equivalent quality control
24procedures.
25(ii) Commencing January 1, 2016, an Individualized Quality
26Control Plan, as incorporated in Appendix C of the State
27Operations Manual adopted by CMS.
28(C) A comprehensive quality assurance program that meets the
29standards of CLIA in Subpart P (commencing with Section
30493.1701) of Title 42 of the Code of Federal Regulations.
begin insertSection 100504 of the end insertbegin insertGovernment Codeend insertbegin insert is amended
32to read:end insert
(a) The board may do the following:
34(1) With respect to individual coverage made available in the
35Exchange, collect premiums and assist in the administration of
36subsidies.
37(2) Enter into contracts.
38(3) Sue and be sued.
P17 1(4) Receive and accept gifts, grants, or donations of moneys
2from any agency of the United States, any agency of the state, and
3any municipality, county, or other political subdivision of the state.
4(5) Receive and accept gifts, grants, or donations from
5individuals, associations, private
foundations, and corporations,
6in compliance with the conflict of interest provisions to be adopted
7by the board at a public meeting.
8(6) Adopt rules and regulations, as necessary. Until January 1,
9begin delete 2016,end deletebegin insert 2017,end insert any necessary rules and regulations may be adopted
10as emergency regulations in accordance with the Administrative
11Procedure Act (Chapter 3.5 (commencing with Section 11340) of
12Part 1 of Division 3 of Title 2). The adoption of these regulations
13shall be deemed to be an emergency and necessary for the
14immediate preservation of the public peace, health and safety, or
15general welfare. Notwithstanding Chapter 3.5 (commencing with
16Section 11340) of Part 1 of Division 3 of Title 2, including
17subdivisions (e) and (h) of Section 11346.1, any emergency
18regulation adopted pursuant to this section shallbegin delete notend delete be repealed
19bybegin delete the Office of Administrative Law until revised or repealed by operation of law unless the
20the board, except that an emergency regulation adopted pursuant
21to this section shall be repealed byend delete
22adoption, amendment, or repeal of the regulation is promulgated
23by the board pursuant to Chapter 3.5 (commencing with Section
2411340) of Part 1 of Division 3 of Title 2 of the Government Code
25withinbegin delete twoend deletebegin insert threeend insert years of the initial adoption of the emergency
26regulation. Notwithstanding subdivision (h) of Section 11346.1,
27until January 1,begin delete 2017,end deletebegin insert 2020,end insert the Office of Administrative Law may
28approve more than two readoptions of an emergency regulation
29adopted pursuant to this section.begin insert The amendments made to this
30paragraph by the act adding this sentence shall apply to any
31emergency regulation adopted pursuant to this section prior to
32the effective date of the Budget Act of 2015.end insert
33(7) Collaborate with the State Department of Health Care
34Services and the Managed Risk Medical Insurance Board, to the
35extent possible, to allow an individual the option to remain enrolled
36with his or her carrier and provider network in the event the
37individual experiences a loss of eligibility of premium tax credits
38and becomes eligible for
the Medi-Cal program or the Healthy
39Families Program, or loses eligibility for the Medi-Cal program
P18 1or the Healthy Families Program and becomes eligible for premium
2tax credits through the Exchange.
3(8) Share information with relevant state departments, consistent
4with the confidentiality provisions in Section 1411 of the federal
5act, necessary for the administration of the Exchange.
6(9) Require carriers participating in the Exchange to make
7available to the Exchange and regularly update an electronic
8directory of contracting health care providers so that individuals
9seeking coverage through the Exchange can search by health care
10provider name to determine which health plans in the Exchange
11include that health care provider in their network. The board may
12also require a carrier to provide regularly updated information to
13the Exchange as to whether a health care provider is
accepting
14new patients for a particular health plan. The Exchange may
15provide an integrated and uniform consumer directory of health
16care providers indicating which carriers the providers contract with
17and whether the providers are currently accepting new patients.
18The Exchange may also establish methods by which health care
19providers may transmit relevant information directly to the
20Exchange, rather than through a carrier.
21(10) Make available supplemental coverage for enrollees of the
22Exchange to the extent permitted by the federal act, provided that
23no General Fund money is used to pay the cost of that coverage.
24Any supplemental coverage offered in the Exchange shall be
25subject to the charge imposed under subdivision (n) of Section
26100503.
27(b) The Exchange shall only collect information from individuals
28or designees of individuals necessary to administer the Exchange
29and
consistent with the federal act.
30(c) begin insert(1)end insertbegin insert end insert The board shall have the authority to standardize
31products to be offered through the Exchange.begin insert Any products
32standardized by the board pursuant to this subdivision shall be
33discussed by the board during at least one properly noticed board
34meeting prior to the board meeting at which the board adopts the
35standardized products to be offered through the Exchange.end insert
36(2) The adoption, amendment, or repeal of a regulation by the
37
board to implement this subdivision is exempt from the rulemaking
38provisions of the Administrative Procedure Act (Chapter 3.5
39(commencing with Section 11340) of Part 1 of Division 3 of Title
402).
begin insertSection 100505 of the end insertbegin insertGovernment Codeend insertbegin insert is amended
2to read:end insert
begin insert(a)end insertbegin insert end insert The board shall establish and use a competitive
4process to select participating carriers and any other contractors
5under this title. Any contract entered into pursuant to this title shall
6be exempt from Chapterbegin delete 2end deletebegin insert 1end insert (commencing with Section 10100)
7ofbegin insert Part 2 ofend insert Division 2 of the Public Contract Code, and shall be
8exempt from the review or approval of any division of the
9Department of General Services.begin insert The board shall adopt a Health
10Benefit Exchange Contracting Manual incorporating procurement
11and contracting policies and procedures that shall be followed by
12the Exchange. The policies and procedures in the manual shall be
13substantially similar to the provisions contained in the State
14Contracting Manual.end insert
15(b) The adoption, amendment, or repeal of a regulation by the
16board to implement this section, including the adoption of a manual
17pursuant to subdivision (a) and any procurement process conducted
18by the Exchange in accordance with the manual, is exempt from
19the rulemaking provisions of the Administrative Procedure Act
20(Chapter 3.5 (commencing with Section 11340) of Part 1 of
21Division 3 of Title 2).
begin insertSection 1266 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is amended
23to read:end insert
(a) The Licensing and Certification Division shall be
25supported entirely by federal funds and special funds by no earlier
26than the beginning of the 2009-10 fiscal year unless otherwise
27specified in statute, or unless funds are specifically appropriated
28from the General Fund in the annual Budget Act or other enacted
29legislation. For the 2007-08 fiscal year, General Fund support
30shall be provided to offset licensing and certification fees in an
31amount of not less than two million seven hundred eighty-two
32thousand dollars ($2,782,000).
33(b) (1) The Licensing and Certification Program fees for the
342006-07 fiscal year shall be as follows:
|
Type of Facility | Fee | |
|
General Acute Care Hospitals |
$ 134.10 |
per bed |
|
Acute Psychiatric Hospitals |
$ 134.10 |
per bed |
|
Special Hospitals |
$ 134.10 |
per bed |
|
Chemical Dependency Recovery Hospitals |
$ 123.52 |
per bed |
|
Skilled Nursing Facilities |
$ 202.96 |
per bed |
|
Intermediate Care Facilities |
$ 202.96 |
per bed |
|
Intermediate Care Facilities- Developmentally Disabled |
$ 592.29 |
per bed |
|
Intermediate Care Facilities- Developmentally Disabled-Habilitative |
$1,000.00 |
per facility |
|
Intermediate Care Facilities- Developmentally Disabled-Nursing |
$1,000.00 |
per facility |
|
Home Health Agencies |
$2,700.00 |
per facility |
|
Referral Agencies |
$5,537.71 |
per facility |
|
Adult Day Health Centers |
$4,650.02 |
per facility |
|
Congregate Living Health Facilities |
$ 202.96 |
per bed |
|
Psychology Clinics |
$ 600.00 |
per facility |
|
Primary Clinics- Community and Free |
$ 600.00 |
per facility |
|
Specialty Clinics- Rehab Clinics (For profit) |
$2,974.43 |
per facility |
|
(Nonprofit) |
$ 500.00 |
per facility |
|
Specialty Clinics- Surgical and Chronic |
$1,500.00 |
per facility |
|
Dialysis Clinics |
$1,500.00 |
per facility |
|
Pediatric Day Health/Respite Care |
$ 142.43 |
per bed |
|
Alternative Birthing Centers |
$2,437.86 |
per facility |
|
Hospice |
$1,000.00 |
per provider |
|
Correctional Treatment Centers |
$ 590.39 |
per bed |
25(2) (A) In the first year of licensure for intermediate care
26facility/developmentally
disabled-continuous nursing (ICF/DD-CN)
27facilities, the licensure fee for those facilities shall be equivalent
28to the licensure fee for intermediate care facility/developmentally
29disabled-nursing facilities during the same year. Thereafter, the
30licensure fee for ICF/DD-CN facilities shall be established pursuant
31to the same procedures described in this section.
32(B) In the first year of licensure for hospice facilities, the
33licensure fee shall be equivalent to the licensure fee for congregate
34living health facilities during the same year. Thereafter, the
35licensure fee for hospice facilities shall be established pursuant to
36the same procedures described in this section.
37(c) Commencing in the 2015-16 fiscal year, the fees for skilled
38nursing facilities shall be increased so as to generate four hundred
39
thousand dollars ($400,000) for the California Department of
40Aging’s Long-Term Care Ombudsman Program for its work related
P21 1to investigating complaints made against skilled nursing facilities
2and increasing visits to those facilities.
3(c)
end delete
4begin insert(d)end insert Commencing February 1, 2007, and every February 1
5thereafter, the department shall publish a list of estimated fees
6pursuant to this section. The calculation of estimated fees and the
7publication of the report and list of estimated fees shall not be
8subject to the rulemaking requirements of Chapter 3.5
9(commencing with Section 11340) of Part 1 of Division 3 of Title
102 of the Government Code.
11(d)
end delete
12begin insert(e)end insert Notwithstanding Section 10231.5 of the Government Code,
13by February 1 of each year, the department shall prepare the
14following reports and shall make those reports, and the list of
15estimated fees required to be published pursuant to subdivision
16begin delete (c),end deletebegin insert (d),end insert available to the public by submitting them to the
17Legislature and posting them on the department’s Internet Web
18site:
19(1) A report of all costs for activities of the Licensing and
20Certification Program. At a minimum, this report shall include a
21narrative of all baseline adjustments and their calculations, a
22description of how each category of facility was calculated,
23descriptions of assumptions used in any calculations, and shall
24recommend Licensing and Certification Program fees in accordance
25with the following:
26(A) Projected workload and costs shall be grouped for each fee
27category, including workload costs for facility categories that have
28been established by statute and for which licensing regulations
29and
procedures are under development.
30(B) Cost estimates, and the estimated fees, shall be based on
31the appropriation amounts in the Governor’s proposed budget for
32the next fiscal year, with and without policy adjustments to the fee
33methodology.
34(C) The allocation of program, operational, and administrative
35overhead, and indirect costs to fee categories shall be based on
36generally accepted cost allocation methods. Significant items of
37costs shall be directly charged to fee categories if the expenses can
38be reasonably identified to the fee category that caused them.
39Indirect and overhead costs shall be allocated to all fee categories
40using a generally accepted cost allocation method.
P22 1(D) The amount of federal funds and General Fund moneys to
2be received in the budget year shall be estimated and allocated to
3each fee
category based upon an appropriate metric.
4(E) The fee for each category shall be determined by dividing
5the aggregate state share of all costs for the Licensing and
6Certification Program by the appropriate metric for the category
7of licensure. Amounts actually received for new licensure
8applications, including change of ownership applications, and late
9payment penalties, pursuant to Section 1266.5, during each fiscal
10year shall be calculated and 95 percent shall be applied to the
11appropriate fee categories in determining Licensing and
12Certification Program fees for the second fiscal year following
13receipt of those funds. The remaining 5 percent shall be retained
14in the fund as a reserve until appropriated.
15(2) (A) A staffing and systems analysis to ensure efficient and
16effective utilization of fees collected, proper allocation of
17departmental resources to
licensing and certification activities,
18survey schedules, complaint investigations, enforcement and appeal
19activities, data collection and dissemination, surveyor training,
20and policy development.
21(B) The analysis under this paragraph shall be made available
22to interested persons and shall include all of the following:
23(i) The number of surveyors and administrative support
24personnel devoted to the licensing and certification of health care
25facilities.
26(ii) The percentage of time devoted to licensing and certification
27activities for the various types of health facilities.
28(iii) The number of facilities receiving full surveys and the
29frequency and number of followup visits.
30(iv) The number
and timeliness of complaintbegin delete investigations.end delete
31begin insert investigations, including data on the department’s compliance
32with the requirements of paragraphs (3), (4), and (5) of subdivision
33(a) of Section 1420.end insert
34(v) Data on deficiencies and citations issued, and numbers of
35citation review conferences and arbitration hearings.
36(vi) Other applicable activities of the licensing and certification
37division.
38(3) The annual program fee report described in subdivision (d)
39of Section 1416.36.
40(e)
end delete
P23 1begin insert(f)end insert The reports required pursuant to subdivisionbegin delete (d)end deletebegin insert (e)end insert shall be
2submitted in compliance with Section 9795 of the Government
3Code.
4(f)
end delete
5begin insert(g)end insert (1) The department shall adjust the list of estimated fees
6published pursuant to subdivisionbegin delete (c)end deletebegin insert(d)end insert if the annual Budget Act
7or other enacted legislation includes an appropriation that differs
8from those proposed in the Governor’s proposed budget for that
9fiscal year.
10(2) The department shall publish a final fee list, with an
11explanation of any adjustment, by the issuance of an all facilities
12letter, by posting the list on the department’s Internet Web site,
13and by including the final fee list as part of the licensing application
14package, within 14 days of the enactment of the annual Budget
15Act. The adjustment of fees and the publication of the final fee list
16shall not be subject to the rulemaking requirements of Chapter 3.5
17(commencing with Section 11340) of Part 1 of Division 3 of Title
182 of the Government Code.
19(g)
end delete
20begin insert(h)end insert (1) Fees shall not be assessed or collected pursuant to this
21section from any state department, authority, bureau, commission,
22or officer, unless federal financial participation would become
23available by doing so and an appropriation is included in the annual
24Budget Act for that state department, authority, bureau,
25commission, or officer for this purpose. Fees shall not be assessed
26or collected pursuant to this section from any clinic that is certified
27only by the federal government and is exempt from licensure under
28Section 1206, unless federal financial participation would become
29available by doing so.
30(2) For
the 2006-07 state fiscal year, a fee shall not be assessed
31or collected pursuant to this section from any general acute care
32hospital owned by a health care district with 100 beds or less.
33(h)
end delete
34begin insert(i)end insert The Licensing and Certification Program may change annual
35license expiration renewal dates to provide for efficiencies in
36operational processes or to provide for sufficient cashflow to pay
37for expenditures. If an annual license expiration date is changed,
38the renewal fee shall be prorated accordingly. Facilities shall be
39provided with a 60-day notice of any change in their annual license
40renewal date.
P24 1(j) Commencing with the 2018-19 November Program estimate,
2the Licensing and Certification Program shall evaluate the
3feasibility of reducing investigation
timelines based on experience
4with implementing paragraphs (3), (4), and (5) of subdivision (a)
5of Section 1420.
begin insertSection 1279.2 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
7amended to read:end insert
(a) (1) In any case in which the department receives
9a report from a facility pursuant to Section 1279.1, or a written or
10oral complaint involving a health facility licensed pursuant to
11subdivision (a), (b), or (f) of Section 1250, that indicates an
12ongoing threat of imminent danger of death or serious bodily harm,
13the department shall make an onsite inspection or investigation
14within 48 hours or two business days, whichever is greater, of the
15receipt of the report or complaint and shall complete that
16investigation within 45 days.
17(2) Until the department has determined by onsite inspection
18that the adverse event has been resolved, the department shall, not
19less than once a year, conduct an
unannounced inspection of any
20health facility that has reported an adverse event pursuant to
21Section 1279.1.
22(b) In any case in which the department is able to determine
23from the information available to it that there is no threat of
24imminent danger of death or serious bodily harm to that patient or
25other patients, the department shall complete an investigation of
26the report within 45 days.
27(c) If the department does not meet the timeframes established
28in subdivision (a), the department shall document the extenuating
29circumstances explaining why it could not meet the timeframes.
30The department shall provide written notice to the facility and the
31complainant, if any, of the basis for the extenuating circumstances
32and the anticipated completion date.
33(c)
end delete
34begin insert(d)end insert The department shall notify the complainant and licensee
35in writing of the department’s determination as a result of an
36inspection or report.
37(d)
end delete
38begin insert(e)end insert For purposes of this section, “complaint” means any oral or
39written notice to the department, other than a report from the health
40facility, of an alleged violation of applicable requirements of state
P25 1or federal law or an allegation of facts that might constitute a
2violation of applicable requirements of state or federal law.
3(e)
end delete
4begin insert(f)end insert The costs of administering and implementing this section
5shall be paid from funds derived from existing licensing fees paid
6by general acute care hospitals, acute psychiatric hospitals, and
7special hospitals.
8(f)
end delete
9begin insert(g)end insert In enforcing this section and Sections 1279 and 1279.1, the
10department shall take into account the special circumstances of
11small and rural hospitals, as defined in Section 124840, in order
12to protect the quality of patient care in those hospitals.
13(g)
end delete
14begin insert(h)end insert In preparing the staffing and systems analysis required
15pursuant to Section 1266, the department shall also report regarding
16the number and timeliness of investigations of adverse events
17initiated in response to reports of adverse events.
begin insertSection 1367.54 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
19amended to read:end insert
begin insert(a)end insertbegin insert end insert Every group health care service plan contract
21that provides maternity benefits, except for a specialized health
22care service plan contract, that is issued, amended, renewed, or
23delivered on or after January 1, 1999, and every individual health
24care service plan contract of a type and form first offered for sale
25on or after January 1, 1999, that provides maternity benefits, except
26a specialized health care service plan contract, shall provide
27coverage for participation in thebegin delete Expanded Alpha Feto Protein begin insert California Prenatal Screening Program,end insert which
28(AFP) program,end delete
29is a statewide prenatal testing program administered by the State
30Department ofbegin delete Health Services.end deletebegin insert Public Health, pursuant to Section
31124977.end insert Notwithstanding any other provision of law, a health care
32service plan that provides maternity benefits shall not require
33participation in the statewide prenatal testing program administered
34by the State Department ofbegin delete Healthend deletebegin delete Servicesend deletebegin insert Public Healthend insert as a
35prerequisite to eligibility for, or receipt of, any other service.
36(b) Coverage required by this section shall not be subject to
37copayment, coinsurance, deductible, or any other form of cost
38sharing.
P26 1(c) Reimbursement for services covered pursuant to this section
2shall be paid at the amount set pursuant to Section 124977 and
3regulations adopted thereunder.
begin insertSection 1373.622 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
5amended to read:end insert
(a) (1) After the termination of the pilot program
7under Section 1373.62, a health care service plan shall continue
8to provide coverage under the same terms and conditions specified
9in Section 1376.62 as it existed on January 1, 2007, including the
10terms of the standard benefit plan and the subscriber payment
11amount, to each individual who was terminated from the program
12pursuant to subdivision (f) of Section 12725 of the Insurance Code
13during the term of the pilot program and who enrolled or applied
14to enroll in a standard benefit plan within 63 days of termination.
15Thebegin delete Managed Risk Medical Insurance Boardend deletebegin insert State Department of
16Health Care Servicesend insert shall continue to pay the amount described
17in Section 1376.62 for each of those individuals. A health care
18service plan shall not be required to offer the coverage described
19in Section 1373.62 after the termination of the pilot program to
20individuals not already enrolled in the program.
21(2) Notwithstanding paragraph (1) of this subdivision or Section
221373.62 as it existed on January 1, 2007, the following rules shall
23apply:
24(A) (i) A health care service plan shall not be obligated to
25provide coverage to any individual pursuant to this section on or
26after January 1, 2014.
27(ii) Thebegin delete Managed Risk Medical Insurance Boardend deletebegin insert State
28Department of Health Care Servicesend insert shall not be obligated to
29provide any payment to any health care service plan under this
30section for (I) health care expenses incurred on or after January 1,
312014, or (II) the standard monthly administrative fee, as defined
32in Section 1373.62 as it existed on January 1, 2007, for any month
33after December 2013.
34(B) Each health care service plan providing coverage pursuant
35to this section shall, on or before October 1, 2013, send a notice
36to each individual enrolled in a standard benefit plan that is in at
37least 12-point type and with, at minimum, the following
38information:
39(i) Notice as to whether or not the plan will terminate as of
40January 1,
2014.
P27 1(ii) The availability of individual health coverage, including
2through Covered California, including at least all of the following:
3(I) That, beginning on January 1, 2014, individuals seeking
4coverage may not be denied coverage based on health status.
5(II) That the premium rates for coverage offered by a health
6care service plan or a health insurer cannot be based on an
7individual’s health status.
8(III) That individuals obtaining coverage through Covered
9California may, depending upon income, be eligible for premium
10subsidies and cost-sharing subsidies.
11(IV) That individuals seeking coverage must obtain this coverage
12during an open or special enrollment period, and a description of
13
the open and special enrollment periods that may apply.
14(C) As a condition of receiving payment for a reporting period
15pursuant to this section, a health care service plan shall provide
16thebegin delete Managed Risk Medical Insurance Boardend deletebegin insert State Department of
17Health Care Servicesend insert with a complete, final annual reconciliation
18report by the earlier of December 31, 2014, or an earlier date as
19prescribed by Section 1373.62, as it existed on January 1, 2007,
20for that reporting period. To the extent that it receives a complete,
21final reconciliation report for a reporting period by the date required
22pursuant to this subparagraph, thebegin delete Managed Risk Medical Insurance begin insert State Department of Health Care Servicesend insert shall complete
23Boardend delete
24reconciliation with the health care service plan for that reporting
25period withinbegin delete sixend deletebegin insert 18end insert monthsbegin delete ofend deletebegin insert afterend insert receiving the report.
26(b) If the state fails to expend, pursuant to this section, sufficient
27funds for the state’s contribution amount to any health care service
28plan, the health care service plan may increase the monthly
29payments that its subscribers are required to pay for any standard
30benefit plan to the amount that thebegin delete Managed Risk Medical begin insert State Department of Health Care Servicesend insert would
31Insurance Boardend delete
32charge without a state subsidy for the same plan issued to the same
33individual within the program.
34(c) begin deleteThe adoption and readoption, by the Managed Risk Medical begin insertNotwithstanding Chapter 3.5 (commencing with
35Insurance Board, end delete
36Section 11340)end insert ofbegin delete regulations implementing the amendments to
37this section enacted by the legislation adding this subdivision shall
38be deemed an emergency and necessary to avoid serious harm to
39the public peace, health, safety, or general welfare for purposesend delete
40begin insert Part 1end insert ofbegin delete Sections 11346.1 and 11349.6 ofend deletebegin insert Division 3 of Title 2 ofend insert
P28 1 the Government Code,begin delete andend delete thebegin delete Managed Risk Medical Insurance begin insert State Department of Health
2Board is hereby exempted from the requirement that it describe
3facts showing the need for immediate action and from review by
4the Office of Administrative Law.end delete
5Care Services may implement, interpret, or make specific this
6section by means of all-county letters, plan letters, plan or provider
7bulletins, or similar instructions, without taking regulatory action.end insert
begin insertSection 1420 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is amended
9to read:end insert
(a) (1) Upon receipt of a written or oral complaint,
11the state department shall assign an inspector to make a preliminary
12review of the complaint and shall notify the complainant within
13two working days of the receipt of the complaint of the name of
14the inspector. Unless the state department determines that the
15complaint is willfully intended to harass a licensee or is without
16any reasonable basis, it shall make an onsite inspection or
17investigation within 10 working days of the receipt of the
18complaint. In any case in which the complaint involves a threat of
19imminent danger of death or serious bodily harm, the state
20department shall make an onsite inspection or investigation within
2124 hours of the receipt of the complaint. In any event, the
22complainant shall be
promptly informed of the state department’s
23proposed course of action and of the opportunity to accompany
24the inspector on the inspection or investigation of the facility. Upon
25the request of either the complainant or the state department, the
26complainant or his or her representative, or both, may be allowed
27to accompany the inspector to the site of the alleged violations
28during his or her tour of the facility, unless the inspector determines
29that the privacy of any patient would be violated thereby.
30(2) When conducting an onsite inspection or investigation
31pursuant to this section, the state department shall collect and
32evaluate all available evidence and may issue a citation based
33upon, but not limited to, all of the following:
34(A) Observed conditions.
35(B) Statements of witnesses.
36(C) Facility records.
37(3) begin deleteWithin 10 working end deletebegin insert(A)end insertbegin insert end insertbegin insertForend insertbegin insert a complaint that involves a
38threat of imminent danger of death or serious bodily harm that is
39received on or after July 1, 2016, the state department shall
40complete an investigation of the complaint within 90end insert days ofbegin insert receipt
P29 1ofend insert thebegin insert complaint. At theend insert completion of the complaint investigation,
2the state
department shall notify the complainant and licensee in
3writing of thebegin insert stateend insert department’s determination as a result of the
4inspection or investigation.
5(B) The time period described in subparagraph (A) may be
6extended up to an additional 60 days if the investigation cannot
7be completed due to extenuating circumstances. The state
8department shall document these circumstances in its final
9determination and notify the facility and the complainant in writing
10of the basis for the extension and the estimated completion date.
11(4) (A) For a complaint that does not involve a
threat of
12imminent danger of death or serious bodily harm pursuant to
13paragraph (3) and that is received on or after July 1, 2017, and
14prior to July 1, 2018, the state department shall complete an
15investigation of the complaint within 90 days of receipt of the
16complaint. At the completion of the complaint investigation, the
17state department shall notify the complainant and licensee in
18writing of the state department’s determination as a result of the
19inspection or investigation.
20(B) The time period described in subparagraph (A) may be
21extended up to an additional 90 days if the investigation cannot
22be completed due to extenuating circumstances. The state
23department shall document these circumstances in its final
24determination and notify the facility and the complainant in writing
25of the basis for the extension and the estimated completion
date.
26(5) (A) For a complaint that is received on or after July 1, 2018,
27the state department shall complete an investigation of the
28complaint within 60 days of receipt of the complaint. At the
29completion of the complaint investigation, the state department
30shall notify the complainant and licensee in writing of the state
31department’s determination as a result of the inspection or
32investigation.
33(B) The time period described in subparagraph (A) may be
34extended up to an additional 60 days if the investigation cannot
35be completed due to extenuating circumstances. The state
36department shall document these circumstances in its final
37determination and
notify the facility and the complainant in writing
38of the basis for the extension and the estimated completion date.
39(b) Upon being notified of the state department’s determination
40as a result of the inspection or investigation, a complainant who
P30 1is dissatisfied with the state department’s determination, regarding
2a matter which would pose a threat to the health, safety, security,
3welfare, or rights of a resident, shall be notified by the state
4department of the right to an informal conference, as set forth in
5this section. The complainant may, within five business days after
6receipt of the notice, notify the director in writing of his or her
7request for an informal conference. The informal conference shall
8be held with the designee of the director for the county in which
9the long-term health care facility which is the subject of the
10complaint is located. The long-term health care facility may
11participate as a party in
this informal conference. The director’s
12designee shall notify the complainant and licensee of his or her
13determination within 10 working days after the informal conference
14and shall apprise the complainant and licensee in writing of the
15appeal rights provided in subdivision (c).
16(c) If the complainant is dissatisfied with the determination of
17the director’s designee in the county in which the facility is located,
18the complainant may, within 15 days after receipt of this
19determination, notify in writing the Deputy Director of the
20Licensing and Certification Division of the state department, who
21shall assign the request to a representative of the Complainant
22Appeals Unit for review of the facts that led to both determinations.
23As a part of the Complainant Appeals Unit’s independent
24investigation, and at the request of the complainant, the
25representative shall interview the complainant in the district office
26where the complaint was initially
referred. Based upon this review,
27the Deputy Director of the Licensing and Certification Division
28of the state department shall make his or her own determination
29and notify the complainant and the facility within 30 days.
30(d) Any citation issued as a result of a conference or review
31provided for in subdivision (b) or (c) shall be issued and served
32upon the facility withinbegin delete three workingend deletebegin insert 30end insert days of the final
33begin delete determination, unless the licensee agrees in writing to an extension begin insert determination.end insert Service shall be effected either
34of this time.end delete
35personally or by registered or certified mail. A copy of the citation
36shall also be sent to each complainant by registered or certified
37mail.
38(e) A miniexit conference shall be held with the administrator
39or his or her representative upon leaving the facility at the
40completion of the investigation to inform him or her of the status
P31 1of the investigation. Thebegin insert stateend insert department shall also state the items
2of noncompliance and compliance found as a result of a complaint
3and those items found to be in compliance, provided the disclosure
4maintains the
anonymity of the complainant. In any matter in which
5there is a reasonable probability that the identity of the complainant
6will not remain anonymous, the state department shall also notify
7the facility that it is unlawful to discriminate or seek retaliation
8against a resident, employee, or complainant.
9(f) Any citation issued as a result of the complaint investigation
10provided for in paragraph (3), (4), or (5) of subdivision (a), and
11in compliance with Section 1423, shall be issued and served upon
12the facility within 30 days of the completion of the complaint
13investigation.
14(f)
end delete
15begin insert(g)end insert For purposes of this section, “complaint” means any oral or
16written notice to the state department, other than a report from the
17facility of an alleged violation of applicable requirements of state
18or federal law or any alleged facts that might constitute such a
19violation.
20(h) Nothing in this section shall be interpreted to diminish the
21state department’s authority and obligation to investigate any
22alleged violation of applicable requirements of state or federal
23law, or any alleged facts that might constitute a violation of
24applicable requirements of
state or federal law, and to enforce
25applicable requirements of law.
begin insertSection 1423 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
27amended to read:end insert
(a) If upon inspection or investigation the director
29determines that any nursing facility is in violation of any state or
30federal law or regulation relating to the operation or maintenance
31of the facility, or determines that any other long-term health care
32facility is in violation of any statutory provision or regulation
33relating to the operation or maintenance of the facility, the director
34shall promptly, but not later than 24 hours, excluding Saturday,
35Sunday, and holidays, after the director determines or has
36reasonable cause to determine that an alleged violation has
37occurred, issue a notice to correct the violation and of intent to
38issue a citation to the licensee. Before completing the investigation
39and making thebegin insert finalend insert
determination whether to issue a citation, the
40department shall hold an exit conference with the licensee to
P32 1identify the potential for issuing a citation for any violation, discuss
2investigative findings, and allow the licensee to provide the
3department with additional information related to the violation.
4The department shall consider this additional information, in
5conjunction with information from the inspection or investigation,
6in determining whether to issue a citation, or whether other action
7would be appropriate. If the department determines that the
8violation warrants the issuing of a citation and an exit conference
9has been completed it shall either:
10(1) Recommend the imposition of a federal enforcement remedy
11or remedies on a nursing facility in accordance with federal law;
12or
13(2) Issue a citation pursuant to state licensing laws, and if the
14facility
is a nursing facility, may recommend the imposition of a
15federal enforcement remedy.
16A state citation shall be served upon the licensee withinbegin delete threeend delete
17begin insert 30end insert days after completion of thebegin delete investigation, excluding Saturday, begin insert investigation.end insert Service shall be effected either
18Sunday, and holidays, unless the licensee agrees in writing to an
19extension of time.end delete
20personally or by registered or certified mail. A copy of the citation
21shall also be sent to each complainant. Each citation shall be in
22writing and shall describe with particularity the nature of the
23violation, including a reference to the statutory provision, standard,
24rule, or regulation alleged to have been violated, the particular
25place or area of the facility in which it occurred, as well as the
26amount of any proposed assessment of a civil penalty. The name
27of any patient jeopardized by the alleged violation shall not be
28specified in the citation in order to protect the privacy of the
29patient. However, at the time the licensee is served with the
30citation, the licensee shall also
be served with a written list of each
31of the names of the patients alleged to have been jeopardized by
32the violation, that shall not be subject to disclosure as a public
33record. The citation shall fix the earliest feasible time for the
34elimination of the condition constituting the alleged violation,
35when appropriate.
36(b) Where no harm to patients, residents, or guests has occurred,
37a single incident, event, or occurrence shall result in no more than
38one citation for each statute or regulation violated.
39(c) No citation shall be issued for a violation that has been
40reported by the licensee to the state department, or its designee,
P33 1as an “unusual occurrence,” if all of the following conditions are
2met:
3(1) The violation has not caused harm to any patient, resident,
4or guest, or significantly contributed thereto.
5(2) The licensee has promptly taken reasonable measures to
6correct the violation and to prevent a recurrence.
7(3) The unusual occurrence report was the first source of
8information reported to the state department, or its designee,
9regarding the violation.
begin insertSection 104150 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
11amended to read:end insert
(a) begin insert(1)end insertbegin insert end insert A provider or entity that participates in the
13grant made to the department by the federal Centers for Disease
14Control and Prevention breast and cervical cancer early detection
15program established under Title XV of the federal Public Health
16Service Act (42 U.S.C. Sec. 300k et seq.) in accordance with
17requirements of Section 1504 of that act (42 U.S.C. Sec. 300n)
18may only render screening services under the grant to an individual
19if the provider or entity determines that the individual’s family
20income does not exceed 200 percent of the federal poverty level.
21(2) Providers, or the enrolling entity, shall make available to
22all applicants and beneficiaries, prior to or concurrent with
23enrollment, information on the manner in which to apply for
24insurance affordability programs, in a manner determined by the
25State Department of Health Care Services. The information shall
26include the manner in which applications can be submitted for
27insurance affordability programs, information about the open
28enrollment periods for the California Health Benefit Exchange,
29and the continuous enrollment aspect of the Medi-Cal program.
30(b) The department shall provide for breast cancer and cervical
31cancer screening services under the grant at the level of funding
32budgeted from state and other resources during the fiscal year in
33which the Legislature has appropriated funds to the department
34for this purpose. These screening services shall
not be deemed to
35be an entitlement.
36(c) To implement the federal breast and cervical cancer early
37detection program specified in this section, the department may
38contract, to the extent permitted by Section 19130 of the
39Government Code, with public and private entities, or utilize
40existing health care service provider enrollment and payment
P34 1mechanisms, including the Medi-Cal program’s fiscal intermediary.
2However, the Medi-Cal program’s fiscal intermediary shall only
3be utilized if services provided under the program are specifically
4identified and reimbursed in a manner that does not claim federal
5financial reimbursement. Any contracts with, and the utilization
6of, the Medi-Cal program’s fiscal intermediary shall not be subject
7to Chapter 3 (commencing with Section 12100) of Part 2 of
8Division 2 of the Public Contract Code. Contracts to implement
9the federal breast and cervical cancer early detection program
10entered into by the department with
entities other than the Medi-Cal
11program’s fiscal intermediary shall not be subject to Part 2
12(commencing with Section 10100) of Division 2 of the Public
13Contract Code.
14(d) The department shall enter into an interagency agreement
15with the State Department of Health Care Services to transfer that
16portion of the grant made to the department by the federal Centers
17for Disease Control and Prevention breast and cervical cancer early
18detection program established under Title XV of the federal Public
19Health Service Act (42 U.S.C. Sec. 300k et seq.) to the State
20Department of Health Care Services. The department shall have
21no other liability to the State Department of Health Care Services
22under this article.
begin insertSection 104322 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
24amended to read:end insert
(a) (1) The State Department of Health Care Services
26shall develop and implement a program to provide quality prostate
27cancer treatment for low-income and uninsured men.
28(2) The State Department of Health Care Services shall award
29one or more contracts to provide prostate cancer treatment through
30private or public nonprofit organizations, including, but not limited
31to, community-based organizations, local health care providers,
32the University of California medical centers, and the Charles R.
33Drew University of Medicine and Science, an affiliate of the David
34Geffen School of Medicine at the University of California at Los
35Angeles. Contracts awarded, subsequent to the effective date of
36the amendments to this section made during the 2005
portion of
37the 2005-06 Regular Session, pursuant to this paragraph shall be
38consistent with both of the following:
39(A) Eighty-seven percent of the total contract funding shall be
40used for direct patient care.
P35 1(B) No less than 70 percent of the total contract funding shall
2be expended on direct patient care treatment costs, which shall be
3defined as funding to fee-for-service providers for Medi-Cal
4eligible services.
5(3) The contracts described in paragraph (2) shall not be subject
6to Part 2 (commencing with Section 10100) of Division 2 of the
7Public Contract Code. Commencing July 1, 2006, those contracts
8shall be entered into on a competitive bid basis.
9(4) It is the intent of the Legislature to support the prostate
10cancer treatment program provided for
pursuant to this section,
11and that the program be cost-effective and maximize the number
12of men served for the amount of funds appropriated. It is further
13the intent of the Legislature to ensure that the program has an
14adequate health care provider network to facilitate reasonable
15access to treatment.
16(b) begin insert(1)end insertbegin insert end insert Treatment provided under this chapter shall be provided
17to uninsured and underinsured men with incomes at or below 200
18percent of the federal poverty level.begin delete Covered services shall be
19limited to prostate cancer treatment and prostate cancer-related
20services. Eligible men shall be enrolled in a 12-month treatment
21regimen.end delete
22(2) The enrolling entity shall make available to all applicants
23and beneficiaries, prior to or concurrent with enrollment,
24information on the manner in which to apply for insurance
25affordability programs, in a manner determined by the State
26Department of Health Care Services. The information provided
27shall include the manner in which applications can be submitted
28for insurance affordability programs, information about the open
29enrollment periods for the California Health Benefit Exchange,
30and the continuous enrollment aspect of the Medi-Cal program.
31(3) Covered services shall be limited to prostate cancer
32treatment and prostate cancer-related services. Eligible men shall
33be enrolled in a 12-month treatment regimen.
34(c) The State Department of Health Care Services shall contract
35for prostate cancer treatment services only at the level of funding
36budgeted from state and other sources during a fiscal year in which
37the Legislature has appropriated funds to the department for this
38purpose.
39(d) Notwithstanding subdivision (a) of Section 2.00 of the
40Budget Act of 2003 and any otherbegin delete provision ofend delete law, commencing
P36 1with the 2003-04 fiscal year and for each fiscal year thereafter,
2any amount appropriated to the State Department of Health Care
3Services for the prostate
cancer treatment program implemented
4pursuant to this chapter shall be made available, for purposes of
5that program, for encumbrance for one fiscal year beyond the year
6of appropriation and for expenditure for two fiscal years beyond
7the year of encumbrance.
begin insertSection 110050 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
9amended to read:end insert
The Food Safety Fund is hereby created as a special
11fund in the State Treasury. All moneys collected by the department
12under subdivision (c) of Section 110466 and Sections 110470,
13110471, 110485, 114365, 114365.6, 111130, and 113717, and
14under Article 7 (commencing with Section 110810) of Chapterbegin delete 5end delete
15begin insert 5, or awarded to the department pursuant to court orders or
16settlements for the use of food safety-related activities,end insert shall be
17deposited in the fund, for use by the department, upon appropriation
18by the Legislature, for the purposes of providing funds necessary
19to carry out and implement the inspection provisions of this part
20relating to food, licensing,
inspection, enforcement, and other
21provisions of Article 12 (commencing with Section 111070)begin insert
of
22Chapter 5,end insert relating to water, the provisions relating to education
23and training in the prevention of microbial contamination pursuant
24to Section 110485, and the registration provisions of Article 7
25(commencing with Section 110810) of Chapter 5, and to carry out
26and implement the provisions of the California Retail Food Code
27(Part 7 (commencing with Section 113700) of Division 104).
begin insertSection 120780.2 is added to the end insertbegin insertHealth and Safety
29Codeend insertbegin insert, to read:end insert
In order to reduce the spread of HIV, hepatitis C,
31and other potentially deadly blood-borne pathogens, the State
32Department of Public Health may purchase sterile hypodermic
33needles and syringes, and other supplies, for distribution to syringe
34exchange programs authorized pursuant to law. Supplies provided
35to programs, including those administered by local health
36departments, are not subject to the formulas and limits of Section
37120780.1.
begin insertSection 120960 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
39amended to read:end insert
(a) The department shall establish uniform standards
2of financial eligibility for the drugs under the program established
3under this chapter.
4(b) Nothing in the financial eligibility standards shall prohibit
5drugs to an otherwise eligible person whosebegin insert modifiedend insert adjusted
6gross income does not exceedbegin delete fifty thousand dollars ($50,000)end deletebegin insert 500
7percent of the federal poverty levelend insert perbegin delete year.end deletebegin insert year based on family
8size and household income.end insert However, the director may authorize
9drugs for persons with incomes higher thanbegin delete fifty thousand dollars begin insert 500 percent of the federal poverty levelend insert per yearbegin insert based
10($50,000)end delete
11on family size and household incomeend insert if the estimated cost of those
12drugs in one year is expected to exceed 20 percent of the person’s
13begin insert modifiedend insert adjusted gross income.
14(c) The department shall establish and may administer a payment
15schedule to determine the payment obligation of a person receiving
16drugs. No person shall be obligated for payment whosebegin insert modifiedend insert
17 adjusted gross income
is less than four times the federal poverty
18begin delete level.end deletebegin insert level based on family size and household income.end insert The
19payment obligation shall be the lesser of the following:
20(1) Two times the person’s annual state income tax liability,
21less funds expended by the person for health insurance premiums.
22(2) The cost of drugs.
23(d) Persons who have been determined to have a payment
24obligation pursuant to subdivision (c) shall be advised by the
25department of their right to request a reconsideration of that
26determination to the department. Written notice of the right to
27request a reconsideration shall be provided to the person at the
28time that notification is given that he or she is subject to a payment
29obligation. The
payment determination shall be reconsidered if
30one or more of the following apply:
31(1) The determination was based on an incorrect calculation
32made pursuant to subdivision (b).
33(2) There has been a substantial change in income since the
34previous eligibility determination that has resulted in a current
35income that is inadequate to meet the calculated payment
36obligation.
37(3) Unavoidable family or medical expenses that reduce the
38disposable income and that result in current income that is
39inadequate to meet the payment obligation.
P38 1(4) Any other situation that imposes undue financial hardship
2on the person and would restrict his or her ability to meet the
3payment obligation.
4(e) The department
may exempt a person, who has been
5determined to have a payment obligation pursuant to subdivision
6(c), from the obligation if both of the following criteria are
7satisfied:
8(1) One or more of the circumstances specified in subdivision
9(d) exist.
10(2) The department has determined that the payment obligation
11will impose an undue financial hardship on the person.
12(f) If a person requests reconsideration of the payment obligation
13determination, the person shall not be obligated to make any
14payment until the department has completed the reconsideration
15request pursuant to subdivision (d). If the department denies the
16exemption, the person shall be obligated to make payments for
17drugs received while the reconsideration request is pending.
18(g) A county public
health department administering this
19program pursuant to an agreement with the director pursuant to
20subdivision (b) of Section 120955 shall use no more than 5 percent
21of total payments it collects pursuant to this section to cover any
22administrative costs related to eligibility determinations, reporting
23requirements, and the collection of payments.
24(h) A county public health department administering this
25program pursuant to subdivision (b) of Section 120955 shall
26provide all drugs added to the program pursuant to subdivision (a)
27of Section 120955 within 60 days of the action of the director,
28subject to the repayment obligations specified in subdivision (d)
29of Section 120965.
30(i) For purposes of this section, the following terms shall have
31the following meanings:
32(1) “Family size” has the meaning given to that term in Section
3336B(d)(1) of the Internal Revenue Code of 1986, and shall include
34same or opposite sex married couples, registered domestic
35partners, and any tax dependents, as defined by Section 152 of the
36Internal Revenue Code of 1986, of either spouse or registered
37domestic partner.
38(2) “Federal poverty level” refers to the poverty guidelines
39updated periodically in the Federal Register by the United States
P39 1Department of Health and Human Services under the authority of
2Section 9902(2) of Title 42 of the United States Code.
3(3) “Household income” means the
sum of the applicant’s or
4recipient’s modified adjusted gross income, plus the modified
5adjusted gross income of the applicant’s or recipient’s spouse or
6registered domestic partner, and the modified adjusted gross
7incomes of all other individuals for whom the applicant or
8recipient, or the applicant’s or recipient’s spouse or registered
9domestic partner, is allowed a federal income tax deduction for
10the taxable year.
11(4) “Internal Revenue Code of 1986” means Title 26 of the
12United States Code, including all amendments enacted to that
13code.
14(5) “Modified adjusted gross income” has the meaning given
15to that term in Section 36B(d)(2)(B) of the Internal Revenue Code
16of
1986.
begin insertSection 120962 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
18amended to read:end insert
(a) (1) For the purpose of verifying financial
20eligibility pursuant to Section 120960 and the federal Ryan White
21HIV/AIDS Treatment Extension Act of 2009 (42 U.S.C. Sec. 201
22et seq.), the department shall verify the accuracy of the adjusted
23 gross income reported on an AIDS Drug Assistance Program
24application submitted by an applicant or recipient with data, if
25available, from the Franchise Tax Board.
26(2) Notwithstanding any other law, the department shall disclose
27the name and individual taxpayer identification number (ITIN) or
28social security number of an applicant for, or recipient of, services
29under this chapter to the Franchise Tax Board for the purpose of
30verifying the adjusted gross incomebegin insert
of, any tax-exempt interest
31received by, any tax-exempt social security benefits received by,
32and any foreign earned incomeend insert of an applicant or recipient pursuant
33to subdivision (b) of Section 120960.
34(b) (1) The Franchise Tax Board, upon receipt of this
35information, shall inform the department of all of the following:
36(A) The amount of the federal adjusted gross income as reported
37by the taxpayer to the Franchise Tax Board.
38(B) The amount of the California
adjusted gross income as
39reported by the taxpayer to the Franchise Tax Board or as adjusted
40by the Franchise Tax Board.
P40 1(C) The amount of any tax-exempt interest received by the
2taxpayer, as reported to the Franchise Tax Board.
3(D) The amount of any tax-exempt social security benefits
4received by the taxpayer, as reported to the Franchise Tax Board.
5(E) The amount of any foreign earned income of the taxpayer,
6as reported to the Franchise Tax Board.
7(b)
end delete
8begin insert(2)end insert The Franchise Taxbegin delete Board, upon receipt of this information, Board
9shall inform the department of the amount of the federal adjusted
10gross income as reported by the taxpayer to the Franchise Tax
11Board, and the California adjusted gross income as reported by
12the taxpayer to the Franchise Taxend deletebegin delete or as adjusted by the shall provide the
13Franchise Tax Board. The Franchise Tax Boardend delete
14information to the department for the most recent taxable year that
15the Franchise Tax Board has information available, and shall
16include the first and last name, date of birth, and the ITIN or social
17security number of the taxpayer.
18(c) (1) Information provided by the department pursuant to this
19section shall constitute confidential public health records as defined
20in Section 121035, and shall remain subject to the confidentiality
21protections and restrictions on further disclosure by the recipient
22under subdivisions (d) and (e) of Section 121025.
23(2) To the extent possible, verification of financial eligibility
24shall be done in a way to eliminate or minimize, by use of computer
25programs or other electronic means,
Franchise Tax Board staff
26and contractors’ access to confidential public health records.
27(3) Prior to accessing confidential HIV-related public health
28records, Franchise Tax Board staff and contractors shall be required
29to annually sign a confidentiality agreement developed by the
30department that includes information related to the penalties under
31Section 121025 for a breach of confidentiality and the procedures
32for reporting a breach of confidentiality under subdivision (h) of
33Section 121022. Those agreements shall be reviewed annually by
34the department.
35(4) The Franchise Tax Board shall return or destroy all
36information received from the department after completing the
37exchange of information.
38(d) For purposes of this section,
“foreign earned income” also
39includes any deduction taken for the housing expenses of an
P41 1individual while living abroad pursuant to Section 911 of Title 26
2of the Internal Revenue Code.
begin insertThe heading of Chapter 17 (commencing with Section
4121348) of Part 4 of Division 105 of the end insertbegin insertHealth and Safety Codeend insert
5begin insert is amended to read:end insert
6
begin insertSection 121348.4 is added to the end insertbegin insertHealth and Safety
10Codeend insertbegin insert, to read:end insert
Upon an appropriation in the annual Budget Act,
12the State Department of Public Health shall establish the
13Pre-Exposure Prophylaxis (PrEP) Navigator Services Program,
14under which the department shall provide for the following
15activities:
16(a) Oversight and evaluation of the PrEP Navigator Services
17Program.
18(b) Implementation of a process to request applications, and
19award funding on a competitive basis, to community-based
20organizations or local health departments. An eligible entity shall
21collaborate with the Office of AIDS to conduct outcome and
22process evaluation of navigator services. An entity in any county
23shall be eligible to receive funding if it can demonstrate all of the
24following:
25(1) Capacity to ensure access for and serve the most vulnerable
26and underserved Californians at high risk for HIV.
27(2) Ability to develop protocols to conduct outreach to targeted
28populations, to provide PrEP education to clients and providers,
29and to assess and refer persons to appropriate clinical care and
30prevention services.
31(c) Development and distribution of PrEP education materials
32statewide, including providing training for and support of any
33additional activity that is consistent with the goals of this chapter.
begin insertSection 122425 is added to the end insertbegin insertHealth and Safety
35Codeend insertbegin insert, to read:end insert
There is hereby established a three-year Hepatitis C
37Linkage to Care demonstration pilot project to allow for innovative,
38evidence-based approaches to provide outreach, hepatitis C
39screening, and linkage to, and retention in, quality health care for
40the most vulnerable and underserved individuals living with, or
P42 1at high risk for, hepatitis C viral infection (HCV). This
2demonstration pilot project is authorized for fiscal years 2015-16,
32016-17, and 2017-18.
begin insertSection 122430 is added to the end insertbegin insertHealth and Safety
5Codeend insertbegin insert, to read:end insert
(a) Upon an appropriation for the purpose described
7in Section 122425 in the annual Budget Act for the 2015-16,
82016-17, and 2017-18 fiscal years, the department shall award
9funding, on a competitive basis, to community-based organizations
10or local health jurisdictions to operate demonstration pilot projects
11pursuant to this chapter. The department shall determine the
12funding levels of each demonstration project based on scope and
13geographic area. Funds may be used to support other activities
14consistent with the goals of this chapter, including the purchase
15of hepatitis C viral infection (HCV) test kits, syringe exchange
16supplies, or other HCV prevention and linkage to care materials
17and activities.
18(b) An applicant for funding shall
demonstrate each of the
19following qualifications:
20(1) Leadership on access to HCV care and testing issues and
21experience addressing the needs of highly marginalized populations
22in accessing medical care and support.
23(2) Experience with the target population or relationships with
24community-based organizations or nongovernmental organizations,
25or both, that demonstrates expertise, history, and credibility
26working successfully in engaging the target population.
27(3) Experience working with nontraditional collaborators who
28work within and beyond the field of HCV education and outreach,
29including homeless services, veterans’ medical and service
30programs, substance use disorders treatment, syringe exchange
31programs, women’s health, reproductive health, immigration,
32mental health, or human immunodeficiency virus (HIV)
prevention
33and treatment.
34(4) Strong relationships with community-based HCV health
35care providers that have the trust of the targeted population.
36(5) Strong relationships with the state and local health
37departments.
38(6) Capacity to coordinate a communitywide planning phase
39involving multiple community collaborators.
P43 1(7) Experience implementing evidence-based programs or
2generating innovative strategies, or both, with at least preliminary
3evidence of program effectiveness.
4(8) Administrative systems and accountability mechanisms for
5grant management.
6(9) Capacity to participate in evaluation activities.
7(10) Strong communication systems that are in place to
8participate in public relations activities.
begin insertSection 122435 is added to the end insertbegin insertHealth and Safety
10Codeend insertbegin insert, to read:end insert
During the demonstration pilot project described in
12Section 122425, each demonstration pilot project shall prepare
13and disseminate information regarding best practices for, and the
14lessons learned regarding, providing outreach and education to
15the most vulnerable and underserved individuals living with
16hepatitis C viral infection (HCV) or at a high risk for HCV
17infection, for use by providers, the State Department of Public
18Health, including the Office of AIDS and the Office of Viral
19Hepatitis Prevention, federal departments and agencies, including
20the federal Department of Health and Human Services, and other
21national HIV/AIDS and viral hepatitis groups.
begin insertSection 124040 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
23amended to read:end insert
(a) The governing body of each county or counties
25shall establish a community child health and disability prevention
26program for the purpose of providing early and periodic
27assessments of the health status of children in the county or
28counties by July 1, 1974. However, this shall be the responsibility
29of the department for all counties that contract with the state for
30health services. Contract counties, at the option of the board of
31supervisors, may provide services pursuant to this article in the
32same manner as other county programs,begin delete providedend deletebegin insert ifend insert the option is
33exercised prior to the beginning of each fiscal year. Each plan shall
34include, but is not limited to, the following requirements:
35(1) Outreach and educational services.
36(2) Agreements with public and private facilities and
37practitioners to carry out the programs.
38(3) Health screening and evaluation services for allbegin delete childrenend delete
39begin insert children,end insert including a physical examination, immunizations
40appropriate for the child’s age and health history, and laboratory
P44 1procedures appropriate for the child’s age and population group
2performed by, or under the supervision or responsibility of, a
3physician licensed to practice medicine in California or by a
4certified family nurse practitioner or a certified pediatric nurse
5practitioner.
6(4) Referral for diagnosis or treatment when needed, including,
7for all children eligible for Medi-Cal, referral for treatment by a
8provider participating in the Medi-Cal program of the conditions
9detected, and methods for assuring referral is carried out.
10(5) Recordkeeping and program evaluations.
11(6) The health screening and evaluation part of each community
12child health and disability prevention program plan shall include,
13but is not limited to, the following for each child:
14(A) A health and development history.
15(B) An assessment of physical growth.
16(C) An examination for obvious physical defects.
17(D) Ear, nose, mouth, and throat inspection, including inspection
18of teeth and gums, and for all childrenbegin delete three yearsend deletebegin insert one yearend insert of age
19and older who are eligible for Medi-Cal, referral to a dentist
20participating in the Medi-Cal program.
21(E) Screening tests for vision, hearing, anemia, tuberculosis,
22diabetes, and urinary tract conditions.
23(7) An assessment of nutritional status.
24(8) An assessment of immunization status.
25(9) begin deleteWhere end deletebegin insertIf end insertappropriate, testing for sickle-cell trait, lead
26poisoning, and other tests
that may be necessary to the
27identification of children with potential disabilities requiring
28diagnosis and possibly treatment.
29(10) For all children eligible for Medi-Cal, necessary assistance
30with scheduling appointments for services and with transportation.
31(b) Dentists receiving referrals of children eligible for Medi-Cal
32under this section shall employ procedures to advise the child’s
33parent or parents of the need for and scheduling of annual
34appointments.
35(c) Standards for procedures to carry out health screening and
36evaluation services and to establish the age at which particular
37tests should be carried out shall be established by the director. At
38the discretion of the department, these health screening and
39evaluation services may be provided at the frequency provided
40under the Healthy Families Program and
permitted in managed
P45 1care plans providing services under the Medi-Cal program, and
2shall be contingent upon appropriation in the annual Budget Act.
3Immunizations may be provided at the frequency recommended
4by the Committee on Infectious Disease of the American Academy
5of Pediatrics and the Advisory Committee on Immunization
6Practices of the Centers for Disease Control and Prevention.
7(d) Each community child health and disability prevention
8program shall, pursuant to standards set by the director, establish
9a record system that contains a health case history for each child
10so that costly and unnecessary repetition of screening,
11immunization and referral will not occur and appropriate health
12treatment will be facilitated as specified in Section 124085.
begin insertSection 124977 of the end insertbegin insertHealth and Safety Codeend insertbegin insert is
14amended to read:end insert
(a) It is the intent of the Legislature that, unless
16otherwise specified, the genetic disease testing program carried
17out pursuant to this chapter be fully supported from fees collected
18for services provided by the program.
19(b) (1) The department shall charge a fee to all payers for any
20tests or activities performed pursuant to this chapter. The amount
21of the fee shall be established by regulation and periodically
22adjusted by the director in order to meet the costs of this chapter.
23Notwithstanding any other law, any fees charged for prenatal
24screening and followup services provided to persons enrolled in
25the Medi-Cal program, health care service plan enrollees, or
26persons covered by health insurance policies, shall be paid in full
27and
deposited in the Genetic Disease Testing Fund or the Birth
28Defects Monitoringbegin insert Programend insert Fund consistent with thisbegin delete section, begin insert section.end insert
29subject to all terms and conditions of each enrollee’s or insured’s
30health care service plan or insurance coverage, whichever is
31applicable, including, but not limited to, copayments and
32deductibles applicable to these services, and only if these
33copayments, deductibles, or limitations are disclosed to the
34subscriber or enrollee pursuant to the disclosure provisions of
35Section 1363.end delete
36(2) The department shall expeditiously undertake all steps
37necessary to implement the fee collection process, including
38personnel, contracts, and data processing, so as to initiate the fee
39collection process at the earliest opportunity.
P46 1(3) Effective for services provided on and after July 1, 2002,
2the department shall
charge a fee to the hospital of birth, or, for
3births not occurring in a hospital, to families of the newborn, for
4newborn screening and followup services. The hospital of birth
5and families of newborns born outside the hospital shall make
6payment in full to the Genetic Disease Testing Fund. The
7department shall not charge or bill Medi-Cal beneficiaries for
8services provided under this chapter.
9(4) (A) The department shall charge a fee for prenatal screening
10to support the pregnancy blood sample storage, testing, and
11research activities of the Birth Defects Monitoring Program.
12(B) The prenatal screening fee for activities of the Birth Defects
13Monitoring Program shall be ten dollars ($10).
14(5) The department shall set guidelines for invoicing, charging,
15and collecting from approved researchers
the amount necessary
16to cover all expenses associated with research application requests
17made under this section, data linkage, retrieval, data processing,
18data entry, reinventory, and shipping of blood samples or their
19components, and related data management.
20(6) The only funds from the Genetic Disease Testing Fund that
21may be used for the purpose of supporting the pregnancy blood
22sample storage, testing, and research activities of the Birth Defects
23Monitoring Program are those prenatal screening fees assessed
24and collected prior to the creation of the Birth Defects Monitoring
25Program Fund specifically to support those Birth Defects
26Monitoring Program activities.
27(7) The Birth Defects Monitoring Program Fund is hereby
28created as a special fund in the State Treasury. Fee revenues that
29are collected pursuant to paragraph (4) shall be deposited into the
30fund and shall be available
upon appropriation by the Legislature
31to support the pregnancy blood sample storage, testing, and
32research activities of the Birth Defects Monitoring Program.
33Notwithstanding Section 16305.7 of the Government Code, interest
34earned on funds in the Birth Defects Monitoring Program Fund
35shall be deposited as revenue into the fund to support the Birth
36Defects Monitoring Program.
37(c) (1) The Legislature finds that timely implementation of
38changes in genetic screening programs and continuous maintenance
39of quality statewide services requires expeditious regulatory and
40administrative procedures to obtain the most cost-effective
P47 1electronic data processing, hardware, software services, testing
2equipment, and testing and followup services.
3(2) The expenditure of funds from the Genetic Disease Testing
4Fund for these purposes shall not be subject to Section 12102 of,
5and
Chapter 2 (commencing with Section 10290) of Part 2 of
6Division 2 of, the Public Contract Code, or to Division 25.2
7(commencing with Section 38070). The department shall provide
8the Department of Finance with documentation that equipment
9and services have been obtained at the lowest cost consistent with
10technical requirements for a comprehensive high-quality program.
11(3) The expenditure of funds from the Genetic Disease Testing
12Fund for implementation of the Tandem Mass Spectrometry
13screening for fatty acid oxidation, amino acid, and organic acid
14disorders, and screening for congenital adrenal hyperplasia may
15be implemented through the amendment of the Genetic Disease
16Branch Screening Information System contracts and shall not be
17subject to Chapter 3 (commencing with Section 12100) of Part 2
18of Division 2 of the Public Contract Code, Article 4 (commencing
19with Section 19130) of Chapter 5 of Part 2 of Division 5 of Title
202 of the Government
Code, and any policies, procedures,
21regulations, or manuals authorized by those laws.
22(4) The expenditure of funds from the Genetic Disease Testing
23Fund for the expansion of the Genetic Disease Branch Screening
24Information System to include cystic fibrosis, biotinidase, severe
25combined immunodeficiency (SCID), and adrenoleukodystrophy
26(ALD) may be implemented through the amendment of the Genetic
27Disease Branch Screening Information System contracts, and shall
28not be subject to Chapter 2 (commencing with Section 10290) or
29Chapter 3 (commencing with Section 12100) of Part 2 of Division
302 of the Public Contract Code, Article 4 (commencing with Section
3119130) of Chapter 5 of Part 2 of Division 5 of Title 2 of the
32Government Code, or Sections 4800 to 5180, inclusive, of the
33State Administrative Manual as they relate to approval of
34information technology projects or approval of increases in the
35duration or costs of information technology projects.
This
36paragraph shall apply to the design, development, and
37implementation of the expansion, and to the maintenance and
38operation of the Genetic Disease Branch Screening Information
39System, including change requests, once the expansion is
40implemented.
P48 1(d) (1) The department may adopt emergency regulations to
2implement and make specific this chapter in accordance with
3Chapter 3.5 (commencing with Section 11340) of Part 1 of Division
43 of Title 2 of the Government Code. For the purposes of the
5Administrative Procedure Act, the adoption of regulations shall
6be deemed an emergency and necessary for the immediate
7preservation of the public peace, health and safety, or general
8welfare. Notwithstanding Chapter 3.5 (commencing with Section
911340) of Part 1 of Division 3 of Title 2 of the Government Code,
10these emergency regulations shall not be subject to the review and
11approval of the Office of Administrative Law. Notwithstanding
12
Sections 11346.1 and 11349.6 of the Government Code, the
13department shall submit these regulations directly to the Secretary
14of State for filing. The regulations shall become effective
15immediately upon filing by the Secretary of State. Regulations
16shall be subject to public hearing within 120 days of filing with
17the Secretary of State and shall comply with Sections 11346.8 and
1811346.9 of the Government Code or shall be repealed.
19(2) The Office of Administrative Law shall provide for the
20printing and publication of these regulations in the California Code
21of Regulations. Notwithstanding Chapter 3.5 (commencing with
22Section 11340) of Part 1 of Division 3 of Title 2 of the Government
23Code, the regulations adopted pursuant to this chapter shall not be
24repealed by the Office of Administrative Law and shall remain in
25effect until revised or repealed by the department.
26(3) The
Legislature finds and declares that the health and safety
27of California newborns is in part dependent on an effective and
28adequately staffed genetic disease program, the cost of which shall
29be supported by the fees generated by the program.
begin insertSection 10123.184 of the end insertbegin insertInsurance Codeend insertbegin insert is amended
31to read:end insert
begin insert(a)end insertbegin insert end insert Every group policy of disability insurance that
33covers hospital, medical, or surgical expenses, and that provides
34maternity benefits, that is issued, amended, renewed, or delivered
35on or after January 1, 1999, and every individual policy of
36disability insurance that covers hospital, medical, or surgical
37expenses, and that provides maternity benefits, that is of a type
38and form first offered for sale on or after January 1, 1999, shall
39provide coverage for participation in thebegin delete Expanded Alpha Feto begin insert California Prenatal Screening Program,end insert
40Protein (AFP) program,end delete
P49 1 which is a statewide prenatal testing program administered by the
2State Department ofbegin insert Public Health, pursuant to Section 124977
3of theend insert Healthbegin delete Services.end deletebegin insert and Safety Code.end insert Notwithstanding any other
4begin delete provision ofend delete law, a disability insurer that provides coverage for
5maternity benefits shall not require participation in the statewide
6prenatal testing program administered by the State Department of
7begin insert Publicend insert Healthbegin delete Servicesend delete as a prerequisite to eligibility for, or receipt
8of, any other service.
9(b) Coverage required under this section shall not be subject
10to copayment, coinsurance, deductible, or any other form of cost
11sharing.
12(c) Reimbursement for services covered pursuant to this section
13shall be paid at the amount set pursuant to Section 124977 of the
14Health and Safety Code and regulations adopted thereunder.
begin insertSection 10127.16 of the end insertbegin insertInsurance Codeend insertbegin insert is amended
16to read:end insert
(a) (1) After the termination of the pilot program
18under Section 10127.15, a health insurer shall continue to provide
19coverage under the same terms and conditions specified in Section
2010127.15 as it existed on January 1, 2007, including the terms of
21the standard benefit plan and the subscriber payment amount, to
22each individual who was terminated from the program, pursuant
23to subdivision (f) of Section 12725 of the Insurance Code during
24the term of the pilot program and who enrolled or applied to enroll
25in a standard benefit plan within 63 days of termination. The
26begin delete Managed Risk Medical Insurance Boardend deletebegin insert State Department of
27Health Care Servicesend insert shall continue to pay the amount described
28in Section 10127.15 for each of those individuals. A health insurer
29shall not be required to offer the coverage described in Section
3010127.15 after the termination of the pilot program to individuals
31not already enrolled in the program.
32(2) Notwithstanding paragraph (1) of this subdivision or Section
3310127.15 as it existed on January 1, 2007, the following rules shall
34apply:
35(A) (i) A health insurer shall not be obligated to provide
36coverage to any individual pursuant to this section on or after
37January 1, 2014.
38(ii) Thebegin delete Managed Risk Medical Insurance Boardend deletebegin insert State
39Department of Health Care Servicesend insert shall not be obligated to
40provide any payment to any health insurer under this section for
P50 1(I) health care expenses incurred on or after January 1, 2014, or
2(II) the standard monthly administrative fee, as defined in Section
310127.15 as it existed on January 1, 2007, for any month after
4December, 2013.
5(B) Each health insurer providing coverage pursuant to this
6section shall, on or before October 1, 2013, send a notice to each
7individual enrolled in a standard benefit plan that is in at least
812-point type and with, at minimum, the following information:
9(i) Notice as to whether or not the plan will terminate as of
10January 1, 2014.
11(ii) The availability of individual health coverage, including
12through Covered California, including at least all of the following:
13(I) That, beginning on January 1, 2014, individuals seeking
14coverage may not be denied coverage based on health status.
15(II) That the premium rates for coverage offered by a health
16care service plan or a health insurer cannot be based on an
17individual’s health status.
18(III) That individuals obtaining coverage through Covered
19California may, depending upon income, be eligible for premium
20subsidies and cost-sharing subsidies.
21(IV) That individuals seeking coverage must obtain this coverage
22during an open or special enrollment period, and a description of
23the open
and special enrollment periods that may apply.
24(C) As a condition of receiving payment for a reporting period
25pursuant to this section, a health insurer shall provide thebegin delete Managed begin insert State Department of Health Care
26Risk Medical Insurance Boardend delete
27Servicesend insert with a complete, final annual reconciliation report by the
28earlier of December 31, 2014, or an earlier date as prescribed by
29Section 10127.15, as it existed on January 1, 2007, for that
30reporting period. To the extent that it receives a complete, final
31reconciliation report for a reporting period by the date required
32pursuant to this subparagraph, thebegin delete Managed Risk Medical Insurance begin insert State Department of Health Care Servicesend insert shall complete
33Boardend delete
34reconciliation with the health insurer for that reporting period
35withinbegin delete sixend deletebegin insert 18end insert monthsbegin delete ofend deletebegin insert afterend insert receiving the report.
36(b) If the state fails to expend, pursuant to this section, sufficient
37funds for the state’s contribution amount to any health insurer, the
38health insurer may increase the monthly payments that its
39subscribers are required to pay for any standard benefit plan to the
40amount that thebegin delete Managed Risk Medical Insurance Boardend deletebegin insert State
P51 1Department of Health Care Servicesend insert would charge without a state
2subsidy for the same insurance product issued to the same
3individual within the program.
4(c) begin deleteThe adoption and readoption, by the Managed Risk Medical begin insertNotwithstanding Chapter 3.5 (commencing with
5Insurance Board, end delete
6Section 11340) end insertofbegin delete regulations implementing the amendments to
7this section enacted by the legislation adding this subdivision shall
8be deemed an emergency and necessary to avoid serious harm to
9the public peace, health, safety, or general welfare for purposesend delete
10begin insert Part 1end insert ofbegin delete Sections 11346.1 and 11349.6 ofend deletebegin insert Division 3 of Title 2 ofend insert
11 the Government Code,begin delete andend delete thebegin delete Managed Risk Medical Insurance begin insert State Department of Health
12Board is hereby exempted from the requirement that it describe
13facts showing the need for immediate action and from review by
14the Office of Administrative Law.end delete
15Care Services may implement, interpret, or make specific this
16section by means of all-county letters, plan letters, plan or provider
17bulletins, or similar instructions, without taking regulatory action.end insert
begin insertSection 19548.2 of the end insertbegin insertRevenue and Taxation Codeend insert
19begin insert is amended to read:end insert
(a) Notwithstanding any other law and in accordance
21with Section 120962 of the Health and Safety Code, the State
22Department of Public Health shall disclose the name and individual
23taxpayer identification number (ITIN) or social security number
24of an applicant for, or recipient of services pursuant to Chapter 6
25(commencing with Section 120950) of Part 4 of Division 105 of
26the Health and Safety Code to the Franchise Tax Board for the
27purpose of verifying the adjusted gross incomebegin insert of, any tax-exempt
28interest received by, any tax-exempt social security benefits
29received by, and any foreign earned incomeend insert of an applicant or
30recipient.
31(b) (1) The Franchise Tax Board, upon receipt of this
32information, shall inform the State Department of Public Health
33of all of the following:
34(A) The amounts of the federal adjusted gross income as
35reported by the taxpayer to the Franchise Tax Board.
36(B) The amounts of the California adjusted gross income as
37reported by the taxpayer to the Franchise Tax Board or as adjusted
38by the Franchise Tax Board.
39(C) The amount of
any tax-exempt interest received by the
40taxpayer, as reported to the Franchise Tax Board.
P52 1(D) The amount of any tax-exempt social security benefits
2received by the taxpayer, as reported to the Franchise Tax Board.
3(E) The amount of any foreign earned income of the taxpayer,
4as reported to the Franchise Tax Board.
5(b)
end delete
6begin insert(2)end insert The Franchise Taxbegin delete Board, upon receipt of this information, Board
7shall inform the State Department of Public Health of the amounts
8of the federal adjusted gross income as reported by the taxpayer
9to the Franchise Tax Board, and the California adjusted gross
10income as reported by the taxpayer to the Franchise Taxend deletebegin delete or
11as adjusted by the Franchise Tax Board. The Franchise Tax Boardend delete
12 shall provide the information to the State Department of Public
13Health for the most recent taxable year that the Franchise Tax
14Board has information available, and shall include the first and
15last name, date of birth, and the ITIN or social security number of
16the taxpayer.
17(c) (1) Information provided by the State Department of Public
18Health pursuant to this section shall constitute confidential public
19health records as defined in Section 121035 of the Health and
20Safety Code, and shall remain subject to the confidentiality
21protections and restrictions on further disclosure by the recipient
22under subdivisions (d) and (e) of Section 121025.
23(2) Prior to accessing confidential HIV-related public health
24records, Franchise Tax Board staff and
contractors shall be required
25to annually sign a confidentiality agreement developed by the State
26Department of Public Health that includes information related to
27the penalties under Section 121025 of the Health and Safety Code
28for a breach of confidentiality and the procedures for reporting a
29breach of confidentiality under subdivision (h) of Section 121022
30of the Health and Safety Code. Those agreements shall be reviewed
31annually by the State Department of Public Health.
32(3) The Franchise Tax Board shall return or destroy all
33information received from the State Department of Public Health
34after completing the exchange of information.
35(d) For purposes of this section, “foreign earned income” also
36includes any deduction taken for the housing expenses of an
37individual while living abroad pursuant to
Section 911 of Title 26
38of the Internal Revenue Code.
begin insertSection 4369 of the end insertbegin insertWelfare and Institutions Codeend insertbegin insert is
40amended to read:end insert
There is within the State Department of Public Health,
2the Office of Problembegin delete and Pathologicalend delete Gambling.
begin insertSection 4369.1 of the end insertbegin insertWelfare and Institutions Codeend insert
4begin insert is amended to read:end insert
As used in this chapter, the following definitions shall
6apply:
7(a) “Affected individual” means a person who experiences
8adverse psychiatric or physical impacts due to another person’s
9gambling disorder.
10(a)
end delete11begin insert(b)end insert “Department” means the State Department of Public Health.
12(b) “Office” means the Office of Problem and Pathological
13Gambling.
14(c) begin delete“Pathological gambling end deletebegin insert“Gambling end insertdisorder” means a
15begin delete progressive mental disorder meetingend deletebegin insert condition that causesend insert the
16begin insert person to be unable to resist impulses to gamble, which can lead
17to harmful negative consequences, and that meets theend insert diagnostic
18criteria set forthbegin delete byend deletebegin insert inend insert the American Psychiatric Association’s
19Diagnostic and Statisticalbegin delete Manual, Fourthend deletebegin insert Manual of Mental
20Disorders, Fifthend insert Edition.begin insert Gambling disorder includes both
21pathological and problem gambling behavior.end insert
22(d) begin delete“Problem gambling” end deletebegin insert“Office” end insertmeansbegin delete participation in any the
23form of gambling toend deletebegin delete extent that it creates a negative begin insert Officeend insert of
24consequence to the gambler, the gambler’s family, placeend delete
25begin delete employment, or community. This includes patterns of gambling begin insert Problem Gambling.end insert
26and subsequent related behaviors that compromise, disrupt, or
27damage personal, family, educational, financial, or vocational
28interests. The problem gambler does not meet the diagnostic criteria
29for pathological gambling disorder.end delete
30(e) begin delete“Problem gambling prevention programs” end deletebegin insert“Prevention
31program” end insertmeansbegin delete programsend deletebegin insert a programend insert designed to reduce the
32prevalence ofbegin delete problem and pathologicalend delete gamblingbegin insert disordersend insert among
33California residents.begin delete These programsend deletebegin insert The programend insert shall include,
34butbegin delete areend deletebegin insert isend insert not limited to, public education and awareness, outreach
35to high-risk populations, early identification and responsible
36gambling programs.
37(f) “Treatment program” means a program designed to assist
38individuals who experience harmful negative consequences related
39to gambling disorders. This program shall include, but is not
40limited to, training and educating providers, establishing a
P54 1provider network for the provision of treatment services, and
2conducting research to ensure the delivery of evidence-based
3practices.
begin insertSection 4369.2 of the end insertbegin insertWelfare and Institutions Codeend insert
5begin insert is amended to read:end insert
(a) The office shall develop abegin delete problemend delete gambling
7begin insert disorderend insert prevention program, which shallbegin delete be the first priority for consist of all of the following:
8funding appropriated to this office. The prevention program shall
9be based upon the allocation priorities established by the
10department and subject to funding being appropriated for the
11purpose of this subdivision, and shallend delete
12(1) A toll-free telephone service for immediate crisis
13managementbegin delete and containmentend delete with subsequentbegin delete referralend deletebegin insert referralsend insert
14 ofbegin delete problemend deletebegin insert gamblersend insert andbegin delete pathological gamblersend deletebegin insert affected
15individualsend insert to health providersbegin insert at various levels of careend insert who can
16provide treatment for gamblingbegin insert disorders andend insert related problems
17and to self-help groups.
18(2) Public awareness campaigns that focus on prevention and
19education among the general public including, for example,
20dissemination of youth oriented preventive literature, educational
21experiences, and public service announcements in the media.
22(3) Empirically driven research programs focusing on
23epidemiology/prevalence,
etiology/causation, and best practices
24in prevention and treatment.
25(4) Training of health care professionals and educators, and
26training for law enforcement agencies and nonprofit organizations
27in the identification ofbegin delete problemend delete gamblingbegin delete behaviorend deletebegin insert disordersend insert and
28knowledge of referral services and treatment programs.
29(5) Training of gambling industry personnel in identifying
30customers at risk forbegin delete problem and pathologicalend delete gamblingbegin insert disordersend insert
31 and knowledge of referral and treatment services.
32(b) The office shall develop abegin delete program to supportend delete treatment
33begin delete servicesend deletebegin insert programend insert for California residentsbegin delete with problem and begin insert who have aend insert gambling
34pathologicalend deletebegin delete issues. The program shall be begin insert disorder or
35based upon the allocation priorities established by the department
36and subject to funding being appropriated for the purposes of this
37subdivision. These priorities shall also be based on the best
38available existing state programs as well as on continuing research
39into best practices and on the needs of California. Theend delete
P55 1who are affected individuals. Theend insert treatment programbegin delete shallend deletebegin insert mayend insert
2 consist of all of the following components:
3(1) Training for licensed health providers, including screening
4and assessment of gambling disorders, the use of evidence-based
5treatment modalities, and the administrative practices for treatment
6services implemented under this chapter.
7(1) Treatment services
end delete
8begin insert(2)end insertbegin insert end insertbegin insertA network
of licensed health providers authorized to receive
9reimbursement from the stateend insert forbegin delete problem and pathologocal begin insert the
10gamblers and directly involved family members. Theseend delete
11provision ofend insert treatmentbegin delete services willend deletebegin insert services. This network mayend insert be
12created through partnerships with established healthbegin insert or substance
13use disorder facilities or individuals in private practiceend insert that can
14provide treatment for gamblingbegin delete related probleams, substance abuse begin insert
disorders.end insert State funded treatmentbegin insert servicesend insert
15facilities, and providers.end delete
16 may include, butbegin delete isend deletebegin insert areend insert not limited to, the following:
17self-administered, home-based educational programs;begin insert telephone
18counseling; group treatment;end insert outpatient treatment;begin delete residential and inpatientbegin insert residentialend insert treatment when medically
19treatment;end delete
20necessary.
21(2)
end delete
22(3) A research program to conduct studies and develop
23evidence-based tools for use in treating gambling disorders.
24begin insert(4)end insert A funding allocation methodology that ensures treatment
25services are delivered efficiently and effectively to areas of the
26state most in need.
27(3)
end delete
28begin insert(5)end insert Appropriate review and monitoring ofbegin insert theend insert treatment
29begin delete programsend deletebegin insert programend insert by the director of the office or a designated
30institution, including grant oversight andbegin delete monitoring,end deletebegin insert monitoring
31of contracts, theend insert standards for treatment, and outcome monitoring.
32(4)
end delete
33begin insert(6)end insert Treatment efforts shall provide services that are relevant to
34the needs of a diverse multicultural population with attention to
35groups with unique needs, including female gamblers, underserved
36ethnic groups, the elderly, and the physically challenged.
37(c) The office shall make information available as requested by
38the Governor and the Legislature with respect to the comprehensive
39program.
begin insertSection 4369.3 of the end insertbegin insertWelfare and Institutions Codeend insert
2begin insert is amended to read:end insert
In designing and developing the overall program, the
4office shall do all of the following:
5(a) Develop a statewide plan to addressbegin delete problem and begin insert gambling disorders.end insert
6pathological gambling.end delete
7(b) Adopt any regulations necessary to administer the program.
8(c) Develop priorities for funding services and criteria for
9distributing program funds.
10(d) Monitor the expenditures of state funds by agencies and
11organizations receiving program funding.
12(e) Evaluate the effectiveness of services provided through the
13program.begin insert The department is authorized to contract with academic
14experts to perform these evaluations.end insert
15(f) Notwithstanding any other provision of law, any contracts
16required to meet the requirements of this chapter are exempt from
17the requirements contained in the Public Contract Code and the
18State Administrative Manual, and are exempt from the approval
19of the Department of General Services.
20(g) The first and highest priority of the office with respect to
21the use of any funds appropriated for the purposes of this chapter
22shall be to carry out subdivision (a).
23(h)
end delete
24begin insert(g)end insert Administrative costs for the program may not exceed 10
25percent of the total funding budgeted for the program.
begin insertSection 4369.4 of the end insertbegin insertWelfare and Institutions Codeend insert
27begin insert is amended to read:end insert
All state agencies, including, but not limited to, the
29California Horse Racing Board, the California Gambling Control
30Commission, the Department of Justice, and any other agency that
31regulates casino gambling or cardrooms within the state, and the
32Department of Corrections and Rehabilitation, the State Department
33of Public Health, the State Department of Health Care Services,
34and the California State Lottery, shall coordinate with the office
35to ensure that state programs take into account, as much as
36practicable,begin delete problem and pathological gamblers.end deletebegin insert gambling
37disorders.end insert The office shall also coordinate and work with other
38entities involved in gambling and the treatment ofbegin delete problem and begin insert gambling disorders.end insert
39pathological gamblers.end delete
begin insertSection 4369.5 of the end insertbegin insertWelfare and Institutions Codeend insert
2begin insert is amended to read:end insert
(a) It is the intent of the Legislature that the Office of
4Problembegin delete and Pathologicalend delete Gambling establish and maintain
5ongoing venues for system stakeholders to provide input into public
6policy issues related tobegin delete problem gambling,end deletebegin insert gambling disorders,end insert
7 including, but not limited to, consumers of services and their
8families, providers of services and supports, and county
9representatives. It is further the intent of the Legislature that the
10Office of Problembegin delete and Pathologicalend delete Gambling shall have input
11into policy discussions at the State Department of Public Health
12and at the California Health and Human Services Agency, when
13appropriate.
14(b) It is the intent of the Legislature to ensure that the impacts
15of the transition of the Office of Problembegin delete and Pathologicalend delete
16 Gambling from the State Department of Alcohol and Drug
17Programs to the State Department of Public Health are identified
18and evaluated, initially and over time. It is further the intent of the
19Legislature to establish a baseline for evaluating, on an ongoing
20basis, how and why services provided and overseen by the Office
21of Problembegin delete and Pathologicalend delete Gambling were improved, or
22otherwise changed, as a result of this transition.
23(c) begin insert(1)end insertbegin insert end insert By April 1, 2014, and March 1 annually thereafter, the
24State Department of Public Health shall report to the Joint
25Legislative Budget Committee and the appropriate budget
26subcommittees and policy committees of the Legislature, and
27publicly post a report on the Office of Problembegin delete and Pathologicalend delete
28 Gambling on its Internet Web site.
29(1)
end delete30begin insert(2)end insert The report shall contain all of the following:
31(A) A description of education and outreach activities related
32to the prevention program and how the Office of Problembegin delete and Gambling establishes linkages with State Department
33Pathologicalend delete
34of Public Health partners, including local health officers and other
35relevant entities, in order to increase awareness of, and provide
36input to, the Office of Problembegin delete and Pathologicalend delete Gambling, and
37how stakeholder involvement was changed, maintained, or
38enhanced after the transition.
39(B) Beginning in the 2012-13 fiscal year, a description of
40year-over-year changes in the following: access to services,
P58 1demographics of people served, the number of providers, and
2treatment program outcomes. The description of access to services
3shall include, but not be limited to, information regarding
4utilization of services and waiting lists for services. The description
5of providers shall include, but not be limited to, types and numbers
6of providers, includingbegin delete problemend delete gamblingbegin insert disorderend insert counselors,
7training protocols for providers, and workforce trends. The
8description of demographics of people served shall include, but
9not be limited to, age, sex, ethnicity, economic status, and
10geographic regions. The description of treatment program outcomes
11shall include, but not be limited to, participation levels in programs,
12recidivism rates, and quality of life measures.
13(2) By November 30, 2013, the State Department of Public
14Health shall consult with legislative staff and with system
15stakeholders, including county representatives, to develop a
16reporting format consistent with the Legislature’s desired level of
17outcome and reporting detail.
18(d) This section shall become inoperative on July 1, 2018, and,
19as of January 1, 2019, is repealed, unless a later enacted statute,
20that becomes operative on or before January 1, 2019, deletes or
21extends the dates on which it becomes inoperative and is repealed.
begin insertSection 14007.2 of the end insertbegin insertWelfare and Institutions Codeend insert
23begin insert is amended to read:end insert
(a) Any individual who is otherwise eligible for
25Medi-Cal services, but who does not meet the documentation
26requirements described in subdivision (e) of Section 14011.2, shall
27be eligible only for the scope of services made available to aliens
28under subdivision (d) of Section 14007.5, and Sectionsbegin delete 14007.65end delete
29begin insert 14007.65, 14007.7,end insert andbegin delete 14007.7.end deletebegin insert 14007.8.end insert
30(b) To the extent that federal financial participation is available
31to fund services described under subdivision (a), the department
32shall file all necessary state plan amendmentsbegin insert or waiversend insert to obtain
33that funding.
begin insertSection 14007.5 of the end insertbegin insertWelfare and Institutions Codeend insert
35begin insert is amended to read:end insert
(a) Aliens shall be eligible for Medi-Cal, whether
37federally funded or state-funded, only to the same extent as
38permitted under federal law and regulations for receipt of federal
39financial participation under Title XIX of the federal Social
P59 1Security Act, except as otherwise provided in this section and
2begin delete Section 14007.7.end deletebegin insert elsewhere in this chapter.end insert
3(b) In accordance with Section 1903(v)(1) of the federal Social
4Security Act (42 U.S.C. Sec. 1396b(v)(1)), an alien shall only be
5eligible for the full scope of Medi-Cal benefits, if the alien has
6been lawfully admitted for permanent residence, or is otherwise
7permanently residing in the United States under color of law.
8For purposes of this section, aliens “permanently residing in the
9United States under color of law” shall be interpreted to include
10all aliens residing in the United States with the knowledge and
11permission of the United States Immigration and Naturalization
12Service and whose departure the United States Immigration and
13Naturalization Service does not contemplate enforcing and with
14
respect to whom federal financial participation is available under
15Title XIX of the federal Social Security Act.
16(c) Any alien whose immigration status has been adjusted either
17to lawful temporary resident or lawful permanent resident in
18accordance with the provisions of Section 210, 210A, or 245A of
19the federal Immigration and Nationality Act, and who meets all
20other eligibility requirements, shall be eligible only for care and
21services under Medi-Cal for which the alien is not disqualified
22pursuant to those sections of the federal act.
23(d) Any alien who is otherwise eligible for Medi-Cal services,
24but who does not meet the requirements under subdivision (b) or
25(c), shall only be eligible for care and services that are necessary
26for the treatment of an emergency medical condition and medical
27care directly related to the emergency, as defined in federal law.
28For purposes of this
section, the term “emergency medical
29condition” means a medical condition manifesting itself by acute
30symptoms of sufficient severity, including severe pain, such that
31the absence of immediate medical attention could reasonably be
32expected to result in any of the following:
33(1) Placing the patient’s health in serious jeopardy.
34(2) Serious impairment to bodily functions.
35(3) Serious dysfunction to any bodily organ or part. It is the
36intent of this section to entitle eligible individuals to inpatient and
37outpatient services that are necessary for the treatment of the
38emergency medical condition in the same manner as administered
39by the department through regulations and provisions of federal
40law.
P60 1(e) Pursuant to Section 14001.2, each county department
shall
2require that each applicant for, or beneficiary of, Medi-Cal,
3including a child, shall provide his or her social security number
4account number, or numbers, if he or she has more than one social
5security number.
6(f) (1) In order to be eligible for benefits under subdivision (b)
7or (c), an alien applicant or beneficiary shall present alien
8registration documentation or other proof of satisfactory
9immigration status from the United States Immigration and
10Naturalization Service.
11(2) Any alien who meets all other program requirements but
12who lacks documentation of alien registration or other proof of
13satisfactory immigration status shall be provided a reasonable
14opportunity to submit the evidence. For purposes of this paragraph,
15“reasonable opportunity” means 30 days or the time it actually
16takes the county to process the Medi-Cal application, whichever
17is
longer.
18(3) During the reasonable opportunity period under paragraph
19(2), the county department shall process the applicant’s application
20for medical assistance in a manner that conforms to its normal
21processing procedures and timeframes.
22(g) (1) The county department shall grant only the Medi-Cal
23benefits set forth in subdivision (d) of this section or in Section
2414007.7 to any individual who, after 30 calendar days or the time
25it actually takes the county to process the Medi-Cal application,
26whichever is longer, has failed to submit documents constituting
27reasonable evidence indicating a satisfactory immigration status
28for Medi-Cal purposes, or who is reported by the United States
29Immigration and Naturalization Service to lack a satisfactory
30immigration status for Medi-Cal purposes.
31(2) If an
alien has been receiving Medi-Cal benefits based on
32eligibility established prior to the effective date of this section and
33that individual, upon redetermination of eligibility for benefits,
34fails to submit documents constituting reasonable evidence
35indicating a satisfactory immigration status for Medi-Cal purposes,
36the county department shall discontinue the Medi-Cal benefits,
37except for the care and services set forth in subdivision (d) of this
38section or in Section 14007.7. The county department shall provide
39adequate notice to the individual of any adverse action and shall
P61 1accord the individual an opportunity for a fair hearing if he or she
2requests one.
3(h) To the extent permitted by federal law and regulations, an
4alien applying for services under subdivisions (b) and (c) shall be
5granted eligibility for the scope of services to which he or she
6would otherwise be entitled if, at the time the county department
7makes the determination about
his or her eligibility, the alien meets
8either of the following requirements:
9(1) He or she has not had a reasonable opportunity to submit
10documents constituting reasonable evidence indicating satisfactory
11immigration status.
12(2) He or she has provided documents constituting reasonable
13evidence indicating a satisfactory immigration status, but the
14county department has not received timely verification of the
15alien’s immigration status from the United States Immigration and
16Naturalization Service.
17(3) The verification process shall protect the privacy of all
18participants. An alien’s immigration status shall be subject to
19verification by the United States Immigration and Naturalization
20Service, to the extent required for receipt of federal financial
21participation in the Medi-Cal program.
22(i) If an alien does not declare status as a lawful permanent
23resident or alien permanently residing under color of law, or as an
24alien legalized under Section 210, 210A, or 245A of the federal
25Immigration and Nationality Actbegin delete (P.L.end deletebegin insert (Public Lawend insert 82-414),
26Medi-Cal coverage under subdivision (d) of this section or in
27Section 14007.7 shall be provided to the individual if he or she is
28otherwise eligible.
29(j) If an alien subject to this section is not fluent in English, the
30county department shall provide an understandable explanation of
31the requirements of this section in a language in which the alien
32is fluent.
33(k) Aliens who were receiving long-term care or renal dialysis
34services (1) on the day prior to the effective date of the amendment
35to paragraph (1) of subdivision (f) of Section 1 of Chapter 1441
36of the Statutes of 1988 at the 1991-92 Regular Session of the
37Legislature and (2) under the authority of paragraph (1) of
38subdivision (f) of
Section 1 of Chapter 1441 of the Statutes of 1988
39as it read on June 30, 1992, shall continue to receive these services.
40The authority for continuation of long-term care or renal dialysis
P62 1services in this subdivision shall not apply to any person whose
2long-term care or renal dialysis services end for any reason after
3the effective date of the amendment described in this subdivision.
begin insertSection 14007.8 is added to the end insertbegin insertWelfare and
5Institutions Codeend insertbegin insert, to read:end insert
(a) After the director determines, and communicates
7that determination in writing to the Department of Finance, that
8systems have been programmed for implementation of this section,
9but no sooner than May 1, 2016, an individual who is under 19
10years of age and who does not have satisfactory immigration status
11or is unable to establish satisfactory immigration status as required
12by Section 14011.2 shall be eligible for the full scope of Medi-Cal
13benefits, if he or she is otherwise eligible for benefits under this
14chapter.
15(b) To the extent permitted by state and federal law, an
16individual eligible under this section shall be required to enroll
17in a Medi-Cal managed care health plan in those counties in which
18a Medi-Cal managed care health
plan is available.
19(c) The department shall seek any necessary federal approvals
20to obtain federal financial participation in implementing this
21section. Benefits for services under this section shall be provided
22with state-only funds only if federal financial participation is not
23available for those services.
24(d) The department shall maximize federal financial
25participation in implementing this section to the extent allowable.
26(e) This section shall be implemented only to the extent it is in
27compliance with Section 1621(d) of Title 8 of the United States
28Code.
29(f) (1) Notwithstanding Chapter 3.5 (commencing with Section
3011340) of Part 1 of Division 3 of Title 2 of the Government Code,
31the department, without taking any further
regulatory action, shall
32implement, interpret, or make specific this section by means of
33all-county letters, plan letters, plan or provider bulletins, or similar
34instructions until the time any necessary regulations are adopted.
35Thereafter, the department shall adopt regulations in accordance
36with the requirements of Chapter 3.5 (commencing with Section
3711340) of Part 1 of Division 3 of Title 2 of the Government Code.
38(2) Commencing six months after the effective date of this
39section, and notwithstanding Section 10231.5 of the Government
40Code, the department shall provide a status report to the
P63 1Legislature on a semiannual basis, in compliance with Section
29795 of the Government Code, until regulations have been adopted.
3(g) In implementing this section, the department may contract,
4as necessary, on a bid or nonbid basis. This subdivision establishes
5an accelerated process for
issuing contracts pursuant to this
6section. Those contracts, and any other contracts entered into
7pursuant to this subdivision, may be on a noncompetitive bid basis
8and shall be exempt from the following:
9(1) Part 2 (commencing with Section 10100) of Division 2 of
10the Public Contract Code and any policies, procedures or
11regulations authorized by that part.
12(2) Article 4 (commencing with Section 19130) of Chapter 5 of
13Part 2 of Division 5 of Title 2 of the Government Code.
14(3) Review or approval of contracts by the Department of
15General Services.
begin insertSection 14015.5 of the end insertbegin insertWelfare and Institutions Codeend insert
17begin insert is amended to read:end insert
(a) Notwithstanding any otherbegin delete provision ofend delete state law,
19the department shall retain or delegate the authority to perform
20Medi-Cal eligibility determinations as set forth in this section.
21(b) If after an assessment and verification for potential eligibility
22for Medi-Cal benefits using the applicable MAGI-based income
23standard of all persons that apply through an electronic or a paper
24application processed by CalHEERS, which is jointly managed
25by the department and the Exchange, and to the extent required
26by federal law and regulation is completed, the Exchange and the
27department is able to electronically determine the applicant’s
28eligibility for Medi-Cal benefits using only the information initially
29provided online, or through the written application submitted by,
30or on behalf of, the applicant, and without further staff review to
31verify the accuracy of the submitted information, the Exchange
32and the department shall
determine that applicant’s eligibility for
33the Medi-Cal program using the applicable MAGI-based income
34standard.
35(c) Except as provided in subdivision (b) and Section 14015.7,
36the county of residence shall be responsible for eligibility
37determinations and ongoing case management for the Medi-Cal
38program.
39(d) (1) Notwithstanding any otherbegin delete provision ofend delete state law, the
40Exchange shall be authorized to provide information regarding
P64 1available Medi-Cal managed health care plan selection options to
2applicants determined to be eligible for Medi-Cal benefits using
3the MAGI-based income standard and allow those applicants to
4choose an available managed health care plan.
5(2) The Exchange is authorized to record an applicant’s health
6plan selection into CalHEERS for reporting to the department.
7CalHEERS shall have the ability to report to the department the
8results of an applicant’s health plan selection.
9(e) Notwithstanding Chapter 3.5 (commencing with Section
1011340) of Part 1 of Division 3 of Title 2 of the Government Code,
11the department, without taking any further regulatory action, shall
12implement, interpret, or make specific this section by means of
13all-county
letters, plan letters, plan or provider bulletins, or similar
14instructions until the time regulations are adopted. Thereafter, the
15department shall adopt regulations in accordance with the
16requirements of Chapter 3.5 (commencing with Section 11340) of
17Part 1 of Division 3 of Title 2 of the Government Code. Beginning
18six months after the effective date of this section, and
19notwithstanding Section 10231.5 of the Government Code, the
20department shall provide a status report to the Legislature on a
21semiannual basis until regulations have been adopted.
22(f) For the purposes of this section, the following definitions
23shall apply:
24(1) “ACA” means the federal Patient Protection and Affordable
25Care Act (Public Law 111-148), as amended by the federal Health
26Care and Education Reconciliation Act of 2010 (Public Law
27111-152).
28(2) “CalHEERS” means the California Healthcare Eligibility,
29Enrollment, and Retention System developed under Section 15926.
30(3) “Exchange” means the California Health Benefit Exchange
31established pursuant to Section 100500 of the Government Code.
32(4) “MAGI-based income” means income calculated using the
33financial methodologies described in Section 1396a(e)(14) of Title
3442 of the United States Code as added by ACA and any subsequent
35amendments.
36(g) This section shall be implemented only if and to the extent
37that federal financial participation is available and any necessary
38federal approvals have been obtained.
39(h) This section shall become operative on October 1, 2013.
P65 1(i) This section shall remain in effect only until July 1, 2015,
2and as of that date is repealed, unless a later enacted statute, that
3is enacted before July 1, 2015, deletes or extends that date.
begin insertSection 14105.94 of the end insertbegin insertWelfare and Institutions Codeend insert
5begin insert is amended to read:end insert
(a) An eligible provider, as described in subdivision
7(b), may, in addition to the rate of payment that the provider would
8otherwise receive for Medi-Cal ground emergency medical
9transportation services, receive supplemental Medi-Cal
10reimbursement to the extent provided in this section.
11(b) A provider shall be eligible for supplemental reimbursement
12only if the provider has all of the following characteristics
13continuously during a state fiscal year:
14(1) Provides ground emergency medical transportation services
15to Medi-Cal beneficiaries.
16(2) Is a provider that is enrolled as a Medi-Cal provider for the
17period being claimed.
18(3) Is owned or operated by the state, a city, county, city and
19county, fire protection district organized pursuant to Part 2.7
20(commencing with Section 13800) of Division 12 of the Health
21and Safety Code, special district organized pursuant to Chapter 1
22(commencing with Section 58000) of Division 1 of Title 6 of the
23Government Code, community services district organized pursuant
24to Part 1 (commencing with Section 61000) of Division 3 of Title
256 of the Government Code, health care district organized pursuant
26to Chapter 1 (commencing with Section 32000) of Division 23 of
27the Health and Safety Code, or a federally recognized Indian tribe.
28(c) An eligible provider’s supplemental reimbursement pursuant
29to this section shall be calculated and paid as follows:
30(1) The supplemental reimbursement to an eligible provider, as
31
described in subdivision (b), shall be equal to the amount of federal
32financial participation received as a result of the claims submitted
33pursuant to paragraph (2) of subdivision (f).
34(2) In no instance shall the amount certified pursuant to
35paragraph (1) of subdivision (e), when combined with the amount
36received from all other sources of reimbursement from the
37Medi-Cal program, exceed 100 percent of actual costs, as
38determined pursuant to the Medi-Cal State Plan, for ground
39emergency medical transportation services.
P66 1(3) The supplemental Medi-Cal reimbursement provided by this
2section shall be distributed exclusively to eligible providers under
3a payment methodology based on ground emergency medical
4transportation services provided to Medi-Cal beneficiaries by
5eligible providers on a per-transport basis or other federally
6permissible basis. The department shall obtain approval
from the
7federal Centers for Medicare and Medicaid Services for the
8payment methodology to be utilized, and may not make any
9payment pursuant to this section prior to obtaining that approval.
10(d) (1) It is the Legislature’s intent in enacting this section to
11provide the supplemental reimbursement described in this section
12without any expenditure from the General Fund. An eligible
13provider, as a condition of receiving supplemental reimbursement
14pursuant to this section, shall enter into, and maintain, an agreement
15with the department for the purposes of implementing this section
16and reimbursing the department for the costs of administering this
17section.
18(2) The nonfederal share of the supplemental reimbursement
19submitted to the federal Centers for Medicare and Medicaid
20Services for purposes of claiming federal financial participation
21shall be paid only with
funds from the governmental entities
22described in paragraph (3) of subdivision (b) and certified to the
23state as provided in subdivision (e).
24(e) Participation in the program by an eligible provider described
25in this section is voluntary. If an applicable governmental entity
26elects to seek supplemental reimbursement pursuant to this section
27on behalf of an eligible provider owned or operated by the entity,
28as described in paragraph (3) of subdivision (b), the governmental
29entity shall do all of the following:
30(1) Certify, in conformity with the requirements of Section
31433.51 of Title 42 of the Code of Federal Regulations, that the
32claimed expenditures for the ground emergency medical
33transportation services are eligible for federal financial
34participation.
35(2) Provide evidence supporting the certification as
specified
36by the department.
37(3) Submit data as specified by the department to determine the
38appropriate amounts to claim as expenditures qualifying for federal
39financial participation.
P67 1(4) Keep, maintain, and have readily retrievable, any records
2specified by the department to fully disclose reimbursement
3amounts to which the eligible provider is entitled, and any other
4records required by the federal Centers for Medicare and Medicaid
5Services.
6(f) (1) The department shall promptly seek any necessary federal
7approvals for the implementation of this section. The department
8may limit the program to those costs that are allowable
9expenditures under Title XIX of the federal Social Security Act
10(42 U.S.C. 1396 et seq.). If federal approval is not obtained for
11implementation of this section, this
section shall not be
12implemented.
13(2) The department shall submit claims for federal financial
14participation for the expenditures for the services described in
15subdivision (e) that are allowable expenditures under federal law.
16(3) The department shall, on an annual basis, submit any
17necessary materials to the federal government to provide assurances
18that claims for federal financial participation will include only
19those expenditures that are allowable under federal law.
20(g) (1) If either a final judicial determination is made by any
21court of appellate jurisdiction or a final determination is made by
22the administrator of the federal Centers for Medicare and Medicaid
23Services that the supplemental reimbursement provided for in this
24section must be made to any provider not described in this
section,
25the director shall execute a declaration stating that the
26determination has been made and on that date this section shall
27become inoperative.
28(2) The declaration executed pursuant to this subdivision shall
29be retained by the director, provided to the fiscal and appropriate
30policy committees of the Legislature, the Secretary of State, the
31Secretary of the Senate, the Chief Clerk of the Assembly, and the
32Legislative Counsel, and posted on the department’s Internet Web
33site.
34(h) Notwithstanding Chapter 3.5 (commencing with Section
3511340) of Part 1 of Division 3 of Title 2 of the Government Code,
36the department may implement and administer this section by
37means of provider bulletins, or similar instructions, without taking
38regulatory action.
39(i) (1) Upon the effective date of the act that added this
40subdivision, the department shall develop, in consultation with the
P68 1providers described in subdivision (b), and seek any necessary
2federal approvals for, a modified program for the supplemental
3reimbursement authorized by this section that will seek to provide
4increased reimbursement to an eligible provider that participates
5in the program. The nonfederal share of any supplemental
6reimbursement provided under the modified program shall be
7derived from voluntary intergovernmental transfers of local funds.
8The department shall otherwise develop the modified program
9consistent with the requirements of this section, except for
10paragraph (2) of subdivision (c), and only to the extent that federal
11financial participation is available.
12(2) The
department shall be reimbursed for costs associated
13with administering the modified program described in paragraph
14(1) in accordance with subdivision (d). The department shall not
15otherwise assess a percentage fee in connection with any
16intergovernmental transfer of funds made pursuant to this
17subdivision.
18(3) The department shall not implement the modified program
19described in paragraph (1) until it obtains all necessary federal
20approvals. Until those federal approvals are obtained,
21supplemental reimbursement shall continue to be available
22pursuant to the provisions of this section that were operative prior
23to the effective date of the act that added this subdivision.
24(j) The department shall not implement the modified program
25described in paragraph (1) of subdivision (i) unless it determines
26that the modified program will likely result in an overall increase
27to the supplemental reimbursement available pursuant to the
28provisions of this section that were operative prior to the effective
29date of the act that added this subdivision.
begin insertSection 14105.192 of the end insertbegin insertWelfare and Institutions
31Codeend insertbegin insert is amended to read:end insert
(a) The Legislature finds and declares the
33following:
34(1) Costs within the Medi-Cal program continue to grow due
35to the rising cost of providing health care throughout the state and
36also due to increases in enrollment, which are more pronounced
37during difficult economic times.
38(2) In order to minimize the need for drastically cutting
39enrollment standards or benefits during times of economic crisis,
40it is crucial to find areas within the program where reimbursement
P69 1levels are higher than required under the standard provided in
2Section 1902(a)(30)(A) of the federal Social Security Act and can
3be reduced in accordance with federal law.
4(3) The Medi-Cal program delivers its services and benefits to
5Medi-Cal beneficiaries through a wide variety of health care
6providers, some of which deliver care via managed care or other
7contract models while others do so through fee-for-service
8arrangements.
9(4) The setting of rates within the Medi-Cal program is complex
10and is subject to close supervision by the United States Department
11of Health and Human Services.
12(5) As the single state agency for Medicaid in California, the
13department has unique expertise that can inform decisions that set
14or adjust reimbursement methodologies and levels consistent with
15the requirements of federal law.
16(b) Therefore, it is the intent of the Legislature for the
17department to analyze and identify where reimbursement levels
18can be reduced consistent with the standard
provided in Section
191902(a)(30)(A) of the federal Social Security Act and consistent
20with federal and state law and policies, including any exemptions
21contained in the provisions of the act that added this section,
22provided that the reductions in reimbursement shall not exceed 10
23percent on an aggregate basis for all providers, services and
24products.
25(c) Notwithstanding any otherbegin delete provision ofend delete law, the director
26shall adjust provider payments, as specified in this section.
27(d) (1) Except as otherwise provided in this section, payments
28shall be reduced by 10 percent for Medi-Cal fee-for-service benefits
29for dates of service on and after June 1, 2011.
30(2) For managed health care plans that contract with the
31department pursuant to this chapter or Chapter 8 (commencing
32with Section 14200), except contracts with Senior Care Action
33Network and AIDS Healthcare Foundation, payments shall be
34reduced by the actuarial equivalent amount of the payment
35reductions specified in this section pursuant to contract
36amendments or change orders effective on July 1, 2011, or
37thereafter.
38(3) Payments shall be reduced by 10 percent for
non-Medi-Cal
39programs described in Article 6 (commencing with Section 124025)
40of Chapter 3 of Part 2 of Division 106 of the Health and Safety
P70 1Code, and Section 14105.18, for dates of service on and after June
21, 2011. This paragraph shall not apply to inpatient hospital
3services provided in a hospital that is paid under contract pursuant
4to Article 2.6 (commencing with Section 14081).
5(4) (A) Notwithstanding any otherbegin delete provision ofend delete law, the director
6may adjust the payments specified in paragraphs (1) and (3) of
7this subdivision with respect to one or more categories of Medi-Cal
8providers, or for one or more products or services rendered, or any
9combination thereof, so long as the resulting reductions to any
10category of Medi-Cal providers, in the aggregate, total no more
11than 10 percent.
12(B) The adjustments authorized in subparagraph (A) shall be
13implemented only if the director determines that, for each affected
14product, service, or provider category, the payments resulting from
15the adjustment comply with subdivision (m).
16(e) Notwithstanding any other provision of this section,
17payments to hospitals that are not under contract with the State
18Department of Health Care Services pursuant to Article 2.6
19(commencing with Section 14081) for
inpatient hospital services
20provided to Medi-Cal beneficiaries and that are subject to Section
2114166.245 shall be governed by that section.
22(f) Notwithstanding any other provision of this section, the
23following shall apply:
24(1) Payments to providers that are paid pursuant to Article 3.8
25(commencing with Section 14126) shall be governed by that article.
26(2) (A) Subject to subparagraph (B), for dates of service on and
27after June 1, 2011, Medi-Cal reimbursement rates for intermediate
28care facilities for the developmentally disabled licensed pursuant
29to subdivision (e), (g), or (h) of Section 1250 of the Health and
30Safety Code, and facilities providing continuous skilled nursing
31care to developmentally disabled individuals pursuant to the pilot
32project established by Section 14132.20, as determined
by the
33applicable methodology for setting reimbursement rates for these
34facilities, shall not exceed the reimbursement rates that were
35applicable to providers in the 2008-09 rate year.
36(B) (i) If Section 14105.07 is added to the Welfare and
37Institutions Code during the 2011-12 Regular Session of the
38Legislature, subparagraph (A) shall become inoperative.
39(ii) If Section 14105.07 is added to the Welfare and Institutions
40Code during the 2011-12 Regular Session of the Legislature, then
P71 1for dates of service on and after June 1, 2011, payments to
2intermediate care facilities for the developmentally disabled
3licensed pursuant to subdivision (e), (g), or (h) of Section 1250 of
4the Health and Safety Code, and facilities providing continuous
5skilled nursing care to developmentally disabled individuals
6pursuant to the pilot project established by Section 14132.20,
shall
7be governed by the applicable methodology for setting
8reimbursement rates for these facilities and by Section 14105.07.
9(g) The department may enter into contracts with a vendor for
10the purposes of implementing this section on a bid or nonbid basis.
11In order to achieve maximum cost savings, the Legislature declares
12that an expedited process for contracts under this subdivision is
13necessary. Therefore, contracts entered into to implement this
14section and all contract amendments and change orders shall be
15exempt from Chapter 2 (commencing with Section 10290) of Part
162 Division 2 of the Public Contract Code.
17(h) To the extent applicable, the services, facilities, and
18payments listed in this subdivision shall be exempt from the
19payment reductions specified in subdivision (d) as follows:
20(1) Acute hospital inpatient
services that are paid under contracts
21pursuant to Article 2.6 (commencing with Section 14081).
22(2) Federally qualified health center services, including those
23facilities deemed to have federally qualified health center status
24pursuant to a waiver pursuant to subsection (a) of Section 1115 of
25the federal Social Security Act (42 U.S.C. Sec. 1315(a)).
26(3) Rural health clinic services.
27(4) Payments to facilities owned or operated by the State
28Department of State Hospitals or the State Department of
29Developmental Services.
30(5) Hospice services.
31(6) Contract services, as designated by the director pursuant to
32subdivision (k).
33(7) Payments to providers to the extent that the payments are
34funded by means of a certified public expenditure or an
35intergovernmental transfer pursuant to Section 433.51 of Title 42
36of the Code of Federal Regulations. This paragraph shall apply to
37payments described in paragraph (3) of subdivision (d) only to the
38extent that they are also exempt from reduction pursuant to
39subdivision (l).
P72 1(8) Services pursuant to local assistance contracts and
2interagency agreements to the extent the funding is not included
3in the funds appropriated to the department in the annual Budget
4Act.
5(9) Breast and cervical cancer treatment provided pursuant to
6Section 14007.71 and as described in paragraph (3) of subdivision
7(a) of Section 14105.18 or Article 1.5 (commencing with Section
8104160) of Chapter 2 of Part 1 of Division 103 of the Health and
9Safety Code.
10(10) The Family Planning, Access, Care, and Treatment (Family
11PACT) Program pursuant to subdivision (aa) of Section 14132.
12(11) (A) Effective for dates of service on or after July 1, 2015,
13or the effective date of any necessary federal approvals as required
14by subdivisions (n) and (o), whichever is later, dental services and
15applicable ancillary services.
16(B) For dental managed care plans that contract with the
17department pursuant to this chapter or Chapter 8 (commencing
18with Section 14200), payments pursuant to contract amendments
19or change orders effective on or after July 1, 2015, or the effective
20date of
any necessary federal approvals as required by subdivisions
21(n) and (o), whichever is later.
22(i) Subject to the exception for services listed in subdivision
23(h), the payment reductions required by subdivision (d) shall apply
24to the benefits rendered by any provider who may be authorized
25to bill for the service, including, but not limited to, physicians,
26podiatrists, nurse practitioners, certified nurse-midwives, nurse
27anesthetists, and organized outpatient clinics.
28(j) Notwithstanding any otherbegin delete provision ofend delete law, for dates of
29service on and after June 1, 2011, Medi-Cal reimbursement rates
30applicable to the following classes of providers shall not exceed
31the reimbursement rates that were applicable to those classes of
32providers in the 2008-09 rate year, as described in subdivision (f)
33of Section 14105.191, reduced by 10 percent:
34(1) Intermediate care facilities, excluding those facilities
35identified in paragraph (2) of subdivision (f). For purposes of this
36section, “intermediate care facility” has the same meaning as
37defined in Section 51118 of Title 22 of the California Code of
38Regulations.
39(2) Skilled nursing facilities that are distinct parts of general
40acute care hospitals. For purposes of this section, “distinct part”
P73 1has the same meaning as defined in Section 72041 of Title 22 of
2the California Code of
Regulations.
3(3) Rural swing-bed facilities.
4(4) Subacute care units that are, or are parts of, distinct parts of
5general acute care hospitals. For purposes of this subparagraph,
6“subacute care unit” has the same meaning as defined in Section
751215.5 of Title 22 of the California Code of Regulations.
8(5) Pediatric subacute care units that are, or are parts of, distinct
9parts of general acute care hospitals. For purposes of this
10subparagraph, “pediatric subacute care unit” has the same meaning
11as defined in Section 51215.8 of Title 22 of the California Code
12of Regulations.
13(6) Adult day health care centers.
14(7) Freestanding pediatric subacute care units, as defined in
15Section 51215.8 of
Title 22 of the California Code of Regulations.
16(k) Notwithstanding Chapter 3.5 (commencing with Section
1711340) of Part 1 of Division 3 of Title 2 of the Government Code,
18the department may implement and administer this section by
19means of provider bulletins or similar instructions, without taking
20regulatory action.
21(l) The reductions described in this section shall apply only to
22payments for services when the General Fund share of the payment
23is paid with funds directly appropriated to the department in the
24annual Budget Act and shall not apply to payments for services
25paid with funds appropriated to other departments or agencies.
26(m) Notwithstanding any other provision of this section, the
27payment reductions and adjustments provided for in subdivision
28(d) shall be implemented only if the director determines
that the
29payments that result from the application of this section will
30comply with applicable federal Medicaid requirements and that
31federal financial participation will be available.
32(1) In determining whether federal financial participation is
33available, the director shall determine whether the payments
34comply with applicable federal Medicaid requirements, including
35those set forth in Section 1396a(a)(30)(A) of Title 42 of the United
36States Code.
37(2) To the extent that the director determines that the payments
38do not comply with the federal Medicaid requirements or that
39federal financial participation is not available with respect to any
40payment that is reduced pursuant to this section, the director retains
P74 1the discretion to not implement the particular payment reduction
2or adjustment and may adjust the payment as necessary to comply
3with federal Medicaid requirements.
4(n) The department shall seek any necessary federal approvals
5for the implementation of this section.
6(o) (1) The payment reductions and adjustments set forth in
7this section shall not be implemented until federal approval is
8obtained.
9(2) To the extent that federal approval is obtained for one or
10more of the payment reductions and adjustments in this section
11and Section 14105.07, the payment reductions and adjustments
12set forth in Section 14105.191 shall cease to be implemented for
13the same services provided by the same class of providers. In the
14event of a conflict between this section and Section 14105.191,
15other than the provisions setting forth a payment reduction or
16adjustment, this section shall govern.
17(3) When federal
approval is obtained, the payments resulting
18from the application of this section shall be implemented
19retroactively to June 1, 2011, or on any other date or dates as may
20be applicable.
21(4) The director may clarify the application of this subdivision
22by means of provider bulletins or similar instructions, pursuant to
23subdivision (k).
24(p) Adjustments to pharmacy drug product payment pursuant
25to this section shall no longer apply when the department
26determines that the average acquisition cost methodology pursuant
27to Section 14105.45 has been fully implemented and the
28department’s pharmacy budget reduction targets, consistent with
29payment reduction levels pursuant to this section, have been met.
begin insertSection 14127.7 is added to the end insertbegin insertWelfare and
31Institutions Codeend insertbegin insert, to read:end insert
(a) The Health Home Program Account is hereby
33created in the Special Deposit Fund within the State Treasury in
34order to collect and allocate non-General Fund public or private
35grant funds, to be expended, upon appropriation by the Legislature,
36for the purposes of implementing the Health Home Program
37established pursuant to this article.
38(b) The department may accept funding from local governments,
39foundations, or other organizations to provide funding for the
40Health Home Program.
P75 1(c) Any unexpended funds within the Health Home Program
2Account, within the Special Deposit Fund, from a local government,
3foundation, or other organization, shall be returned to the
4contributing
entity.
begin insertSection 14134 of the end insertbegin insertWelfare and Institutions Codeend insertbegin insert,
6as
amended by Section 65 of Chapter 23 of the Statutes of 2013,
7is amended to read:end insert
(a) Except for any prescription, refill, visit, service,
9device, or item for which the program’s payment is ten dollars
10($10) or less, in which case no copayment shall be required, a
11recipient of services under this chapter shall be required to make
12copayments not to exceed the maximum permitted under federal
13regulations or federalbegin delete waiversend deletebegin insert waivers,end insert as follows:
14(1) Copayment of five dollars ($5) shall be made for
15nonemergency services received in an emergency department or
16emergency room when the services do not result in the treatment
17of an emergency medical condition or inpatient admittance. For
18the purposes of this section, “nonemergency services” means
19services not required to, as appropriate, medically screen, examine,
20evaluate, or stabilize an emergency medical condition that
21manifests itself by acute symptoms of sufficient severity, including
22severe pain,begin delete suchend deletebegin insert soend insert that the absence of immediate medical
23attention could reasonably be expected to result in any of the
24following:
25(A) Placing the individual’s health, or, with respect to a pregnant
26woman, the health of the woman or her unborn child, in serious
27jeopardy.
28(B) Serious impairment to bodily functions.
29(C) Serious dysfunction of any bodily organ or part.
30(2) Copayment of one dollar ($1) shall be made for each drug
31prescription or refill.
32(3) Copayment of one dollar ($1) shall be made for each visit
33for services under
subdivisions (a) and (h) of Section 14132.
34(4) The copayment amounts set forth in paragraphs (1), (2), and
35(3) may be collected andbegin delete retainedend deletebegin insert retained,end insert or waived by the
36provider.
37(5) The department shall not reduce the reimbursement otherwise
38due to providers as a result of the copayment. The copayment
39amounts shall be in addition to any reimbursement otherwise due
40begin insert toend insert the provider for services rendered under this program.
P76 1(6) This section does not apply to emergency services, family
2planning services, or to any services receivedbegin delete by:end deletebegin insert by any of the
3following:end insert
4(A) begin deleteAny end deletebegin insertA end insertchild in AFDC-Foster Care, as defined in Section
511400.
6(B) begin deleteAny end deletebegin insertA end insertperson who is an inpatient in a health facility, as
7defined in Section 1250 of the Health and Safety Code.
8(C) begin deleteAny end deletebegin insertA
end insertperson 18 years of age or under.
9(D) begin deleteAny end deletebegin insertA end insertwoman receiving perinatal care.
10(7) Paragraph (2) does not apply tobegin delete anyend deletebegin insert aend insert person 65 years of
11age or over.
12(8) A provider of service shall not deny care or services to an
13individual solely because of that person’s inability to copay under
14this section.begin delete Anend deletebegin insert However, anend insert individualbegin delete shall, however,end deletebegin insert shallend insert
15 remain liable to the provider for any copayment amount owed.
16(9) This section shall not apply tobegin delete anyend delete preventive services that
17are assigned a grade of A or B by the United States Preventive
18Services Task Force provided by a physician or other licensed
19practitioner of the healing arts, or any approved adult vaccines and
20their administration recommended by the Advisory Committee on
21Immunization Practices. Pursuant to Section 1905(b) of the federal
22Social Security Act (42 U.S.C. Sec. 1396d(b)), these services shall
23be provided without any cost sharing by the beneficiary in order
24for the state to receive an increased federal medical assistance
25percentage for these services.
26(10)
end delete
27begin insert(b)end insert The department shall seek any federal waivers necessary to
28implement this section. The provisions for which appropriate
29federal waivers cannot be obtained shall not be implemented, but
30provisions for which waivers are either obtained or found to be
31unnecessary shall be unaffected by the inability to obtain federal
32waivers for the other provisions.
33(11)
end delete
34begin insert(c)end insert The director shall adoptbegin delete anyend delete regulations necessary to
35implement this section as emergency regulations in accordance
36with Chapter 3.5 (commencing with Section 11340) of Part 1 of
37Division 3 of Title 2 of the Government Code. The adoption of
38the regulations shall be deemed to be an emergency and necessary
39for the immediate preservation of the public peace, health and
40safety, or general welfare. The director shall transmit these
P77 1emergency regulations directly to the Secretary of State for filing
2and the regulations shall become effective immediately upon filing.
3Upon completion of the formal regulation adoption process and
4prior to the expiration of the 120 day duration period of emergency
5regulations, the director shall transmit directly to the Secretary of
6State for filing the adopted regulations, the rulemaking file, and
7the certification of compliance as required by subdivision (e) of
8Section 11346.1 of the Government Code.
9(b) This section, or subdivisions thereof, if applicable, shall
10become inoperative on the implementation date for copayments
11stated in the declaration executed by the director pursuant to
12Section 14134 as added by Section 101.5 of Chapter 3 of the
13Statutes of 2011.
begin insertSection 14134 of the end insertbegin insertWelfare and Institutions Codeend insertbegin insert,
15as
amended by Section 66 of Chapter 23 of the Statutes of 2013,
16is repealed.end insert
(a) The Legislature finds and declares all of the
18following:
19(1) Costs within the Medi-Cal program continue to grow due
20to the rising cost of providing health care throughout the state and
21also due to increases in enrollment, which are more pronounced
22during difficult economic times.
23(2) In order to minimize the need for drastically cutting
24enrollment standards or benefits or imposing further reductions
25on Medi-Cal providers during times of economic crisis, it is crucial
26to find areas within the program where beneficiaries can share
27responsibility for utilization of health care, whether they are
28participating in the fee-for-service or the managed care model of
29
service delivery.
30(3) The establishment of cost-sharing obligations within the
31Medi-Cal program is complex and is subject to close supervision
32by the United States Department of Health and Human Services.
33(4) As the single state agency for Medicaid in California, the
34State Department of Health Care Services has unique expertise
35that can inform decisions that set or adjust cost-sharing
36responsibilities for Medi-Cal beneficiaries receiving health care
37services.
38(b) Therefore, it is the intent of the Legislature for the
39department to obtain federal approval to implement cost-sharing
40for Medi-Cal beneficiaries and permit providers to require that
P78 1individuals meet their cost-sharing obligation prior to receiving
2care or services.
3(c) A Medi-Cal beneficiary
shall be required to make
4copayments as described in this section. These copayments
5represent a contribution toward the rate of payment made to
6providers of Medi-Cal services and shall be as follows:
7(1) Copayment of up to fifty dollars ($50) shall be made for
8nonemergency services received in an emergency department or
9emergency room when the services do not result in the treatment
10of an emergency condition or inpatient admittance. For the
11purposes of this section, “nonemergency services” means services
12not required to, as appropriate, medically screen, examine, evaluate,
13or stabilize an emergency medical condition that manifests itself
14by acute symptoms of sufficient severity, including severe pain,
15such that the absence of immediate medical attention could
16reasonably be expected to result in any of the following:
17(A) Placing the individual’s health, or, with respect to a
pregnant
18woman, the health of the woman or her unborn child, in serious
19jeopardy.
20(B) Serious impairment to bodily functions.
21(C) Serious dysfunction of any bodily organ or part.
22(2) Copayment of up to fifty dollars ($50) shall be made for
23emergency services received in an emergency department or
24emergency room when the services result in the treatment of an
25emergency medical condition or inpatient admittance. For purposes
26of this section, “emergency services” means services required to,
27as appropriate, medically screen, examine, evaluate, or stabilize
28an emergency medical condition that manifests itself by acute
29symptoms of sufficient severity, including severe pain, such that
30the absence of immediate medical attention could reasonably be
31expected to result in any of the following:
32(A) Placing the individual’s health, or, with respect to a pregnant
33woman, the health of the woman or her unborn child, in serious
34jeopardy.
35(B) Serious impairment to bodily functions.
36(C) Serious dysfunction of any bodily organ or part.
37(3) Copayment of up to one hundred dollars ($100) shall be
38made for each hospital inpatient day, up to a maximum of two
39hundred dollars ($200) per admission.
P79 1(4) Copayment of up to three dollars ($3) shall be made for each
2preferred drug prescription or refill. A copayment of up to five
3dollars ($5) shall be made for each nonpreferred drug prescription
4or refill. Except as provided in subdivision (g), “preferred drug”
5shall have the same meaning as in Section
1916A of the Social
6Security Act (42 U.S.C. Sec. 1396o-1).
7(5) Copayment of up to five dollars ($5) shall be made for each
8visit for services under subdivision (a) of Section 14132 and for
9dental services received on an outpatient basis provided as a
10Medi-Cal benefit pursuant to this chapter or Chapter 8
11(commencing with Section 14200), as applicable.
12(6) This section does not apply to services provided pursuant
13to subdivision (aa) of Section 14132.
14(d) The copayments established pursuant to subdivision (c) shall
15be set by the department, at the maximum amount provided for in
16the applicable paragraph, except that each copayment amount shall
17not exceed the maximum amount allowable pursuant to the state
18plan amendments or other federal approvals.
19(e) The
copayment amounts set forth in subdivision (c) may be
20collected and retained or waived by the provider. The department
21shall deduct the amount of the copayment from the payment the
22department makes to the provider whether retained, waived, or not
23collected by the provider.
24(f) Notwithstanding any other provision of law, and only to the
25extent allowed pursuant to federal law, a provider of service has
26no obligation to provide services to a Medi-Cal beneficiary who
27does not, at the point of service, pay the copayment assessed
28pursuant to this section. If the provider provides services without
29collecting the copayment, and has not waived the copayment, the
30provider may hold the beneficiary liable for the copayment amount
31owed.
32(g) (1) Notwithstanding any other provision of law, except as
33described in paragraph (2), this section shall apply to Medi-Cal
34
beneficiaries enrolled in a health plan contracting with the
35department pursuant to this chapter or Chapter 8 (commencing
36with Section 14200), except for the Senior Care Action Network
37or AIDS Healthcare Foundation. To the extent permitted by federal
38law and pursuant to any federal waivers or state plan adjustments
39obtained, a managed care health plan may establish a lower
40copayment or no copayment.
P80 1(2) For the purpose of paragraph (4) of subdivision (c),
2copayments assessed against a beneficiary who receives Medi-Cal
3services through a health plan described in paragraph (1) shall be
4based on the plan’s designation of a drug as preferred or
5nonpreferred.
6(3) To the extent provided by federal law, capitation payments
7shall be calculated on an actuarial basis as if copayments described
8in this section were collected.
9(h) This section shall not apply to any preventive services that
10are assigned a grade of A or B by the United States Preventive
11Services Task Force provided by a physician or other licensed
12practitioner of the healing arts, or any approved adult vaccines and
13their administration recommended by the Advisory Committee on
14Immunization Practices. Pursuant to Section 1905(b) of the federal
15Social Security Act (42 U.S.C. Sec. 1396d(b)), these services shall
16be provided without any cost sharing by the beneficiary in order
17for the state to receive an increased federal medical assistance
18percentage for these services.
19(i) This section shall be implemented only to the extent that
20federal financial participation is available. The department shall
21seek and obtain any federal waivers or state plan amendments
22necessary to implement this section. The provisions for which
23appropriate federal waivers or state plan amendments cannot be
24obtained
shall not be implemented, but provisions for which
25waivers or state plan amendments are either obtained or found to
26be unnecessary shall be unaffected by the inability to obtain federal
27waivers or state plan amendments for the other provisions.
28(j) Notwithstanding Chapter 3.5 (commencing with Section
2911340) of Part 1 of Division 3 of Title 2 of the Government Code,
30the department may implement, interpret, or make specific this
31section by means of all-county letters, all-plan letters, provider
32bulletins, or similar instructions, without taking further regulatory
33actions.
34(k) (1) This section shall become operative on the date that the
35act adding this section is effective, but shall not be implemented
36until the date in the declaration executed by the director pursuant
37to paragraph (2). In no event shall the director set an
38implementation date prior to the date
federal approval is received.
39(2) The director shall execute a declaration that states the date
40that implementation of the copayments described in this section
P81 1or subdivisions thereof, if applicable, will commence and shall
2post the declaration on the department’s Internet Web site and
3provide a copy of the declaration to the Chair of the Joint
4Legislative Budget Committee, the Chief Clerk of the Assembly,
5the Secretary of the Senate, the Office of the Legislative Counsel,
6and the Secretary of State.
begin insertSection 14154 of the end insertbegin insertWelfare and Institutions Codeend insert
8begin insert is amended to read:end insert
(a) (1) The department shall establish and maintain a
10plan whereby costs for county administration of the determination
11of eligibility for benefits under this chapter will be effectively
12controlled within the amounts annually appropriated for that
13administration. The plan, to be known as the County Administrative
14Cost Control Plan, shall establish standards and performance
15criteria, including workload, productivity, and support services
16standards, to which counties shall adhere. The plan shall include
17standards for controlling eligibility determination costs that are
18incurred by performing eligibility determinations at county
19hospitals, or that are incurred due to the outstationing of any other
20eligibility function. Except as provided in Section 14154.15,
21reimbursement to a county for outstationed
eligibility functions
22shall be based solely on productivity standards applied to that
23county’s welfare department office.
24(2) (A) The plan shall delineate both of the following:
25(i) The process for determining county administration base costs,
26which include salaries and benefits, support costs, and staff
27development.
28(ii) The process for determining funding for caseload changes,
29cost-of-living adjustments, and program and other changes.
30(B) The annual county budget survey document utilized under
31the plan shall be constructed to enable the counties to provide
32sufficient detail to the department to support their budget requests.
33(3) The plan shall be part of a single
state plan, jointly developed
34by the department and the State Department of Social Services, in
35conjunction with the counties, for administrative cost control for
36the California Work Opportunity and Responsibility to Kids
37(CalWORKs), CalFresh, and Medical Assistance (Medi-Cal)
38programs. Allocations shall be made to each county and shall be
39limited by and determined based upon the County Administrative
40Cost Control Plan. In administering the plan to control county
P82 1administrative costs, the department shall not allocate state funds
2to cover county cost overruns that result from county failure to
3meet requirements of the plan. The department and the State
4Department of Social Services shall budget, administer, and
5allocate state funds for county administration in a uniform and
6consistent manner.
7(4) The department and county welfare departments shall
8develop procedures to ensure the data clarity, consistency, and
9reliability of information
contained in the county budget survey
10document submitted by counties to the department. These
11procedures shall include the format of the county budget survey
12document and process, data submittal and its documentation, and
13the use of the county budget survey documents for the development
14of determining county administration costs. Communication
15between the department and the county welfare departments shall
16be ongoing as needed regarding the content of the county budget
17surveys and any potential issues to ensure the information is
18complete and well understood by involved parties. Any changes
19developed pursuant to this section shall be incorporated within the
20state’s annual budget process by no later than the 2011-12 fiscal
21year.
22(5) The department shall provide a clear narrative description
23along with fiscal detail in the Medi-Cal estimate package, submitted
24to the Legislature in January and May of each year, of each
25component of the county
administrative funding for the Medi-Cal
26program. This shall describe how the information obtained from
27the county budget survey documents was utilized and, if applicable,
28modified and the rationale for the changes.
29(6) Notwithstanding any other law, the department shall develop
30and implement, in consultation with county program and fiscal
31representatives, a new budgeting methodology for Medi-Cal county
32administrative costs that reflects the impact of PPACA
33implementation on county administrative work. The new budgeting
34methodology shall be used to reimburse counties for eligibility
35processing and case maintenance for applicants and beneficiaries.
36(A) The budgeting methodology may include, but is not limited
37to, identification of the costs of eligibility determinations for
38applicants, and the costs of eligibility redeterminations and case
39maintenance activities for recipients, for
different groupings of
40cases, based on variations in time and resources needed to conduct
P83 1eligibility determinations. The calculation of time and resources
2shall be based on the following factors: complexity of eligibility
3rules, ongoing eligibility requirements, and other factors as
4determined appropriate by the department. The development of
5the new budgeting methodology may include, but is not limited
6to, county survey of costs, time and motion studies, in-person
7observations by department staff, data reporting, and other factors
8deemed appropriate by the department.
9(B) The new budgeting methodology shall be clearly described,
10state the necessary data elements to be collected from the counties,
11and establish the timeframes for counties to provide the data to
12the state.
13(C) The new budgeting methodology developed pursuant to this
14paragraph shall be implemented no sooner than
the 2015-16 fiscal
15year. The department may develop a process for counties to phase
16in the requirements of the new budgeting methodology.
17(D) The department shall provide the new budgeting
18methodology to the legislative fiscal committees by March 1 of
19the fiscal year immediately preceding the first fiscal year of
20implementation of the new budgeting methodology.
21(E) To the extent that the funding for the county budgets
22developed pursuant to the new budget methodology is not fully
23appropriated in any given fiscal year, the department, with input
24from the counties, shall identify and consider options to align
25funding and workload responsibilities.
26(F) For purposes of this paragraph, “PPACA” means the federal
27Patient Protection and Affordable Care Act (Public Law 111-148),
28as amended by the federal Health Care and
Education
29Reconciliation Act of 2010 (Public Law 111-152) and any
30subsequent amendments.
31(G) Notwithstanding Chapter 3.5 (commencing with Section
3211340) of Part 1 of Division 3 of Title 2 of the Government Code,
33the department may implement, interpret, or make specific this
34paragraph by means of all-county letters, plan letters, plan or
35provider bulletins, or similar instructions until the time any
36necessary regulations are adopted. The department shall adopt
37regulations by July 1, 2017, in accordance with the requirements
38of Chapter 3.5 (commencing with Section 11340) of Part 1 of
39Division 3 of Title 2 of the Government Code. Beginning six
40months after the implementation of the new budgeting methodology
P84 1pursuant to this paragraph, and notwithstanding Section 10231.5
2of the Government Code, the department shall provide a status
3report to the Legislature on a semiannual basis, in compliance with
4Section 9795 of the Government Code, until
regulations have been
5adopted.
6(b) Nothing in this section, Section 15204.5, or Section 18906
7shall be construed to limit the administrative or budgetary
8responsibilities of the department in a manner that would violate
9Section 14100.1, and thereby jeopardize federal financial
10participation under the Medi-Cal program.
11(c) (1) The Legislature finds and declares that in order for
12counties to do the work that is expected of them, it is necessary
13that they receive adequate funding, including adjustments for
14reasonable annual cost-of-doing-business increases. The Legislature
15further finds and declares that linking appropriate funding for
16county Medi-Cal administrative operations, including annual
17cost-of-doing-business adjustments, with performance standards
18will give counties the incentive to meet the performance standards
19and enable them to continue to do the
work they do on behalf of
20the state. It is therefore the Legislature’s intent to provide
21appropriate funding to the counties for the effective administration
22of the Medi-Cal program at the local level to ensure that counties
23can reasonably meet the purposes of the performance measures as
24contained in this section.
25(2) It is the intent of the Legislature to not appropriate funds for
26the cost-of-doing-business adjustment for the 2008-09, 2009-10,
272010-11, 2011-12, 2012-13,begin insert 2014-15,end insert andbegin delete 2014-15end deletebegin insert 2015-16end insert
28 fiscal years.
29(d) The department is responsible for the Medi-Cal program in
30accordance with state and federal law. A county shall determine
31Medi-Cal eligibility in accordance with state and federal law. If
32in the course of its duties the department becomes aware of
33accuracy problems in any county, the department shall, within
34available resources, provide training and technical assistance as
35appropriate. Nothing in this section shall be interpreted to eliminate
36any remedy otherwise available to the department to enforce
37accurate county administration of the program. In administering
38the Medi-Cal eligibility process, each county shall meet the
39following performance standards each fiscal year:
40(1) Complete eligibility determinations as follows:
P85 1(A) Ninety percent of the general applications without applicant
2errors and are complete shall be completed within 45 days.
3(B) Ninety percent of the applications for Medi-Cal based on
4disability shall be completed within 90 days, excluding delays by
5the state.
6(2) (A) The department shall establish best-practice guidelines
7for expedited enrollment of newborns into the Medi-Cal program,
8preferably with the goal of enrolling newborns within 10 days after
9the county is informed of the birth. The department, in consultation
10with counties and other stakeholders, shall work to develop a
11process for expediting enrollment for all newborns, including those
12born to mothers receiving CalWORKs assistance.
13(B) Upon the development and implementation of the
14best-practice guidelines and expedited processes, the department
15and the counties may develop an expedited enrollment timeframe
16for newborns that is separate from the standards for all other
17applications, to the extent that the timeframe is consistent with
18these guidelines and processes.
19(3) Perform timely annual redeterminations, as follows:
20(A) Ninety percent of the annual redetermination forms shall
21be mailed to the recipient by the anniversary date.
22(B) Ninety percent of the annual redeterminations shall be
23completed within 60 days of the recipient’s annual redetermination
24date for those redeterminations based on forms that are complete
25and have been returned to the county by the recipient in a timely
26manner.
27(C) Ninety percent of those annual redeterminations where the
28redetermination form has not been returned to the county by the
29recipient shall be completed by sending a notice of action to the
30recipient within 45 days after the date the form was due to the
31county.
32(D) If a child is determined by the county to change from no
33share of cost to a share of cost and the child meets the eligibility
34criteria for the Healthy Families Program established under Section
3512693.98 of the Insurance Code, the child shall be placed in the
36Medi-Cal-to-Healthy Families Bridge Benefits Program, and these
37cases shall be processed as follows:
38(i) Ninety percent of the families of these children shall be sent
39a notice informing them of the Healthy Families Program within
40five working days from the determination of a share of cost.
P86 1(ii) Ninety percent of all annual redetermination forms for these
2children shall be sent to the Healthy Families Program within five
3working days from the determination of a share of cost if the parent
4has given consent to send this information to the Healthy Families
5Program.
6(iii) Ninety percent of the families of these children placed in
7the Medi-Cal-to-Healthy Families Bridge Benefits Program who
8have not consented to sending the child’s annual redetermination
9form to the Healthy Families Program shall be sent a request,
10within five working days of the determination of a share of cost,
11to consent to send the information to the Healthy Families Program.
12(E) Subparagraph (D) shall not be implemented until 60 days
13after the Medi-Cal and Joint Medi-Cal and Healthy Families
14applications and the Medi-Cal redetermination
forms are revised
15to allow the parent of a child to consent to forward the child’s
16information to the Healthy Families Program.
17(e) The department shall develop procedures in collaboration
18with the counties and stakeholder groups for determining county
19review cycles, sampling methodology and procedures, and data
20reporting.
21(f) On January 1 of each year, each applicable county, as
22determined by the department, shall report to the department on
23the county’s results in meeting the performance standards specified
24in this section. The report shall be subject to verification by the
25department. County reports shall be provided to the public upon
26written request.
27(g) If the department finds that a county is not in compliance
28with one or more of the standards set forth in this section, the
29county shall, within 60 days, submit
a corrective action plan to the
30department for approval. The corrective action plan shall, at a
31minimum, include steps that the county shall take to improve its
32performance on the standard or standards with which the county
33is out of compliance. The plan shall establish interim benchmarks
34for improvement that shall be expected to be met by the county in
35order to avoid a sanction.
36(h) (1) If a county does not meet the performance standards for
37completing eligibility determinations and redeterminations as
38specified in this section, the department may, at its sole discretion,
39reduce the allocation of funds to that county in the following year
40by 2 percent. Any funds so reduced may be restored by the
P87 1department if, in the determination of the department, sufficient
2improvement has been made by the county in meeting the
3performance standards during the year for which the funds were
4reduced. If the county continues not to meet
the performance
5standards, the department may reduce the allocation by an
6additional 2 percent for each year thereafter in which sufficient
7improvement has not been made to meet the performance standards.
8(2) No reduction of the allocation of funds to a county shall be
9imposed pursuant to this subdivision for failure to meet
10performance standards during any period of time in which the
11cost-of-doing-business increase is suspended.
12(i) The department shall develop procedures, in collaboration
13with the counties and stakeholders, for developing instructions for
14the performance standards established under subparagraph (D) of
15paragraph (3) of subdivision (d), no later than September 1, 2005.
16(j) No later than September 1, 2005, the department shall issue
17a revised annual redetermination form to allow a parent to indicate
18
parental consent to forward the annual redetermination form to
19the Healthy Families Program if the child is determined to have a
20share of cost.
21(k) The department, in coordination with the Managed Risk
22Medical Insurance Board, shall streamline the method of providing
23the Healthy Families Program with information necessary to
24determine Healthy Families eligibility for a child who is receiving
25services under the Medi-Cal-to-Healthy Families Bridge Benefits
26Program.
27(l) Notwithstanding Chapter 3.5 (commencing with Section
2811340) of Part 1 of Division 3 of Title 2 of the Government Code,
29and except as provided in subparagraph (G) of paragraph (6) of
30subdivision (a), the department shall, without taking any further
31regulatory action, implement, interpret, or make specific this
32section and any applicable federal waivers and state plan
33amendments by means of all-county letters or
similar instructions.
begin insertSection 14186 of the end insertbegin insertWelfare and Institutions Codeend insert
35begin insert is amended to read:end insert
(a) It is the intent of the Legislature that long-term
37services and supports (LTSS) be covered through managed care
38health plans in Coordinated Care Initiative counties.
39(b) It is further the intent of the Legislature that all of the
40following occur:
P88 1(1) Persons receiving health care services through Medi-Cal
2receive these services through a coordinated health care system
3that reduces the unnecessary use of emergency and hospital
4services.
5(2) Coordinated health care services, including medical,
6long-term services and supports, and enhanced care management
7be covered through Medi-Cal managed care health plans in order
8to eliminate
system inefficiencies and align incentives with positive
9health care outcomes.
10(3) Managed care health plans shall, in coordination with LTSS
11care management providers, develop and expand care coordination
12practices in consultation with counties, nursing facilities, area
13agencies on aging, and other home- and community-based
14providers, and share best practices. Unless the consumer objects,
15managed care health plans may establish care coordination teams
16as needed. If the consumer is an IHSS recipient, his or her
17participation and the participation of his or her provider shall be
18subject to the consumer’s consent. These care coordination teams
19shall include the consumer, and his or her authorized representative,
20health plan, county social services agency, Community-Based
21Adult Services (CBAS) case manager for CBAS clients,
22Multipurpose Senior Services Program (MSSP) case manager for
23MSSP clients, and, if an IHSS recipient, may include others.
24(4) To the extent possible, for Medi-Cal beneficiaries also
25enrolled in the Medicare Program, that the department work with
26the federal government to coordinate financing and incentives and
27permit managed care health plans to coordinate health care
28provided under both health care systems.
29(5) The health care choices made by Medi-Cal beneficiaries be
30considered with regard to all of the following:
31(A) Receiving care in a home- and community-based setting to
32maintain independence and quality of life.
33(B) Selecting their health care providers in the managed care
34plan network.
35(C) Controlling care planning, decisionmaking, and coordination
36with their health care providers.
37(D) Gaining access to services that are culturally, linguistically,
38and operationally sensitive to meet their needs or limitations and
39that improve their health outcomes, enhance independence, and
40promote living in home- and community-based settings.
P89 1(E) Self-directing their care by being able to hire, fire, and
2supervise their IHSS provider.
3(F) Being assured by the department and coordinating
4departments of their oversight of the quality of these coordinated
5health care services.
6(6) (A) Counties continue to perform functions necessary for
7the administration of the IHSS program, including conducting
8assessments and determining authorized hours for recipients,
9pursuant to Article 7 (commencing with Section 12300) of Chapter
103. County
agency assessments shall be shared with care
11coordination teams, when applicable. The county agency thereafter
12may receive and consider additional input from the care
13coordination team.
14(B) Managed care health plans may authorize personal care
15services and related domestic services in addition to the hours
16authorized under Article 7 (commencing with Section 12300) of
17Chapter 3, which managed care health plans shall be responsible
18for paying at no share of cost to the county. The department, in
19consultation with the State Department of Social Services, shall
20develop policies and procedures for these additional benefits, which
21managed care health plans may authorize. The grievance process
22for these benefits shall be the same process as used for other
23benefits authorized by managed care health plans, and shall comply
24with Section 14450, and Sections 1368 and 1368.1 of the Health
25and Safety Code.
26(7) (A) begin deleteEffective January 1, 2015, end deletebegin insertNo later than December 31,
272017,end insertbegin insert end insertorbegin delete 19 months after commencement of beneficiary enrollment begin insert on the date the managed care health plans and
28into managed careend delete
29MSSP providers jointly satisfy the readiness criteria developedend insert
30 pursuant tobegin delete Sections 14182 and 14182.16,end deletebegin insert subparagraph (D) of
31paragraph (4) of subdivision (b) of Section 14186.3,end insert whichever is
32begin delete later,end deletebegin insert earlier,end insert MSSP services shall transition from a federal waiver
33pursuant to Section 1915(c) under the federal Social Security Act
34(42 U.S.C. Sec.begin delete 1396n et seq.)end deletebegin insert 1396n(c))end insert to a benefit administered
35and allocated by managed care health plans in Coordinated Care
36Initiative counties.
37(B) Notwithstanding Chapter 8 (commencing with Section 9560)
38of Division 8.5, it is also the intent of the Legislature that the
39provisions of this article shall apply to dual eligible and
40Medi-Cal-only beneficiaries enrolled in MSSP. It is the further
P90 1intent of the Legislature that managed care health plans shall work
2in collaboration with MSSP providers to begin development of an
3integrated, person-centered care management and care coordination
4model that works within the context of managed care, and explore
5which portions of the MSSP program model may be adapted to
6managed care while maintaining the integrity and efficacy of the
7MSSP model.
8(C) At least 30 days before the MSSP services transition to a
9benefit administered and allocated by managed care health plans
10in Coordinated Care Initiative counties, the department shall notify
11the appropriate policy and fiscal committees of the Legislature of
12its intent to transition the MSSP services to managed care health
13plans.
14(8) In lieu of providing nursing facility services, managed care
15health plans may authorize home- and community-based services
16plan benefits, as defined in subdivision (d) of Section 14186.1,
17which managed care health plans shall be responsible for paying
18at no share of cost to the county.
19(c) If the Coordinated Care Initiative becomes inoperative
20pursuant to Section 34 of Chapter 37
of the Statutes of 2013, MSSP
21services shall be governed by the provisions of Chapter 8
22(commencing with Section 9560) of Division 8.5.
begin insertSection 14186.1 of the end insertbegin insertWelfare and Institutions Codeend insert
24begin insert is amended to read:end insert
For purposes of this article, the following definitions
26shall apply unless otherwise specified:
27(a) “Coordinated Care Initiative counties” has the same meaning
28as that term is defined in paragraph (1) of subdivision (b) of Section
2914182.16.
30(b) “Home- and community-based services” means services
31provided pursuant to paragraphs (1), (2), and (3) of subdivision
32(c).
33(c) “Long-term services and supports” or “LTSS” means all of
34the following:
35(1) In-home supportive services (IHSS) provided pursuant to
36Article 7 (commencing with Section 12300) of Chapter 3, and
37Sections 14132.95, 14132.952, and
14132.956.
38(2) Community-Based Adult Services (CBAS).
39(3) Multipurpose Senior Services Program (MSSP) services,
40which include those services approved under a federal home- and
P91 1community-based services waiver or, beginning January 1,begin delete 2015,end delete
2begin insert 2018,end insert orbegin delete after 19 months,end deletebegin insert on the date the managed care health
3plans and MSSP providers jointly satisfy the readiness criteria
4developed pursuant to subparagraph (D) of paragraph (4) of
5subdivision (b) of Section 14186.3, whichever is earlier,end insert equivalent
6services.
7(4) Skilled nursing facility services and subacute care services
8established under subdivision (c) of Section 14132, including those
9services described in Sections 51511 and 51511.5 of Title 22 of
10the California Code of Regulations, regardless of whether the
11service is included in the basic daily rate or billed separately, and
12any leave of absence or bed hold provided consistent with Section
1372520 of Title 22 of the California Code of Regulations or the
14state plan. However, services provided by any category of
15intermediate care
facility for the developmentally disabled shall
16not be considered long-term services and supports.
17(d) “Home- and community-based services (HCBS) plan
18benefits” may include in-home and out-of-home respite, nutritional
19assessment, counseling, and supplements, minor home or
20environmental adaptations, habilitation, and other services that
21may be deemed necessary by the managed care health plan,
22including its care coordination team. The department, in
23consultation with stakeholders, may determine whether health
24plans shall be required to include these benefits in their scope of
25service, and may establish guidelines for the scope, duration, and
26intensity of these benefits. The grievance process for these benefits
27shall be the same process as used for other benefits authorized by
28managed care health plans, and shall comply with Section 14450,
29and Sections 1368 and 1368.1 of the Health and Safety Code.
30(e) “Managed care health plan” means an individual,
31organization, or entity that enters into a contract with the
32department pursuant to Article 2.7 (commencing with Section
3314087.3), Article 2.8 (commencing with Section 14087.5), Article
342.81 (commencing with Section 14087.96), or Article 2.91
35(commencing with Section 14089), of this chapter, or Chapter 8
36(commencing with Section 14200). For purposes of this article,
37“managed care health plan” shall not include an individual,
38organization, or entity that enters into a contract with the
39department to provide services pursuant to Chapter 8.75
P92 1(commencing with Section 14591) or the Senior Care Action
2Network.
3(f) “Other health coverage” means health coverage providing
4the same full or partial benefits as the Medi-Cal program, health
5coverage under another state or federal medical care program
6except for the Medicare Program (Title XVIII of
the federal Social
7Security Act (42 U.S.C. Sec. 1395 et seq.)), or health coverage
8under a contractual or legal entitlement, including, but not limited
9to, a private group or indemnification insurance program.
10(g) “Recipient” means a Medi-Cal beneficiary eligible for IHSS
11provided pursuant to Article 7 (commencing with Section 12300)
12of Chapter 3, and Sections 14132.95, 14132.952, and 14132.956.
13(h) “Stakeholder” shall include, but not be limited to, area
14agencies on aging and independent living centers.
begin insertSection 14186.3 of the end insertbegin insertWelfare and Institutions Codeend insert
16begin insert is amended to read:end insert
(a) (1) No sooner than July 1, 2012,
18Community-Based Adult Services (CBAS) shall be a Medi-Cal
19benefit covered under every managed care health plan contract
20and available only through managed care health plans. Medi-Cal
21beneficiaries who are eligible for CBAS shall enroll in a managed
22care health plan in order to receive those services, except for
23beneficiaries exempt under subdivision (c) of Section 14186.2 or
24in counties or geographic regions where Medi-Cal benefits are not
25covered through managed care health plans. Notwithstanding
26subdivision (a) of Section 14186.2 and pursuant to the provisions
27of an approved federal waiver or plan amendment, the provision
28of CBAS as a Medi-Cal benefit through a managed care health
29plan shall not be limited to Coordinated Care Initiative counties.
30(2) Managed care health plans shall determine a member’s
31medical need for CBAS using the assessment tool and eligibility
32criteria established pursuant to the provisions of an approved
33federal waiver or amendments and shall approve the number of
34days of attendance and monitor treatment plans of their members.
35Managed care health plans shall reauthorize CBAS in compliance
36with criteria established pursuant to the provisions of the approved
37federal waiver or amendment requirements.
38(b) (1) Beginning in the 2012 calendar year, managed care
39health plans shall collaborate with MSSP providers to begin
40development of an integrated, person-centered care management
P93 1and care coordination model and explore how the MSSP program
2model may be adapted to managed care while maintaining the
3efficacy of the MSSP model. The California Department of Aging
4and the department shall
work with the MSSP site association and
5managed care health plans to develop a template contract to be
6used by managed care health plans contracting with MSSP sites
7in Coordinated Care Initiative counties.
8(2) Notwithstanding the implementation date authorized in
9paragraph (1) of subdivision (a) of Section 14186.2,begin delete beginningend delete no
10begin delete soonerend deletebegin insert laterend insert thanbegin delete June 1, 2013,end deletebegin insert December 31, 2017,end insert or on the date
11begin delete that any necessary federal approvals or waivers are obtained,
12whichever is later, and effective January 1, 2015, or 19 months
13after commencement of beneficiary enrollment into managed careend delete
14begin insert the managed care health plans and MSSP providers jointly satisfy
15the readiness criteria developedend insert pursuant tobegin delete Sections 14182 and begin insert subparagraph (D) of paragraph (4),end insert whichever is
1614182.16,end deletebegin delete later:end delete
17begin insert earlier:end insert
18(A) Multipurpose Senior Services Program (MSSP) services
19shall be a Medi-Cal benefit available only through managed care
20health plans, except for beneficiaries exempt under subdivision
21(c) of Section 14186.2 in Coordinated Care Initiative counties.
22(B) Managed care health plans shall contract with all county
23and nonprofit organizations that are designated providers of MSSP
24services for the provision of MSSP case management and waiver
25services. These contracts shall provide for all of the following:
26(i) Managed care health plans shall allocate to the MSSP
27providers the same level of funding they would have otherwise
28received under their MSSP
contract with the California Department
29of Aging.
30(ii) MSSP providers shall continue to meet all existing federal
31waiver standards and program requirements, which include
32maintaining the contracted service levels.
33(iii) Managed care plans and MSSP providers shall share
34confidential beneficiary data with one another, as necessary to
35implement the provisions of this section.
36(C) The California Department of Aging shall continue to
37contract with all designated MSSP sites, including those in the
38counties participating in the demonstration project, and perform
39MSSP waiver oversight and monitoring.
P94 1(D) The California Department of Aging and the department,
2in consultation with MSSP providers, managed care health plans,
3and stakeholders, shall develop service
fee structures, services,
4and person-centered care coordination models that shall be effective
5June 2013, for the provision of care coordination and home- and
6community-based services to beneficiaries who are enrolled in
7managed care health plans but not enrolled in MSSP, and who
8may have care coordination and service needs that are similar to
9MSSP participants. The service fees for MSSP providers and MSSP
10services for any additional beneficiaries and additional services
11for existing MSSP beneficiaries shall be based upon, and consistent
12with, the rates and services delivered in MSSP.
13(3) In the 2014 calendar year, the provisions of paragraph (2)
14shall continue. In addition, managed care health plans shall work
15in collaboration with MSSP providers to begin development of an
16integrated, person-centered care management and care coordination
17model that works within the context of managed care and explore
18which portions of the MSSP program model
may be adapted to
19managed care while maintaining the integrity and efficacy of the
20MSSP model.
21(4) (A) begin deleteEffective January 1, 2015, or 19 months after the begin insertNo later than
22commencement of beneficiary enrollment into managed care
23pursuant to Sections 14182 and 14182.16, or end delete
24December 31, 2017, orend insertbegin insert end inserton the datebegin delete that any necessary federal begin insert the managed care health plans
25approvals or waivers are obtained,end delete
26and MSSP providers jointly satisfy the readiness criteria developed
27pursuant to subparagraph (D) of this paragraph,end insert whichever is
28begin delete later,end deletebegin insert earlier,end insert MSSP services in Coordinated Care Initiative
29counties shall transition from a federal waiver pursuant to Section
301915(c) under the federal Social Security Act (42 U.S.C. Sec.
31begin delete 1396n et seq.)end deletebegin insert 1396n(c))end insert to a benefit administered and allocated
32by managed care health plans.
33(B) No later than January 1, 2014, the department, in
34consultation with the California Department of Aging and the
35Department of Managed Health Care, and with stakeholder input,
36shall submit a transition plan to the Legislature to describe how
37subparagraph (A) shall be implemented. The plan shall incorporate
38the principles of the MSSP in the managed care benefit, and shall
39include provisions to ensure seamless transitions and continuity
40of care. Managed care health plans shall, in partnership with local
P95 1MSSP providers, conduct a local stakeholder process to develop
2recommendations that the department shall consider when
3developing the transition plan.
4(C) No later than 90 days prior to implementation of
5subparagraph (A), the department, in consultation with the
6California Department of Aging and the Department of Managed
7Health Care, and with stakeholder input, shall submit a transition
8plan to the Legislature that includes steps to address concerns, if
9any, raised by stakeholders subsequent to the plan developed
10pursuant to subparagraph (B).
11(D) Before MSSP services transition to a benefit administered
12and allocated by managed care health plans pursuant to
13subparagraph (A) of paragraph (2), the California Department of
14Aging and the department, in consultation with MSSP providers,
15managed care health plans, and stakeholders, shall develop
16readiness criteria for the transition. The readiness criteria shall
17include, but are not limited to, the mutual
agreement of the affected
18managed care health plans and MSSP providers to the transition
19date. The department shall evaluate the readiness of the managed
20care health plans and MSSP providers to commence the transition
21of MSSP services to managed care health plans.
22(E) At least 30 days before the MSSP services transition to a
23benefit administered and allocated by managed care health plans
24in Coordinated Care Initiative counties, the department shall notify
25the appropriate policy and fiscal committees of the Legislature of
26its intent to transition the MSSP services to managed care health
27plans.
28(c) (1) Not sooner than March 1, 2013, or on the date that any
29necessary federal approvals or waivers are obtained, whichever is
30later,
nursing facility services and subacute facility services shall
31be Medi-Cal benefits available only through managed care health
32plans.
33(2) Managed care health plans shall authorize utilization of
34nursing facility services or subacute facility services for their
35members when medically necessary. The managed care health
36plan shall maintain the standards for determining levels of care
37and authorization of services for both Medicare and Medi-Cal
38services that are consistent with policies established by the federal
39Centers for Medicare and Medicaid Services and consistent with
40the criteria for authorization of Medi-Cal services specified in
P96 1Section 51003 of Title 22 of the California Code of Regulations,
2which includes utilization of the “Manual of Criteria for Medi-Cal
3Authorization,” published by the department in January 1982, last
4revised April 11, 2011.
5(3) The managed care health
plan shall maintain continuity of
6care for beneficiaries by recognizing any prior treatment
7authorization made by the department for not less than six months
8following enrollment of a beneficiary into the health plan.
9(4) When a managed care health plan has authorized services
10in a facility and there is a change in the beneficiary’s condition
11under which the facility determines that the facility may no longer
12meet the needs of the beneficiary, the beneficiary’s health has
13improved sufficiently so the resident no longer needs the services
14provided by the facility, or the health or safety of individuals in
15the facility is endangered by the beneficiary, the managed care
16health plan shall arrange and coordinate a discharge of the
17beneficiary and continue to pay the facility the applicable rate until
18the beneficiary is successfully discharged and transitioned into an
19appropriate setting.
20(5) The managed care health plan shall pay providers, including
21institutional providers, in accordance with the prompt payment
22provisions contained in each health plan’s contracts with the
23department, including the ability to accept and pay electronic
24claims.
begin insertSection 15894 of the end insertbegin insertWelfare and Institutions Codeend insert
26begin insert is amended to read:end insert
begin insert(a)end insertbegin insert end insert Except as provided in Section 15894.5, the
28department shall authorize the expenditure of money in the fund
29to cover program expenses, including program expenses that exceed
30subscriber contributions, and to cover expenses relating to Section
3110127.16 of the Insurance Code, or to Section 1373.622 of the
32Health and Safety Code. The department shall determine the
33amount of funds expended for each of these purposes, taking into
34consideration the requirements of this chapter, Section 10127.16
35of the Insurance Code, and Section 1373.622 of the Health and
36Safety Code.
37(b) Following consultation with a health care service plan or
38health insurer, if the department and the health care service plan
39or health insurer have not agreed to a final reconciliation of the
40amount to be expended from the fund or to be reimbursed to the
P97 1fund, the department shall give written notice of its determination
2to the health care service plan or health insurer of the final
3reconciliation amount, as determined by the department. The health
4care service plan or health insurer shall remit payment to the
5department within 60 days of the date of notice from the
6department. If payment is not received, interest shall accrue in the
7amount of 7 percent per annum. The department may offset the
8amount to be reimbursed to the fund against any other payments
9owed to the health care service plan or health insurer by the
10department, or may negotiate a payment plan with the health care
11service plan or health insurer for full payment, and in that
case
12may waive interest accrual as long as payment from the health
13care service plan or health insurer is made in accordance with
14the payment plan. This subdivision shall control over any conflict
15or ambiguity between this subdivision and the provisions of Section
161373.622 of the Health and Safety Code, Section 10127.16 of the
17Insurance Code, Part 6.5 (commencing with Section 12700) of
18Division 2 of the Insurance Code, or this chapter.
begin insertSection 24005 of the end insertbegin insertWelfare and Institutions Codeend insert
20begin insert is amended to read:end insert
(a) This section shall apply to the Family Planning,
22Access, Care, and Treatment Program identified in subdivision
23(aa) of Section 14132 and this program.
24(b) Only licensed medical personnel with family planning skills,
25knowledge, and competency may provide the full range of family
26planning medical services covered in this program.
27(c) Medi-Cal enrolled providers, as determined by the
28department, shall be eligible to provide family planning services
29under the program when these services are within their scope of
30practice and licensure. Those clinical providers electing to
31participate in the program and approved by the department shall
32provide the full scope of family planning education, counseling,
33
and medical services specified for the program, either directly or
34by referral, consistent with standards of care issued by the
35department.
36(d) The department shall require providers to enter into clinical
37agreements with the department to ensure compliance with
38standards and requirements to maintain the fiscal integrity of the
39program. Provider applicants, providers, and persons with an
40ownership or control interest, as defined in federal medicaid
P98 1regulations, shall be required to submit to the department their
2social security numbers to the full extent allowed under federal
3law. All state and federal statutes and regulations pertaining to the
4audit or examination of Medi-Cal providers shall apply to this
5program.
6(e) Clinical provider agreements shall be signed by the provider
7under penalty of perjury. The department may screen applicants
8at the initial application and at any
reapplication pursuant to
9requirements developed by the department to determine provider
10suitability for the program.
11(f) The department may complete a background check on clinical
12provider applicants for the purpose of verifying the accuracy of
13information provided to the department for purposes of enrolling
14in the program and in order to prevent fraud and abuse. The
15background check may include, but not be limited to, unannounced
16onsite inspection prior to enrollment, review of business records,
17and data searches. If discrepancies are found to exist during the
18preenrollment period, the department may conduct additional
19inspections prior to enrollment. Failure to remediate significant
20discrepancies as prescribed by the director may result in denial of
21the application for enrollment. Providers that do not provide
22services consistent with the standards of care or that do not comply
23with the department’s rules related to the fiscal integrity of
the
24program may be disenrolled as a provider from the program at the
25sole discretion of the department.
26(g) The department shall not enroll any applicant who, within
27the previous 10 years:
28(1) Has been convicted of any felony or misdemeanor that
29involves fraud or abuse in any government program, that relates
30to neglect or abuse of a patient in connection with the delivery of
31a health care item or service, or that is in connection with the
32interference with, or obstruction of, any investigation into health
33care related fraud or abuse.
34(2) Has been found liable for fraud or abuse in any civil
35proceeding, or that has entered into a settlement in lieu of
36conviction for fraud or abuse in any government program.
37(h) In addition, the department may deny
enrollment to any
38applicant that, at the time of application, is under investigation by
39the department or any local, state, or federal government law
40enforcement agency for fraud or abuse. The department shall not
P99 1deny enrollment to an otherwise qualified applicant whose felony
2or misdemeanor charges did not result in a conviction solely on
3the basis of the prior charges. If it is discovered that a provider is
4under investigation by the department or any local, state, or federal
5government law enforcement agency for fraud or abuse, that
6provider shall be subject to immediate disenrollment from the
7program.
8(i) (1) The program shall disenroll as a program provider any
9individual who, or any entity that, has a license, certificate, or other
10approval to provide health care, which is revoked or suspended
11by a federal, California, or other state’s licensing, certification, or
12other approval authority, has otherwise lost that
license, certificate,
13or approval, or has surrendered that license, certificate, or approval
14while a disciplinary hearing on the license, certificate, or approval
15was pending. The disenrollment shall be effective on the date the
16license, certificate, or approval is revoked, lost, or surrendered.
17(2) A provider shall be subject to disenrollment if the provider
18submits claims for payment for the services, goods, supplies, or
19merchandise provided, directly or indirectly, to a program
20beneficiary, by an individual or entity that has been previously
21suspended, excluded, or otherwise made ineligible to receive,
22directly or indirectly, reimbursement from the program or from
23the Medi-Cal program and the individual has previously been listed
24on either the Suspended and Ineligible Provider List, which is
25published by the department, to identify suspended and otherwise
26ineligible providers or any list published by the federal Office of
27the Inspector
General regarding the suspension or exclusion of
28individuals or entities from the federal Medicare and medicaid
29programs, to identify suspended, excluded, or otherwise ineligible
30providers.
31(3) The department shall deactivate, immediately and without
32prior notice, the provider numbers used by a provider to obtain
33reimbursement from the program when warrants or documents
34mailed to a provider’s mailing address, its pay to address, or its
35service address, if any, are returned by the United States Postal
36Service as not deliverable or when a provider has not submitted a
37claim for reimbursement from the program for one year. Prior to
38taking this action, the department shall use due diligence in
39attempting to contact the provider at its last known telephone
40number and to ascertain if the return by the United States Postal
P100 1Service is by mistake and shall use due diligence in attempting to
2contact the provider by telephone or in writing to ascertain
whether
3the provider wishes to continue to participate in the Medi-Cal
4program. If deactivation pursuant to this section occurs, the
5provider shall meet the requirements for reapplication as specified
6in regulation.
7(4) For purposes of this subdivision:
8(A) “Mailing address” means the address that the provider has
9identified to the department in its application for enrollment as the
10address at which it wishes to receive general program
11correspondence.
12(B) “Pay to address” means the address that the provider has
13identified to the department in its application for enrollment as the
14address at which it wishes to receive warrants.
15(C) “Service address” means the address that the provider has
16identified to the department in its application for enrollment as
the
17address at which the provider will provide services to program
18beneficiaries.
19(j) Subject to Article 4 (commencing with Section 19130) of
20Chapter 5 of Part 2 of Division 5 of Title 2 of the Government
21Code, the department may enter into contracts to secure consultant
22services or information technology including, but not limited to,
23software, data, or analytical techniques or methodologies for the
24purpose of fraud or abuse detection and prevention. Contracts
25under this section shall be exempt from the Public Contract Code.
26(k) Enrolled providers shall attend specific orientation approved
27by the department in comprehensive family planning services.
28Enrolled providers who insert IUDs or contraceptive implants shall
29have received prior clinical training specific to these procedures.
30(l) Upon receipt of
reliable evidence that would be admissible
31under the administrative adjudication provisions of Chapter 5
32(commencing with Section 11500) of Part 1 of Division 3 of Title
332 of the Government Code, of fraud or willful misrepresentation
34by a provider under the program or commencement of a suspension
35under Section 14123, the department may do any of the following:
36(1) Collect any State-Only Family Planning program or Family
37Planning, Access, Care, and Treatment Program overpayment
38identified through an audit or examination, or any portion thereof
39from any provider. Notwithstanding Section 100171 of the Health
40and Safety Code, a provider may appeal the collection of
P101 1overpayments under this section pursuant to procedures established
2in Article 5.3 (commencing with Section 14170) of Chapter 7 of
3Part 3 of Division 9. Overpayments collected under this section
4shall not be returned to the provider during the pendency of any
5appeal and may be offset to
satisfy audit or appeal findings, if the
6findings are against the provider. Overpayments shall be returned
7to a provider with interest if findings are in favor of the provider.
8(2) Withhold payment for any goods or services, or any portion
9thereof, from any State-Only Family Planning program or Family
10begin delete Planning Access Careend deletebegin insert Planning, Access, Care,end insert and Treatment
11Program provider. The department shall notify the provider within
12five days of any withholding of payment under this section. The
13notice shall do all of the following:
14(A) State that payments are being withheld in accordance with
15this paragraph and that the withholding is for a temporary period
16and will not continue after it is determined that the evidence of
17fraud or willful misrepresentation is insufficient or when legal
18proceedings relating to the alleged fraud or willful
19misrepresentation are completed.
20(B) Cite the circumstances under which the withholding of the
21payments will be terminated.
22(C) Specify, when appropriate, the type or types of claimed
23payments being withheld.
24(D) Inform the provider of the right to submit written evidence
25that is evidence that would be admissible under the administrative
26adjudication provisions of Chapter 5 (commencing with Section
2711500) of Part 1 of Division 3 of Title 2 of the Government Code,
28for consideration by the department.
29(3) Notwithstanding Section 100171 of the Health and Safety
30Code, a provider may appeal a withholding of payment under this
31section pursuant to Section 14043.65. Payments withheld under
32this section shall not be returned to the provider during the
33pendency of any appeal and may be offset to satisfy audit or appeal
34findings.
35(m) As used in this section:
36(1) “Abuse” means either of the following:
37(A) Practices that are inconsistent with sound fiscal or business
38practices and result in unnecessary cost to the medicaid program,
39the Medicare program, the Medi-Cal program, including the Family
40Planning, Access, Care, and Treatment Program, identified in
P102 1subdivision (aa) of Section 14132, another state’s medicaid
2program, or the State-Only Family Planning program, or other
3health care programs operated, or financed in whole or in part, by
4the federal government or any state or local agency in this state or
5any other state.
6(B) Practices that are inconsistent with sound medical practices
7and result in reimbursement, by any of the programs referred to
8in subparagraph (A) or other health care programs operated, or
9financed in whole or in part, by the federal government or any
10state or local agency in this state or any other state, for services
11that
are unnecessary or for substandard items or services that fail
12to meet professionally recognized standards for health care.
13(2) “Fraud” means an intentional deception or misrepresentation
14made by a person with the knowledge that the deception could
15result in some unauthorized benefit to himself or herself or some
16other person. It includes any act that constitutes fraud under
17applicable federal or state law.
18(3) “Provider” means any individual, partnership, group,
19association, corporation, institution, or entity, and the officers,
20directors, owners, managing employees, or agents of any
21partnership, group, association, corporation, institution, or entity,
22that provides services, goods, supplies, or merchandise, directly
23or indirectly, to a beneficiary and that has been enrolled in the
24program.
25(4) “Convicted” means any of the following:
26(A) A judgment of conviction has been entered against an
27individual or entity by a federal, state, or local court, regardless
28of whether there is a post-trial motion or an appeal pending or the
29judgment of conviction or other record relating to the criminal
30conduct has been expunged or otherwise removed.
31(B) A federal, state, or local court has made a finding of guilt
32against an individual or entity.
33(C) A federal, state, or local court has accepted a plea of guilty
34or nolo contendere by an individual or entity.
35(D) An individual or entity has entered into participation in a
36first offender, deferred adjudication, or other program or
37arrangement where judgment of conviction has been withheld.
38(5) “Professionally recognized standards of health care” means
39statewide or national standards of care, whether in writing or not,
40that professional peers of the individual or entity whose provision
P103 1of care is an issue, recognize as applying to those peers practicing
2or providing care within a state. When the United States
3Department of Health and Human Services has declared a treatment
4modality not to be safe and effective, practitioners that employ
5that treatment modality shall be deemed not to meet professionally
6recognized standards of health care. This definition shall not be
7construed to mean that all other treatments meet professionally
8recognized standards of care.
9(6) “Unnecessary or substandard items or services” means those
10that are either of the following:
11(A) Substantially in excess of the provider’s usual
charges or
12costs for the items or services.
13(B) Furnished, or caused to be furnished, to patients, whether
14or not covered by Medicare, medicaid, or any of the state health
15care programs to which the definitions of applicant and provider
16apply, and which are substantially in excess of the patient’s needs,
17or of a quality that fails to meet professionally recognized standards
18of health care. The department’s determination that the items or
19services furnished were excessive or of unacceptable quality shall
20be made on the basis of information, including sanction reports,
21from the following sources:
22(i) The professional review organization for the area served by
23the individual or entity.
24(ii) State or local licensing or certification authorities.
25(iii) Fiscal agents or contractors, or private insurance companies.
26(iv) State or local professional societies.
27(v) Any other sources deemed appropriate by the department.
28(7) “Enrolled or enrollment in the program” means authorized
29under any and all processes by the department or its agents or
30contractors to receive, directly or indirectly, reimbursement for
31the provision of services, goods, supplies, or merchandise to a
32program beneficiary.
33(n) In lieu of, or in addition to, the imposition of any other
34sanctions available, including the imposition of a civil penalty
35under Sections 14123.2 or 14171.6, the program may impose on
36providers any or all of the penalties pursuant to Section 14123.25,
37in accordance with the provisions of that
section. In addition,
38program providers shall be subject to the penalties contained in
39Section 14107.
P104 1(o) (1) Notwithstanding any other provision of law, every
2primary supplier of pharmaceuticals, medical equipment, or
3supplies shall maintain accounting records to demonstrate the
4manufacture, assembly, purchase, or acquisition and subsequent
5sale, of any pharmaceuticals, medical equipment, or supplies, to
6providers. Accounting records shall include, but not be limited to,
7inventory records, general ledgers, financial statements, purchase
8and sales journals, and invoices, prescription records, bills of
9lading, and delivery records.
10(2) For purposes of this subdivision, the term “primary supplier”
11means any manufacturer, principal labeler, assembler, wholesaler,
12or retailer.
13(3) Accounting records
maintained pursuant to paragraph (1)
14shall be subject to audit or examination by the department or its
15agents. The audit or examination may include, but is not limited
16to, verification of what was claimed by the provider. These
17accounting records shall be maintained for three years from the
18date of sale or the date of service.
19(p) Each provider of health care services rendered to any
20program beneficiary shall keep and maintain records of each service
21rendered, the beneficiary to whom rendered, the date, and such
22additional information as the department may by regulation require.
23Records required to be kept and maintained pursuant to this
24subdivision shall be retained by the provider for a period of three
25years from the date the service was rendered.
26(q) A program provider applicant or a program provider shall
27furnish information or copies of records and documentation
28requested by
the department. Failure to comply with the
29department’s request shall be grounds for denial of the application
30or automatic disenrollment of the provider.
31(r) A program provider may assign signature authority for
32transmission of claims to a billing agent subject to Sections 14040,
3314040.1, and 14040.5.
34(s) Moneys payable or rights existing under this division shall
35be subject to any claim, lien, or offset of the State of California,
36and any claim of the United States of America made pursuant to
37federal statute, but shall not otherwise be subject to enforcement
38of a money judgment or other legal process, and no transfer or
39assignment, at law or in equity, of any right of a provider of health
P105 1care to any payment shall be enforceable against the state, a fiscal
2intermediary, or carrier.
3(t) (1) Notwithstanding any other law, within 30 calendar days
4of receiving a complete application for enrollment into the Family
5PACT Program from an affiliate primary care clinic licensed under
6Section 1218.1 of the Health and Safety Code, the department shall
7do one of the following:
8(A) Approve the provider’s Family PACT Program application,
9provided the applicant meets the Family PACT Program provider
10enrollment requirements set forth in this section.
11(B) If the provider is an enrolled Medi-Cal provider in good
12standing, notify the applicant in writing of any discrepancies in
13the Family PACT Program enrollment application. The applicant
14shall have 30 days from the date of written notice to correct any
15identified discrepancies. Upon receipt of all requested corrections,
16the department shall approve the application within 30 calendar
17days.
18(C) If the provider is not an enrolled Medi-Cal provider in good
19standing, the department shall not proceed with the actions
20described in this subdivision until the department receives
21confirmation of good standing and enrollment as a Medi-Cal
22provider.
23(2) The effective date of enrollment into the Family PACT
24Program shall be the later of the date the department receives
25confirmation of enrollment as a Medi-Cal provider, or the date the
26applicant meets all Family PACT Program provider enrollment
27requirements set forth in this section.
28(u) Providers, or the enrolling entity, shall make available to
29all applicants and beneficiaries prior to, or concurrent with,
30enrollment, information on the manner in which to apply for
31insurance
affordability programs, in a manner determined by the
32State Department of Health Care Services. The information
33provided shall include the manner in which applications can be
34submitted for insurance affordability programs, information about
35the open enrollment periods for the California Health Benefit
36Exchange, and the continuous enrollment aspect of the Medi-Cal
37program.
begin insertSection 70 of Chapter 23 of the Statutes of 2013 is
39amended to read:end insert
(a) The State Department of Health Care Services
2shall accept contributions by private foundations in the amount of
3at least fourteen million dollars ($14,000,000) for the purpose of
4this section and shall immediately seek an equal amount of federal
5matching funds.
6(b) Entities and persons that are eligible for Medi-Cal in-person
7enrollment assistance payments of fifty-eight dollars ($58) per
8approved Medi-Cal application and payment processing costs shall
9be those trained and eligible for in-person enrollment assistance
10payments by the California Health Benefit Exchange. The
11payments may be made by the State Department of Health Care
12Services or through the California Health Benefit Exchange
13in-person assistance payment system.
14(c) Enrollment assistance payments shall be made only for
15Medi-Cal applicants newly eligible for coverage pursuant to the
16federal Patient Protection and Affordable Care Act (Public Law
17111-148), as amended by the Health Care and Education
18Reconciliation Act of 2010 (Public Law 111-152), or those who
19have not been enrolled in the Medi-Cal program during the
20previous 12 months prior to making the application.
21(d) The commencement of enrollment assistance payments shall
22be consistent with those of the California Health Benefit Exchange.
23(e) The State Department of Health Care Services or the
24California Health Benefit Exchange shall provide monthly and
25cumulative payment updates and number of persons enrolled
26through in-person assistance payments on its Internet Web site.
27(f) The State Department of Health Care Services shall make
28enrollment assistance payments pursuant to this section for
29submitted applications received through June 30, 2015, that result
30in approved applications. Once all of those payments have been
31made, any remaining funds described in subdivision (a) shall be
32allocated to the county outreach and enrollment grants under
33Section 71 of Chapter 23 of the Statutes of 2013. Any of those
34remaining funds that are allocated to those grants shall be
35distributed to community-based organizations providing enrollment
36assistance to prospective Medi-Cal enrollees pursuant to Section
3771 of Chapter 23 of the Statutes of 2013. The State Department of
38Health Care Services shall make authorized payments to counties
39for distribution to community-based organizations. Counties that
40receive money pursuant to this subdivision may retain an amount
P107 1for administrative costs not to exceed 10 percent of grants
2approved by
the State Department of Health Care Services. The
3State Department of Health Care Services shall require progress
4reports, in a manner as determined by the department, from those
5receiving allocations under this subdivision. The State Department
6of Health Care Services shall make an initial allocation to the
7counties for these funds no later than January 1, 2016, and the
8final allocation no later than June 30, 2016.
9(g) This section shall be inoperative and cease to be
10implemented on the date that all of the private contributions
11accepted pursuant to subdivision (a) and any federal matching
12funds have been exhausted.
begin insertSection 71 of Chapter 23 of the Statutes of 2013, as
14amended by Section 4 of Chapter 361 of the Statues of 2013, is
15amended to read:end insert
(a) (1) The State Department of Health Care Services
17shall accept funding from private foundations in the amount of at
18leastbegin delete $12.5 millionend deletebegin insert twelve million five hundred thousand dollars
19($12,5000,000)end insert to provide allocations for the management and
20funding of Medi-Cal outreach and enrollment plans specific to the
21provisions contained in this section.
22(2) The department shall seek necessary federal approval for
23purposes of obtaining federal funding for activities conducted
24under this section.
25(3) Notwithstanding any other law, and in a manner that the
26Director of Health Care Services shall provide, the department
27may make allocations to fund Medi-Cal outreach and enrollment
28activities as described in this section.
29(b) (1) Funds appropriated by the Legislature to the department
30for the purposes of this section shall be made available to selected
31counties, counties acting jointly, and the County Medical Services
32Program Governing Board pursuant to Section 16809 of the
33Welfare and Institutions Code.
34(2) Selected counties, counties acting jointly, and the County
35Medical Services Program Governing Board may partner with
36community-based organizations as applicable to conduct outreach
37and enrollment to the target population as contained in subdivision
38(d).
39(3) The director may,
at his or her discretion, also give
40consideration to community-based organizations in an area or
P108 1region of the state if a county, or counties acting jointly do not
2seek an allocation or funds are made available.
3(4) For purposes of this section only, “county” shall be defined
4as county, city and county, a consortium of counties serving a
5region consisting of more than one county, the County Medical
6Services Program Governing Board, or a health authority.
7(c) (1) The allocations shall be apportioned geographically, by
8the entities identified in subdivision (b), according to the estimated
9number of persons who are eligible but not enrolled in Medi-Cal
10and who will be newly Medi-Cal eligible as of January 1, 2014.
11(2) The department may determine the number of allocations
12and the application
process. The director may consult or obtain
13technical assistance from private foundations in implementation
14of the application and allocation process.
15(3) The department shall coordinate and partner with the
16California Health Benefit Exchange on certified application assister
17and outreach, enrollment, and marketing activities related to the
18federal Patient Protection and Affordable Care Act.
19(d) Notwithstanding any other law, the department shall develop
20selection criteria to allocate funds for the Medi-Cal outreach and
21enrollment activities with special emphasis targeting all of the
22following populations:
23(1) Persons with mental health disorder needs.
24(2) Persons with substance use disorder needs.
25(3) Persons who are homeless.
26(4) Young men of color.
27(5) Persons who are in county jail, in state prison, on state
28parole, on county probation, or under postrelease community
29supervision.
30(6) Families of mixed-immigration status.
31(7) Persons with limited English proficiency.
32(e) (1) The funds allocated under this section shall be used only
33for the Medi-Cal outreach and enrollment activities and may
34supplement, but shall not supplant, existing local, state, and
35foundation funding of county outreach and enrollment activities.
36(2) Notwithstanding Section 10744 of the Welfare and
37Institutions
Code, the department may recoup or withhold all or
38part of an allocation for failure to comply with any requirements
39or standards set forth by the department for the purposes of this
40section.
P109 1(f) The department shall begin the payment for the outreach and
2enrollment allocation program no later than February 1, 2014.
3(g) Under the terms of the approved allocation for the outreach
4and enrollment program, funded entities under this section shall
5not receive payment for in-person assister payments for assisting
6potential Medi-Cal enrollees.
7(h) The department shall require progress reports, in a manner
8as determined by the department, from those receiving allocations
9under this section.
10(i) To the extent federal funding is received for the services
11
specified in this section, reimbursements for costs incurred under
12the approved allocations shall be made in compliance with federal
13law.
14(j) Notwithstanding Chapter 3.5 (commencing with Section
1511340) of Part 1 of Division 3 of Title 2 of the Government Code,
16the department may implement, interpret, or make specific this
17section by means of all-county letters, provider bulletins, or similar
18instructions.
19(k) This section shall become inoperative on June 30, 2018.
end insert
begin insertSection 5 of Chapter 361 of the Statutes of 2013 is
21amended to read:end insert
(a) The Healthcare Outreach and Medi-Cal Enrollment
23Account is hereby created in the Special Deposit Fund within the
24State Treasury in order to collect and allocate non-General Fund
25public or private grant funds, to be expended upon appropriation
26by the Legislature, for the purposes of outreach to and enrollment
27of targeted Medi-Cal populations and to compensate Medi-Cal
28in-person assisters, as specified in Sections 70 and 71 of Chapter
2923 of the Statutes of 2013.
30(b) There is hereby appropriated to the State Department of
31Health Care Services the following sums to compensate eligible
32Medi-Cal in-person assisters as specified in Section 70 of Chapter
3323 of the Statues of 2013:
34(1) The sum of fourteen
million dollars ($14,000,000) from the
35Healthcare Outreach and Medi-Cal Enrollment Account, to be
36available for encumbrance or expenditure until June 30,begin delete 2016end deletebegin insert 2018end insert.
37(2) The sum of fourteen million dollars ($14,000,000) from the
38Federal Trust Fund, to be available for encumbrance or expenditure
39until June 30,begin delete 2016end deletebegin insert 2018end insert.
P110 1(3) After June 30, 2015, the State Department of Health Care
2Services is authorized to expend all or any
portion of the remaining
3funds targeted for payment of enrollment assistance for Medi-Cal
4applications in the Healthcare Outreach and Medi-Cal Enrollment
5Account that has been created within the Special Deposit Fund
6within the State Treasury and any matching federal funds, as
7specified in paragraph (2), for the funding of allocations for
8Medi-Cal Outreach And Enrollment plans, as specified in Section
971 of Chapter 23 of the Statutes of 2013, as amended by the act
10the added this paragraph.
11(c) There is hereby appropriated to the State Department of
12Health Care Services the following sums to provide allocations
13for outreach and enrollment grants to eligible entities as specified
14in Section 71 of Chapter 23 of the Statutes of 2013:
15(1) The sum of twelve million five hundred thousand dollars
16($12,500,000) from the Healthcare Outreach and Medi-Cal
17Enrollment
Account, to be available for encumbrance or
18expenditure until June 30,begin delete 2016end deletebegin insert 2018end insert.
19(2) The sum of twelve million five hundred thousand dollars
20($12,500,000) from the Federal Trust Fund, to be available for
21encumbrance or expenditure until June 30,begin delete 2016end deletebegin insert 2018end insert.
22(d) Of the amounts appropriated in subdivisions (b) and (c), the
23State Department of Health Care Services may expend in aggregate
24up to five hundred thousand dollars ($500,000) annually in fiscal
25years 2013-14, 2014-15, and 2015-16, inclusive, to
administer
26the activities described in Sections 70 and 71 of Chapter 23 of the
27Statutes of 2013, including funding for four three-year limited-term
28positions, which are hereby authorized to be established. Any
29private foundation funding expended by the department to
30administer the activities under Sections 70 and 71 of Chapter 23
31of the Statutes of 2013 shall be expended only for filled positions
32and administrative expenses directly related to these sections.
33(e) The State Department of Health Care Services may expend,
34in aggregate, up to five hundred thousand dollars ($500,000)
35annually for the 2016-17 and 2017-18 fiscal years, to administer
36the activities described in Sections 70 and 71 of Chapter 23 of the
37Statutes of 2013, and Section 1 of Chapter 551 of the Statutes of
382014, as amended by that act that added this subdivision. Any
39private foundation funding
expended by the department for
40administration shall be expended only for the administrative
P111 1expenses directly related to Sections 70 and 71 of Chapter 23 of
2the Statutes of 2013, and Section 1 of Chapter 551 of the Statutes
3of 2014.
4(e)
end delete
5begin insert(f)end insert This section shall become inoperative on June 30,begin delete 2018,end delete
6begin insert 2020,end insert and, as of January 1, 2021, is repealed, unless a later enacted
7statute, that becomes operative on or before January 1,begin delete 2019,end deletebegin insert
2021,end insert
8 deletes or extends the dates on which it becomes inoperative and
9is repealed.
begin insertSection 1 of Chapter 551 of the Statutes of 2014 is
11amended to read:end insert
(a) (1) The State Department of Health Care
13Services shall accept contributions by private foundations in the
14amount of at least six million dollars ($6,000,000) for the purpose
15of providing Medi-Cal renewal assistance payments starting
16January 1, 2015. These contributions shall be deposited in the
17Healthcare Outreach and Medi-Cal Enrollment Account that has
18been created in the Special Deposit Fund within the State Treasury
19for the purposes specified in this section.
20(2) There is hereby appropriated to the State Department of
21Health Care Services the following sums for the purposes specified
22in this section:
23(A) The sum of six million dollars ($6,000,000) from the
24Healthcare
Outreach and Medi-Cal Enrollment Account, to be
25available for encumbrance or expenditure untilbegin delete December 31, 2016end delete
26begin insert
June 30, 2018end insert.
27(B) The sum of six million dollars ($6,000,000) from the Federal
28Trust Fund, to be available for encumbrance or expenditure until
29begin delete December 31, 2016end deletebegin insert June 30, 2018end insert.
30(3) The department may expend a portion of the five hundred
31thousand dollars ($500,000) authorized for expenditure in
32subdivision (d) of Section 5 of Chapter 361 of the Statutes of 2013
33to administer the activities described in this section. Private
34foundation funding expended by the department to administer the
35activities described in this section shall be expended only for filled
36positions and administrative expenses directly related to this
37section.
38(b) (1) Notwithstanding any other law, and in a manner that
39the Director of the State Department of Health Care Services shall
P112 1provide, the department may make allocations to fund Medi-Cal
2renewal assistance activities as described in this section.
3(2) The department may determine the number of allocations
4and the application process. The director may consult or obtain
5technical assistance from private foundations in implementation
6of the application and allocation process.
7(3) The director may, at his or her discretion, give consideration
8to distributing funds to community-based organizations in an area
9or region of the state if a county or counties, acting jointly, do not
10seek an allocation or if funds are made available.
11(c) Renewal assistance payments shall be distributed to
12community-based organizations providing renewal assistance to
13Medi-Cal beneficiaries. Authorized payments shall be made to
14counties by the department for distribution of funds to
15community-based organizations. Counties may retain an amount
16for administrative costs that have been approved by the department.
17(d) The department, in collaboration with the County Welfare
18Directors Association and legal services organizations, shall
19develop renewal assistance training for employees of
20community-based organizations that shall be consistent with the
21counties’ human services agencies Medi-Cal redetermination
22timeframes and process. In order to be eligible for renewal
23assistance payments under this section, the community-based
24organization’s employees providing the assistance shall have
25completed the renewal assistance training developed under this
26subdivision.
27(e) (1) The funds allocated under this section shall be used only
28for the Medi-Cal renewal assistance activities and may supplement,
29but shall not supplant, existing local, state, and foundation funding
30of county renewal assistance activities.
31(2) Notwithstanding Section 10744 of the Welfare and
32Institutions Code, the department may recoup or withhold all or
33part of an allocation for failure to comply with any requirements
34or standards set forth by the department for the purposes of this
35section.
36(f) The department shall require progress reports, in a manner
37as determined by the department, from those receiving allocations
38under this section.
39(g) The department shall seek federal matching funds for the
40contributions to the extent
permissible for training, testing,
P113 1certifying, supporting, and compensating persons and entities
2providing renewal assistance and for any other permissible renewal
3assistance related activities and shall seek all necessary federal
4approvals for purposes of obtaining federal funding for activities
5conducted under this section.
6(h) To the extent federal funding is received for the services
7specified in this section, reimbursements for costs incurred under
8the approved allocations shall be made in compliance with federal
9law.
10(i) Notwithstanding Chapter 3.5 (commencing with Section
1111340) of Part 1 of Division 3 of Title 2 of the Government Code,
12the department may implement, interpret, or make specific this
13section by means of all-county letters, provider bulletins, or similar
14instructions.
15(j) This section shall cease
to be implemented when all of the
16private contributions and any federal matching funds have been
17exhausted.
The sum of fifty million dollars ($50,000,000) is
19hereby appropriated from the Health Home Program Account to
20the State Department of Health Care Services for the purposes of
21implementing the Health Home Program established pursuant to
22Article 3.9 (commencing with Section 14127) of Chapter 7 of Part
233 of Division 9 of the Welfare and Institutions Code.
24Notwithstanding Section 16304 of the Government Code, this
25appropriation shall be available for encumbrance or expenditure
26until June 30, 2020.
(a) For the 2015-16 fiscal year, and upon an
28appropriation of funds by the Legislature for this purpose, the
29State Department of Health Care Services shall provide a grant
30to health benefit plans that meet all of the following requirements:
31(1) The health benefit plan has a valid exemption letter from
32the Internal Revenue Service pursuant to Section 501(c)(9) of the
33Internal Revenue Code.
34(2) The health benefit plan is a multiemployer plan, as defined
35in Section
3(37) of the federal Employee Retirement Income
36Security Act of 1974 (29 U.S.C. Sec. 1002(37)(A)).
37(3) The health benefit plan is funded by contributions made by
38agricultural employers, as defined in subdivision (c) of the Section
391140.4 of the Labor Code, where 85 percent or more of the plan’s
40eligible participants are agricultural employees, as defined in
P114 1subdivision (b) of Section 1140.4 of the Labor Code, for work
2performed and covered under a collective bargaining agreement.
3(b) On or before September 1, 2015, the State Department of
4Health Care Services shall pay the funds allocated pursuant to
5this section to the health plan that meets the criteria set forth in
6this section. The funds shall be used to provide health care
7coverage for agricultural employees and dependents.
8(c) The payment set forth in
subdivision (b) shall not require
9the State Department of Health Care Services to contract with the
10recipient of the funds nor shall the payment of funds be subject to
11the requirements of Part 2 (commencing with Section 10100) of
12Division 2 of the Public Contract Code.
(a) For the 2015-16 fiscal year, and upon an
14appropriation of funds by the Legislature for this purpose, the
15State Department of Health Care Services shall provide a grant
16to LifeLong Medical Care, a federally qualified health center in
17Contra Costa County.
18(b) On or before September 1, 2015, the State Department of
19Health Care Services shall pay the funds allocated pursuant to
20this section to LifeLong Medical Care. The funds shall be
21considered a grant to be used to support LifeLong Medical Care
22and are not a payment for
services.
23(c) To the extent allowable by federal law, the grant received
24pursuant to subdivision (b) is not income for the purposes of the
25prospective payment system rate setting or rate reconciliations
26that are conducted by the State Department of Health Care Services
27for LifeLong Medical Care.
28(d) The grant made pursuant to subdivision (b) does not require
29the State Department of Health Care Services to contract with the
30recipient of the funds, nor is the grant subject to the requirements
31of Part 2 (commencing with Section 10100) of Division 2 of the
32Public Contract Code.
(a) For the 2015-16 fiscal year, the California Health
34Facilities Financing Authority (CHFFA) may authorize up to three
35million dollars ($3,000,000) in unencumbered funds, as
36appropriated in Item 0977-101-0001 for Mental Health Wellness
37Grants, of Section 2.00 of the Budget Act of 2013, to develop peer
38respite sites.
39(b) Any grant awards authorized by CHFFA for peer respite
40sites shall be used to expand local resources for the development,
P115 1capital, equipment acquisition, and applicable program startup
2or expansion costs to
increase bed capacity for peer respite support
3services. This may include, but not be limited to, the purchase of
4property, purchase of equipment, and the remodeling or
5construction of housing for the purposes of operating a peer respite
6site.
7(c) Any recipient of a grant to develop peer respite sites shall
8adhere to all applicable laws relating to scope of practice,
9licensure, certification, staffing, and building codes.
10(d) CHFFA may adopt emergency regulations relating to grants
11for peer respite sites, including emergency regulations that define
12eligible costs, and determine minimum and maximum grant
13amounts. The adoption, amendments, or repeal of these regulations
14shall be in accordance with the Administrative Procedure Act
15(Chapter 3.5 (commencing with Section 11340) of Part 1 of
16Division 3 of Title 2 of the Government Code) and shall be deemed
17to be an emergency and
necessary for the immediate preservation
18of the public peace, health, safety, or general welfare.
The Office of System Integration shall report to the
20Legislature by April 1, 2017, on the feasibility, benefits, costs, and
21risks of installing the Modified Adjusted Gross Income (MAGI)
22Eligibility Decision Engine in one, two, or all of the Statewide
23Automated Welfare System consortia systems.
The Legislature finds and declares that the sections
25of this act that amend Section 120962 of the Health and Safety
26Code and Section 19548.2 of the Revenue and Taxation Code
27impose a limitation on the public’s right of access to the meetings
28of public bodies or the writings of public officials and agencies
29within the meaning of Section 3 of Article I of the California
30Constitution. Pursuant to that constitutional provision, the
31Legislature makes the following findings to demonstrate the interest
32protected by this limitation and the need for protecting that
33interest:
34In order to continue to protect the confidentiality of public health
35records under specified provisions of this act, the limitations on
36the public’s right of access imposed under this act are necessary.
The Legislature finds and declares that a special law
38is necessary and that a general law cannot be made applicable
39within the meaning of Section 16 of Article IV of the California
P116 1Constitution because of the unique circumstances regarding
2providing urgent care to the citizens of Contra Costa County.
No reimbursement is required by this act pursuant
4to Section 6 of Article XIII B of the California Constitution for
5certain costs that may be incurred by a local agency or school
6district because, in that regard, this act creates a new crime or
7infraction, eliminates a crime or infraction, or changes the penalty
8for a crime or infraction, within the meaning of Section 17556 of
9the Government Code, or changes the definition of a crime within
10the meaning of Section 6 of Article XIII B of the California
11Constitution.
12However, if the Commission on State Mandates determines that
13this act contains other costs mandated by the state, reimbursement
14to local agencies and school districts for those costs shall be made
15pursuant to Part 7 (commencing with Section 17500) of Division
164 of Title 2 of the Government Code.
This act is a bill providing for appropriations related
18to the Budget Bill within the meaning of subdivision (e) of Section
1912 of Article IV of the California Constitution, has been identified
20as related to the budget in the Budget Bill, and shall take effect
21immediately.
Item 0540-001-0140 of Section 2.00 of the Budget
23Act of 2014 is amended to read:
|
0540-001-0140--For support of Secretary of the Natural Resources Agency, payable from the California Environmental License Plate Fund | 9,403,000 | ||||||
|
Schedule: | |||||||
| (1) |
10-Administration of Natural Resources Agency | 26,442,000 | |||||
| (2) |
Reimbursements | −598,000 | |||||
| (3) |
Amount payable from the Safe Neighborhood Parks, Clean Water, Clean Air, and Coastal Protection (Villaraigosa-Keeley Act) Bond Fund (Item 0540-001-0005) | −135,000 | |||||
| (4) |
Amount payable from the Environmental Enhancement and Mitigation Program Fund (Item 0540-001-0183) | −297,000 | |||||
| (5) |
Amount payable from the Federal Trust Fund (Item 0540-001-0890) | −9,205,000 | |||||
| (6) |
Amount payable from the Timber Regulation and Forest Restoration Fund (Item 0540-001-3212) | −480,000 | |||||
| (6.5) |
Amount payable from the Cost of Implementation Account, Air Pollution Control Fund (0540-001-3237) | −529,000 | |||||
| (7) |
Amount payable from the California Clean Water, Clean Air, Safe Neighborhood Parks, and Coastal Protection Fund (Item 0540-001-6029) | −728,000 | |||||
| (8) |
Amount payable from the Water Security, Clean Drinking Water, Coastal and Beach Protection Fund of 2002 (Item 0540-001-6031) | −1,207,000 | |||||
| (9) |
Amount payable from the Safe Drinking Water, Water Quality and Supply, Flood Control, River and Coastal Protection Fund of 2006 (Item 0540-001-6051) | −3,064,000 | |||||
| (10) |
Amount payable from the Disaster Preparedness and Flood Prevention Bond Fund of 2006 (Item 0540-001-6052) | −196,000 | |||||
| (11) |
Amount payable from the California Ocean Protection Trust Fund (Item 0540-001-6076) | −600,000 | |||||
| Provisions: | |||||||
| 1. | Of the funds appropriated in this item, $5,000,000 is available for a fourth climate change assessment and shall be available for encumbrance until June 30, 2016. Of this amount, $2,500,000 is available for expenditure in the 2014-15 fiscal year. | ||||||
Item 0540-001-6052 of Section 2.00 of the Budget
35Act of 2014 is amended to read:
|
0540-001-6052--For support of Secretary of the Natural Resources Agency, for payment to Item 0540-001-0140, payable from the Disaster Preparedness and Flood Prevention Bond Fund of 2006 | 196,000 | ||||||
| Provisions: | |||||||
| 1. | The amount appropriated in this item shall be available for encumbrance until June 30, 2020, and available for liquidation until June 30, 2023. | ||||||
Item 0540-492 is added to Section 2.00 of the Budget
7Act of 2014, to read:
|
0540-492--Reappropriation, Secretary of the Natural Resources Agency. Notwithstanding any other law, the balance as of June 30, 2015, of any prior year appropriations, except any reversion item, from the Disaster Preparedness and Flood Prevention Bond Fund of 2006 (Fund 6052) shall be available for encumbrance until June 30, 2020, and available for liquidation until June 30, 2023. | |||||||
| Provisions: | |||||||
| 1. | The Secretary of the Natural Resources Agency may transfer amounts reappropriated in this item to Item 0540-001-6052. | ||||||
| 2. | The Department of Finance shall provide to the Controller an itemized list of appropriations subject to this item immediately upon enactment of the act adding this item. | ||||||
Item 0690-001-0001 of Section 2.00 of the Budget
26Act of 2014 is amended to read:
|
0690-001-0001--For support of the Office of Emergency Services | 44,118,000 | ||||||
|
Schedule: | |||||||
| (1) |
20-Emergency Management Services | 50,379,000 | |||||
| (2) |
40-Special Programs and Grant Management | 75,697,000 | |||||
| (3) |
65.01-Administration and Executive Program | 15,505,000 | |||||
| (4) |
65.02-Distributed Administration and Executive | −15,505,000 | |||||
| (4.5) |
70-Public Safety Communications | 74,309,000 | |||||
| (5) |
Reimbursements | −4,323,000 | |||||
| (6) |
Amount payable from the State Emergency Telephone Number Account (Item 0690-001-0022) | −2,394,000 | |||||
| (7) |
Amount payable from the Unified Program Account (Item 0690-001-0028) | −812,000 | |||||
| (8) |
Amount payable from the Nuclear Planning Assessment Special Account (Item 0690-001-0029) | −1,224,000 | |||||
| (9) |
Amount payable from the Restitution Fund (Item 0690-001-0214) | −8,000 | |||||
| (10) |
Amount payable from the Federal Trust Fund (Item 0690-001-0890) | −70,754,000 | |||||
| (11) |
Amount payable from the Local Public Prosecutors and Public Defenders Training Fund (Item 0690-002-0241) | −83,000 | |||||
| (12) |
Amount payable from the Victim-Witness Assistance Fund (Item 0690-002-0425) | −1,366,000 | |||||
| (13) |
Amount payable from the Equality in Prevention and Services for Domestic Abuse Fund (Item 0690-001-3112) | −5,000 | |||||
| (14) |
Amount payable from the Transit System Safety, Security, and Disaster Response Account, Highway Safety, Traffic Reduction, Air Quality, and Port Security Fund of 2006 (Item 0690-001-6061) | −2,660,000 | |||||
| (15) |
Amount payable from the Antiterrorism Fund (Item 0690-010-3034) | −723,000 | |||||
| (16) |
Amount payable from the Technology Services Revolving Fund (Item 0690-001-9730) | −71,915,000 | |||||
|
Provisions: | |||||||
| 1. |
Funds appropriated in this item may be reduced by the Director of Finance, after giving notice to the Chairperson of the Joint Legislative Budget Committee, by the amount of federal funds made available for the purposes of this item in excess of the federal funds scheduled in Item 0690-001-0890. | ||||||
| 2. |
Upon approval by the Department of Finance, the Controller shall transfer such funds as are necessary between this item and Item 0690-101-0890. | ||||||
| 3. | Of the funds appropriated in this item, $4,372,000 shall be available for encumbrance until June 30, 2016, for the state operations center for providing assistance to local jurisdictions and local assistance centers that provide local communities with technical guidance and disaster recovery support. | ||||||
Item 3540-001-0001 of Section 2.00 of the Budget
12Act of 2014 is amended to read:
|
3540-001-0001--For support of Department of Forestry and Fire Protection | 609,751,000 | ||||||
|
Schedule: | |||||||
| (1) |
10-Office of the State Fire Marshal | 25,412,000 | |||||
| (2) |
11-Fire Protection | 1,294,541,000 | |||||
| (3) |
12-Resource Management | 73,627,000 | |||||
| (4) |
13-State Board of Forestry and Fire Protection | 1,685,000 | |||||
| (5) |
14-Department of Justice Legal Services | 6,164,000 | |||||
| (6) |
20.01-Administration | 77,112,000 | |||||
| (7) |
20.02-Distributed Administration | −74,578,000 | |||||
| (8) |
Reimbursements | −405,593,000 | |||||
| (9) |
Less funding provided by capital outlay | −18,403,000 | |||||
| (10) |
Amount payable from the General Fund (Item 3540-006-0001) | −209,000,000 | |||||
| (11) |
Amount payable from the State Emergency Telephone Number Account (Item 3540-001-0022) | −4,322,000 | |||||
| (12) |
Amount payable from the Unified Program Account (Item 3540-001-0028) | −674,000 | |||||
| (13) |
Amount payable from the State Fire Marshal Licensing and Certification Fund (Item 3540-001-0102) | −2,888,000 | |||||
| (14) |
Amount payable from the California Environmental License Plate Fund (Item 3540-001-0140) | −548,000 | |||||
| (15) |
Amount payable from the California Fire and Arson Training Fund (Item 3540-001-0198) | −3,246,000 | |||||
| (16) |
Amount payable from the Hazardous Liquid Pipeline Safety Fund (Item 3540-001-0209) | −3,431,000 | |||||
| (17) |
Amount payable from the Professional Forester Registration Fund (Item 3540-001-0300) | −226,000 | |||||
| (18) |
Amount payable from the Toxic Substances Control Account (Item 3540-001-0557) | −1,500,000 | |||||
| (19) |
Amount payable from the Federal Trust Fund (Item 3540-001-0890) | −19,723,000 | |||||
| (20) |
Amount payable from the Forest Resources Improvement Fund (Item 3540-001-0928) | −9,118,000 | |||||
| (21) |
Amount payable from the State Responsibility Area Fire Prevention Fund (Item 3540-001-3063) | −81,220,000 | |||||
| (22) |
Amount payable from the State Fire Marshal Fireworks Enforcement and Disposal Fund (Item 3540-001-3120) | −617,000 | |||||
| (23) |
Amount payable from the Building Standards Administration Special Revolving Fund (Item 3540-001-3144) | −404,000 | |||||
| (24) |
Amount payable from the Timber Regulation and Forest Restoration Fund (Item 3540-001-3212) | −14,893,000 | |||||
| (25) |
Amount payable from the Greenhouse Gas Reduction Fund (Item 3540-001-3228) | −17,847,000 | |||||
| (26) |
Amount payable from the Cost of Implementation Account, Air Pollution Control Fund (Item 3540-001-3237) | −559,000 | |||||
|
Provisions: | |||||||
| 1. |
Notwithstanding any other provision of law, the Director of Finance may authorize the temporary or permanent redirection of funds from this item for purposes of emergency fire suppression and detection costs and related emergency refutation costs. | ||||||
| 2. |
Notwithstanding any other provision of law, the Director of Finance may authorize a loan from the General Fund, in an amount not to exceed 45 percent of reimbursements appropriated in this item, to the Department of Forestry and Fire Protection, provided that: | ||||||
| (a) |
The loan is to meet cash needs resulting from the delay in receipt of reimbursements for services provided. | ||||||
| (b) |
The loan is for a short term and shall be repaid by September 30 of the fiscal year following that in which the loan was authorized. | ||||||
| (c) |
Interest charges may be waived pursuant to subdivision (e) of Section 16314 of the Government Code. | ||||||
| (d) |
Within 10 days after approval, the Director of Finance shall notify the Joint Legislative Budget Committee of the loan approved pursuant to this provision. | ||||||
| 3. |
The Director of Finance may adjust amounts in Schedule (2) to provide equivalent fire protection base funding changes to contract counties in accordance with Section 4130 of the Public Resources Code. | ||||||
| 4. |
Notwithstanding any other provision of law, the Director of Finance may authorize a loan from the General Fund to the Department of Forestry and Fire Protection to meet cash needs resulting from the delay in receipt of revenues into the State Responsibility Area Fire Prevention Fund, provided that: | ||||||
| (a) |
The loan is for a short term and shall be repaid by December 31 of the fiscal year following that in which the loan was authorized. | ||||||
| (b) |
Interest charges may be waived pursuant to subdivision (e) of Section 16314 of the Government Code. | ||||||
| (c) |
The Director of Finance may not approve the loan unless the approval is made in writing and filed with the Chairperson of the Joint Legislative Budget Committee and the chairpersons of the committees in each house of the Legislature that consider appropriations not later than 30 days prior to the effective date of the approval, or not later than whatever lesser time prior to that date the chairperson of the joint committee, or his or her designee, may determine. | ||||||
| 5. |
The Department of General Services, with the consent of the Department of Forestry and Fire Protection, may enter into a lease, lease-purchase agreement, or lease with a purchase option, with Riverside County for build-to-suit facilities to replace the Hemet-Ryan Air Attack Base, subject to Department of Finance approval. The agreement may contain one or more purchase options during the term of the agreement. Thirty days prior to approving any agreement pursuant to this provision, the Department of Finance shall notify the chairpersons of the committees in each house of the Legislature that consider appropriations and the Joint Legislative Budget Committee of the terms and conditions of the agreement. | ||||||
| 6. |
Notwithstanding any other provision of law, the funds appropriated in this item for purposes of Division 10.5 (commencing with Section 12200) of the Public Resources Code shall be available for purposes of support or capital outlay. | ||||||
| 7. |
Notwithstanding any other provision of law, the Director of Finance may adjust this item for the direct and indirect cost reimbursements received pursuant to Sections 4142 and 4144 of the Public Resources Code. Any increase shall occur no sooner than 30 days after notification in writing of the necessity of the increase to the Joint Legislative Budget Committee, or not sooner than whatever lesser time after notification the Chairperson of the Joint Legislative Budget Committee, or his or her designee, may in each instance determine. | ||||||
| 8. |
Notwithstanding any other provision of law, the Department of Forestry and Fire Protection may provide contractual services pursuant to Sections 4142 and 4144 of the Public Resources Code without an executed agreement from July to September of each fiscal year to better align contract start times with the budget process and to finalize staff benefit rates that are dependent upon actions by the Public Employees’ Retirement System and passage of the annual Budget Act. | ||||||
| 9. |
Notwithstanding any other provision of law, the Director of Finance may authorize a loan from the General Fund to the State Fire Marshal Fireworks Enforcement and Disposal Fund to meet cash needs resulting from the delay in receipt of revenues into State Fire Marshal Fireworks Enforcement and Disposal Fund, provided that: | ||||||
| (a) |
The loan is for a short term and shall be repaid by June 30 of the fiscal year following that in which the loan was authorized. | ||||||
| (b) |
Interest charges may be waived pursuant to subdivision (e) of Section 16314 of the Government Code. | ||||||
| (c) |
The Director of Finance may not approve the loan unless the approval is made in writing and filed with the Chairperson of the Joint Legislative Budget Committee and the chairpersons of the committees in each house of the Legislature that consider appropriations not later than 30 days prior to the effective date of the approval, or not later than whatever lesser time prior to that date the chairperson of the joint committee, or his or her designee, may determine. | ||||||
| 10. |
The Department of Forestry and Fire Protection may contract with the Department of General Services for environmental consultation or planning. | ||||||
| 11. |
The Department of Finance may authorize the transfer of an amount from this item to Item 3540-101-3228 in order to implement fire risk reductions, forest health activities, and urban forestry projects. Within 10 days after approval, the Director of Finance shall notify the Joint Legislative Budget Committee of the transfer approved pursuant to this provision and shall include a detail of the change in program delivery and the conditions necessitating the change. | ||||||
| 12. | Of the amount appropriated in this item, $3,000,000 is available for water shortages at fire stations and shall be available for encumbrance until June 30, 2016. | ||||||
Item 3600-001-0001 of Section 2.00 of the Budget
10Act of 2014 is amended to read:
|
3600-001-0001--For support of Department of Fish and Wildlife, for payment to Item 3600-001-0200, payable from the General Fund | 103,644,000 | ||||||
| Provisions: | |||||||
| 1. | The Department of Fish and Wildlife shall identify and utilize any available existing appropriations, including those supported by fees paid by state and federal water project users, bond funds, and federal funds, to mitigate drought impacts on fish species consistent with the drought activities funded by this item. The department shall report to the Legislature any General Fund cost savings due to these efforts on or before January 10, 2015. | ||||||
| 2. | Of the funds appropriated in this item, $15,560,000 is available for maximizing water delivery and efficiency to key endangered species habitats; monitoring of endangered species, native fish, and the delta species; water delivery system projects; and enhancing in-stream flows. These funds shall be available for encumbrance until June 30, 2016. | ||||||
Item 3600-001-0200 of Section 2.00 of the Budget
34Act of 2014 is amended to read:
|
3600-001-0200--For support of Department of Fish and Wildlife | 118,692,300 | ||||||
|
Schedule: | |||||||
| (1) |
20-Biodiversity Conservation Program | 139,161,000 | |||||
| (2) |
25-Hunting, Fishing, and Public Use | 78,227,000 | |||||
| (3) |
30-Management of Department Lands and Facilities | 62,212,000 | |||||
| (4) |
40-Enforcement | 76,330,000 | |||||
| (5) |
45-Communication, Education, and Outreach | 3,679,000 | |||||
| (6) |
50-Spill Prevention and Response | 42,786,000 | |||||
| (7) |
61-Fish and Game Commission | 1,597,300 | |||||
| (8) |
70.01-Administration | 45,618,000 | |||||
| (9) |
70.02-Distributed Administration | −45,623,000 | |||||
| (10) |
Reimbursements | −27,004,000 | |||||
| (11) |
Amount payable from the Harbors and Watercraft Revolving Fund (Item 3600-001-0516) | −2,783,000 | |||||
| (12) |
Amount payable from the General Fund (Item 3600-001-0001) | −103,644,000 | |||||
| (13) |
Amount payable from the Safe Neighborhood Parks, Clean Water, Clean Air, and Coastal Protection (Villaraigosa-Keeley Act) Bond Fund (Item 3600-001-0005) | −500,000 | |||||
| (14) |
Amount payable from the California Environmental License Plate Fund (Item 3600-001-0140) | −15,411,000 | |||||
| (15) |
Amount payable from the Waste Discharge Permit Fund (Item 3600-001-0193) | −500,000 | |||||
| (16) |
Amount payable from the Fish and Wildlife Pollution Account (Item 3600-001-0207) | −884,000 | |||||
| (17) |
Amount payable from the California Waterfowl Habitat Preservation Account, Fish and Game Preservation Fund (Item 3600-001-0211) | −245,000 | |||||
| (18) |
Amount payable from the Marine Invasive Species Control Fund (Item 3600-001-0212) | −1,381,000 | |||||
| (19) |
Amount payable from the Public Resources Account, Cigarette and Tobacco Products Surtax Fund (Item 3600-001-0235) | −1,957,000 | |||||
| (20) |
Amount payable from the Oil Spill Prevention and Administration Fund (Item 3600-001-0320) | −35,378,000 | |||||
| (21) |
Amount payable from the Environmental Enhancement Fund (Item 3600-001-0322) | −759,000 | |||||
| (22) |
Amount payable from the Wildlife Restoration Fund (Item 3600-001-0447) | −2,535,000 | |||||
| (23) |
Amount payable from the Federal Trust Fund (Item 3600-001-0890) | −42,228,000 | |||||
| (24) |
Amount payable from the Special Deposit Fund (Item 3600-001-0942) | −1,660,000 | |||||
| (25) |
Amount payable from the Hatchery and Inland Fisheries Fund (Item 3600-001-3103) | −19,793,000 | |||||
| (26) |
Amount payable from the Timber Regulation and Forest Restoration Fund (Item 3600-001-3212) | −5,545,000 | |||||
| (27) |
Amount payable from the Greenhouse Gas Reduction Fund (Item 3600-001-3228) | −3,382,000 | |||||
| (28) |
Amount payable from the Interim Water Supply and Water Quality Infrastructure and Management Subaccount (Item 3600-001-6027) | −545,000 | |||||
| (29) |
Amount payable from the Water Security, Clean Drinking Water, Coastal and Beach Protection Fund of 2002 (Item 3600-001-6031) | −2,841,000 | |||||
| (30) |
Amount payable from the Safe Drinking Water, Water Quality and Supply, Flood Control, River and Coastal Protection Fund of 2006 (Item 3600-001-6051) | −15,561,000 | |||||
| (31) |
Amount payable from the California Sea Otter Fund (Item 3600-001-8047) | −186,000 | |||||
| (32) |
Amount payable from the Salton Sea Restoration Fund (Item 3600-001-8018) | −573,000 | |||||
|
Provisions: | |||||||
| 1. |
The funds appropriated in this item may be increased with the approval of, and under the conditions set by, the Director of Finance to meet current obligations proposed to be funded in Schedules (10) and (23). The funds appropriated in this item shall not be increased until the Department of Fish and Wildlife has a valid contract, signed by the client agency, that provides sufficient funds to finance the increased authorization. This increased authorization may not be used to expand services or create new obligations. Reimbursements received under Schedules (10) and (23) shall be used in repayment of any funds used to meet current obligations pursuant to this provision. | ||||||
| 2. |
The funds appropriated in this item for purposes of subdivision (n) of Section 75050 of the Public Resources Code shall continue only so long as the Bureau of Reclamation within the United States Department of the Interior continues to provide federal funds and continues to carry out federal actions to implement the settlement agreement in Natural Resources Defense Council v. Rodgers (2005) 381 F.Supp.2d 1212. | ||||||
| 3. | Of the funds appropriated in this item, $3,250,000, available for emergency drought response, shall be available for encumbrance until June 30, 2016. | ||||||
Item 3600-101-0001 of Section 2.00 of the Budget
34Act of 2014 is amended to read:
|
3600-101-0001--For local assistance, Department of Fish and Wildlife | 5,777,000 | ||||||
|
Schedule: | |||||||
| (1) |
20-Biodiversity Conservation Program | 5,777,000 | |||||
| Provisions: | |||||||
| 1. | Of the funds appropriated in this item, $1,500,000 is for the Fisheries Restoration Grant Program and shall be available for encumbrance until June 30, 2016. | ||||||
Item 3640-493 of Section 2.00 of the Budget Act of
72014 is amended to read:
|
3640-493--Reappropriation, Wildlife Conservation Board. The balances of the appropriations provided in the following citations are reappropriated for the purposes provided for in those appropriations and shall be available for encumbrance or expenditure until June 30, 2020: | |||||||
| 6031--Water Security, Clean Drinking Water, Coastal and Beach Protection Fund of 2002 | |||||||
| (1) | Item 3640-311-6031, Budget Act of 2004 (Ch. 208, Stats. 2004), as reappropriated by Item 3640-492 Budget Act of 2009 (Ch. 1, 2009-10 3rd Ex. Sess., as revised by Ch. 1, 2009-10 4th Ex. Sess.) and Item 3640-492, Budget Act of 2011 (Ch. 33, Stats. 2011) | ||||||
| (2) | Item 3640-311-6031, Budget Act of 2006 (Chs. 47 and 48, Stats. 2006), as reappropriated by Item 3640-491 Budget Act of 2009 (Ch. 1, 2009-10 3rd Ex. Sess., as revised by Ch. 1, 2009-10 4th Ex. Sess.) and Item 3640-490, Budget Act of 2013 (Chs. 20 and 354, Stats. 2013) | ||||||
Item 3640-494 is added to Section 2.00 of the Budget
32Act of 2014, to read:
|
3640-494--Reappropriation, Wildlife Conservation Board. The balances of the appropriations provided in the following citations are reappropriated for the purposes provided for in those appropriations and shall be available for transfer upon the order of the Director of Finance until June 30, 2020: | |||||||
| 6052--Disaster Preparedness and Flood Prevention Bond Fund of 2006 | |||||||
| (1) | Item 3640-311-6052, Budget Act of 2008 (Chs. 268 and 269, Stats. 2008) as reappropriated by Item 3640-490, Budget Act of 2012 (Ch. 21 and 29, Stats. 2012) | ||||||
| (2) | Item 3640-311-6052, Budget Act of 2009 (Ch. 1, 2009-10 3rd Ex. Sess., as revised by Ch. 1, 2009-10 4th Ex. Sess.) as reappropriated by Item 3640-490, Budget Act of 2013 (Ch. 20, Stats. 2013) | ||||||
| (3) | Item 3640-311-6052, Budget Act of 2010 (Ch. 712, Stats. 2010) | ||||||
| (4) | Item 3640-311-6052, Budget Act of 2011 (Ch. 33, Stats. 2011) | ||||||
| (5) | Item 3640-311-6052, Budget Act of 2012 (Chs. 21 and 29, Stats. 2012) | ||||||
| Provisions: | |||||||
| 1. | Upon order of the Director of Finance, the Controller shall transfer the amounts appropriated in this item to the Habitat Conservation Fund. | ||||||
| 2. | The funds appropriated and transferred pursuant to this item shall be used for purposes consistent with the requirements of the Habitat Conservation Fund. | ||||||
Item 3760-311-6052 is added to Section 2.00 of the 25Budget Act of 2014, to read:
|
3760-311-6052--For transfer by the Controller from the Disaster Preparedness and Flood Prevention Bond Fund of 2006 to the Habitat Conservation Fund | 1,127,000 | ||||||
| Provisions: | |||||||
| 1. | This appropriation represents the unliquidated balance of Item 3760-311-6052, Budget Act of 2008 (Chs. 268 and 269, Stats. 2008), that has reverted because funds from the original appropriation were never transferred into the Habitat Conservation Fund | ||||||
| 2. | Upon order of the Director of Finance, the Controller shall transfer the amounts appropriated in this item to the Habitat Conservation Fund. | ||||||
| 3. | The funds appropriated and transferred pursuant to this item shall be used for purposes consistent with the requirements of the Habitat Conservation Fund. | ||||||
Item 3760-490 is added to Section 2.00 of the Budget
6Act of 2014, to read:
|
3760-490--Reappropriation, State Coastal Conservancy. The balances of the appropriations provided in the following citations are reappropriated for the purposes provided for in those appropriations and shall be available for transfer upon the order of the Director of Finance until June 30, 2020: | |||||||
| 6052-Disaster Preparedness and Flood Prevention Bond Fund of 2006 | |||||||
| (1) | Item 3760-311-6052, Budget Act of 2009 (Ch. 1, 2009-10 3rd Ex. Sess., as revised by Ch. 1, 2009-10 4th Ex. Sess.) | ||||||
| (2) | Item 3760-311-6052, Budget Act of 2010 (Ch. 712, Stats. 2010) | ||||||
| (3) | Item 3760-311-6052, Budget Act of 2011 (Ch. 33, Stats. 2011) | ||||||
| (4) | Item 3760-311-6052, Budget Act of 2012 (Chs. 21 and 29, Stats. 2012) | ||||||
| Provisions: | |||||||
| 1. | Upon order of the Director of Finance, the Controller shall transfer the amounts appropriated in this item to the Habitat Conservation Fund. | ||||||
| 2. | The funds appropriated and transferred pursuant to this item shall be used for the purposes consistent with the requirements of the Habitat Conservation Fund. | ||||||
Item 3760-493 of Section 2.00 of the Budget Act of
342014 is repealed.
Item 3790-001-0392 of Section 2.00 of the Budget
36Act of 2014 is amended to read:
|
3790-001-0392--For support of Department of Parks and Recreation, payable from the State Parks and Recreation Fund | 161,201,000 | ||||||
|
Schedule: | |||||||
| (1) |
For support of Department of Parks and Recreation | 427,992,000 | |||||
| (2) |
Boating and Waterways | 29,472,000 | |||||
| (3) |
Legal Services | 341,000 | |||||
| (4) |
Reimbursements | −27,015,000 | |||||
| (5) |
Less funding provided by capital outlay | −4,000,000 | |||||
| (6) |
Amount payable from the General Fund (Item 3790-001-0001) | −115,938,000 | |||||
| (7) |
Amount payable from the Safe Neighborhood Parks, Clean Water, Clean Air, and Coastal Protection (Villaraigosa-Keeley Act) Bond Fund (Item 3790-001-0005) | −569,000 | |||||
| (8) |
Amount payable from the Safe Neighborhood Parks, Clean Water, Clean Air, and Coastal Protection (Villaraigosa-Keeley Act) Bond Fund (Item 3790-003-0005) | −12,261,000 | |||||
| (9) |
Amount payable from the California Environmental License Plate Fund (Item 3790-001-0140) | −3,258,000 | |||||
| (10) |
Amount payable from the Public Resources Account, Cigarette and Tobacco Products Surtax Fund (Item 3790-001-0235) | −7,744,000 | |||||
| (11) |
Amount payable from the Off-Highway Vehicle Trust Fund (Item 3790-001-0263) | −67,357,000 | |||||
| (11.5) |
Amount payable from the Lake Tahoe Conservancy Account (Item 3125-001-0286) . | −120,000 | |||||
| (12) |
Amount payable from the Winter Recreation Fund (Item 3790-001-0449) | −347,000 | |||||
| (13) |
Amount payable from the Harbors and Watercraft Revolving Fund (Item 3790-001-0516) | −28,355,000 | |||||
| (14) |
Amount payable from the Federal Trust Fund (Item 3790-001-0890) | −18,093,000 | |||||
| (15) |
Amount payable from the California Clean Water, Clean Air, Safe Neighborhood Parks, and Coastal Protection Fund (Item 3790-001-6029) | −1,736,000 | |||||
| (16) |
Amount payable from the Water Security, Clean Drinking Water, Coastal and Beach Protection Fund of 2002 (Item 3790-001-6031) | −292,000 | |||||
| (17) |
Amount payable from the Safe Drinking Water, Water Quality and Supply, Flood Control, River and Coastal Protection Fund of 2006 (Item 3790-001-6051) | −4,572,000 | |||||
| (18) |
Amount payable from the Safe Drinking Water, Water Quality and Supply, Flood Control, River and Coastal Protection Fund of 2006 (Item 3790-003-6051) | −3,520,000 | |||||
| (19) |
Amount payable from the Disaster Preparedness and Flood Prevention Bond Fund of 2006 (Item 3790-001-6052) | −1,427,000 | |||||
|
Provisions: | |||||||
| 1. |
Of the funds appropriated in this act from special funds, other than the Off-Highway Vehicle Trust Fund and bond funds, to the Department of Parks and Recreation for local assistance grants to local agencies, the department may allocate an amount not to exceed 3.7 percent of each project’s allocation, except to the extent otherwise restricted by law, to allow the department to administer its grants. Those funds shall be available for encumbrance or expenditure until June 30, 2020. | ||||||
| 2. |
It is the intent of the Legislature that salaries, wages, operating expenses, and positions associated with implementing specific Department of Parks and Recreation capital outlay projects continue to be funded through capital outlay appropriations, and that these funds should also be reflected in the department’s state operations budget in the Governor’s Budget as a special item of expense reflecting the funding provided from the capital outlay appropriations. | ||||||
| 3. |
Notwithstanding any other provision of law, the Director of Finance may authorize a loan from the General Fund, in an amount not to exceed 35 percent of reimbursements appropriated in this item to the Department of Parks and Recreation, provided that: | ||||||
| (a) |
The loan is to meet cash needs resulting from the delay in receipt of reimbursements for services provided. | ||||||
| (b) |
The loan is for a short term and shall be repaid by September 30, 2015. | ||||||
| (c) |
Interest charges may be waived pursuant to subdivision (e) of Section 16314 of the Government Code. | ||||||
| (d) |
The Director of Finance may not approve the loan unless the approval is made in writing and filed with the Chairperson of the Joint Legislative Budget Committee and the chairpersons of the committees in each house of the Legislature that consider appropriations not later than 30 days prior to the effective date of the approval, or not later than whatever lesser time prior to that effective date that the chairperson of the joint committee, or his or her designee, may determine. | ||||||
| 4. |
The Department of Parks and Recreation is authorized to enter into a contract for fee collection and other services required by the department with a cooperative association that has and will continue to fund state employees on an ongoing basis. | ||||||
| 5. |
Of the amount appropriated in this item, $6,000,000 shall be available for support or capital outlay, and available for expenditure and encumbrance until June 30, 2016, for water, wastewater, and sewer system projects. | ||||||
Item 3790-001-0516 of Section 2.00 of the Budget
39Act of 2014 is amended to read:
|
3790-001-0516--For support of Department of Parks and Recreation, for payment to Item 3790-001-0392, payable from the Harbors and Watercraft Revolving Fund | 28,355,000 | ||||||
|
Provisions: | |||||||
| 1. |
Notwithstanding any other provision of law, $300,000 of the funds appropriated in this item may be used for emergency repairs. | ||||||
| 2. | Of the amount appropriated in this item, $3,993,000 is available for aquatic invasive species mitigation and shall be available for encumbrance until June 30, 2016. | ||||||
Item 3790-001-6052 of Section 2.00 of the Budget
13Act of 2014 is amended to read:
|
3790-001-6052--For support of Department of Parks and Recreation, payable to Item 3790-001-0392, from the Disaster Preparedness and Flood Prevention Bond Fund of 2006 | 1,427,000 | ||||||
| Provisions: | |||||||
| 1. | The amount appropriated in this item shall be available for encumbrance until June 30, 2020, and available for liquidation until June 30, 2023. | ||||||
Item 3790-492 is added to Section 2.00 of the Budget
25Act of 2014, to read:
|
3790-492--Reappropriation, Department of Parks and Recreation. Notwithstanding any other law, the balance as of June 30, 2015, of any prior year appropriations, except any reversion item, from the Disaster Preparedness and Flood Prevention Bond Fund of 2006 (Fund 6052) shall be available for encumbrance until June 30, 2020, and available for liquidation until June 30, 2023. | |||||||
| Provisions: | |||||||
| 1. | The Department of Parks and Recreation may transfer amounts reappropriated in this item to Item 3790-001-6052. | ||||||
| 2. | The Department of Finance shall provide to the Controller an itemized list of appropriations subject to this item immediately upon enactment of the act adding this item. | ||||||
Item 3860-001-0001 of Section 2.00 of the Budget
5Act of 2014 is amended to read:
|
3860-001-0001--For support of Department of Water Resources | 89,560,000 | ||||||
|
Schedule: | |||||||
| (1) |
10-Continuing Formulation of the California Water Plan | 97,913,000 | |||||
| (2) |
20-Implementation of the State Water Resources Development System | 4,106,000 | |||||
| (3) |
30-Public Safety and Prevention of Damage | 109,897,000 | |||||
| (4) |
35-Central Valley Flood Protection Board | 13,795,000 | |||||
| (5) |
40-Services | 7,510,000 | |||||
| (6) |
45-California Energy Resources Scheduling (CERS) | 23,235,000 | |||||
| (7) |
50.01-Management and Administration | 88,704,000 | |||||
| (8) |
50.02-Distributed Management and Administration | −88,704,000 | |||||
| (9) |
Reimbursements | −37,525,000 | |||||
| (10) |
Amount payable from the California Environmental License Plate Fund (Item 3860-001-0140) | −921,000 | |||||
| (11) |
Amount payable from the Energy Resources Programs Account (Item 3860-001-0465) | −2,641,000 | |||||
| (12) |
Amount payable from the Sacramento Valley Water Management and Habitat Protection Subaccount (Item 3860-001-0544) | −26,000 | |||||
| (13) |
Amount payable from the California Safe Drinking Water Fund of 1988 (Item 3860-001-0793) | −109,000 | |||||
| (14) |
Amount payable from the Federal Trust Fund (Item 3860-001-0890) | −12,840,000 | |||||
| (15) |
Amount payable from the Dam Safety Fund (Item 3860-001-3057) | −12,005,000 | |||||
| (16) |
Amount payable from the Department of Water Resources Electric Power Fund (Item 3860-001-3100) | −23,235,000 | |||||
| (17) |
Amount payable from the Greenhouse Gas Reduction Fund (Item 3860-001-3228) ...... | −1,000,000 | |||||
| (18) |
Amount payable from the Cost of Implementation Account, Air Pollution Control Fund (Item 3860-001-3237) | −330,000 | |||||
| (19) |
Amount payable from the Safe Drinking Water, Clean Water, Watershed Protection, and Flood Protection Bond Fund (Item 3860-001-6001) | −358,000 | |||||
| (20) |
Amount payable from the Flood Protection Corridor Subaccount (Item 3860-001-6005) | −100,000 | |||||
| (21) |
Amount payable from the Urban Stream Restoration Subaccount (Item 3860-001-6007) | −45,000 | |||||
| (22) |
Amount payable from the Yuba Feather Flood Protection Subaccount (Item 3860-001-6010) | −400,000 | |||||
| (23) |
Amount payable from the Water Conservation Account (Item 3860-001-6023) | −498,000 | |||||
| (24) |
Amount payable from the Conjunctive Use Subaccount (Item 3860-001-6025) | −50,000 | |||||
| (25) |
Amount payable from the Bay-Delta Multipurpose Water Management Subaccount (Item 3860-001-6026) | −4,346,000 | |||||
| (26) |
Amount payable from the Water Security, Clean Drinking Water, Coastal and Beach Protection Fund of 2002 (Item 3860-001-6031) | −5,269,000 | |||||
| (27) |
Amount payable from the Safe Drinking Water, Water Quality and Supply, Flood Control, River and Coastal Protection Fund of 2006 (Item 3860-001-6051) | −14,419,000 | |||||
| (28) |
Amount payable from the Disaster Preparedness and Flood Prevention Bond Fund of 2006 (Item 3860-001-6052) | −50,779,000 | |||||
|
Provisions: | |||||||
| 1. |
The amounts appropriated in Items 3860-001-0001 to 3860-001-6052, inclusive, shall be transferred to the Water Resources Revolving Fund (0691) for direct expenditure in such amounts as the Department of Finance may authorize, including cooperative work with other agencies. | ||||||
| 2. |
The funds appropriated in this item for purposes of subdivision (n) of Section 75050 of the Public Resources Code may be expended only so long as the United States Bureau of Reclamation continues to provide federal funds and continues to carry out federal actions to implement the settlement agreement in Natural Resources Defense Council v. Rodgers (E.D. Cal. 2005) 381 F.Supp.2d 1212. | ||||||
| 3. | Until June 30, 2016, upon the order of the Director of Finance, the amount available for expenditure in this item may be augmented to support maintenance, operations, and removal of emergency drought barriers and actions to minimize impacts of the barriers on affected aquatic species in the Sacramento-San Joaquin Delta. The Department of Finance shall provide notification in writing to the Joint Legislative Budget Committee of any augmentation approved under this provision not less than 30 days prior to the effective date of the augmentation. This 30-day notification shall include a detailed workload and cost analysis. Any funds provided to remove emergency drought barriers in the Delta shall be available for encumbrance or expenditure until June 30, 2016. Any funds that are not expressly used for that purpose shall revert to the General Fund. | ||||||
| 4. | Of the amount provided to the Department of Water Resources, $2,000,000 shall be allocated to assist local agencies with emergency water supply drought projects. | ||||||
| 5. | The Department of Water Resources is required to report to the Legislature on or before January 10, 2015, with specific reductions in funding for the 72.0 positions that were backfilled pursuant to the Governor’s emergency drought response proposal. | ||||||
| 6. | Of the amount appropriated in this item, $14,025,000 is available for drought emergency response activities and shall be available for encumbrance until June 30, 2016. | ||||||
Item 3860-001-3228 is added to Section 2.00 of the Budget Act of 2014, to read:
|
3860-001-3228--For support of Department of Water Resources, for payment to Item 3860-001-0001, payable from the Greenhouse Gas Reduction Fund | 1,000,000 | ||||||
| Provisions: | |||||||
| 1. | The amount appropriated in this item shall be available for encumbrance or expenditure until June 30, 2017. | ||||||
| 2. | The funds appropriated in this item shall be expended to administer a grant program for local agencies, joint powers authorities, or nonprofit organizations to implement residential, commercial, or institutional water efficiency programs or projects that reduce greenhouse gas emissions and water and energy use. | ||||||
Item 3860-101-0001 is added to Section 2.00 of the Budget Act of 2014, to read:
|
3860-101-0001--For local assistance, Department of Water Resources | 5,000,000 | ||||||
| Provisions: | |||||||
| 1. | The amount appropriated in this item shall be available for encumbrance or expenditure until June 30, 2016. | ||||||
| 2. | The funds appropriated in this item shall be available for local assistance for emergency drinking water support for small communities, including addressing private well shortages. | ||||||
Item 3860-101-3228 is added to Section 2.00 of the Budget Act of 2014, to read:
|
3860-101-3228--For local assistance, Department of Water Resources, payable from the Greenhouse Gas Reduction Fund | 9,000,000 | ||||||
| Provisions: | |||||||
| 1. | The amount appropriated in this item shall be available for encumbrance or expenditure until June 30, 2017. | ||||||
| 2. | The funds appropriated in this item shall be available for local assistance for local agencies, joint powers authorities, or nonprofit organizations to implement residential, commercial, or institutional water efficiency programs or projects that reduce greenhouse gas emissions and water and energy use. | ||||||
Item 3860-101-6052 of Section 2.00 of the Budget Act of 2014 is amended to read:
|
3860-101-6052--For local assistance, Department of Water Resources, payable from the Disaster Preparedness and Flood Prevention Bond Fund of 2006 | 294,184,000 | ||||||
| Provisions: | |||||||
| 1. | The amount appropriated in this item shall be available for encumbrance until June 30, 2020, and available for liquidation until June 30, 2023. | ||||||
| 2. | The Department of Water Resources may transfer amounts appropriated in this item to Item 3860-301-6052 of this act. | ||||||
Item 3860-301-3228 is added to Section 2.00 of the Budget Act of 2014, to read:
|
3860-301-3228--For capital outlay, Department of Water Resources, payable from the Greenhouse Gas Reduction Fund | 10,000,000 | ||||||
| Schedule: | |||||||
| (1) |
20.20.212-Water-Energy Efficiency Projects | 10,000,000 | |||||
| Provisions: | |||||||
| 1. | The amount appropriated in this item shall be available for encumbrance or expenditure until June 30, 2018. | ||||||
Item 3860-301-6052 is added to Section 2.00 of the Budget Act of 2014, to read:
|
3860-301-6052--For capital outlay, Department of Water Resources, payable from the Disaster Preparedness and Flood Prevention Bond Fund of 2006 | 386,000,000 | ||||||
| Schedule: | |||||||
| (1) |
30.95.350-Urban Flood Risk Reduction Program | 320,000,000 | |||||
| (2) |
30.95.360-Non-Urban Flood Risk Management | 118,000,000 | |||||
| (3) |
Reimbursements | −52,000,000 | |||||
| Provisions: | |||||||
| 1. | The funds appropriated in this item may be expended for relocations and acquisition of land, easements, and rights-of-way, including, but not limited to, borrow pits, spoil areas, and easements for levees, clearing, flood control works, and flowage, and for appraisals, surveys, and engineering studies necessary for the completion or operation of the projects in the Sacramento and San Joaquin watersheds as authorized by Section 8617.1 and Chapters 1 (commencing with Section 12570), 2 (commencing with Section 12639), 3 (commencing with Section 12800), 3.5 (commencing with Section 12840), and 4 (commencing with Section 12850) of Part 6 of Division 6 of the Water Code. Notwithstanding paragraph (1) of subdivision (a) of Section 12582.7 and Section 12585.5 of the Water Code, prior to state and federal authorization of the project and appropriation of federal construction funds by Congress and subsequent to submittal of a report to the Legislature pursuant to Section 12582.7 of the Water Code, the amounts appropriated in this item may be expended for state costs associated with preconstruction design and engineering work conducted by the federal government and others. | ||||||
| 2. | Funds appropriated in this item may also be expended for the evaluation, repair, rehabilitation, reconstruction, or replacement of flood protection facilities consistent with subdivision (a) of Section 5096.821 of the Public Resources Code; for study, evaluation, improvement, and addition of facilities to provide enhanced levels of flood protection consistent with subdivision (b) of Section 5096.821 of the Public Resources Code; or for the protection, creation, and enhancement of flood protection corridors and bypasses consistent with Section 5096.825 of the Public Resources Code. | ||||||
| 3. | Funds appropriated in this item may also be used for any of the following: | ||||||
| (a) | Advances to the federal government, or payments to the federal government or others for incidental construction or reconstruction items that are an obligation of the state in connection with the completion or operation of the projects and for materials. | ||||||
| (b) | Flood protection-related activities of the state associated with construction, reconstruction, relocation, or alterations to levees, other flood control works, highways, railroads, bridges, power lines, communication lines, pipelines, irrigation works, and other structures and facilities, and for appraisals, surveys, mitigation and engineering studies incidental thereto. | ||||||
| (c) | Flood protection-related planning studies, surveys, preliminary plans, drawings, acquisitions, relocations, rights-of-way, construction, construction supervision, contract administration, and other work activities to be performed by Department of Water Resources personnel and contractors for completion of the projects. | ||||||
| 4. | Funds appropriated in this item may be used to implement the projects identified in this item without arrangements with the federal government while making reasonable efforts to obtain funding from the federal government in advance or by arranging to perform work that is a federal responsibility prior to the availability of federal appropriations with the intention that the costs will be reimbursed or eligible for credit by the federal government as provided in Public Law 99-662, Section 104, November 17, 1986; Public Law 90-483, Section 215, August 13, 1968; or other applicable law. | ||||||
| 5. | Notwithstanding Section 26.00, funds may be transferred, with the approval of the Department of Finance, among projects specified in this item and other Department of Water Resources flood protection-related major capital outlay projects with an active appropriation. The Director of Finance shall notify, in writing, the chairpersons of the committees in each house of the Legislature that consider appropriations and the Chairperson of the Joint Legislative Budget Committee, within 30 days or such lesser time as the chairperson of the joint committee, or his or her designee, may determine, prior to any transfer. | ||||||
| 6. | Payments from a local sponsor may be received by the Department of Water Resources and may be advanced to the federal government. | ||||||
| 7. | The amounts appropriated in this item shall be available for encumbrance until June 30, 2020, and available for liquidation until June 30, 2023. | ||||||
| 8. | The Department of Water Resources may transfer amounts appropriated in this item to Item 3860-101-6052 of this act. | ||||||
| 9. | The Department of Finance shall submit a report to the Joint Legislative Budget Committee on state operations, local assistance, and capital outlay expenditures from the Disaster Preparedness and Flood Prevention Bond Fund upon the annual release of the Governor’s Budget, until such funds are exhausted. The annual report shall identify actual prior-year expenditures, current-year budgeted amounts, and estimated budget-year expenditures by major program area. If the funding for a major program area was, or is planned to be, expended for a specific capital project, the department shall identify that project in the report. | ||||||
Item 3860-490 is added to Section 2.00 of the Budget Act of 2014, to read:
|
3860-490--Reappropriation, Department of Water Resources. Notwithstanding any other law, including this act, the balance as of June 30, 2015, of any prior year appropriations, except any reversion item, from the Disaster Preparedness and Flood Prevention Bond Fund of 2006 (Fund 6052) shall be available for encumbrance until June 30, 2020, and available for liquidation until June 30, 2023. | |||||||
| Provisions: | |||||||
| 1. | The Department of Water Resources may transfer amounts reappropriated in this item to Item 3860-101-6052 and Item 3860-301-6052. | ||||||
| 2. | The Department of Finance shall provide to the Controller an itemized list of appropriations subject to this item immediately upon enactment of the act adding this item. | ||||||
Item 3940-001-6083 is added to Section 2.00 of the Budget Act of 2014, to read:
|
3940-001-6083--For support of the State Water Resources Control Board, payable from the Water Quality, Supply, and Infrastructure Improvement Fund of 2014, to be available for expenditure until June 30, 2016 | 6,833,000 | ||||||
| Schedule: | |||||||
| (1) |
10-Water Quality | 6,970,000 | |||||
| (2) |
Reimbursements | −137,000 | |||||
Item 3940-002-0001 is added to Section 2.00 of the Budget Act of 2014, to read:
|
3940-002-0001--For support of the State Water Resources Control Board, to be available for encumbrance or expenditure until June 30, 2016 | 9,121,000 | ||||||
| Schedule: | |||||||
| (1) |
20-Water Rights | 9,121,000 | |||||
| Provisions: | |||||||
| 1. | Of the amount appropriated in this item, $6,727,000 shall be available to the State Water Resources Control Board for drought-related water right and water conservation actions, including establishing and enforcing requirements to prevent the waste or unreasonable use of water and to promote water recycling, establishing and enforcing curtailments in diversion based on unavailability of water under the diverters priority of right, and enforcing terms and conditions of water right permits and licenses. | ||||||
| 2. | Of the amount appropriated in this item, $2,394,000 shall be available to the State Water Resources Control Board to complete instream flow studies for tributaries identified in the report titled “Instream Flow Studies for the Protection of Public Trust Resources: A Prioritized Schedule and Estimate of Costs, December 2010” and to provide support for establishing and implementing flow requirements based on the flow studies. | ||||||
Item 3940-002-0679 is added to Section 2.00 of the Budget Act of 2014, to read:
|
3940-002-0679--For support of State Water Resources Control Board, payable from the State Water Quality Control Fund, to be available for encumbrance or expenditure until June 30, 2016 | 916,000 | ||||||
| Schedule: | |||||||
| (1) |
10-Water Quality | 916,000 | |||||
| Provisions: | |||||||
| 1. | The funds appropriated in this item are appropriated from the State Water Pollution Cleanup and Abatement Account, created pursuant to Section 13440 of the Water Code, to the State Water Resources Control Board to administer grants and direct expenditures to fund actions to address drought-related drinking water emergencies or threatened emergencies, without regard to whether the need for the emergency drinking water is as a result of the discharge of waste. | ||||||
| 2. | The amount appropriated in this item includes revenues derived from the assessment of fines and penalties imposed as specified in Section 13332.18 of the Government Code. | ||||||
Item 3940-101-0679 is added to Section 2.00 of the Budget Act of 2014, to read:
|
3940-101-0679--For local assistance, State Water Resources Control Board, for Program 10-Drinking Water, payable from the State Water Quality Control Fund | 15,000,000 | ||||||
| Schedule: | |||||||
| (1) |
10-Water Quality | 15,000,000 | |||||
| Provisions: | |||||||
| 1. | The funds appropriated in this item are appropriated from the State Water Pollution Cleanup and Abatement Account, created pursuant to Section 13440 of the Water Code, to the State Water Resources Control Board for encumbrance until June 30, 2016, for grants and direct expenditures to fund actions to address drought-related drinking water emergencies or threatened emergencies, without regard to whether the need for emergency drinking water is as a result of the discharge of waste. Guidelines adopted by the State Water Resources Control Board for allocation and administration of these moneys shall not be subject to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code. Expenditures pursuant to this appropriation shall be exempt from contracting and procurement requirements to the extent necessary to take immediate action to protect public health and safety. | ||||||
| 2. | The amount appropriated in this item includes revenues derived from the assessment of fines and penalties imposed as specified in Section 13332.18 of the Government Code. | ||||||
| 3. | Notwithstanding any other provision of law, upon approval and order of the Director of Finance, the State Water Resources Control Board may borrow sufficient funds for cash purposes from special funds that otherwise provide support for the board. Any such loans are to be repaid with interest at the rate earned in the Pooled Money Investment Account. | ||||||
Item 3940-101-6083 is added to Section 2.00 of the Budget Act of 2014, to read:
|
3940-101-6083--For local assistance, State Water Resources Control Board, for Program 10-Water Quality, payable from the Water Quality, Supply, and Infrastructure Improvement Fund of 2014, to be available for expenditure until June 30, 2018 | 261,500,000 | ||||||
Item 3940-102-0679 is added to Section 2.00 of the Budget Act of 2014, to read:
|
3940-102-0679--For support of State Water Resources Control Board, payable from the State Water Quality Control Fund | 4,000,000 | ||||||
| Provisions: | |||||||
| 1. | The funds appropriated in this item are appropriated from the State Water Pollution Cleanup and Abatement Account, created pursuant to Section 13440 of the Water Code, to the State Water Resources Control Board to provide interim emergency drinking water to disadvantaged communities with contaminated drinking water supplies, without regard to the source of contamination, including those contaminated drinking water supplies exacerbated by drought conditions. These funds shall be available for expenditure until June 30, 2016. | ||||||
| 2. | The amount appropriated in this item includes revenues derived from the assessment of fines and penalties imposed as specified in Section 13332.18 of the Government Code. | ||||||
Item 5180-101-0001 of Section 2.00 of the Budget Act of 2014 is amended to read:
|
5180-101-0001--For local assistance, Department of Social Services | 930,075,000 | ||||||
|
Schedule: | |||||||
| (1) |
16.30-CalWORKs | 3,940,902,834 | |||||
| (2) |
16.65-Other Assistance Payments | 901,147,166 | |||||
| (3) |
Reimbursements | −474,000 | |||||
| (4) |
Amount payable from the Emergency Food Assistance Program Fund (Item 5180-101-0122) | −588,000 | |||||
| (5) |
Amount payable from the Federal Trust Fund (Item 5180-101-0890) | −3,904,401,000 | |||||
| (6) |
Amount payable from the Child Support Collections Recovery Fund (Item 5180-101-8004) | −6,512,000 | |||||
|
Provisions: | |||||||
| 1. | (a) |
No funds appropriated in this item shall be encumbered unless every rule or regulation adopted and every all-county letter issued by the State Department of Social Services that adds to the costs of any program is approved by the Department of Finance as to the availability of funds before it becomes effective. In making the determination as to availability of funds to meet the expenditures of a rule, regulation, or all-county letter that would increase the costs of a program, the Department of Finance shall consider the amount of the proposed increase on an annualized basis, the effect the change would have on the expenditure limitations for the program set forth in this act, the extent to which the rule, regulation, or all-county letter constitutes a deviation from the premises under which the expenditure limitations were prepared, and any additional factors relating to the fiscal integrity of the program or the state’s fiscal situation. | |||||
| (b) |
Notwithstanding Sections 28.00 and 28.50, the availability of funds contained in this item for rules, regulations, or all-county letters that add to program costs funded from the General Fund in excess of $500,000 on an annual basis, including those that are the result of a federal regulation, but excluding those that are (a) specifically required as a result of the enactment of a federal or state law or (b) included in the appropriation made by this act, shall not be approved by the Department of Finance sooner than 30 days after notification in writing to the chairpersons of the committees in each house of the Legislature that consider appropriations and the Chairperson of the Joint Legislative Budget Committee, or sooner than such lesser time after notification as the chairperson of the joint committee, or his or her designee, may in each instance determine. | ||||||
| 2. |
Notwithstanding Chapter 1 (commencing with Section 18000) of Part 6 of Division 9 of the Welfare and Institutions Code, a loan not to exceed $500,000,000 shall be made available from the General Fund, from funds not otherwise appropriated, to cover the costs of a program or programs when the federal funds have not been received or funds in any subaccount within the Local Revenue Fund have not been deposited prior to the usual time for the state to transmit payment to the counties. This loan from the General Fund shall be repaid when the federal funds or the funds for any subaccounts within the Local Revenue Fund for the program or programs becomes available. | ||||||
| 3. |
The Department of Finance may authorize the transfer of amounts from this item to Item 5180-001-0001 in order to fund the costs of the administrative hearing process associated with the CalWORKs program. | ||||||
| 4. | (a) |
The Department of Finance is authorized to approve expenditures in those amounts made necessary by changes in either caseload or payments, including, but not limited to, the timing of federal payments, or any rule or regulation adopted and any all-county letter issued as a result of the enactment of a federal or state law, the adoption of a federal regulation, or a court action, during the 2014-15 fiscal year that are within or in excess of amounts appropriated in this act for that year. | |||||
| (b) |
If the Department of Finance determines that the estimate of expenditures will exceed the expenditures authorized for this item, the department shall so report to the Legislature. At the time the report is made, the amount of the appropriation made in this item shall be increased by the amount of the excess unless and until otherwise provided by law. | ||||||
| 5. |
Nonfederal funds appropriated in this item which have been budgeted to meet the state’s Temporary Assistance for Needy Families maintenance-of-effort requirement established pursuant to the federal Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104-193) may not be expended in any way that would cause their disqualification as a federally allowable maintenance-of-effort expenditure. | ||||||
| 6. |
In the event of declared disaster and upon county request, the State Department of Social Services may act in the place of any county and assume direct responsibility for the administration of eligibility and grant determination. Upon recommendation of the Director of Social Services, the Department of Finance may authorize the transfer of funds from this item and Item 5180-101-0890, to Items 5180-001-0001 and 5180-001-0890, for this purpose. | ||||||
| 7. |
Pursuant to the Electronic Benefit Transfer (EBT) Act (Chapter 3 (commencing with Section 10065) of Part 1 of Division 9 of the Welfare and Institutions Code) and in accordance with the EBT System regulations (Manual of Policies and Procedures Section 16-401.15), in the event a county fails to reimburse the EBT contractor for settlement of EBT transactions made against the county’s cash assistance programs, the state is required to pay the contractor. The State Department of Social Services may use funds from this item to reimburse the EBT contractor for settlement on behalf of the county. The county shall be required to reimburse the department for the county’s settlement via direct payment or administrative offset. | ||||||
| 8. |
The Department of Finance is authorized to approve expenditures for the California Food Assistance Program in those amounts made necessary by changes in the CalFresh Program Standard Utility Allowance, including those that result from midyear Standard Utility Allowance adjustments requested by the state. If the Department of Finance determines that the estimate of expenditures will exceed the expenditure authority of this item, the department shall so report to the Legislature. At the time the report is made, the amount of the appropriation made in this item shall be increased by the amount of the excess unless and until otherwise provided by law. | ||||||
| 9. | (a) | Upon request of the State Department of Social Services, the Department of Finance may increase expenditure authority in this item by up to $37,000,000 for food assistance programs associated with persons affected by the drought. Notwithstanding any other provision of law, these funds shall be available for commodity purchases and state and local agency administrative costs incurred on or before December 31, 2016, to provide food assistance associated with the drought through existing partnerships. The Department of Finance shall notify the Joint Legislative Budget Committee of the adjustment within 10 working days of the date the Department of Finance approved the adjustment. | |||||
| (b) | It is the intent of the Legislature that, in addition to the counties identified by the Governor’s Drought Task Force as being drought-impacted, the food assistance authorized in subdivision (a) also shall be made available to Imperial County, San Luis Obispo County, Santa Barbara County, Ventura County, and the Coachella Valley in Riverside County. | ||||||
| (c) | Upon request of the State Department of Social Services, the Department of Finance may increase expenditure authority above the amount authorized in subdivision (a). The Department of Finance shall authorize any such increase not sooner than 10 days after notification of the necessity thereof in writing to the chairpersons of the committees in each house of the Legislature that consider appropriations and the Chairperson of the Joint Legislative Budget Committee. | ||||||
| 10. | Of the amount appropriated in Schedule (1), $20,000,000 shall be available for housing supports for those families in receipt of CalWORKs for whom homelessness or housing instability is a barrier to self-sufficiency or child well-being pursuant to Section 11330.5 of the Welfare and Institutions Code. | ||||||
Item 8570-001-0001 of Section 2.00 of the Budget Act of 2014 is amended to read:
|
8570-001-0001--For support of Department of Food and Agriculture | 60,441,000 | ||||||
|
Schedule: | |||||||
| (1) |
11-Agricultural Plant and Animal Health, Pest Prevention, Food Safety Services | 174,692,000 | |||||
| (2) |
21-Marketing, Commodities, and Agricultural Services | 22,649,000 | |||||
| (3) |
31-Assistance to Fairs and County Agricultural Activities | 1,276,000 | |||||
| (4) |
41.01-Executive, Management, and Administrative Services | 21,062,000 | |||||
| (5) |
41.02-Distributed Executive, Management, and Administrative Services | −20,883,000 | |||||
| (6) |
51-General Agricultural Activities | 50,426,000 | |||||
| (7) |
Reimbursements | −17,664,000 | |||||
| (8) |
Amount payable from the Motor Vehicle Account, State Transportation Fund (Item 8570-001-0044) | −6,799,000 | |||||
| (9) |
Amount payable from the Department of Agriculture Account, Department of Food and Agriculture Fund (Item 8570-001-0111) | −38,408,000 | |||||
| (10) |
Amount payable from the Fair and Exposition Fund (Item 8570-001-0191) | −1,276,000 | |||||
| (11) |
Amount payable from the Harbors and Watercraft Revolving Fund (Item 8570-001-0516) | −4,378,000 | |||||
| (12) |
Amount payable from the Department of Agriculture Building Fund (Item 8570-001-0601) | −1,963,000 | |||||
| (13) |
Amount payable from the Federal Trust Fund (Item 8570-001-0890) | −91,585,000 | |||||
| (14) |
Amount payable from the Antiterrorism Fund (Item 8570-001-3034) | −548,000 | |||||
| (15) |
Amount payable from the Analytical Laboratory Account, Department of Food and Agriculture Fund (Item 8570-001-3101) | −533,000 | |||||
| (16) |
Amount payable from the Specialized License Plate Fund (Item 8570-001-3139) | −477,000 | |||||
| (17) |
Amount payable from the Greenhouse Gas Reduction Fund (Item 8570-001-3228) | −25,000,000 | |||||
| (17.5) |
Amount payable from the Cost of Implementation Account, Air Pollution Control Fund (Item 8570-001-3237) | −140,000 | |||||
| (18) |
Amount payable from the Municipal Shelter Spay-Neuter Fund (Item 8570-001-8055) | −10,000 | |||||
|
Provisions: | |||||||
| 1. |
The Secretary of Food and Agriculture shall furnish to the Director of Finance and the Chairperson of the Joint Legislative Budget Committee annual reports on all expenditures from all fund sources for emergency detection and eradication activities relating to agricultural plant or animal pests or diseases for which no other program funds are available to be used to detect or eradicate such pest or disease if the pest or disease is not considered established in California and the pest or disease infests or infects plants or animals of commercial or noncommercial agriculture, ornamental horticulture, or habitat of significance. The report shall specify the amount expended by funding source, the activities performed, the pest or disease, the location where the pest was detected, the location where the eradication efforts were performed, and the animal or plant affected for each emergency detection or eradication. | ||||||
| 2. |
The Department of Food and Agriculture shall require full public participation, including public meetings, from all major regions of the state for each notification of proposed actions within the Light Brown Apple Moth program. | ||||||
| 3. | Of the amount appropriated in this item, $200,000 is available for a study to evaluate the impacts of drought on the agriculture sector and shall be available for encumbrance until June 30, 2016. | ||||||
Item 8570-001-3228 of Section 2.00 of the Budget Act of 2014 is amended to read:
|
8570-001-3228--For support of Department of Food and Agriculture, for payment to Item 8570-001-0001, payable from the Greenhouse Gas Reduction Fund | 25,000,000 | ||||||
| Provisions: | |||||||
| 1. | The funds appropriated in this item shall be available for encumbrance or expenditure until June 30, 2016. | ||||||
Item 9800-001-0001 of Section 2.00 of the Budget Act of 2014 is amended to read:
|
9800-001-0001--For Augmentation for Employee Compensation | 271,039,000 | ||||||
|
Provisions: | |||||||
| 1. |
The amount appropriated in this item shall not be construed to control or influence collective bargaining between the state employer and employee representatives. | ||||||
| 2. |
The funds appropriated in this item are for compensation increases and increases in benefits related thereto of employees whose compensation, or portion thereof, is chargeable to the General Fund, to be allocated by budget executive order by the Director of Finance to the several state offices, departments, boards, bureaus, commissions, and other state agencies, in augmentation of their respective appropriations or allocations, in accordance with approved memoranda of understanding or, for employees excluded from collective bargaining, in accordance with salary and benefit schedules established by the Department of Human Resources. | ||||||
| 3. |
It is the intent of the Legislature that all proposed augmentations for increased employee compensation costs, including, but not limited to, base salary increases, pay increases to bring one group of employees into a pay equity position with another group of public employees, and recruitment and retention differentials, be budgeted and considered on a comprehensive, statewide basis. Therefore, the Legislature declares its intent to reject any proposed augmentations that are not included in Items 9800-001-0001, 9800-001-0494, and 9800-001-0988, given that these are the items where the funds to implement comprehensive statewide compensation policies, including those adopted pursuant to collective bargaining, are considered. This provision shall not apply to augmentations for increased employee compensation costs resulting from mandatory judicial orders to raise pay for any group of employees or augmentations for increased compensation costs, or approvals for departments to provide increased employee compensation levels, that are included in bills separate from the budget act. | ||||||
| 4. |
This item contains funds estimated to be necessary to implement side letters, appendices, or other addenda to a memorandum of understanding (collectively referred to as “pending agreements”) that have been determined by the Joint Legislative Budget Committee to require legislative approval prior to their implementation, but which may not have been approved in separate legislation as of the date of the passage of this act. In the event that the Legislature does not approve separate legislation to authorize implementation of any of the pending agreements, the Director of Finance shall not allocate any funds related to those pending agreements pursuant to Provision 2, and the expenditure of funds for those pending agreements shall not be deemed to have been approved by the Legislature. | ||||||
| 5. |
As of July 31, 2015, the unencumbered balances of the above appropriation shall revert to the General Fund. | ||||||
| 6. |
The Director of Finance may adjust this item of appropriation to reflect the health benefit premium rates approved by the Board of Administration of the California Public Employees’ Retirement System for the 2015 calendar year. Within 30 days of making any adjustment pursuant to this provision, the Director of Finance shall report the adjustment in writing to the Chairperson of the Joint Legislative Budget Committee and the chairpersons of the committees in each house of the Legislature that consider appropriations. | ||||||
| 7. |
By inclusion of this provision, for purposes of Sections 3517.5 and 3517.63 of the Government Code, the Legislature hereby ratifies the following agreements that require the expenditure of funds: (1) addendum concerning Aviation Consultants, dated November 22, 2013, to the Memorandum of Understanding (MOU) with State Bargaining Unit 1 (Service Employees International Union); (2) addendum concerning Recreational Therapists, dated March 4, 2014, to the MOU with State Bargaining Unit 19 (American Federation of State, County, and Municipal Employees); (3) the MOU dated May 5, 2014, with State Bargaining Unit 13 (International Union of Operating Engineers), including continuous appropriation of economic terms in the event that a budget act is not in place prior to July 1, 2016, such appropriation will be subsumed by the expenditure authority approved in the budget act for each affected department upon enactment of each applicable Budget Act; (4) addendum concerning Correctional Officers, dated May 9, 2014, to the MOU with State Bargaining Unit 6 (California Correctional Peace Officers Association); and (5) the MOU dated May 21, 2014, with State Bargaining Unit 10 (California Association of Professional Scientists), including continuous appropriation of economic terms in the event that a budget act is not in place prior to June 30, 2016, such appropriation will be subsumed by the expenditure authority approved in the budget act for each affected department upon enactment of each applicable budget act. The estimated costs to implement these agreements are included in this item or in departmental appropriations. | ||||||
| 8. | By inclusion of this provision, for purposes of Sections 3517.5 and 3517.63 of the Government Code, the Legislature hereby ratifies the following agreement that requires the expenditure of funds: the addendum, dated September 3, 2014, to the MOU with State Bargaining Unit 19 (American Federation of State, County and Municipal Employees, Health and Social Services/Professional). | ||||||
Section 39 of the Budget Act of 2014 (Chapter 25 of the Statutes of 2014) is amended to read:
The Legislature hereby finds and declares that the following bills are other bills providing for appropriations related to the Budget Bill within the meaning of subdivision (e) of Section 12 of Article IV of the California Constitution: AB 1458, AB 1459, AB 1460, AB 1461, AB 1462, AB 1463, AB 1464, AB 1465, AB 1466, AB 1467, AB 1468, AB 1469, AB 1471, AB 1472, AB 1473, AB 1474, AB 1475, AB 1477, AB 1478, AB 1479, AB 1480, AB 1481, AB 1482, AB 1483, AB 1484, AB 1485, AB 1486, AB 1487, AB 1488, AB 1489, AB 1490, AB 1491, AB 1492, AB 1493, AB 1494, AB 1495, AB 1496, AB 1497, SB 853, SB 854, SB 855, SB 856, SB 857, SB 858, SB 859, SB 860, SB 861, SB 862, SB 863, SB 864, SB 866, SB 867, SB 868, SB 869, SB 870, SB 873, SB 874, SB 875, SB 876, SB 877, SB 878, SB 879, SB 880, SB 881, SB 882, SB 883, SB 884, SB 885, SB 886, SB 887, SB 888, SB 889, SB 890, and SB 891 of the 2013-14 Regular Session and SB 76 and AB 92 of the 2015-16 Regular Session.
This act is a Budget Bill within the meaning of subdivision (e) of Section 12 of Article IV of the California Constitution and shall take effect immediately.
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