BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      SB 75


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          (Without Reference to File)





          SENATE THIRD READING


          SB  
          75 (Committee on Budget and Fiscal Review)


          As Amended  June 16, 2015


          Majority vote. Budget Bill Appropriation Takes Effect  
          Immediately


          SENATE VOTE:  Vote not relevant


          SUMMARY:  This is the Omnibus Health Trailer Bill for 2015-16.   
          It contains necessary changes related to the Budget Act of 2015.  
           This bill makes various statutory changes to implement the  
          2015-16 Budget.  Specifically, this bill:


          1)Requires enrolling providers in the Every Woman Counts,  
            Improving Access, Counseling, and Treatment for Californians  
            with Prostate Cancer (IMPACT), and Family Planning Access Care  
            and Treatment (FPACT) programs to provide enrolling  
            individuals information on how to apply for insurance  
            affordability programs. 
          2)Codifies the existing practice of providing dental referrals  
            to children in the Children's Health and Disability Program at  
            one year of age. 









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          3)Extends the timelines for incorporating the Multipurpose  
            Senior Services Program (MSSP) into the Coordinated Care  
            Initiative. Requires MSSP services to transition from a  
            federal waiver to a managed care benefit in Coordinated Care  
            Initiative (CCI) counties no later than December 31, 2017, or  
            on the date the managed care plans and MSSP providers jointly  
            satisfy the readiness criteria.  Requires DHCS to notify the  
            Legislature of its intent to transition MSSP services to a  
            managed care benefit at least 30 days prior to the MSSP  
            services transition.  Requires MSSP services to be offered in  
            its current structure should the CCI become inoperative.


          4)Eliminates the sunset on the use of Modified Adjusted Gross  
            Income (MAGI) eligibility determinations within the California  
            Healthcare Eligibility, Enrollment, and Retention System  
            (CalHEERS).


          5)Suspends the annual Cost of Living Adjustment (COLA) for the  
            budget year for counties for Medi-Cal eligibility  
            administration funding.


          6)Creates the Health Home Program Account to collect and  
            allocate non-General Fund public or private grants to  
            implement the Health Home Program.  Authorizes the department  
            to accept funding from local governments, foundations, or  
            other organizations for the Health Home Program. 


          7)Requires Department of Health Care Services (DHCS) to make  
            Medi-Cal enrollment assistance payments for applications  
            received through June 30, 2015, after which any remaining  
            funds shall be allocated to the county outreach and enrollment  
            grants.  Requires remaining funds not allocated to be  
            distributed to community-based organizations providing  
            enrollment assistance to enrollees.  Requires DHCS to make an  








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            initial allocation to the counties of these funds no later  
            than January 1, 2016, and the final allocation no later than  
            June 30, 2016. 


          8)Authorizes a transition from using certified public  
            expenditures to inter-governmental transfers in order to  
            increase federal funding in the Ground Emergency Medical  
            Transportation Supplemental Reimbursement Program.


          9)Requires the Office of System Integration to report to the  
            Legislature by April 1, 2017, on the feasibility, benefits,  
            costs and risks of installing the MAGI Eligibility Decision  
            Engine in one, two, or all of the Statewide Automated Welfare  
            System consortia systems.


          10)Requires DHCS to consult with health care service plans on  
            reconciling Major Risk Medical Insurance Program and Guarantee  
            Issue Program costs, and stipulates various requirements  
            associated with these reconciliations.  Requires health care  
            service plans to remit payment to DHCS within 60 days of the  
            date of notice from DHCS, and authorizes 7% annual interest to  
            accrue, unless waived by DHCS.  Extends the reconciliation  
            period for DHCS with health care service plans from six to 18  
            months.


          11)Eliminates copays in Medi-Cal for non-emergency care provided  
            in emergency rooms.


          12)Expands full-scope Medi-Cal coverage to children, regardless  
            of immigration status, who currently would be eligible for  
            Medi-Cal if not for immigration status, beginning when the  
            department declares that systems are ready for implementation,  
            but no sooner than May 1, 2016.  Requires children eligible in  
            this category to enroll in Medi-Cal managed care.  Requires  








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            DHCS to seek federal financial participation (FFP), but  
            requires coverage to be provided regardless of FFP.  Requires  
            DHCS to provide a semiannual status report to the Legislature  
            until regulations have been adopted.


          13)Eliminates the 10% rate reduction, adopted through AB 97  
            (Budget Committee), Chapter 3, Statutes of 2011 (budget  
            trailer bill), for dental care providers in the Medi-Cal  
            program, beginning July 1, 2015. 


          14)Authorizes DHCS to make grants to health benefit plans for  
            2015-16 that are funded by contributions made by agricultural  
            employers, where 85% or more of the plan's eligible  
            participants are agricultural employees for work performed and  
            covered under a collective bargaining agreement, and meet  
            other specified requirements.


          15)Authorizes DHCS, for 2015-16, to provide a grant to LifeLong  
            Medical Care, a federally qualified health center in Contra  
            Costa County, to support extended urgent care hours.


          16)Updates the language, and codifies the activities, that  
            govern the Office of Problem Gambling that provides gambling  
            treatment services.


          17)Authorizes legal settlement funds to be deposited into the  
            Food Safety Fund. 


          18)Prohibits insurance coverage to utilize copayments,  
            coinsurance, deductibles, or any other form of cost sharing  
            for the Prenatal Screening Program fee. Requires reimbursement  
            for services covered under this program to be paid at the  
            amount set in statute and regulations. 








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          19)Modernizes the acquired immune deficiency syndrome (AIDS)  
            Drug Assistance Program eligibility standards by changing  
            eligibility from a maximum modified adjusted gross income of  
            $50,000 to 500% of the federal poverty level based on family  
            size and household income.  Authorizes the sharing of  
            information between the Department of Public Health and the  
            Franchise Tax Board in order to verify the income of  
            applicants. 


          20)Requires the licensing fees for skilled nursing facilities to  
            be increased in order to generate $400,000 for the Department  
            of Aging's Long-Term Care Ombudsman Program for its work  
            investigating complaints made against skilled nursing  
            facilities and increasing visits to those facilities.


          21)Clarifies that regulations meet the requirements of the  
            Clinical Laboratory Improvement Act (CLIA), as in effect  
            January 1, 2015, and may include the clinical laboratory's use  
            of the following alternative quality control testing  
            procedures recognized by the federal Center for Medicare and  
            Medicaid Services (CMS):  until December 31, 2015, equivalent  
            quality control procedures; and commencing January 1, 2016, an  
            Individualized Quality Control Plan as included in the State  
            Operations Manual adopted by CMS.


          22)Establishes the Pre-Exposure Prophylaxis (PrEP) Navigator  
            Services Program, a competitive grant program for  
            community-based organizations or local health departments.   
            Requires grantees to develop protocols to conduct outreach to  
            targeted populations, provide PrEP education to clients and  
            providers, and to assess and refer persons to clinical care  
            and prevention services.  Requires the department to develop  
            and distribute PrEP educational materials statewide, provide  
            training and support for any related activities, and conduct  








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            oversight and evaluation of the program.


          23)Authorizes the Department of Public Health to purchase  
            necessary supplies for syringe exchange programs and  
            distribute those supplies to syringe exchange programs.


          24)Establishes a three-year hepatitis C Linkage to Care  
            demonstration pilot project to allow for innovative,  
            evidence-based approaches providing outreach, hepatitis C  
            screening, and linkage to, and retention in, quality health  
            care for individuals with, or at high risk of hepatitis C.   
            Authorizes this project for 2015-16, 2016-17, and 2017-18.   
            Requires utilization of a competitive grant process for  
            community-based organizations or local health jurisdictions  
            and stipulates the qualifications required of grantees.


          25)Establishes timelines for nursing home complaint  
            investigations of:  90 days with a possible 90-day extension  
            beginning July 1, 2016 (for complaints that involve a threat  
            of imminent danger of death or serious bodily harm); 90 days  
            with a possible 60-day extension beginning July 1, 2017; and  
            60 days with a possible 60-day extension beginning July 1,  
            2018.  Requires the department to report to the Legislature,  
            within the Licensing and Certification Program estimates,  
            beginning in 2018-19, on the feasibility of reducing the  
            complaint investigation timelines.  Establishes the  
            Legislature's intent that the department seek to reduce the  
            amount of time to complete investigations as much as possible  
            with a goal of 45 days.  Extends the time period for the  
            department to issue and serve any citation from three to 30  
            days.  Requires the department, when it fails to meet the  
            statutorily required deadline for hospital-based complaint  
            investigations, to document the extenuating circumstances  
            explaining why it could not meet the timeframes, and notify  
            the facility and the complainant in writing of the basis for  
            the extension and estimated completion date.








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          26)Extends Covered California's emergency regulations authority  
            for one year and provides limited statutory exemptions from  
            the rulemaking provisions of the Administrative Procedure Act.


          27)Authorizes the California Health Facilities Financing  
            Authority to use up to $3 million in unencumbered Investment  
            in Mental Health Wellness grant funds for peer respite  
            programs. 


          28)Appropriates $50 million from the Health Home Program Account  
            to DHCS to implement the Health Home Program.  Makes this  
            appropriation available for encumbrance or expenditure until  
            June 30, 2020.


          COMMENT:  This bill is a budget trailer bill within the overall  
          2015-16 budget package to implement actions taken affecting the  
          Departments of Health Care Services and Public Health, Covered  
          California, and the California Health Facilities Financing  
          Authority.




          Analysis Prepared by:                                             
                          Andrea Margolis / BUDGET / (916) 319-2099  FN:  
          0001030
















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