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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