Amended in Senate April 13, 2015

Senate Bill No. 315

Introduced by Senators Monning and Hernandez

February 23, 2015

An act to amend Section 15438.10 of the Government Code, relating to health care, and making an appropriation therefor.

LEGISLATIVE COUNSEL’S DIGEST

SB 315, as amended, Monning. Health care access demonstration project grants.

Existing law establishes a program for the California Health Facilities Authority to award grants that do not exceed $1,500,000 to one or more projects designed to demonstrate specified new or enhanced cost-effective methods of delivering quality health care services to improve access to quality health care for vulnerable populations or communities, or both, that are effective at enhancing health outcomes and improving access to quality health care and preventive services. begin insert Existing law requires a recipient of that grant to adhere to all applicable laws relating to scope of practice, licensure, staffing, and building codes. end insert Existing law authorizes the authority, if a demonstration project receiving a grant is successful at developing such a new method of delivering high-quality and cost-effective health care services, to implement a 2nd grant program, as specified, to replicate in additional California communities the model developed by that demonstration project. Existing law requires the authority to prepare and provide a report to the Legislature and the Governor on the outcomes of the demonstration grant program that includes, among other information, the total amount of grants issued and the amount of each grant issued.

This bill would create the California Health Access Model Program Two Account within the California Health Facilities Financing Authority Fund for purposes of administering a 2nd competitive grant selection process, in accordance with existing grant provisions, to fund one or more projects designed to demonstrate specified new or enhanced cost-effective methods of delivering quality health care services to improve access to quality health care for vulnerable populations or communities, or both. The bill would transfer up to $6,500,000 from the California Health Facilities Financing Authority Hospital Equipment Loan Program Fund to the account for the purposes of the bill, and would require that any moneys remaining in the account as of January 1, 2023, revert to California Health Facilities Financing Authority Hospital Equipment Loan Program Fund. By expanding the purposes for which a continuously appropriated fund may be used, this bill would make an appropriation.

The bill would also require the authority to prepare and provide a report to the Legislature and the Governor by January 1, 2017, on the outcomes of this 2nd competitive grant selection process, as specified.

begin insert

This bill would also make the existing requirement for adherence to all applicable laws relating to scope of practice, licensure, staffing, and building to codes applicable to a recipient of a grant provided pursuant to the 2nd grant program described above.

end insert

Vote: majority. Appropriation: yes. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

SECTION 1.  

Section 15438.10 of the Government Code is
amended to read:

15438.10.  

(a) The Legislature finds and declares the following:

(1) Many Californians face serious obstacles in obtaining needed
health care services, including, but not limited to, medical, mental
health, dental, and preventive services. The obstacles faced by
vulnerable populations and communities include existence of
complex medical, physical, or social conditions, disabilities,
economic disadvantage, and living in remote or underserved areas
that make it difficult to access services.

(2) With the recent passage of national health care reform, there
is an increased demand for innovative ways to deliver quality
health care, including preventive services, to individuals in a
cost-effective manner.

(3) There is a need to develop new methods of delivering health
services utilizing innovative models that can be demonstrated to
be effective and then replicated throughout California and that
bring community-based health care preventive services to
individuals where they live or receive education, social, or general
health services.

(4) For more than 30 years, the California Health Facilities
Financing Authority has provided financial assistance through
tax-exempt bonds, low-interest loans, and grants to health facilities
in California, assisting in the expansion of the availability of health
services and health care facilities throughout the state.

(b) (1) Following the completion of a competitive selection
process, the authority may award one or more grants that, in the
aggregate, do not exceed one million five hundred thousand dollars
($1,500,000) to one or more projects designed to demonstrate
specified new or enhanced cost-effective methods of delivering
quality health care services to improve access to quality health
care for vulnerable populations or communities, or both, that are
effective at enhancing health outcomes and improving access to
quality health care and preventive services. These health care
services may include, but are not limited to, medical, mental health,
or dental services for the diagnosis, care, prevention, and treatment
of human illness, or individuals with physical, mental, or
developmental disabilities. More than one demonstration project
may receive a grant pursuant to this section. It is the intent of the
Legislature for a demonstration project that receives a grant to
allow patients to receive screenings, diagnosis, or treatment in
community settings, including, but not limited to, school-based
health centers, adult day care centers, and residential care facilities
for the elderly, or for individuals with mental illness or
developmental disabilities.

(2) A grant awarded pursuant to this subdivision may be
allocated in increments to a demonstration project over multiple
years to ensure the demonstration project’s ability to complete its
work, as determined by the authority. Prior to the initial allocation
of funds pursuant to this subdivision, the administrators of the
demonstration project shall provide evidence that the demonstration
project has or will have additional funds sufficient to ensure
completion of the demonstration project. If the authority allocates
a grant in increments, each subsequent year’s allocation shall be
provided to the demonstration project only upon submission of
research that shows that the project is progressing toward the
identification of a high-quality and cost-effective delivery model
that improves health outcomes and access to quality health care
and preventive services for vulnerable populations or communities,
and can be replicated throughout the state in community settings.

(3) Except for a health facility that qualifies as a “small and
rural hospital” pursuant to Section 124840 of the Health and Safety
Code, a health facility that has received tax-exempt bond financing
from the authority shall not be eligible to receive funds awarded
for a demonstration project. Such a health facility may participate
as an uncompensated partner or member of a collaborative effort
that is awarded a demonstration project grant. A health facility
that participates in a demonstration project that receives funds
pursuant to this section may not claim the funding provided by the
authority toward meeting its community benefit and charity care
obligations.

(4) Funds provided to a demonstration project pursuant to this
subdivision may be used to supplement, but not to supplant,
existing financial and resource commitments of the grantee or
grantees or any other member of a collaborative effort that has
been awarded a demonstration project grant.

(c) (1) If a demonstration project that receives a grant pursuant
to subdivision (b) is successful at developing a new method of
delivering high-quality and cost-effective health care services in
community settings that result in increased access to quality health
care and preventive services or improved health care outcomes for
vulnerable populations or communities, or both, then beginning
as early as the second year after the initial allocation of moneys
provided pursuant to subdivision (b), the authority may implement
a second grant program that awards not more than five million
dollars ($5,000,000), in the aggregate, to eligible recipients as
defined by the authority, to replicate in additional California
communities the model developed by a demonstration project that
received a grant pursuant to subdivision (b). Prior to the
implementation of this second grant program, the authority shall
prepare and provide a report to the Legislature and the Governor
on the outcomes of the demonstration project. The report shall be
made in accordance with Section 9795.

(2) If the authority implements the second grant program, the
authority shall also report annually, beginning with the first year
of implementation of the second grant program, to the Legislature
and the Governor regarding the program, including, but not limited
to, the total amount of grants issued pursuant to this subdivision,
the amount of each grant issued, and a description of each project
awarded funding for replication of the model.

(3) Grants under this subdivision may be utilized for eligible
costs, as defined in subdivision (c) of Section 15432, including
equipment, information technology, and working capital, as defined
in subdivision (h) of Section 15432.

(4) The authority may adopt regulations relating to the grant
program authorized pursuant to this subdivision, including
regulations that define eligible recipients, eligible costs, and
minimum and maximum grant amounts.

(d) (1) The authority shall prepare and provide a report to the
Legislature and the Governor by January 1, 2014, on the outcomes
of the demonstration grant program, including, but not limited to,
the following:

(A) The total amount of grants issued.

(B) The amount of each grant issued.

(C) A description of other sources of funding for each project.

(D) A description of each project awarded funding.

(E) A description of project outcomes that demonstrate
cost-effective delivery of health care services in community
settings, that result in improved access to quality health care or
improved health care outcomes.

(2) The authority shall prepare and provide a report to the
Legislature and the Governor by January 1, 2017, on the outcomes
of the second competitive grant selection process authorized in
subdivision (g), including, but not limited to, the information
specified in subparagraphs (A) to (E), inclusive, of paragraph (1).

(3) A report submitted pursuant to this subdivision shall be
submitted in compliance with Section 9795.

(e) There is hereby created the California Health Access Model
Program Account in the California Health Facilities Financing
Authority Fund. All moneys in the account are hereby continuously
appropriated to the authority for carrying out the purposes of this
section. An amount of up to six million five hundred thousand
dollars ($6,500,000) shall be transferred from funds in the
California Health Facilities Financing Authority Fund that are not
impressed with a trust for other purposes into the California Health
Access Model Program Account for the purpose of issuing grants
pursuant to this section. Any moneys remaining in the California
Health Access Model Program Account on January 1, 2020, shall
revert as of that date to the California Health Facilities Financing
Authority Fund.

(f) Any recipient of a grant provided pursuant to begin delete subdivision end delete
begin insert subdivisions end insert (b) begin insert and (c) end insert shall adhere to all applicable laws relating
to scope of practice, licensure, staffing, and building codes.

(g) There is hereby created the California Health Access Model
Program Two Account within the California Health Facilities
Financing Authority Fund for purposes of administering a second
competitive grant selection process, in accordance with
subdivisions (b) and (c), to fund one or more projects designed to
demonstrate specified new or enhanced cost-effective methods of
delivery quality health care services to improve access to quality
health care for vulnerable populations or communities, or both.
An amount of up to six million five hundred thousand dollars
($6,500,000) shall be transferred from funds in the California
Health Facilities Financing Authority Hospital Equipment Loan
Program Fund that are not impressed with a trust for other purposes
into the California Health Access Model Program Two Account
for the purpose of administering a second competitive grant
selection process pursuant to this subdivision. Any moneys
remaining in the California Health Access Model Program Two
Account on January 1, 2023, shall revert as of that date to the
California Health Facilities Financing Authority Hospital
Equipment Loan Program Fund.