BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                     SB 315


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          SENATE THIRD READING


          SB  
          315 (Monning and Hernandez)


          As Amended  August 31, 2015


          Majority vote


          SENATE VOTE:  29-10


           ------------------------------------------------------------------ 
          |Committee       |Votes|Ayes                  |Noes                |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |----------------+-----+----------------------+--------------------|
          |Health          |18-0 |Bonta, Maienschein,   |                    |
          |                |     |Bonilla, Burke, Chiu, |                    |
          |                |     |Gomez, Gonzalez,      |                    |
          |                |     |Roger Hernández,      |                    |
          |                |     |Lackey, McCarty,      |                    |
          |                |     |Nazarian, Patterson,  |                    |
          |                |     |Ridley-Thomas,        |                    |
          |                |     |Rodriguez, Steinorth, |                    |
          |                |     |Thurmond, Waldron,    |                    |
          |                |     |Wood                  |                    |
          |                |     |                      |                    |
          |----------------+-----+----------------------+--------------------|
          |Appropriations  |17-0 |Gomez, Bigelow,       |                    |
          |                |     |Bloom, Bonta,         |                    |
          |                |     |Calderon, Chang,      |                    |
          |                |     |Nazarian, Eggman,     |                    |
          |                |     |Gallagher, Eduardo    |                    |








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          |                |     |Garcia, Holden,       |                    |
          |                |     |Jones, Quirk, Rendon, |                    |
          |                |     |Wagner, Weber, Wood   |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
           ------------------------------------------------------------------ 


          SUMMARY:  Authorizes the California Health Facilities Financing  
          Authority (CHFFA) to transfer up to $3 million from its Hospital  
          Equipment Loan Program Fund (Fund) for use in a second  
          California Health Access Model Program (CHAMP) competitive grant  
          selection process.  Specifically, this bill:  


          1)Creates a California Health Access Model Program Two (CHAMP 2)  
            Account within the CHFFA Fund for the purpose of administering  
            a second competitive grant selection process, to fund one or  
            more projects designed to demonstrate new or enhanced  
            cost-effective methods of delivery of health care services to  
            improve access to care for vulnerable populations or  
            communities.


          2)Requires any funds remaining in the CHAMP 2 account on January  
            1, 2023 to revert to the CHFFA Fund.


          3)Requires CHFFA to prepare and provide a biennial report to the  
            Legislature and the Governor, commencing on January 1, 2017,  
            on the outcomes of CHAMP and CHAMP 2.


          4)Lowers from 62 to 60 the age range used in the CHFFA  
            definition of a residential care facility for the elderly  
            (RCFE) to be consistent with the age range used by the  
            Department of Social Services for RCFE licensing requirements.










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          5)Makes enactment of these provisions contingent upon enactment  
            of AB 648 (Low) of the current legislative session, which  
            would establish a grant program to provide funding to support  
            virtual dental homes and authorize a $3 million appropriation  
            from CHFFA to be used for the program.


          FISCAL EFFECT:  According to the Assembly Appropriations  
          Committee, $3 million from the CHFFA Fund will be redirected to  
          fund the CHAMP 2 effort as specified, to be allocated to  
          eligible projects, as defined.  The timing of actual  
          expenditures is unclear.


          COMMENTS:  According to the author, this bill is needed to  
          provide CHFFA with the legislative authority to utilize up to $3  
          million from CHFFA's Hospital Equipment Loan Program Fund to  
          support a second round of CHAMP grants for demonstration  
          projects designed to improve health outcomes and advance the  
          innovative delivery of health care to underserved and vulnerable  
          populations throughout California.  The CHAMP grants have the  
          potential to increase health access, improve clinical outcomes,  
          and achieve cost savings in the health care system.


          CHFFA provides financial assistance to public and nonprofit  
          health care providers through loans funded by the issuance of  
          tax-exempt bonds.  CHFFA also provides direct loans to small and  
          rural health facilities through the Healthcare Expansion Loan  
          Program II Financing Program and the Medi-Cal Bridge Loan  
          Program.  Generally, non-profit, licensed health facilities in  
          California, including adult day health centers, community  
          clinics, skilled nursing facilities, developmentally disabled  
          centers, hospitals, and drug and alcohol rehabilitation centers  
          are eligible for CHFFA financing.  Additionally, CHFFA  
          administers four grant programs, the Community Clinic Grant  
          Program, the Children's Hospital Programs, CHAMP, and the  
          Investment in Mental Health Wellness Grant Program to provide  
          funding to community clinics, children's hospitals, a  








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          demonstration project that seeks to fund innovative models of  
          health care delivery, and counties to improve access to mental  
          health crisis services.


          According to CHFFA, in 2013 it informed over 900 interested  
          parties of the opportunity to submit a letter of interest to  
          participate in the initial phase of CHAMP, including  
          California's health care related associations, foundations,  
          colleges, clinics, and counties.  A single CHAMP grant of $1.4  
          million was awarded to the San Francisco Health Plan (SFHP) for  
          its Community-Based Care Management pilot program.  The program,  
          known as CareSupport, serves vulnerable SFHP members who are  
          high utilizers of hospital inpatient and emergency departments  
          and who are at extremely high risk for mortality and mobility  
          due to housing instability, mental illness, and addiction.   
          SFHP's partners in the project are the San Francisco Department  
          of Public Health and San Francisco General Hospital and Trauma  
          Center.  CHFFA will monitor the outcomes of the Program and  
          determine 18 months after the first grant allocation if the  
          implementation of the second grant is warranted.


          According to California State Treasurer, John Chiang, the  
          sponsor of this bill, California's health care and medical  
          services systems have undergone devastating reductions, leaving  
          its most vulnerable and underserved populations without the  
          proper access to health care needed to survive and thrive.  The  
          Treasurer states, we continue to see limited funding for adult  
          dental benefits and decreased access as fewer providers accept  
          Medi-Cal patients due to decreases in provider payments.  In  
          2012 the Legislature took steps to address these issues and  
          increase health access to those most vulnerable by passing CHAMP  
          as part of a Budget trailer bill.  The existing CHAMP program  
          furthers CHFFA's mission to utilize available funds to spur  
          innovative and cost-effective health care services approaches.   
          The Treasurer concludes, with the same vision in mind, this bill  
          would provide CHFFA with another opportunity to support the  
          creation of new models for health care deliver to California's  








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          most vulnerable populations and communities.


          Analysis Prepared by:                   Lara Flynn / HEALTH /  
          (916) 319-2097                                   FN: 0001715