BILL ANALYSIS Ó SENATE COMMITTEE ON HEALTH Senator Ed Hernandez, O.D., Chair BILL NO: SB 804 --------------------------------------------------------------- |AUTHOR: |Committee on Health | |---------------+-----------------------------------------------| |VERSION: |March 26, 2015 | --------------------------------------------------------------- --------------------------------------------------------------- |HEARING DATE: |April 29, 2015 | | | --------------------------------------------------------------- --------------------------------------------------------------- |CONSULTANT: |Juan Reyes | --------------------------------------------------------------- SUBJECT : Health SUMMARY : Updates obsolete references to county mental health directors and county drug and alcohol program administrators to instead reference county behavioral health directors and/or the County Behavioral Health Directors Association. Requires the Department of Health Care Services to report to the Legislature with quarterly updates on caseload, estimated expenditures, and related program monitoring data for the Every Woman Counts Program. Deletes additional references to non-profit hospital service plans not included in last year's committee bill. Technical clean-up to ensure individuals that can prove their homeless status are not subject to any fee when requesting a certified record of live birth. Extends indefinitely the sunset date of the California Office of Health Information Integrity. Existing law: 1.Regulates provision of programs and services relating to mental health and alcohol and drug abuse at the state and local levels. 2.Requires the State Department of Health Care Services (DHCS), no later than January 10 and concurrently with the May Revision of the annual budget, to provide the fiscal committees of the Legislature with an estimate package for the Every Woman Counts (EWC) Program for early detection of breast and cervical cancer. 3.Establishes the State Department of Public Health (DPH) and sets forth its powers and duties, including, but not limited to, duties as State Registrar relating to the uniform administration of provisions relating to vital records and health statistics. SB 804 (Committee on Health) Page 2 of ? 4.Requires, on or after July 1, 2015, each local registrar or county recorder to issue, without a fee, a certified record of live birth to any person who can verify his or her status as a homeless person or a homeless child or youth, as defined. 5.Permits the Office of Health Information Integrity (CalOHII) to assume statewide leadership, coordination, policy formulation, direction, and oversight responsibilities for HIPAA implementation, and exercises full authority relative to state entities to establish policy, provide direction to state entities, monitor progress, and report on implementation efforts. 6.Repeals CalOHII on June 30, 2016. This bill: 1.Replaces obsolete references relevant in existing law to the California Mental Health Directors Association (CMHDA) and the County Alcohol and Drug Program Administrators' Association of California (CADPAAC) to instead reference the County Behavioral Health Directors' Association of California (CBHDAC) to reflect the merging of the two organizations. 2.Replaces references to county mental health directors and county alcohol and drug program administrators to instead reference the county behavioral health directors. 3.Requires DHCS to provide the appropriate policy and fiscal committees of the Legislature with quarterly updates on caseload, estimated expenditures, and related program monitoring data for the EWC program. 4.Clarifies that a person can verify his or her status as a homeless person or a homeless child or youth, in addition to verification provided by a homeless services provider, is to be issued a certified record of live birth, as specified, without an issuance fee or any other associated fee. 5.Deletes sunset date for CalOHII. 6.Deletes obsolete references to nonprofit hospital service plans in three provisions of Medi-Cal law. SB 804 (Committee on Health) Page 3 of ? FISCAL EFFECT : This bill has not been analyzed by a fiscal committee. COMMENTS : 1.Author's statement. According to the author, this bill makes a number of technical and clarifying changes to existing law and other substantive changes: Last year, the Legislature decided, unanimously, to assist individuals enduring difficult times in their efforts to get back on their feet by not subjecting homeless persons or homeless youth to a fee when requesting a certified record of live birth. Nearly every government program or social service, programs that these individuals so desperately need, require some form of identification, including a birth certificate. This bill will further clarify that homeless individuals are not subject to any surprise fees as they seek the documentation needed to access social services programs. This bill will also extend the sunset date of the California Office of Health Information Integrity (CalOHII) indefinitely. CalOHII has focused on making confidential health information available in the most secure ways and the sunset date has continued to be extended. At a time when confidentiality, particularly of personal health information, is paramount, the work done by CalOHII will be needed in the immediate and distant future. 2.County Behavioral Health Directors Association of California. As of 2004, California administered its alcohol, drug and mental health programs in two separate agencies, the now-defunct Department of Alcohol and Drug Programs (ADP) and the Department of Mental Health (DMH). The California Performance Review published in its 2004 report a set of recommendations for developing a more efficient and effective government. One of the recommendations included consolidating the management of the behavioral health programs to improve coordination of county administered services to persons suffering from both mental illness and substance use disorders. Ultimately, ADP was folded into DHCS and some functions of DMH were also folded into DHCS while others were incorporated into the newly formed Department of State Hospitals. Similarly, on July 1, 2014 the CMHDA and the CADPAAC became the CBHDAC to also reflect the need to SB 804 (Committee on Health) Page 4 of ? integrate mental health and drug and alcohol use services. 3.Every Woman Counts Program. According to the DHCS website, the EWC program provides free clinical breast exams, mammograms, pelvic exams, and Pap tests to California's underserved women. The mission of EWC is to save lives by preventing and reducing the devastating effects of cancer for Californians through education, early detection, diagnosis and treatment, and inte grated preventive services, with special emphasis on the underserved. In 2010, DPH was required to provide the fiscal committees of the Legislature detailed estimate packages in the Governor's January and May budget proposals each year for the EWC progra4.m. DPH was also required to provide the appropriate policy and fiscal committees of the Legislature with quarterly reports that include all expenditure data available for this program. In 2012, the EWC program was transferred from DPH to DHCS. With the passage of AB 82 (Committee on Budget), Chapter 23, Statutes of 2013, DHCS is now required to provide the fiscal committees with similar estimate packages that were once provided by DPH. This bill will require DHCS to provide the appropriate policy and fiscal committees with the quarterly updates for the EWC program that were once provided by DPH. 5.Vital records. The base fee for a copy of a birth certificate was $12 and counties were allowed to raise the fee to cover the costs of modernizing vital record operations and improving the collection and analysis of health related birth and death certificate information (costs ranged on average from $23 to $28.) With the enactment of AB 1733 (Quirk-Silva et al.), Chapter 764, Statutes of 2014, beginning on or after July 1, 2015, local registrars or county recorders will be required to issue a birth certificate without a fee to homeless persons. During a teleconference convened by DPH, which consultants of this committee joined, concerns of language ambiguity were raised about the reference to "a fee." The intent of AB 1733 was clear that no individual, who can prove his or her homeless status, is subject to a fee for requesting a birth certificate. The sponsors of AB 1733 are concerned that, as drafted, a "search fee," separate from an "issuance fee" could be charged. This bill will clarify that a birth certificate will be provided, upon verification of housing status without SB 804 (Committee on Health) Page 5 of ? any fee to a homeless person or youth. 6.Prior legislation. SB 1465 (Committee on Health), Chapter 442, Statutes of 2014, among other provisions, deleted obsolete references to nonprofit hospital service plans in two provisions of Medi-Cal law. AB 1733 (Quirk-Silva, Atkins, and Maienschein), Chapter 764, Statutes of 2014, requires each local registrar or county recorder, without a fee, to issue a certified record of live birth to any person who can verify his or her status as a homeless person or a homeless child or youth and a homeless services provider that has knowledge of a person's housing status shall verify a person's status for the purposes of exemption from a fee. This bill also requires the Department of Public Health to develop an affidavit attesting to an applicant's status as a homeless person or homeless child or youth and that the affidavit is not complete until signed by both the person making the request for the record and the homeless services provider with knowledge of the person's housing status. AB 82 (Committee on Budget), Chapter 23, Statutes of 2013, requires DHCS, no later than January 10 and concurrently with the release of the May Revision, to provide the fiscal committees of the Legislature with an estimate package for the Every Woman Counts Program. AB 1467 (Committee on Budget), Chapter 23, Statutes of 2012, extended the sunset on the Office of Health Information and Integrity (CalOHI) to June 30, 2016. This bill also transferred the Every Woman Counts Program, the Prostate Cancer Treatment Program, and the Family Planning Access Care and Treatment Program from the Department of Public Health to the DHCS. SB 853 (Committee on Budget and Fiscal Review), Chapter 717, Statutes of 2010, required DPH to include detailed estimate packages in the Governor's January and May budget proposals each year for the Women Infant and Children (WIC) Program, Licensing and Certification Program, and the Every Woman Counts Program. This bill also required DPH to provide the appropriate fiscal and policy committees of the Legislature with quarterly reports that include all expenditure data SB 804 (Committee on Health) Page 6 of ? available for this program. 7.Support. The California State Association of Counties (CSAC) states in support that the merging of the organizations CMHDA and CADPAAC is a reflection of the integration of the mental health and substance use disorder agencies at the county level and general understanding that these areas are often interdependent of each other and the people they serve. SUPPORT AND OPPOSITION : Support: California State Association of Counties County Behavioral Health Directors Association of California Housing California Oppose: None received. -- END --