BILL ANALYSIS Ó
SB 804
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Date of Hearing: July 7, 2015
ASSEMBLY COMMITTEE ON HEALTH
Rob Bonta, Chair
SB
804 (Committee on Health) - As Introduced March 26, 2015
SENATE VOTE: 39-0
SUBJECT: Health.
SUMMARY: Makes technical and conforming changes to specific
sections of the Health and Safety Code and the Welfare and
Institutions Code. Specifically, this bill:
1)Updates obsolete references to county mental health directors
and county drug and alcohol program administrators by
referring to them as county behavioral health directors and/or
the County Behavioral Health Directors Association (CBHDA).
2)Requires the Department of Health Care Services (DHCS) to
report to the Legislature with quarterly updates on caseload,
estimated expenditures, and related program monitoring data
for the Every Woman Counts (EWC) Program.
3)Deletes references to a non-profit hospital service plan from
inclusion as a fiscal intermediary, prepaid health plan, or
group health coverage.
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4)Makes technical changes to ensure individuals that can prove
their homeless status are not subject to any fee when
requesting a certified record of live birth.
5)Deletes the sunset date of the California Office of Health
Information Integrity (CalOHII).
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 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
EWC Program for early detection of breast and cervical cancer.
3)Establishes the California 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.
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 CalOHII to assume statewide leadership, coordination,
policy formulation, direction, and oversight responsibilities
for Health Insurance Portability and Accountability Act
implementation, and exercises full authority relative to state
entities to establish policy, provide direction to state
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entities, monitor progress, and report on implementation
efforts.
6)Repeals CalOHII on June 30, 2016.
FISCAL EFFECT: According to the Senate Appropriations
Committee, annual costs of $3.7 million ($2.4 million General
Fund and $1.3 million reimbursements) to extend indefinitely the
operations of the Office of Health Information Integrity.
COMMENTS:
1)PURPOSE OF THIS BILL. According to the author, 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 adults or youth to a fee when
requesting a certified record of live birth. The author
states that 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.
The author also states that this bill will also extend the
sunset date of the 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. The author concludes that 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)BACKGROUND.
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a) 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 Departments of Alcohol and Drug
Programs (ADP) and 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 County Mental Health Directors Association (CMHDA) and
the County Alcohol and Drug Program Administrators
Association of California (CADPAAC) became the CBHDA to
also reflect the need to integrate mental health and drug
and alcohol use services.
b) Every Woman Counts Program. 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
integrated 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 program. 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 and is now
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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.
c) 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, Atkins, Maienschein),
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.
Concerns of language ambiguity have been 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 any
fee to a homeless adult or youth.
3)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
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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.
4)PREVIOUS LEGISLATION.
a) 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.
b) AB 1733 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. AB 1733 also requires
DPH 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.
c) 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 EWC Program.
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d)AB 1467 (Committee on Budget), Chapter 23, Statutes of 2012,
extends the sunset on CalOHII until June 30, 2016. AB 1467
also transferred the EWC Program, the Prostate Cancer
Treatment Program, and the Family PACT Program from DPH to the
DHCS.
e) 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
Program, Licensing and Certification Program, and the EWC
Program. SB 853 also required DPH to provide the
appropriate fiscal and policy committees of the Legislature
with quarterly reports that include all expenditure data
available for this program.
REGISTERED SUPPORT / OPPOSITION:
Support
California State Association of Counties
County Behavioral Health Directors Association of California
Housing California
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Opposition
None on file.
Analysis Prepared by:Paula Villescaz / HEALTH / (916)
319-2097