BILL ANALYSIS Ó ----------------------------------------------------------------- |SENATE RULES COMMITTEE | SB 1477| |Office of Senate Floor Analyses | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ----------------------------------------------------------------- UNFINISHED BUSINESS Bill No: SB 1477 Author: Committee on Health Amended: 8/19/16 Vote: 21 SENATE HEALTH COMMITTEE: 9-0, 4/13/16 AYES: Hernandez, Nguyen, Hall, Mitchell, Monning, Nielsen, Pan, Roth, Wolk SENATE FLOOR: 39-0, 4/21/16 (Consent) AYES: Allen, Anderson, Bates, Beall, Berryhill, Block, Cannella, De León, Fuller, Gaines, Galgiani, Glazer, Hall, Hancock, Hernandez, Hertzberg, Hill, Hueso, Huff, Jackson, Lara, Leno, Leyva, Liu, McGuire, Mendoza, Mitchell, Monning, Moorlach, Morrell, Nguyen, Nielsen, Pan, Pavley, Roth, Stone, Vidak, Wieckowski, Wolk NO VOTE RECORDED: Runner ASSEMBLY FLOOR: 78-0, 8/24/16 - See last page for vote SUBJECT: Health SOURCE: Author DIGEST: This omnibus committee bill requires the California Health Benefit Exchange to also be known as Covered California, replaces references from the now-repealed Healthy Families Program to the Medi-Cal program, and from the repealed AIM-Linked Infants Program to the Medi-Cal Access Program, permits the Department of Health Care Services (DHCS) to enter into contracts for administrative activities to help implement the new Medicaid Managed Care regulations, and makes a technical change to ensure that trade associations remain eligible for federal emergency preparedness funds. SB 1477 Page 2 Assembly Amendments authorized DHCS to enter into contracts for administrative activities by DHCS' Mental Health and Substance Use Disorder Services Division concerning federal Medicaid managed care regulations and associated guidance issued by the federal government in May 2016 without going through existing contracting requirements or review by the Office of Administrative Law. Additionally, the amendments required contracts entered into by DHCS for administrative activities under this provision to be publicly available under the California Public Records Act, and sunsetted these provisions on January 1, 2020. ANALYSIS: Existing federal law requires, under the Patient Protection and Affordable Care Act (ACA, Public Law 111-148), as amended by the Health Care Education and Reconciliation Act of 2010 (Public Law 111-152), each state, by January 1, 2014, to establish an American Health Benefit Exchange that makes qualified health plans available to qualified individuals and qualified employers. Requires, if a state does not establish an Exchange, the federal government to administer the Exchange. Existing state law: 1)Establishes the California Health Benefit Exchange (known as Covered California) in state government, and specifies its duties and authority. Requires Covered California to be governed by a board that includes the Secretary of the California Health and Human Services Agency and four members with specified expertise who are appointed by the Governor and the Legislature. 2)Establishes the Medi-Cal Program, administered by DHCS, which provides comprehensive health benefits to low-income children up to 266 % of the federal poverty level (FPL), parents and adults up to 138 % of the FPL, pregnant women, and elderly, blind or disabled persons, who meet specified eligibility criteria. 3)Establishes the Medi-Cal Access Program, which was formerly SB 1477 Page 3 known as the Access for Infants and Mothers Program (or AIM) as a low-cost health coverage program for pregnant women and infants. The Medi-Cal Access Program provides coverage to pregnant women with a household income between 208% and 317% of the federal poverty. 4)Establishes provisions of law to govern those instances when federal funding is allocated and expended for public health preparedness and response by local health jurisdictions, hospitals, long-term health care facilities, clinics, emergency medical systems, and poison control centers for the prevention of, and response to, bioterrorist attacks and other public health emergencies. 5)Requires federal funding received by the Department of Public Health (DPH) for bioterrorism preparedness and emergency response to be subject to appropriation in the annual Budget Act or other statute. Requires that that funds appropriated for these purposes are to be allocated through the use of agreements that are not subject to the State Contract Act, as specified. 6)Establishes the Medi-Cal program, administered by the DHCS, under which health care services are provided to qualified, low-income persons. Establishes, through federal regulations, requirements for Medicaid managed care organizations, including new requirements issued by the federal government in May 2016. This bill: 1)Requires the California Health Benefit Exchange to also be known as Covered California, and deems any reference to the California Health Benefit Exchange or the Exchange to refer to Covered California. 2)Replaces references from the now-repealed Healthy Families Program to the Medi-Cal program, and from the repealed AIM-Linked Infants Program to the Medi-Cal Access Program. 3)Clarifies that trade associations are eligible for federal emergency preparedness funds by including trade associations SB 1477 Page 4 in the list of eligible entities that may receive funds through the use of agreements that are not subject to the State Contract Act. 4)Authorizes DHCS to enter into contracts for administrative activities by DHCS' Mental Health and Substance Use Disorder Services Division concerning federal Medicaid managed care regulations and associated guidance issued by the federal government in May 2016 without going through existing contracting requirements or review by the Office of Administrative Law. 5)Requires contracts entered into by DHCS for administrative activities under this bill to be publicly available under the California Public Records Act. 6)Sunsets the provisions in 4) and 5) above on January 1, 2020. Comments 1)Author's statement. According to the author, this is an omnibus committee bill intended to make technical, clarifying, or noncontroversial changes to various provisions of law relating to health care. This bill revises law in four areas: formally recognizing Covered California as the name of the California Health Benefit Exchange as Covered California while retaining the ability to continue using the full California Health Benefit Exchange if necessary for legal purposes; correcting outdated terminology by replacing references to the now-repealed Healthy Families Program and the AIM-Linked Infants Program to the Medi-Cal program and the Medi-Cal Access Program, respectively; clarifying a bill from last year that allowed trade associations to be eligible for federal emergency preparedness funds by also adding trade associations to a related provision of law governing how these funds are allocated; and, permitting DHCS to enter into contracts for administrative activities to help implement the new Medicaid Managed Care Regulations. Related/Prior Legislation SB 1477 Page 5 1)AB 1149 (Wood, Chapter 93, Statutes of 2015) added trade associations to the list of entities that are eligible to receive federal funding, that has been allocated to DPH for public health preparedness and response; 2)SB 900 (Alquist, Chapter 659, Statutes of 2010), established Covered California as an independent public entity within state government, and requires Covered California to be governed by a board composed of the Secretary of the Agency, or his or her designee, and four other members appointed by the Governor and the Legislature who meet specified criteria; 3)AB 1494 (Committee on Budget, Chapter 28, Statutes of 2012), transitioned children enrolled in the Healthy Families Program to the Medi-Cal Program beginning January 1, 2013, in four Phases throughout 2013; and, 4)SB 857 (Committee on Budget, Chapter 31, Statutes of 2014), transferred the coverage of pregnant women through AIM to DHCS and renamed AIM as the Medi-Cal Access Program. FISCAL EFFECT: Appropriation: No Fiscal Com.:YesLocal: No According to the Assembly Committee on Appropriations there is no fiscal effect. SUPPORT: (Verified8/24/16) SB 1477 Page 6 California Association of Health Facilities OPPOSITION: (Verified8/24/16) None received ARGUMENTS IN SUPPORT: This bill is supported by the California Association of Health Facilities (CAHF), which states that recently, DPH has stated that statutory clean-up to AB 1149 (Wood) of 2015 is needed to continue the status quo of who is eligible to receive funding through the Hospital Preparedness Program for strengthening public health emergency preparedness. This bill will assure that trade associations, such as CAHF, can continue to participate in the program, as it has for years. ASSEMBLY FLOOR: 78-0, 8/24/16 AYES: Achadjian, Alejo, Travis Allen, Arambula, Atkins, Baker, Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang, Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina Garcia, Gatto, Gipson, Gomez, Gonzalez, Gordon, Gray, Grove, Hadley, Harper, Roger Hernández, Holden, Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Quirk, Ridley-Thomas, Rodriguez, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber, Wilk, Williams, Wood, Rendon NO VOTE RECORDED: Daly, Eduardo Garcia Prepared by:Vince Marchand/ HEALTH / 8/25/16 17:49:36 SB 1477 Page 7 **** END ****