BILL ANALYSIS                                                                                                                                                                                                    Ó




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                                 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          replaces references from the now-repealed Healthy Families  
          Program to the Medi-Cal program, and from the repealed  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.








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          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  








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            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  








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            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









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          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)











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          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








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