BILL ANALYSIS
AB 525
Page 1
Date of Hearing: May 18, 2005
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Judy Chu, Chair
AB 525 (Chu) - As Amended: April 26, 2005
Policy Committee: HealthVote:11-1
Urgency: No State Mandated Local Program:
Yes Reimbursable: Yes
SUMMARY
This bill requires Department of Health Services (DHS) to
develop and implement a system and a card, to be known as the
Health Access Programs Card, to enroll individuals in specified
state health care programs, as specified. Specifically, this
bill :
1)Prohibits MRMIB from imposing, as a condition of eligibility
for the AIM Program, a written verification of pregnancy
requirement, a requirement that a pregnancy be fewer than 30
weeks, or a requirement that an enrollee pay monthly premiums
for 12 months or pay premiums for any month in which a woman
has ceased to be pregnant, including as a result of a
miscarriage.
2)Requires DHS to exempt pregnant women receiving benefits under
the 1931(b) Medi-Cal aid category (families with incomes at or
below 100% of the federal poverty level at the time of
application) from the assets test. Requires DHS, by March 1,
2006, to seek approval for implementation of this option, or,
if this option does not exist, a waiver to implement this
option.
3)Requires that pregnant women be eligible for Medi-Cal under
1931(b) Medi-Cal aid category beginning in the first trimester
of pregnancy. Requires DHS, if a federal waiver or other
federal approval is necessary to implement this requirement,
to submit a request for the waiver/approval by March 1, 2006.
AB 525
Page 2
FISCAL EFFECT
1)DHS indicates first year system-related program costs of $2.2
million and on-going costs of $1.2 million.
2)Indeterminate increased caseload costs to the extent
simplifying enrollment increases program enrollment in AIM,
Medi-Cal benefits for pregnancy-related care, Medi-Cal breast
and cervical cancer screening and treatment, and prostate
cancer screening and treatment.
3)Increased AIM costs, potentially in the low millions of
dollars annually.
SUMMARY CONTINUED
1)Requires an individual who is eligible for the Family
Planning, Access, Care, and Treatment (Family PACT) Waiver
Program to have the option of being deemed to have applied and
been determined to be eligible for, subject to certain
conditions, Medi-Cal benefits for pregnancy-related care,
Medi-Cal breast and cervical cancer screening and treatment,
and prostate cancer screening and treatment under the
Improving Access, Counseling, and Treatment for Californians
with Prostrate Cancer (IMPACT) program.
2)Deems any individual to have applied and been determined to be
eligible for the AIM Program if the individual is pregnant and
the individual has undergone screening and would be eligible
for Family PACT but for the fact that her income falls within
the AIM income eligibility thresholds.
3)Requires DHS, by July 1, 2006, to develop and implement an
enrollment system card for implementation of this bill known
as the Health Access Programs Card.
4)Requires DHS to immediately implement the provision of
AB 525
Page 3
nonemergency benefits for the prevention and treatment of
dental and periodontal disease for all pregnant Medi-Cal
beneficiaries by clearly informing Denti-Cal and other
Medi-Cal providers through a provider bulletin or bulletins
that these benefits are included for all pregnant
beneficiaries. Prohibits this provision from being delayed
pending adoption of administrative regulations.
COMMENTS
Purpose . This bill is jointly sponsored by the American
Association of University Women, the California Family Health
Council, Maternal Child Health Access, and Planned Parenthood
Affiliates of California. The sponsors argue this bill would
create an integrated system of care to ensure recipients and
providers of continuity of services. All of the programs
identified in this bill have different enrollment procedures,
and beneficiaries must navigate a disjointed system of care to
obtain the services. These barriers also discourage
participation by providers, which further discourages access.
Streamlining the enrollment procedures for programs with similar
functions and similar eligibility requirements, especially when
the beneficiary is the same person presenting for care, would
reduce administrative costs, increase access to care, and
improve oversight capabilities.
Analysis Prepared by : Scott Bain / APPR. / (916) 319-2081