BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 188
                                                                  Page  1

          CONCURRENCE IN SENATE AMENDMENTS
          AB 188 (Jones)
          As Amended  October 14, 2009
          2/3 vote.  Urgency
           
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          |ASSEMBLY:  |     |(May 4, 2009)   |SENATE: |28-9 |(October 14,   |
          |           |     |                |        |     |2009)          |
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                    (vote not relevant)
           
           Original Committee Reference:    BUDGET  

           SUMMARY  :  Appropriates funding to administer requirements  
          established by AB 1383 (Jones), Chapter 627, Statutes of 2009.   
          Establishes a quality assurance fee (QAF) on California  
          hospitals to leverage federal financial participation (FFP) and  
          to increase Medi-Cal payments to hospitals while federal  
          stimulus funding is available.  
           
          The Senate amendments  delete the prior contents of the bill and  
          instead: 

          1)Appropriate $13.5 billion (special fund) from the Hospital  
            Quality Assurance Revenue Fund (HQARF) (established by AB  
            1383) to the California Department of Health Care Services  
            (DHCS) to increase Medi-Cal payments to hospitals until  
            January 1, 2013. 

          2)Appropriate $2 million (50% General Fund (GF)/50% federal)  
            from the Private Hospital Supplemental Fund to DHCS to support  
            administrative requirements of AB 1383. Requires $1 million GF  
            to be repaid from the HQARF if federal approval for the QAF is  
            granted. 

          3)Add an urgency clause, allowing this bill to take effect  
            immediately upon enactment. 
           
          FISCAL EFFECT  :

          1)A $13.5 billion (special fund) appropriation from the Hospital  
            Quality Assurance Revenue Fund to DHCS to increase Medi-Cal  
            payments to hospitals. 









                                                                  AB 188
                                                                  Page  2


          2)A $2 million (50% GF) appropriation from the Private Hospital  
            Supplemental Fund to support DHCS workload.

           COMMENTS  :

           1)Rationale  .  This urgency bill contains appropriations to fund  
            workload and enable the payment of up to $2.3 billion (100%  
            federal) per federal fiscal year until 2013 to California  
            hospitals.  The QAF established by the recently enacted AB  
            1383 will provide increased support to hospitals with no  
            state, patient, or taxpayer cost.  This bill, together with AB  
            1383, maximizes funding opportunities generally available via  
            federal Medicaid QAF authority and while funding enhancement  
            (61.59% federal) is available under the American Recovery and  
            Reinvestment Act (ARRA). 

           2)Signing Message  .  This bill addresses a portion of the  
            Governor's signing message of AB 1383.  The signing message  
            indicates the lack of an appropriation in AB 1383 means DHCS  
            will have unfunded workload and that no steps will be taken to  
            implement that legislation until a subsequent appropriation is  
            passed by the Legislature.  This bill establishes necessary  
            appropriations to enable workload and related expenditures. 

           
          Analysis Prepared by  :   Mary Ader / APPR. / (916) 319-2081 



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