BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 217
                                                                  Page  1

          Date of Hearing:   May 13, 2009 

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                    AB 217 (Beall) - As Amended:  April 28, 2009 

          Policy Committee:                              HealthVote:19-0

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill establishes the Medi-Cal Alcohol and Drug Screening  
          and Brief Intervention (SBI) Services Matching Fund (Fund) to  
          draw down federal funds to match voluntary county spending on  
          SBI services. The SBI Fund will allow local drug treatment  
          programs to certify public expenditures (CPE) to leverage  
          federal Med-Cal funding. 

           FISCAL EFFECT  

          1)One-time GF cost pressures of $150,000 (50% GF) to the  
            Department of Health Care Services (DHCS) to develop and  
            manage a federal waiver to qualify local SBI expenditures for  
            matched funding. Annual costs to manage the waiver and related  
            approval of CPE of $50,000 (50% GF). On-going costs could be  
            less depending on how many counties take advantage of the  
            federal funding opportunity created by this bill. 

            Although this bill expresses legislative intent to not use any  
            GF to support the activities in the bill, it unclear that  
            initial workload to garner federal support and document local  
            expenditures can be accomplished without an initial GF  
            investment. 

          2)Unknown additional federal funding to the extent SBI  
            activities are funded by Medi-Cal with a federal share of  
            cost. 

          3)Unknown treatment costs and future savings to the extent SBI  
            reduces or prevents substance abuse. 

           COMMENTS  








                                                                  AB 217
                                                                  Page  2


           1)Rationale  . This bill addresses a funding opportunity created  
            by the federal government in January 2007. SBI features five  
            screening questions intended to identify risky alcohol and  
            substance abuse behavior prior to health, financial, social,  
            employment, or family problems occur by identifying treatment  
            needs early. 

          New billing codes approved by the federal government allow  
            reimbursement for SBI services.  The federal funding  
            opportunity is designed to increase the identification of  
            individuals in need of treatment.  In California, 20 counties  
            have chosen to begin their own county-funded prenatal SBI  
            programs. The author indicates these counties have seen a  
            decline both in rates of substance abuse during pregnancy and  
            in a reduction in low birth weight newborns. This bill builds  
            on these current efforts by creating a funding opportunity  
            statewide. 

           2)Substance Abuse Services and Funding  . The governor's budget  
            proposes $663 million ($287 million GF) for support of  
            Department of Alcohol and Drug Programs (DADP) in 2008-09.  
            Counties receive an annual allocation of federal and state  
            funds from DADP, a portion of which must be matched using  
            county funds. These funds come from a variety of sources,  
            including the federal Substance Abuse Prevention and Treatment  
            (SAPT) Block Grant, Medi-Cal program reimbursements, and the  
            state General Fund.The DADP directs and coordinates the  
            state's efforts to prevent or minimize the effects of  
            alcohol-related problems, narcotic addiction, and drug abuse.  
            Services include prevention, early intervention,  
            detoxification, and recovery. DADP administers the Drug  
            Medi-Cal Program, which provides substance abuse treatment  
            services for beneficiaries of the Medi-Cal Program. It also  
            allocates other funds to local providers under Proposition 36.  


           3)Related Legislation  . AB 2124(Beall) in 2008 was similar to  
            this bill and was held on the Suspense File of the Senate  
            Appropriations Committee. 

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