BILL ANALYSIS
AB 217
Page 1
ASSEMBLY THIRD READING
AB 217 (Beall)
As Amended June 1, 2009
Majority vote
HEALTH 19-0 APPROPRIATIONS 17-0
-----------------------------------------------------------------
|Ayes:|Jones, Fletcher, Adams, |Ayes:|De Leon, Nielsen, |
| |Ammiano, Block, Carter, | |Ammiano, |
| |Conway, De La Torre, De | |Charles Calderon, Davis, |
| |Leon, Emmerson, Gaines, | |Duvall, Fuentes, Hall, |
| |Hall, Hayashi, Hernandez, | |Harkey, Miller, |
| | | |John A. Perez, Price, |
| |Bonnie Lowenthal, Nava, | |Skinner, Solorio, Audra |
| |V. Manuel Perez, Salas, | |Strickland, Torlakson, |
| |Audra Strickland | |Krekorian |
| | | | |
-----------------------------------------------------------------
SUMMARY : Establishes the Medi-Cal Alcohol and Drug Screening
and Brief
Intervention Services Program (Program) for Medi-Cal
beneficiaries who are pregnant or women of childbearing age,
with county or local government entities paying the nonfederal
share of expenditures through certified public expenditures
(CPEs). Specifically, this bill :
1)Requires the Department of Health Care Services (DHCS), in
consultation with the Department of Alcohol and Drug Programs,
to administer the Program for the purpose of increasing the
state's ability to make available alcohol and drug screening
and brief intervention (SBI) services for Medi-Cal
beneficiaries who are pregnant or women of childbearing age.
2)Requires DHCS to administer this bill in accordance with the
CPE requirements described in federal regulations, or any
successor thereto, in certifying that the claimed expenditures
for alcohol and drug screening and brief intervention services
for Medi-Cal beneficiaries are eligible for federal financial
participation (FFP).
3)Requires the nonfederal share of expenditures submitted to
federal Centers for Medicare and Medicaid Services (for
purposes of claiming FFP to be comprised of only those funds
AB 217
Page 2
that are paid by a public entity (county or other local
governmental entity) and certified in accordance with this
bill. Requires a public entity that participates in the
Program, upon receiving FFP for CPEs made for alcohol and drug
screening and brief intervention services, reimburse the state
for any costs of creating and administering the Program.
Implements this bill only if, and to the extent that, federal
funds are available for this purpose.
4)Requires DHCS to take specified actions in administering this
bill, and requires DHCS, upon receipt of federal reimbursement
for the claim, including federal matching funds, to provide
the reimbursement to the public entity for which the claim was
submitted.
5)Requires participation in the Program to be voluntary for a
Medi-Cal beneficiary, and requires participation in the
Program, and results of the screening, to be maintained in the
beneficiary's confidential medical records, and subject to all
confidentiality requirements applicable to medical records.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, General Fund (GF) cost pressure of under $150,000
(50% GF) to the DHCS to develop and manage a federal waiver to
qualify local SBI expenditures for matched funding. Annual
on-going cost pressure to manage the waiver and related approval
of CPEs of less than $50,000 (50% GF). On-going actual costs
could be less depending on how many counties take advantage of
the federal funding opportunity created by this bill.
COMMENTS : According to the author, fetal alcohol syndrome is
one of the leading known preventable causes of birth defects and
developmental disabilities. Prenatal exposure to alcohol,
tobacco, and other drugs have been proven to severely damage the
development, formation, and functioning of the fetal brain.
According to the U.S. Centers for Disease Control, approximately
one in twelve pregnant women admit to consuming alcohol and one
in thirty pregnant women said they had engaged in binge
drinking. Effective prevention, intervention, and screening can
reduce the incidence of exposed infants while significantly
reducing long term health care costs. However, despite the
evidence of the benefits, SBI have not yet been widely used in
primary care settings, emergency rooms, state licensed
facilities and clinics. SBI evaluates patients for potential
AB 217
Page 3
substance abuse by asking a series of five questions about their
potential substance use. The questions can easily be integrated
into the initial prenatal visit and used for follow-up screening
throughout the pregnancy. If the patient screens positive
indicating they are at risk for alcohol or other substance
abuse, the provider will recommend a brief intervention
involving one or more short counseling sessions. Individuals
who are considered high risk for abuse or addiction are given a
brief intervention counseling session and are also scheduled for
a brief treatment appointment. The author reports San
Bernardino County recorded an 18% reduction in low birth weights
over three years among women whose physicians provided SBIs
compared with women whose physicians did not provide those
services. The author states an evaluation of 20 counties found
a definitive decline in substance abuse rates during pregnancy
and low birth weights.
Analysis Prepared by : Scott Bain / HEALTH / (916) 319-2097
FN: 0001339