BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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          |SENATE RULES COMMITTEE            |                   AB 217|
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                                 THIRD READING


          Bill No:  AB 217
          Author:   Beall (D)
          Amended:  6/1/09 in Assembly
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  10-1, 7/8/09
          AYES:  Alquist, Strickland, Cedillo, Cox, DeSaulnier, Leno,  
            Maldonado, Negrete McLeod, Pavley, Wolk
          NOES:  Aanestad
          
          SENATE APPROPRIATIONS COMMITTEE  :  11-2, 8/27/09
          AYES:  Kehoe, Cox, Corbett, Denham, Hancock, Leno, Oropeza,  
            Price, Wolk, Wyland, Yee
          NOES:  Runner, Walters

           ASSEMBLY FLOOR  :  78-0, 6/2/09 - See last page for vote


           SUBJECT  :    Medi-Cal:  alcohol and drug screening and brief  
          intervention
                      services

           SOURCE  :     Author


           DIGEST  :    This bill establishes a screening and brief  
          intervention services program within the Medi-Cal program,  
          to be administered by the Department of Health Care  
          Services, in collaboration with the Department of Alcohol  
          and Drug Programs, for the purpose of allowing local funds  
          to be used to secure federal matching funds for these  
          services. 
                                                           CONTINUED





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           ANALYSIS  :    

          Existing federal law: 

          1. Establishes the Medicaid program, which provides basic  
             health care coverage for low-income individuals and  
             their families; pregnant women; elderly, blind, or  
             disabled persons; nursing home residents; and refugees  
             who meet specified eligibility criteria.  

          2. Requires states that participate in the Medicaid program  
             to offer certain benefits and allows states the option  
             of providing other specified benefits, including  
             substance abuse programs.  

          3. Provides that states can obtain Medicaid reimbursement  
             if they choose to offer screening and brief intervention  
             (SBI) in their Medicaid program.

          Existing state law:

          1. Establishes the Medi-Cal program, the state's version of  
             Medicaid, and provides that the program will be  
             administered by the Department of Health Care Services  
             (DHCS).  

          2. Names the Department of Alcohol and Drug Programs (DADP)  
             as the lead state agency for alcohol and drug programs  
             and establishes the Drug Medi-Cal program which is  
             administered by DADP.  

          3. Requires Drug Medi-Cal to provide defined modes of  
             treatment for Medi-Cal eligible persons with drug or  
             alcohol abuse problems.  

          This bill:

          1. Establishes an alcohol and drug SBI program in Medi-Cal,  
             to be administered by DHCS, in consultation with DADP  
             for the purpose of making available alcohol and drug  
             screening and brief intervention services for Medi-Cal  
             beneficiaries who are pregnant women or women of  
             childbearing age.  







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          3


          2. Makes specific findings concerning the benefits of the  
             SBI program and maximizing the use of federal funds.  

          3. Provides that participation in the screening and  
             intervention program shall be voluntary for a Medi-Cal  
             beneficiary and that the results shall be maintained in  
             the beneficiary's confidential medical records and  
             subject to all confidentiality requirements applicable  
             to medical records.

          4. Defines "public entity" to mean a county, or other local  
             governmental entity designated by DHCS, that elects to  
             provide or contract for SBI services for Medi-Cal  
             beneficiaries pursuant to this bill.  

          5. Requires a public entity that participates in the  
             program to do all of the following:

             A.    Certify that the claimed expenditures for SBI  
                services for Medi-Cal beneficiaries are eligible for  
                federal financial participation (FFP).

             B.    Provide evidence supporting the certification, as  
                specified by DHCS.

             C.    Submit data, as specified by DHCS, to determine  
                the appropriate amounts to claim as expenditures  
                qualifying for FFP, and maintain records as specified  
                by DHCS and the federal Centers for Medicare and  
                Medicaid Services (CMS).

          6. Requires DHCS to administer this bill in accordance with  
             the certified public expenditure requirements described  
             in applicable federal regulations.  

          7. Requires DHCS to seek any federal approvals necessary to  
             implement this bill.  

          8. Requires DHCS to submit claims for FFP, and submit, on  
             an annual basis, necessary materials to the federal  
             government, to provide assurances that claims for FFP  
             will include only those expenditures that are allowable  
             under federal law.  







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          9. Directs DHCS to develop an appropriate mechanism to  
             enable a public entity to pay the nonfederal share of  
             the cost of providing services under this bill.

          10.Requires DHCS to pass the federal reimbursement on to  
             the claiming public entity.  

          11.Requires that the states share of the reimbursement  
             submitted to CMS for purposes of claiming FFP, must be  
             comprised of only those funds that are certified  
             expenditures by a public entity.  

          12.Directs a public entity that participates in the SBI  
             program to reimburse the state for any costs of creating  
             and administering the program.  

          13.Mandates that this bill would be implemented only if  
             federal funds are available.  

          14.Allows DHCS to implement this bill by means of all  
             county letters, provider bulletins, and similar  
             instructions.

           Background  

          Alcohol and other drug abuse is a major factor in chronic  
          disease, the spread of infectious diseases, hospital  
          emergency room visits, newborn health problems, violence,  
          and auto fatalities.  A 2004 DADP survey of alcohol and  
          drug use in the month prior to the survey found that an  
          estimated 18.5 million persons had used alcohol, 7.5  
          million had engaged in binge drinking (drinking four or  
          more drinks in a row), and 3.5 million had used illicit  
          drugs.  DADP estimated that the 2005 cost to society of  
          alcohol and drug abuse in California was over $44 billion,  
          including loss of productivity, health care costs,  
          prevention and treatment costs, criminal justice costs, and  
          losses due to crimes.  DADP reported that in 2004, 308,683  
          Californians were arrested on alcohol-related charges and  
          431,769 on drug-related charges. 

          Fetal alcohol syndrome, caused by drinking during  
          pregnancy, is a major cause of developmental disabilities  







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          and birth defects in the United States and is completely  
          preventable.  While the exact incidence is unknown, such  
          defects and disabilities are more common than Down's  
          syndrome or spina bifida and are the leading cause of  
          mental retardation, a specific developmental disability, as  
          defined by the American Psychiatric Association.  While  
          prenatal alcohol exposure does not automatically result in  
          fetal alcohol syndrome, the United States Surgeon General  
          advises pregnant women to abstain from alcohol use due to  
          the risk of the syndrome.

          Alcohol and other drug dependency is a treatable condition  
          and treatment is widely considered to save money by  
          combating the problems associated with substance abuse.   
          The benefit cost analysis done in conjunction with the  
          evaluation of the Substance Abuse and Crime Prevention Act  
          of 2000, which was Proposition 36 on the ballot, found  
          that, for every $1 invested in substance abuse treatment,  
          state and local governments have saved $2.50 from reduced  
          health costs, crime and other impacts.  Other studies have  
          found that the per capita cost of treatment is  
          significantly less than the cost of incarceration.   
          According to the Institute of Medicine, the cost of  
          incarceration is approximately $40,000 per year, compared  
          to $12,500 and $3,100 for residential and outpatient  
          treatments, respectively.  Despite the cost effectiveness  
          of substance abuse treatment programs, a substantial gap  
          exists between the number of people who need treatment and  
          the number who receive treatment.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

          According to the Senate Appropriations Committee:

                         Fiscal Impact (in thousands)

           Major Provisions      2009-10     2010-11     2011-12     Fund  

          DHCS administration           unknown, but likely  
          hundreds of         General/
          of SBI program      thousands annually             
          Federal/
                                                            Local







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          SBI services as a   unknown, but likely in the  
          millionsFederal/ 
          Medi-Cal benefit                                  Local

           SUPPORT  :   (Verified  8/28/09)

          American College of Obstetricians and Gynecologists,  
          District IX
          California Medical Association
          California State Association of Counties
          Commission on the Status of Women
          National Association of Social Workers
          Santa Clara County Board of Supervisors

           OPPOSITION  :    (Verified  8/28/09)

          Department of Finance

           ARGUMENTS IN SUPPORT  :    Supporters argue that effective  
          screening and intervention services are a vital tool that  
          can lower the risk of substance abuse during pregnancy and  
          prevent birth defects in infants and this measure would  
          allow counties to provide these services to Medi-Cal  
          beneficiaries by drawing down federal dollars to match  
          scarce county funds.  They note that under existing law,  
          counties must provide the full cost of services and,  
          because of the cost factor, not all counties provide these  
          vital services to expectant mothers.  Supporters argue that  
          accessing federal funds would provide more money to  
          counties to provide these programs and help mothers give  
          birth to healthy babies. 

           ARGUMENTS IN OPPOSITION  :    The Department of Finance  
          states:  
           
             "The Administration supports the concept of authorizing  
            the use of local funds to match federal funds for the  
            provision of alcohol and drug screening to individuals  
            that need such services.  However, in order to implement  
            a cost effective program, it should be structured in a  
            way that targets the services only to those individuals  
            who reasonably have indications of substance abuse  
            problems.  As drafted this bill would conflict with that  







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            approach.

            "DHCS has raised an operational policy concern regarding  
            implementation of the program as envisioned.  The  
            Medi-Cal payment system cannot be set up to ensure that  
            local funds support the program costs rather than state  
            General Fund.  To the extent that the local funds were  
            set up as a General Fund revenue intended to offset  
            General Fund expenditures for Medi-Cal benefits, once the  
            services are authorized there is no practical way to  
            ensure that revenues fully support the costs of services  
            provided.  Without such administrative safeguards, a  
            significant and unintended General Fund cost could  
            result."


           ASSEMBLY FLOOR  : 
          AYES:  Adams, Ammiano, Anderson, Arambula, Beall, Tom  
            Berryhill, Blakeslee, Blumenfield, Brownley, Buchanan,  
            Caballero, Charles Calderon, Carter, Chesbro, Conway,  
            Cook, Coto, Davis, De La Torre, De Leon, DeVore, Duvall,  
            Emmerson, Eng, Evans, Feuer, Fletcher, Fong, Fuentes,  
            Fuller, Furutani, Gaines, Galgiani, Garrick, Gilmore,  
            Hagman, Hall, Harkey, Hayashi, Hernandez, Hill, Huber,  
            Huffman, Jeffries, Jones, Knight, Krekorian, Lieu, Logue,  
            Bonnie Lowenthal, Ma, Mendoza, Miller, Monning, Nava,  
            Nestande, Niello, Nielsen, John A. Perez, V. Manuel  
            Perez, Portantino, Price, Ruskin, Salas, Saldana, Silva,  
            Skinner, Smyth, Solorio, Audra Strickland, Swanson,  
            Torlakson, Torres, Torrico, Tran, Villines, Yamada, Bass
          NO VOTE RECORDED:  Bill Berryhill, Block


          CTW/JJA:mw  8/28/09   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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