BILL NUMBER: AB 861 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY MARCH 31, 2009
INTRODUCED BY Assembly Member Ruskin
FEBRUARY 26, 2009
An act to amend Sections 18986.86 and 18986.87 of the
Welfare and Institutions Code, relating to county integrated health
and human services. An act to add Section 100571 to
the Health and Safety Code, relating to public health.
LEGISLATIVE COUNSEL'S DIGEST
AB 861, as amended, Ruskin. County integrated health and
human services. Public health services: consolidated
contracts.
Under existing law, the State Department of Public Health is
authorized, within its authority to contract with a provider for the
provision of health services, to enter into a single contractual
instrument encompassing services in any number of specified health
services subject areas.
This bill, in addition, would require the department, within
existing resources, to implement a consolidated and streamlined
administration and contracting process with the counties for the
department's center of infectious diseases and the center for family
health, and the programs administered by the respective centers. The
bill would require the 2 designated program centers within the
department to develop a consolidated and streamlined administration
of its programs by developing, at a minimum, uniform program
requirements and unified contracts across multiple related program
areas. The bill would require each program center to develop a single
allocation contract between the department and each county that
incorporates the programs administered by the center, including, but
not limited to, specified elements.
Existing law authorizes Humboldt, Mendocino, and Alameda Counties,
and any additional county or counties, as determined by the
Secretary of the California Health and Human Services Agency, with
the assistance and participation of the appropriate state
departments, within the existing resources of those departments, to
implement a pilot program, upon approval of the county board of
supervisors, for the funding and delivery of services and benefits
through an integrated and comprehensive county health and human
services system.
This bill would, instead, authorize each county, with the
assistance and participation of the appropriate state departments,
within the existing resources of those departments, to implement a
program, upon approval of the county board of supervisors, for the
funding and delivery of services and benefits through an integrated
and comprehensive county health and human services system.
Existing law authorizes the integrated system to include specified
health and human services.
This bill would authorize the integrated system to include, but
not be limited to, those existing specified services and additional
services and programs.
Existing law requires a participating county, in consultation with
the appropriate state departments, as designated by the Secretary of
the California Health and Human Services Agency, to prepare an
interim evaluation not later than 6 months following the 3rd year of
the implementation of the program and a final evaluation not later
than July 1, 2008, and submit them to the Governor or the Governor's
designee and the appropriate policy committees of the Legislature.
This bill would require a participating county to evaluate its
program with the participation of the appropriate state departments,
prepare an evaluation, submit it to the Governor or the Governor's
designee and the appropriate policy committees of the Legislature not
later than 6 months following the 3rd year of the implementation of
the program, and seek private funding to provide for the evaluation.
The bill would only require the evaluation to be conducted if
nonstate resources are made available for this purpose.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 100571 is added to the
Health and Safety Code , to read:
100571. (a) In order to unify overlapping programs that address
community public health needs administered by the program centers
within the State Department of Public Health, and to reduce
administrative costs to counties so that more resources are available
to directly serve the families and the communities towards whom the
programs are directed, the State Department of Public Health, within
existing resources, shall implement a consolidated and streamlined
administration and contracting process with counties for the
department's center for infectious diseases and the center for family
health, and the programs administered by the respective centers.
(b) Each program center specified in subdivision (a) shall develop
a consolidated and streamlined administration of its programs by
developing, at a minimum, uniform program requirements and unified
contracts across multiple related program areas. Each program center
shall develop a single allocation contract between the department and
each county that incorporates the programs administered by the
center, which shall include, but need not be limited to, all of the
following elements:
(1) Consistent budget regulations, including format, indirect
costs rate, and allowable costs.
(2) A single invoice format.
(3) Uniform reporting requirements and outcome measures.
(4) Uniform staff time surveys.
(c) This section shall not authorize a county to discontinue
meeting its obligations under existing law to provide services or to
reduce its accountability for the provision of these services.
(d) The public health program centers subject to this section may
waive regulations regarding the method of providing services and the
method of reporting and accountability, as may be required to meet
the goals set forth in subdivision (b). However, the program centers
shall not waive a regulation pertaining to privacy and
confidentiality of records, civil service merit systems, or
collective bargaining. The program centers shall not waive a
regulation if the waiver results in a diminished amount or level of
services or benefits to an eligible recipient, as compared to the
benefits and services that would have been provided to a recipient
absent the waiver.
(e) For purposes of this section,"program center" means an
administrative subdivision of the State Department of Public Health,
whether created by statute or by administrative regulation, that
oversees and administers multiple public health programs relating to
a specified public health subject area.
SECTION 1. Section 18986.86 of the Welfare and
Institutions Code is amended to read:
18986.86. (a) A county, with the assistance and participation of
the appropriate state departments, within the existing resources of
those departments, may implement a program, upon approval of the
county board of supervisors for the funding and delivery of services
and benefits through an integrated and comprehensive county health
and human services system.
(b) In providing services through an integrated system to families
and individuals, the program may, among other things, do all of the
following:
(1) Implement and evaluate a system of universal intake for those
seeking services.
(2) Implement and evaluate a system whereby a family or individual
eligible for more than one service may be provided those services
through an integrated, coordinated service plan.
(3) Implement and evaluate a system of administration that
integrates and coordinates the management and support of client
services.
(4) Implement and evaluate a system of reporting and
accountability that provides for the combined provision of services
as provided for in paragraph (2), without the loss of state or
federal funds provided under current law.
(5) In consultation with the appropriate state departments, as
designated by the Secretary of Health and Human Services, a
participating county may develop specific goals in addition to those
specified in paragraphs (1) to (4), inclusive, to achieve an
integrated and comprehensive county health and human services system.
(c) The integrated system may include, but need not be limited to,
the following:
(1) Adoption services.
(2) Child abuse prevention services.
(3) Child welfare services.
(4) Delinquency prevention services.
(5) Drug and alcohol services.
(6) Mental health services.
(7) Eligibility determination.
(8) Employment and training services.
(9) Foster care services.
(10) Health services.
(11) Public health services.
(12) Housing services.
(13) Medically indigent program services.
(14) California Children's Services Program.
(15) Child Health and Disability Prevention Program.
(16) Health care services for children in foster care.
(17) Childhood Lead Poisoning Prevention Program.
(18) Immunization outreach and education.
(19) Maternal and child health services.
(20) Adolescent Family Life Program.
(21) Tuberculosis control services.
(22) Bioterrorism preparedness and emergency response services.
(23) HIV/AIDS counseling and testing.
(24) HIV/AIDS education and prevention.
(25) HIV/AIDS surveillance.
(26) Oral health services.
(27) Preventative health care services for the aging.
(28) Sexually transmitted disease control.
(29) Tobacco control program services.
(30) Women, Infants, and Children Supplemental Nutrition Program.
(d) (1) Part 2.6 (commencing with Section 56) of Division 1 of the
Civil Code shall apply to the programs or services providing
integrated services.
(2) Before a program obtains an individual's medical information,
including mental health and drug treatment records, his or her
informed authorization shall be obtained, or the informed
authorization of his or her custodial parent, or his or her guardian
shall be obtained if the individual is a minor, unless the minor is
authorized to give consent.
(3) Medical information shall not be disclosed to any individual
who is not authorized to have that information pursuant to the
authorization provided in paragraph (2).
(4) Medical information shall not be disclosed for any purpose
that is not authorized by the authorization in paragraph (2).
(5) The sharing of information permitted under paragraphs (2),
(3), and (4) shall be governed by memoranda of understanding among
the agencies represented on the team. These memoranda shall specify
the types of information that may be shared without a signed release
form, and the process to be used to ensure that current
confidentiality requirements, as described in subdivision (d), are
met.
(6) A client shall have access to his or her medical information
and shall have the right to correct any inaccurate information
contained in the medical information.
(e) Programs or services shall be included in the program only to
the extent that federal funding to either the state or the county
will not be reduced as a result of the inclusion of the services in
the project. This program shall not generate any increased
expenditures from the General Fund.
(f) Each participating county and the appropriate state
departments shall jointly seek federal approval of the program, as
may be needed to ensure its funding and allow for the integrated
provision of services.
(g) This chapter shall not authorize a participating county to
discontinue meeting its obligations under current law to provide
services or to reduce its accountability for the provision of these
services.
(h) This chapter shall not authorize a participating county to
reduce the county's eligibility under current law for state funding
for the services included in the program.
(i) A participating county shall utilize any and all state general
and county funds that it is legally allocated or entitled to
receive. Through the creation of integrated health and social
services structures, the county shall maximize federal matching
funds.
(j) The Secretary of Health and Human Services shall designate a
lead department to coordinate the state's participation in the county'
s program.
(k) The appropriate state departments that are assisting,
participating, and cooperating in the implementation of the program
authorized by this chapter shall have the authority to waive
regulations regarding the method of providing services and the method
of reporting and accountability, as may be required to meet the
goals set forth in subdivision (b). However, the departments shall
not waive regulations pertaining to privacy and confidentiality of
records, civil service merit systems, or collective bargaining. The
departments shall not waive regulations if the waiver results in a
diminished amount or level of services or benefits to eligible
recipients as compared to the benefits and services that would have
been provided to recipients absent the waiver.
SEC. 2. Section 18986.87 of the Welfare and
Institutions Code is amended to read:
18986.87. (a) A participating county shall, in consultation with
the appropriate state departments, develop outcomes and performance
measures specific to the project prior to the implementation of the
program.
(b) A participating county shall evaluate its program with the
participation of the appropriate state departments and prepare an
evaluation and submit it to the Governor or the Governor's designee
and the appropriate policy committees of the Legislature. The
evaluation shall be submitted not later than six months following the
third year of the implementation of the program.
(c) A participating county, with the assistance of the appropriate
state departments, shall seek private funding to provide for the
program evaluation. The evaluation required by this section shall be
conducted only if nonstate resources are made available for this
purpose.