BILL NUMBER: AB 1462	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  APRIL 14, 2009

INTRODUCED BY   Assembly Member Feuer

                        FEBRUARY 27, 2009

    An act relating to senior services.   An act
to amend Section 14083 of the Welfare and Institutions Code,
relating to Medi-Cal. 



	LEGISLATIVE COUNSEL'S DIGEST


   AB 1462, as amended, Feuer.  Health and long-term care:
frail elderly.   Medi-Cal: inpatient hospital services
contracts.  
   Existing law provides for the Medi-Cal program, administered by
the State Department of Health Care Services, under which qualified
low-income persons are provided with health care services.  

   Under existing law, the California Medical Assistance Commission
is authorized to negotiate inpatient hospital services contracts
binding upon the State Department of Health Care Services. Existing
law requires the commission to consider certain factors in
negotiating inpatient hospital services contracts.  
   This bill would add graduate medical education programs to the
list of factors the commission is required to consider when
negotiating inpatient hospital services contracts.  
   Existing law establishes programs, such as the Multipurpose Senior
Services Program, administered through the California Department of
Aging, to provide specified services to frail elderly individuals, as
defined.  
   This bill would declare the intent of the Legislature to enact
legislation to promote the development of community-based, capitated
health and long-term care programs for the frail elderly. 
   Vote: majority. Appropriation: no. Fiscal committee:  no
  yes  . State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    Section 14083 of the   Welfare
and Institutions Code   is amended to read: 
   14083.  The factors to be considered by the negotiator in
negotiating contracts under this article, or in drawing
specifications for competitive bidding, include, but are not limited
to, all of the following:
   (a) Beneficiary access.
   (b) Utilization controls.
   (c) Ability to render quality services efficiently and
economically.
   (d) Demonstrated ability to provide or arrange needed specialized
services.
   (e) Protection against fraud and abuse.
   (f) Any other factor which would reduce costs, promote access, or
enhance the quality of care. 
   (g) Graduate medical education programs.  
   (g) 
    (h)  The capacity to provide a given tertiary service,
such as specialized children's services, on a regional basis.

   (h) 
    (i) Recognition of the variations in severity of illness
and complexity of care. 
   (i) 
    (j)  Existing labor-management collective bargaining
agreements. 
   (j) 
    (k)  The situation of county hospitals and university
medical centers contracting with counties for provision of health
care to indigent persons entitled to care under Section 17000, which
are burdened to a greater extent than private hospitals with bad
debts, indirect costs, medical education programs, and capital needs.

   (k) 
    (l)  The special circumstances of hospitals serving a
disproportionate number of Medi-Cal beneficiaries and patients who
are not covered by other third-party payers, including the costs
associated with assuring an adequate supply of registered nurses.

   () 
    (m)  The costs of providing complex emergency services,
including the costs of meeting and maintaining state and local
requirements for trauma center designation. 
   (m) 
    (n)  The hospital does any of the following:
   (1) Provides additional obstetrical beds.
   (2) Contracts with one or more comprehensive perinatal providers.
   (3) Permits certified nurse midwives, subject to hospital rules,
and consistent with existing laws and regulations, to admit patients
to the health facility.
   (4) Expands overall obstetrical services in the hospital. 

   (n) 
    (o)  The special circumstances of hospitals whose
Medi-Cal inpatient utilization rate exceeds the mean Medicaid
inpatient utilization rate by at least one-half of one standard
deviation. 
   (o) 
    (p)  The ability and capacity of the contracting
hospital in a closed health facility planning area to provide health
care services to beneficiaries who are in life threatening or
emergency situations, but have been sufficiently stabilized at
another noncontracting facility in order to facilitate transportation
to the contracting hospital. 
   (p) 
    (q)  The ability of the contracting hospital to provide
a secure environment for the provision of health care services. In
this regard, the negotiator shall consider additional security
measures that the contracting hospital may have taken to provide a
secure environment, including, but not limited to, the use of
detection equipment or procedures to detect lethal weapons, the
appropriate use of surveillance cameras, limiting access of
unauthorized personnel to the emergency department, installation of
bullet proof glass as appropriate in designated areas, the use of
emergency "panic" buttons to alert local law enforcement agencies,
and assigning full-time security personnel to the emergency
department. 
  SECTION 1.    It is the intent of the Legislature
to enact legislation to promote the development of community-based,
capitated health and long-term care programs for the frail elderly.