BILL ANALYSIS
AB 1599
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Date of Hearing: April 28, 2010
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 1599 (Beall) - As Amended: April 13, 2010
Policy Committee: Health Vote: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
screening services for pregnant women and women of child bearing
age. This bill provides an avenue by which local drug treatment
programs may document certify public expenditures (CPE) to
leverage federal Med-Cal funding.
FISCAL EFFECT
1)One-time GF costs of $200,000 (50% GF) to $300,000 (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. On-going costs in the range of $50,000
(50%GF). This bill requires local programs to pay the state
for GF costs, but the mechanisms of payment would need to be
established by DHCS.
2)DHCS is in the process of negotiating a multi-billion dollar
Medi-Cal waiver that may provide a bridge to major expansions
in Medi-Cal under federal health reform. If enacted, this bill
may create substantial DHCS work load at a time when the
department is focused on issues such as enrolling tens and
hundreds of thousands of low-income beneficiaries in public
programs.
3)The DHCS submitted a budget change proposal on a similar
subject in 2008 that included $1.6 million GF and was rejected
by the Legislature.
4)Although this bill expresses legislative intent to not use any
AB 1599
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GF to support the activities in the bill, it unclear the
workload to garner federal support and document local
expenditures can be accomplished without an initial GF
investment.
5)Potentially significant savings to the extent SBI reduces or
prevents substance abuse.
COMMENTS
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. Thus far 16 counties have
screened 80,000 individuals through 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)Related Legislation . AB 217 (Beall) in 2009 was similar to
this bill and was vetoed due to concerns about implementation
and GF risk. It is unclear whether AB 1599 addresses veto
concerns.
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