BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1599
                                                                  Page  1

          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
                                                                  Page  2

            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