BILL ANALYSIS
AB 2590
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Date of Hearing: May 12, 2010
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 2590 (Lowenthal) - As Amended: April 27, 2010
Policy Committee: Health Vote: 11-2
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill authorizes the California Department of Health Care
Services (DHCS) to share information under specified
circumstances with a contractor providing disease management
services to Medi-Cal beneficiaries who are HIV-positive or who
have been diagnosed with AIDS. Specifically, this bill:
1)Establishes requirements related to collecting informed
consent from Medi-Cal beneficiaries.
2)Establishes parameters for the content of patient information
that may be disclosed to a contractor.
3)Establishes contractor prohibitions regarding marketing and
outreach to beneficiaries.
FISCAL EFFECT
1)Costs in the range of $300,000 (50% GF) to $500,000 (50% GF)
to the extent DHCS uses the authority established in this bill
to procure informed consent from potential beneficiaries of a
disease management program related to HIV or AIDS. Actual
costs would depend on how many beneficiary contacts are made
and the complexity and mode of contact.
2)Due to the highly sensitive nature of medical information in
general and HIV-status specifically, it is unclear how the
informed consent mechanism in this bill would be established.
Medi-Cal is funded at the state level, but eligibility
determinations and consumer interactions are typically with
county Medi-Cal eligibility workers. It seems this bill would
create requirements for county eligibility workers that are
AB 2590
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outside their scope of service and may involve sensitive
information about health status.
COMMENTS
1)Rationale . This bill is sponsored by the AIDS Healthcare
Foundation in Los Angeles to improve future disease management
programs. Disease management refers to coordinated care
provided to patients with chronic conditions such as diabetes,
chronic obstructive pulmonary disease (COPD), and
hypertension. AB 1732 (Committee on Budget), Chapter 230,
Statutes of 2003 established several DHCS disease management
programs, including one for which the AIDS Healthcare
Foundation was the contractor. This bill establishes
parameters for collecting informed consent from Medi-Cal
beneficiaries in order to improve contractor access to patient
information and thereby increase enrollment in future disease
management efforts.
2)Background . The DHCS-AIDS Healthcare Foundation disease
management program started enrolling patients in the spring of
2009. While other disease management programs have been
opt-out, meaning beneficiaries have to disenroll to not
participate, the AIDS Healthcare Foundation program was
established to be opt-in, meaning a beneficiary had to
affirmatively agree to enroll. The contractor, who began
enrolling individuals last year, faced numerous obstacles to
enrollment. These obstacles included out-of-date contact
information, attempted contacts with indigent individuals
living on the street, and a lack of sufficient data to reach
potential participants. After expenditures of $1 million, the
contractor was only able to enroll 400 of a potential 4,000
Medi-Cal beneficiaries. This bill will reduce these kinds of
barriers following an individual providing informed consent.
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081