BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 90
                                                                  Page  1

          Date of Hearing:   July 15, 2009

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                 SB 90 (Ducheny) - As Introduced:  January 20, 2009 

          Policy Committee:                               
          AppropriationsVote: 

          Urgency:     Yes                  State Mandated Local Program:  
          No     Reimbursable:               

           SUMMARY  

          This bill, as proposed to be amended  , appropriates $645 million  
          (GF) to the Department of Corrections and Rehabilitation (CDCR)  
          to augment the Budget Acts of 2007 and 2008 to cover  
          deficiencies for those years. (This appropriation is factored  
          into current budget figures and does not add to the current  
          budget deficit.) Specifically, this bill:  

           1)Appropriates $135.1 million (GF) to augment the 2007 Budget  
            Act for CDCR health care-related deficiencies, and authorizes  
            the transfer of up to $126.5 million (GF) between the main  
            CDCR budget support item and the CDCR health care item to  
            account for increased health delivery costs. 


          2)Appropriates $486.8 million (GF) to augment the 2008 Budget  
            Act for CDCR health care-related deficiencies.


          3)Requires Prison Health Care Services (PHCS) (the federal  
            health care receiver) to provide the Legislature written  
            reports, as specified, detailing actions taken and planned to  
            reduce and better manage medical contract service costs in  
            2009-10.


          4)Appropriates $23.3 million (GF) to augment the 2008 Budget Act  
            for net inmate population and caseload adjustments. 


          5)Requires any unencumbered funds to revert to the GF. 








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           FISCAL EFFECT  


          1)Appropriates $135,064,000 (GF) to augment the 2007 Budget Act  
            as follows: 


             a)   $128,706,000 for health care funding pursuant to the  
               federal court receivership over the Department of  
               Corrections and Rehabilitations (CDCR) provision of health  
               care services. (Expenditures for prison medical care in  
               2007-08 were about $1.4 billion.)   


               i)     $82,868,000 to provide overtime funding for health  
                 care guarding and transportation to provide inmates  
                 specialty care outside of prisons in order to comply with  
                 court mandates to provide constitutional levels of  
                 medical care to all inmates. 


               ii)    $45,838,000 to augment pharmaceuticals and medical  
                 supplies base funding. 


             b)   $6,358,000 to implement September 2007 court orders in  
               the Armstrong v Schwarzenegger case, which requires CDCR to  
               address issues related to disabled inmates. 


          2)Appropriates $510,125,000 (GF) to augment the 2008 Budget Act  
            as follows:


             a)   $486,800,000 for contract medical services. This  
               appropriation, augmenting a contract medical services base  
               of $359 million, is directly related to the Receiver's  
               implementation of reforms determined necessary to address  
               the federal court's order to raise inmate health care above  
               what the court deemed cruel and unusual punishment. 


             b)   $23,325,000 for inmate population and caseload  








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               adjustments. 


           COMMENTS  


           1)Rationale.  This bill contains funding necessary to address  
            deficiencies in the 2007 and 2008 Budget Acts for CDCR. These  
            funds have already been spent. The appropriations in this bill  
            will not impact current budget difficulties. 


            The proposed funding in this measure has been approved by the  
            DOF and the Joint Legislative Budget Committee. 


           2)LAO crabby regarding receiver request, but acknowledges the  
            state has little choice  . The LAO notes in a June 23, 2009  
            letter that deficiency funding - or supplemental  
            appropriations, as deficiencies are now known - is meant to  
            cover unanticipated expenses in advance of expenditure. The  
            LAO notes, in reference to the receiver's $486 million  
            deficiency request, that the request for additional funding  
            came after a large share of the requested funding had already  
            been spent. "As a result, the Legislature has little choice at  
            this point but to approve the supplemental appropriation,  
            since there is no other feasible alternative at this time to  
            address the increased expenditures resulting from a court  
            order regarding inmate medical care."


            The LAO's recommendations that any supplemental appropriations  
            for contract medical costs be restricted to that purpose, that  
            any unspent funds revert to the GF, and that the receiver  
            provide detailed cost control plans to the Legislature, are  
            all included in this bill.


           3)According to federal receiver, burgeoning reforms will hold  
            contract medical costs in check  . While the use and cost of  
            medical service contracts increases each year, PHCS is  
            implementing cost containment measures to minimize continuing  
            deficiencies. According to PHCS, "In the short term, trends  
            show that contract medical will continue to increase until  
            cost containment measures can be fully implemented. In 2008,  








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            CPHCS began to invest the funding needed to implement a  
            Utilization Management (UM) program. The UM program would lead  
            to cost containment measures by evaluating the  
            appropriateness, medical need, and efficiency of health care  
            services procedures and facilities according to established  
            criteria and/ or guidelines?.


            "Another attempt at cost containment is having a third party  
            administrator (TPA) pay medical invoices. The CPHCS does not  
            currently administer a healthcare claims processing system as  
            would typically be found in the public sector. Instead, the  
            current process relies on providers to submit invoices for  
            payment and then the invoices are manually entered into a  
            database that collects minimal utilization and expenditure  
            data and has no ability to track whether the services or line  
            items on the claim are valid. The staff that enters the data  
            into this database are not industry-trained.  Most health  
            plans (including Medi-Cal and Medicare) rely on the services  
            of a TPA to electronically process claims. Directing most  
            CPHCS hospital, physician and ambulance claims to the TPA will  
            eliminate the substantial errors and duplications in payment.  
            Additionally, the TPA will conduct a two-year post audit to  
            identify which claims were paid incorrectly to allow CPHCS to  
            set up accounts receivable to collect the difference.  
            Additionally, paying on time and reducing penalties will allow  
            CPHCS to renegotiate lower rates from providers."


           4)Related Legislation.  


             a)   SB 1069 (Ducheny) appropriated $135 million to address  
               the 2007 Budget Act CDCR deficiencies. SB 1069 passed this  
               committee 11-0 but was held on the Assembly floor.  


             b)   SB 1068 (Ducheny) appropriated $22 million to address  
               2007-08 deficiencies. SB 1068 was chaptered June 2, 2008. 


             c)   SB 100 (Ducheny) appropriated $141 million to address  
               2006-07 deficiencies. SB 100 was chaptered June 5, 2007. 










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             d)   SB 101 (Ducheny) appropriated $213 million to address  
               2006-07 deficiencies. SB 101 was chaptered July 17, 2007. 



           Analysis Prepared by  :    Geoff Long / APPR. / (916) 319-2081