BILL ANALYSIS                                                                                                                                                                                                    







                      SENATE COMMITTEE ON PUBLIC SAFETY
                             Senator Mark Leno, Chair                S
                             2009-2010 Regular Session               B

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          SB 724 (Cogdill)                                            
          As Amended April 13, 2009 
          Hearing date:  April 28, 2009
          Penal Code
          AA:br

                     DEPARTMENT OF CORRECTIONS AND REHABILITATION  :  

                            PAYMENT FOR HOSPITAL SERVICES  

                                       HISTORY

          Source:  California Hospital Association

          Prior Legislation: None

          Support: Taxpayers for Improving Public Safety

          Opposition:None known


                                         KEY ISSUE
          

          SHOULD THE Controller BE REQUIRED to transfer a third of the  
          Department of Corrections and Rehabilitation's ("CDCR") annual  
          payments to hospitals into a newly-created "Hospital Interim Payment  
          Fund" created in the state treasury, from which hospitals that have  
          provided services to CDCR would be paid when the annual state budget  
          is late, with payments thereafter required where 1) an invoice has  
          been submitted for the services; and 2) payment for the services is  
          due and payable and the Department of Corrections and  
          Rehabilitation, including the Division of Juvenile Facilities,  




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                                                           SB 724 (Cogdill)
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          determines that payment would be valid, AS SPECIFIED?




                                       PURPOSE


          The purpose of this bill is to require the Controller to  
          transfer a third of the Department of Corrections and  
          Rehabilitation's ("CDCR") annual payments to hospitals into a  
          newly-created "Hospital Interim Payment Fund" created in the  
          state treasury, from which hospitals that have provided services  
          to CDCR would be paid when the annual state budget is late, with  
          payments thereafter required where 1) an invoice has been  
          submitted for the services; and 2) payment for the services is  
          due and payable and the Department of Corrections and  
          Rehabilitation, including the Division of Juvenile Facilities,  
          determines that payment would be valid.

           Current law  creates in state government the Department of  
          Corrections and Rehabilitation (CDCR), headed by a secretary who  
          is appointed by the Governor, subject to Senate confirmation,  
          and serves at the pleasure of the Governor.  CDCR consists of  
          Adult Operations, Adult Programs, Juvenile Justice, the  
          Corrections Standards Authority, the Board of Parole Hearings,  
          the State Commission on Juvenile Justice, the Prison Industry  
          Authority, and the Prison Industry Board.  (Government Code   
          12838 (a).)

           Current law  provides that it "is the intent of the Legislature  
          that (CDCR) operate in the most cost-effective and efficient  
          manner possible when purchasing health care services for  
          inmates.  To achieve this goal, it is desirable that the  
          department have the benefit and experience of the California  
          Medical Assistance Commission in planning and negotiating for  
          the purchase of health care services."  (Penal Code  5023 (a).)

           Current law  requires CDCR to "consult with the commission to  
          assist the department in planning and negotiating contracts for  




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                                                           SB 724 (Cogdill)
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          the purchase of health care services.  The commission shall  
          advise the department, and may negotiate directly with providers  
          on behalf of the department, as mutually agreed upon by the  
          commission and the department."  (Penal Code  5023 (b).)

           Current law  authorizes CDCR to "contract with providers of  
          emergency health care services.  Hospitals that do not contract  
          with (CDCR) for emergency health care services shall provide  
          these services to these departments on the same basis as they  
          are required to provide these services (under federal law, as  
          specified).  (CDCR shall not) reimburse a hospital that provides  
          these services, and that the department has not contracted with,  
          at a rate that exceeds the hospital's reasonable and allowable  
          costs, regardless of whether the hospital is located within or  
          outside of California."  (Penal Code  5023.5 (a).)

           Current law  provides that an entity that provides ambulance or  
          any other emergency or nonemergency response service to CDCR,  
          and that does not contract with the department for that service,  
          shall be reimbursed for the service at the rate established by  
          Medicare.  CDCR is prohibited from reimbursing a provider of any  
          of these services that the department has not contracted with at  
          a rate that exceeds the provider's reasonable and allowable  
          costs, regardless of whether the provider is located within or  
          outside of California.  (Penal Code  5023.5 (b).)

           
          Current law  requires CDCR to "work with the State Department of  
          Health Services in obtaining hospital cost information in order  
          to establish the costs allowable under this section.  The State  
          Department of Health Services may provide (CDCR) with hospital  
          cost information that the State Department of Health Services  
          obtains, as specified."  (Penal Code  5023.5 (c).)

           Under current law  pursuant to an order of the United States  
          District Court for the Northern District of California issued  
          on June 30, 2005, a Receivership has been appointed to take  
          control of the delivery of medical services to all California  
          state prisoners confined by the California Department of  
          Corrections and Rehabilitation.  (See Findings of Fact and  




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          Conclusions of Law Re: Appointment of Receiver, Oct. 3, 2005,  
          Marciano Plata v. Schwarzenegger, No. C01-1351 TEH (U.S. Dist.  
          Court for the Northern District of California.); See also  
          Comment #3 of this analysis.)  As of the writing of this  
          analysis, the receivership remains empowered by the federal  
          courts to control medical services in CDCR.


           This bill  would provide that, "(n)otwithstanding any other  
          provision of law and without regard to fiscal year, if the  
          annual Budget Act is not enacted by June 30 of any fiscal year  
          preceding the fiscal year to which the budget would apply or  
          there is a deficiency in the budget during any fiscal year, the  
          Controller shall annually transfer from the General Fund, in the  
          form of one or more loans, an amount equal to a cumulative total  
          of 33 percent of the Department of Corrections and  
          Rehabilitation's annual payments to all hospitals in the  
          immediately preceding fiscal year, to the Hospital Interim  
          Payment Fund, which is hereby created in the State Treasury."



          This bill further would provide that, ". . . the Hospital  
          Interim Payment Fund is hereby continuously appropriated for the  
          purpose of making payments to hospitals, on or after July 1 of a  
          fiscal year for which no budget has been enacted and before  
          November 1 of that year for the purpose of making payments to  
          hospitals during the period in which the program has a  
          deficiency.  Payments shall be made pursuant to this section if  
          both of the following conditions have been met:



          (a)An invoice has been submitted for the services.

          (b)Payment for the services is due and payable and the  
          Department of Corrections and Rehabilitation, including the  
          Division of Juvenile Facilities, determines that payment would  
          be valid."





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              RECEIVERSHIP/OVERCROWDING CRISIS AGGRAVATION IMPLICATIONS
          
          California continues to face a severe prison overcrowding  
          crisis.  The Department of Corrections and Rehabilitation (CDCR)  
          currently has about 170,000 inmates under its jurisdiction.  Due  
          to a lack of traditional housing space available, the department  
          houses roughly 15,000 inmates in gyms and dayrooms.   
          California's prison population has increased by 125% (an average  
          of 4% annually) over the past 20 years, growing from 76,000  
          inmates to 171,000 inmates, far outpacing the state's population  
          growth rate for the age cohort with the highest risk of  
          incarceration.<1>

          In December of 2006 plaintiffs in two federal lawsuits against  
          CDCR sought a court-ordered limit on the prison population  
          pursuant to the federal Prison Litigation Reform Act.  On  
          February 9, 2009, the three-judge federal court panel issued a  
          tentative ruling that included the following conclusions with  
          respect to overcrowding:

               No party contests that California's prisons are  
               overcrowded, however measured, and whether considered  
               in comparison to prisons in other states or jails  
               within this state.  There are simply too many  
               prisoners for the existing capacity.  The Governor,  
               the principal defendant, declared a state of emergency  
               in 2006 because of the "severe overcrowding" in  
               California's prisons, which has caused "substantial  
               risk to the health and safety of the men and women who  
               work inside these prisons and the inmates housed in  
               them."  . . .  A state appellate court upheld the  
               Governor's proclamation, holding that the evidence  
               supported the existence of conditions of "extreme  
               ----------------------
          <1>  "Between 1987 and 2007, California's population of ages 15  
          through 44 - the age cohort with the highest risk for  
          incarceration - grew by an average of less than 1% annually,  
          which is a pace much slower than the growth in prison  
          admissions."  (2009-2010 Budget Analysis Series, Judicial and  
          Criminal Justice, Legislative Analyst's Office (January 30,  
          2009).)



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               peril to the safety of persons and property."  
               (citation omitted)  The Governor's declaration of the  
               state of emergency remains in effect to this day.

               . . .  the evidence is compelling that there is no  
               relief other than a prisoner release order that will  
               remedy the unconstitutional prison conditions.

               . . .

               Although the evidence may be less than perfectly  
               clear, it appears to the Court that in order to  
               alleviate the constitutional violations California's  
               inmate population must be reduced to at most 120% to  
               145% of design capacity, with some institutions or  
               clinical programs at or below 100%.  We caution the  
               parties, however, that these are not firm figures and  
               that the Court reserves the right - until its final  
               ruling - to determine that a higher or lower figure is  
               appropriate in general or in particular types of  
               facilities.

               . . .

               Under the PLRA, any prisoner release order that we  
               issue will be narrowly drawn, extend no further than  
               necessary to correct the violation of constitutional  
               rights, and be the least intrusive means necessary to  
               correct the violation of those rights.  For this  
               reason, it is our present intention to adopt an order  
               requiring the State to develop a plan to reduce the  
               prison population to 120% or 145% of the prison's  
               design capacity (or somewhere in between) within a  











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               period of two or three years.<2>

          The final outcome of the panel's tentative decision, as well as  
          any appeal that may be in response to the panel's final  
          decision, is unknown at the time of this writing.

           This bill  does not aggravate the prison overcrowding crisis  
          outlined above.

                                      COMMENTS

          1.  Stated Need for This Bill
           
          The author states:

              Under existing law there is no mechanism in place to  
              allow the Department of Corrections and  
              Rehabilitation to continue making payments to  
              hospitals when a budget has not been passed by June  
              30th of the year preceding a new fiscal year.  As a  
              result, during protracted budget delays, hospitals  
              that provide emergency care to prison inmates do not  
              receive payments for their services.  The financial  
              strain that is placed on these hospitals threatens  
              their financial viability thereby endangering the  
              health and safety of the communities that depend on  
              them.

          2.  What This Bill Would Do


           As explained in detail above, this bill essentially would  
          establish a mechanism, including a set-aside of funding, to  
          ensure hospitals that provide services for CDCR inmates are paid  
          ---------------------------
          <2>  Three Judge Court Tentative Ruling, Coleman v.  
          Schwarzenegger, Plata v. Schwarzenegger, in the United States  
          District Courts for the Eastern District of California and the  
          Northern District of California United States District Court  
          composed of three judges pursuant to Section 2284, Title 28  
          United States Code (Feb. 9, 2009).



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          during a state budget delay.  The bill would require the  
          Controller to transfer a third of CDCR's annual payments to  
          hospitals into a "Hospital Interim Payment Fund" created in the  
          state treasury, from which hospitals that have provided services  
          to CDCR would be paid when the annual state budget is late.   
          Payments would be required where 1) an invoice has been  
          submitted for the services; and 2) payment for the services is  
          due and payable and the Department of Corrections and  
          Rehabilitation, including the Division of Juvenile Facilities,  
          determines that payment would be valid.
           
           3.  Background:  Plata v. Schwarzenegger:  the Establishment of a  
            Federal Receiver for the Delivery of Medical Services to  
            California Prison Inmates
           
          On June 30, 2005, in a class action lawsuit filed four years  
          earlier, the United States District Court for the Northern  
          District of California ruled from the bench that it would  
          establish a Receivership to take control of the delivery of  
          medical services to all California state prisoners confined by  
          the California Department of Corrections and Rehabilitation.  In  
          the Findings of Fact and Conclusions of Law Re: Appointment of  
          Receiver, United States District Judge Thelton E. Henderson  
          stated in part:

               By all accounts, the California prison medical  
               care system is broken beyond repair.  The harm  
               already done in this case to California's prison  
               inmate population could not be more grave and the  
               threat of future injury and death is virtually  
               guaranteed in the absence of drastic action. . .  
               .  (I)t is an uncontested fact that, on average,  
               an inmate in one of California's prisons  
               needlessly dies every six to seven days due to  
               constitutional deficiencies in the CDCR's medical  
               delivery system. . . .

               It is clear to the Court that this unconscionable  
               degree of suffering and death is sure to continue  
               if the system is not dramatically overhauled.   




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               Decades of neglecting medical care while vastly  
               expanding the size of the prison system has led  
               to a state of institutional paralysis.  The  
               prison system is unable to function effectively  
               and suffers a lack of will with respect to  
               prisoner medical care.<3>

          On February 14, 2006, Judge Henderson appointed Robert Sillen to  
          serve as Receiver in this case.  In its order, the Court set  
          forth comprehensive duties for the Receiver, including  
          leadership and executive management of the California prison  
          medical health care delivery system.  The Court stated in part:

               (T)he Receiver shall have the duty to control,  
               oversee, supervise, and direct all  
               administrative, personnel, financial, accounting,  
               contractual, legal, and other operational  
               functions of the medical delivery component of  
               the CDCR.<4>

          The Court additionally ordered the Receiver to develop a  
          detailed plan of action to effectuate the restructuring and  
          development of a constitutionally adequate medical health care  
          delivery system, as specified; to determine the annual CDCR  
          medical health care budgets and implement an accounting system  
          that meets professional standards; and to provide the Court with  
          bimonthly progress reports, as specified.<5>

          The Court expressly ordered the Receiver to "exercise all powers  
          vested by law in the Secretary of the CDCR as they relate to the  
          administration, control, management, operation, and financing of  
          the California Medical Health Care System."  The Court suspended  
          the Secretary's exercise of these powers for the duration of the  
          ---------------------------
          <3>  Findings of Fact and Conclusions of Law Re: Appointment of  
          Receiver, Oct. 3, 2005, Marciano Plata v. Schwarzenegger, No.  
          C01-1351 TEH (U.S. Dist. Court for the Northern District of  
          California).  Hereafter all references to the Court pertain to  
          this case.
          <4>  Order Appointing Receiver, Feb. 14, 2006.
          <5>  Id.



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          Receivership.

          The Receiver has the power to:









































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                 hire, fire, suspend, supervise, promote,  
               transfer, discipline, and take all other personnel  
               actions regarding CDCR employees or contract  
               employees who perform services related to medical  
               health care;
                 establish personnel policies and to create,  
               abolish, or transfer positions, as specified;
                 negotiate new contracts and renegotiate existing  
               contracts; and
                 acquire, dispose of, modernize, repair, and lease  
               property, equipment, and other tangible goods to  
               carry out his duties.<6>

          The Court's order expressly provides that, "(a)ll costs incurred  
          in the implementation of the policies, plans, and decisions of  
          the Receiver relating to the fulfillment of his duties under  
          this Order shall be borne by (the state).  (The state) shall  
          also bear all costs of establishing and maintaining the Office  
          of Receiver, including the compensation of the Receiver and his  
          staff."<7>

          In an order dated January 23, 2008, the Court terminated its  
          appointment of Robert Sillen and appointed J. Clark Kelso as the  
          new Receiver.<8>  In its order the Court made clear its intent  
          to transact the implementation of long-term and sustainable  
          reform:

              The Receivership has reached a critical juncture at  
              which it must now move from a primarily investigative  
              and evaluative phase, during which the Receivership  
              analyzed the current system to determine what reforms  
              were necessary and worked to create the  
              infrastructure required to effectuate such reforms,  
              into an implementation phase, during which the  
              Receivership must translate the conceptualized  
              reforms into reality.  . . .  (T)he Receivership's  
              ----------------------
          <6>  Id.
          <7>  Id.
          <8>  Order Appointing New Receiver, January 23, 2008.



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              focus can and must now shift towards long-term reform  
              that will achieve the implementation of a  
              sustainable, constitutionally adequate system of  
              delivering medical care to Plaintiffs - and, not  
              inconsequentially, a system that must ultimately be  
              transitioned back to the State of California's  
              control.  Put another way, the Receivership's  
              overarching goal should be working itself out of  
              existence once delivery of medical care to  
              California's inmates has been brought up to  
              constitutional standards.

              . . .  The Receivership must continue to maintain its  
              independence as an arm of the federal courts  
              established to take over state operations, but it  
              also must work more closely at this stage with all  
              stakeholders, including State officials, to ensure  
              that the system developed and implemented by the  
              Receivership can be transferred back to the State in  
              a reasonable time frame.  Such collaboration appears  
              to be more important now than ever, given the current  
              budget crisis faced by the State of California.<9>

          In 2008, the state challenged the receivership ordered by the  
          federal court.  The final outcome of that challenge is pending  
          at the time of this writing.

          HOW DOES THE FACT OF THE RECEIVERSHIP IMPACT THE FUNCTION OF  
          THIS BILL?

          4.  Other Vendors

           The purpose of this bill is to assure hospitals are paid for  
          CDCR-related services during a delay in the state budget.  Many  
          vendors that provide services to the state, including CDCR, are  
          negatively and sometimes severely impacted when the state budget  






          ---------------------------
          <9>     Id.














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          is late.<10>  The author and sponsor submit that the proposed  
          fund and payment provisions are analogous to the Medical  
          Providers Interim Fund, relating to Medi-Cal payments.  This  
          existing system provides funding for the state to continue to  
                                                                    reimburse hospitals for the care provided to Medi-Cal  
          beneficiaries.<11>

          Members of the Committee may wish to discuss why hospitals  
          should be treated differently than other vendors with respect to  
          ensuring payment for CDCR-related services during a delayed  
          state budget.

          SHOULD HOSPITALS BE TREATED DIFFERENTLY THAN OTHER VENDORS WHO  
          ARE NOT PAID BY CDCR DURING A BUDGET DELAY?

          IS THE MEDICAL PROVIDERS' INTERIM FUND, RELATING TO MEDI-CAL  
          PAYMENTS CONTINUING TO HOSPITALS FOR MEDI-CAL BENEFICIARIES  
          DURING A BUDGET CRISIS, SUFFICIENTLY ANALOGOUS TO APPLY IN THIS  
          INSTANCE, WHERE HOSPITAL PROVIDERS WOULD BE DISTINGUISHED FROM  
          OTHER CDCR VENDORS PROVIDING GOODS OR SERVICES FOR PRISONS?
           

                                    ***************




          ---------------------------

          <10>  See, for example, State's Vendors Stiffed As Bills Go  
          Unpaid Amid Crisis,  Sacramento Bee  , published Jul. 30, 2008.   
          (". . .  'Right now, they owe us about $360,000 for July,' said  
          Mulhern, who with her husband, Michael, owns Superior Produce,  
          which operates from a warehouse off 16th Street, less than two  
          miles from the Capitol.  'And we're still paying all our bills .  
          . . we've got one more week left before we're out of money.' . .  
          . The Mulherns' Superior Produce has had state contracts almost  
          since the company's inception in 1988, providing produce to  
          Northern California prisons. . .  Most of the time, Cyndy  
          Mulhern said, the relationship is very good, and the company's  
          invoices get paid promptly.  'But when this budget thing  
          happens,' she said, 'it goes right out the window.'  . . .  The  
          Mulherns recently sold the part of their business that catered  
          to restaurants, and 90 percent of Superior's income now comes  
          from contracts with state prisons."
          <11>  This information is provided by the author's office, on  
          file with the Committee.