BILL ANALYSIS                                                                                                                                                                                                    �



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          Date of Hearing:  May 8, 2012

                            ASSEMBLY COMMITTEE ON HEALTH
                              William W. Monning, Chair
                    ACR 148 (Butler) - As Introduced:  May 1, 2012
           
          SUBJECT  :  California Family Planning Guarantee.

           SUMMARY  :  Resolves that the State should provide a family 
          planning guarantee that would ensure the backfill of any budget 
          shortfalls experienced by family planning services in California 
          as a result of cuts in federal funding.  Specifically,  this 
          resolution  :   

          1)Makes the following declarations:
             a)   Family planning services are essential to providing 
               basic health care and family planning to millions of women, 
               including well-woman examinations, lifesaving cancer 
               screenings, and contraceptive services;
             b)   Due to cuts in federal funding, access to preventative 
               health care for millions of women is at risk;
             c)   The volatility of federal funding for family planning 
               services is a matter of statewide concern; and,
             d)   Financial support for the basic health care for women 
               should not be contingent on funding from the federal 
               government.

          2)Resolves that the State of California should provide for a 
            family planning guarantee which would ensure that California 
            will stand with women and backfill any budget shortfalls 
            experienced by family planning services in California as a 
            result of cuts in federal funding.

           EXISTING LAW  establishes the Family Planning Access, Care, and 
          Treatment (Family PACT) Waiver Program, to provide comprehensive 
          clinical family planning services to any person whose family 
          income is not in excess of 200% of the federal poverty level 
          (FPL), if the waiver is obtained by the federal government.

           FISCAL EFFECT  .  This resolution has not yet been analyzed by a 
          fiscal committee.

           COMMENTS  :

           1)PURPOSE OF THIS RESOLUTION  .  According to the author, this 








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            resolution is needed to bring awareness to the vulnerability 
            of California's family planning service providers to cuts in 
            federal funding.

           2)FAMILY PACT  .  Family PACT is California's major publicly 
            funded family planning program designed to provide 
            "comprehensive family planning services" to low-income men and 
            women in California with no other source of family planning 
            and reproductive health care insurance coverage.  According to 
            the California Department of Public Health (DPH), since it 
            started in 1997, Family PACT has helped thousands of women get 
            reproductive health care at community clinics and private 
            doctors' offices throughout the State.  Family PACT does not 
            cover abortion or prenatal care, however, it does cover the 
            following services:

             a)   Pregnancy tests;
             b)   All forms of birth control approved by the United States 
               Food and Drug Administration (FDA);
             c)   Male and female sterilization;
             d)   Emergency Contraception (the morning-after pill);
             e)   Gynecological care such as pap smear and breast 
               examines;
             f)   Dysplasia services (treatment of abnormal or 
               precancerous cells on the cervix);
             g)   Test and treatment for human immunodeficiency virus 
               (HIV) and other sexually transmitted infections;
             h)   Screening and treatment for urinary tract infections and 
               hepatitis B;
             i)   Basic infertility screening and treatment; and,
             j)   Referrals for services not covered by the program.

            Family PACT is administered by DPH, Office of Family Planning. 
             According to DPH, women and men are eligible if they reside 
            in California, are at risk of pregnancy or causing pregnancy, 
            have a gross family income at or below 200% of FPL, and have 
            no other source of health care coverage for family planning 
            services.  

            According to a fiscal year (FY) 2010-11 University of 
            California, San Francisco Family PACT program report (Family 
            PACT Report), preliminary data indicate that Family PACT 
            served 1.79 million clients in FY 2010-11 and when all claims 
            are processed, this number is expected to increase to 1.90 
            million.  Preliminary data indicate that the number of clients 








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            served increased by 4.3% from FY 2009-10 which follows a 3.1% 
            increase in the previous year.  Preliminary data also shows 
            that total reimbursement to Family PACT providers was $576 
            million for services provided in FY 2010-11 and when all 
            claims are processed, this number is expected to grow to about 
            $638 million.  The Family PACT Report indicates that 62% of 
            the total growth in reimbursement in FY 2010-11 was due to the 
            increase in the number of clients served, with the remaining 
            38% due to the changes in cost and services utilization.

            DPH maintains that Family PACT has reduced the number of 
            unintended pregnancies in California resulting in substantial 
            financial savings to local, state, and federal governments.  
            DPH indicates that each unintended pregnancy averted by a 
            female Family PACT client saved the public sector 
            approximately $6,557 in medical, welfare, and other social 
            service costs for a woman and child from conception to age two 
            and saved $14,111 from conception to age five.

            According to DPH, Family PACT was initially funded only by 
            State funds, however, in 1999 the program received a Centers 
            for Medicare and Medicaid Services 1115 Waiver.  Medicaid 
            waivers allow states to waive Medicaid rules and are used to 
            test new or promising ways to deliver or pay for health care 
            services.  Under the 1115 Waiver the State received federal 
            matching funds for Family PACT services delivered.  Effective 
            July 1, 2010, the State submitted a State Plan Amendment, as 
            permitted by the newly passed healthcare reform law, the 
            federal Patient Protection and Affordability Act (ACA).  Under 
            the ACA's Family Planning State Option, all features of 
            California's Family PACT have been retained.

           3)OTHER FUNDING SOURCES FOR FAMILY PLANNING  .  The Medi-Cal 
            program also provides funding for health services for 
            low-income and uninsured women, including those who are 
            pregnant and need either abortion services or prenatal care.  
            As California's version of the federal Medicaid program, 
            Medi-Cal helps thousands of women obtain inexpensive services 
            after learning they are pregnant.

          Additionally, in 1999 Governor Gray Davis signed the Women's 
            Contraceptive Equity Act, making California one of a handful 
            of states to require private insurance plans that cover 
            prescription drugs to cover FDA approved contraceptives as 
            well.  








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           4)SUPPORT  .  Planned Parenthood Affiliates of California and 
            Planned Parenthood Advocacy project, Los Angeles County, write 
            in support of this resolution that California has the most 
            successful and cost-effective family planning program in the 
            country, Family PACT, which fills a critical gap in health 
            care by providing no or low-cost family planning services.  
            While California is not facing federal cuts to family planning 
            at this time, nationally, family planning is under attack.  
            Supporters maintain that the State has an opportunity to 
            continue to be at the forefront of women's health by ensuring 
            that access to important family planning services such as 
            contraception and life-saving cancer screenings are protected 
            in our State.
           
            5)SUGGESTED AMENDMENT  .  Recognizing the significant success 
            Family PACT has had in the State by increasing access to 
            services and filling a critical gap in health care for 
            underinsured and uninsured Californians, the fiscal 
            implications of this resolution in light of the State's 
            current budget crisis, are a cause for concern.  The author 
            may wish to delete the current formal resolution language and 
            amend the language to resolve the following:  
             
               "The State is committed to supporting access to family 
               planning services and strongly urges the preservation 
               of funding to ensure that California will stand with 
               women and allow them to enjoy improved health and 
               experience fewer unplanned pregnancies and births."  

          REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Planned Parenthood Advocacy Project, Los Angeles County
          Planned Parenthood Affiliates of California

           Opposition 
           
          None on file.
           
          Analysis Prepared by  :    Tanya Robinson-Taylor / HEALTH / (916) 
          319-2097 










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