BILL NUMBER: AB 351 AMENDED
BILL TEXT
AMENDED IN SENATE AUGUST 24, 2012
INTRODUCED BY Assembly Member Chesbro
( Coauthors: Assembly Members
Mitchell and Nielsen )
( Coauthors: Senators Evans
and La Malfa )
FEBRUARY 10, 2011
An act to amend Section 25503.5 14087.98
of the Business and Professions Welfare
and Institutions Code, relating to alcoholic
beverages Medi-Cal .
LEGISLATIVE COUNSEL'S DIGEST
AB 351, as amended, Chesbro. Alcoholic beverages:
instruction: tastings. Medi-Cal: county
organized health system.
Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, under
which qualified low-income individuals receive health care services.
The Medi-Cal program is, in part, governed and funded by federal
Medicaid Program provisions. One of the methods by which these
services are provided is pursuant to contracts with various types of
managed care health plans, including through a county organized
health system. Existing law authorizes the Director of Health Care
Services to enter into contracts with one or more managed health care
plans to provide a comprehensive program of managed health care
services to Medi-Cal beneficiaries residing in specified counties.
This bill would require specified counties to be annexed to the
closest, contiguous county organized health system, upon approval of
the county and the county organized health system.
The Alcoholic Beverage Control Act permits a winegrower, beer
manufacturer, or a beer and wine wholesaler to instruct licensees and
their employees on the subject of wine or beer, including but not
limited to, the history, nature, values, and characteristics of those
beverages, as provided.
This bill would specifically reference the composition of the beer
or wine as a subject which may be included in this type of
instruction.
Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 14087.98 of the
Welfare and Institutions Code is amended to read:
14087.98. (a) The purpose of this article is to provide a
comprehensive program of managed health care plan services to
Medi-Cal recipients residing in the following counties that currently
receive Medi-Cal services on a fee-for-service basis: Alpine,
Amador, Butte, Calaveras, Colusa, Del Norte, El Dorado, Glenn,
Humboldt, Imperial, Inyo, Lake, Lassen, Mariposa, Modoc, Nevada,
Mono, Placer, Plumas, San Benito, Shasta, Sierra, Siskiyou, Sutter,
Tehama, Trinity, Tuolumne, and Yuba.
(b) The director may enter into exclusive or nonexclusive
contracts on a bid or negotiated basis with one or more managed
health care plans to provide a comprehensive program of managed
health care plan services to Medi-Cal recipients residing in the
counties described in subdivision (a). The director shall give
special consideration to managed health care plans that meet all of
the following:
(1) Have demonstrated experience in effectively serving Medi-Cal
beneficiaries, including diverse populations.
(2) Have demonstrated experience in effectively partnering with
public and traditional safety net health care providers.
(3) Have demonstrated experience in working with local
stakeholders, including consumers, providers, advocates, and county
officials, in plan oversight and in delivery of care.
(4) Have the lowest administrative costs.
(5) Show support from local county officials as demonstrated by an
action of the county board of supervisors.
(6) Show recent successful experience with expansion of managed
care to a rural area.
(7) Offer a quality improvement program for primary care
providers.
(c) Contracts entered into or amended pursuant to this section
shall be exempt from the provisions of Chapter 2 (commencing with
Section 10290) of Part 2 of Division 2 of the Public Contract Code
and Chapter 6 (commencing with Section 14825) of Part 5.5 of Division
3 of Title 2 of the Government Code.
(d) The managed health care plans that the department contracts
with under this article shall comply with the requirements of Section
14087.48 and meet all of the following:
(1) Have Medi-Cal managed health care plan contract experience, or
evidence of the ability to meet these contracting requirements.
(2) Be in good financial standing and meet licensure requirements
under the Knox-Keene Health Care Service Plan Act of 1975 (Chapter
2.2 (commencing with Section 1340) of Division 2 of the Health and
Safety Code), if applicable.
(3) Meet quality measures, which may include Medi-Cal and Medicare
Healthcare Effectiveness Data and Information Set measures and other
quality measures determined or developed by the department and the
federal Centers for Medicare and Medicaid Services.
(e) The managed health care plans that the department contracts
with under this article shall provide Medi-Cal beneficiaries with
information about enrollment rights and options, plan benefits and
rules, and care plan elements so that beneficiaries have the ability
to make informed choices. This information shall be delivered in a
format and language accessible to beneficiaries. The managed health
care plans shall provide access to providers in compliance with
applicable state and federal laws, including, but not limited to,
physical accessibility and the provision of health plan information
in alternative formats.
(f) The department shall conduct a stakeholder process including
relevant stakeholders to ensure that beneficiaries, health care
providers, and managed health care plans have an opportunity to
provide input into the delivery model for these counties and to help
ensure smooth care transitions for beneficiaries.
(g) Enrollment in a Medi-Cal managed health care plan or plans
under this article shall be mandatory in order to receive services
under Medi-Cal, except as otherwise provided by law.
(h) Each beneficiary or eligible applicant shall be informed that
he or she may choose to continue an established patient-provider
relationship if his or her treating provider is a primary care
provider or clinic contracting with the managed health care plan, has
the available capacity, and agrees to continue to treat that
beneficiary or eligible applicant. The managed health care plans
shall comply with continuity of care requirements in Section 1373.96
of the Health and Safety Code.
(i) (1) Notwithstanding Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code, the
department may implement, interpret, or make specific this section
and amend regulations and orders adopted by the department by means
of plan letters, plan or provider bulletins, or similar instructions,
without taking regulatory action, until the time regulations are
adopted. It is the intent of the Legislature that the department have
temporary authority as necessary to implement program changes until
completion of the regulatory process.
(2) The department shall adopt emergency regulations no later than
July 1, 2014. The department may readopt any emergency regulation
authorized by this section that is the same as or substantially
equivalent to an emergency regulation previously adopted pursuant to
this section. The initial adoption of emergency regulations
implementing this section shall be deemed an emergency and necessary
for the immediate preservation of the public peace, health, safety,
or general welfare. Initial emergency regulations and the one
readoption of emergency regulations authorized by this section shall
be exempt from review by the Office of Administrative Law.
(3) The initial emergency regulations and the one readoption of
emergency regulations authorized by this section shall be submitted
to the Office of Administrative Law for filing with the Secretary of
State and each shall remain in effect for no more than 180 days, by
which time final regulations may be adopted.
(j) The cost of any program established under this section shall
not exceed the total amount that the department estimates it would
pay for all services and requirements within the same geographic area
under the fee-for-service Medi-Cal program.
(k) The department shall have exclusive authority to set the
rates, terms, and conditions of managed health care plan contracts
and contract amendments under this article. The director may include
in the contract a provision for quality assurance withholding from
the plan payment, to be paid only if quality measures identified in
the plan contract are met.
(l) The department shall provide the fiscal and appropriate policy
committees of the Legislature with quarterly updates, commencing
January 1, 2014, and ending January 1, 2016, regarding the expansion
of Medi-Cal managed care into the new counties authorized pursuant to
this section. These updates shall include, but not be limited to,
continuity of care requests, grievance and appeal rates, and
utilization reports for the new counties.
(m) The department shall seek all necessary federal approvals to
allow for federal financial participation in expenditures under this
article. This article shall not be implemented until all necessary
federal approvals have been obtained.
(n) Notwithstanding subdivision (b), the Counties of Del Norte,
Humboldt, Lake, Lassen, Modoc, Shasta, Siskiyou, and Trinity shall be
annexed to the closest, contiguous county organized health system,
upon the approval of the county and that county organized health
system.
(n)
(o) This section shall be implemented only to the
extent federal financial participation or funding is available.
(o)
(p) Notwithstanding subdivision (q) of Section 6254 of
the Government Code, a contract or contract amendments executed by
both parties after the effective date of the act adding this
subdivision shall be considered a public record for purposes of the
California Public Records Act (Chapter 3.5 (commencing with Section
6250) of Division 7 of Title 1 of the Government Code) and shall be
disclosed upon request. This subdivision applies to contracts that
reveal the department's rates of payment for health care services,
the rates themselves, and rate manuals.
(p)
(q) To implement this section, the department may
contract with public or private entities. Contracts or amendments
entered into under this section may be on an exclusive or
nonexclusive basis and a noncompetitive bid basis and shall be exempt
from the following:
(1) Part 2 (commencing with Section 10100) of Division 2 of the
Public Contract Code and any policies, procedures, or regulations
authorized by that part.
(2) Article 4 (commencing with Section 19130) of Chapter 5 of Part
2 of Division 5 of Title 2 of the Government Code.
(3) Review or approval of contracts by the Department of General
Services.
SECTION 1. Section 25503.5 of the Business and
Professions Code is amended to read:
25503.5. (a) A winegrower, beer manufacturer, or a beer and wine
wholesaler may, without charge, instruct licensees and their
employees, or conduct courses of instruction for licensees and their
employees, on the subject of wine or beer, including but not limited
to, the history, nature, values, composition, and characteristics of
wine or beer, the use of wine lists, and the methods of presenting
and serving wine or beer. The winegrower, beer manufacturer, or beer
and wine wholesaler may furnish wine or beer and the equipment,
materials and utensils that may be required for use in connection
with the instruction or courses of instruction.
(b) A distilled spirits manufacturer, distilled spirits
manufacturer's agent, distilled spirits general rectifier, or
distilled spirits general importer may, without charge, instruct
licensees and their employees, or conduct courses of instruction for
licensees and their employees, on the subject of distilled spirits,
including, but not limited to, the history, nature, values, and
characteristics of distilled spirits, and the methods of presenting
and serving distilled spirits. The distilled spirits manufacturer or
distilled spirits manufacturer's agent may furnish distilled spirits
and the equipment, materials, and utensils that may be required for
use in connection with the instruction or courses of instruction.
(c) A winegrower or distilled spirits manufacturer, or its
authorized agent may instruct consumers at an on-sale retail licensed
premises authorized to sell its product with the permission of the
retail on-sale licensee. The instruction may include, without
limitation, the history, nature, values, and characteristics of the
product and the methods of presenting and serving the product. The
instruction of consumers may include the furnishing of not more than
three tastings to any individual in one day. A single tasting of
distilled spirits may not exceed one-fourth of one ounce and a single
tasting of wine may not exceed one ounce. The winegrower or
distilled spirits manufacturer, or its authorized agent shall remove
any unfinished alcoholic beverages that he or she provided following
the instruction. Nothing in this subdivision shall limit the giving
away of samples pursuant to subdivision (a) of Section 23386.
(d) The instruction or courses of instruction, authorized in
subdivision (a) or (b), may be given at the premises of the
winegrower, beer manufacturer, beer and wine wholesaler, distilled
spirits manufacturer, distilled spirits manufacturer's agent,
distilled spirits general rectifier, distilled spirits general
importer or of a licensee, including an on-sale retail licensee, or
elsewhere.