BILL ANALYSIS �
AB 540
Page 1
Date of Hearing: May 4, 2011
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
AB 540 (Beall) - As Amended: April 7, 2011
Policy Committee: HealthVote:17-0
Urgency: No State Mandated Local Program:
No Reimbursable: No
SUMMARY
This bill establishes the Medi-Cal Alcohol and Drug Screening
and Brief Intervention (SBI) Services Matching program to draw
down federal funds to match voluntary county spending on
screening services for pregnant women and women of child bearing
age. It also directs the Department of Health Care Services to
create a mechanism by which local drug treatment programs may
leverage federal Med-Cal funding for SBI services.
FISCAL EFFECT
1)One-time state administrative costs of $200,000 to $300,000 to
the Department of Health Care Services (DHCS) to develop and
manage a federal waiver to qualify local SBI expenditures for
matched funding. On-going state administrative costs in the
range of $50,000. This bill requires local programs to pay the
state costs associated with the program, but the mechanisms of
payment would need to be established by DHCS.
2)The DHCS submitted a budget change proposal on a similar
subject in 2008 that included $1.6 million (GF) and was
rejected by the Legislature.
3)Although this bill expresses legislative intent to not use any
GF to support the activities in the bill, it unclear the
workload to garner federal support and document local
expenditures can be accomplished without an initial GF
investment.
4)Potentially significant savings to the extent SBI reduces or
prevents substance abuse or results in improved birth
outcomes.
AB 540
Page 2
COMMENTS
1)Rationale . The author indicates that new billing codes
approved by the federal government allow Medi-Cal
reimbursement for SBI services, and that the federal funding
opportunity is designed to increase the early identification
of individuals in need of treatment. Some counties currently
screen individuals through county-funded prenatal SBI
programs, and the author states that this bill would allow
counties to receive reimbursement for the services provided.
2)Screening and Brief Intervention (SBI) . SBI features
screening questions intended to identify and prevent risky
alcohol and substance abuse behavior before it causes health
problems or other personal problems. A recent study based on a
Kaiser Permanente trial in Northern California indicates that
SBI services for pregnant women result in better birth
outcomes.
3)Comprehensive Perinatal Services Program (CPSP). CPSP is a
Medi-Cal program through which eligible women receive enhanced
perinatal services, including prenatal care, health education,
nutrition services, and psychosocial support for up to 60 days
after delivery of their infants. The extent to which the
proposed program would interact with or compliment the CPSP is
unclear.
4)Related Legislation . AB 1599 (Beall) in 2010 was similar to
this bill and was held on the Suspense File of this committee.
AB 1599 and the current bill do not appear to address the
concerns noted in the veto message for AB 217 (below).
AB 217 (Beall) in 2009 was similar to this bill and was vetoed
due to concerns about implementation and GF risk.
AB 2124 (Beall) in 2008 was similar to this bill and was held
on the Suspense File of the Senate Appropriations Committee.
Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081