BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 678
                                                                  Page  1

          Date of Hearing:   April 13, 2011

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                     AB 678 (Pan) - As Amended:  March 25, 2011 

          Policy Committee:                              HealthVote:18-0

          Urgency:     No                   State Mandated Local Program: 
          No     Reimbursable:              No

           SUMMARY  

          This bill establishes a supplemental payment program that allows 
          local governmental entities who provide emergency medical 
          transportation services to Medi-Cal enrollees to leverage 
          federal funding for this purpose.  The bill requires the 
          Department of Health Care Services to seek federal approval for 
          the program and stipulates that DHCS administrative costs are 
          reimbursed by the program, and prohibits General Fund 
          expenditures. 

           FISCAL EFFECT  

          Ongoing DHCS administrative costs of approximately $300,000 (50% 
          General Fund, 50% federal funds) would be reimbursed by the 
          local entities who participate in the program. 

           COMMENTS  

           1)Rationale  .  According to the bill's sponsor, California 
            Professional Firefighters, Medi-Cal reimbursement for 
            emergency ground transportation is far less than the cost of 
            such transport.  This bill would allow local governmental 
            entities that choose to participate in the program to leverage 
            federal financial participation (FFP) for costs that exceed 
            their Medi-Cal reimbursement. 

           2)CPEs Used To Leverage Federal Funding  . This bill would allow 
            participating entities to use local Certified Public 
            Expenditures (CPEs) as the state share of cost to draw down 
            FFP. CPEs are a mechanism used by many public entities in 
            California, including public hospitals, to leverage federal 
            funding.  In this program, local governmental expenditures on 








                                                                  AB 678
                                                                  Page  2

            emergency ground transport for Medi-Cal patients that exceed 
            Medi-Cal reimbursements would be certified by the local entity 
            and verified by the state DHCS as eligible for federal 
            reimbursement.  At the state's current 50% federal matching 
            rate, this program would essentially allow participating 
            entities to recoup half of their costs that exceed their 
            Medi-Cal reimbursement.  This bill is modeled on a current 
            successful program established by AB 915 (Frommer), Chapter 
            747, Statutes of 2002 authorizing local public agencies and 
            public health facilities to use local funds to obtain FFP for 
            supplemental Medi-Cal reimbursements for hospital outpatient 
            services.

           Analysis Prepared by  :    Lisa Murawski / APPR. / (916) 319-2081